Final Assessment Research Articles

Surgical Treatment Outcomes of Anterior-Only Correction and Reconstruction for Severe Cervical Kyphotic Deformity with Neurofibromatosis-1: A Retrospective Study with a 5-Year Follow-Up.

Currently, anterior-only (AO), posterior-only, and combined anterior-posterior spinal fusions are common strategies for treating cervical kyphosis in patients with neurofibromatosis-1 NF-1. Nevertheless, the choice of surgical strategy remains a topic of controversy. The aim of our study is to evaluate the safety and effectiveness of anterior decompression and spinal reconstruction for the treatment of cervical kyphosis in patients with NF-1. Twelve patients with NF-1-associated cervical kyphotic deformity were reviewed retrospectively between January 2010 and April 2020. All patients underwent AO correction and reconstruction. The X-ray was followed up in all these patients to assess the preoperative and postoperative local kyphosis angle (LKA), the global kyphosis angle (GKA), the sagittal vertical axis, and the T1 slope. The visual analog scale score, Japanese Orthopedic Association (JOA) score, and neck disability index (NDI) score were used to evaluate the improvement inclinical symptoms. The results of the difference in improvement from preoperatively to the final follow-up assessment were assessed using a paired t-test or Mann-Whitney U-test. The LKA and GKA decreased from the preoperative average of 64.42 (range, 38-86) and 35.50 (range, 10-81) to an average of 16.83 (range, -2 to 46) and 4.25 (range, -22 to 39) postoperatively, respectively. The average correction rates of the LKA and GKA were 76.11% and 111.97%, respectively. All patients had achieved satisfactory relief of neurological symptoms (p < 0.01). JOA scores were improved from 10.42 (range, 8-16) preoperatively to 15.25 (range, 11-18) at final follow-up (p < 0.01). NDI scores were decreased from an average of 23.25 (range, 16-34) preoperatively to an average of 7.08 (range, 3-15) at the final follow-up (p < 0.01). Anterior-only correction and reconstruction is a safe and effective method for correcting cervical kyphosis in NF-1 patients. In fixed cervical kyphosis cases, preoperative skull traction should also be considered.

Comparison of Surgically Induced Astigmatism Following Manual Sics: Superior and Temporal Approach

Aim: The operable cataract cases in the developing world is high compared to the cataract surgical rate, and economical and effective methods are required to deal with this curable blindness, in order to provide the highest achievable uncorrected distance visual acuity. This study aimed to compare the surgically induced corneal astigmatism in patients undergoing manual small incision cataract surgery by superior (s-MSICS) and temporal (t-MSICS) scleral tunnel incisions. Methods: Prospective, interventional cases series of 60 eyes of 60 patients. Uncorrected distance visual acuity (UDVA), mean keratometry (KMean) and surgically induced astigmatism (SIA) were the main outcome measures which were compared between the two groups, s-MSICS and t-MSICS. Results: The mean patient age was 58.60 ± 7.11 years and 59.63 ± 8.39 years in the s-MSICS and t-MSICS groups respectively. Uncorrected distance visual acuity (UDVA) on day 90 was 0.27 ± 0.14 logMAR in the s-MSICS group and 0.18 ± 0.16 logMAR in the t-MSICS group (p=0.05). At the final assessment s-MSICS had 1.43 ± 0.99D of SIA and t-MSICS had 0.76 ± 0.66D of SIA (p=0.02). Four patients in the s-MSICS group and 25 patients in the t-MSICS group had WTR astigmatism (p&lt;0.001). Likewise, there were 26 cases of ATR and one case of ATR in the s-MSICS and t-MSICS respectively (p&lt;0.001). Conclusion: In this prospective study, t-MSICS had significantly lesser surgically induced astigmatism than s-MSICS. The temporal incision decreased against the rule astigmatism, as well, which is the astigmatism prevalent in the adult population.

Analysis of the Level of Difficulty and Differentiating Power of the Final Semester Assessment Made by Teachers of Class XI High School Chemistry Subjects in Cirebon in the Odd Semester of the 2022/2023 School Year

This study aims to determine the quality on the Odd Semester Final Assessment (PAS) of Grade XI Chemistry Subjects in SMAs in the Cirebon Region for the 2022/2023 Academic Year. This research is a quantitative description research with data collection methods using document analysis to obtain data. The sample of this study was grade XI students. Quantitative research was conducted with the help of the ANATES software program version 4.09. the results showed: (1) In terms of Distinguishing Power, the highest value is in school E (77%) and the lowest value is school C (50%). (2) In terms of Level of difficulty there is a proportional comparison in school B with a ratio of 3:5:2.

Infective Native Aortic Aneurysm: a Delphi Consensus Document on Treatment, Follow Up, and Definition of Cure

Abstract Background Evidence is lacking to guide the management of infective native aortic aneurysm (INAA). Aims The aim of this study was to establish expert consensus on surgical and antimicrobial treatment and follow up, and to define when an INAA is considered cured. Methods Delphi methodology was used. The principal investigators invited 47 international experts (specialists in infectious diseases, radiology, nuclear medicine, and vascular and cardiothoracic surgery) via email. Four Delphi rounds were performed, 3 weeks each, using an online questionnaire with initially 28 statements. The panelists rated the statements on a 5-point Likert scale. Comments on statements were analysed, statements were revised and added or deleted, and the results were presented in the iterative rounds. Consensus was defined as ≥ 75% of the panel rating a statement as strongly agree or agree on the Likert scale, and consensus on the final assessment was defined as Cronbach’s α &amp;gt; 0.80. Results All 49 panelists fulfilled all four rounds, resulting in 100% participation. One statement was added based on the results and comments of the panel, resulting in 29 final statements: n = 3 on need for consensus, n = 20 on treatment, n = 5 on follow up, and n = 1 on definition of cure. All 29 statements reached agreement of ≥ 86%. Cronbach’s α increased for each consecutive round; round 1, 0.85; round 2, 0.90; round 3, 0.91; and round 4, 0.94. Thus, consensus was reached for all statements. Conclusion INAA is rare, and high-level evidence is lacking to guide optimal management. This consensus document was established with the aim of helping clinicians manage these challenging patients, as a supplement to current guidelines. The presented consensus will need future amendments in accordance with newly acquired knowledge.

Infective Native Aortic Aneurysms: A Delphi Consensus Document on Terminology, Definition, Classification, Diagnosis, and Reporting Standards

Abstract Background There is no consensus regarding the terminology, definition, classification, diagnostic criteria, and algorithm, or reporting standards for the disease of infective native aortic aneurysm (INAA), previously known as mycotic aneurysm. Aims The aim of this study was to establish this by performing a consensus study. Methods The Delphi methodology was used. Thirty-seven international experts were invited via mail to participate. Four two-week Delphi rounds were performed, using an online questionnaire, initially with 22 statements and nine reporting items. The panellists rated the statements on a five-point Likert scale. Comments on statements were analysed, statements revised, and results presented in iterative rounds. Consensus was defined as ≥ 75% of the panel selecting “strongly agree” or “agree” on the Likert scale, and consensus on the final assessment was defined as Cronbach's alpha coefficient &amp;gt; .80. Results All 38 panellists completed all four rounds, resulting in 100% participation and agreement that this study was necessary, and the term INAA was agreed to be optimal. Three more statements were added based on the results and comments of the panel, resulting in a final 25 statements and nine reporting items. All 25 statements reached an agreement of ≥ 87%, and all nine reporting items reached an agreement of 100%. The Cronbach's alpha increased for each consecutive round (round 1 = .84, round 2 = .87, round 3 = .90, and round 4 = .92). Thus, consensus was reached for all statements and reporting items. Conclusion This Delphi study established the first consensus document on INAA regarding terminology, definition, classification, diagnostic criteria, and algorithm, as well as reporting standards. The results of this study create essential conditions for scientific research on this disease. The presented consensus will need future amendments in accordance with newly acquired knowledge.

MR Imaging Features of Critical Spinal Demyelinating Lesions Associated with Progressive Motor Impairment.

Progressive MS is typically heralded by a myelopathic pattern of asymmetric progressive motor weakness. Focal individual "critical" demyelinating spinal cord lesions anatomically associated with progressive motor impairment may be a compelling explanation for this clinical presentation as described in progressive solitary sclerosis (single CNS demyelinating lesion), progressive demyelination with highly restricted MR imaging lesion burden (2-5 total CNS demyelinating lesions; progressive paucisclerotic MS), and progressive, exclusively unilateral hemi- or monoparetic MS (>5 CNS demyelinating progressive unilateral hemi- or monoparetic MS [PUHMS] lesions). Critical demyelinating lesions appear strikingly similar across these cohorts, and we describe their specific spinal cord MR imaging characteristics. We performed a retrospective, observational MR imaging study comparing spinal cord critical demyelinating lesions anatomically associated with progressive motor impairment with any additional "noncritical" (not anatomically associated with progressive motor impairment) spinal cord demyelinating lesions. All spinal cord MR images (302 cervical and 91 thoracic) were reviewed by an experienced neuroradiologist with final radiologic assessment on the most recent MR imaging. Anatomic association with clinical progressive motor impairment was confirmed independently by MS subspecialists. Ninety-one individuals (PUHMS, 37 [41%], progressive paucisclerosis 35 [38%], progressive solitary sclerosis 19 [21%]) with 91 critical and 98 noncritical spinal cord MR imaging demyelinating lesions were evaluated. MR imaging characteristics that favored critical spinal cord demyelinating lesions over noncritical lesions included moderate-to-severe, focal, lesion-associated spinal cord atrophy: 41/91 (45%) versus 0/98 (0%) (OR, 161.91; 9.43 to >999.9); lateral column axial location (OR, 10.43; 3.88-28.07); central region (OR, 3.23; 1.78-5.88); ventral column (OR, 2.98; 1.55-5.72); and larger lesion size of the axial width (OR, 2.01;1.49-2.72), transverse axial size (OR, 1.66; 1.36-2.01), or lesion area (OR, 1.14; 1.08-1.2). Multiple regression analysis revealed focal atrophy and lateral axial location as having the strongest association with critical demyelinating lesions. Focal, lesion-associated atrophy, lateral column axial location, and larger lesion size are spinal cord MR imaging characteristics of critical demyelinating lesions. The presence of critical demyelinating lesions should be sought as these features may be associated with the development of progressive motor impairment in MS.

Protocol for physiotherapeutic management of home care for elderly patients with hip and knee osteoarthritis

Background: Lower body musculoskeletal disorders are problems that affect muscles, bones, joints, tendons, ligaments, and nerves of the lower limbs. Osteoarthritis of the hip and knee is a degenerative disease that affects the cartilage of the hip and knee joints. It causes pain, stiffness, and limited movement. Objective: to implement a physiotherapy management protocol for home care for the elderly with osteoarthritis of the hip and knee, to improve functional capacity. Methods: a study was carried out with a 12-week intervention guideline on 20 participants with a mean age of 72 years. Weight was measured with a scale (omron) and height with a stadiometer (seca) in order to obtain the value of the Body Mass Index (BMI). The exercise guide consists of three phases: the first includes isometric exercises; the second involves isotonic and resistance exercises; and, the third includes balance exercises, gait re-education, reintegration into activities of daily living, a study with initial and final assessment, and instruments to measure functional capacity. The Short Physical Performance Battery (SPPB) was used. It consists of three tests (balance, walking, sitting and standing). The manual dynamometer measures muscle strength in lower limbs and the visual scale measures the perception of pain in the hip and knee. Results: the physical exercise guideline in elderlies with hip and knee osteoarthritis improved functional capacity increased muscle-strength, and pain perception. Conclusions: the exercise protocol increases the functional capacity of the elderly with osteoarthritis of the hip and knee, presenting adequate control in the lower body.

Design and Analysis of a Base Bleed Unit for the Drag Reduction of a High-Power Rocket Operating at Transonic Speeds

In the present study, a passive flow device is considered for drag reduction purposes through implementation in a transonic high-power rocket. The high-power rocket serves as a reference platform that, apart from the operating conditions, enforces several constraints in terms of available volume and placement locations. A step-by-step methodology is suggested, where the unit is initially broken down into an inlet and an outlet component. The flow field is investigated by means of computational modeling (CFD), where the Reynolds-averaged Navier–Stokes equations are solved coupled with turbulence models that vary depending on the design phase and the individual component. In the first design phase, the best alternative configuration is selected for each component by comparing mass flow rates and discharge coefficients. In the second design phase, each component is analyzed in greater detail based on the first phase results. Indicatively, the protruding inlet diffuser-type channel is converted into a protruding inlet nozzle-type channel to avoid choked flow phenomena, and a nozzle geometry is selected as the outlet amongst the other considered scenarios. The two components are eventually integrated into a common base bleed unit and a final assessment is made. The computational results are used to predict the performance and trajectory of the rocket through a well-established trajectory software. The overall methodology is validated against full-scale test flight data. The results show that the base bleed unit developed in the framework of this study yields a drag reduction of approximately 15% at transonic speeds without impacting the rocket mass and stability.

DOMPERIDONE VS METOCLOPRAMIDE: COMPARATIVE EVALUATION OF EFFICACY IN TREATING DIABETIC GASTROPARESIS

Diabetic gastroparesis, a common complication of diabetes mellitus, presents a challenging clinical scenario characterised by delayed gastric emptying and symptoms such as nausea, vomiting, abdominal pain, and bloating. Objectives: The primary aim of the study is to compare domperidone vs metoclopramide to evaluate their efficacy in treating diabetic gastroparesis. Methods: This comparative study was conducted in DHQ Hospital Nowshera Khyber Pakhtunkhwa—from June 2022 to June 2023. Data was collected from 190 patients from both genders. Patients meeting the inclusion criteria are randomised into Group A (Domperidone) and Group B (Metoclopramide). The severity of gastroparesis symptoms is assessed using validated symptom-scoring tools before treatment initiation and at regular intervals throughout the study. Results: Data was collected from 190 patients suffering from DM. The mean age of the patients in group A was 52.4 ± 8.2 years and in group B, 53.1 ± 7.5 years. There were 105 female and 185 male patients. The mean duration of DM is 12.3 ± 4.1 years and 11.8 ± 3.8 years in groups A and B, respectively. Group A (Domperidone) and Group B (Metoclopramide) demonstrated significant improvement in symptom scores from baseline to the final assessment. Group A exhibited a substantial reduction in symptom score from 18.2 ± 4.5 at baseline to 8.7 ± 3.2 at the end of the study (p &lt; 0.001), while Group B showed a decrease from 17.9 ± 4.3 to 9.5 ± 3.8 (p &lt; 0.001). Moreover, both groups experienced notable reductions in gastric emptying time. Conclusion: It is concluded that both domperidone and metoclopramide are effective in managing diabetic gastroparesis, with nuances in their safety profiles.

Mathematics video classes produced by students: a proposal to enhance learning

This work aimed to analyze whether high school students’ production of mathematics video classes enhances their learning. We examined how students learn function concepts when producing video classes. The research was carried out in two classes of the first grade of high school integrated into technical education in the federal network. In one class, students produced video classes, and learning was compared with that of the other class. Qualitative research was adopted, in which data were collected through questionnaires, interviews, field observation, and analysis of video classes produced by students. The video classes students created reproduced the classes they were used to watching, as they did not present innovations and/or different methodologies. Ultimately, we noticed a gain in learning with the video class production process. The students demonstrated the ability to work as a team, gained autonomy in their studies, and presented satisfactory results in the final assessments.

Enhancing self-learning skills and quality through formative actions and feedback within chemistry classes in the laboratory – A useful model

In here a novel method is described to improve student success rates in a first-year basic chemistry theoretical/practical hybrid course (n = 31 students) by implementing simple ways of formative assessment. This to reduce student dropout rates following the philosophy of encouraging students’ self-control. Essential is to train first-year bachelor students in their self-learning skills and to enhance their evaluative judgment. As a result, students are able to provide better quality of the assessment products at the end of the course. In practice the course is redesigned and intervention tools are integrated at multiple levels throughout the course. The lecturers’ role was adapted to a coaching role, thereby introducing low-effort personalized micro-interventions to meet the personalized needs of students. To clarify these learning needs for students, awareness of the quality desired for the final assessment products is important. Awareness was improved by providing examples of varying quality and introducing multiple peer- and self-assessment moments during the course. The final evaluation of the course examination products showed that the quality of the laboratory notebook was substantially higher after following this approach. Additionally students learned other important skills such as self-learning skills, collaborating in practical work and giving and receiving feedback. Unexpectedly, the high perceived lecturers’ workload decreased. The work presented here provides a novel approach in the form of a model and a practical blueprint with tools for a practical chemistry course design which develops students’ self-learning skills thereby substantially improving student success rates. In our example course, the ultimate student success rate increased form 83 % to 95 % after using this novel approach.

Residual Acetabular Dysplasia at Walking Age: A Study of 470 Hips Treated With Pavlik Harness.

This study aims to report on the acetabular indices of walking age children following successful DDH treatment with Pavlik harness and investigate risk factors for residual acetabular dysplasia (RAD). We retrospectively reviewed the data for children treated for DDH at a single centre between 2015 and 2020. Acetabular indices (AI) measured on pelvic radiographs taken at 2- and 4-year follow-up visits were referenced against age-matched and sex-matched normal data. Values ≥90th percentile were considered to represent RAD. A total of 305 children with 470 hips were suitable for inclusion. The mean age at treatment initiation was 7.0±4.5 weeks and mean treatment duration was 15.9±4.3 weeks. Overall, 27% and 19% of hips were found to have RAD at 2- (n=448) and 4-year (n=206) follow-up, respectively. The χ 2 test for independence demonstrated that the difference in the proportion of hips with RAD at both time points was significant ( P =0.032). Patients with RAD at 2 years were found to have been treated for longer ( P =0.028) and had lower alpha angles on final ultrasound assessment ( P <0.001). Patients with RAD at 4 years were older at initiation of treatment ( P =0.041), had lower alpha angles on final ultrasound assessment ( P <0.001) and were more likely to have had RAD at 2 years ( P <0.001). Multivariate analysis identified lower alpha angles on final ultrasound to be predictive for RAD at 2 years ( P =0.011), and presence of RAD at 2 years to be predictive for RAD at 4 years ( P <0.001). The risk of RAD beyond walking age in children successfully treated with Pavlik harness is not negligible. However, we observed that a significant proportion of children with RAD at 2-year follow-up had spontaneously improved without any intervention. This data suggests that routine long-term radiologic follow-up of children treated with Pavlik harness is necessary, and surgical intervention to address RAD should be delayed until at least 4 years of age. Level III-case-control study.

From spelling to reading: An intervention program with children at risk of reading failure

This study aimed to assess the impact of an interactive spelling program on reading acquisition of children at risk of developing reading difficulties as well as to assess its effect on spelling and phonemic awareness. From an initial pool of 144 first-grade children attending four Portuguese primary schools, 53 children with low performances in letter knowledge and phonemic awareness tasks, and considered by their teachers to be at risk of developing reading difficulties, were selected. These children were randomly assigned to three groups: an experimental group that underwent an interactive spelling program, a comparison group that underwent a phonological awareness program, and a control group that underwent a copying program. The programs, conducted in pairs, comprised 12 sessions lasting 20 to 30 min twice a week. The pretest and posttest included word reading, word spelling, and phonemic awareness assessments. Data analysis showed that the spelling group significantly outperformed the other groups across all measures except in the phonemic awareness task, where there were no differences with the phonological group. The word copying group consistently yielded the lowest results. Unlike the other two groups, the posttest results of the experimental group also reached the class average in word reading. For ethical reasons, after the final assessments the control group underwent a version of the interactive spelling program. This study suggests that spelling activities can contribute significantly to reading acquisition and can serve as a valuable pedagogical tool to proactively address challenges in learning to read.

Improving outcomes for patients with hard-to-heal wounds following adoption of the Wound Hygiene Protocol: real-world evidence.

To evaluate the impact of a four-step biofilm-based wound care strategy, Wound Hygiene Protocol (WHP: cleanse, debride, refashion, and dress), on hard-to-heal wounds. This was a prospective, real-world analysis of hard-to-heal wounds managed with the WHP that incorporated Aquacel Ag+ (Convatec Ltd., UK) dressings. Data were captured electronically between April 2021 and December 2022. The primary endpoint was change in wound volume from baseline to final assessment. A total of 693 wounds in 669 patients (median patient age: 74 years) were included in the analysis with a median treatment time of 31 days. Most health professionals were general nurses (50%) or nurse practitioners (38%). Patient homes (27%) and community clinics (27%) were the most common clinical settings. Venous leg ulcers (26%) and pressure ulcers/injuries (17%) were the most common wound type. Duration was >12 months in 21% of wounds. At baseline, the mean wound volume was 57.8cm3. At the final assessment, mean wound volume was 17.2cm3, corresponding to an 80% reduction from baseline; p<0.001). At baseline, 66% of wounds were static or deteriorating. At final assessment, this had decreased to 5%, and 94% had improved or healed. Exudate levels were moderate or high in 69% of wounds at baseline which decreased to 25% at final assessment (p<0.001). Suspected biofilm and local wound infection decreased from 79% and 43%, respectively, at baseline, to 18% and 3%, respectively, at final assessment (p<0.001 for both). The WHP is a new proposed standard of care that successfully treated hard-to-heal wounds by addressing the key local barriers to wound healing.

An enhancement of the Genium™ microprocessor-controlled knee improves safety and different aspects of the perceived prosthetic experience for unilateral and bilateral users.

Bilateral microprocessor-controlled prosthetic knee (MPK) users have unique needs in traversing environmental barriers compared to unilateral users. An enhancement to the Genium™/Genium X3™ MPK which included an updated ruleset, hydraulics, and new bilateral parameter presets was made to improve safety while stumbling and the smoothness of gait for all users while also improving the experience of bilateral users. The purpose of the study was to evaluate the effectiveness of the enhancements in a sample with unilateral and bilateral amputation. A convenience sample of MPK users was recruited from two sites in the USA in two phases. Assessments included the L-Test of Functional Mobility, Activity-specific Balance Confidence Scale, Prosthetic Limb User Survey of Mobility, a study-specific questionnaire, and the Comparative Activities of Daily Living (ADL) Questionnaire. Statistical significance of extracted data was tested with the Wilcoxon Rank-Sum Test for independent data and Wilcoxon Signed-Rank for paired data with an a priori significance level of p < 0.05. Unilateral subjects were age-matched to the group of bilateral subjects for between-groups and within-groups analyses. Twenty-six subjects (n = 26) were enrolled. Stumble frequency reduced 85% from 16.0 ± 39.7 to 2.4 ± 2.3 (p = 0.008) between baseline and final assessment overall. The bilateral group reported 50% (p = 0.009) and 57% (p = 0.009) greater relative improvement in patient-reported ease and safety, respectively, of completing ADLs compared to the unilateral group. The unilateral group reported residual limb pain and low back pain reduced from 2.3 to 1.4 (p = 0.020) and 3.8 to 1.8 (p = 0.027), respectively, whereas the bilateral group did not. Substantial reductions in stumbles, residual limb pain, and back pain were shown overall. These reductions were driven by the unilateral group who also showed improvements in comfort, exertion, and concentration while walking. The enhancements to the knee likely reduced some gait asymmetry for unilateral users. Improvements in patient-reported ease and safety of completing ADLs were shown overall and were driven by the bilateral group. This study shows further improvement in patient experience is achievable through innovation in MPK technology even for patients who appear to be functioning well.

Abstract PO3-07-02: Radiomics Models for B-mode Breast Ultrasound and Strain Elastography to improve Breast Cancer Diagnosis (INSPiRED 005): An International, Multicenter Analysis

Abstract Background: Breast Elastography, a technique that quantifies tissue stiffness, has been evaluated to objectify and improve the performance of B-mode breast ultrasound. However, large prospective trials showed benefits in BI-RADS 4a breast masses only and a high operator dependency. Modern Artificial Intelligence techniques for automated image processing like radiomics, a technique where quantified features are extracted from images, may overcome these limitations. We aimed to develop and validate radiomics models based on B-mode and Strain Elastography (SE) images for patients with BI-RADS 3 or 4 breast masses and compare their performance to the respective human experts. Methods: This is a secondary analysis of an international, multicenter trial (NCT02638935), evaluating the performance of SE in women with BI-RADS 3 or 4 breast masses. Women were recruited at 12 institutions in 7 countries and underwent B-mode breast ultrasound as well as SE. B-mode images were saved and re-assed by three ultrasound readers ( &amp;gt;10 years of experience), resulting in three independent assessments and a final consensus assessment. SE was interpreted using the E-/B ratio. B-mode and strain images were manually segmented and quantitative radiomics features were extracted using pyradiomics. We used 10-fold cross-validation to build machine learning models (XGBoostTree, MARS) based on data of 11 of 12 study sites. The data of the 12th (largest) study site was used as external validation set. Performance metrics included sensitivity, specificity and area under the receiver operator characteristic curve (AUROC). Results: The study included a total of 1288 patients, 1206 with evaluable B-mode images and 1190 with evaluable Strain images. Mean age was 46.6 years (SD 16.02) and a total number of 29.0% (350 of 1206) and 28.9% (344 of 1190) breast masses were malignant in the B-mode and Strain cohort, respectively. Distribution of BI-RADS categories was 33.0%, 34.5%, 14.5%, and 18.0% for BI-RADS 3, 4a, 4b, and 4c, respectively. In the external validation set (n = 342), the B-mode radiomics model (XGBoostTree) achieved an AUROC of 0.86 (95% CI 0.82 to 0.90), with a sensitivity of 97.4% (95% CI 0.93 to 1.00, 113 of 116) and a specificity of 27.0% (95% CI 0.21 to 0.33, 61 of 226). The model showed equivalent performance compared to the three ultrasound readers (P = 0.133); see also Table 1. In the external validation set (n = 333), the Strain radiomics model (MARS) achieved an AUROC of 0.84 (95% CI 0.79 to 0.88), with a sensitivity of 100% (95% CI 47.0 to 58.0, 115 of 115) and a specificity of 25.5% (95% CI 0.22 to 0.34, 60 of 218). The model showed equivalent performance compared to the three ultrasound readers (P = 0.696) and performed significantly better compared to SE (P = 0.002); see also Table 1. Sensitivity of the strain model was descriptively higher (100% vs. 97.4%, see Table 1). Both models were well-calibrated. Conclusion: This is the largest development and validation study for radiomics models based on B-mode breast ultrasound and SE, to date. The radiomics models performed on par with human readers, with the strain radiomics model showing potential to identify initially missed carcinomas in BI-RADS 3 breast masses. Future implementation studies may evaluate the performance of these image analysis algorithms in clinical routine and their integration into the multi-modal breast cancer diagnostics process, including mammography and MRI. Table 1. Diagnostic performance metrics Citation Format: André Pfob, Tanja He, Lie Cai, Richard G. Barr, Volker Duda, Zaher Alwafai, Corinne Balleyguier, Dirk-André Clevert, Sarah Fastner, Christina Gomez, Manuela Goncalo, Ines Gruber, Markus Hahn, André Hennigs, Panagiotis Kapetas, Sheng-Chieh Lu, Juliane Nees, Ralf Ohlinger, Fabian Riedel, Matthieu Rutten, Benedikt Schaefgen, Anne Stieber, Riku Togawa, Mitsuhiro Tozaki, Sebastian Wojcinski, Cai Xu, Geraldine Rauch, Jörg Heil, Chris Sidey-Gibbons, Michael Golatta. Radiomics Models for B-mode Breast Ultrasound and Strain Elastography to improve Breast Cancer Diagnosis (INSPiRED 005): An International, Multicenter Analysis [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-07-02.

Web 2.0 technologies and translator training: assessing trainees’ use of instant messaging as a collaborative tool in accomplishing translation tasks

Web 2.0 technologies have had a significant impact on collaborative communication practices in teaching, learning, and professional work environments. In translation studies, computer-supported collaborative translation tasks have mainly been discussed within the project-based learning framework, where research has foregrounded correlations between collaboration and performance. However, trainees’ specific uses of collaborative tools, including transcripts of real-time exchanges, have neither been sufficiently investigated nor informed pedagogical strategies and approaches in any tangible way. This study bridges this gap by evaluating trainees’ collaborative practices while they translated a text, localized a restaurant menu, and simulated the design and launch of a language service agency. Data was gathered from a questionnaire, in-class presentations, and real-time instant messaging (IM) transcripts. Data analysis of the real-time IM exchanges unveiled considerable trainee communicative practices during collaborative tasks. Furthermore, correlations were established between the volume of instant messages, time of exchange, role played by trainees, and conversation themes with the teams’ final assessment performances. This study provided valuable insights into the effectiveness of IM as a collaborative tool in training environments. It also informed our suggested guidelines for properly integrating IM into the translator training curriculum.

Telerehabilitation of Chronic Obstructive Pulmonary Disease Patients in a Tertiary Care Hospital in Western India: A 3-month Follow-up Study

Abstract Introduction: India grapples with a mounting chronic obstructive pulmonary disease (COPD) crisis driven by pervasive air pollution, especially from biomass burning. New Delhi’s classification as the capital with the worst pollution, with 35 other Indian cities in the global top 50, underscores the severity. COPD, the third-leading cause of global mortality, claimed 3.23 million lives in 2019, with a projected surge due to prevalent smoking and ongoing pollution. Domestically, COPD accounts for 9.5% of all deaths. Emphasizing the urgency of Sustainable Development Goal 3.4 to reduce mortality from non-communicable diseases, including chronic respiratory diseases, cost-effective pulmonary rehabilitation (PR), particularly telerehabilitation, emerges as a promising avenue for comprehensive COPD management in this challenging landscape. Methods: Patients with COPD (gold stages 1–3) confirmed by pulmonary function tests were enrolled. Functional exercise capacity, dyspnoea levels and health-related quality of life (HRQoL) were assessed using the 6-min walk test (6MWD), modified Medical Research Council (mMRC) dyspnoea scale and SGRQ-C questionnaire, respectively. Participants received home-based PR and attended one 2-h PR session 3 days a week for 12 weeks. Follow-up was conducted telephonically monthly, and a final assessment was done at the end of the 3rd month. Results: Of the 88 initially recruited patients, 26 were lost to follow-up, leaving 62 who completed the 3-month programme. Significant improvements were observed in exercise tolerance (6-min walk test [6MWD]), with mean values increasing from 383.00 ± 71.22 to 441.3 ± 87.3 (P &lt; 0.001). HRQoL, assessed by SGRQ-C, showed an overall improvement, with statistically significant reductions in total scores (42.15 ± 3.52–39.54 ± 3.41, P &lt; 0.001) and in each domain (symptom, impact and activity). Conclusion: The study affirms telerehabilitation’s efficacy in enhancing exercise capacity and improving the quality of life for COPD patients, advocating its integration, particularly in regions with limited access to conventional rehabilitation programmes.

Effect of a Neuromodulation Protocol Associated With Sports Training on the Precision Sports Performance of a Wheelchair Basketball Para-Athlete: A Case Study.

To investigate whether transcranial direct-current stimulation (tDCS) optimizes the performance of a wheelchair basketball player on precision tasks. A right-handed wheelchair basketball player (1.5 points functional class) with myelomeningocele (low lumbar level) participated in this case study. The tDCS neuromodulation protocol was applied throughout 10 interventions of 20 minutes with a current intensity of 2mA, simultaneously with sport-specific training, 3times a week for 4weeks. Anodic stimulation was performed on the right cerebellar hemisphere (CB2) and cathodic stimulation in the left dorsolateral prefrontal cortex. A control participant was submitted to a sham-tDCS stimulation protocol for the same period. Functional performance was assessed before the intervention and after the 5th and 10th interventions using "pass accuracy," "free-throw shooting," and "spot shot" tests. Outcome measures were compared using percentage differences between preintervention, intermediate intervention, and postintervention values. There was a gradual increase in the athlete's total and average scores in all tests performed, with an overall improvement of 78% between the baseline and final assessments, while the control participant had an overall improvement of 6.5%. The tDCS protocol was effective in improving performance in precision activities in a wheelchair basketball player.

Assessment of an online tooth morphology course and 3D examination tool during the COVID-19 pandemic.

The COVID-19 pandemic brought major disruptions to dental teaching and has impacted the delivery of tooth morphology courses where students are introduced to the three-dimensional features of the dentition. The aim of this study was to assess the implementation of newly developed online teaching modalities for tooth morphology, evaluate their usefulness and identify elements that are beneficial for learners. Following the delivery of an online course that included online 3D models, 2D cue cards, live discussion sessions and Socrative™ quizzes, the participants were asked to rate the usability and usefulness of each tool. The participants' knowledge of tooth morphology was assessed through an online examination using 3D-digitised tooth models. The participants identified lecture handouts and online 3D models as their preferred learning tools, while lecture video recordings and 2D cue cards were viewed as less useful. Data analysis from Socrative™ quizzes demonstrated improvement in tooth identification skills throughout the course delivery. Finally, results from the final assessment are in line with previous in-person deliveries of this course. The study provides valuable information on the usefulness of teaching modalities that were implemented in response to the COVID-19 pandemic and their merit to be retained in future deliveries of the course. The 3D models have been identified as particularly useful in this context, but the participants still value the opportunity to learn with extracted teeth. Furthermore, it remains to be confirmed whether tooth identification skills acquired using 3D models can be transferred to the clinical setting.