Free Online Research Articles

Decentralized social networks and the future of free speech online

Decentralized social networks like Mastodon and BlueSky are trending topics that have drawn much attention and discussion in recent years. By devolving powers from the central node to the end users, decentralized social networks aim to cure existing pathologies on the centralized platforms and have been viewed by many as the future of the Internet. This article critically and systematically assesses the decentralization project's prospect for communications online. It uses normative theories of free speech to examine whether and how the decentralization design could facilitate users’ freedom of expression online. The analysis shows that both promises and pitfalls exist, highlighting the importance of value-based design in this area. Two most salient issues for the design of the decentralized networks are: how to balance the decentralization ideal with constant needs of centralization on the network, and how to empower users to make them truly capable of exercising their control. The article then uses some design examples, such as the shared blocklist and the opt-in search function, to illustrate the value considerations underlying the design choices. Some tentative proposals for law and policy interventions are offered to better facilitate the design of the new network. Rather than providing clear answers, the article seeks to map the value implications of the design choices, highlight the stakes, and point directions for future research.

The Development and Application of KinomePro-DL: A Deep Learning Based Online Small Molecule Kinome Selectivity Profiling Prediction Platform.

Characterizing the kinome selectivity profiles of kinase inhibitors is essential in the early stages of novel small-molecule drug discovery. This characterization is critical for interpreting potential adverse events caused by off-target polypharmacology effects and provides unique pharmacological insights for drug repurposing development of existing kinase inhibitor drugs. However, experimental profiling of whole kinome selectivity is still time-consuming and resource-demanding. Here, we report a deep learning classification model using an in-house built data set of inhibitors against 191 well-representative kinases constructed based on a novel strategy by systematically cleaning and integrating six public data sets. This model, a multitask deep neural network, predicts the kinome selectivity profiles of compounds with novel structures. The model demonstrates excellent predictive performance, with auROC, prc-AUC, Accuracy, and Binary_cross_entropy of 0.95, 0.92, 0.90, and 0.37, respectively. It also performs well in a priori testing for inhibitors targeting different categories of proteins from internal compound collections, significantly improving over similar models on data sets from practical application scenarios. Integrated to subsequent machine learning-enhanced virtual screening workflow, novel CDK2 kinase inhibitors with potent kinase inhibitory activity and excellent kinome selectivity profiles are successfully identified. Additionally, we developed a free online web server, KinomePro-DL, to predict the kinome selectivity profiles and kinome-wide polypharmacology effects of small molecules (available on kinomepro-dl.pharmablock.com). Uniquely, our model allows users to quickly fine-tune it with their own training data sets, enhancing both prediction accuracy and robustness.

Online Utilization of the Nominal Group Technique to Gather Consensus Opinion Across Geographically Disparate Locations

Introduction: The nominal group technique (NGT) is a structured focus group that gathers opinion and generates consensus from groups on topics of interest. Previous studies using online NGTs (ONGTs) in health have been conducted in regions of high population density and internet connectivity. This activity aimed to determine the feasibility and utility of ONGTs in gathering opinion and reaching consensus on curriculum topics for a continuing research education program for health professionals dispersed across various locations in Southern Queensland. Methods: Fifteen clinical education academics from a range of health professions participated in 1-hour ONGT sessions from 2 University Department of Rural Health sites or their home offices. The traditional NGT was adapted for online use, using two free online platforms (Zoom for videoconferencing and Wooclap for voting and response collation). Results: The chosen platforms were effective in presenting ONGTs, allowing active and effective contributions to research topic ideas from all participants, including those with low internet connectivity. Silent generation enabled sharing, open discussion, and clarification of generated ideas. Wooclap was effective in reviewing and voting on generated responses and providing real-time feedback on voting outcomes. Outcomes were consistent with group consensus and useful in prioritizing research training topics. Discussion: The modified ONGT is effective in gathering opinion and gaining consensus from a geographically dispersed health workforce with varied levels of internet connectivity and experience with online platforms. It represents a cost-effective and time-effective alternative to face-to-face NGTs that is less likely to be affected by workforce disruptions.

PredPSP: a novel computational tool to discover pathway-specific photosynthetic proteins in plants.

Photosynthetic proteins play a crucial role in agricultural productivity by harnessing light energy for plant growth. Understanding these proteins, especially within C3 and C4 pathways, holds promise for improving crops in challenging environments. Despite existing models, a comprehensive computational framework specifically targeting plant photosynthetic proteins is lacking. The underutilization of plant datasets in computational algorithms accentuates the gap this study aims to fill by introducing a novel sequence-based computational method for identifying these proteins. The scope of this study encompassed diverse plant species, ensuring comprehensive representation across C3 and C4 pathways. Utilizing six deep learning models and seven shallow learning algorithms, paired with six sequence-derived feature sets followed by feature selection strategy, this study developed a comprehensive model for prediction of plant-specific photosynthetic proteins. Following 5-fold cross-validation analysis, LightGBM with 65 and 90 LGBM-VIM selected features respectively emerged as the best models for C3 (auROC: 91.78%, auPRC: 92.55%) and C4 (auROC: 99.05%, auPRC: 99.18%) plants. Validation using an independent dataset confirmed the robustness of the proposed model for both C3 (auROC: 87.23%, auPRC: 88.40%) and C4 (auROC: 92.83%, auPRC: 92.29%) categories. Comparison with existing methods demonstrated the superiority of the proposed model in predicting plant-specific photosynthetic proteins. This study further established a free online prediction server PredPSP ( https://iasri-sg.icar.gov.in/predpsp/ ) to facilitate ongoing efforts for identifying photosynthetic proteins in C3 and C4 plants. Being first of its kind, this study offers valuable insights into predicting plant-specific photosynthetic proteins which holds significant implications for plant biology.

Free tools for crystallographic symmetry handling and visualization.

Online courses and innovative teaching methods have triggered a trend in education, where the integration of multimedia, online resources and interactive tools is reshaping the view of both virtual and traditional classrooms. The use of interactive tools extends beyond the boundaries of the physical classroom, offering students the flexibility to access materials at their own speed and convenience and enhancing their learning experience. In the field of crystallography, there are a wide variety of free online resources such as web pages, interactive applets, databases and programs that can be implemented in fundamental crystallography courses for different academic levels and curricula. This paper discusses a variety of resources that can be helpful for crystallographic symmetry handling and visualization, discussing four specific resources in detail: the Bilbao Crystallographic Server, the Cambridge Structural Database, VESTA and Jmol. The utility of these resources is explained and shown by several illustrative examples.

Chemical Profiling, In Silico Pharmacokinetics Analysis and Molecular Docking Study of Phytocompounds of Homeopathy Medicine Echinacea angustifolia Q against Suppurative Bacterial Proteins

Background Computer-aided drug design is the emerging field for identification of drug action on its target organs. The pharmacokinetic study helps find out drug ADMET (absorption, distribution, metabolism, excretion, and toxicity) and drug likeness properties. PyRx software helps with molecular docking of the bioactive compounds on their target organ within a short period of time. In homeopathy, Echinacea angustifolia is one of the most commonly used drugs for microbial infective skin lesions used in internal administration as well as an external application. Objective This study was aimed at identifying the compounds present in Echinacea angustifolia Q through liquid chromatography mass spectrometry (LC-MS), ADMET, and drug likeness properties, followed by molecular docking by PyRx software to recognize the interaction between drug compounds against 12 target microbial proteins of commonly infective suppurative bacteria. Materials and Methods An analysis of the phytoconstituents of Echinacea angustifolia Q was performed using the Agilent 1290 Infinity LC system coupled to the Agilent 6545 Accurate Mass Quadrupole Time-of-Flight (QTOF) with Agilent Jet Stream Thermal Gradient Technology. In silico ADMET and drug likeness properties were assessed by free online tools, followed by a detailed docking study by PyRx software. The drug compounds with the lower glide docking score are considered to have the best binding affinity. Result The five compounds of Echinacea angustifolia Q satisfy all properties of ADMET and drug likeness. The three compounds of Echinacea angustifolia Q have low glide score of >-7.0 kcal/mol against the three microbial target proteins of Salmonella enterica, Proteus mirabilis, and Staphylococcus aureus. Conclusion Echinacea angustifolia Q has fulfilled the ADMET and drug-likeness properties for internal administration as well as external application for various suppurative bacterial infective disorders, which were confirmed through molecular docking. Therefore, Echinacea angustifolia Q may function as a potential therapeutic agent for the treatment of illnesses associated with antimicrobial resistance.

Quality of Male and Female Medical Content on English-Language Wikipedia: Quantitative Content Analysis.

Wikipedia is the largest free online encyclopedia and the seventh most visited website worldwide, containing >45,000 freely accessible English-language medical articles accessed nearly 1.6 billion times annually. Concerns have been expressed about the balance of content related to biological sex on Wikipedia. This study aims to categorize the top 1000 most-read (most popular) English-language Wikipedia health articles for June 2019 according to the relevance of the article topic to each sex and quality. In the first step, Wikipedia articles were identified using WikiProject Medicine Popular Pages. These were analyzed on 13 factors, including total views, article quality, and total number of references. In the second step, 2 general medical textbooks were used as comparators to assess whether Wikipedia's spread of articles was typical compared to the general medical coverage. According to the article's content, we proposed criteria with 5 categories: 1="exclusively female," 2="predominantly female but can also affect male individuals," 3="not sex specific or neutral," 4=predominantly male but can affect female individuals," and 5="exclusively male." Of the 1000 Wikipedia health articles, 993 (93.3%) were not sex specific and 67 (6.7%) were sex specific. There was no statistically significant difference in the number of reads per month between the sex-specific and non-sex-specific articles (P=.29). Coverage of female topics was higher (50/1000, 5%) than male topics (17/1000, 1.7%; this difference was also observed for the 2 medical textbooks, in which 90.2% (2330/2584) of content was not sex specific, female topics accounted for 8.1% (209/2584), and male topics for accounted for 1.7% (45/2584; statistically significant difference; Fisher exact test P=.03). Female-category articles were ranked higher on the Wikipedia medical topic importance list (top, high, or mid importance) than male-category articles (borderline statistical significance; Fisher exact test P=.05). Female articles had a higher number of total and unique references; a slightly higher number of page watchers, pictures, and available languages; and lower number of edits than male articles (all were statistically nonsignificant). Across several metrics, a sample of popular Wikipedia health-related articles for both sexes had comparable quality. Wikipedia had a lower number of female articles and a higher number of neutral articles relative to the 2 medical textbooks. These differences were small, but statistically significant. Higher exclusively female coverage, compared to exclusively male coverage, in Wikipedia articles was similar to the 2 medical textbooks and can be explained by inclusion of sections on obstetrics and gynecology. This is unlike the imbalance seen among biographies of living people, in which approximately 77.6% pertain to male individuals. Although this study included a small sample of articles, the spread of Wikipedia articles may reflect the readership and the population's content consumption at a given time. Further study of a larger sample of Wikipedia articles would be valuable.

SP8.8 - Inspiring Overseas Surgeons for a Life in the NHS: Results from an International Cohort

Abstract Aims Entry into the NHS can be fraught with difficulty, especially when entering from outside of the UK. Numerous socioeconomic and cultural barriers exist, which can be prohibitory. Currently only extremely limited methods of motivating international medical graduates (IMG) exist. Surgical specialist training recruitment has decreased over the past few years. We instigated an innovative introduction to the NHS with the aim of inspiring overseas doctors to pursue a career within surgery in the NHS. Methods An agenda was created targeted at medical students and IMG. Speakers were recruited based upon these including students and doctors who had visited the NHS or are current workers. Collaboration was sought with international students who aided with distribution. Individuals were invited to sign up via an electronic link. The session was delivered with free online video conferencing software. Participants answered a series of 5-point Likert scale questions. Results 102 registrations were received. Participants attended from Brazil (64.3%), USA (14.3%), India (7.1%) and the UK (7.1%). The event attracted a wide range of seniority from medical students (35.7%) to residents (7.1%). 100% of participants stated they had a better understanding of the NHS and 100% were more likely to attempt to enter the NHS after attending the event. Conclusions Chronic staffing shortages are a ubiquitous problem in the NHS. Application rates for surgical posts have been declining. Our innovative method of inspiring surgeons of the future has been shown to be effective in our international cohort.

Expanding Accessibility in Cleft Care: The Role of Artificial Intelligence in Improving Literacy of Alveolar Bone Grafting Information.

The American Medical Association (AMA) recommends patient education materials (PEMs) be written at or below a sixth grade reading level. This study seeks to determine the quality, readability, and content of available alveolar bone grafting (ABG) PEMs and determine if artificial intelligence can improve PEM readability. Review of free online PEMs. Online ABG PEMs were retrieved from different authoring body types (hospital/academic center, medical society, or private practice). None. Content was assessed by screening PEMs for specific ABG-related topics. Quality was evaluated with the Patient Education Material Assessment Tool (PEMAT), which has measures of understandability and actionability. Open-access readability software (WebFX) determined readability with Flesch Reading Ease, Flesch-Kincaid Grade Level, and Gunning-Fog Index. PEMs were rewritten with ChatGPT, and readability metrics were reassessed. Quality, readability, and content of ABG PEMs. 34 PEMs were analyzed. Regarding quality, the average PEMAT-understandability score was 67.0 ± 16.2%, almost at the minimum acceptable score of 70.0% (p = 0.281). The average PEMAT-actionability score was low at 33.0 ± 24.1%. Regarding readability, the average Flesch Reading Ease score was 64.6 ± 12.8, categorized as "standard/plain English." The average Flesch-Kincaid Grade Level was 8.0 ± 2.3, significantly higher than AMA recommendations (p < 0.0001). PEM rewriting with ChatGPT improved Flesch-Kincaid Grade Level to 6.1 ± 1.3 (p < 0.0001). Available ABG PEMs are above the recommended reading level, yet ChatGPT can improve PEM readability. Future studies should improve areas of ABG PEMs that are most lacking, such as actionability.

Compressive Syndrome of the Ostio-fibrous Tunnel at Carp Level - A literary review

CTS tunnel syndrome is characterized by compression of the median nerve inside the carpal tunnel, at the level of the wrist. This disease still has unknown etiology, but it presents itself in a secondary way when related to other pathologies. Compression of the median nerve in the carpal tunnel occurs in most cases of nonspecific chronic flexor tenosynovitis, and it can also occur in many other nosological entities or lesions that occupy space in the tunnel. The prevalence of ostiofibrous tunnel compression syndrome at the carpal level is estimated to be between 4% and 5% of the population, ranging from 51 to 125:100,000, and it occurs more frequently in females, especially between 40 and 60 years of age. The main clinical manifestations include paresthesia in the territory of median nerve sensitivity (particularly in the thumb, index, middle and radial aspect of the ring finger), hyperesthesia (less frequent hypo or anesthesia), wrist pain that may radiate to the fingers, hands, elbows, and in some cases, even the shoulder (such symptoms may disappear with movement of the limb or massage). Diagnosis must be clinical, based on the patient's history and physical examination. For the physical examination, the Tinel and Phalen tests can be used. Complementary tests are used to make a diagnosis, the most recommended being: electroneuromyography (ENMG), magnetic resonance imaging (MRI), computed tomography (CT) and ultrasonography (US). Treatment can be conservative or surgical. The conservative way consists of adopting techniques to alleviate symptoms, such as pain control through wrist orthoses for immobilization, injections and medication, alternative therapies and physiotherapy. Surgical treatment aims to decompress the median nerve and reduce pressure on the carpal tunnel. This approach is adopted when conservative treatment does not lead to an improvement in the clinical condition within 6 to 8 weeks. This paper aims to review the medical aspects of ostiofibrous tunnel compression syndrome at the level of the carpus. The methodology used is analytical in nature through a literature review. The data extracted in the research were from the US National Library of Medicine (PubMed) with the descriptors: median nerve, wrist and carpal tunnel syndrome, according to the Health Sciences Descriptors (DeCS). To perform the crossing of these, the Boolean operator AND was used. 43 articles were found and after inclusion and exclusion criteria, 36 articles were used. Those used for inclusion: articles in English, Portuguese or Spanish, between June 2015 and July 2021, and that were available in full and for free online access. Studies that did not address the relevant concept for achieving the objective were excluded; repeated studies; according to criteria of methodological quality. Thus, the medical evaluation must be performed in a specific way, making it essential to collect the clinical history, physical exams and complementary exams in order to choose to improve conservative therapy and, later, surgical, if necessary. These facts will allow a greater therapeutic success, allowing the greatest well-being to the patient.

Meningkatkan Akses Pendidikan Masyarakat melalui Workshop Gratis: Program Pengabdian untuk Masyarakat

Learning is a right for every individual. However, many people are still unable to pursue education to the fullest. The field of information technology is currently in high demand. Yet, many Indonesians cannot study this field due to various reasons, such as financial constraints and limited access. Recognizing this, Hacktiv8, in collaboration with the Semarang Android Developer Centre (SANDEC), has organized a free online workshop event for the community members who wish to learn about information technology but lack adequate resources. Through this program, workshop participants receive basic training in Android development, equipping them with relevant skills to compete in the digital era.

Competences for the future (Future Work 4S) – Green skills and environmental education

This article describes an innovative Future Work 4S project and provides comprehensive feedback on a free Massive Open Online Course (MOOC) focused on environmental skills. Feedback was collected from two main target groups: educators (including university professors, teachers, and trainers) and student adult learners from Bulgaria, Greece, the Czech Republic, and Italy. The purpose of this survey is to provide an in-depth analysis of the feedback received on the Green Skills course and to highlight the main strengths identified by both educators and students. The findings reveal a high appreciation for the course’s interactive and experiential learning approach by both the students and the educators. Specifically, 93% of participants agreed that the course was interesting, engaging, relevant, accessible, and developmental. The course’s interactive exercises and gamification elements were particularly praised, enhancing learning and motivation. However, suggestions were made for including more practical examples and improving the uniformity of the text.

Risks for Enlisted Navy Divers Compared to Other Enlisted Sailors: An Examination of Illnesses That May Be Associated With Exposure to Contaminated Water Diving.

Illnesses among Navy divers degrade readiness, decrease manpower levels, and increase costs for medical care. Prior research has shown that Navy divers have high rates of the types of illnesses that might be because of diving in contaminated water. The objectives of this study were to examine medical records of U.S. Navy Sailors from 2016 to 2022 and determine if divers have higher incidence rates of health conditions that might be associated with contaminated water diving compared to non-divers. For this retrospective cohort study, we used data from the Defense Medical Epidemiology Database (DMED). The DMED is operated by the Armed Forces Health Surveillance Division and uses data from the Defense Manpower Data Center to classify occupations. The DMED provides free online access to a de-identified subset of data contained within the Defense Medical Surveillance System.The population was U.S. Navy enlisted males, aged 25 to 29 years. Divers were compared to non-divers using 8 selected diagnoses that may reasonably be associated with diving in contaminated water. During the study period, the database contained a total of 5,474 diver and 827,406 non-diver person-years. Of the 8 diagnoses, the ones with the largest number of cases for divers were upper respiratory infections with 128 and ear disorders with 62. The relative risks (RRs) for divers compared to non-divers were higher for otitis externa (RR = 1.44; confidence interval = 1.03, 2.01) and for ear disorders (RR = 1.15; confidence interval = 0.89, 1.47); for the other 6 diagnoses, the divers had lower rates than the non-divers. The high RRs found for otitis externa and ear disorders support the need to devote resources to better understand the reasons for these higher risks and to develop, test, and implement targeted risk-reduction strategies. Future studies should attempt to link verified contaminated water exposures with adverse health outcomes and calculate risks based on criteria such as age and dive factors.

Synergistic insights: the integrated role of CT/CTP and clinical parameters in hemorrhagic transformation prediction.

Acute ischemic stroke presents significant challenges in healthcare, notably due to the risk and poor prognosis associated with hemorrhagic transformation (HT). Currently, there is a notable gap in the early clinical stage for a valid and reliable predictive model for HT. This single-center retrospective study analyzed data from 224 patients with acute ischemic stroke due to large vessel occlusion. We collected comprehensive clinical data, CT, and CTP parameters. A predictive model for HT was developed, incorporating clinical indicators alongside imaging data, and its efficacy was evaluated using decision curve analysis and calibration curves. In addition, we have also built a free browser-based online calculator based on this model for HT prediction. The study identified atrial fibrillation and hypertension as significant risk factors for HT. Patients with HT showed more extensive initial ischemic damage and a smaller ischemic penumbra. Our novel predictive model, integrating clinical indicators with CT and CTP parameters, demonstrated superior predictive value compared to models based solely on clinical indicators. The research highlighted the intricate interplay of clinical and imaging parameters in HT post-thrombectomy. It established a multifaceted predictive model, enhancing the understanding and management of acute ischemic stroke. Future studies should focus on validating this model in broader cohorts, further investigating the causal relationships, and exploring the nuanced effects of these parameters on patient outcomes post-stroke.

The future of medicine: an outline attempt using state-of-the-art business and scientific trends.

Currently, there is a lot of discussion about the future of medicine. From research and development to regulatory approval and access to patients until the withdrawal of a medicinal product from the market, there have been many challenges and a lot of barriers to overcome. In parallel, the business environment changes rapidly. So, the big question is how the pharma ecosystem will evolve in the future. The current literature about the latest business and scientific evolutions and trends was reviewed. In the business environment, vast changes have taken place via the development of the internet as well as the Internet of Things. A new approach to production has emerged in a frame called Creative Commons; producer and consumer may be gradually identified in the context of the same process. As technology rapidly evolves, it is dominated by Artificial Intelligence (AI), its subset, Machine Learning, and the use of Big Data and Real-World Data (RWD) to produce Real-World Evidence (RWE). Nanotechnology is an inter-science field that gives new opportunities for the manufacturing of devices and products that have dimensions of a billionth of a meter. Artificial Neural Networks and Deep Learning (DL) are mimicking the use of the human brain, combining computer science with new theoretical foundations for complex systems. The implementation of these evolutions has already been initiated in the medicinal products' lifecycle, including screening of drug candidates, clinical trials, pharmacovigilance (PV), marketing authorization, manufacturing, and the supply chain. This has emerged as a new ecosystem which features characteristics such as free online tools and free data available online. Personalized medicine is a breakthrough field where tailor-made therapeutic solutions can be provided customized to the genome of each patient. Various interactions take place as the pharma ecosystem and technology rapidly evolve. This can lead to better, safer, and more effective treatments that are developed faster and with a more solid, data-driven and evidence-concrete approach, which will drive the benefit for the patient.

Creating Connections: Using Problem-Based Instruction with Mathematics and Technology like GeoGebra for STEM Integration

This paper will provide several examples of science and mathematics integration: navigation/map-reading, ecology/ecosystems/population growth, and chemistry/molecular structures. This paper underscores integrating STEM subjects with problem-based learning with technology such as video/computer simulations/programming/coding and the dynamic free online software GeoGebra. The paper suggests some GeoGebra-based connections to the science and math that is taught and a way to connect the disciplines with technology. Science involves and uses mathematics, and both subjects involve problem solving, and math is the tool that science uses. Subsequently, integrating science and mathematics using problem-based learning with technology might be a way to improve science and mathematics instruction while building confidence for STEM. Recommendations for STEM teachers are made along with some GeoGebra illustrations.

Normal Values for the fT3/fT4 Ratio: Centile Charts (0-29 Years) and Their Application for the Differential Diagnosis of Children with Developmental Delay.

Primary congenital hypothyroidism is easily diagnosed on the basis of elevated plasma levels of thyroid-stimulating hormone (TSH). In contrast, in the rare disorders of thyroid hormone resistance, TSH and, in mild cases, also thyroid hormone levels are within the normal range. Thyroid hormone resistance is caused by defects in hormone metabolism, transport, or receptor activation and can have the same serious consequences for child development as congenital hypothyroidism. A total of n = 23,522 data points from a large cohort of children and young adults were used to generate normal values and sex-specific percentiles for the ratio of free triiodothyronine (T3) to free thyroxine (T4), the fT3/fT4 ratio. The aim was to determine whether individuals with developmental delay and genetically confirmed thyroid hormone resistance, carrying defects in Monocarboxylate Transporter 8 (MCT8), Thyroid Hormone Receptor alpha (THRα), and Selenocysteine Insertion Sequence-Binding Protein 2 (SECISBP2), had abnormal fT3/fT4 ratios. Indeed, we were able to demonstrate a clear separation of patient values for the fT3/fT4 ratio from normal and pathological controls (e.g., children with severe cerebral palsy). We therefore recommend using the fT3/fT4 ratio as a readily available screening parameter in children with developmental delay for the identification of thyroid hormone resistance syndromes. The fT3/fT4 ratio can be easily plotted on centile charts using our free online tool, which accepts various SI and non-SI units for fT3, fT4, and TSH.

Correlation Between Oncotype Dx Recurrence Score and PREDICT Estimates in Early Breast Cancer: A Single Institution Experience.

Oncotype Dx Recurrence Score (RS) is prognostic and predictive of chemotherapy benefit in women with node-negative and node-positive in hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) early breast cancer. Nevertheless, its direct cost may be inhibitive. This study assesses the correlation between the RS and the free online PREDICT tools' estimations of adjuvant chemotherapy benefit. A retrospective review of the electronic medical records of 112 patients with tumors tested for the RS and the PREDICT tool was used to estimate survival benefits. The correlation between RS and PREDICT estimations was analyzed using Spearman rank and McNemar tests. The median age of patients was 53 (95% CI, 50 to 55) years, with most patients having negative axillary lymph nodes (78%). While the absolute value for RS showed significant positive correlations with adjuvant chemotherapy's benefit as estimated by PREDICT, no significant correlations were found between the two methods in the percentage of chemotherapy gain. Notably, discordance rates between 48% and 67% between RS-based risk assignments and those based on PREDICT estimates were significant across the study population and subgroups. Only one disease recurrence and one breast cancer-related death were documented over a median follow-up of 23.5 (95% CI, 19.8 to 27.2) months. Our findings highlight a significant discordance between RS and PREDICT tools in predicting the benefits of adjuvant chemotherapy in patients with HR+, HER2- early breast cancer. While both tools aim to personalize cancer treatment, their discordance varies, suggesting that PREDICT could not substitute RS to predict adjuvant chemotherapy benefits regardless of patient risk classification. Further studies are needed to explore these relationships and optimize precision medicine approaches in breast cancer management.

Prevalence of obsessive-compulsive symptoms among adult population in primary care centers in Bahrain - A cross-sectional study.

The global increasing prevalence of obsessive-compulsive disorders and symptoms among various age groups and nationalities is considered a great clinical challenge. However, limited data are available on this topic in the Middle East and Gulf Council Countries. This study aimed to raise awareness of obsessive-compulsive symptoms among adults in Bahrain by determining its prevalence and risk factors among patients attending primary healthcare centers. A cross-sectional study was conducted among adult patients attending primary healthcare centers in Bahrain. A self-administered online questionnaire using Google form, a free online survey-creating website, was distributed through WhatsApp messages. A snowball sampling technique was used. The questionnaire consisted of three parts: the socio-demographic data of participants, the Maudsley Obsessional-Compulsive Inventory, and the Yale-Brown Obsessive-Compulsive Scale. Descriptive and inferential analyses were conducted. A total of 614 participants were included with a mean age of 30.04 ± 13.04 years. Most participants were females (82.5%) and single (n = 347, 56.5%). The estimated prevalence of obsessive-compulsive symptoms among the participants was 15%; most of them reported mild symptoms (85%). Significantly higher obsession and compulsion symptoms were found among non-Bahraini (P < 0.001 and P < 0.002), single (P < 0.001 and P < 0.033), and student participants (P < 0.001 and P = 0.002) compared to their counterparts, respectively. In addition, undergraduates reported higher obsessions compared to other participants (P = 0.005). Approximately, one in every eight people in Bahrain were found to suffer from obsessive-compulsive symptoms, especially single, students, and non-Bahraini participants. These findings highlight the need for raising awareness of obsessive-compulsive disorder and its symptoms as well as the importance of early detection and management of obsessive-compulsive disorder.

How to perform standardized sonographic examination of Cesarean scar pregnancy in the first trimester.

Early diagnosis and appropriate management of Cesarean scar pregnancy (CSP) are crucial to prevent severe complications, such as uterine rupture, severe hemorrhage and placenta accreta spectrum disorders. In this article, we provide a step-by-step tutorial for the standardized sonographic evaluation of CSP in the first trimester. Practical steps for performing a standardized transvaginal ultrasound examination to diagnose CSP are outlined, focusing on criteria and techniques essential for accurate identification and classification. Key sonographic markers, including gestational sac location, cardiac activity, placental implantation and myometrial thickness, are detailed. The evaluation process is presented according to assessment of the uterine scar, differential diagnosis, detailed CSP evaluation and CSP classification. This step-by-step tutorial emphasizes the importance of scanning in two planes (sagittal and transverse), utilizing color or power Doppler and differentiating CSP from other low-lying pregnancies. The CSP classification is described in detail and is based on the location of the largest part of the gestational sac relative to the uterine cavity and serosal lines. This descriptive classification is recommended for clinical use to stimulate uniform description and evaluation. Such a standardized sonographic evaluation of CSP in the first trimester is essential for early diagnosis and management, helping to prevent life-threatening complications and to preserve fertility. Training sonographers in detailed evaluation techniques and promoting awareness of CSP are critical. The structured approach to CSP diagnosis presented herein is supported by a free e-learning course available online. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.