Grading Method Research Articles

Instruments for Measuring the Burden of Family Caregivers of Cancer Patients: A Systematic Review of Measurement Properties.

This study identifies instruments for assessing the burden on family caregivers of cancer patients and evaluates their psychometric properties using COSMIN criteria. A systematic review based on COSMIN methodology. The review adhered to PRISMA guidelines. Relevant studies were identified through searches in PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Database, and China Science and Technology Journal Database, covering literature from inception to September 2024. Included studies focused on developing or validating measurement tools and assessing psychometric properties such as reliability, internal consistency and construct validity. Two independent researchers screened the literature, extracted data and evaluated psychometric properties using COSMIN criteria while assessing evidence quality via the GRADE method. A total of 32 studies were included, encompassing 17 tools for assessing caregiver burden. None reported measurement error, cross-cultural validity or responsiveness. The Caregiver's Burden Scale in End-of-Life Care (CBS-EOLC) demonstrated strong reliability, validity and internal consistency, receiving a strong recommendation for clinical practice. In contrast, the Zarit Burden Interview (ZBI), Family Caregiver Burden Interview Scale (FBIS) and Bakas Caregiving Outcomes Scale (BCOS) are not recommended due to insufficient supporting evidence. Other tools showed weak evidence, leading to weak recommendations. The CBS-EOLC exhibits comprehensive psychometric properties suitable for clinical applications. The ZBI, FBIS and BCOS lack adequate supporting evidence and are not recommended. Future research should focus on measurement error, cross-cultural validity and responsiveness to enhance these tools' applicability and reliability. This review provides evidence for healthcare providers to select instruments for assessing caregiver burden in cancer patients. This systematic review highlights the need for comprehensive assessments of caregiver burden based on COSMIN guidelines. This study is a systematic review with no patient or public participation.

Factors associated with HPV vaccine acceptance and hesitancy in Africa: a systematic review protocol

IntroductionHuman papillomavirus (HPV) infection is the most prevalent sexually transmitted infection worldwide. HPV vaccination is an important tool to prevent and control HPV infection and its complications. Despite carrying the...

HPB SO50 - A comprehensive review of clinical practice guidelines for managing hepatic adenoma

Abstract Background Hepatic adenoma(HCA) are increasingly diagnosed as incidentalomas. Clinical implications and management vary across and within the different types of Hepatic adenomas. Practice guidelines are needed, because of the many variation, diagnostic tools, and conservative and invasive management protocols. Therefore, our aim was to systematically search for available clinical practice guidelines on hepatic adenoma, critically appraise them, and compare management recommendations. Method Systematic literature search was performed by two investigators using appropriate prespecified search terms within the bibliographic databases of MEDLINE, EMBASE, and PubMed. All HCA guidelines published in peer-reviewed, and English language journals were eligible for inclusion. Clinical practice guidelines on HCA were analysed, compared, and critically appraised using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations (PRISMA) 2020 checklist. Results The literature search yielded unique 199 papers, 187 were excluded after screening of title/abstract, and 9 after full-text screening. Guidelines included were: (EASL; 2016, (ACG; 2014), (SBH; 2015),). There were no set standards in the assessment methods for grading and gravity of recommendations between guidelines. Observed differences were: (1) indications for biopsy; (2) advices on contraceptive pills and follow-up; (3) use of an lesion centred approach to HCA; (4) lack of adequate treatment recommendations of HCA in male population ; and (5) approach to HCA depending on subtype varaition on magnetic resonance imaging. Conclusion Recognising differences in recommendations can assist in formulating practice standards and identify needs for research.

Placental Extracts, Proteins, and Hydrolyzed Proteins as Active Ingredients in Cosmetic Preparations for Hair Loss: A Systematic Review of Available Clinical Evidence

Placentae and their derivatives have been used in both traditional and modern medicine, as well as in cosmetic sciences. Although hair loss is frequently mentioned among problems for which the placenta is supposed to be a remedy, the evidence seems rather scarce. The aim of this study was to highlight the clinical evidence for the efficacy of placenta products against baldness and hair loss. Methods: This systematic review was performed according to PRISMA and PICO guidelines. Database searches were conducted in PubMed, Google Scholar and Scopus. Results: Among the 2922 articles retrieved by the query, only 3 previously published clinical trials on placental products were identified. One study was a randomized controlled trial, in which the efficacy of a bovine placenta hair tonic was found to be comparable to that of minoxidil 2% in women with androgenic alopecia. Another controlled study showed that a porcine placenta extract significantly accelerated the regrowth of shaved hair in healthy people. The third study was an uncontrolled trial of a hair shampoo and tonic containing equine placental growth factor in women with postpartum telogen effluvium with unclear and difficult-to-interpret results. Due to the design and methodology of these studies, the level of evidence as assessed with the GRADE method was low for the first study and very low for the other two. Conclusions: The very limited scientific evidence available to date appears, overall, to indicate the efficacy of placental products in both inhibiting hair loss and stimulating hair growth. Unfortunately, the number of clinical studies published to date is very limited. Further, carefully designed, randomized controlled trials of well-defined placental products are needed to definitively address the question of the value of the placenta and its derivatives in hair loss.

Stem cell therapy for non-ischemic dilated cardiomyopathy: a systematic review and meta-analysis

BackgroundStem cell therapy is the transplantation of human cells to aid the healing of damaged or wounded tissues and cells. Only a few small-scale trials have been conducted to investigate stem cell therapy for non-ischemic dilated cardiomyopathy (DCM). We aimed to perform a systematic review and meta-analysis to assess the efficacy and safety of stem cell therapy for DCM.MethodsA comprehensive search of the databases of PubMed, Embase, Web of Science Core Collection, Cochrane Library, and ProQuest was conducted from their inception to June 30, 2024, to access randomized controlled trials (RCTs) that were centered on stem cell therapy for DCM. The primary outcome was left ventricular ejection fraction (LVEF), and the secondary outcomes included left ventricular end-diastolic dimension (LVEDD), left ventricular end-diastolic volume (LVEDV), 6-min walk test (6MWT), NYHA functional classification, quality of life (QoL) such as Minnesota Living with Heart Failure Questionnaire (MLHFQ) and Kansas City Cardiomyopathy Questionnaire (KCCQ), N-terminal pro-brain natriuretic peptide (NT-proBNP), and VO2 peak. Moreover, major adverse cardiovascular events (MACEs) were also recorded. The Cochrane risk-of-bias assessment tool was used to evaluate the quality of the included RCTs, and the certainty of the evidence was assessed using the GRADE method. Sensitivity analysis was taken into consideration to determine the stability of the results. This review was registered with PROSPERO (CRD42024568912).ResultsEleven RCTs involving 637 participants were included in the quantitative analysis. The results indicated that there was a significant increase in mean LVEF (MD = 4.84, 95% CI 3.25–6.42, P < 0.00001) and considerable decrease in LVEDV (MD = − 29.51, 95% CI − 58.07 to − 0.95, P = 0.04) and NT-proBNP (MD = − 737.55, 95% CI − 904.28 to − 570.82, P < 0.00001) in DCM patients treated with stem cell therapy compared with controls. Stem cell therapy was also related to the improvement in functional capacity, as evaluated by 6MWT (MD = 44.32, 95% CI 34.70 − 53.94, P < 0.00001) and NYHA functional classification (MD = − 0.63, 95% CI − 0.96 to − 0.30, P = 0.0002). It also had positive effects on improving QoL, including significantly decreasing MLHFQ score (MD = − 16.60, 95% CI − 26.57 to − 6.63, P = 0.001) and increasing the KCCQ score (MD = 14.76, 95% CI 7.76 − 21.76, P < 0.0001). No significant differences were observed in LVEDD, VO2 peak, and MACEs between the two groups. The GRADE analysis revealed that the evidence was graded from low to moderate. Sensitivity analysis of the results suggested that the results were stable.ConclusionThe systematic review and meta-analysis indicates that stem cell therapy may be an effective and safe approach to improve cardiac function and quality of life in DCM patients. Nevertheless, given the limitations of existing studies, larger well-designed RCTs are required to confirm and support our findings.

Multi-Modal Vision Transformer with Explainable Shapley Additive Explanations Value Embedding for Cymbidium goeringii Quality Grading

Cymbidium goeringii (Rchb. f.) is a traditional Chinese flower with highly valued biological, cultural, and artistic properties. However, the valuation of Rchb. f. mainly relies on subjective judgment, lacking a standardized digital evaluation and grading methods. Traditional grading methods solely rely on unimodal data and are based on fuzzy grading standards; the key features for values are especially inexplicable. Accurately evaluating Rchb. f. quality through multi-modal algorithms and clarifying the impact mechanism of key features on Rchb. f. value is essential for providing scientific references for online orchid trading. A multi-modal Transformer for Rchb. f. quality grading combined with the Shapley Additive Explanations (SHAP) algorithm was proposed, which mainly includes one embedding layer, one UNet, one Vision Transformer (ViT) and one Encoder layer. A multi-modal orchid dataset including images and text was obtained from Orchid Trading Website, and seven key features were extracted. Based on petals’ RGB segmented from UNet and global fine-grained features extracted from ViT, text features and image features were organically fused into Transformer Encoders throughout concatenation operation, a 93.13% accuracy was achieved. Furthermore, SHAP algorithm was utilized to quantify and rank the importance of seven features, clarifying the impact mechanism of key features on Rchb. f. quality and value. This multi-modal Transformer with SHAP algorithm for Rchb. f. grading provided a novel idea to represent the explainable features accurately, exhibiting good potential for establishing a reliable digital evaluation method for agricultural products with high value.

An Exploratory Study of Student Perceptions of Ungrading in Upper-Level Psychology Courses

Background Ungrading is an innovative approach to assessment that relies on feedback rather than numerical grades to deprioritize (or remove) grades, but that has gone relatively unexplored in the psychology classroom. Objective The current study examined student perceptions of ungrading in three psychology courses. Method Using an inductive approach, we examined patterns and themes in student reflections across two time points (start and end of the semester) in three upper-division psychology courses. Results Students generally had positive impressions of ungrading, but stress around grade uncertainty was an area of concern. Conclusion Implementation of alternative grading methods has the potential for many benefits in the psychology classroom, but careful consideration is needed to overcome negative student perceptions. Teaching Implications Going gradeless is an intriguing option that may potentially impact student learning, engagement, motivation, mental health, and equity. This exploratory study offers insight into student perceptions of ungrading, which can help instructors who are considering this method.

A high-precision two-parameter road roughness grading and identification methodology across multiple frequency intervals

Based on a dual track road shape meter, various road roughness was measured. It was discovered that the road grading method in ISO 8608 assumes a constant waviness value of W = 2 with a one-straight line approximation, but it could not accurately fit and grade the measured road roughness. A high-precision piecewise fitting function for the low-frequency and high-frequency parts of the road roughness power spectral density (PSD) is established. A high-precision two-parameter grade method in multiple frequency bands for road roughness is proposed ( G q( n0), the geometric average of the road roughness index at n0, W, the waviness, is the slope of the road roughness PSD fitting expression in the double logarithmic coordinate system). According to the vehicle driving performance obtained by simulation, the grading method is verified. For Paved and Undulating roads, compared to the road roughness classification method in ISO 8608, the performance simulated based on the grade results of the two parameters grading method are closer to the performance simulated based on the measured road roughness. The grading method proposed in this paper can more accurately fit and classify the measured road roughness. The influence of these parameters at each frequency interval on vehicle driving performance is studied. A two-parameter identification method for road roughness PSD at variable intervals over a large frequency range is proposed. In the double logarithmic coordinate system, this method divides the selected spatial frequency into three sub-intervals along the abscissa, in each sub-interval, the parameters G q( n0) and W are identified separately. This method can provide effective control inputs for the vehicle’s active or semi-active suspension system.

Research and Implementation of a Classification Method of Industrial Big Data for Security Management

ABSTRACTPurpose/SignificanceWith the extensive adoption of cloud computing, big data, artificial intelligence, the Internet of Things, and other novel information technologies in the industrial field, the data flow in industrial companies is rapidly increasing, leading to an explosion in the total volume of data. Ensuring effective data security has become a critical concern for both national and industrial entities.Method/ProcessTo tackle the challenges of classification management of industrial big data, this study proposed an Information Security Triad Assessment‐Support Vector Machine (AIC‐ASVM) model according to information security principles. Building on national policy requirements, FIPS 199 standards, and the ABC grading method, a comprehensive classification framework for industrial data, termed “two‐layer classification, three‐dimensional grading,” was developed. By integrating the concept of Data Protection Impact Assessment (DPIA) from the GDPR, the classification of large industrial data sets was accomplished using a Support Vector Machine (SVM) algorithm.Result/ConclusionSimulations conducted using MATLAB yielded a classification accuracy of 96.67%. Furthermore, comparisons with decision tree and random forest models demonstrated that AIC‐ASVM outperforms these alternatives, significantly improving the efficiency of big data classification and the quality of security management.

Role of High-Resolution Computed Tomography in Classifying Pneumatization of the Temporal Bone: Typical Patterns, Prevalence, and Implications

Introduction: Pneumatization patterns in the temporal bone have been implicated in the prognostic outcomes of various pathological conditions, such as cholesterol granulomas, otitis media, and cholesteatomas. This study investigated how high-resolution computed tomography (HRCT) helps to classify pneumatization patterns in the temporal bone, exploring its impact on the pathogenesis, surgical outcomes of temporal bone diseases, and its association with age and gender. Methods: HRCT of temporal bone of fifty patients of age 13 years and more with normal findings were included. The petrous apex, mastoid, and infra-labyrinthine regions’ pneumatization patterns were categorized using previously published grading methods. Results: The dominant pattern of pneumatization in the petrous apex was classified as group 2, indicating that less than 50% of the pneumatization was located medially in the labyrinth. Conversely, in the mastoid, the prevailing pattern was group 4, which signifies hyper-pneumatization. In the infra-labyrinthine region, the prevailing pattern was categorized as type B, indicating limited pneumatization. It was found that patients who exhibited augmented pneumatization in one compartment of the temporal bone tended to display similar changes on the opposite side and in other compartments on the same side (P &lt; 0.05). Importantly, it was observed that younger age (P &lt; 0.001) and male gender (P = 0.001) were associated with increased pneumatization in the petrous apex and infra-labyrinthine compartments. Conclusion: Different compartments of temporal bone show varying degrees of pneumatization. The level of pneumatization of the temporal bone is highly associated with age and sex.

Analisis Kesulitan dalam Menyelesaikan Soal Persamaan Linear Satu Variabel dengan Metode Demonstrasi untuk Siswa Kelas VII SMP Negeri 5 Lamboya

This study aims to find out the difficulties of students in solving PLSV problems using the demonstration method for grade VII students of SMP Negeri 5 Lamboya. This study uses a qualitative approach with a descriptive method. 14 students as subjects to be researched to the extent to which the students can work on one-variable lienar equation problems. The data collection methods used are tests, interviews, and documentation. Data analysis is carried out qualitatively with the stages of data reduction, data presentation, and conclusion drawing. The results of the study showed that there was still a lack of ability of students to solve PLSV questions that answered the questions correctly and incorrectly. The results of the analysis for problems number 1, 2 and 3 were at the stage of difficulty in interpreting mathematical language (59.66%), the stage of difficulty in using data (64.33%), the stage of difficulty in mastering concepts correctly (66.66%), the stage of difficulty in using calculation operations (66.66%), and the stage of difficulty in drawing conclusions (83.33%). The cause of incompetence is that students do not read the questions carefully so that they make mistakes in writing down what is known and what is asked, so that they are less able to solve problems, in a hurry so that others are incomplete.

Effects of Hyrax Maxillary Expander on Nasal Cavity and Upper Airway in Adolescents: A Systematic Review and Meta-Analysis.

Whether Hyrax maxillary expander is an effective treatment for maxillary transverse deficiency as well as expansion of the upper airway is still controversial. The study's purpose was to evaluate 3D changes in upper airway dimensions of adolescent patients measured primarily by cone-beam computed tomography (CBCT) after rapid maxillary expansion (RME) with the Hyrax maxillary expander. Studies up to 1 April 2024 were searched in the following databases: PubMed/MEDICINE, Web of Science, Cochrane Library, and Embase. Inclusion criteria were clinical trials and cohort studies that assessed the effect of RME in adolescent patients with upper airway stenosis using CBCT-based three-dimensional analysis. The risk of bias in the study outcomes was assessed using the Cochrane Collaboration's risk of bias tool, the GRADE method, and a tool for evaluating non-randomized controlled study (non-RCT) literature from a previous systematic review, depending on the types of articles. The study was reported in accordance with PRISMA guidelines. The study conducted a random effects meta-analysis of mean differences and 95% confidence intervals for changes in upper airway volumes, including the nasal cavity (NC), in the outcomes of 16 included studies, followed by subgroup analyses. A significant increase in nasopharynx volume was observed after rapid maxillary expansion (RME) by Hyrax maxillary expander (MD = 0.69, 95% CI (0.09~1.28), p = 0.02).

Comparison of interrupted and uninterrupted anticoagulation strategies for cardiac implantable electronic device insertion: a systematic review and meta-analysis

Abstract Introduction Up to 35% of patients who are candidates for a cardiac implantable electronic device (CIED) receive chronic anticoagulation. However, guidelines on anticoagulant management in the perioperative period of CIED insertion differ worldwide. It is uncertain whether interrupting or continuing anticoagulation in these settings provides optimal outcomes. Purpose To assess the effects of interrupting versus continuing chronic anticoagulation with either warfarin or a direct oral anticoagulant (DOAC) in the perioperative setting of CIED insertion. Methods CENTRAL, MEDLINE, Embase, Web of Science, and two trial registries were searched from inception to 26 November 2021. Randomised controlled trials (RCTs) assessing interrupting chronic warfarin or DOAC therapy, with or without heparin bridging, versus continuing anticoagulation in adults undergoing CIED insertion were included. Comparisons were divided into two categories: interrupted versus uninterrupted warfarin and interrupted versus uninterrupted DOAC. Outcomes were expressed as risk ratios (RR) with 95% confidence intervals (95%CI). Inverse variance random-effects models were used for the meta-analyses. Risk of bias (RoB) was assessed using the Cochrane RoB2 tool, and certainty of evidence (CoE) per outcome was assessed with GRADE methods. Results Ten RCTs (n=2221) were included: five RCTs (n=1267) used warfarin; four RCTs (n=954) used DOACs. One additional RCT using warfarin was ongoing without any outcome data available. Bleeding events included device-pocket haematoma, haemothorax, cardiac tamponade, and non-tamponade pericardial effusion. Interrupted versus uninterrupted warfarin: The evidence is very uncertain on the effect of interrupted warfarin on device-pocket haematoma (RR 1.89, 95%CI 0.85 to 4.20, 5 RCTs, very low CoE) and bleeding events (RR 1.94, 95%CI 0.86 to 4.41, 5 RCTs, very low CoE). Interrupted warfarin may result in little to no difference in thromboembolic events (RR 0.85, 95%CI 0.18 to 4.11, 5 RCTs, low CoE) and ischaemic stroke (RR 1.01, 95%CI 0.11 to 9.61, 2 RCTs, low CoE). Interrupted warfarin may reduce all-cause mortality (RR 0.35, 95%CI 0.04 to 2.93, 3 RCTs, low CoE). Interrupted versus uninterrupted DOAC: The evidence is very uncertain on the effect of interrupted DOAC on device-pocket haematoma (RR 1.15, 95%CI 0.58 to 2.28, 4 RCTs, very low CoE) and bleeding events (RR 1.14, 95%CI 0.58 to 2.21, 4 RCTs, very low CoE). Interrupted DOAC may result in little to no difference in thromboembolic events (RR 0.98, 95%CI 0.06 to 15.63, 3 RCT, low CoE) and ischaemic stroke (RR 0.98, 95%CI 0.06 to 15.63, 2 RCTs, low CoE). Interrupted DOAC may reduce all-cause mortality slightly (RR 0.49, 95% CI 0.04 to 5.39, 2 RCTs, low CoE). Conclusion Interrupting anticoagulation with either warfarin or DOACs in patients undergoing CIED insertion produced similar outcomes as uninterrupted anticoagulation.Figure 1.Figure 2.

Effects of Yi Jin Jing on enhancing muscle strength and physical performance in older individuals: a systematic review and meta-analysis.

The aging population is rapidly increasing, leading to physical decline and higher risks of chronic diseases, including sarcopenia, which adversely affects muscle quality and strength. Yi Jin Jing (YJJ), a traditional Chinese exercise method, can enhance flexibility and strength, but evidence regarding its effectiveness in older adults is conflicting. This meta-analysis aims to systematically evaluate the effects of YJJ on muscle strength and physical performance in this demographic. We searched seven electronic databases: China National Knowledge Infrastructure, Wanfang Data, Sinomed, Web of Science, PubMed, Cochrane Library, and EMBASE to identify randomized controlled trials (RCTs). Following PRISMA guidelines, we quantified the effects of YJJ on muscle strength (grip strength, isokinetic strength) and physical performance (chair sit-to-stand, squatting-to-standing, shoulder flexibility, sit-and-reach tests). Treatment effects were calculated using Hedges'g. The Cochrane tool assessed risk of bias, the PEDro scale evaluated methodological quality, and the GRADE method assessed evidence quality. Data analysis was conducted using Stata 17.0 software, utilizing standardized mean differences (SMD) and 95% confidence intervals (CIs). This meta-analysis included 10 RCTs involving 590 participants. The overall risk of bias was assessed to be low. The methodological quality of these studies was generally moderate, and the quality of the main results varied from low to moderate. The findings revealed that YJJ had considerable effects on the chair sit-to-stand test (Hedges'g = 1.06), squatting-to-standing test (Hedges'g = 1.08), and small to moderate effects on handgrip strength (Hedges'g = 0.25), 60°/s extensor peak torque (Hedges'g = 0.47), 60°/s extensor average power (Hedges'g = 0.31), 60°/s extensor total work (Hedges'g = 0.29), 60°/s flexor peak torque (Hedges'g = 0.42), 60°/s flexor average power (Hedges'g = 0.37), and 180°/s extensor peak torque (Hedges'g = 0.29), and left shoulder flexibility (Hedges'g = 0.4). However, there were no significant improvement effects in 180°/s extensor average power (Hedges'g = 0.19), 180°/s extensor total work (Hedges'g = 0.11), 180°/s flexor peak torque (Hedges'g = 0.01), 180°/s flexor average power (Hedges'g = -0.08), right shoulder flexibility (Hedges'g = 0.09), and sit-and-reach test (Hedges'g = 0.15). YJJ significantly enhances specific aspects of physical performance, particularly chair sit-to-stand and squatting-to-standing tests, while showing small and moderate improvements in handgrip strength and knee muscle strength. However, it had no significant effects on other metrics, including shoulder flexibility and sit-and-reach tests. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024530487, Registration number: CRD42024530487.

Evaluating the Effectiveness of Probiotic Supplementation in Combination With Doxycycline for the Treatment of Moderate Acne: A Randomized Double-Blind Controlled Clinical Trial.

Acne is a chronic inflammatory skin disease that negatively affects patients' quality of life. Increasing antibiotic resistance is making acne less responsive to treatment. Probiotics are live microorganisms that can provide health benefits by fighting pathogens and maintaining intestinal homeostasis and skin microbiome balance. This study investigates the effects of probiotics in the treatment of acne vulgaris. In this randomized controlled clinical trial, 80 patients with moderate acne were divided into two groups of 40. All patients received the same topical treatment, which consisted of a daily antibacterial face wash and Adapalene gel every other night. The control group received one capsule of doxycycline (100 mg) daily, whereas the intervention group received one probiotic capsule daily in addition to doxycycline. Patients underwent photography of facial acne lesions, and treatment response was assessed using the global acne grading system (GAGS) and acne grading method at baseline, as well as during follow-up visits at 1, 2, and 3 months. The global acne grading system indicated that both groups showed improvement. However, analyses revealed that outcomes were significantly better in the doxycycline plus probiotics group for the forehead (p = 0.018), chin (p = 0.021), and nose (p = 0.021). No significant differences were observed for the left and right cheeks, back, and chest areas, with the mean GAGS score reduction between the two groups differing by only 2%. Treatment with probiotics significantly reduced the severity of lesions compared to the control group (p < 0.001). The acne grading method also indicated that the intervention group had a significantly better treatment response than the control group (p < 0.001). Furthermore, treatment with probiotics did not result in any side effects. Probiotics can serve as an effective and safe treatment option, enhancing the outcomes of routine acne treatments, particularly for patients with acne on the forehead, chin, and nose.

Building a pelvic organ prolapse diagnostic model using vision transformer on multi-sequence MRI.

Although the uterus, bladder, and rectum are distinct organs, their muscular fasciae are often interconnected. Clinical experience suggests that they may share common risk factors and associations. When one organ experiences prolapse, it can potentially affect the neighboring organs. However, the current assessment of disease severity still relies on manual measurements, which can yield varying results depending on the physician, thereby leading to diagnostic inaccuracies. This study aims to develop a multilabel grading model based on deep learning to classify the degree of prolapse of three organs in the female pelvis using stress magnetic resonance imaging (MRI) and provide interpretable result analysis. We utilized sagittal MRI sequences taken at rest and during maximum Valsalva maneuver from 662 subjects. The training set included 464 subjects, the validation set included 98 subjects, and the test set included 100 subjects (training set n=464, validation set n=98, test set n=100). We designed a feature extraction module specifically for pelvic floor MRI using the vision transformer architecture and employed label masking training strategy and pre-training methods to enhance model convergence. The grading results were evaluated using Precision, Kappa, Recall, and Area Under the Curve (AUC). To validate the effectiveness of the model, the designed model was compared with classic grading methods. Finally, we provided interpretability charts illustrating the model's operational principles on the grading task. In terms of POP grading detection, the model achieved an average Precision, Kappa coefficient, Recall, and AUC of 0.86, 0.77, 0.76, and 0.86, respectively. Compared to existing studies, our model achieved the highest performance metrics. The average time taken to diagnose a patient was 0.38s. The proposed model achieved detection accuracy that is comparable to or even exceeds that of physicians, demonstrating the effectiveness of the vision transformer architecture and label masking training strategy for assisting in the grading of POP under static and maximum Valsalva conditions. This offers a promising option for computer-aided diagnosis and treatment planning of POP.

Can routine EPA-based assessments predict OSCE performances of undergraduate medical students?

Background Objective structured clinical examination (OSCE) is used worldwide. This study aims to explore potential alternatives to the OSCE by using entrustable professional activities (EPA)-based assessments in the workplace. Methods This study enrolled 265 six-year undergraduate medical students (UGY) from 2021 to 2023. During their rotations, students were assessed using 13 EPAs, with the grading methods modified to facilitate application. Before graduation, they participated in two mock OSCEs and a National OSCE. We used generalized estimating equations to analyze the associations between the EPA assessments and the OSCE scores, adjusting for age and sex, and developed a prediction model. EPA8 and EPA9, which represent advanced abilities that were not significant in the regression models, were removed from the prediction model. Results Most EPAs were significantly correlated with OSCE scores across the three cohorts. The prediction model for forecasting passing in the three OSCEs demonstrated fair predictive capacity (area under curve = 0.82, 0.66, and 0.71 for students graduated in 2021, 2022, and 2023, respectively all p < 0.05). Conclusions The workplace-based assessments (EPA) showed a high correlation with competency-based assessments in simulated settings (OSCE). EPAs may serve as alternative tools to formal OSCE for medical students.

Pathologist-level diagnosis of ulcerative colitis inflammatory activity level using an automated histological grading method

Background and AimsInflammatory bowel disease (IBD) is a global disease that is evolving with increasing incidence. However, there are few works on computationally assisted diagnosis of IBD based on pathological images. Therefore, based on the UK and Chinese IBD diagnostic guidelines, our study established an artificial intelligence-assisted diagnostic system for histologic grading of inflammatory activity in ulcerative colitis (UC). MethodsWe proposed an efficient deep-learning (DL) method for grading inflammatory activity in whole-slide images (WSIs) of UC pathology. Our model was constructed using 603 UC WSIs from Nanjing Drum Tower Hospital for model train set and internal test set. We collected 212 UC WSIs from Zhujiang Hospital as an external test set. Initially, the pre-trained ResNet50 model on the ImageNet dataset was employed to extract image patch features from UC patients. Subsequently, a multi-instance learning (MIL) approach with embedded self-attention was utilized to aggregate tissue image patch features, representing the entire WSI. Finally, the model was trained based on the aggregated features and WSI annotations provided by senior gastrointestinal pathologists to predict the level of inflammatory activity in UC WSIs. ResultsIn the task of distinguishing the presence or absence of inflammatory activity, the Area Under Curve (AUC) value in the internal test set is 0.863 (95% confidence interval [CI] 0.829, 0.898), with a sensitivity of 0.913 (95% [CI] 0.866, 0.961), and specificity of 0.816 (95% [CI] 0.771, 0.861). The AUC in the external test set is 0.947 (95% confidence interval [CI] 0.939, 0.955), with a sensitivity of 0.889 (905% [CI] 0.837, 0.940), and specificity of 0.858 (95% [CI] 0.777, 0.939). For distinguishing different levels of inflammatory activity in UC, the average Macro-AUC in the internal test set and the external test set are 0.827 (95% [CI] 0.803, 0.850) and 0.908 (95% [CI] 0.882, 0.935). the average Micro-AUC in the internal test set and the external test set are 0.816 (95% [CI] 0.792, 0.840) and 0.898 (95% [CI] 0.869, 0.926). ConclusionsComparative analysis with diagnoses made by pathologists at different expertise levels revealed that the algorithm reached a proficiency comparable to the pathologist with 5 years of experience. Furthermore, our algorithm performed superior to other MIL algorithms.

Prediction and analysis of interior sound quality of high-speed trains based on XGBoost

This paper primarily investigates the objective quantification of subjective perceptions of sound quality in high-speed trains. The study measures and analyzes the sound quality in high-speed trains under high-speed operating conditions and calculates psychoacoustic parameters. A subjective evaluation of the interior sound quality is conducted using the grading scale method. An Extreme Gradient Boosting (XGBoost) algorithm is utilized to construct a predictive model for sound quality in high-speed trains and get high predictive accuracy for sound quality evaluation. Employing AI-based evaluation models to evaluate the sound quality in high-speed trains offers a more effective method for studying the interior sound quality of high-speed trains.

Sound quality evaluation in special vehicles based on multiple linear regression

The issue of interior sound quality in specialized vehicles has received widespread attention, which could directly affect the riding comfort of the vehicle. This research primarily focuses on the objective quantification of subjective perception of sound qualitySQ in special vehicles. The noise of special vehicles under different working conditions is measured and analyzed, and psychoacoustic parameters and A-weighted sound pressure levels are calculated. The subjective evaluation of interior sound quality was conducted using the grading scale method. A multiple linear regression model is used to establish the correspondence between subjective perceptions and objective parameters. It provides a reference basis for evaluating the sound quality of special vehicles.