Grading Scheme Research Articles

Prognostic Impact of a Histologic Grading Scheme in Dogs Diagnosed With Rib Chondrosarcoma.

Data regarding the outcome of canine rib chondrosarcoma is sparse and varied. While grade of tumour is associated with outcome for canine appendicular chondrosarcoma, the association of grade with outcome for canine rib chondrosarcoma is unclear. This study aimed to correlate the grade of canine rib chondrosarcoma with median survival time. Retrospectively, cases of primary rib chondrosarcoma were identified, and tumours were graded based on a 3-tier adapted human grading scheme. Twenty-two patients were included in the survival analysis. The median survival time was 1427 days (range: 27-3354 days). This was not significantly different for patients with grade I versus II versus III (p = 0.82), grade I-II versus III (p = 0.34), or grade I versus II-III (p = 0.49). No variables assessed including age, weight, tumour location (cranial vs. caudal thorax; left vs. right hemithorax), tumour location on rib (proximal, middle, and distal), radiographic appearance (lytic, proliferative, or mixed), elevated serum alkaline phosphatase activity, grade, grade specific histologic features (matrix production, architecture, pleomorphism, cellularity, necrosis, and total score), adjunct therapy post-surgical excision, development of metastatic disease post-surgery, or local recurrence post-surgery were found to impact the risk of death due to chondrosarcoma. In this limited group of patients, the grading scheme reported here, and the other variables assessed did not appear to offer additional prognostic information. However, this data must be interpreted considering the small sample size and thus low statistical power. Additional studies are needed to determine the true impact of grade on outcome for canine rib chondrosarcomas.

Interexaminer agreement of gonioscopy examinations in dogs using the European College of Veterinary Ophthalmologists Hereditary Eye Diseases grading scheme.

Prospective observational study with preregistered study protocol to assess interexaminer agreement using the 2022 European College of Veterinary Ophthalmologists Hereditary Eye Disease (ECVO-HED) gonioscopy grading scheme. Sixty client-owned dogs presented for gonioscopy as part of the required certification process prior to breeding. Two ECVO diplomates with comparable clinical experience performed gonioscopy with a Koeppe gonioscopy lens and slit-lamp biomicroscope at 10x magnification on all eyes in a randomized fashion. One hundred and eighteen of 120 eyes (60 dogs) were included. In 110/118 eyes (93%), both examiners provided the same breeding recommendation (yes/no). This translated into an agreement on the final breeding recommendation in 58/60 dogs (97%). Examiners disagreed on pectinate ligament abnormality (PLA) grading in 19/118 eyes and iridocorneal angle width (ICAW) grading in 9/118 eyes. PLA grading disagreement was mostly observed between neighboring grades. Disagreement between PLA and ICAW grading sometimes occurred within the same eye accounting for an observed disagreement in iridocorneal angle abnormality (ICAA) grading in 19/118 eyes in total. Cohen's kappa was Κ = 0.62 (95% TI 0.34-0.89), whereas maximum kappa was maxΚ = 0.82 (95% TI 0.59-1). Mixed model analysis suggested no significant examiner influence on breeding recommendations (OR 0.17; 95% CI 0.02-1.12, p = .09). Although examiners disagreed on ICAA grading in 19/118 eyes, this resulted in a different breeding recommendation (yes/no) in eight eyes and in two dogs only. Therefore, the use of the 2022 ECVO-HED gonioscopy grading scheme seems to result in examiners providing the same breeding recommendations in most cases.

Emergency Medicine Clerkship Grading Scheme, Grade, and Rank-List Distribution as Reported on Standardized Letters of Evaluation

Background: The Standardized Letter of Evaluation (SLOE) is a crucial component of the emergency medicine (EM) application process. Given the critical role of the SLOE, we attempted to better understand the grading scales used, as well as the distribution of grades and rank-list positions.Objectives: Our primary objective in this study was to determine the distribution of grading formats, grades given, and rank-list positions across EM clerkships using the SLOE. Methods: We performed a cross-sectional study of the grading formats, grades given, and ranking distributions as reported on the SLOE during the 2022–23 application cycle. We obtained data on SLOEs from EM residency programs accredited by the Accreditation Council for Graduate Medical Education by reviewing all applicants who applied to either of two EM residency programs in geographically different regions. Trained abstractors recorded the following data: number of students rotating in the prior year; grading format used; and grade and rank distribution among students. Results: We included 264 programs in our final analysis, after 13 programs met exclusion criteria. The majority of programs (72.2%) use an Honors/High Pass/Pass/Fail grading scheme. We determined the mean percent of each grade: Honors/A 27.6%; High Pass/B 31.1%; Pass/C 40.8%; Low Pass/D 0.2%; and Fail/F 0.3%. Finally, we determined the mean percent for each rank-list position: top 10% was 17.6%; top third 36.5%; mid third 34.1%; and low third 11.8%. Conclusion: We determined the grading schemes and grade and rank-list distributions for EM programs during the 2022–2023 academic year. Most programs used a Honors/High Pass/Pass/Fail grading scheme, with the majority of students receiving Honors or High Pass, while 0.3% failed their rotation. Both grades and rank list demonstrated evidence of a skewed distribution toward higher grades and rank-list position.

Use of respiratory signal analysis to assess severity of Brachycephalic Obstructive Airway Syndrome (BOAS) in dogs

Brachycephalic Obstructive Airway Syndrome (BOAS) is a potentially life-threatening condition that can be challenging to diagnose and grade objectively. The aim of this study was to investigate the use of respiratory signal analysis to assess severity of BOAS in dogs. Hundred and seventeen client-owned dogs of brachycephalic and non-brachycephalic breeds were enrolled. Respiratory sounds were recorded using an electronic stethoscope before and after a 3-minute exercise test (ET). Dogs were assigned a BOAS severity grade (BOAS 0–3) using a validated respiratory functional grading scheme. Signal analysis techniques were used to identify seven sound variables. Analysis of variance (ANOVA) was used to investigate associations between variables and BOAS severity and receiver operating characteristic (ROC) curves to assess the diagnostic efficacy of each sound variable. For each sound variable, there was a significant association with BOAS grade. An increase in BOAS grade resulted in greater sound magnitude in the frequency spectrum (0–1000 Hz), and in a greater contribution of lower frequencies (170–260 Hz). The variable “Peak 1” had the best performance in predicting BOAS negative (BOAS 0 +1) versus BOAS positive dogs (BOAS 2 + 3) before the ET; area under the curve (AUC) = 76.6 % (95 % confidence interval 67.4–85.8 %), whereas the variable “Valley 1” had the highest predictive value after the ET; AUC = 87.8 % (95 % confidence interval 81.4–94.3 %). Respiratory signal analysis has good potential for assessing BOAS severity and could be valuable for clinicians in clinical decision processes and for breeders when selecting suitable breeding dogs.

Ungrading’s Impact on Learning and Autonomy: Insights from an Empirical Study

Library and Information Science (LIS) is an interdisciplinary field that integrates principles from various disciplines, including computer science and the humanites, positioning itself uniquely within STEM. This paper explores the adoption of ungrading in STEM-focused LIS courses and challenges grading paradigms to foster more inclusive and effective learning environments. Through a mixed-methods study involving thirteen graduate students, the research examines the impact of ungrading on student engagement, learning effectiveness, and perceptions of the learning environment. The research is ongoing, but preliminary findings suggest that ungrading reduces stress, shifts focus towards mastery, supports interest-driven learning, and promotes student responsibility for their own learning. The effects align with Universal Design for Learning (UDL) principles, suggesting that ungrading can enhance educational access and equity. This study contributes to the discourse on pedagogical innovation in LIS education and advocates for a shift towards assessment methods that emphasize learning and improvement over traditional grading schemes.

High-Grade Progression, Sarcomatous Transformation, and/or Metastasis of Pituitary Neuroendocrine Neoplasms (PitNENs): The UCSF Experience.

Pituitary neuroendocrine tumors (PitNET) that metastasize comprise ~ 0.2% of adenohypophyseal tumors are aggressive and are challenging to treat. However, many non-metastatic tumors are also aggressive. Herein, we review 21 specimens from 13 patients at UCSF with metastatic PitNETs (CSF or systemic, N = 7 patients), high-grade pituitary neuroendocrine neoplasms (HG-PitNEN, N = 4 patients), and/or PitNETs with sarcomatous transformation (PitNET-ST, N = 5 patients). We subtyped cases using the World Health Organization (WHO) and International Agency for Research on Cancer (IARC) criteria for neuroendocrine neoplasms (NENs). Lineage subtypes included acidophil stem cell, null cell, thyrotroph, corticotroph, lactotroph, and gonadotroph tumors. The median Ki-67 labeling index was 25% (range 5-70%). Lack of p16 was seen in 3 cases, with overexpression in 2. Strong diffuse p53 immunopositivity was present in 3 specimens from 2 patients. Loss of Rb expression was seen in 2 cases, with ATRX loss in one. Molecular analysis in 4 tumors variably revealed TERT alterations, homozygous CDKN2A deletion, aneuploidy, and mutations in PTEN, TP53, PDGFRB, and/or PIK3CA. Eight patients (62%) died of disease, 4 were alive at the last follow-up, and 1 was lost to the follow-up. All primary tumors had worrisome features, including aggressive lineage subtype, high mitotic count, and/or high Ki-67 indices. Additional evidence of high-grade progression included immunohistochemical loss of neuroendocrine, transcription factor, and/or hormone markers. We conclude that metastatic PitNET is not the only high-grade form of pituitary NEN. If further confirmed, these histopathologic and/or molecular features could provide advanced warning of biological aggressiveness and be applied towards a future grading scheme.

A Review for automated classification of knee osteoarthritis using KL grading scheme for X-rays

A Review for automated classification of knee osteoarthritis using KL grading scheme for X-rays

Describing the current landscape of pass/fail grading schemes within skills-based pharmacy curricula

IntroductionOptimal methods for grading students in skills-based courses within pharmacy education have not been fully explored. This research aimed to assess the current landscape of pass/fail grading schemes within pharmacy skills-based courses and explore faculty perceptions of pass/fail grading schemes. MethodsA 29-item, cross-sectional survey was electronically distributed to the American Association of Colleges of Pharmacy Laboratory Special Interest Group. The survey collected demographics, course grading schemes, faculty perceptions of student performance, and impact of implementing pass/fail grading schemes. Survey respondents were also invited to participate in semi-structured interviews, which were summarized due to limited participation. Descriptive statistics were used for analysis of survey data. ResultsFifty-five participants responded to the survey, representing 23 pharmacy institutions. Most respondents (82 %) used a traditional grading system for final course grades in skills-based courses. Some respondents (40 %) used specification grading for skills assessment, and 64 % of respondents used pass/fail grading to assess specific skills. Most respondents perceived that the change to pass/fail grading either improved or made no difference in faculty workload, wellbeing, general faculty creativity, quality of feedback, timeliness of grading, grade grievances, and faculty preparation time. The main concern was decreased student motivation and engagement. Semi-structured interviews identified a need for specific, validated rubrics, importance of faculty buy-in, and lack of impact on faculty workload as a result of the change. Concerns about residency placement and student motivation were also identified. ConclusionThere is variability in grading schemes used within skills-based pharmacy curricula. Faculty perceptions of pass/fail grading schemes are positive overall. Considering the limited number of institutions utilizing this grading scheme, additional research is needed.

A clinically feasible algorithm for the parallel detection of glioma-associated copy number variation markers based on shallow whole genome sequencing.

Molecular features are incorporated into the integrated diagnostic system for adult diffuse gliomas. Of these, copy number variation (CNV) markers, including both arm-level (1p/19q codeletion, +7/-10 signature) and gene-level (EGFR gene amplification, CDKN2A/B homozygous deletion) changes, have revolutionized the diagnostic paradigm by updating the subtyping and grading schemes. Shallow whole genome sequencing (sWGS) has been widely used for CNV detection due to its cost-effectiveness and versatility. However, the parallel detection of glioma-associated CNV markers using sWGS has not been optimized in a clinical setting. Herein, we established a model-based approach to classify the CNV status of glioma-associated diagnostic markers with a single test. To enhance its clinical utility, we carried out hypothesis testing model-based analysis through the estimation of copy ratio fluctuation level, which was implemented individually and independently and, thus, avoided the necessity for normal controls. Besides, the customization of required minimal tumor fraction (TF) was evaluated and recommended for each glioma-associated marker to ensure robust classification. As a result, with 1× sequencing depth and 0.05 TF, arm-level CNVs could be reliably detected with at least 99.5% sensitivity and specificity. For EGFR gene amplification and CDKN2A/B homozygous deletion, the corresponding TF limits were 0.15 and 0.45 to ensure the evaluation metrics were both higher than 97%. Furthermore, we applied the algorithm to an independent glioma cohort and observed the expected sample distribution and prognostic stratification patterns. In conclusion, we provide a clinically applicable algorithm to classify the CNV status of glioma-associated markers in parallel.

A pragmatic approach to selecting a grading system for clinical practice recommendations in palliative care.

The limited palliative care evidence base is poorly amenable to existing grading schemes utilized in guidelines. Many recommendations are based on expert consensus or clinical practice standards, which are often considered 'low-quality' evidence. Reinforcing provider hesitancy in translating recommendations to practice has implications for patient care. To rationalize the selection of an appropriate grading system for rating evidence to support recommendations made in palliative care clinical practice guidelines. Review of the methodology sections of international palliative care guidelines published in English identified five grading systems comparison: Grading of Recommendations, Assessment, Development and Evaluations (GRADE); the Scottish Intercollegiate Guidelines Network (SIGN); Infectious Diseases Society of America-European Society for Medical Oncology (IDSA-ESMO); Confidence in the Evidence from Reviews of Qualitative research (CERQual) and the National Service Framework for Long Term Conditions (NSF-LTC). There is heterogeneity among grading systems used in published palliative care or terminal symptom management guidelines. GRADE has been increasingly adopted for its methodological rigour and inter-guideline consistency with other medical associations. CERQual has the potential to support recommendations informed by qualitative evidence, but its role in clinical guidelines is less defined. The IDSA-ESMO system has an intuitive typology with the ability to categorize tiers of lower-quality evidence. It is challenging to apply commonly used grading systems to the palliative care evidence base, which often lacks robust randomized controlled trials (RCTs). Adoption of IDSA-ESMO offers a feasible and practical alternative for lower-resourced guideline developers and palliative clinicians without a prerequisite for methodological expertise.

Long-term Speckle Interferometric Monitoring of Binary Systems: 2007–2023 Positional Measurements and Orbits of Seven Objects

The results of seventeen years of speckle interferometric monitoring of seven objects (Chara 122Aa, GJ 3010, HIP 1987, GJ 3076, HIP 11253, HIP 11352, and HIP 14929) are presented. Observational data were obtained at the 6 m Big Telescope Alt-azimuthal Special Astrophysical Observatory of the Russian Academy of Science (BTA SAO RAS) from 2007 to the present. Analysis of previously published and new measurements made it possible to construct completely new orbits for Chara 122Aa, HIP 11253, and HIP 14929. The orbit of GJ 3076 cannot be constructed accurately due to the large influence of the weights assigned to the measurements. The resulting orbital solutions are classified based on a grading scheme suggested by W.I. Hartkopf, B.D. Mason and C.E. Worley; most orbits are “definitive” (Grade 1). The mass sums and masses of components calculated by two independent methods using Hipparcos and Gaia DR2 and DR3 parallaxes were compared for the objects under study.

Corneal Sensitivity and Neuropathy in Patients With Ocular Graft-Versus-Host Disease.

To assess corneal sensitivity changes in patients with ocular graft-versus-host disease using a non-contact and Cochet-Bonnet esthesiometer. In addition, we evaluate the association between corneal sensitivity and subbasal nerve changes and epitheliopathy in these patients. In this retrospective study, the clinical data and images were evaluated for 36 patients (19 female, 17 male) who fulfilled the inclusion criteria. The analyzed data included demographic and ocular surface parameters, including best-corrected visual acuity, corneal sensitivity with non-contact (mbar) and Cochet-Bonnet (cm) esthesiometer, corneal fluorescein staining (CFS) and symptoms scores, tear volume (Schirmer-I test, mm/5'), and subbasal nerve density (μm/mm2; assessed with in vivo confocal microscopy). The mean age of the study cohort was 59.9 ± 10.5 years. The mean corneal sensitivity assessed by Cochet-Bonnet and non-contact esthesiometer was 5.9 ± 0.3 cm and 7.3 ± 2.0 mbar, respectively. The ocular surface parameters included a corneal fluorescein staining (CFS) score, as per the National Eye Institute grading scheme, of 6.9 ± 3.5, and a Schirmer-I test result of 7.5 ± 6.2 mm/5 minutes.. Total corneal subbasal nerve density was inversely associated with CFS scores (r = -0.74; P < 0.001). Moreover, similar correlations between CFS scores and main trunk (r = -0.62; P < 0.001) and branch (r = -0.59; P < 0.001) nerve densities were observed. A significant correlation was found between reduced corneal sensitivity and higher CFS scores (r = 0.66; P < 0.001). Higher pressures were correlated with lower total (r = -0.83; P < 0.001), main trunk (r = -0.62; P < 0.001), and branch (r = -0.72; P < 0.001) nerve densities. The univariate analysis showed that corneal sensitivity loss (assessed with non-contact esthesiometer) was correlated with advanced age of the patients (P = 0.049) and inversely associated with total (P < 0.001), main trunk (P < 0.001), and branch (P < 0.001) nerve densities. In addition, sensitivity loss was inversely associated with punctal occlusion (cauterization (P = 0.001) or plug placement (P < 0.001). The multivariate analysis adjusted for age and punctal occlusion confirmed the associations in the univariate analysis. In this study, we observed that corneal sensitivity loss was associated with reduced main trunk, branch, and total nerve density in patients with ocular graft-versus-host disease. In addition, a significant correlation was observed between reduced corneal nerve density, corneal sensitivity, and severity of epitheliopathy.

Students’ Perceptions of Specifications Grading: Development and Evaluation of the Perceptions of Grading Schemes (PGS) Instrument

Students’ Perceptions of Specifications Grading: Development and Evaluation of the Perceptions of Grading Schemes (PGS) Instrument

Low-Stakes, Growth-Oriented Testing in Large-Enrollment General Chemistry 1: Formulation, Implementation, and Statistical Analysis.

We formulate an alternative to high-stakes examinations that is designed to help students grow, and we describe its implementation in a large-enrollment General Chemistry 1 class. In our alternative grading approach, students complete weekly assessments. Each assessment has four items that are aligned to explicit learning objectives and a level in Marzano's taxonomy, retrieval, comprehension, analysis, and knowledge utilization, which can be used by students and instructors to gauge the progression of student learning. Proficiency-based grading and multiple attempts reduce the stakes of the assessments. Unique assessments are generated through a computational infrastructure that draws question stems from an item bank and further randomizes quantities, elements, compounds, reactions, spectra, Lewis structures, orbitals, etc. in the questions. Nearly all assessment items require student-generated responses and cover a complete General Chemistry 1 curriculum. We interpret Marzano's taxonomy in the General Chemistry context and outline the structure of the learning objectives, cognitive levels, assessment schedule, and grading scheme. Item response theory (Rasch analysis) validates the theoretical framework and indicates that assessment items are high quality. Students demonstrate improvement through assessment retakes, and they report that the system motivates them to study and learn.

A magnetic resonance imaging-based lymph node regression grading scheme for nasopharyngeal carcinoma after radiotherapy.

Among patients with nasopharyngeal carcinoma (NPC), there is no established method to distinguish between patients with residual disease that may eventually progress and those who have achieved cured. We thus aimed to assess the prognostic value of magnetic resonance imaging (MRI)-based lymph node regression grade (LRG) in the risk stratification of patients with NPC following radiotherapy (RT). This study retrospectively enrolled 387 patients newly diagnosed with NPC between January 2010 and January 2013. A four-category MRI-LRG system based on the areal analysis of RT-induced fibrosis and residual tumor was established. Univariate analysis was performed using the Kaplan-Meier method, and comparisons were conducted via the log-rank test. Multivariate analyses were conducted using Cox regression models to calculate the hazard ratios (HRs) with 95% confidence intervals (CIs) and adjusted P values. Survival curves were calculated using the Kaplan-Meier method and compared using the log-rank test. The sum of MRI-LRG scores (LRG-sum) was an independent prognostic factor for progression-free survival (PFS) (HR 2.50, 95% CI: 1.28-4.90; P<0.001). LRG-sum ≤9 and >9 showed a poorer 5-year PFS rate than did LRG-sum ≤2 (66.1%, 42.9%, and 77.6%, respectively; P<0.001). A survival clustering analysis-based decision tree model showed more complex interactions among LRG-sum and pretreatment and post-RT Epstein-Barr virus (EBV) DNA, yielding four patient clusters with differentiated disease progression risks (5-year PFS rates of 89.5%, 76.4%, 57.6%, and 27.8%, respectively), which showed better risk stratification than did post-RT EBV DNA alone (P<0.001). The MRI-LRG system adds prognostic information and is a potentially reliable, noninvasive means to stratify treatment modalities for patients with NPC.

Exploring Assessment Practice in Community Schools in Nepal

The assessment that reflects the praxis of students’ hands-on learning experiences motivates students to link theoretical learning to real-life situations. The existing assessment is blamed for being poor in assessing such quality. Therefore, this paper makes an in-depth study of existing practices of assessment systems and explores student-friendly, evidence-based, and goal-oriented assessment practices that lead students from the area of their interest to the designed goals. Following narrative inquiry as a research design, information was collected, coded, schematized, and generated meaning from the participants’ meaning making of the assessment system in the schools. The study found that the students have a sort of fear and detestation of the existing high stakes testing. Similarly, the practical examination has lacked trustworthiness, validity, and consistency. Although students have experienced some assessment tools as friendly, engaged, and goal oriented, they have weak decisive roles in grading. Classroom activities should be learner-engaged, performance-based, and hands-on experience-oriented. Their participation and performance in classroom activities can lead them to transcend the designed objectives. The grading scheme should be made so transparent and precise that the students by themselves can identify where their learning level is. The paper-pencil test as an assessment tool should reflect how the learning contents, classroom activities, and overall, the programs are. The study concludes that classroom activities should be designed in such a way that students’ participation in the activities can lead them to achieve the designed goals.

Multicenter Study on Tumor Budding in Lung Squamous Cell Carcinoma: Comparison Between Biopsy and Resection With Interobserver Variability Assessment

Grading lung squamous cell carcinoma (LUSC) is controversial and not universally accepted. The histomorphologic feature of tumor budding (TB) is an established independent prognostic factor in colorectal cancer, and its importance is growing in other solid cancers, making it a candidate for inclusion in tumor grading schemes. We aimed to compare TB between preoperative biopsies and resection specimens in pulmonary squamous cell carcinoma and assess interobserver variability. A retrospective cohort of 249 consecutive patients primarily resected with LUSC in Bern (2000-2013, n = 136) and Lausanne (2005-2020, n = 113) with available preoperative biopsies was analyzed for TB and additional histomorphologic parameters, such as spread through airspaces and desmoplasia, by 2 expert pathologists (M.M., C.N.). Results were correlated with clinicopathologic parameters and survival. In resection specimens, peritumoral budding (PTB) score was low (0-4 buds/0.785 mm2) in 47.6%, intermediate (5-9 buds/0.785 mm2) in 27.4%, and high (≥10 buds/0.785 mm2) in 25% of cases (median bud count, 5; IQR, 0-26). Both the absolute number of buds and TB score were similar when comparing tumor edge and intratumoral zone (P = .192) but significantly different from the score obtained in the biopsy (P < .001). Interobserver variability was moderate, regardless of score location (Cohen kappa, 0.59). The discrepant cases were reassessed, and consensus was reached in all cases with identification of causes of discordance. TB score was significantly associated with stage (P = .002), presence of lymph node (P = .033), and distant metastases (P = .020), without significant correlation with overall survival, tumor size, or pleural invasion. Desmoplasia was significantly associated with higher PTB (P < .001). Spread through airspaces was present in 34% and associated with lower PTB (P < .001). To conclude, despite confirming TB as a reproducible factor in LUSC, we disclose areas of scoring ambiguity. Preoperative biopsy evaluation was insufficient in establishing the final TB score of the resected tumor.

Assessing cachexia in obesity: contradiction or perfectly possible?

Existing definitions of clinically important weight loss in patients with cancer do not specifically address weight loss in patients who are obese at presentation. This review explores the clinical impact of weight loss and depletion of the skeletal muscle mass (i.e., criteria defining cancer cachexia), in patients with obesity. Overweight and obese BMI values are shown by many recent studies to pose a survival advantage in patients with cancers of advanced stage, when compared with BMI in normal and underweight ranges. The classification of cancer-associated weight loss has evolved, and current grading schemes evaluate the impact of weight across the range of BMI values. Weight loss is associated with mortality in patients with BMI more than 30 kg/m 2 , however this is to a much lesser degree than in patients with lower BMI values. Diagnostic imaging permits the precise assessment of skeletal muscle index (SMI) in patients with cancer, and it has been clearly shown that while usually quite muscular, obese patients can have profound muscle depletion (i.e., sarcopenia), independent of the presence of weight loss. Muscle depletion associates strongly with mortality in obese patients, as well as with complications of cancer surgery and systemic therapy. It would seem contradictory to diagnose concurrent obesity and cachexia, as these terms represent opposite ends of the weight spectrum. Weight loss can occur in anyone with cancer, however its priority for clinical management may be lesser in obese versus low body weight individuals. Sarcopenic obesity is strongly associated with a poor clinical outcome and deserves further research, diagnosis in clinical practice, and new strategies for mitigation.

A Preliminary Study of Quantitative MRI Cartilage Loss Fraction and Its Association With Future Arthroplasty Using the Osteoarthritis Initiative Database.

Background and objective Osteoarthritis (OA) is the most common arthritis in the world. Despite the high disease burden, there is no therapy to prevent, halt, or reverse OA, and many clinical trials relied on radiographic biomarkers for therapy response. It is important to identify patients with early OA who will eventually need arthroplasty, the end-stage treatment for osteoarthritis. This pilot study evaluates a novel MRI biomarker, cartilage loss fraction, for association with future arthroplasty and evaluates its feasibility of use and effect size estimates. Materials and methods Publicly available knee MRIs from the Osteoarthritis Initiative were used. A total of 38 participants with Kellgren-Lawrence (K-L) grade >1 and 38 participants with K-L grade ≤ 1 at enrollment were matched in age, sex, race, and BMI, and assessed for the degree of full-thickness cartilage loss, or cartilage loss fraction. Univariate conditional logistic regression analysis was performed for differences in cartilage loss fractions between groups. Receiver operating characteristic (ROC) curve analysis was performed to assess the association of MRI biomarkers and knee arthroplasty during the eight-year follow-up. Results The medial femoral condyle, medial tibial plateau, total, and two-year progression cartilage loss fractions were significantly higher in participants with K-L grade >1 (p < 0.01 for all) and showed high area under the curve (AUC) values on ROC analysis (812, 0.827, 0.917, and 0.933, respectively).These results were comparable or more strongly associated with other OA grading schemes. Conclusion MRI biomarker cartilage loss fractions are significantly higher in subjects with K-L grade >1 and show a strong association with arthroplasty.After further validation, cartilage loss fracture may be used to predict future arthroplasty.

Relationships between European carcass evaluation and Meat Standards Australia grading scheme applied to young beef cattle

The European carcass grading scheme (EUROP) places large emphasis on meat yield and therefore on quantitative traits such as carcass conformation and superficial fat coverage. However, it falls short in considering sensory properties and consumer satisfaction. In contrast, the Meat Standards Australia (MSA) grading scheme considers, among others, animals' ossification, marbling, and ultimate pH as primary indicators of beef eating quality. This study aims to characterize MSA carcass grading scheme applied to the Italian beef production system, considering its significant role in European beef market. The study involved 3204 Charolais, Limousin, and crossbred young bulls and heifers slaughtered in a commercial Italian abattoir. Data collection spanned a broad range of variables, including animal characteristics, MSA traits, and EUROP carcass grading traits. Regardless of the sex of the animal, no significant relationship was observed between MSA traits and EUROP carcass grading scores. Factors such as sex, age, and arrival season at the fattening unit significantly affected most of MSA traits. Females had significantly higher marbling score, and lower ossification score and hump height than males. Animals imported in autumn and winter had significantly lower marbling score, but similar ossification score compared to those imported in spring and summer. Older females had the highest marbling scores. While further research is needed to assess whether the MSA grading scheme can be adapted to all different European rearing systems, results of this study are a prelude to the potential benefits that the MSA grading scheme can bring to the European beef industry.