High Level Of Confidence Research Articles

Exposure and Sensitivity of Terrestrial Vertebrates to Biological Invasions Worldwide.

While biological invasions continue to threaten biodiversity, most of current assessments focus on the sole exposure to invasive alien species (IAS), without considering native species' response to the threat. Here, we address this gap by assessing vertebrates' vulnerability to biological invasions, combining measures of both (i) exposure to 304 identified IAS and (ii) realized sensitivity of 1600 native vertebrates to this threat. We used the IUCN Red List of Threatened Species to identify species threatened by IAS, their distribution, and the species' range characteristics of their associated IAS. We found that 38% of worldwide terrestrial lands are exposed to biological invasions, but exposure alone was insufficient to assess vulnerability since we further found that most of the world hosted native species sensitive to biological invasions. We delineated areas highly vulnerable to biological invasions, that is, combining areas of high exposure and high sensitivity to IAS, located in Australia and coastal states of North America with a high confidence level, but also-depending on the group-in Pacific islands, Southern America, Western Europe, Southern Africa, Eastern Asia, and New-Zealand with a medium confidence level. Assessing the completeness in exposure data, we revealed strong biases in the global description of the well-known invasion hotspots, with limited areas being assessed with a medium to high confidence level. The completeness of sensitivity was overall very high, for the three studied taxonomic groups. We also demonstrated that coldspots of vulnerability to biological invasions were areas of low confidence in terms of data completeness, which coincided with biodiversity hotspots. There is thus a critical need to address these knowledge shortfalls which jeopardize efficient conservation initiatives, regarding the threats to well-known vertebrate taxa.

Contrast-enhanced pseudo-CT of finger joints: Improved diagnostic confidence for detection of inflammatory erosions

PurposeTo evaluate the interest of additional pseudo-CT images to standard clinical contrast-enhanced MR images (CE-MRI) in the detection of inflammatory erosions and to differentiate them from intraosseous ganglia at the finger joints. Method47 prospectively included patients with suspected or diagnosed rheumatoid arthritis received a CE-MRI of the fingers. Additionally, pseudo-CT images were derived from non-contrast MRI (pCT) and from contrast-enhanced MRI data (CE-pCT) using a high-resolution gradient-echo 3D fast low-angle shot sequence (FLASH), respectively. CE-MRI, pCT, and CE-pCT images were evaluated for erosions and intraosseous ganglia at the metacarpophalangeal and proximal interphalangeal joints by two musculoskeletal radiologists. Findings were defined on CE-MRI by an experienced independent 3rd reader which served as reference standard. Diagnostic confidence (1 = worst,4 = best) was rated for 3 different image sets (1 = CE-MRI,2 = CE-MRI + pCT,3 = CE-MRI + CE-pCT) and compared. ResultsReference standard revealed 44 erosions and 37 intraosseous ganglia on CE-MRI. Diagnostic confidence for CE-MRI was moderate for erosions (both readers) and intraosseous ganglia (reader 2). For the combination of CE-MRI and pCT, high confidence levels were observed for erosions for both readers (median 3 (Q1–Q3: 2–3) and 3 (3–3);p<.001 and p<.001) and for intraosseous ganglia for reader 2 (3 (3–3); p<.001). CE-MRI combined with CE-pCT showed very high confidence levels for both readers for erosions (4 (3–4) and 4 (4–4);p<.001 and p<.001) and for intraosseous ganglia (4 (3.5–4) and 4 (4–4);p<.001 and p<.001). ConclusionsPseudo-CT combined with CE-MRI increases the confidence in detection of inflammatory erosions at the finger joints, with CE-pCT being superior to pCT.

Enhancing interpretability in random forest: Leveraging inTrees for association rule extraction insights

The random forest model is a powerful supervised learner, recognized for its ability to learn the pattern within data with superior predictive accuracy. However, it is a black box model because it lacks interpretability. This study addressed the interpretable challenge by employing the inTree framework. The rules were extracted from each decision tree in a random forest model, and the association rules were determined through measured matrix support and confidence to reveal the frequent variable interactions for predicting unemployment. This approach provided insight into the relationships between specific variables and unemployment outcomes. The developed method used data set from the integrated labor force survey (ILFS) 2020/2021 in Zanzibar. Zanzibar’s unemployment rate consistently increased across surveys conducted in 2006, 2014, and 2020/2021. Results have shown that the rules that most predict unemployment for individuals are female and lack of health insurance and secondary education level, female and youth age group and lack of health insurance and secondary education level with a high confidence level. This study provides practical insights for Zanzibar’s government to develop effective interventions, programs, and policies. Improving the interpretability of the random forest model enhances decision-making to address unemployment challenges.

Persepsi Mahasiswa Teknologi Rekayasa Konstruksi Bangunan Air dalam Penggunaan Teknologi Finansial

Quantitative research with a descriptive approach was conducted to determine students' perceptions of the Water Construction Engineering Technology study program at Samarinda State Polytechnic in using Financial Technology services in this modern digital era. In this study, the researcher used purposive sampling: all Water Construction Engineering Technology Study Program students in semesters 1, 3, and 5. The research data was obtained by filling out a Google Forms questionnaire online and distributing it through the Line application. The three main aspects of the questionnaire that were distributed included the elements of Usefulness, Ease, and Trust. For the aspect of the usefulness of using financial technology, the highest positive attitude was 3.79, followed by the element of ease of use of financial technology with a positive attitude score of 3.56, and the lowest score for a positive attitude of 3.51 was given by respondents to the trust in using financial technology. Overall, the respondents had a positive attitude towards the financial technology they were currently using. The millennial generation on campus already understands financial technology as a digital financial transaction tool. It is well aware of its benefits, demonstrating a high level of knowledge and confidence in their understanding.

Mapping Seagrass Distribution and Abundance: Comparing Areal Cover and Biomass Estimates Between Space-Based and Airborne Imagery

This study evaluated the effectiveness of Planet satellite imagery in mapping seagrass coverage in Santa Rosa Sound, Florida. We compared very-high-resolution aerial imagery (0.3 m) collected in September 2022 with high-resolution Planet imagery (~3 m) captured during the same period. Using supervised classification techniques, we accurately identified expansive, continuous seagrass meadows in the satellite images, successfully classifying 95.5% of the 11.18 km2 of seagrass area delineated manually from the aerial imagery. Our analysis utilized an occurrence frequency (OF) product, which was generated by processing ten clear-sky images collected between 8 and 25 September 2022 to determine the frequency with which each pixel was classified as seagrass. Seagrass patches encompassing at least nine pixels (~200 m2) were almost always detected by our classification algorithm. Using an OF threshold equal to or greater than &gt;60% provided a high level of confidence in seagrass presence while effectively reducing the impact of small misclassifications, often of individual pixels, that appeared sporadically in individual images. The image-to-image uncertainty in seagrass retrieval from the satellite images was 0.1 km2 or 2.3%, reflecting the robustness of our classification method and allowing confidence in the accuracy of the seagrass area estimate. The satellite-retrieved leaf area index (LAI) was consistent with previous in situ measurements, leading to the estimate that 2700 tons of carbon per year are produced by the Santa Rosa Sound seagrass ecosystem, equivalent to a drawdown of approximately 10,070 tons of CO2. This satellite-based approach offers a cost-effective, semi-automated, and scalable method of assessing the distribution and abundance of submerged aquatic vegetation that provides numerous ecosystem services.

Massive open online course: a new strategy for faculty development needs in healthcare simulation

Faculty development in medical simulation is a growing need, given the increased use of simulation-based learning in healthcare. Training of trainers is demanding and resource-consuming; therefore, there is a need for accessible, practical, and resource-saving solutions enabling efficient faculty development. For that purpose, we investigated whether a massive open online course (MOOC) could meet these challenges. This manuscript presents a MOOC, its pedagogical strategies, and its impacts on faculty development. The University of Liège Medical Simulation Center developed a MOOC with five learning units focused on the foundations of simulation training. Each unit ends with a set of theoretical and practical exercises. Our results showed knowledge and skills acquisition (objective exercise score data) among participants with a success rate of 67%, as well as high levels of engagement and confidence in learning (self-reported data). We demonstrate that a MOOC for faculty development in healthcare simulation is effective, has the potential to be an accessibility enabler, and offers an additional tool for trainer training. We recommend designing it with various asynchronous online modalities and multiplying social interactions with peers and trainers to favor trainees’ engagement and subsequent learning. Further perspectives should study blended learning strategies in faculty development and define the optimum ratio between face to face and online synchronous and asynchronous modalities.Graphical Characteristics and advantages of MOOCs as an asynchronous online teaching tool for faculty development in healthcare simulation.

Navigating Complexity: GPT-4's Performance in Predicting Earnings and Stock Returns in China's A-Share Market

This study investigates the application of GPT-4, a large language model, in predicting earnings changes and stock returns within China's A-share market from 2000 to 2023. We evaluate the model's performance using various metrics, including prediction accuracy, F1 score, stock returns, Sharpe ratio, and alpha. Our findings reveal significant fluctuations in the model's predictive accuracy, ranging from 10.62% to 48.67%, with an average F1 score of 0.30. Despite inconsistent accuracy, the model maintained high prediction confidence levels between 75% and 90%. Stock returns associated with the model's predictions varied widely, from -4.86% to 13.59%, showing no consistent correlation with prediction accuracy. The study highlights the challenges of applying AI models to financial analysis in emerging markets, particularly given the unique characteristics of China's A-share market, such as frequent policy interventions and a high proportion of retail investors. We discuss the implications of these findings for the future of AI-driven financial analysis, emphasizing the need for improved model calibration, ethical considerations, and regulatory frameworks.

Influencing perception of COVID-19 illness and vaccines using an educational intervention tool in a lower-middle-income country

The case-control study was planned to determine if an educational intervention tool could reduce coronavirus disease-2019 vaccine hesitance and resistance in people visiting a tertiary care hospital in a developing country. Participants were randomly enrolled into intervention group A and control group B from July to December 2021. Participants in group A reviewed an educational intervention tool prior to completing a questionnaire, while participants in group B did not. Responses from 440 participants were included in the final analysis. The use of the educational intervention tool significantly lowered beliefs in conspiracy theories and the impression that coronavirus disease-2019 was a simple flu that did not lead to any serious illness. It also resulted in higher levels of confidence in the effectiveness of the coronavirus disease-2019 vaccines available in the country. Of the 440 subjects, 228(51.8%) were in group A and 212(48.2%) in group B. Before reading the educational intervention, .........Cont.

Comparing Confidence in Institutions among Latino and White Catholics and Evangelicals: Exploring Religious Differences

ABSTRACT Recent surveys reveal declines in the U.S. public’s confidence in various institutions. Although some studies link these declines to religious factors, few disaggregate these patterns across racial and ethnic groups. Here, we focus on Latinos—a growing segment of the U.S. population and an increasingly religiously diverse part of the electorate. Using original, nationally representative survey data (N=4,321), we compare Latino evangelicals and Catholics to their white counterparts in their confidence in five institutions (religious organizations, higher education, the scientific community, Congress, and the press). We find that Latino and white Catholics consistently show high levels of confidence across institutions relative to white evangelicals. Our findings suggest that there may be more similarities in institutional confidence among those of different racial and ethnic groups who share a similar religious tradition than those who are of the same race or ethnicity but share different religious traditions. Patterns observed highlight the importance of examining institutional confidence through an intersectional lens that considers religious diversity within and across racial and ethnic groups.

Water CO2 Emission Monitoring in a Romanian Peri-Urban Wetland to Enhance GHG Reporting

This study emphasises the complexity of carbon dioxide (CO2) emission dynamics by conducting a wetland case study along the Dambovita River. Our evaluation highlights the importance of considering spatial variability, meteorological parameters and water quality parameters. The variations in CO2 emissions have been monitored using two complementary methods: a closed static chamber and a closed dynamic chamber. The closed dynamic chamber method has the highest level of confidence. The statistical results of correlations facilitated the validation of the closed static chamber method and its independent use in wetland ecosystems. Also, our findings revealed distinct patterns in emissions across locations that are influenced by parameters such as pH, redox potential (ORP), chlorophyll, dissolved oxygen concentration (DO), and temperature for the water–atmosphere interface. These results contribute to the understanding of the carbon cycle in wetlands and contribute to the improvement of greenhouse gas (GHG) reporting by obtaining data with a high level of confidence, regarding the role of wetland ecosystems in the carbon cycle.

Revisiting the Efficacy and Safety of Bivalirudin in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention: Insights From a Mixed Treatment Comparison Meta-Analysis of Randomized Trials.

Randomized trials of bivalirudin in patients with ST elevation myocardial infarction (STEMI) have yielded heterogeneous results. Our aim was to evaluate the efficacy and safety of four antithrombin regimens-unfractionated heparin (UFH), bivalirudin (stopped soon after percutaneous coronary intervention [PCI]), extended bivalirudin (continued for a few hours after PCI), and combined UFH and a Gp2b3a inhibitors (GPI) in patients who present with STEMI. A PubMed, EMBASE, and clinicaltrials.gov databases were searched for randomized clinical trials (RCTs) of the above antithrombin in patients with STEMI. The primary outcome was net adverse cardiovascular events (NACE). The primary ischemic endpoint was major adverse cardiovascular events (MACE), and the primary safety endpoint was major bleeding, and other endpoints included all-cause mortality and stent thrombosis. The primary analysis compared the effect of these antithrombin regimens in reference to UFH using a mixed treatment comparison meta-analysis. In the 14 RCTs evaluating 25,415 patients with STEMI, when compared to UFH monotherapy, extended bivalirudin lowered NACE (OR = 0.71 with 95% CI: 0.53-0.96; moderate level of confidence) driven by a significant decrease in major bleeding (OR = 0.42 with 95% CI: 0.26-0.68; high level of confidence) without any significant difference in MACE or all-cause mortality. When compared with UFH monotherapy, UFH+GPI reduced risk of MACE (OR = 0.76 with 95% CI: 0.60-0.97; high level of confidence) but at the expense of an increase in major bleeding (OR = 1.48 with 95% CI: 1.11-1.98; high level of confidence) with no difference in NACE or all-cause mortality. For major bleeding, extended bivalirudin infusion ranked #1, bivalirudin ranked #2, UFH monotherapy ranked #3, and combined UFH and GPI ranked #4. For NACE, extended bivalirudin infusion ranked #1, bivalirudin ranked #2, combined UFH and GPI ranked #3, and UFH monotherapy ranked #4. Cluster plots for MACE and major bleeding demonstrated that extended bivalirudin had the best balance for efficacy and safety. In patients undergoing PCI for STEMI, extended bivalirudin offers the best balance for primary ischemic (MACE) and safety (major bleeding) outcomes.

Students’ Self-Confidence in Their English-Speaking Fluency: A Case Study at SMP Islam Terpadu Generasi Muslim Cendikia

This research aims to determine how students' self-confidence is seen from their fluency in speaking English, types of self-confidence in students seen from their self-confidence, and also the strategies used by teachers to increase students' self-confidence at SMP Islam Terpadu Generasi Muslim Cendikia. This research uses a qualitative descriptive method. Data were collected using observation techniques, speaking tests, questionnaires, and interviews. The subjects were 24 female students of class VIII/C at SMP Islam Terpadu Generasi Muslim Cendikia. The observations were indirect observations, where the researcher was not directly involved in the activities. A speaking rubric was used to measure the level of fluency in speaking English, and student self-confidence was determined based on self-confidence indicators during student speaking. For the questionnaire, a Likert scale is used and finally, the researcher conducted interviews were conduct is used with related teachers to determine strategies to increase student self-confidence. Based on the results of the analysis the results of the speaking test and survey questionnaire showed that students who have a high level of confidence also have high scores, and vice versa. There are 5 kinds of self-confidence in students, namely confidence in speaking in formal situations, confidence in speaking in class discussions, confidence in speaking with peers, confidence in speaking in everyday situations, and confidence in speaking in academic contexts, it is also found that there are 8 strategies that teachers can use to increase students' self-confidence.

Pengaruh Overconfidence Dimoderasi Gender terhadap Keputusan Investasi pada Generasi Milenial di Karawang

This research aims to examine the influence of overconfidence on investment decisions of the millennial generation in Karawang and evaluate whether gender variables can moderate this relationship. This research uses a survey research design. There is an independent variable, namely overconfidence and a dependent variable (dependent) investment decisions. This research focuses on the millennial generation population in Karawang, which numbers around 1,029,290 people. Meanwhile, the sample used was the millennial generation in Karawang who were active in investment activities, totaling 268 respondents. In this research, verification analysis uses Simple Linear Regression Analysis to test whether or not there is an influence of overconfidence on investment decisions. The next test to see whether the influence of the moderating variable (gender) can strengthen or weaken the overconfidence variable on investment decisions, the Moderated Regression Analysis (MRA) test is used. The research the results show that overconfidence has an influence on the investment decisions of the millennial generation. This generation tends to make investment decisions with a high level of self-confidence, which can lead to investment risks. However, gender is not able to moderate the relationship between overconfidence and investment decisions, meaning that both men and women show the same pattern regarding the influence of overconfidence on their investment decisions. Based on these findings, it is recommended to improve financial education to help the millennial generation make more rational and wise investment decisions.

The Influence of Self Cofidence in Public Speaking

This journal article discusses the influence of self-confidence on public speaking skills in adolescents. This article finds interesting facts that social interaction with the environment and even includes support from peers, family, and teachers, plays an important role of one's self in shaping and increasing one's self-confidence. From the results of the interviews and questionnaires that we distributed, it can be concluded that for someone to improve their public speaking skills, efforts are also needed to strengthen and increase their confidence through positive social interaction and also support from the surrounding environment. From this article, it is hoped that it can contribute even to the development of educational strategies as well as effective interventions to improve public speaking skills in everyone. The research methods used include interviews and questionnaire distribution. The questionnaire was distributed to collect quantitative data on the level of confidence and its influence on public speaking skills. The results of our study show that self-confidence has a significant role in determining a person's success in public speaking. A person with a high level of confidence tends to be better able to overcome fear and anxiety, and is more effective in conveying their message to the audience. The hope of the discussion in this article is that we can all learn and even understand that there are causes and effects experienced by others that are certainly different from what we experience. So that we can also learn to see someone's reasoning from another point of view.

Is confidence in knowledge related to childbirth fear and mode of birth among Polish women?

Abstract Background In Poland, cesarean section (CS) rate is 48% what means that it is one of the highest rate among OECD countries and the highest in the European Union. WHO has considered that CS rates higher than 15% at the population level are not associated with reductions in maternal and newborn mortality rates. Fear and attitudes towards childbirth are shaped years before the first pregnancy. Yet, little is understood about how young people’s knowledge, attitudes and fears concerning the birth process shape their healthcare preferences around birth. Thus, the aim of the study was to examine whether confidence in knowledge was associated with childbirth fear prior to pregnancy and preference for CS. Methods We recruited 782 women aged 18 - 35 (mean 24.7, sd = 3.19) who had never been pregnant but wished to have at least one child in the future. The women answered questions about: (i) socio-economic situation, (ii) confidence in knowledge and educational needs related to pregnancy and childbirth; (iii) fear of childbirth prior to pregnancy; (iv) preferred mode of birth in the hypothetical pregnancy in which there are no medical indications for cesarean section. Results Almost one in four women (22.1%) preferred CS in a hypothetical low-risk pregnancy. In addition, most often young women gained knowledge on pregnancy and birth from experiences and stories of family members (62.3%). Women with moderate and high level of confidence in knowledge had respectively lower odds of high level of childbirth fear prior to pregnancy comparing to women with low level of confidence in knowledge (OR = 0.57, 95% CI: 0.39-0.83 and OR = 0.54, 95% CI: 0.33-0.88, respectively). Conclusions Increasing knowledge about pregnancy and childbirth among young women might lower childbirth fear and thus, indirectly, lower rates of CS in the future. Key messages • The results of this study may solve very important public health problem i.e. the growing rates of cesarean section. • Confidence in knowledge may be an important factor associated with the level of childbirth fear.

Proteome-wide associations of pulse pressure in the UK Biobank

Abstract Introduction Large artery stiffness (LAS) significantly contributes to the burden of cardiovascular morbidity and mortality, and is marked by an increased pulse pressure (PP)(1). Therapeutically targeting LAS may help in mitigating cardiovascular disease and other comorbidities. Purpose We aimed to investigate the proteomic associations of PP, and their putative causal role using Mendelian randomization (MR). Methods We first investigated associations between baseline circulating protein levels for 2,941 protein analytes measured using Olink technology, and PP in the UK Biobank (N=54,219). Regression analyses were adjusted for age, sex, mean arterial pressure, body mass index and stroke volume. Next, we conducted two-sample MR analyses to evaluate associations between genetically-predicted plasma protein levels and PP, for 1,820 proteins with available genetic instruments. We conducted inverse-variance weighted MR as our main analysis, and genetic colocalization analyses as sensitivity. We used a 5% false discovery rate (FDR) threshold to account for multiple comparisons. Results After correction for multiple comparisons, measured levels of 61 out of 2,923 proteins were significantly associated with PP (Figure 1). Genetically-predicted levels for 58 proteins were significantly associated with PP after FDR correction (Figure 2). At nominal significance, 31 proteins were concordantly associated with PP in both analyses, and 19 had consistent directions of effect, including natriuretic peptide B (NPPB, βobservational=0.04, Standard Error (SE)=0.009, PFDR&amp;lt;0.001), thrombospondin-2 (THBS2, βobservational=0.05, SE=0.009, PFDR&amp;lt;0.001), paraoxonase-2 (PON2, βobservational=-0.03, SE=0.008, PFDR&amp;lt;0.001), and sclerostin (SOST, βobservational=-0.03, SE=0.009, PFDR&amp;lt;0.001). NPPB was concordant in direction of effect and met an FDR-corrected significance threshold. Conclusions Our study identifies multiple novel proteins with a putative causal effect on PP. Our findings identify NPPB with a high level of statistical confidence, which could have important implications given the current availability of FDA-approved medications to boost NPPB effects. Our findings will lead to further investigations regarding the biology and clinical role of the identified candidate therapeutic targets.

Genomic characterization of Pantoea dispersa A003 isolated from a clinical patient

IntroductionPantoea dispersa is a Gram-negative bacterium generally considered as a plant pathogen and rarely causes human infections. To date, there have been 13 studies that have documented clinical infections linked to P. dispersa, with a primary emphasis on the initial identification of this pathogen. The genomic features and the mechanisms underlying the pathogenesis of P. dispersa remain largely uninvestigated. In the present study, we describe a clinical infection caused by P. dispersa and provide the first genomic analysis of this bacterium.MethodsThe bacterial strain designated A003 was isolated from blood samples. Preliminary identification of strain A003 was conducted using matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) technology (VITEK® MS, bioMérieux, France). Biochemical and antimicrobial susceptibility assessments were carried out utilizing the VITEK-2 compact automated microbial analysis system (bioMérieux, France). Additionally, whole genome sequencing and subsequent analysis were performed to further elucidate the potential pathogenicity.ResultsThe bacterial isolate was cultured overnight at 35°C in a CO2-enriched environment on Columbia blood agar, resulting in the appearance of a white, smooth, Gram-negative rod-shaped bacterium with diameters ranging from 1 to 2 mm. Identification of strain A003 was achieved with a high confidence level of 99.9% as P. dispersa using MALDI-TOF mass spectrometry. The average nucleotide identity (ANI) value between strain A003 and the reference strain P. dispersa DSM 30073T was 98.08%, while the DNA–DNA hybridization (DDH) value was 84.10% (Formula 2) based on genome sequencing data, which further confirmed that A003 belonged to the P. dispersa species. Comprehensive analysis revealed the presence of 372 virulence factors, 15 antibiotic resistance genes, 222 carbohydrate-active enzymes, and 666 genes related to Type III secretion system (T3SS) effector proteins, as identified through the core databases of VFDB (Virulence Factors of Pathogenic Bacteria), CARD (Comprehensive Antibiotic Resistance Database), CAZY (Carbohydrate-Active enZYmes Database), and T3SS. The virulence factors included type IV pili (TFP), type VI secretion system, flagella, iron uptake system, and ompA, which are implicated in bacterial pathogenicity. The antibiotic resistance profile indicated resistance to fluoroquinolones, cephalosporins, penams, macrolides, and aminoglycosides, as annotated by the CARD database.ConclusionThe draft genome sequenced represents the inaugural genomic sequence of P. dispersa derived from clinical sources. This advancement may enhance clinical practitioners’ comprehension of the organism’s clinical attributes and serve as a foundational resource for future research into its virulence, antibiotic resistance, and host–pathogen interactions.

Dynamic Retrieval Augmented Generation of Ontologies using Artificial Intelligence (DRAGON-AI)

BackgroundOntologies are fundamental components of informatics infrastructure in domains such as biomedical, environmental, and food sciences, representing consensus knowledge in an accurate and computable form. However, their construction and maintenance demand substantial resources and necessitate substantial collaboration between domain experts, curators, and ontology experts.We present Dynamic Retrieval Augmented Generation of Ontologies using AI (DRAGON-AI), an ontology generation method employing Large Language Models (LLMs) and Retrieval Augmented Generation (RAG). DRAGON-AI can generate textual and logical ontology components, drawing from existing knowledge in multiple ontologies and unstructured text sources.ResultsWe assessed performance of DRAGON-AI on de novo term construction across ten diverse ontologies, making use of extensive manual evaluation of results. Our method has high precision for relationship generation, but has slightly lower precision than from logic-based reasoning. Our method is also able to generate definitions deemed acceptable by expert evaluators, but these scored worse than human-authored definitions. Notably, evaluators with the highest level of confidence in a domain were better able to discern flaws in AI-generated definitions. We also demonstrated the ability of DRAGON-AI to incorporate natural language instructions in the form of GitHub issues.ConclusionsThese findings suggest DRAGON-AI's potential to substantially aid the manual ontology construction process. However, our results also underscore the importance of having expert curators and ontology editors drive the ontology generation process.

Impact of a PD-L1 Learning Collaborative: outcomes from a mixed-methods evaluation

Abstract Introduction/Objective PD-L1 Immunohistochemistry testing is often required to determine eligibility for immune checkpoint inhibitor therapy. An ASCP PD-L1 Learning Collaborative (LC) was formed aiming to: 1) identify ways to streamline PD-L1 testing; 2) encourage members to locally implement changes; and 3) develop a resource guide for the community. Methods/Case Report The PD-L1 LC (n=38 pathologists and laboratory professionals) participated in 3 activities: 1) 4 meetings in which LC members discussed current literature and practice; 2) 3 30-minute on-demand, credit-bearing panel videos, in which selected LC members summarized the LC outputs and shared their experiences; and 3) a guide summarizing resources relevant to streamlining PD-L1 testing. The mixed-methods evaluation included: 1) five- minute surveys before (n=24), immediately after (n=11) and 7-months post-LC (n=17); 2) polling questions (2-4 per meeting); 3) semi-structured interviews (n=5). Quantitative data was analysed using descriptive and inferential analysis, qualitative data using a thematic analysis / inductive reasoning approach. Results (if a Case Study enter NA) Baseline data confirmed delays in testing caused by unstandardized PD-L1 testing processes and suboptimal confidence in PD-L1 validation and methodologies. Post-LC, members self-reported perceived increased knowledge and higher confidence levels regarding discussion of PD-L1 scientific evidence and best practices. At the 7-month follow-up, 59% of respondents reported at least one PD-L1-related practice change, with 29% of participants selecting:1) Improving protocols for specimen acquisition, handling, or processing; 2) Improving communication with multidisciplinary care team; 3) Optimizing biomarker testing workflows. Remaining suboptimal knowledge post-LC suggests need for further educational efforts. Participants identified “Tumor-specific considerations” as the main resource missing for PD-L1 testing. Conclusion A learning collaborative has shown impact in improving PD-L1 testing processes and related practices among a group of pathology professionals. The group successfully made available three panel videos and a resource guide, and PD-L1-related practice changes were reported. Future initiatives should address remaining gaps and develop tumor-specific PD-L1 testing considerations.

An International Survey of the Diagnosis and Management of Ménière's Disease Amongst Otolaryngology Consultants.

Ménière's Disease (MD) is a disease that may be difficult to diagnose and manage. Our UK survey showed variability in the practice of UK Otolaryngology consultants. We hence surveyed Otolaryngology consultants internationally, to assess their confidence levels in diagnosing MD, their use of the AAO-HNS guidelines and current diagnostic and treatment modalities. An online questionnaire was distributed internationally over four weeks. The questionnaire asked respondents to anonymously rank their confidence in diagnosing MD, identify the minimum investigations required to make a diagnosis, describe their use of the AAO-HNS criteria, share their preferred treatment modalities for acute attacks, and state their 1st and 2nd-line preventative treatment options. A total of 173 responses were collected with 77% of respondents reporting high levels of confidence in diagnosing MD. Most respondents stated the minimum tests required were "History, Otoscopy, Clinical Vestibular testing, and Pure Tone Audiometry" although some chose as few as 1 test. Regarding the use of the AAO-HNS criteria, responses ranged from "always" (20.2%) to "never" (22.5%). Cinnarizine was the first-line treatment for acute attacks followed by betahistine. Betahistine (30.1%) and dietary restrictions (28.3%) were recommended almost equally as first-line preventative measures. The most popular second-line measure was intratympanic steroids injection (30.1%). Our survey revealed disparities in the diagnosis of MD and its management, like the results of our previously conducted UK survey. This suggests the need for an international consensus regarding the diagnosis and subsequent management strategies for this disease.