Independent Criterion Research Articles

MS2Lipid: A Lipid Subclass Prediction Program Using Machine Learning and Curated Tandem Mass Spectral Data

Background: Untargeted lipidomics using collision-induced dissociation-based tandem mass spectrometry (CID-MS/MS) is essential for biological and clinical applications. However, annotation confidence still relies on manual curation by analytical chemists, despite the development of various software tools for automatic spectral processing based on rule-based fragment annotations. Methods: In this study, we present a novel machine learning model, MS2Lipid, for the prediction of known lipid subclasses from MS/MS queries, providing an orthogonal approach to existing lipidomics software programs in determining the lipid subclass of ion features. We designed a new descriptor, MCH (mode of carbon and hydrogen), to increase the specificity of lipid subclass prediction in nominal mass resolution MS data. Results: The model, trained with 6760 and 6862 manually curated MS/MS spectra for the positive and negative ion modes, respectively, classified queries into one or several of 97 lipid subclasses, achieving an accuracy of 97.4% in the test set. The program was further validated using various datasets from different instruments and curators, with the average accuracy exceeding 87.2%. Using an integrated approach with molecular spectral networking, we demonstrated the utility of MS2Lipid by annotating microbiota-derived esterified bile acids, whose abundance was significantly increased in fecal samples of obese patients in a human cohort study. This suggests that the machine learning model provides an independent criterion for lipid subclass classification, enhancing the annotation of lipid metabolites within known lipid classes. Conclusions: MS2Lipid is a highly accurate machine learning model that enhances lipid subclass annotation from MS/MS data and provides an independent criterion.

Automatic Design of Robot Swarms under Concurrent Design Criteria: A Study Based on Iterated F‐Race

Automatic design is an appealing approach to realizing robot swarms. In this approach, a designer specifies a mission that the swarm must perform, and an optimization algorithm searches for the control software that enables the robots to perform the given mission. Traditionally, research in automatic design has focused on missions specified by a single design criterion, adopting methods based on single‐objective optimization algorithms. In this study, we investigate whether existing methods can be adapted to address missions specified by concurrent design criteria. We focus on the bi‐criteria case. We conduct experiments with a swarm of e‐puck robots that must perform sequences of two missions: each mission in the sequence is an independent design criterion that the automatic method must handle during the optimization process. We consider modular and neuroevolutionary methods that aggregate concurrent criteria via the weighted sum, hypervolume, or ‐norm. We compare their performance with that of Mandarina, an original automatic modular design method. Mandarina integrates Iterated F‐race as an optimization algorithm to conduct the design process without aggregating the design criteria. Results from realistic simulations and demonstrations with physical robots show that the best results are obtained with modular methods and when the design criteria are not aggregated.

7956 Assessing Factors Influencing Polycystic Ovarian Syndrome Using Hybrid Multi-Criteria Decision Analysis

Abstract Disclosure: N.B. Trivedi: None. J. Amin: None. M. Patel: None. S. Patel: None. P. Rana: None. A. Rajani: None. V. Dave: None. Polycystic Ovarian Syndrome (PCOS) is a complex hormonal disorder having multifactorial origins. This study aims to apply Multi-Criteria Decision Analysis (MCDA) methods like Decision Making Trial and Evaluation Laboratory (DEMATEL) and Analytical Hierarchy Process (AHP) to prioritize factors influencing PCOS. In our study, 10 criteria impacting PCOS were identified through extensive literature review. AHP and DEMATEL were used via matrices, assessed by 13 experts. AHP determined relative importance/weights while DEMATEL assessed interconnectedness among criteria. AHP revealed that family history held the highest weight (0.22) while Insulin resistance held the lowest weight at 0.04. The results obtained from DEMATEL indicated that factors like obesity, insulin resistance, diet, psychological stress and sedentary lifestyle displayed higher D+R values, suggesting a strong influence on other factors; indicating their significant impact on the syndrome. The division of criteria into cause and effect groups based on D-R values revealed that family history, environmental factors, diet, sedentary lifestyle and psychological stress appear to be causative and sleep disturbances, low-grade inflammation, excess androgen and insulin resistance seem to be the consequences of PCOS. In AHP the criteria are treated as being independent to each other and their hierarchal order is determined. However, in realistic scenarios factors may have some sort of interdependency/relationship with one another. To identify that interdependency which AHP fails to focus on, DEMATEL was used. DEMATEL ensues that Insulin resistance along with obesity, sedentary lifestyle, and psychological stress show strong level of influence and interconnectedness, indicating a significant impact on the syndrome. However, insulin resistance, when treated as an independent criterion in AHP, displays lower weightage. In the end, improved PCOD treatment would come from targeted interventions and strategies that centre on the variables with a higher D+R value. When the criteria were considered independent of each other in AHP, highest weight is conferred to family history (despite of it having moderately low level of influence/interconnectedness on other criteria as ensued from DEMATEL) thus prompting more research in the direction of investigating genetic and familial factors associated with PCOS. This could consequently lead to early diagnosis and effective long term management. The combined methodology (DEMATEL+AHP) ensures comprehensive assessment of PCOS factors. Previous studies might have focused on individual factors separately or failed to adequately explore their interrelationships and relative importance. MCDA can be further employed in healthcare to assess conflicting treatment modalities, risk factors etc. for other multifactorial disorders. Presentation: 6/2/2024

Analyzing the relationship between processing speed impairment and Rey-15 item test performance

ABSTRACT Objective This study investigated the relationship between processing speed impairment severity and performance on the Rey 15-Item Test (RFIT) and RFIT + Recognition. Method Cross-sectional data from 285 examinees (228 valid/57 invalid) referred for neuropsychological assessment who were administered the RFIT, Weschler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Processing Speed Index (PSI), Brief Visuospatial Memory Test – Revised, Rey Auditory Verbal Learning Test, and three independent criterion PVTs were included. PSI bands were operationalized as Intact (≥85SS; n = 163), Reduced/Possibly Impaired (77-84SS; n = 36), or Impaired (≤76 SS; n = 29). Receiver operator characteristic (ROC) curve analyses tested the RFIT and RFIT + Recognition’s classification accuracy for detecting invalid performance for the overall sample and by PSI impairment status. Results Those with intact processing speed performed significantly better on the RFIT and RFIT + Recognition than those with reduced/possibly impaired and impaired processing speed. Though verbal/visual memory predicted RFIT scores independently, PSI contributed additional variance. ROC curves for RFIT and RFIT + Recognition were significant (AUC=.64-.84). Optimal cut-scores yielded modest sensitivity (30%-63%) and high specificity (89%-93%) among those with intact and reduced processing speed but yielded unacceptable accuracy in those with impaired speed (AUC=.59-.62). Conclusions Although the RFIT and RFIT + Recognition demonstrated acceptable classification accuracy in those with intact processing speed, accuracy diminished with increasing speed impairment. This finding was more pronounced for RFIT + Recognition compared to the traditional RFIT. As such, the RFIT may have limited clinical utility in examinees with more significant processing speed deficits.

B - 131 Validation of the California Verbal Learning Test-II-Short Form Forced Choice Paradigm as an Indicator of Performance Validity

Abstract Objective Although the Forced Choice (FC) paradigm of the standard California Verbal Learning Test-Second Edition (CVLT-II) has been extensively validated as an embedded performance validity test (PVT), no studies have validated the CVLT-II Short Form (SF) against a standard battery of external PVTs. Method Participants included 98 veterans (Mage = 69.7 ± 9.0; 86.7% cisgender-male) who completed the CVLT-II-SF FC and the following independent criterion freestanding/embedded PVTS as part of comprehensive outpatient neuropsychological evaluations: the Advanced Clinical Solutions Word Choice Test, Test of Memory Malingering-Trial 1, and Reliable Digit Span from the Wechsler Adult Intelligence Test-Fourth Edition Digit Span subtest. Invalid performance was identified using two different criteria: (1) failing ≥2 PVTs in addition to other clinical indicators of poor engagement, or (2) failing one PVT. Receiver Operator Characteristic (ROC) curves tested the classification accuracy of identifying participants in the invalid group versus those with valid presentations and with or without cognitive impairment. Results Using both criteria, ROC analyses accurately identified invalidity (AUCs = 0.708–0.807) in the total sample, with cut-scores of ≤7 or ≤ 8 on the CVLT-II-SF FC exhibiting adequate specificities (0.900–0.986) and sensitivities of 0.407–0.500. Classification accuracy was acceptable for differentiating the invalid and cognitively intact groups (AUCs = 0.734–0.829) at a cut score of ≤8 (specificities = 0.923–0.958, sensitivities = 0.500–0.704), but was variably acceptable for differentiating the invalid and cognitively impaired groups (AUCs = 0.684–0.794; cut-score of ≤7 with specificities = 0.962–0.978 and sensitivities = 0.229–0.407). Conclusions Our findings support the CVLT-II-SF FC trial as an embedded PVT, particularly when differentiating cognitively intact examinees from those with noncredible presentations.

Optimizing single blastocyst selection: the role of day 3 embryo morphology in vitrified-warmed blastocyst transfer cycles

Can day 3 embryo morphology serve as an independent criterion for optimal single blastocyst selection? This retrospective, single-centre cohort study included 1517 single vitrified-warmed blastocyst transfer (SVBT) cycles conducted between October 2019 and July 2022. The live birth rate (LBR) and other clinical outcomes of SVBT cycles were evaluated, considering both good-quality and non-good-quality day 3 embryos. The associations of day 3 morphological characteristics, encompassing number of blastomeres and embryo grade, were assessed. Multivariable analyses were undertaken using multiple models adjusted for day of blastocyst development and blastocyst grade. Blastocysts from good-quality day 3 embryos had significantly higher LBR compared with those from non-good-quality embryos for both day 5 (51.5% versus 42.9%; P = 0.013) and day 6 (25.1% versus 17.6%; P = 0.018) blastocysts. LBR did not differ significantly with number of blastomeres on day 3, regardless of day of blastocyst development (day 5/6) or blastocyst grade. LBR varied significantly by day 3 embryo grade for both day 5 (48.0%, 51.5%, 46.6% and 32.7% for grades I, II, III and IV-V; P = 0.005) and day 6 (41.5%, 23.6%, 15.9% and 16.1% for grades I, II, III and IV-V; P = 0.001) blastocysts. Multivariable logistic regression revealed that non-good-quality embryos and lower morphological grade (IV-V) on day 3 were significantly and negatively correlated with LBR, while the number of blastomeres on day 3 was not an independent factor. When selecting blastocysts of equal quality for SVBT cycles, those with higher day 3 morphological scores are preferred. Day 3 morphological evaluation is a valuable supplement to conventional selection methods.

Is a larger patient benefit always better in healthcare priority setting?

When considering the introduction of a new intervention in a budget constrained healthcare system, priority setting based on fair principles is fundamental. In many jurisdictions, a multi-criteria approach with several different considerations is employed, including severity and cost-effectiveness. Such multi-criteria approaches raise questions about how to balance different considerations against each other, and how to understand the logical or normative relations between them. For example, some jurisdictions make explicit reference to a large patient benefit as such a consideration. However, since patient benefit is part of a cost-effectiveness assessment it is not clear how to balance considerations of greater patient benefit against considerations of severity and cost-effectiveness. The aim of this paper is to explore the role of a large patient benefit as an independent criterion for priority setting in a healthcare system also considering severity and cost-effectiveness. By taking the opportunity cost of new interventions (i.e., the health forgone in patients already receiving treatment) into account, we argue that patient benefit has a complex relationship to priority setting. More specifically, it cannot be reasonably concluded that large patient benefits should be given priority if severity, cost-effectiveness, and opportunity costs are held constant. Since we cannot find general support for taking patient benefit into account as an independent criterion from any of the most discussed theories about distributive justice: utilitarianism, prioritarianism, telic egalitarianism and sufficientarianism, it is reasonable to avoid doing so. Hence, given the complexity of the role of patient benefit, we conclude that in priority practice, a large patient benefit should not be considered as an independent criterion, on top of considerations of severity and cost-effectiveness.

Effect of processing speed and memory performance on classification accuracy of the dot counting test in a mixed neuropsychiatric sample

ABSTRACT Objective This study examined the impact of impairment in two specific cognitive abilities, processing speed and memory, on Dot Counting Test (DCT) classification accuracy by evaluating performance validity classification accuracy across cognitively unimpaired, single-domain impairment, and multidomain impairment subgroups within a mixed clinical sample. Method Cross-sectional data were analyzed from 348 adult outpatients classified as valid (n = 284) or invalid (n = 64) based on four independent criterion performance validity tests (PVTs). Unimpaired (n = 164), single-domain processing speed impairment (n = 24), single-domain memory impairment (n = 53), and multidomain processing speed and memory impairment (n = 43) clinical subgroups were established among the valid group. Both the traditional DCT E-score and unrounded E-score were examined. Results Overall, the DCT demonstrated acceptable to excellent classification accuracy across the unimpaired (area under the curve [AUC] traditional E-score=.855; unrounded E-score=.855) and single-domain impairment groups (traditional E-score AUCs = .690–.754; unrounded E-score AUCs = .692–747). However, it did not reliably discriminate the multidomain processing speed and memory impairment group from the invalid performers (traditional and unrounded E-scores AUC = .557). Conclusions Findings support the DCT as a non-memory-based freestanding PVT for use with single-domain cognitive impairment, with traditional E-score ≥17 (unrounded E-score ≥16.95) recommended for those with memory impairment and traditional E-score ≥19 (unrounded ≥18.08) with processing speed impairment. Moreover, results replicated previously established optimal cutoffs for unimpaired groups using both the traditional (≥14) and unrounded (≥13.84) E-scores. However, the DCT did not reliably discriminate between invalid performance and multidomain cognitive impairment, indicating caution is warranted when using the DCT with patients suspected of greater cognitive impairment.

Alleinerziehende in der Betreuungsplatzvergabe: Status quo und Handlungsempfehlungen

Abstract Single parents and their children benefit particularly from early childhood education and childcare programmes. Nevertheless, almost a third of single parents in Germany who need childcare for their children under the age of three are unable to find it. Although around 70 % of day care providers claim to take the single-parent criterion into account when allocating slots, the prevailing allocation procedures cannot guarantee that this is implemented. This article shows how transparent allocation criteria can be designed nationwide and how their implementation can be realised through suitable, centralised, municipal allocation systems. Particularly in (western) German regions with a high unmet demand for institutional childcare, single-parent status should be considered as an independent criterion in addition to other factors such as employment and child age.

Crystal structure prediction using neural network potential and age-fitness Pareto genetic algorithm

While crystal structure prediction (CSP) remains a longstanding challenge, we introduce ParetoCSP, a novel algorithm for CSP, which combines a multi-objective genetic algorithm (GA) with a neural network inter-atomic potential model to find energetically optimal crystal structures given chemical compositions. We enhance the updated multi-objective GA (NSGA-III) by incorporating the genotypic age as an independent optimization criterion and employ the M3GNet universal inter-atomic potential to guide the GA search. Compared to GN-OA, a state-of-the-art neural potential-based CSP algorithm, ParetoCSP demonstrated significantly better predictive capabilities, outperforming by a factor of $$ 2.562 $$ across $$ 55 $$ diverse benchmark structures, as evaluated by seven performance metrics. Trajectory analysis of the traversed structures of all algorithms shows that ParetoCSP generated more valid structures than other algorithms, which helped guide the GA to search more effectively for the optimal structures. Our implementation code is available at https://github.com/sadmanomee/ParetoCSP .

The Elephant in the Nursery: Paediatric Exceptionalism?

Prior to the COVID-19 pandemic (hereafter, ‘the pandemic’), there was already widespread concern about the adequacy of health care resources across Canada. The COVID-19 pandemic exacerbated these concerns exponentially, widening already significant cracks in provincial health care systems. Currently the system is struggling with the exacerbation of wait times for surgeries previously delayed by mandated closures during the pandemic. In Ontario, the backlog of surgeries, and associated backlogs in radiology and other services critical to paediatric care, led to the creation of a consortium of paediatric hospitals committed to advocacy for more funding for paediatrics. Thus far, the provincial and federal governments have agreed to a one-time cash infusion, but the consortium is calling for a permanent increase in funding for paediatrics. A challenge is that the adult sector has also suffered from delays and backlogs. Furthermore, as already noted, older adults have borne the brunt of morbidity and mortality associated with COVID-19. The challenge for the paediatric sector is whether and how to defend the prioritization of children and youth. In this paper, we review four approaches to just allocation – utilitarian ageism, fair innings, the prudential lifespan approach, and prioritarian ageism – and examine their strengths and weaknesses. We conclude by endorsing prioritarian ageism (prioritarianism). Prioritarianism retains the strengths of utilitarian ageism and fair innings while avoiding their weaknesses. Furthermore, because prioritarianism does not treat age as an independent moral criterion, allocation schemes based on this foundation are less susceptible to legal challenge and may be more palatable to the general public.

Возможности реконструктивной хирургии при раке молочной железы у пожилых женщин. Клинический случай

The number of surgical interventions with a reconstructive component in elderly patients with breast cancer has been increasing over the recent years due to the development of reconstructive surgical techniques and anesthesia care improvement. Age is not an independent criterion allowing one to decide on the reconstruction feasibility, however, the algorithm of reconstructive option selection for this cohort of patients has some essential features.

Cross-validation of the Trail Making Test as a non-memory-based embedded performance validity test among veterans with and without cognitive impairment

ABSTRACT Objective This study cross-validated multiple Trail Making Test (TMT) Parts A and B scores as non-memory-based embedded performance validity tests (PVTs) for detecting invalid neuropsychological performance among veterans with and without cognitive impairment. Method Data were collected from a demographically and diagnostically diverse mixed clinical sample of 100 veterans undergoing outpatient neuropsychological evaluation at a Southwestern VA Medical Center. As part of a larger battery of neuropsychological tests, all veterans completed TMT A and B and four independent criterion PVTs, which were used to classify veterans into valid (n = 75) and invalid (n = 25) groups. Among the valid group 47% (n = 35) were cognitively impaired. Results Among the overall sample, all embedded PVTs derived from TMT A and B raw and demographically corrected T-scores significantly differed between validity groups (ηp2 = .21–.31) with significant areas under the curve (AUCs) of .72–.78 and 32–48% sensitivity (≥91% specificity) at optimal cut-scores. When subdivided by cognitive impairment status (i.e., valid-unimpaired vs. invalid; valid-impaired vs. invalid), all TMT scores yielded significant AUCs of .80–.88 and 56%–72% sensitivity (≥90% specificity) at optimal cut-scores. Among veterans with cognitive impairment, neither TMT A or B raw scores were able to significantly differentiate the invalid from the valid-cognitively impaired group; however, demographically corrected T-scores were able to significantly differentiate groups but had poor classification accuracy (AUCs = .66–.68) and reduced sensitivity of 28%–44% (≥91% specificity). Conclusions Embedded PVTs derived from TMT Parts A and B raw and T-scores were able to accurately differentiate valid from invalid neuropsychological performance among veterans without cognitive impairment; however, the demographically corrected T-scores generally were more robust and consistent with prior studies compared to raw scores. By contrast, TMT embedded PVTs had poor accuracy and low sensitivity among veterans with cognitive impairment, suggesting limited utility as PVTs among populations with cognitive dysfunction.

Change in total lesion PSMA (TLP) during [177Lu]Lu-PSMA-617 radioligand therapy predicts overall survival in patients with mCRPC: monocentric evaluation of a prospective registry

PurposeThis study investigates imaging response of [177Lu]Lu-PSMA-617 radioligand therapy (RLT) based on the whole-body parameter total lesion PSMA (TLP), derived by PSMA-PET/CT and reflecting the total tumor burden, in patients with metastatic castration-resistant prostate cancer (mCRPC) enrolled in a prospective registry (NCT 04833517).MethodsA total of n = 102 mCRPC patients received a [68Ga]Ga-PSMA-11 PET/CT at baseline and after two cycles of PSMA-RLT, in which TLP was measured by using a semi-automated tumor segmentation. TLP was defined as the summed products of volume and uptake (∑ Volume × SUVmean) of all tumor lesions. The Kaplan-Meier method was used to determine the most appropriate ∆TLP thresholds for classification into partial remission (PR), stable disease (SD), and progressive disease (PD) regarding overall survival (OS). Furthermore, we analyzed criteria that are also frequently used in established response frameworks, such as the occurrence of new metastases as independent criterion (I) or in combination with change in tumor burden (II), and the change in PSA serum value (III).ResultsFor the ∆TLP thresholds −30%/+30% (and also for higher thresholds, −40%/+40% or −50%/+50%), significant differences between all three response categories became apparent (PR/PD: p = 0.001; PR/SD: p = 0.001; SD/PD: p = 0.018). Including the development of new metastases as independent criterion of PD, there was no significant difference in OS between SD and PD (p = 0.455), neither when applied in combination with TLP (p = 0.191). Similarly, significant differentiation between SD and PD was not achieved by PSA serum value (p = 0.973).ConclusionIn the largest monocentric study to date, TLP is shown to be a qualified prognostic biomarker, applying ∆TLP thresholds of −30%/+30%. It significantly differentiated between PR, SD, and PD, whereas other response criteria did not differentiate SD vs. PD. Using TLP, the development of new metastases is not a required information for predicting OS.

Diagnostics and prediction of intracranial hypertension on primary computed tomography in patients with severe traumatic brain injury

The objective was to compare the optic nerve sheath diameter measured by CT (ODSN-CT) with the level of compression of the mesencephalic cisterns and the midline shift in the diagnosis and prediction of intracranial hypertension (ICH) during the first 3 days after brain injury. Materials and methods. We examined 90 patients with TBI, the average age was 34.2 ± 13 years, GCS < 9. All patients had invasive ICP monitoring. At the time of implantation of the ICP sensor, intracranial hypertension (ICH) was in 11 (12%) patients; later, during the first 3 days, the development of ICH was in 58 (64%) patients. All patients underwent computed tomography of the head at the time of hospitalization: mesencephalic cisternae was compressed in 57 (63%) and midline shift was observed in 34 (38%) patients, mean value of ONSD-CT was 7.26 ± 0.9 mm, maximum value of ONSD-CT was 7.34 ± 0.9. We used correlation analysis, logistic regression and ROC-analysis.Results. The level of mesencephalic cisternae compression, mean and maximum value of ONSD-CT correlated with the ICP value measured at the time of ICP sensor implantation and during the first 72 hours after brain injury (p < 0.05). Midline shift did not correlate with ICP value measured at the time of sensor implantation and during the first 72 hours after brain injury (p > 0.05). In the diagnosis of ICP > 20 mm Hg at the time of implantation of the sensor – the average ONSD-CT, AUC 0.902 ± 0.046 (0.812; 0.991), cut-off 7.8 mm with sensitivity and specificity of 82 and 80%, respectively. When predicting ICP > 20 mm Hg in the first 72 hours - the maximum ONSD-CT, AUC 0.815 ± 0.047 (0.724; 0.907), cut-off 7.1 mm with sensitivity and specificity of 85 and 66%, respectively.Conclusions. The ONSD-CT parameter is an independent diagnostic and prognostic criterion of ICH in the first 3 days in patients with severe TBI. The mean ONSD-CT can be used to diagnose ICH along with such signs of ICP as level of mesencephalic cisterna compression and midline shift and to make a decision on invasive ICP monitoring. The maximum value of ONSD-CT can be used to assess the probability of ICH in the first three days after TBI

Whale Optimized Deep Model for Paddy and Maize Leaf Disease Detection

Plant disease management is an essential process to minimize loss in the field of agriculture. Plant leaf disease detection(PLDD) technology helps the formers to reduce the loss of quality yield production. This study focuses on detecting paddy and maize plant leaf disease-detecting methods. It contributes to a PLDD method to improve detection accuracy and overall performance. The PLDD method introduced a whales-optimized artificial neural network (WOANN) method for classifying the four Maize and four rice leaf disease-related classes. The WOANN uses the whale optimizer's food-searching functionalities to improve the performance and detection accuracy of the dense net model. This WOANN classifies the maize leaf light, maize grey leaf spot, maize common rust, rice bacterial leaf blight, rice bacterial leaf steak, rice brown spot, and healthy leaves of both Maize and paddy. It uses the Hilbert-Schmidt independent criterion lasso correlation algorithm to support the WOANN classifier in selecting the significant features. The performance analysis shows that the WOANN-based approach achieves a maximum of 99.35% detection accuracy for maize leaf disease and 99.13% for paddy leaf disease. Its efficiency analysis shows that the WOANN-based approaches achieve a maximum accuracy rate than comparison approaches.

Features of the organization of 3D experiments in physics

This article examines the study of the features of the easy organization of virtual experiments in the section «Optics». This research is aimed at improving the conceptual skills of a future specialist in the field of optics with the help of a virtual laboratory. This research and development consisted of three stages, namely preliminary research, design of a virtual laboratory and testing of a virtual laboratory. Due to the training conditions, it is very difficult to perform virtual laboratory work. Combining query-based learning with virtual laboratory activities can be an alternative to developing a simpler, but meaningful learning process within the framework of training. This study is aimed at analyzing virtual laboratory activities through training based on the request for scientific literacy on the topics of light phenomena and optics. The study used mixed methods with a consistent design in the form of a non-equivalent design of the control group. Samples were taken using the target sampling method. The data was collected through observations, surveys and tests, as well as interviews. The data were then analyzed using an independent sampling criterion and a homogeneity test to see the effectiveness of the training of the two sample groups. The results show that the practical effectiveness of training using a virtual laboratory was very successful and received good reviews. The effectiveness of the virtual laboratory can be assessed by the level. Thus, virtual laboratories can be used as teaching aids that can make a positive contribution to improving student academic performance.

Effect of incorporating Lode angle into fracture criterion on predicting ballistic resistance of 6061-T651 aluminum alloy plates with different thicknesses struck by blunt projectiles

According to existing research, in addition to the second deviatoric stress invariant, Lode angle parameter (hereinafter abbreviated as Lode angle), which is related to the third deviatoric stress invariant, is also required to be taken into account when studying plastic flow and failure of metal materials. In order to study the effect of incorporating Lode angle into fracture criterion on predicting ballistic resistance of 6061-T651 aluminum alloy plates, a one-stage gas gun system was used to conduct ballistic tests of 6061-T651 aluminum alloy plates with different thicknesses when struck by the blunt projectile with a diameter of 12.66 mm and a mass of 34.0 g. Meanwhile, Abaqus/Explicit finite element software with user-defined material subroutine (VUMAT) was used to establish corresponding finite element models. Under the same constitutive model, numerical simulations were carried out by using Lode independent MJC fracture criterion and Lode dependent WMJC fracture criterion. It is found that when using MJC fracture criterion, not only the ductility of material is overestimated in low stress triaxiality state, resulting in significantly higher predicted ballistic limits; but also the predicted material fracture strain in high stress triaxiality state is negative, sometimes causing irrational predictions. Therefore, some modifications to MJC fracture criterion are needed to reasonably predict the impact process. By contrast, the predicted results of Lode dependent WMJC fracture criterion are more consistent with experiments. Besides, as the thickness of the target increases, the ballistic limit shows an “S” shaped growth trend. Overall, for ballistic tests of targets with different thicknesses, WMJC criterion has a better predictive effect than MJC criterion, indicating the importance of incorporating Lode angle into fracture criteria.

The Impact of Moderate Hypophosphatemia on the Clinical Management of Primary Hyperparathyroidism.

Background and objective The impact of moderate hypophosphatemia (hypoP) on primary hyperparathyroidism (PHPT) and its use as an independent surgical criterion has not been adequately evaluated in the literature. In light of this, we conducted this study to address the scarcity of data on this topic. Methods We conducted a retrospective evaluation of data related to 164 (133 females and 31 males) patients with PHPT who met the criteria for inclusion in the study. HypoP, which is indicated by phosphorus (P) levels lower than 2.5 mg/dL, was found in 78 (47.5%) patients, and moderate hypoP (1-1.99 mg/dL) was found in 25 patients (15.2%). Results PHPT severity was worse in hypoP patients than non-hypoP patients, as evidenced by higher levels ofmean serum calcium (12.9 ±1.0 mg/dL vs. 11.1 ±0.3 mg/dL respectively,p<0.001), parathormone (PTH) [median (interquartile range, IQR): 455.3 (455.3)ng/L vs.124.0 (84.0)ng/L respectively, p<0.001] and mean 24-hour urinary calcium (414.6 ±168.5 mg/day vs. 291.5 ±161.4 mg/day respectively, p=0.026) as well as lower levels of mean BMI (25.6 ±3.9 kg/m2vs. 29.0 ±4.0 kg/m2 respectively, p=0.18) and mean 25-hydroxy vitamin D3 (13.8 ±7.3 µg/L vs. 18.2 ±7.8 µg/L respectively, p=0.001). Among the whole study populationas well as among patients with Ca levels <1.0 mg/dLaccording to the upper limit of normal, P level was determined to be an independent factor affecting the indication for surgical treatment [β: -1.96,p=0.038, odds ratio (OR): 0.14, 95% confidence interval (CI): 0.02-0.89 and β: -2.3, p=0.034, OR: 0.10, 95% CI: 0.12-0.84 respectively]. Conclusion We found a strong correlation between moderate hypoP and the severity of the biochemical manifestations of PHPT. In asymptomatic PHPT patients, moderate hypoP was predictive of surgical indication, independent of age and level of hypercalcemia.

Hereditary Renal Cell Carcinoma: Is Age an Independent Criterion for Genetic Testing? A Large Cohort from a Latin America Referral Center.

Although age younger than 46 years has been an independent criterion for genetic testing in hereditary renal cell carcinoma (hRCC), there is a lack of evidence in the literature. This study aims to analyze whether a 46-year-old cut-off should be considered an independent genetic testing criterion and to elucidate risk factors predicting a positive genetic test. Observational study from January 2010 to December 2021. All patients under 46 years with a non-metastatic kidney mass and surgical indication were included. We assume patients who relapse in the first 5 years of follow-up could have a positive genetic test. As risk factors for relapse, ergo positive genetic test, we consider those patients who presented multifocal, bilateral, or previous renal tumor. Of 2,232 nephrectomies for kidney cancer, 301 patients met the inclusion criteria. The median follow-up was 60 months (IQR 29-101). The estimated five-year RFS was 94.4% (95% CI 91.3-97.5). Tumor size, previous renal tumor, multifocality, bilaterality, and pT3 or pT4 stage were independent recurrence risk factors. Genetic testing was performed on 24 patients. 10 patients had pathogenic variants in the test, 8 of which recurred during their life. 46-year-old cut-off has shown low performance in genetic testing. Therefore, we recommend that it be considered only if other hRCC risk criteria exist. Multifocality, bilaterality, and previous renal tumor could predict a positive genetic test.