Independent Evaluation Research Articles

Allergens Causing Allergic Contact Dermatitis in Cosmetic Products: A Systematic Review

Background: The increasing use of cosmetics worldwide has led to a rise in allergic reactions, particularly due to inadequate risk assessment. Identifying common allergens in cosmetic products causing dermatitis is crucial for effective prevention and management strategies. Objectives: This systematic review aims to determine the list of allergens that most commonly cause allergic contact dermatitis in cosmetic products and to find the patch test positivity rate for cosmetic products. Methods: This systematic review, following the PRISMA guidelines, investigated patch test results on cosmetic-induced contact dermatitis from January 2013 to September 2023 on PubMed, Cochrane, and Medline databases. Inclusion criteria comprised retrospective cohort and clinical trial studies reporting patch test positivity rates and positive allergens in cosmetics, with eligibility determined through independent screening, full-text evaluation, and data extraction. Exclusion criteria comprised abstract-only publications, non-English or Indonesian languages, review articles, and studies with incomplete text. Result: 13 studies were included out of 2,162 initially screened articles, involving 111,097 participants. The selected studies encompassed ten retrospective studies and three clinical trials conducted in various locations, including India, Brazil, North America, Korea, Sweden, and the Czech Republic. The patch test positivity rate ranged from 13% to 100%. The predominant allergens identified in cosmetics were nickel sulfate, fragrance mix I, cobalt chloride, para-phenylenediamine base, potassium dichromate, and balsam of Peru. Conclusion: This systematic review highlights the diversity in patch test positivity rates and identifies key allergens responsible for allergic contact dermatitis in cosmetic products, emphasizing the need for comprehensive evaluation and awareness of cosmetic safety.

Evaluation of sea surface temperature from ocean reanalysis products over the North Indian Ocean

Ocean and sea ice reanalyses (ORAs or ocean syntheses) are reconstructions of the ocean and sea ice states using an ocean model integration constrained by atmospheric surface forcing and ocean observations via a data assimilation method. Ocean reanalyses are a valuable tool for monitoring and understanding long-term ocean variability at depth, mainly because this part of the ocean is still largely unobserved. Sea surface temperature (SST) is the key variable that drives the air–sea interaction process on different time scales. Despite improvements in model and reanalysis schemes, ocean reanalyses show errors when evaluated with independent observations. The independent evaluation studies of SST from ocean reanalysis over the Indian Ocean are limited. In this study, we evaluated the SST from 10 reanalysis products (ECCO, BRAN, SODA, NCEP-GODAS, GODAS-MOM4p1, ORAS5, CGLORS, GLORYS2V4, GLOSEA, and GREP) and five synthetic observation products (COBE, ERSST, OISST, OSTIA, and HadISST) and from the pure observation-based product AMSR2 for 2012–2017 with 12 in-situ buoy observations (OMNI) over the Arabian Sea and Bay of Bengal. Even though the reanalysis and observational products perform very well in the open ocean, the performance is poorer near the coast and islands. The reanalysis products perform comparatively better than most of the observational products. COBE and OISST perform better among the synthetic observational products in the northern Indian Ocean. GODAS-MOM4p1 and GREP performs best among the reanalysis products, often surpassing the observational products. ECCO shows poorer performance and higher bias in the Bay of Bengal. Comparing the BRAN daily and monthly SST, the monthly SST performance of reanalysis is better than the daily time scale.

Evaluation of Learning Management Standards to Improve Higher Education Quality Standards Through Internal Quality Audits

Independent evaluation is required through an internal quality control system through internal quality audit activities. This study evaluated the achievement of learning management standards, inhibiting factors, and recommendations for improving education quality standards at Palembang Polytechnic. This type of qualitative research uses observation methods, structured interviews, and literature studies. The research instrument is the author directly involved in the research. The informants in this study were determined using a purposive technique: three research informants. The study’s results obtained data on implementing internal quality audits on learning management standards that have not been implemented. An effective internal quality management model is needed as a platform or application that supports collecting, storing, and managing data and information on website-based internal quality management system services to support fast, precise, and efficient internal quality management system integration.

PATH-39. AI-BASED IDENTIFICATION OF GLIOMA IDH MUTATIONAL STATUS FROM H&E-STAINED WHOLE SLIDE IMAGES

Abstract INTRODUCTION Isocitrate-dehydrogenase (IDH) mutational status is diagnostically critical in adult gliomas, with prognostic and therapeutic implications. IDH status cannot be determined by sole histologic assessment and requires molecular testing. We hypothesize that AI-based analysis can accurately predict IDH mutational status in glioma, by retrieving sub-visual cues in H&E-stained digitized tissue sections. MATERIALS AND METHODS A retrospective discovery cohort of 1,534 cases (756/778 IDH-wildtype/IDH-mutant, including all available grades) from the TCGA-LGG/TCGA-GBM collections was used for model development with 10-fold cross-validation (CV). A replication cohort of 114 cases (82/32 IDH-wildtype/IDH-mutant) from the University of Pennsylvania Health System (UPHS) was used for independent hold-out evaluation. Each 20X magnification whole slide image (WSI) underwent comprehensive curation for elimination of artifactual content, followed by partitioning into 256x256 patches, and feature extraction using pre-trained i) ImageNet weights (baseline), and ii) self-supervised vision transformer (ViT). A weakly-supervised attention-based multiple-instance-learning framework distinguished cases as IDH-wildtype or IDH-mutant, while generating visually interpretable attention heatmaps. RESULTS Evaluation on discovery and replication cohorts with the ViT yield accuracy of 90.84% (AUCDiscovery=97.16%) and 93.94% (AUCReplication=97.36%), respectively, with high sensitivity (i.e., high confidence in correctly predicting IDH-wildtype glioma). Comparison of the ViT with the baseline model on the replication cohort indicates the ViT superiority by improvements of 8% and 9.5% in accuracy and AUC, respectively. Histologic assessment of heatmaps indicates IDH-wildtype tumors exhibiting distinct regions of significant pleomorphism and microvascular proliferation, while IDH-mutant tumors exhibit dense nodular cell concentrations, microcystic architecture, and gemistocytic cells. CONCLUSION Our accurate H&E-based computational determination of glioma IDH status, with interpretations aligned with human-identifiable features, can contribute to obviating the need for molecular analyses and enable expedited diagnosis even in community healthcare settings. This study robustly identifies morpho-IDH correlates and could enable expedited patient prognostic stratification.

‘Thanks, but no thanks’: The public's response to engagement with NHS Talking Therapies – a salutary tale?

AbstractObjectivesThe English NHS Talking Therapies has been hailed as a world leader in demonstrating outcomes, generating 1.76 million referrals in the year 2022–2023, with a claimed 49.9% recovery rate, but there has been a dearth of independent evaluations. Importantly, there have been no published data on those who only attended one assessment/treatment session. This also applies to public services internationally. The issue of the acceptability of psychological treatment has not been addressed.MethodThe user‐friendliness of NHS Talking Therapies was examined, drawing on unpublished data revealed following a Freedom Of Information request response to the author in June 2024. These data are set alongside the service's published data to give a more comprehensive view of real‐world outcomes and whether it should be a template for other countries to follow.ResultsAlmost half (45%) do not complete treatment, and for completers, the results are no better than for placebo. The diagnostic status of almost a third (29.1%) who attend just one session is unknown. The numbers of people who attend one assessment/ treatment session is approximately half of those who attend two or more treatment sessions, but the ratio varies by disorder.ConclusionNHS Talking Therapies' engagement difficulties casts serious doubt on the service's claim to be a ‘world beater’. There is no evidence that NICE‐compliant evidence‐based psychological treatments have been delivered. While this model has been widely adopted in the UK, this should not be transferred to other service systems without contextualisation and evidence on whether/how some of its components could be implemented in those settings.

Establishing the Institute of Independent Evaluation of Higher Education in the Russian Federation

The paper presents the results of the search, systematization and analysis of independent higher education evaluation systems that have been developed in the country in the recent decade. The research has been carried out using standardised evaluation mechanisms that adhere to the criteria of mass scale, openness, and stability. The analysis of the independent evaluation of higher education’s present situation revealed certain inconsistencies between the legislative and regulatory framework and real practice. It should be emphasised that, while different processes have now been developed for this type of evaluation, they still require enhancement. The assessment mechanisms themselves need to undergo an external, independent evaluation to ensure their reliability, integrity, and trustworthy evidence. It has been indicated that independent evaluation procedures have jointly developed into a system: the institution of independent evaluation. This system is characterised by integrity, orderliness, and definite linkages. One may consider the aggregating technology of the aforementioned evalu-ations to be the synergistic outcome of the system’s establishment. In order to achieve a synergistic effect on the evaluation of all higher education institutions and educational programmes in the country, the authors suggest a method for aggregating the outcomes of the described evaluation procedures. The obtained research outcomes prove their applicability to the internal and external evaluation of a higher education institution’s performance and to the strategic planning of the development of both the institution and the higher education system.

3D-Printed Permanent Resin Crowns on Pre-Molar and Molar Teeth; Two-Year Results of a Prospective Clinical Study.

The aim of this prospective clinical study was to evaluate the 12 and 24-month clinical results of overlay and one-piece endodontic crown restorations applied with additively manufactured 3D printed permanent ceramic-filled resin (PCR) according to the Modified US Public Health Service (USPHS) criteria. A total of 33 indirect restorations (16 overlay, 17 endocrown) (4 premolar, 29 molar) produced using PCR (Formlabs) were applied to 30 patients by a single dentist. The restorations were evaluated according to the modified USPHS criteria at baseline (7 days), 12 and 24 months times by two independent evaluators. The study registration number is NCT05168852. In the comparisons of the dependent criteria scores, the Related Samples Cochran Q test was used, and in post-hoc paired comparisons, the Bonferroni test. The Fisher-Freeman-Halton test was applied in the comparisons of categorical variables according to the restoration type groups (α = 0.05). No statistically significant difference was determined between the evaluation criteria scores at baseline, 12 months, and 24 months for the marginal adaptation (P=0.05), retention (P=1), interproximal contact (P=0.368), color match (P=1), surface texture (P=1), and patient satisfaction (P=1). The only score criteria that showed a statistically significant difference between baseline and 24 months (P=0.001) among all other criteria was marginal discoloration. This criteria's score change was from 100% A score to 69.7% A score. In the 2-year follow-up of indirect single-tooth restorations produced with 3D-printed PCR, all restorations showed acceptable clinical performance. (≥99.5%A+B score at 2 years).

Detection, classification, and characterization of proximal humerus fractures on plain radiographs.

The purpose of this study was to develop a convolutional neural network (CNN) for fracture detection, classification, and identification of greater tuberosity displacement ≥ 1 cm, neck-shaft angle (NSA) ≤ 100°, shaft translation, and articular fracture involvement, on plain radiographs. The CNN was trained and tested on radiographs sourced from 11 hospitals in Australia and externally validated on radiographs from the Netherlands. Each radiograph was paired with corresponding CT scans to serve as the reference standard based on dual independent evaluation by trained researchers and attending orthopaedic surgeons. Presence of a fracture, classification (non- to minimally displaced; two-part, multipart, and glenohumeral dislocation), and four characteristics were determined on 2D and 3D CT scans and subsequently allocated to each series of radiographs. Fracture characteristics included greater tuberosity displacement ≥ 1 cm, NSA ≤ 100°, shaft translation (0% to < 75%, 75% to 95%, > 95%), and the extent of articular involvement (0% to < 15%, 15% to 35%, or > 35%). For detection and classification, the algorithm was trained on 1,709 radiographs (n = 803), tested on 567 radiographs (n = 244), and subsequently externally validated on 535 radiographs (n = 227). For characterization, healthy shoulders and glenohumeral dislocation were excluded. The overall accuracy for fracture detection was 94% (area under the receiver operating characteristic curve (AUC) = 0.98) and for classification 78% (AUC 0.68 to 0.93). Accuracy to detect greater tuberosity fracture displacement ≥ 1 cm was 35.0% (AUC 0.57). The CNN did not recognize NSAs ≤ 100° (AUC 0.42), nor fractures with ≥ 75% shaft translation (AUC 0.51 to 0.53), or with ≥ 15% articular involvement (AUC 0.48 to 0.49). For all objectives, the model's performance on the external dataset showed similar accuracy levels. CNNs proficiently rule out proximal humerus fractures on plain radiographs. Despite rigorous training methodology based on CT imaging with multi-rater consensus to serve as the reference standard, artificial intelligence-driven classification is insufficient for clinical implementation. The CNN exhibited poor diagnostic ability to detect greater tuberosity displacement ≥ 1 cm and failed to identify NSAs ≤ 100°, shaft translations, or articular fractures.

ChatGPT: a force for good? Using the I.D.E.As framework to ’develop and empower’ students

Generative artificial intelligence (GenAI) tools (for example, ChatGPT) are a specific application of artificial intelligence which generate novel content in response to questions or instructions. Their use in education has generated diverse responses. Critics express concerns that they might discourage students from engaging in independent analysis, evaluation and problem-solving, and hinder the development of critical thinking skills (Farrokhnia et al., 2023). Another concern is the potential effect on the development of meaningful student-teacher and peer-to-peer interactions, important in fostering student belonging, and developing communication and social-emotional skills. Conversely, supporters see these tools as valuable resources providing instant access to tailored information, facilitating personalised learning experiences and promoting student engagement. They argue that rather than undermining higher-order skills like critical thinking and evaluative judgment, GenAI tools can enhance their development. Some propose they may even help address the ‘awarding gap’ (Fido and Wallace, 2023), with students using such tools as a ‘dialogic tutor’, to personalise learning and so develop their knowledge and understanding (Compton, 2023a). The presentation introduced the ‘I.D.E.As framework’ (Hack, 2023), a resource developed to help structure thinking and curate ideas regarding using GenAI tools in learning and teaching. The session explored ways in which GenAI tools may be used as a ‘force for good’, to enhance the student learning experience and support their individual learning development. Resources to ‘develop and empower’ students as independent learners were shared, providing an opportunity for attendees to reflect on how/whether they might be incorporated into their own learning and teaching contexts.

India and the African Union’s Engagement Through IAFS: Challenges of Strengthening Partnership

India’s engagement with the African Union has been one of its important partnership agreements with Africa. The India–Africa Forum Summit (IAFS) kickstarted the engagement with African countries through the African Union overtaking bilateral relations and partnerships with regional organisations. India has since then remained a unique, request and need-based partner of the African Union. The various capacity-building initiatives taken up through IAFS have shown that India has shown serious commitment to India–Africa partnership. The first three IAFS shows that India committed substantial amounts of funds through IAFS. However, in reality, it could only deliver a very small portion due to the slow implementation of projects. Only 4% of Indian grants in 2017–18 were committed to Africa which improved slightly after 2019. Subsequently, over 40% of funds were committed but implementation had been very slow. There is never a third independent party evaluation of these projects for impact assessment or to suggest a solution for implementation issues. Presently, there is an urgent need to hold the next IAFS which has been delayed for a long time now. There is a need to organise review meetings with AU on a regular basis. India made extra-ordinary efforts to get the African Union admitted in G20 at the New Delhi meeting. However, the Indian expansion of Banjul Formula for IAFS, India’s renewed focus on Global South, bureaucracy-driven implementation of partnership projects and insufficient political-level communications with AU leadership throw new challenges.

Combined radiographic and ultrasound evaluations to decipher joint involvement in the hands of patients with systemic sclerosis.

The objective of this study was to explore the etiologies and contributing factors of synovial and tenosynovial involvement in SSc, as well as to assess the phenotype of patients with these synovial and tenosynovial features. 171 SSc patients with hand manifestations (either vascular, skin or joint manifestations) who underwent standard X-rays of both hands and hand ultrasound (US), were included. Two independent evaluators recorded the presence or absence of acro-osteolysis, calcinosis, microcrystalline and degenerative rheumatisms, including osteophytosis on X-Rays. The presence of synovitis and tenosynovitis (active or fibrotic) was assessed through US by a third evaluator, blinded for X-ray parameters. In multivariate analysis, the characteristics associated with active synovitis and tenosynovitis were CRP>10mg/L (p = 0.013), fibrotic tenosynovitis on US (p = 0.005), anti-RNA polymerase III antibodies (p = 0.043) and poly-osteophytosis on hand X-rays (p = 0.001). After exclusion of patients with RA (n = 5) and/or poly-osteophytosis (n = 53), 14 remaining patients (12.7%) had active synovitis and/or tenosynovitis on US. In multivariate analyses, parameters associated with active synovitis and/or tenosynovitis in this selected population were scleroderma renal crisis (p = 0.012) and fibrotic tenosynovitis on US (p < 0.001). Our study confirms that osteophytosis is a significant contributor of joint involvement in SSc patients based on real life data. After exclusion of potential confounders, more than 10% of SSc patients still had active synovitis and/or tenosynovitis on US, providing indirect evidence for the existence of a specific SSc-related synovial and/or tenosynovial involvement.

Fatigue in Air Traffic Operations—Opportunities to Enhance Safety

This Viewpoint reports the findings of a 2024 independent scientific evaluation of fatigue risk in air traffic operations commissioned by the US Federal Aviation Administration.

Castellvi classification of lumbosacral transitional vertebrae: comparison between conventional radiography, CT, and MRI.

The reliability and diagnostic accuracy of commonly used diagnostic imaging modalities in the classification of lumbosacral transitional vertebrae (LSTV) are poorly known, and comparative studies are scarce. To compare the diagnostic performance of conventional radiography (CR), computed tomography (CT), and magnetic resonance imaging (MRI) in classifying LSTVs. In this retrospective cross-sectional study, a total of 852 patients undergoing lumbar imaging studies using all three modalities were initially assessed for the presence of LSTV using CT scans. In total, 100 patients with LSTV anatomy were identified. Four readers performed blinded and independent evaluations of these 100 patients on each modality, and an experienced fellowship-trained radiologist performed a gold standard read using all three modalities. Inter-reader reliability metrics were analyzed in comparison to the gold standard. Statistical software R (4.2.1) was used for the analyses. We found superior diagnostic efficacy for CT: the sensitivity, specificity, accuracy, and balanced accuracy were 76%, 93%, 77%, and 84%, respectively. For MRI, the metrics were 54%, 88%, 56%, and 68%, and for CR 32%, 85%, 42%, and 59%, respectively. Inter-reader reliability was found to be good for CT (κ = 0.63-0.71) and fair for both CR (κ = 0.16-0.32) and MRI (κ = 0.24-0.56). CT had the highest diagnostic performance in all measured metrics with good inter-reader reliability. MRI and CR showed fairly poor sensitivity and accuracy, and thus consideration should be used when classifying LSTVs with these two modalities.

Reliability of Three Pain Assessment Tools in Children Requiring Dental Treatment: A Comparative Clinical Study

ABSTRACT Background: Accurate pain assessment in pediatric dental patients is crucial for effective pain management and treatment planning. Materials and Methods: A total of 120 children aged 6-12 years, requiring dental treatment, were enrolled in this study. Each child was assessed using the three pain scales after undergoing a standardized dental procedure. The assessments were performed by two independent evaluators to determine inter-rater reliability. The intraclass correlation coefficient (ICC) was used to evaluate the reliability of each tool. Data were analyzed using descriptive statistics and repeated measures ANOVA to compare the mean pain scores across the three scales. Results: The mean pain scores reported were 4.3 ± 1.2 for the VAS, 4.5 ± 1.4 for the FPS-R, and 4.2 ± 1.3 for the WBFPRS. The ICC values for inter-rater reliability were 0.88 for the VAS, 0.86 for the FPS-R, and 0.90 for the WBFPRS, indicating high reliability for all tools. However, the WBFPRS showed slightly higher reliability compared to the other scales. No significant differences were found in pain scores across the three tools (P = 0.72). Conclusion: All three pain assessment tools demonstrated high reliability in assessing pain in pediatric dental patients. The Wong-Baker Faces Pain Rating Scale showed the highest inter-rater reliability, suggesting it may be the most reliable tool for clinical use in this population.

High-Sensitivity Cardiac Troponin [hs-cTn] as a Valuable Biomarker for Pulmonary Hypertension Risk Stratification: A Contemporary Review of the Literature.

Background: Pulmonary hypertension (PH) can lead to cardiac failure, thereby significantly affecting life expectancy and quality of life. Due to inadequate disease surveillance and risk assessment, clinical challenges persist despite advances in diagnosis and treatment. We aimed to review the potential of high-sensitivity cardiac troponin (hs-cTn) as a biomarker for predicting outcomes in PH patients. Methods: A thorough examination of the PubMed and Google Scholar databases was conducted through March 2023. Studies involving adult PH patients and hsTn as a prognostic indicator of outcomes such as mortality, hospitalization, and disease progression were included, after screening their titles and abstracts. Two independent evaluators extracted data, with the quality assessed using the JBI critical appraisal tool. Results: This review uncovered eight studies that examined the prognostic value of hs-cTn in PH patients. Higher hs-cTn levels were associated with increased mortality and hospitalization rates, according to the studies. The severity of PH, cardiac dysfunction, right ventricular function, and systolic dysfunction were associated with hs-cTn. Multiple studies have demonstrated that hsTn has the potential to identify high-risk PH patients who could benefit from targeted therapies and increased clinical monitoring. Conclusions: This review suggests that hsTn may be a biomarker for PH risk stratification and prognosis. Across PH subtypes, elevated hsTn levels predict poor outcomes. However, large-scale prospective studies are needed to confirm hs-cTn's function in diagnosing pulmonary hypertension and determine its potential value in treatment.

Evaluating Agreement Between Medical Record Diagnoses and Independent Evaluator Diagnoses in a Community-Based Effectiveness Study

ABSTRACT Background Youth anxiety disorders are prevalent but undertreated. Poor diagnostic agreement between clinicians and researchers may contribute to misdiagnosis and mistreatment. However, few studies of diagnostic agreement focus specifically on anxiety disorders. Objective The current study evaluates diagnostic agreement between community clinicians and independent evaluators (IE) associated with a research study. Method IEs administered the Anxiety Disorders Interview Schedule for DSM-5, Child Version, Child and Parent Forms to youth participating in a randomized controlled trial. Diagnostic agreement was assessed using Cohen’s kappas. Youth (N = 103) were about 14.3 years old (SD = 1.6), largely cis-gender female (66%, n = 68), heterosexual (57.3%, n = 59), Hispanic/Latinx (53.4%, n = 55), and White (53.4%, n = 55). Results IEs assigned significantly more diagnoses than community clinicians (t(99)=-12.738, d = 1.66, p < .001). Individual diagnoses were collapsed into diagnostic clusters: anxiety, depression, trauma and stressor, obsessive-compulsive, and behavioral disorders. There was no agreement for anxiety, trauma and stressor, obsessive-compulsive clusters (ks < 0.20). The depression cluster showed minimal agreement (k = 0.28, p < .001), and behavioral disorders showed weak agreement (k = 0.49, p < .001). There was no agreement for four individual anxiety disorder diagnoses (ks < 0.20) except for panic disorder, which had minimal agreement (k = .32, p < .001). Four additional anxiety disorder diagnoses could not be analyzed due to no diagnoses in one or both settings. Discussion This study shows diagnostic agreement is poor between clinicians and researchers, especially for anxiety disorders. Findings suggest that semi-structured interviews can detect diagnoses that are being missed by clinicians. Future work should seek to identify and address barriers to implementation of evidenced-based assessments in community settings.

Legal regulation of education in Ukraine. Part 6: Features of admission to higher education in Ukraine

This article examines the legal issues of regulating the access of citizens of Ukraine to higher education of the third educational and scientific degree (doctor of philosophy) in the paradigm of international acts, the Constitution of Ukraine, the Laws of Ukraine, and Resolutions of the Cabinet of Ministers of Ukraine in the field of education. This is related to the existence of certain legal conflicts in the education sector, which arose as a result of the ambiguity and imperfection of the legislation of Ukraine on education, which the Ministry of Education and Science of Ukraine uses to illegally restrict the access of citizens of Ukraine to higher education of the third educational and scientific degree. Taking into account the requirements of the Constitution of Ukraine, the Universal Declaration of Human Rights of the United Nations, and the Convention for the Protection of Human Rights and Fundamental Freedoms, the article presents the results of a study of the peculiarities of the application of the provisions of the relevant legislative acts in the field of education (with all changes and additions introduced as of September 1, 2024), namely the Law of Ukraine “On Education” (dated September 5, 2017, under No. 2145-VIII), the Law of Ukraine “On Higher Education” (dated July 1, 2014, under No. 1556- VII) and the “Procedure for Training Candidates for Higher Education Degrees of Doctor of Philosophy and Doctor of Sciences in institutions of higher education (scientific institutions)”, approved by Resolution No. 261 of the Cabinet of Ministers of Ukraine (dated March 23, 2016). At the same time, the research is mainly focused on the peculiarities of applying the above­mentioned legislative acts to determine the differences in the conditions of access to free and paid education and the established legitimacy and feasibility of certain elements of such conditions. Principally this concerns the introduction by the State of Ukraine of unified professional exams and other tests (with the use of external independent evaluation) as a condition for access to the next stage of tests, namely, entrance exams and other tests for admission to study introduced by higher education institutions of Ukraine. That is, the legality of establishing a two-level system of competitions and entrance tests for those who wish to obtain a higher education of the third educational and scientific degree (doctor of philosophy) on a paid basis (i.e., at their own expense or the expense of non-state grants and scholarships) is being considered. The article is the sixth one within the cycle of studies in which the peculiarities of access of Ukrainian citizens to higher education in martial law conditions are addressed.

Assessing the feasibility of ChatGPT-4o and Claude 3-Opus in thyroid nodule classification based on ultrasound images.

Large language models (LLMs) are pivotal in artificial intelligence, demonstrating advanced capabilities in natural language understanding and multimodal interactions, with significant potential in medical applications. This study explores the feasibility and efficacy of LLMs, specifically ChatGPT-4o and Claude 3-Opus, in classifying thyroid nodules using ultrasound images. This study included 112 patients with a total of 116 thyroid nodules, comprising 75 benign and 41 malignant cases. Ultrasound images of these nodules were analyzed using ChatGPT-4o and Claude 3-Opus to diagnose the benign or malignant nature of the nodules. An independent evaluation by a junior radiologist was also conducted. Diagnostic performance was assessed using Cohen's Kappa and receiver operating characteristic (ROC) curve analysis, referencing pathological diagnoses. ChatGPT-4o demonstrated poor agreement with pathological results (Kappa = 0.116), while Claude 3-Opus showed even lower agreement (Kappa = 0.034). The junior radiologist exhibited moderate agreement (Kappa = 0.450). ChatGPT-4o achieved an area under the ROC curve (AUC) of 57.0% (95% CI: 48.6-65.5%), slightly outperforming Claude 3-Opus (AUC of 52.0%, 95% CI: 43.2-60.9%). In contrast, the junior radiologist achieved a significantly higher AUC of 72.4% (95% CI: 63.7-81.1%). The unnecessary biopsy rates were 41.4% for ChatGPT-4o, 43.1% for Claude 3-Opus, and 12.1% for the junior radiologist. While LLMs such as ChatGPT-4o and Claude 3-Opus show promise for future applications in medical imaging, their current use in clinical diagnostics should be approached cautiously due to their limited accuracy.

Quality assurance for online adaptive radiotherapy: a secondary dose verification model with geometry-encoded U-Net

Abstract Background &amp; Purpose: In online adaptive radiotherapy (ART), quick computation-based secondary dose verification is crucial for ensuring the quality of ART plans while the patient is positioned on the treatment couch. However, traditional dose verification algorithms are generally time-consuming, reducing the efficiency of ART workflow. This study aims to develop an ultra-fast deep-learning (DL) based secondary dose verification algorithm to accurately estimate dose distributions using CT and fluence maps (FMs). &amp;#xD;Methods: We integrated FMs into the CT image domain by explicitly resolving the geometry of treatment delivery. For each gantry angle, an FM was constructed based on the optimized multi-leaf collimator apertures and corresponding monitoring units (MUs). To effectively encode treatment beam configuration, the constructed FMs were back-projected to 30 cm away from the isocenter with respect to the exact geometry of the treatment machines. Then, a 3D U-Net was utilized to take the integrated CT and FM volume as input to estimate dose. Training and validation were performed on 381 prostate cancer cases, with an additional 40 testing cases for independent evaluation of model performance.&amp;#xD;Results: The proposed model can estimate dose in ~15 ms for each patient. The average γ passing rate (3%/2mm, 10% threshold) for the estimated dose was 99.9% ± 0.15% on testing patients. The mean dose differences for the planning target volume (PTV) and organs at risk (OARs) were 0.07%±0.34% and 0.48%±0.72%, respectively.&amp;#xD;Conclusion: We have developed a geometry-resolved DL framework for accurate dose estimation and demonstrated its potential in real-time online ART doses verification.&amp;#xD;

Examining Agreement in Psychotic Symptom Assessment: Insights from Parkinson's Disease Dementia Dyads.

Psychosis and cognitive decline often co-occur in Parkinson's Disease (PD), which complicates assessment. We measured agreement between patients with PD and dementia (PDD) and care partners (CPs) in their independent evaluation of PD-related psychotic symptoms. We compared responses to a PD psychosis rating scale (SAPS-PD) in 21 dyads of patients with PDD and cognitively normal CPs. We assessed the concordance of responses using the intraclass correlation coefficient (ICC). Following the psychosis assessment, the clinician used all available information and adjudicated who provided the most reliable responses. Dyads demonstrated poor concordance in summary scores (ICC = 0.464). Six of the nine individual items had poor agreement. The clinician adjudicated the patient's response as the more reliable in 71.4% of cases. Although many psychotic symptoms are internal and not observable, in the context of PDD, both patient and CP inputs are valuable, but final adjudication favors patient responses.