Likert Scale Score Research Articles

Abstract PO3-17-03: Impalpable breast lesion localisation device satisfaction in UK surgeons and radiologists: results of the iBRA-NET national practice questionnaire

Abstract Introduction A national practice questionnaire in 2020 collected quantitative data from UK breast surgeons on breast localisation device use and found wire to be the most frequently used localisation device for impalpable lesions (Somasundaram, et al., 2020). Wire localisation was found to be associated with significant logistical issues including displacement and delays in theatre scheduling. Localisation device practice has changed greatly in the three years since the last questionnaire (Dave, et al., 2022). This study aimed to assess the change in device use, impact on logistics and to qualitatively assess surgeon and radiologist experience across the range of localisation devices. Methods The questionnaire was designed with identical questions to the 2020 study to allow for direct comparison of change, this collected information on demographics, logistics and device use. A pilot study was conducted to ascertain domains that were important to clinicians in differentiating between the quality of localisation device experience. The qualitative questions asked respondents to assign a Likert scale score of 0-10 for satisfaction in each identified domain. Two national practice questionnaires were created used SurveyMonkey® and were distributed to UK breast surgeons and radiologists via direct email, social media and the Association of Breast Surgery newsletter. The means of the satisfaction responses were compared with the mean responses for wire as the standard using a two-sample t test using Microsoft Excel. Results The surveys were completed between August and December 2022. There were 157 completed questionnaires, with 76 responses being from surgeons and 81 from radiologists. There has been significant change in the use of localisation devices in the UK, from 83% wire, 5% radio-occult lesion localisation (ROLL), 2% radioiodine seed and 9% Magseed® in 2020 to 45% wire, 2% ROLL, 3% radioiodine seed, 30% Magseed®, 5% SAVI SCOUT, 12% Hologic LOCalizer® and 2% Sirius Pintuition® by 2022. In 2020 9% of patients had localisation performed prior to the day of surgery, by 2022 this had increased to 64% (p < 0.05). Changes in localisation techniques also allowed these patients to undergo surgery earlier on a list; 15% of units in 2020 could operate on a localisation patient prior to 9am, by 2022 this was 41%. The satisfaction scores for Magseed® were statistically significantly higher than for wire in six of eight domains for surgeons and seven of nine domains for radiologists (p < 0.05). Surgeons found SAVI SCOUT® and Hologic LOCalizer® to be preferable to wire in five and seven domains respectively (p < 0.05). Discussion The follow-up survey demonstrates a change in practice in the use of newer localisation devices. The outcomes of the change seem to be an ability to place devices in advance, earlier start times in theatre and higher clinician satisfaction. The qualitative data demonstrates that clinicians are able to differentiate between the attributes of localisation devices. Due to a small sample size in some of the newer devices we are unable to directly compare between the newer devices, however, Magseed® scored significantly higher than wires in seven of the nine domains. Table 1: Qualitative comparison of feedback on the performance of devices. This Table shows the means of the satisfaction scores for surgeons and radiologists in the eight and nine qualitative domains respectively. Localisation devices were compared to wire as the standard using a two-sample t test, statistically significantly different results (p < 0.05) are marked with an asterisk. Citation Format: Fiona Mavor, James Harvey. Impalpable breast lesion localisation device satisfaction in UK surgeons and radiologists: results of the iBRA-NET national practice questionnaire [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-17-03.

817 Promoting Durable Well-Being Among Neurosurgical Professionals via an Interactive, Online, Wellness Educational Initiative

INTRODUCTION: Burnout is increasingly recognized as a source of worse job satisfaction and well-being within neurosurgery. We initiated a 10-week department-wide wellness course (Peace Education Program, PEP) with the goal of improving well-being. METHODS: We utilized PEP, a free, interactive, online wellness course focusing on 10 domains (hope, appreciation, inner strength, self-awareness, clarity, understanding, dignity, choice, peace, and contentment). Two weeks before and 6 months after the course, we distributed de-identified surveys based upon the validated Schwartz Outcome Scale-10 (SOS) with Likert scale scores 0-6 to assess participant wellness. Completion of the course was defined as attending >7 of 10 sessions. Mann-Whitney U testing analyzed statistical differences between post-and pre-course data. p-values <0.05 were considered statistically significant. RESULTS: Sixty-nine faculty, trainees, and staff registered to participate, 41 joined >1 session, and 15 completed the course. Twenty-one and ten participants completed the pre- and post-course survey, respectively. Pre-course mean(+SD) SOS-10 score was 4.32 ± 1.23, which improved to 5.10 ± 0.75 post-course (p < 0.001). Pre-course, the lowest domain score related to “appreciation” (3.95 ± 1.46); post-course the highest domain score related to “hope” (5.30 ± 0.48). Overall, all 10 domains demonstrated improved mean scores over time, with 5 domains [“inner strength” (p = 0.008), “understanding” (p = 0.030), “hope” (p = 0.020), “choice” (p = 0.026), and “peace” (p = 0.048)] demonstrating statistically significant score improvements six months after course completion. Focusing on participants who completed >7 sessions, we additionally found statistically significant score improvements in the domains of “clarity” (p = 0.019), “contentment” (p = 0.030), and “appreciation” (p = 0.029) six months after course completion. CONCLUSIONS: Our findings demonstrate improved wellness in participants up to 6 months after wellness course completion. Participants attending >7 sessions benefited more than counterparts. This free, interactive, online course can be utilized at other neurosurgical training programs to combat burnout and improve wellness.

The application of computer-aided diagnosis in Breast Imaging Reporting and Data System ultrasound training for residents-a randomized controlled study.

The consistency of Breast Imaging Reporting and Data System (BI-RADS) classification among experienced radiologists is different, which is difficult for inexperienced radiologists to master. This study aims to explore the value of computer-aided diagnosis (CAD) (AI-SONIC breast automatic detection system) in the BI-RADS training for residents. A total of 12 residents who participated in the first year and the second year of standardized resident training in Ningbo No. 2 Hospital from May 2020 to May 2021 were randomly divided into 3 groups (Group 1, Group 2, Group 3) for BI-RADS training. They were asked to complete 2 tests and questionnaires at the beginning and end of the training. After the first test, the educational materials were given to the residents and reviewed during the breast imaging training month. Group 1 studied independently, Group 2 studied with CAD, and Group 3 was taught face-to-face by experts. The test scores and ultrasonographic descriptors of the residents were evaluated and compared with those of the radiology specialists. The trainees' confidence and recognition degree of CAD were investigated by questionnaire. There was no statistical significance in the scores of residents in the first test among the 3 groups (P=0.637). After training and learning, the scores of all 3 groups of residents were improved in the second test (P=0.006). Group 2 (52±7.30) and Group 3 (54±5.16) scored significantly higher than Group 1 (38±3.65). The consistency of ultrasonographic descriptors and final assessments between the residents and senior radiologists were improved (κ3 > κ2 > κ1), with κ2 and κ3 >0.4 (moderately consistent with experts), and κ1 =0.225 (fairly agreed with experts). The results of the questionnaire showed that the trainees had increased confidence in BI-RADS classification, especially Group 2 (1.5 to 3.5) and Group 3 (1.25 to 3.75). All trainees agreed that CAD was helpful for BI-RADS learning (Likert scale score: 4.75 out of 5) and were willing to use CAD as an aid (4.5, max. 5). The AI-SONIC breast automatic detection system can help residents to quickly master BI-RADS, improve the consistency between residents and experts, and help to improve the confidence of residents in the classification of BI-RADS, which may have potential value in the BI-RADS training for radiology residents. Chinese Clinical Trial Registry (ChiCTR2400081672).

Knowledge and Confidence of Obstetrics and Gynecology Residents in the Evaluation and Management of Heavy Menstrual Bleeding Due to Inherited Bleeding Disorders.

Heavy menstrual bleeding (HMB) is common, and 20-30% of patients presenting with HMB are diagnosed with an inherited bleeding disorder (IBD). Despite the frequent association of HMB with bleeding disorders, specific learning objectives on this topic are lacking for Obstetrics and Gynecology (OBGYN) residents. We sought to determine the exposure of OBGYN residents to didactics, clinical training, and confidence in evaluation and management of patients with HMB due to IBDs. Prospective survey of OBGYN residents through email solicitation. Residents were invited to complete an anonymous 26-item survey, querying residents' confidence in evaluation and management of HMB in patients with and without IBDs. In total, 239 OBGYN residency programs were invited to participate and 20 programs responded. Among 388 residents, 84 completed the survey (21.6%). The majority reported didactics on HMB evaluation (n = 71, 85.5%) and treatment (n = 77, 92.8%); however, for HMB due to IBDs, only 35 residents (42.4%) reported didactics on evaluation and 28 (33.7%) reported didactics on treatment. Confidence in evaluation and management of HMB was high but decreased significantly with an IBD. Residents who received didactics on IBDs reported more confidence in their evaluation than residents who did not receive didactics (mean Likert scale score of 3.67 vs. 3.23, p = 0.002). Increasing postgraduate year level was associated with more confidence in treatment (p < 0.001) and did not differ based on type of training program (p = 0.825). OBGYN residents have decreased confidence in evaluation and management of HMB due to IBDs. Resident confidence increases with didactics and training. Residents would benefit from curricula designed to address this deficit in training.

Analysis of Validity and Reliability Test of Self Efficacy Instrument in Learning Wave Material Physics at SMA Kota Padang

&lt;table border="1" cellspacing="0" cellpadding="0"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td valign="top" width="369"&gt;&lt;p&gt;Self efficacy is the result of a person's cognitive processes that produce decisions. A person's beliefs or expectations regarding their ability to complete a task or action necessary to achieve a desired outcome. This research aims to create an instrument that can measure student self efficacy by measuring the level of validity and reliability and this instrument was tested by expert lecturers and tried out in schools. The student self efficacy instrument in learning wave material physics was processed using the SPSS application. This research uses quantitative methods. This research was conducted at SMA 7 Padang City with a total sample of 122 students in this study. The results obtained were that on the instruments tested by expert lecturers, all aspects of the research obtained an overall percentage score of 91%. The self efficacy instrument used contains 5 indicators with a total of 30 statement items. With responses based on a Likert scale score of 1 to 4. Furthermore, the results of this research found that from the 30 statement items, 17 statements were valid. Meanwhile, the reliability calculation obtained was (? = 0.758).&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;

DanceAnyWay: Synthesizing Beat-Guided 3D Dances with Randomized Temporal Contrastive Learning

We present DanceAnyWay, a generative learning method to synthesize beat-guided dances of 3D human characters synchronized with music. Our method learns to disentangle the dance movements at the beat frames from the dance movements at all the remaining frames by operating at two hierarchical levels. At the coarser "beat" level, it encodes the rhythm, pitch, and melody information of the input music via dedicated feature representations only at the beat frames. It leverages them to synthesize the beat poses of the target dances using a sequence-to-sequence learning framework. At the finer "repletion" level, our method encodes similar rhythm, pitch, and melody information from all the frames of the input music via dedicated feature representations. It generates the full dance sequences by combining the synthesized beat and repletion poses and enforcing plausibility through an adversarial learning framework. Our training paradigm also enforces fine-grained diversity in the synthesized dances through a randomized temporal contrastive loss, which ensures different segments of the dance sequences have different movements and avoids motion freezing or collapsing to repetitive movements. We evaluate the performance of our approach through extensive experiments on the benchmark AIST++ dataset and observe improvements of about 7%-12% in motion quality metrics and 1.5%-4% in motion diversity metrics over the current baselines, respectively. We also conducted a user study to evaluate the visual quality of our synthesized dances. We noted that, on average, the samples generated by our method were about 9-48% more preferred by the participants and had a 4-27% better five-point Likert-scale score over the best available current baseline in terms of motion quality and synchronization. Our source code and project page are available at https://github.com/aneeshbhattacharya/DanceAnyWay.

Team performance during vacuum-assisted vaginal delivery: video review of obstetric multidisciplinary teams.

Vacuum extraction is generally considered an operator-dependent task, with most attention directed toward the obstetrician's technical abilities (1-3). Little is known about the effect of the team and non-technical skills on clinical outcomes in vacuum-assisted delivery. This study aimed to investigate whether the non-technical skills of obstetricians were correlated with their level of clinical performance via the analysis of video recordings of teams conducting actual vacuum extractions. We installed between two or three video cameras in each delivery room at Aarhus University Hospital and Horsens Regional Hospital and obtained 60 videos of teams managing vacuum extraction. Appropriate consent was obtained. Two raters carefully reviewed the videos and assessed the teams' non-technical skills using the Assessment of Obstetric Team Performance (AOTP) checklist, rating all items on a Likert scale score from 1 to 5 (1 = poor; 3 = average; and 5 = excellent). This resulted in a total score ranging from 18 to 90. Two different raters independently assessed the teams' clinical performance (adherence to clinical guidelines) using the TeamOBS-Vacuum-Assisted Delivery (VAD) checklist, rating each item (0 = not done, 1 = done incorrectly; and 2 = done correctly). This resulted in a total score with the following ranges (low clinical performance: 0-59; average: 60-84; and high: 85-100). Interrater agreement was analyzed using intraclass correlation (ICC), and the risk of high or low clinical performance was analyzed on a logit scale to meet the assumption of normality. Teams that received excellent non-technical scores had an 81% probability of achieving high clinical performance, whereas this probability was only 12% among teams with average non-technical scores (p < 0.001). Teams with a high clinical performance often had excellent behavior in the non-technical items of "team interaction," "anticipation," "avoidance fixation," and "focused communication." Teams with a low or average clinical performance often neglected to consider analgesia, had delayed abandonment of the attempted vaginal delivery and insufficient use of appropriate fetal monitoring. Interrater reliability was high for both rater-teams, with an ICC for the non-technical skills of 0.83 (95% confidence interval [CI]: 0.71-0.88) and 0.84 for the clinical performance (95% CI: 0.74-0.90). Although assisted vaginal delivery by vacuum extraction is generally considered to be an operator-dependent task, our findings suggest that teamwork and effective team interaction play crucial roles in achieving high clinical performance. Teamwork helped the consultant anticipate the next step, avoid fixation, ensure adequate analgesia, and maintain thorough fetal monitoring during delivery.

CHAMPP4KIDS: Mixed methods study protocol to evaluate acceptability and feasibility of Parenting for Lifelong Health materials in a Canadian context.

Parents and caregivers play a key role in children's healthy development and well-being. Traditional parenting interventions promote positive parenting practices and are key to preventing child maltreatment. However, numerous barriers can limit access to programs, barriers which were further exacerbated by the COVID-19 pandemic. The Parenting for Lifelong Health group developed mass media and public health communication materials to promote positive caregiving behaviours on a population level. The Champions of Positive Parenting 4 Kids (CHAMPP4KIDS) study will examine the acceptability and feasibility of these materials for service providers and caregivers of children aged 2-6 years in Ontario, Canada. This study will use a convergent mixed-methods design. Consenting service providers (n = 200) and caregivers (n = 100) will complete a quantitative survey to rate, rank and give feedback on Parenting for Lifelong Health tip sheets and social media ads. Caregivers will also complete self-report scales measuring depression and anxiety. We will hold focus group discussions with a sub-sample of surveyed providers (n = 40) and caregivers (n = 25). An adapted Trials of Improved Practices methodology will explore caregiver perspectives after implementing the tip sheets. Primary quantitative outcomes will be descriptive statistics of rankings, Likert Scale scores and descriptive analysis of caregiver depression and anxiety. Qualitative data will be analyzed using Rapid Qualitative Inquiry and triangulated through a convergent coding matrix. The Parenting for Lifelong Health COVID-19 parenting materials offer succinct, engaging parenting information in a mass media format that addresses some challenges associated with accessing in-person programming. The CHAMPP4KIDS study will provide mixed methods insights on the materials' acceptability and feasibility from different groups in a Canadian context, with a focus on marginalized families. The use of Trials of Improved Practices methodology could prove a useful tool for participant-led adaptation of existing parenting, early childhood development and other health intervention materials.

Dr. Google to Dr. ChatGPT: assessing the content and quality of artificial intelligence-generated medical information on appendicitis

IntroductionGenerative artificial intelligence (AI) chatbots have recently been posited as potential sources of online medical information for patients making medical decisions. Existing online patient-oriented medical information has repeatedly been shown to be of variable quality and difficult readability. Therefore, we sought to evaluate the content and quality of AI-generated medical information on acute appendicitis.MethodsA modified DISCERN assessment tool, comprising 16 distinct criteria each scored on a 5-point Likert scale (score range 16–80), was used to assess AI-generated content. Readability was determined using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) scores. Four popular chatbots, ChatGPT-3.5 and ChatGPT-4, Bard, and Claude-2, were prompted to generate medical information about appendicitis. Three investigators independently scored the generated texts blinded to the identity of the AI platforms.ResultsChatGPT-3.5, ChatGPT-4, Bard, and Claude-2 had overall mean (SD) quality scores of 60.7 (1.2), 62.0 (1.0), 62.3 (1.2), and 51.3 (2.3), respectively, on a scale of 16–80. Inter-rater reliability was 0.81, 0.75, 0.81, and 0.72, respectively, indicating substantial agreement. Claude-2 demonstrated a significantly lower mean quality score compared to ChatGPT-4 (p = 0.001), ChatGPT-3.5 (p = 0.005), and Bard (p = 0.001). Bard was the only AI platform that listed verifiable sources, while Claude-2 provided fabricated sources. All chatbots except for Claude-2 advised readers to consult a physician if experiencing symptoms. Regarding readability, FKGL and FRE scores of ChatGPT-3.5, ChatGPT-4, Bard, and Claude-2 were 14.6 and 23.8, 11.9 and 33.9, 8.6 and 52.8, 11.0 and 36.6, respectively, indicating difficulty readability at a college reading skill level.ConclusionAI-generated medical information on appendicitis scored favorably upon quality assessment, but most either fabricated sources or did not provide any altogether. Additionally, overall readability far exceeded recommended levels for the public. Generative AI platforms demonstrate measured potential for patient education and engagement about appendicitis.

Knowledge, risk perception and uptake of COVID-19 vaccination among internally displaced persons in complex humanitarian emergency setting, Northeast Nigeria

BackgroundOwing to crowded and unsanitary conditions, internally displaced persons (IDPs) have an increased risk of COVID-19 infection. Adoption of COVID-19 preventive measures among this population is premised on accurate information, adequate knowledge, and risk perception. We assessed COVID-19 knowledge and risk perception and investigated the association between risk perception and COVID-19 preventive measures, including vaccination among IDPs in Northeast Nigeria.MethodsWe conducted a cross-sectional study during July–December 2022 and sampled 2,175 IDPs using stratified sampling. We utilized a 12-point assessment tool to evaluate COVID-19 knowledge. Participants who scored ≥ 6 points were considered to have adequate knowledge. We used a 30-item Risk Behavior Diagnosis Scale to assess COVID-19 risk perception and evaluated each item on a 5-point Likert scale. Participants were divided into risk perception categories by the median of Likert scale scores. We performed weighted logistic regression analysis to identify factors associated with risk perception. Pearson’s chi-squared with Rao-Scott adjustment was used to determine the relationship between risk perception and COVID-19 preventive measures.ResultsOf 2,175 participants, 55.7% were 18–39 years old, 70.9% were females, and 81.7% had no formal education. Among the IDPs, 32.0% (95% CI: 28.8 – 35.0) were considered to have adequate COVID-19 knowledge, and 51.3% (95% CI: 47.8 – 54.8) perceived COVID-19 risk as high. Moreover, 46.3% (95% CI: 42.8 – 50.0) had received one dose of COVID-19 vaccine, and 33.1% (95% CI: 29.8 – 36.0) received two doses. Adequate knowledge (Adjusted Odds Ratio (AOR) = 2.10, [95% CI: 1.46 – 3.03]) and post-primary education (AOR = 3.20, [95% CI: 1.59 – 6.46]) were associated with risk perception. Furthermore, high risk perception was significantly associated with wearing face masks (χ2 = 106.32, p-value < .001), practicing hand hygiene (χ2 = 162.24, p-value < .001), physical distancing (χ2 = 60.84, p-value < .001) and vaccination uptake (χ2 = 46.85, p-value < .001).ConclusionsThis study revealed gaps in COVID-19 knowledge, risk perception, and vaccination uptake but demonstrated a significant relationship between risk perception and COVID-19 preventive practices. Health education and risk communication should be intensified to improve knowledge, elicit stronger risk perception, and enhance COVID-19 preventive practices.

Pediatric disaster preparedness curriculum across emergency medicine residencies.

To assess pediatric disaster medicine (PDM) instruction in emergency medicine (EM) residency programs and to identify barriers to integrating these skills into EM training. National survey study of United States EM Residency Program Directors (PDs) and Assistant PDs during the 2021-2022 academic year. Of the 186 EM residency programs identified, a total of 24 responses were recorded with a response rate of 12.9 percent. Importance of training was rated 5.79 (standard deviation 2.51) using the Likert scale ranging from 1 to 10. Out of 24 programs, 17 (70.8 percent) do not have any PDM training as part of residency training. Live drill, simulation, and tabletop were identified as most effective methods to deliver PDM training with the Likert scale score of 4.78, 4.6, and 4.47, respectively. Senior trainees' level of -knowledge/skills with family reunification (Likert 2.09/5; chemical-biological-radiological-nuclear explosive 2.95/5) and mass casualty preparation of the emergency department (3.3/5) as assessed by the respondents. The main barrier to education included logistics, eg, space and costs (Likert 3.7/5), lack of didactic time (3.7/5), and limited faculty knowledge, skill, or experience (3.3/5). PDM training is lacking and requires standardization. This study highlights the opportunity for the creation of a model for EM resident education in PDM.

The Perceptions and Attitudes of Saudi EFL Students Toward the Use of Communicative Language Teaching in Oral Communication Classes

Communicative Language Teaching (CLT) is widely and extensively practiced in language teaching, especially in EFL classes. In fact, most educators consider it to be the most effective and practical approach to language teaching. Early studies indicated that the positive or negative attitudes of learners toward CLT can affect their language learning process. As a result, the current study aims to unveil the perceptions and attitudes of Saudi college and graduate students toward the implementation of CLT to enhance their speaking and listening skills. Furthermore, gender role is also considered since Saudi has a segregated system of education. Questionnaire items adopted from Komol et al. (2020) were rated on a Likert scale which ranged from “Strongly Disagree” (1, very low) to “Strongly Agree” (5, very high). Mean Likert scale scores were used to evaluate the responses of participants along with the standard deviation (SD). The study found that Saudi participants displayed a higher perception of CLT activities when compared to their attitude. Moreover, females showed a higher perception and attitude toward CLT activities than males did. The highest mean scores of perception items among females are “Making a short video” because it allows them to get more exposure to English use while males have chosen “Teacher’s instruction on class CLT activities” as more significant. Concerning attitudinal items, males believe in using CLT activities to promote their language proficiency. In contrast, females believe in using role-play activities to improve their language proficiency. Finally, females showed less preference for CLT group or class activities than males did.

Lateral Margin Graft for Minimizing Visible Lateral Margin on Radix Using Autologous Rib Cartilage in Asian Rhinoplasty

BackgroundVisible lateral margin after rhinoplasty is considered one of the potential complications. PurposeThe purpose is to assess the suitability of implementing a lateral margin graft (LMG) to mitigate the occurrence of a visible lateral margin (VLM) during augmentation rhinoplasty with autologous rib cartilage.Study Design, Setting, Sample: This is a retrospective cohort study between January 2016 and April 2022 in a private clinic. The inclusion criteria were patients who underwent augmentation rhinoplasty for aesthetic purposes using autologous rib cartilage. Patients who received allogenic tissue grafts or alloplastic materials, those with systemic diseases, and pregnant or breastfeeding females were excluded. Predictor variableThe primary predictor variable is the implementation or non-implementation of a LMG. Main outcome variablesThe primary outcome variable is the aesthetic satisfaction and the degree of minimization of the VLM when LMG is implemented and when it is not. Therefore, to understand the aesthetic satisfaction, the author used the Rhinoplasty Outcome Evaluations questionnaire (ROE), and to understand the degree of minimization of the VLM, the author measured the Lateral margin visibility score (LMVS) using a 5-Point Likert scale score. CovariatesThe evaluated covariates included sex, age at surgery, number of previous rhinoplasties, purpose of surgery and postoperative complications. AnalysesThe data were analyzed using the Independent Samples T-test, Paired T-test, Oneway ANOVA test. A significance level of P< 0.05 was employed for all statistical analyses. ResultsA total of 69 consecutive patients were included in the study, divided into Group 1(21 patients without LMG) and Group 2(48 patients with LMG). Postoperative ROE scores increased by 15.31±4.03 in Group 1 and 22.60±6.77 in Group 2 compared to preoperative ROE scores(P<0.001). In the patients’ LMVS, Group 1 had a score of 2.48±0.81, while Group 2 had a score of 3.06±0.76 points(P=0.009). In the surgeons’ LMVS, surgeon 1 indicated scores of 2.38±0.74 and 2.94±0.89 points, respectively(P=0.007). Furthermore, surgeon 2 indicated scores of 2.28±0.72 and 2.90±0.83 points, respectively(P=0.002). ConclusionWhen performing rhinoplasty using autologous rib cartilage, the use of a LMG can minimize the visible lateral margin, which increases patient satisfaction and the surgical completeness.

Promoting durable well-being among healthcare professionals via an interactive, online, wellness initiative.

Burnout is recognized as a negative contributor to well-being within healthcare. The purpose of this study was to evaluate whether participation in the Peace Education Program (PEP), a 10-week wellness course, promoted durable improvement of burnout and wellness in a large academic medical center. We deployed PEP virtually through a series of free, interactive, online wellness sessions focusing on 10 domains: peace, appreciation, inner strength, self-awareness, clarity, understanding, dignity, choice, hope, and contentment. Two weeks before and six months following the sessions, we distributed de-identified surveys based upon the validated Schwartz Outcome Scale-10 (SOS-10) with Likert scale scores 0-6 to assess participant wellness. The Mann-Whitney U test was used to analyze statistical differences between post- and pre-course data. Sixty-nine faculty, trainees, and staff registered to participate, 21 participants completed the pre-course survey and 10 completed the post-course survey. The pre-course mean + standard error (SE) SOS-10 score was 43.2 ± 0.8, which improved to 51.0 ± 0.7 post-course (P < 0.001). Overall, all 10 domains demonstrated improved mean scores over time, with the five domains of "inner strength" (P = 0.008), "understanding" (P = 0.030), "peace" (P = 0.048), "choice" (P = 0.026), and "hope" (P = 0.020) demonstrating statistically significant score improvements six months after course completion. Participants completing ≥7 sessions benefited more than their counterparts and achieved statistically significant improvement in SOS-10 wellness scores (8.77 points) six months after course completion. Our findings demonstrate improved wellness in participants following peace education course completion. This free, interactive, online course may be utilized at other medical centers to improve wellness.

Evaluating artificial intelligence's role in lung nodule diagnostics: A survey of radiologists in two pilot tertiary hospitals in China.

This study assesses the perceptions and attitudes of Chinese radiologists concerning the application of artificial intelligence (AI) in the diagnosis of lung nodules. An anonymous questionnaire, consisting of 26 questions addressing the usability of AI systems and comprehensive evaluation of AI technology, was distributed to all radiologists affiliated with Beijing Anzhen Hospital and Beijing Tsinghua Changgung Hospital. The data collection was conducted between July 19, and 21, 2023. Of the 90 respondents, the majority favored the AI system's convenience and usability, reflected in "good" system usability scale (SUS) scores (Mean ± standard deviation [SD]: 74.3 ± 11.9). General usability was similarly well-received (Mean ± SD: 76.0 ± 11.5), while learnability was rated as "acceptable" (Mean ± SD: 67.5 ± 26.4). Most radiologists noted increased work efficiency (Mean Likert scale score: 4.6 ± 0.6) and diagnostic accuracy (Mean Likert scale score: 4.2 ± 0.8) with the AI system. Views on AI's future impact on radiology careers varied (Mean ± SD: 3.2 ± 1.4), with a consensus that AI is unlikely to replace radiologists entirely in the foreseeable future (Mean ± SD: 2.5 ± 1.1). Radiologists at two leading Beijing hospitals generally perceive the AI-assisted lung nodule diagnostic system positively, citing its user-friendliness and effectiveness. However, the system's learnability requires enhancement. While AI is seen as beneficial for work efficiency and diagnostic accuracy, its long-term career implications remain a topic of debate.

Needle track technique in strabismus surgery

Aims/Purpose: Scleral perforation during the passage of suture needle is a known complication of strabismus surgery.[1–4] The present study was conducted as a pilot study to evolve a safe and easy technique of passing the suture needle through the sclera. A scleral tunnel was created with a 26‐guage needle through which the suture needle was passed.Methods: After taking clearance from the Institutional Ethics Committee, an interventional study was carried out on twenty consenting patients. A tunnel through approximately half the thickness of the sclera was created with the help of a bent 26‐gauge needle. The suture needle was then passed through this tunnel. Rest of the steps of the surgery were carried out in the conventional manner. In a control group of same number of patients, the surgery was performed in the conventional method. Both the groups were followed up for any complications. Ease of passing suture and surgeons' satisfaction with the technique was noted on a 5‐point Likert scale.Results: None of the patients in either group suffered from any complications. Four surgeons participated in the study. The average Likert scale score of the surgeons for satisfaction with the technique was 5 on a scale of 5. The score for ease of passage of suture needle was 5 on a score of 5.Conclusions: The needle track is an easy technique to perform which eases the passage of suture needle through the sclera. This will increase the confidence of Ophthalmologists, specially the residents in performing strabismus surgery.

The Medical Student Guide to Pharmacy: Piloting an Interactive Textbook on Basic Pharmacology Principles and Clinical Correlations.

Despite the wide use of medications in clinical practice, graduating medical students often feel unprepared for the task of prescribing upon starting residency. With recent educational initiatives aiming to transform learning modalities, we sought to pilot an interactive textbook on basic pharmacology principles at our institution as a supplement to first-year lectures and assess its subjective impact on students' knowledge of content as well as confidence to apply material in the real world through pre- and post-intervention surveys. First-year medical students were invited to complete non-validated, voluntary, anonymous, emailed, online surveys consisting of Likert scale and free-text response questions. Our investigation served as a pilot test for future iterations of this research. Response rates for the pre- and post-intervention surveys were 73/145 (50%) and 38/145 (26%), respectively, with the post-intervention survey further reduced to 13 individuals who indicated use of the interactive textbook. Questions regarding interactive textbook chapters that overlapped with course content were excluded from data analysis due to an inability to separate learning gains from lectures versus the interactive textbook. Post-intervention survey responses all showed significant changes in mean Likert scale scores on student-perceived knowledge and confidence to apply material with P < .001. Free-text response questions revealed limited exposure to the field of pharmacy and interactions with pharmacists prior to medical school. Our pilot study on the initial use of an interactive textbook titled The Medical Student Guide to Pharmacy presented us with valuable insight into providing first-year medical students with a clinically oriented supplemental resource within coursework on basic pharmacology. Challenges for the future include better integrating the interactive textbook into class lectures to facilitate increased use by students as well as developing more targeted, validated assessments of the impact it has on students' learning.

Validity and Reliability Test of the Learning Independence Questionnaire Instrument in Using Electronic Modules

This research aims to create an instrument that can measure students' learning independence by measuring the level of validity and reliability. The instrument is a questionnaire for student learning independence consisting of 41 statements (20 positive statements and 21 negative statements) with responses based on a Likert scale score of 1 to 5. The research location for the empirical test of learning independence was at SMAN 1 Kalasan class XII MIPA in 3 classes. The number of empirical trial participants was 99 students. The results of the empirical test of the learning independence questionnaire instrument were then analyzed using the Winstep Rasch model program. The quality of the instrument can be determined from the unidimensional assumption test, the suitability test of the statement items to the Rasch model (item fit), and the bias of the statement items with the help of the Winstep program. The results obtained were that in the validity calculation there was 1 invalid statement out of 41 existing statements, namely the statement "I try to study as best as possible to achieve good performance" on the responsibility indicator. The reliability of the learning independence questionnaire instrument regarding the use of electronic modules is 0.93 and is in the very high category, so it can be concluded that the other 40 statements are declared valid and variable so that they can be used as instruments in measuring learning independence regarding the use of electronic modules.

Can natural language processing serve as a consultant in oral surgery?

ObjectiveIn this comprehensive evaluation, ten experienced oral surgeon experts posed a total of twenty oral surgery-related questions, including dental implant and tooth extractions, to three distinct Natural Language Processing (NLP)-based chatbot platforms: ChatGPT, Microsoft Bing, and Google Bard. The study aimed to assess the effectiveness of these chatbots in responding to specialized medical questions. Materials and methodsTwo primary evaluation metrics were employed: a Likert Scale (LS) for measuring the accuracy and completeness of responses and a Global Quality Scale (GQS) for evaluating the clarity of responses. Statistical analyses, including one-way analysis of variance (ANOVA) and Post Hoc Tukey, were conducted to assess and compare the performance of the chatbots as rated by the experts. ResultsThe results of the study revealed significant differences in the performance of the chatbots. ChatGPT statistically achieved a better mean LS score of 1.4000±0.15986 than Microsoft Bing (1.8750±0.18143) and Google Bards (2.0500±0.12472) (P < 0.001). Additionally, ChatGPT statistically achieved a higher GQS score of 4.4200±0.30111 than Microsoft Bing (3.7550±0.28621) and Google Bards (3.5250±0.22392) (P < 0.001). ConclusionsThese findings showed the substantial advantage of ChatGPT in effectively addressing oral surgery-related questions with superior accuracy, completeness, and clarity. The study highlights the potential of advanced NLP platforms to enhance information retrieval and communication within the field of oral surgery, reinforcing the utility of such technologies in medical and surgical domains.

Virtual non-contrast images of detector-based spectral computed tomography in dogs: a promising alternative to true non-contrast images in veterinary medicine.

In veterinary medicine, abdominal computer tomographic (CT) examinations regularly require a minimum of two scans, with a native scan (true unenhanced, TUE) as a reference for the subsequent contrast-enhanced CT scan (CECT). Spectral detector CT (SDCT) offers the possibility to calculate virtual non-contrast (VNC) images from the post-contrast scan, but this has not yet been investigated in veterinary medicine. The purpose of this study was to assess the reliability of VNC images for abdominal organs in 44 dogs without abdominal pathologies by evaluating their quantitative and qualitative parameters compared to TUE images. We hypothesized that the subtraction of iodine is sufficient in the VNC series compared to the TUE series and that the image quality of the SDCT series is superior to conventional CT images. Corresponding attenuation values in the VNC and TUE series regarding the regions of interest (ROI) in different parenchymal organs and major vessels of the abdominal cavity were assessed by means of a two one-sided t-test (TOST) and Bland-Altman plots. Additionally, the signal-to-noise ratio (SNR) was calculated for each ROI in the different series. In the second step, two board-certified veterinary radiologists made a qualitative assessment of VNC images vs. TUE images in consensus by rating the iodine subtraction, image noise, and image quality of VNC images based on a specific 5-point Likert scale. The difference in corresponding Hounsfield units (HUs) between TUE and VNC images was less than 10 HU in 78.67% of all ROIs. Regarding the limit of less than 10 HU, in the performed TOST, significant p-values of < 0.05 were reached for the liver, spleen, pancreas, and musculature, implying equivalence of both modalities. The quality of spectral base image (SBI) data was rated equivalent to calculated conventional images in the subjective assessment by reaching an average Likert scale score of 3.2 points. VNC images calculated from SDCT data prove a valid alternative to conventional TUE images in the abdominal organs of canine patients without abdominal pathology. VNC offers the possibility to reduce time under general anesthesia and minimize radiation exposure. Future studies are needed to prove the application of this method in clinically diseased patients.