Moderate Negative Correlation Research Articles

ChatGPT as an item calibration tool: Psychometric insights in a high-stakes examination

Introduction:ChatGPT has attracted a lot of interest worldwide for its versatility in a range of natural language tasks, including in the education and evaluation industry. It can automate time- and labor-intensive tasks with clear economic and efficiency gains. Methods: This study evaluated the potential of ChatGPT to automate psychometric analysis of test questions from the 2020 Portuguese National Residency Selection Exam (PNA). ChatGPT was queried 100 times with the 150 MCQ from the exam. Using ChatGPT's responses, difficulty indices were calculated for each question based on the proportion of correct answers. The predicted difficulty levels were compared to the actual difficulty levels of the 2020 exam MCQ’s using methods from classical test theory. Results:ChatGPT's predicted item difficulty indices positively correlated with the actual item difficulties (r (148) = −0.372, p < .001), suggesting a general consistency between the real and the predicted values. There was also a moderate significant negative correlation between the difficulty index predicted by ChatGPT and the number of challenges (r (148) = −0.302, p < .001), highlighting ChatGPT′s potential for identifying less problematic questions. Conclusion: These findings unveiled ChatGPT’s potential as a tool for assessment development, proving its capability to predict the psychometric characteristics of high-stakes test items in automated item calibration without pre-testing in real-life scenarios.

The Patient's Perspective: Does It Align with Dialysis Adequacy?

The concept of patient-centered care puts the individual's health needs and desired health outcomes as the driving forces behind medical decision-making and quality assessment in the healthcare system. Patients with end-stage kidney disease (ESKD) treated by hemodialysis require frequent encounters with the dialysis facility in order to survive. Therefore, their satisfaction with care and perceived patient experience are important aspects that might impact their adherence to the care regimen. The aim of this study was to evaluate patient satisfaction and its association with perceived patient experience and objective clinical quality parameters, across three hemodialysis clinics. A prospective cohort study analyzed the data of 126 patients with ESKD receiving chronic hemodialysis over 9 months in 3 different care facilities. Sociodemographic characteristics, medical history, treatment details, and dialysis adequacy (measures as STDKt/V) were collected. Perceived quality of care, patient satisfaction and clinical outcomes were assessed. Patients differed significantly between sites by age, diabetes status and biochemical parameters. Satisfaction scores varied significantly for 12/14 survey questions and at the site-level, with Site 2 scoring highest. Overall satisfaction did not correlate with Kt/V. At Site 1, a moderate negative correlation was found between satisfaction and Kt/V. Kt/V correlated positively with age but inversely with satisfaction. Hospitalization rates were similar regardless of satisfaction. Mortality trended lower in the highest Kt/V quartile. Achieving clinical quality while optimizing patient satisfaction requires multifactorial approaches tailored to the unique population of the hemodialysis facility. Further research is needed to fully understand factors influencing satisfaction and perceived quality.

Cerebellitis following COVID-19 infection: A case-based systematic review and pooled analysis

BackgroundThe COVID-19 pandemic has been linked to neurological complications, including Cerebellitis. This study aims to investigate the clinical features, and consequences of Cerebellitis following COVID-19 infection, informing medical management strategies. MethodsA systematic search was conducted through PubMed, Web of Science, Embase, ProQuest, and Cochrane databases from January 2018 to September 12, 2023, on cases post-COVID-19. Demographics, clinical characteristics, and diagnostic techniques were analyzed using descriptive statistics. Chi-Square tests assessed associations between diagnoses and treatments, with visualizations including heatmaps and scatter plots. ResultsAfter the final Screening, the analysis of 18 cases revealed Cerebellitis post-COVID-19 spanned 9 countries, predominantly from the USA (27.8 %), with a mean patient age of 40.1 years (±24.6). Males comprised 94.4 % of cases. Common underlying conditions included hypertension (22.2 %) and diabetes (11.1 %). Neurological symptoms presented on average 15.15 ± 12.7 days post-COVID-19 infection. A moderate negative correlation (r = −0.358) was observed between age and symptom onset. Blood and CSF biomarkers showed weak correlations with symptom onset intervals. Treatment efficacy varied, with most cases achieving symptom-free outcomes. The Chi-Square test for diagnosis-treatment associations yielded a p-value of 0.089, and for follow-up outcomes, a p-value of 0.283, indicating no significant statistical associations. ConclusionThis systematic review highlights increased reports of Cerebellitis in males in their fourth decade of life, with the highest comorbidities being vascular diseases. Marker assessments show a decrease in CSF protein in half of patients, along with complete recovery following combination treatment with antivirals and steroids in acute Cerebellitis.

Patterns and controls of topographic change within the deflation basins of a trough and bowl coastal blowout

AbstractIn North‐West Europe and throughout the world, dune systems are increasingly stabilised by vegetation, due to both human intervention and changes in climate. Blowouts are erosional hollows produced by wind erosion in vegetated or semi‐vegetated dune systems. Where active blowouts are present in vegetated dunes, they provide a source of dynamism and sediment in an otherwise fixed environment. The transition from a fixed vegetated dune to an active blowout is poorly understood, however, and anthropogenic attempts to reactivate areas of bare sand in dunes are often unsuccessful. In this study, we measured topographic change at a monthly resolution in the deflation basins of one bowl and one trough blowout over a 23‐month period in Ainsdale Sand Dunes National Nature Reserve, North‐West England. Our results show that monthly surface change in the blowouts did not correlate strongly with the transport capacity of winds measured at a meteorological station 10 km south of the site. Precipitation was found to have a moderate negative correlation with all indices of surface change, that is, the more it rained the less the surface changed. Inter‐annual (23 months) patterns of topographic change in the bowl and trough blowouts were distinctly different. In the deflation basin of the bowl blowout erosion predominantly took place on the erosional walls facing into the prevailing winds, while minimal change occurred on the erosional walls facing away from the prevailing wind direction. This produced a moderate negative correlation between surface change and slope, that is, the steeper the slope, the more erosion occurred. In the trough blowout, erosion took place in the centre of the deflation basin and minimal change was measured on the easternmost erosional wall, which faced the prevailing winds. Patterns of monthly topographic change were highly variable and demonstrated that changes in the direction of above‐threshold winds can cause blowout walls and floors to ‘flip’ from erosional to depositional surfaces. These findings highlight the variability and complexity of surface change in blowouts and demonstrate that patterns vary because of landform morphology and climatic conditions.

Patterns and controls of topographic change within the deflation basins of a trough and bowl coastal blowout

AbstractIn North‐West Europe and throughout the world, dune systems are increasingly stabilised by vegetation, due to both human intervention and changes in climate. Blowouts are erosional hollows produced by wind erosion in vegetated or semi‐vegetated dune systems. Where active blowouts are present in vegetated dunes, they provide a source of dynamism and sediment in an otherwise fixed environment. The transition from a fixed vegetated dune to an active blowout is poorly understood, however, and anthropogenic attempts to reactivate areas of bare sand in dunes are often unsuccessful. In this study, we measured topographic change at a monthly resolution in the deflation basins of one bowl and one trough blowout over a 23‐month period in Ainsdale Sand Dunes National Nature Reserve, North‐West England. Our results show that monthly surface change in the blowouts did not correlate strongly with the transport capacity of winds measured at a meteorological station 10 km south of the site. Precipitation was found to have a moderate negative correlation with all indices of surface change, that is, the more it rained the less the surface changed. Inter‐annual (23 months) patterns of topographic change in the bowl and trough blowouts were distinctly different. In the deflation basin of the bowl blowout erosion predominantly took place on the erosional walls facing into the prevailing winds, while minimal change occurred on the erosional walls facing away from the prevailing wind direction. This produced a moderate negative correlation between surface change and slope, that is, the steeper the slope, the more erosion occurred. In the trough blowout, erosion took place in the centre of the deflation basin and minimal change was measured on the easternmost erosional wall, which faced the prevailing winds. Patterns of monthly topographic change were highly variable and demonstrated that changes in the direction of above‐threshold winds can cause blowout walls and floors to ‘flip’ from erosional to depositional surfaces. These findings highlight the variability and complexity of surface change in blowouts and demonstrate that patterns vary because of landform morphology and climatic conditions.

Building resilience: Insights into ecosystem-based integrated environmental risk reduction approaches for urban environments in coastal Bangladesh

The intricate relationship between environmental quality, ecosystem services, and human well-being underscores the importance of understanding and addressing environmental complexities. Considering these issues, this research aims to propose ecosystem-based approaches for mitigating environmental risks within the Khulna City Corporation (KCC) area, while also elucidating the connection between ecosystem services and these risks. By doing so, it indirectly addresses disaster risk reduction approaches, acknowledging the relationship between environmental degradation and increased disaster occurrences. Leveraging multi-spectral Landsat images from 2001 (Landsat-5), 2011 (Landsat-5), and 2021 (Landsat-8), the study evaluates LULC dynamics and quantifies ecosystem service values (ESVs) using the Benefit Transfer Method. Additionally, seven key indicators, including land use-based carbon emissions, elevation, LST, NDVI, NDWI, NDSI, and NDBI, were analyzed to monitor spatiotemporal changes. The weighted overlay method was employed to integrate raster data and delineate environmental risk zones driven by deteriorating ESVs in KCC. Notably, the study reveals a significant increase in highly environmental risk areas from 7 % to 34 % and a decrease in medium-risk areas from 92 % to 60 % of the total area between 2001 and 2021 due to the decline in ecosystem services resulting from unplanned rapid urbanization. Furthermore, a moderate negative correlation (R2 values of 0.56, 0.67, and 0.69) between ESVs and the environmental risk index underscores the linkage between deteriorating ecosystem services and the expansion of high-risk zones. Furthermore, this study advocates policies such as drought-resistant tree plantations, community involvement, post-disaster resource provision, funding allocation, and stakeholder knowledge dissemination to enhance the resilience of KCC.

Effect of brimonidine on vascular density and imagej-derived flow index of optic nerve head and macula in primary open angle glaucoma.

To study the effect of brimonidine on vascular density and flow index of optic nerve head (ONH) and macula in primary open angle glaucoma (POAG) using optical coherence tomography angiography (OCTA). Twenty-three brimonidine-naïve POAG patients were started on brimonidine. They underwent OCTA ONH and macula before commencing brimonidine and one month thereafter. Systemic arterial blood pressure (SABP) and intraocular pressure (IOP) were measured at each visit to calculate mean ocular perfusion pressure (MOPP). The OCT angiograms were analyzed using ImageJ software to calculate ONH and macular flow indices. Thirty-seven eyes (23 patients) with a mean age of 56.7 ± 12.49years were included of whom 60.8% were males. Brimonidine was associated with an increase in the superficial flow index (SFI) (P-value = 0.02) and optic nerve head flow index (ONHFI) (P-value = 0.01). Also, superficial vascular density (SVD) for whole image, superior-hemi and fovea increased (P-value = 0.03, 0.02, 0.03 respectively). ONH inferior-hemi vascular density decreased (P-value = 0.01) despite an increase in inferior quadrant retinal nerve fiber layer thickness (RNFLT) (P-value = 0.03). There was no statistically significant correlation between flow indices and MOPP at baseline and follow-up. A moderate negative correlation was found between SVD and DVD at the fovea and MOPP at baseline and follow-up (P-value = 0.03, 0.05) (P-value = 0.02, 0.01) respectively. Brimonidine was associated with an increase in SFI, ONHFI and SVD indicating improved GCC and RNFL perfusion in POAG. Despite the increase in inferior quadrant RNFLT, the concomitant decrease in inferior-hemi ONHVD precluded a conclusion of hemodynamically-mediated improvement of RNFLT.

Investigation on the contaminate of hand washing activities on the surface of environmental objects in intensive care unit

To detect the contaminate of faucets in hospitals and the splash during hand washing, and to explore the reasonable layout of hand washing pools. Two faucets with roughly the same spatial layout in the ICU of a third-class first-class general hospital were selected, and the farthest splashing distance and specific splashing points were measured by color paper. Samples were detected by ATP detection technology and routine microbial detection method, and the contaminate of faucets was analyzed. After 72 h of daily hand-washing activities, the furthest distance to the splash point was about 100 cm around the faucet, and the place 40–110 cm around the faucet was contaminated seriously. The farthest distance that the splash point reached was about 80 cm around the faucet with the center of the circle, and the area 40–60 cm around the faucet was heavily contaminated. The distance from the water outlet of the long handle and the short handle faucet to the detection point had a high negative correlation (r = − 0.811, P < 0.001) and a moderate negative correlation (r = − 0.475, P = 0.001) with the number of splash points, respectively. The qualified rates of ATP detection and microbial culture were 25% and 15%, respectively. Pseudomonas aeruginosa, Staphylococcus epidermidis, and other pathogenic bacteria were detected in the water outlet of the faucet and the surrounding environment. Safe hand hygiene facilities are one of the important guarantees of hand hygiene effect. Clean objects and objects related to patients should not be placed within 1 m range near the water outlet of faucet. Anti-splash baffle should be installed as much as possible when conditions permit to reduce the contaminate caused by splash during hand washing.

Genomic insights into the shared and distinct genetic architecture of cognitive function and schizophrenia

Cognitive impairment is a major determinant of functional outcomes in schizophrenia, however, understanding of the biological mechanisms underpinning cognitive dysfunction in the disorder remains incomplete. Here, we apply Genomic Structural Equation Modelling to identify latent cognitive factors capturing genetic liabilities to 12 cognitive traits measured in the UK Biobank. We identified three broad factors that underly the genetic correlations between the cognitive tests. We explore the overlap between latent cognitive factors, schizophrenia, and schizophrenia symptom dimensions using a complementary set of statistical approaches, applied to data from the latest schizophrenia genome-wide association study (Ncase = 53,386, Ncontrol = 77,258) and the Thematically Organised Psychosis study (Ncase = 306, Ncontrol = 1060). Global genetic correlations showed a significant moderate negative genetic correlation between each cognitive factor and schizophrenia. Local genetic correlations implicated unique genomic regions underlying the overlap between schizophrenia and each cognitive factor. We found substantial polygenic overlap between each cognitive factor and schizophrenia and biological annotation of the shared loci implicated gene-sets related to neurodevelopment and neuronal function. Lastly, we show that the common genetic determinants of the latent cognitive factors are not predictive of schizophrenia symptoms in the Norwegian Thematically Organized Psychosis cohort. Overall, these findings inform our understanding of cognitive function in schizophrenia by demonstrating important differences in the shared genetic architecture of schizophrenia and cognitive abilities.

O-019 Outcomes and correlations between traditional Intracytoplasmic Sperm Injection (ICSI) method and a new AI-enhanced system

Abstract Study question In the context of ICSI, how does the Sperm Tracer Deep Neural Network analysis compare to the embryologist’s sperm selection technique? Summary answer Sperm Tracer AI system significantly improves fertilization rates, offering a standardized, objective approach to sperm selection, but nuanced correlations highlight complexities in sperm parameters. What is known already Traditional sperm selection during ICSI relies on subjective, manual methods, introducing variability and affecting pregnancy success. In response, AI applications, aim to enhance objectivity, potentially improving pregnancy rates. Study design, size, duration Between September and December 2023, the study examined 26 fresh ICSI cycles in a total of 268 sibling oocytes. Men aged 18 years and above with 34.4 mean women’s age. The Sperm Tracer group underwent single embryo culture, while the Embryologists' group underwent group embryo culture. The study analyzes statistical differences in fertilization rates, day 3 and day 5 embryo development. The study duration aligns with the analyzed cycles. Participants/materials, setting, methods The study compared real-time AI-assisted sperm evaluation with the Sperm Tracer system to the traditional ICSI method by embryologists. Correlation analysis was performed for the following kinematic parameters: Amplitude of Lateral Head displacement (ALH), Dance (DNC), Linearity (LIN), Straightness (STR), Wobble (WOB), Curvilinear Velocity (VCL), Linear Velocity (VSL) and Average Path Velocity (VAP). Statistical analysis involved Odds Ratios (OR) with 95% confidence intervals, Mann-Whitney U tests and correlation analyses by Pearson’s coefficient. Main results and the role of chance The Sperm Tracer system exhibited a noteworthy enhancement in fertilization rates (OR: 0.46, 95% Confidence Intervals (CI) [0.23, 0.89], p = 0.0224) but no significant differences in cleavage stages, blastocyst formation, or the production of good-quality embryos compared to conventional methods. For correlation analysis used two groups of sperm population. Group A comprises spermatozoa subjected to ICSI with the Sperm Tracer system, resulting in unsuccessful oocyte fertilization and Group B consists of spermatozoa that achieved successful fertilization. In Group A, correlation analysis identified significant negative associations between DNC and linear parameters (LIN, STR, WOB) (p &amp;lt; 0.001), highlighting the clinical relevance in sperm motility. Group B displayed a distinct negative correlation between DNC and LIN (p = 0.03941), indicating potential effects on sperm linear velocity. LIN in Group A exhibited strong negative correlations with WOB (p = 0.0001), moderate negative correlations with STR (p = 0.0028), and VCL (p = 0.0773). Moreover, ALH analysis in Group A unveiled robust negative correlations with LIN, STR, and WOB, suggesting clinical significance in sperm motility. These intricate findings underscore the Sperm Tracer system's primary advantage in optimizing fertilization rates, offering valuable insights for refining sperm selection strategies in assisted reproduction. Limitations, reasons for caution The study faces limitations due to a small sample, impacting generalizability. Divergence in culture embryo strategies introduces bias, necessitating validation in larger studies. The system includes morphology analysis, but no data analysis has been conducted. Exploring the correlation between morphology, considering embryo culture variations, and motility could provide valuable insights. Wider implications of the findings This study highlights AI applications like Sperm Tracer, showcasing their potential to improve assisted reproduction outcomes. Recognizing AI's impact on IVF success is vital for adoption. Integrating AI into clinic protocols may boost IVF efficiency, requiring training for embryologists to ensure effective utilization. Trial registration number Not applicable

Impact of Pharmacist-Led Intervention on Adherence to Inhalers, Inhalation Technique, and Disease Control Among Asthma/COPD Patients in a Resource Limited Center: An Interventional Study.

Asthma and Chronic obstructive pulmonary disease (COPD) are chronic respiratory conditions characterized by airflow obstruction and respiratory symptoms. Adherence to prescribed inhaler therapy and correct inhalation technique are essential for effective disease management and optimal disease control. However, non-adherence and incorrect inhalation technique are common challenges faced by patients with asthma and COPD, leading to suboptimal treatment outcomes and increased healthcare burden. To study the impact of a pharmacist-led intervention on inhaler adherence, inhalation technique, and disease control among patients with asthma and COPD. A pre-post interventional design assessed the effects of pharmacist-led intervention on inhaler adherence, inhalation techniques, and disease control in asthma and COPD patients at Dhulikhel Hospital in Nepal. Inclusion criteria: adult patient clinically diagnosed with asthma or COPD patients of all genders. The intervention comprised counseling patients with aids like videos, and informational leaflets. Impact was measured using checklist method for inhalation technique, the Test of Adherence to Inhaler (TAI) questionnaire for adherence to inhaler, and "Asthma Control Test (ACT)" or "COPD Assessment Test (CAT)" for disease control. The pharmacist-led intervention significantly increased adherence to inhalers, evidenced by a notable rise in the proportion of patients with good adherence (P<0.001). Sporadic, deliberate, and unwitting noncompliance pattern also improved significantly after the intervention (P<0.001, P<0.001 and P=0.001). Inhalation technique exhibited substantial improvement after intervention (P<0.001). The analysis indicated significant moderate negative correlations between "TIA" and "CAT" [ρ=-0.31; P=0.01], and between "inhalation technique score" and "CAT score" [ρ=-0.31; P=0.01] suggesting that as adherence to inhaler usage and inhalation technique improve, CAT scores tend to decrease, indicating reduced disease impact on the patient. This study shows the potential efficacy of pharmacist-led intervention in enhancing adherence to inhaler, inhalation technique, and disease control in respiratory conditions such as asthma and COPD.

Ocular Perfusion Pressure in Primary Open Angle

Purpose: To determine thecorrelation of Mean Ocular Perfusion Pressure (MOPP) with Mean Arterial Pressure (MAP) in primary open angle glaucoma (POAG)and normal tension glaucoma. Study Design: Cross sectional study. Place and Duration of Study: Khyber Teaching hospital, Peshawar from July, 2017 to December, 2019. Methods: A total of 375 patients with POAG were admitted in the hospital. Patients with variable blood pressure (BP) on admission or history of blood pressure or using anti-hypertensive drugs were selected. Patients with secondary Glaucoma, Primary Angle closure Glaucoma, patients with Diabetes mellitus and age below 40 years were excluded. Finally,200 patients were recruited by convenience sampling. Forty-eight hours monitoring of MAP and Intra ocular pressure (IOP) phasing were done. MAP, MOPP and peak IOP were charted. Results: MAP and MOPP variabilitywas observed in 53% of patients with POAG. The Pearson co-relation coefficient for those patients in which intervention had yet not been done was -0.460 suggesting a moderate negative correlation between MOPP and IOP (p value &lt;0.01). In IOP controlled patients, the coefficient was -0.346 (p&lt;0.01). Theresults showed a negative correlation between the two values in both data sets. The correlation co-efficient for MAP and IOP in both pre-admission and controlled IOP patients showed strong positive correlation (0.816 and 0.854 respectively for two tailed tests with 0.01 significance). Conclusion: MOPP, MAP and IOP are correlated and their determination is important in all Primary Open Angle Glaucoma particularly in Normal Tension Glaucoma.

Laryngopharyngeal reflux diagnosis: Factors associated with patient satisfaction

PurposeTo examine the patient experience of laryngopharyngeal reflux diagnosis and factors that contributed to perceived difficulty with the process. Materials and methodsA 32-question anonymous survey was administered to individuals over 18 years old who reported a diagnosis of laryngopharyngeal reflux. The survey contained questions regarding demographics and individuals' experiences during the diagnostic workup along with the generic short patient experiences questionnaire. Percentages were calculated for all variables. Kendall rank correlation coefficient was performed to measure the strength and direction of association between laryngopharyngeal reflux workup and perceived difficulty with diagnosis. ResultsOf the 232 respondents, 59.9 % reported difficulty with the diagnostic process. Strong positive correlations were found between perceived difficulty with laryngopharyngeal reflux diagnosis and the following factors: total number of physicians seen (τb = 0.483, p < 0.001), time from symptom onset (τb = 0.300, p < 0.001), and time from first physician visit (τb = 0.479, p < 0.001). Results from the generic short patient experiences questionnaire showed moderate negative correlations between perceived difficulty with diagnosis and the following factors: perceived competence of physician (τb = −0.228, p < 0.001), perception that the physician cared for the patient (τb = −0.253, p < 0.001), perceived interest the physician had in the patient (τb = −0.259, p < 0.001), and time interacting with the physician (τb = −0.226, p < 0.001). ConclusionsRespondents report difficulty being diagnosed with laryngopharyngeal reflux. This correlates with increased time to receive a diagnosis, increased number of physicians seen, and factors related to the patient-physician relationship. Physicians can improve patient experience by focusing on clear communication with interactive patient appointments, and scheduling high yield diagnostic tests.

Optimizing Choice of Skin Surrogates for Surface-Guided Stereotactic Body Radiotherapy of Lung Lesions Using Four-Dimensional Computed Tomography.

Image-guided radiotherapy supported by surface guidance can help to track lower lung lesions' respiratory motion while reducing a patient's exposure to ionizing radiation. However, it is not always clear how the skin's respiratory motion magnitude and its correlation with the lung lesion's respiratory motion vary between different skin regions of interest (ROI). Four-dimensional computed tomography (4DCT) images provide information on both the skin and lung respiratory motion and are routinely acquired for the purpose of treatment planning in our institution. An analysis of 4DCT images for 57 patients treated in our institution has been conducted to provide information on the respiratory motion magnitudes of nine skin ROIs of the torso, a tracking structure (TS) representing a lower lung lobe lesion, as well as the respiratory motion correlations between the nine ROIs and the TS. The effects of gender and the adipose tissue volume and distribution on these correlations and magnitudes have been analyzed. Significant differences between the ROIs in both the respiratory motion magnitudes and their correlations with the TS have been detected. An overall negative correlation between the ROI respiratory magnitudes and the adipose tissue has been detected for ROIs with rib cage support. A weak to moderate negative correlation between the adipose tissue volume and ROI-to-TS respiratory correlations has been detected for upper thorax ROIs. The respiratory magnitudes in regions without rib support tend to be larger for men than for women, but no differences in the ROI-to-TS correlation between sexes have been detected. The described findings should be considered when choosing skin surrogates for lower lung lesion motion management.

Evaluation of clopidogrel response in healthy cats using a novel viscoelastic test and thromboelastography.

Cats with cardiomyopathy face an increased risk of arterial thromboembolism (ATE). Although clopidogrel is frequently utilized to mitigate this risk, feline responses to this therapy exhibit variability. This study evaluated 2 viscoelastic devices, thromboelastography (TEG) and Viscoelastic Coagulation Monitor (VCM), for monitoring clopidogrel in cats in comparison to light transmission aggregometry (LTA). Twenty-eight healthy cats received clopidogrel for 7 days. Blood was collected at baseline and after treatment for analysis by TEG, VCM, and LTA. On LTA, maximum amplitude, slope, and area under the curve (AUC) significantly decreased after treatment (p < 0.0001). On VCM, maximum clot firmness (MCF) significantly increased after treatment (p = 0.002). On TEG, R-time significantly prolonged (p = 0.024), while K and alpha angle significantly changed (p = 0.0002 and p = 0.0014, respectively). There was a moderate negative correlation between TEG R-time and LTA AUC (r = -0.39, p = 0.042). Eight cats were identified as non-responders to clopidogrel. Of the 8 non-responders, 6 (75%) had shortened R time after treatment. VCM appeared to be less discriminatory in identifying non-responders. LTA remained the gold standard of monitoring clopidogrel treatment in cats. Unexpected changes on VCM and TEG were likely related to high interindividual and assay variability and increased sensitivity of feline platelets. R-time on TEG may have potential utility for point-of-care monitoring of clopidogrel response in cats.

Translation, Cultural Adaptation, and Validation into Romanian of the Myeloproliferative Neoplasm Symptom Assessment Form-Total Symptom Score (MPN-SAF TSS or MPN-10) Questionnaire.

Background: Patients with myeloproliferative neoplasms (MPNs) experience a high disease-related symptom burden. A specific instrument to evaluate quality of life (QoL), i.e., the MPN Symptom Assessment Form Total Symptom Score (MPN-SAF TSS; MPN-10), was developed. We conducted the translation, cultural adaptation, and validation into Romanian of the MPN-10. Methods: We translated the MPN-10 and tested its psychometric properties. Results: We recruited 180 MPN patients: 66 polycythemia vera (36.67%), 61 essential thrombocythemia (33.89%), 51 primary and secondary myelofibrosis (SMF) (28.33%), and 2 MPN-unclassifiable (1.11%). The mean TSS was 19.51 ± 16.51 points. Fatigue, inactivity, and concentration problems were the most cumbersome symptoms. We detected scoring differences between MPN subtypes regarding weight loss (p < 0.001), fatigue (p = 0.006), early satiety (p = 0.007), night sweats (p = 0.047), pruritus (p = 0.05), and TSS (p = 0.021). There were strong positive associations between TSS and inactivity, fatigue, and concentration problems, and moderate negative correlations between QoL scores and all MPN-10 items. Cronbach's α internal consistency coefficient was 0.855. The Kaiser-Meyer-Olkin construct validity test result was 0.870 and the Bartlett Sphericity Test was significant (p < 0.001). Symptom scores were loaded into one single factor according to the exploratory factor analysis. Conclusions: The Romanian MPN-10 version displayed excellent psychometric properties and is a reliable instrument for assessing symptom burden and QoL in Romanian MPN patients.

Correlating survival outcomes in patients with advanced prostate cancer with novel hyperpolarized 13C MRI metabolic imaging biomarkers.

e15059 Background: Hyperpolarized 13C (HP 13C) MRI is a novel molecular imaging approach that detects aberrant aerobic metabolism, namely elevated rates of pyruvate-to-lactate conversion (kPL), in patients with advanced malignancies. Higher kPL has been shown to correlate with higher tumor grade among patients with localized prostate cancer (PC). This research sought to evaluate the correlation between kPL and clinical outcome measures in patients with advanced PC. Methods: Patients with metastatic or locally advanced PC (castration sensitive or resistant) were prospectively enrolled at our institution and underwent HP 13C MRI of one or more target lesions identified on prior conventional imaging. Voxelwise kPL values were computed in MATLAB using an inputless two site exchange model. kPL,median was defined as the median kPL value per-patient across all target lesions; kPL,kurtosis measured the tailedness of the kPL distribution per-patient. We retrospectively analyzed progression free survival (PFS) and overall survival (OS) in subgroups divided by metabolic activity below versus above cut-point (kPL,median &lt;0.017 s-1 and ≥ 0.017s-1, respectively). Survival statistics were calculated using the Cox PH model. Results: Sixteen patients (6 with castration-sensitive and 10 with castration-resistant PC) were accrued. With a median follow-up of 22.0 months from the date of MRI, the lower-kPL subgroup had significantly longer median PFS (11.2 vs 0.5 months; p&lt;0.01) and OS (NR vs 18.4 months; p&lt;0.05) compared to the higher-kPL subgroup. By comparison, baseline serum PSA (PFS: p=0.19, OS: p=0.41) and LDH (PFS: p=0.60, OS: p=0.34) did not demonstrate a significant association with clinical outcomes. There was a strong negative correlation between kPL,kurtosis and OS (r = -0.75), and moderate negative correlations between kPL,median and OS (r = -0.45) as well as kPL,max with both PFS (r = -0.48) and OS (r = -0.54). There was no significant kPL,median difference between castration-sensitive and resistant subgroups (0.015±0.011 vs 0.016±0.006 s-1, p&gt;0.8). Conclusions: HP 13C MRI-derived non-invasive metabolic biomarker kPL,median significantly correlated with clinical outcome measures in a retrospective analysis of patients with advanced PC, outperforming established serological prognostic markers PSA and LDH. Limitations include our small sample size, retrospective design, and heterogeneous patient population. Nevertheless, these encouraging preliminary results support further investigation of HP 13C MRI as a prognostic and/or predictive PC biomarker in multi-center prospective imaging trials. [Table: see text]

Effectiveness of Genicular Artery Embolization for Reducing Synovitis as Assessed by Contrast-Enhanced MR Imaging in Knee Osteoarthritis: A Pilot Study

PurposeTo investigate the impact of genicular artery embolization (GAE) on synovitis in knee osteoarthritis (OA) using contrast-enhanced magnetic resonance (MR) imaging and assess its predictive role in pain response. Materials and MethodsA single-center retrospective analysis was conducted using contrast-enhanced MR imaging on 33 patients treated with GAE for knee OA between December 2022 and March 2023. MR assessments before the procedure and at 3-month after embolization were utilized in a semiquantitative scoring system for synovitis severity and distribution analysis. Pain and function through Western Ontario and McMaster Universities Osteoarthritis Index and visual analog scale scores were also assessed. ResultsSignificant synovitis reduction was noted after GAE, particularly in parapatellar and periligamentous areas. Synovial contrast enhancement scores significantly decreased from 5.1 (SD ± 2) to 2.9 (SD ± 2) at 3 months (P < .001), with a moderate negative correlation between synovial enhancement scores and pain levels (P = .005). ConclusionsGAE significantly reduced synovitis in knee OA, evidenced by contrast-enhanced MR imaging. The correlation between preprocedural synovial contrast enhancement scores and pain relief after the procedure, although promising, requires careful interpretation because of the complex factors affecting pain in knee OA.

Pulmonary function in Thai patients with systemic sclerosis;a single center 6-year retrospective study.

Pulmonary involvement is a major cause of internal organ complication and the leading cause of death in patients with systemic sclerosis (SSc). This study aimed to demonstrate the characteristics of pulmonary function (PF) in Thai patients with SSc and the association between PF and body mass index (BMI) and anti-topoisomerase (anti-Scl70). All patients diagnosed with SSc in our tertiary care teaching hospital database between 2016 and 2021 were reviewed and analyzed. Of 211 SSc patients, 128 patients who underwent the PF test were enrolled; 102 (79.7%) were female. The mean age was 54 years. The median BMI for all patients was 21.7 kg/m 2. Regarding anti-Scl70, 10.9% of patients were positive, 7.8% were negative, and the status was unreported for 81.3%. The mean (SD) forced expiratory volume in one second (FEV1) forced vital capacity (FVC) ratio was 0.8 (0.1). The mean (SD) % predicted values of FEV1, FVC, and diffusing capacity of the lungs for carbon monoxide (DLCO) were 76.3 (16.3), 69.1 (15.8), and 75.5 (22.8), respectively. A restrictive spirometry pattern (RSP) was found in 78.8% of the patients. DLCO had a moderate positive linear correlation with FVC (r=0.50, p <0.001) and a moderate negative linear correlation with BMI (r=-0.36, p <0.001). However, there was no correlation between FVC and BMI. There was no statistical difference in demographic data or the presence of anti-Scl70 among patients with or without RSP. RSP is common among Thai patients with SSc. However, the power of using demographic data and the presence of anti-Scl70 to determine the probability of pulmonary involvement remains limited.

Mediator Role of Frailty and Biological Deficits in Dementia Prognosis-Retrospective Cohort Study.

Background and Objectives: Dementia is increasing worldwide. This study aimed to examine the impact of comorbidity burden and frailty on dementia prognosis in patients with dementia. Materials and Methods: This retrospective cohort study was conducted with 47 patients with dementia who were followed for up to two years. The Modified Charlson Comorbidity Index (MCCI), Mini-Mental State Examination (MMSE-E), and Edmonton Fragility Scale were used besides laboratory and clinical findings. Results: The mean age of the 47 patients was 78.77 ± 12.44 years. During the follow-up period, MMSE-E scores were observed to improve in 50% of the patients. Initial MMSE-E scores were found to be lowest in men and patients with coronary artery disease or depression, while final MMSE-E scores were observed to be lowest in patients with depression and low vitamin B12 or vitamin D levels. The rates of decrease in MMSE-E scores in non-, moderately and severely frail patients were 21.4%, 55.6%, and 70.6%, respectively. There was a moderate negative correlation between MMSE-E scores and both comorbidity burden and frailty scores. The mediation analysis revealed that frailty was a complete mediator, and that comorbidity burden led to an increase in frailty and a decrease in MMSE-E scores. During the follow-up period, patients with moderate frailty, hypertension, diabetes mellitus, alcohol and tobacco use, low B12 levels, or hypothyroidism showed an increased risk of decrease in cognitive functions. Conclusions: There was a significant association between dementia prognosis and both frailty and biological deficits. We recommend the adoption of a syndemic approach in the follow-up of dementia, as we believe that the prevention of frailty and associated biological deficits will contribute to slowing dementia's clinical course.