Optimal Score Research Articles

Effects of Physical Activity and COVID-19 on Healthy Student Strengths in the University System: Implications for Post-Pandemic Management.

The COVID-19 pandemic has profoundly affected the physical, mental, and social well-being of millions worldwide. It has also brought about abrupt disruptions to the entire university system, whose students form a crucial segment of society. The pandemic's effects on student education and well-being have been particularly significant. One of the primary consequences has been a drastic reduction in physical activity levels among students, leading to mental and physical health problems. Despite the rapid growth in the literature exploring student experiences during the pandemic, there is a paucity of research on how this decline in physical activity has affected the five strengths of the healthy student: optimism, self-efficacy, resilience, engagement, and hope. Therefore, the aim of this investigation is to examine the relationship between physical activity levels and the five strengths of the healthy student at two different time points (pre-COVID-19 and COVID-19) through the International Physical Activity Questionnaire (IPAQ) and the Healthy Student Questionnaire. The study involved 897 participants, with 290 participating in the pre-COVID-19 phase and 607 participating in the COVID-19 phase. The results revealed significant differences in the five strengths between the two periods. Students who engaged in physical activity exhibited significantly higher optimism scores in the pre-COVID-19 phase. During the COVID-19 phase, physically active students demonstrated significantly higher scores in optimism, resilience, and self-efficacy. These findings provide clear guidance for university administrators seeking to enhance student well-being in a post-pandemic world and in the face of future disruptions. Universities should consider implementing physical exercise programs for their students to promote psychosocial well-being and provide training and resources to equip faculty members with new skills to better understand and support students' perceptions.

Validity and reliability of the Persian version of Mini-Addenbrooke’s Cognitive Examination among Iranian highly educated older adults

Background Limited studies have examined psychometric properties of dementia screening tools in university-educated older adults. We aimed to examine this population’s diagnostic accuracy of the Iranian version of Mini-Addenbrooke’s Cognitive Examination (M-ACE). Materials & methods Eighty-seven participants with over 60 years with university education were divided into three groups: Major neurocognitive disorder, mild neurocognitive disorder, and healthy control. The Iranian version of M-ACE, the Mini-Mental State Examination (MMSE), the Geriatric Depression Scale (GDS), the Activities of Daily Living-Instrumental Activities of Daily Living (ADL-IADL) scale and Diagnostic and Statistical Manual of Mental Disorders 5th edition-Text Revision (DSM-5) were used. Results A high internal reliability of questionnaire was confirmed by Cronbach’s alpha coefficient. One-way ANOVA and post hoc analysis confirmed a significant difference between study groups. The scores of M-ACE were found to have a high positive correlation with MMSE, IADL, ADL, and a moderate correlation with GDS. The optimal cutoff score of M-ACE to screen for mild and major neurocognitive disorders were 27.5 and 20.5, respectively. Conclusion The M-ACE was a concise and reliable tool used to identify neurocognitive disorders in highly educated older adults, but they should be evaluated at a higher traditional cut score in earlier stages.

Psychosocial Competencies Among Clinic-Referred and Community-Based Children: Known-Groups Validity of the Psychosocial Strengths Inventory for Children and Adolescents (PSICA).

Child psychosocial competencies protect against the development of psychopathology, ameliorate existing psychosocial problems, and predict positive long-term developmental cascades. Assessment of these competencies can improve identification of children in need of psychosocial services, enrich treatment planning, and improve treatment progress and outcome monitoring. Yet, appropriate measures are limited. One promising option is the Psychosocial Strengths Inventory for Children and Adolescents (PSICA), although its discriminative properties were formerly unknown. The present study evaluated the PSICA's sensitivity, specificity, and optimal cutoff scores with 228 youth (38 clinic-referred and 190 community-based youth with case-control matching) ages 2-10years (Mage = 5.8, 71% boys, 77% White). Results indicated large, significant discrepancies, with clinic-referred youth rated as having less overall psychosocial competence overall and across domains of compliance, prosociality, and attention. Caregivers also reported significantly less satisfaction with the psychosocial competence of clinic-referred versus community youth. Discriminative accuracy of the PSICA's Frequency and Satisfaction scales, and its subscales, were good-to-excellent. Such discriminative accuracy and empirically derived, if preliminary, cutoff scores further support the PSICA as a pragmatic, psychometrically strong tool to screen children for referral into services, and potentiate future investigations into the PSICA's use in treatment planning and evaluation.

Single-plane osteotomy model is inaccurate for evaluating the optimal strategy in treating vertical femoral neck fractures: A finite element analysis

Background and objectivesThe conventional method for simulating vertical femoral neck fractures (vFNFs) is via a vertical single-plane osteotomy (SPO) across the entire femur. However, the accuracy of SPO for evaluating the optimal internal fixation strategy (IFS) and the appropriate assessment parameters is not clear. This study thus aimed to examine the accuracy of SPO in evaluating IFSs and to identify appropriate evaluation parameters using finite element analysis. MethodsEighty patient-specific finite element models were developed based on CT images from eight vFNF patients. The natural fracture model was built using structural features of the affected side, while the SPO was simulated on the healthy side. Five different IFSs were applied to both the natural fracture and SPO groups. Thirteen parameters, including stress, displacement, and stiffness, were subjected to a two-way repeated measures ANOVA to determine the effect of IFSs and fracture morphology on stability. A Pearson correlation analysis was performed on varied parameters with various IFSs to identify independent parameters. Based on these independent parameters, the entropy evaluation method (EEM) score was used to rank the performance of IFSs for each patient. ResultsEight of the thirteen parameters were significantly influenced by IFSs (p < 0.05), two by fracture morphology (p < 0.01), and none by the interaction between IFS and fracture morphology. In the natural fracture group, parameters including screw stress and displacement, bone cut rate (BCR), and compression effects varied independently with distinct IFSs. In the SPO group, trunk displacement, BCR, cut-out risk, and compression effects parameters changed independently. The BCR of the Alpha strategy was significantly higher than that of the Inverted strategy in the natural fracture group (p = 0.002), whereas the opposite was observed in the SPO group (p = 0.016). Regarding compression effects, two IFS pairings in the natural fracture group and seven IFS pairings in the SPO group exhibited significant differences. None of the five IFSs achieved the optimal EEM score for each patient. ConclusionsThe single-plane osteotomy model may have limitations in assessing IFSs, particularly when the bone cut rate and compression effects are the main influencing factors. Parameters of the screw stress and displacement, BCR, and compression effects appear to be relevant in evaluating IFSs for natural fracture models. It indicates that individualized natural fracture models could provide more comprehensive insights for determining the optimal IFS in treating vFNFs.

Do moderate-to-late preterm twins and singletons differ in the early motor repertoire and later developmental functioning?

Purpose: The aim of this study was to investigate the differences in early motor repertoire and later developmental functioning between moderate-to-late preterm twins and singletons. Material and Methods: The study included 40 moderate-to-late preterm twin infants (50% female), and 40 moderate-to-late preterm singleton infants (50% female). All infants were assessed from 9 up to 20 post-term weeks of corrected age using the General Movement Assessment (GMA), and between 24 and 42 months of age using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Results: There were no differences between the Motor Optimality Score (MOS) and its subcategories, including fidgety movements, obtained as a result of detailed GMA (p&gt;0.05), when the early motor repertoire results were examined. At later ages, there were also no significant differences in cognitive, language, and motor domain composite scores between twin and singleton infants, according to Bayley-III (p&gt;0.05). Discussion: Our results suggest moderate-to-late preterm twin infants had a similar developmental process to moderate-to-late preterm singleton infants from early periods up to 3.5 years of age. However, all preterm infants, including moderate-to-late infants, should be assessed in the clinic in terms of the risks of developmental problems from the early period of life.

Screening for Executive Impairment in Patients with Frontotemporal Dementia: Evidence from the Greek Version of the Frontier Executive Screen.

The aim of the present study was to adjust the frontier executive screen (FES) for the Greek population, to develop normative data, and to investigate its ability to discriminate patients diagnosed with frontotemporal dementia from healthy individuals. The FES was administered to 142 community-dwelling healthy adults (age: M = 65.9, SD = 8.5; education: M = 10.8, SD = 4.3; sex: 59% female) and 32 patients diagnosed with frontotemporal dementia (age: M = 69.3, SD = 8.6; education: M = 11.7, SD = 4.8; sex: 31% female). Correlation and regression analyses were performed to determine the association between the FES scores, demographic, and clinical characteristics. Cronbach's α coefficient was used to determine internal consistency. Group differences on the FES were examined with independent samples t-test and Mann-Whitney test. Discriminant and ROC analyses were used to determine diagnostic accuracy and to identify the optimal cutoff score for the discrimination between groups. Regression analyses indicated associations between demographic characteristics and FES scores (age: R2 = .08; education: R2 = .33). Internal consistency was marginally acceptable (α = .69). Patients scored lower than healthy participants on the total FES score (d = 1.91) and its three subscores (verbal fluency: η2 = .60; inhibition: η2 = .52; working memory: d = 0.90). The results indicated high diagnostic accuracy (94%) and the optimal cutoff score was 7 (91% sensitivity, 78% specificity). The Greek version of the FES is a useful tool for the brief evaluation of executive functions in patients diagnosed with frontotemporal dementia.

Identifying Individuals at High Risk for HIV and Sexually Transmitted Infections With an Artificial Intelligence-Based Risk Assessment Tool.

We have previously developed an artificial intelligence-based risk assessment tool to identify the individual risk of HIV and sexually transmitted infections (STIs) in a sexual health clinical setting. Based on this tool, this study aims to determine the optimal risk score thresholds to identify individuals at high risk for HIV/STIs. Using 2008-2022 data from 216 252 HIV, 227 995 syphilis, 262 599 gonorrhea, and 320 355 chlamydia consultations at a sexual health center, we applied MySTIRisk machine learning models to estimate infection risk scores. Optimal cutoffs for determining high-risk individuals were determined using Youden's index. The HIV risk score cutoff for high risk was 0.56, with 86.0% sensitivity (95% CI, 82.9%-88.7%) and 65.6% specificity (95% CI, 65.4%-65.8%). Thirty-five percent of participants were classified as high risk, which accounted for 86% of HIV cases. The corresponding cutoffs were 0.49 for syphilis (sensitivity, 77.6%; 95% CI, 76.2%-78.9%; specificity, 78.1%; 95% CI, 77.9%-78.3%), 0.52 for gonorrhea (sensitivity, 78.3%; 95% CI, 77.6%-78.9%; specificity, 71.9%; 95% CI, 71.7%-72.0%), and 0.47 for chlamydia (sensitivity, 68.8%; 95% CI, 68.3%-69.4%; specificity, 63.7%; 95% CI, 63.5%-63.8%). High-risk groups identified using these thresholds accounted for 78% of syphilis, 78% of gonorrhea, and 69% of chlamydia cases. The odds of positivity were significantly higher in the high-risk group than otherwise across all infections: 11.4 (95% CI, 9.3-14.8) times for HIV, 12.3 (95% CI, 11.4-13.3) for syphilis, 9.2 (95% CI, 8.8-9.6) for gonorrhea, and 3.9 (95% CI, 3.8-4.0) for chlamydia. Risk scores generated by the AI-based risk assessment tool MySTIRisk, together with Youden's index, are effective in determining high-risk subgroups for HIV/STIs. The thresholds can aid targeted HIV/STI screening and prevention.

A Study of General Movement Assessment and Its Association With Neurodevelopmental Outcome at Age 12 to 15 Months Among Term Neonates With Hyperbilirubinemia

BackgroundTo determine the association between optimality score at term age and age three to five months and neurodevelopmental outcome among neonates with hyperbilirubinemia. MethodsFifty infants with and without hyperbilirubinemia were enrolled. The motor repertoires of the infants were evaluated through general movement assessment (GMA) at term age and three to five months post-term. The association between the General Movement Optimality Score (GMOS), Motor Optimality Score (MOS), and Development Assessment Scale for Indian Infants (DASII) at age 12 to 15 months was also assessed. ResultsDuring term age, the median GMOS was significantly lower among infants in the study group when compared with the control group (40 [29 to 42] vs 42 [42 to 42], P < 0.001). However, at age three to five months, there was no significant difference between the groups. Significantly higher number of neonates had abnormal motor repertoire at term age and age three to five months in the study group when compared with the control group (18 [36%] vs 2 [4%], P = 0.001, at term age and 6 [12.2%] vs 1 [2%], P =0.04, at age three to five months). Among neonates with hyperbilirubinemia, the median GMOS and MOS were significantly lower at term age and age three to five months in infants with motor and mental developmental quotient scores <85 when compared with ≥85. ConclusionsGMA including GMOS and MOS performed in neonates with hyperbilirubinemia during the neonatal period and early infancy is associated with neurodevelopmental outcomes in the first year of life. GMA can help initiate early intervention in such neonates.

Series of (([1,1'-Biphenyl]-2-yl)methyl)sulfinylalkyl Alicyclic Amines as Novel and High Affinity Atypical Dopamine Transporter Inhibitors with Reduced hERG Activity.

Currently, there are no FDA-approved medications for the treatment of psychostimulant use disorders (PSUD). We have previously discovered "atypical" dopamine transporter (DAT) inhibitors that do not display psychostimulant-like behaviors and may be useful as medications to treat PSUD. Lead candidates (e.g., JJC8-091, 1) have shown promising in vivo profiles in rodents; however, reducing hERG (human ether-à-go-go-related gene) activity, a predictor of cardiotoxicity, has remained a challenge. Herein, a series of 30 (([1,1'-biphenyl]-2-yl)methyl)sulfinylalkyl alicyclic amines was synthesized and evaluated for DAT and serotonin transporter (SERT) binding affinities. A subset of analogues was tested for hERG activity, and the IC50 values were compared to those predicted by our hERG QSAR models, which showed robust predictive power. Multiparameter optimization scores (MPO > 3) indicated central nervous system (CNS) penetrability. Finally, comparison of affinities in human DAT and its Y156F and Y335A mutants suggested that several compounds prefer an inward facing conformation indicating an atypical DAT inhibitor profile.

Trends in Neosubstrate Degradation by Cereblon-Based Molecular Glues and the Development of Novel Multiparameter Optimization Scores.

Molecular glues enable the degradation of previously "undruggable" proteins via the recruitment of cereblon (CRBN) to the target. One major challenge in designing CRBN E3 ligase modulating compounds (CELMoDs) is the selectivity profile toward neosubstrates, proteins recruited by CRBN E3 ligase agents for degradation. Common neosubstrates include Aiolos, Ikaros, GSPT1, CK1α, and SALL4. Unlike achieving potency and selectivity for traditional small molecule inhibitors, reducing the degradation of these neosubstrates is complicated by the ternary nature of the complex formed between the protein, CRBN, and CELMoD. The standard guiding principles of medicinal chemistry, such as enforcing hydrogen bond formation, are less predictive of degradation efficiency and selectivity. Disclosed is an analysis of our glutarimide CELMoD library to identify interpretable chemical features correlated to selectivity profiles and general cytotoxicity. Included is a simple multiparameter optimization function using only three parameters to predict whether molecules will have undesired neosubstrate activity.

Early Family Experiences, Drug Use, and Psychosocial Adjustment across the Life Span: Is Parental Strictness Always a Protective Factor?

Objective: This study analyzes whether parental strictness, which is shared by authoritative parenting (strictness and warmth) and authoritarian parenting (strictness without warmth) styles, always acts as a main protective factor against drug use and psychosocial maladjustment in children. This conclusion has already been stated in numerous classic studies, though emergent research suggests that there are benefits to parental warmth regardless of whether strictness is present or not. Method: Sample were 2,095 Spanish participants (1,227 females, 58.6%), 581 adolescent children (aged 12-18 years, 27.7%) and 1,514 adult children (72.3%). The measures were the main parenting style dimensions (warmth and strictness), drug use, and a set of indicators of psychosocial adjustment. A 4 × 2 × 4 MANOVA was applied for all outcomes with parenting style, sex, and age as independent variables. Results: Indulgent parenting (warmth without strictness) was related to less drug use than parenting without warmth (authoritarian and neglectful). Additionally, indulgent and authoritative parenting styles were related to better scores on psychosocial adjustment than authoritarian and neglectful styles, although the indulgent parenting was the only style related to the optimal scores being equal or even more effective than the authoritative style. Conclusion: Contrary to classical studies, present findings suggest that it is the parental warmth instead of the parental strictness that seems to be effective in protecting against drug use and psychosocial maladjustment.

Neurological examination of healthy term infants at ages 6 and 10 weeks in Tshwane District.

Globally, there is a significant gap in detailed neurodevelopmental data for infants under 3 months, despite 6 weeks being identified a critical milestone for neuro-behavioural development. Normative values and optimal scores for healthy infants at 6 and 10 weeks postnatally are lacking in many settings. In South Africa, the statutory neurodevelopmental assessments at these ages exclude notable characteristics of central nervous system maturation and limit opportunities to collect data of early developmental progress. Our study aimed to assess developmental characteristics of healthy term infants aged 6 and 10 weeks using the Hammersmith Neonatal Neurological Examination (HNNE). A prospective longitudinal study was performed on 35 healthy term-born infants from low-risk pregnancies at 6 and 10 weeks' postnatal age in the Tshwane district. The statuses of infants' neurodevelopment in six domains were recorded using the HNNE. Optimality scores were derived from the raw scores of 34 items, using the 10th and 5th percentiles as cut-off points. Evidences of neurodevelopmental advancements, particularly in posture, muscle tone and visual behaviour between 6 and 10 weeks were illustrated, and total examination optimality scores of 29.5 in 91% and 31.5 in 94% of infants were recorded at 6 and 10 weeks, respectively. This article provides data on the neurodevelopment characteristics of infants at and between 6- and 10-weeks post term ages. The findings support the viewpoint to identify important milestone characteristics during early screening.

Validity and Reliability of the Korean Versions of the 9- and 19-Item Wearing-Off Questionnaires in Parkinson's Disease.

The wearing-off (WO) phenomenon is the most common motor complication in advanced Parkinson's disease (PD), but its identification remains challenging. The 9- and 19-item Wearing-off Questionnaires (WOQ-9 and WOQ-19) are self-assessment tools for motor and nonmotor symptoms that are widely used for WO screening. We produced Korean versions of the WOQ-19 and WOQ-9 (K-WOQ-19 and K-WOQ-9) and investigated their validity and reliability. We used the translation-back translation method to produce K-WOQ-19 and K-WOQ-9, which were self-administered by 124 patients with PD. We conducted in-depth 10-minute interviews for confirming the presence of the WO phenomenon, and then stratified the participants into groups with and without WO. Diagnostic accuracy was assessed byanalyzing receiver operating characteristic curves. Concurrent validity was assessed using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) andthe Hoehn and Yahr stage with Spearman's rank correlation analysis. Reliability was assessedbased on test-retest Cohen's kappa (κ) values and intraclass correlation coefficients (ICCs). The optimal cutoff scores on the K-WOQ-19 and K-WOQ-9 for WO screening were 4 and 2, respectively. The test-retest ICCs of K-WOQ-19 and K-WOQ-9 were 0.943 and 0.938, respectively. Nineteen of the combined 20 items in K-WOQ-19 and K-WOQ-9 showed moderate-to-substantial agreement (κ=0.412-0.771, p<0.001). The scores on the translated scales were significantly correlated with MDS-UPDRS IV scores. K-WOQ-19 and K-WOQ-9 are reliable and valid tools for detecting WO, with optimal cutoff scores of 4 and 2, respectively.

How can unplugged approach facilitate novice students’ understanding of computational thinking? An exploratory study from a Nigerian university

Computational thinking (CT) has been relevant in teaching STEM courses, and educators are incorporating both plugged and unplugged CT activities in their modules to prepare new entrants for advanced knowledge. However, additional empirical data are needed to understand how an unplugged activities approach can lead to an improved understanding of CT concepts. Therefore, this study investigates the impact of unplugged activities on novice students' CT skills and unravels the characteristics of students' CT competency from performing unplugged activities. The experimental aspect of this study was conducted with a cohort of 210 students participating in an introductory programming course at a University in Nigeria. A mixed-method research approach and a quasi-experimental design were applied in this study to understand how the unplugged approach in teaching CT could help students improve their CT competency. A paired-sample t-test of familiarity score for each CT concept showed a significant increase in the score before and after the intervention. Furthermore, Latent Dirichlet Allocation (LDA) was used for topic modeling of the text describing students’ solutions. Topic modeling allows for more insights into the steps taken by the students to solve CT problems. Only 27.62 % of students' solution descriptions contained CT concepts, 56.90 % of the students solved the puzzle with an optimal score, and 72.41 % of students who applied CT concepts of problem abstraction and decomposition were able to solve the puzzle correctly. Indeed, CT unplugged activities significantly increased the number of students who gained CT competency. In addition, this study provides recommendation for computer science educators and highlight future direction.

Mental Health, Stigma, Resilience, and Mental Health Literacy among Schoolteachers: A Cross-sectional Survey from South India

Abstract Introduction: The mental well-being of teachers profoundly influences educational quality and directly impacts the mental health of students. Recognizing the challenges faced by schoolteachers is crucial for policymakers to address these issues. Objective: The objective of this study is to investigate Indian schoolteachers’ mental health, aiming to uncover issues such as stigma, resilience, and mental health literacy. Methods: This cross-sectional study employed an online survey method, incorporating demographic information, Depression, Anxiety, and Stress Scale, Connor-Davidson Resilience Scale, Reported and Intended Behaviour Scale, and Mental Health Literacy Questionnaire. Google Form survey was disseminated through e-mail to teachers across 65 schools. The study targeted full-time teachers aged between 25 and 50 years, with at least 3 years of experience. Results: Among the 404 completed surveys, a significant majority (59.4%) of teachers demonstrated elevated scores, signaling a need for diagnostic evaluation for anxiety and depression, with 37.4% experiencing comorbid symptoms, and 30.7% reporting elevated stress levels. Teachers with anxiety and depression symptomatology had significantly lower hardiness (t = 3.616, P ≤ 0.001), coping (t = 2.946, P = 0.003), optimism (t = 2.156, P = 0.032), emotion regulation (t = 3.133, P = 0.002), self-efficacy (t = 5.042, P ≤ 0.001), and total resilience scores (t = 3.213, P = 0.001). Despite the majority reporting no personal experience with mental health issues, a substantial number expressed neutrality toward living (42.8%), working (36.1%), or residing nearby (37.6%) with individuals with mental health problems. However, 34.9% slightly disagreed with maintaining relationships with friends facing mental health challenges. While teachers exhibited above-average knowledge of mental health problems and related skills, they also displayed higher levels of erroneous beliefs or stereotypes. Conclusion: These results provide preliminary, data-based insights into the mental health, resilience, stigma, and mental health literacy of schoolteachers in India. The findings underscore the need for targeted programs to empower teachers as effective gatekeepers of child and adolescent mental health.

Higher 10-Year Survival with Breast-Conserving Therapy over Mastectomy for Women with Early-Stage (I-II) Breast Cancer: Analysis of the CDC Patterns of Care Data Base.

Studies in the United States are scarce that assess the survival differences between breast-conserving surgery plus radiation (Breast-Conserving Therapy; BCT) and mastectomy groups using population-based data while accounting for sociodemographic and clinical factors that affect the survival of women with early-stage breast cancer (ESBC). To assess whether BCT provides superior long-term overall survival (OS) and breast cancer-specific survival (BCSS) compared with mastectomy in women with ESBC, while considering key factors that impact survival. Cohort study. We analyzed data on women aged 20 years and older diagnosed with stage I-II breast cancer (BC) in 2004 who received either BCT or mastectomy. The data were collected by 5 state cancer registries through the Centers for Disease Control and Prevention-funded Patterns of Care study. Multivariable Cox proportional hazard models, accounting for sociodemographic and clinical factors, were used to calculate hazard ratios (HRs) with 95% confidence intervals (CI). Sensitivity analysis involved optimal caliper propensity score (PS) matching to address residual confounding. Of the 3495 women, 41.5% underwent mastectomy. The 10-year OS and BCSS were 82.7% and 91.1% for BCT and 72.3% and 85.7% for mastectomy, respectively. Adjusted models showed that mastectomy recipients had a 22% higher risk of all-cause deaths (ACD) (HR = 1.22, 95% CI = [1.06, 1.41]) and a 26% higher risk of breast cancer-specific deaths (BCD) (HR = 1.26, 95% CI = [1.02, 1.55]) than BCT recipients. Sensitivity analysis demonstrated that mastectomy was associated with a higher risk of ACD (P < .05) but did not exhibit a statistically significant risk for BCD. Women with HR+/HER2+ (luminal B) or invasive ductal carcinoma BC who underwent mastectomy had higher risks of ACD and BCD compared with BCT recipients, while the hazards for ACD in triple-negative BC did not remain significant after adjusting for covariates. ESBC BCT recipients demonstrate superior OS and BCSS compared with mastectomy recipients.

Predicting the outcome of death by CALL Score in COVID-19patients.

The aim of this study was to assess the performance of the CALL Score tool in predicting the death outcome in COVID-19 patients. A total of 897 patients were analyzed. Univariate and multivariate logistic regression analyses were conducted to determine the association between characteristics of the CALL Score and the occurrence of death. The relationship between CALL Score risk classification and the occurrence of death was also examined. Receiver operating characteristic curve analysis was performed to identify optimal cutoff points for the CALL Score and the outcome. The study revealed that age>60 years, DHL>500, and lymphocyte count ≤1000 emerged as independent predictors of death. Higher risk classifications of the CALL Score were associated with an increased likelihood of death. The optimal CALL Score cutoff point for predicting the death outcome was 9.5 (≥9.5), with a sensitivity of 70.4%, specificity of 80.3%, and accuracy of 80%. The CALL Score showed promising discriminatory ability for death outcomes in COVID-19 patients. Age, DHL level, and lymphocyte count were identified as independent predictors. Further validation and external evaluation are necessary to establish the robustness and generalizability of the CALL Score in diverse clinical settings.

Turkish Validity and Reliability of Comprehensive Diabetes Self-Management Scale.

A self-care approach is very important in diabetes management. In this study, it was aimed to make the Turkish validity and reliability of the Comprehensive Diabetes Self-Management Scale (CDSMS), which examines the behaviors of diabetes patients. The study is of methodological type. CDSMS, which was translated into Turkish from its original version and tested for language validity, was first included in the pilot application and then in the main study. The validity of the scale was evaluated by the Cronbach's alpha coefficient. Then, a Receiver Operating Characteristic (ROC) analysis was performed to determine the cut off score. The mean age of the study participants was 57.10 ± 11.20 years and the mean disease duration was 9.96 ± 7.79 years. The internal consistency of CDSMS was 0.73, which was measured using Cronbach's alpha. After the ROC analysis, the optimal cut-point score of CDSMS to predict good glycemic control was determined as 21.17 points. With this study, it was found that the Turkish version of CDSMS is valid and reliable for use in the Turkish population. It is thought that CDSMS will be beneficial to physicians working in the clinic in terms of showing the disease management skills of diabetic patients.

Propofol Versus Dexmedetomidine for Conscious Sedation During Vaginal Hysterectomy With Pre-emptive Local Anesthesia: A Prospective Cohort Study.

Hysterectomy is the most frequent gynecological surgery. Vaginal hysterectomy (VH) seems to be related to favorable perioperative outcomes compared to abdominal or laparoscopic approaches. As the population ages, anesthesia that is safer for the elderly, such as local anesthesia (LA) with conscious sedation, is gaining popularity and is related to favorable outcomes in patients' recovery compared to general or regional anesthesia. We aimed to evaluate the efficacy of dexmedetomidine versus propofol for women undergoing VH for uterine prolapse under LA and conscious sedation. A prospective study on 40 women with uterine prolapse stage ≥3 who had VH under LA with conscious sedation under either dexmedetomidine (n=20) or propofol (n=20) was performed. A standardized surgical approach with continuous hemodynamic monitoring and sedation assessment using the Ramsay Sedation Scale (RSS) was conducted. The primary endpoint of the study was to determine the percentage of patients receiving intraoperative fentanyl. Analysis of outcomes demonstrated a significant reduction in the proportion of patients requiring intraoperative rescue fentanyl (35% vs. 5%, respectively, p=0.04) and in postoperative pain scores, with more patients achieving an optimal RSS score of 3 in the dexmedetomidine group. Based on the findings of the present study, dexmedetomidine offered superior analgesia and patient comfort compared to propofol, suggesting a favorable anesthetic profile for VH under LA.

Reliability, Validity, Modification and Expansion of the Chinese Version of the Disease-Specific Anxiety Questionnaire for Chronic Obstructive Pulmonary Disease.

To translate a disease-specific anxiety questionnaire on chronic obstructive pulmonary disease (COPD) and test its reliability and validity in China. The German version of the revised COPD Anxiety Questionnaire (CAF-R) was initially validated using step-by-step translation, back-translation, and cross-cultural adaptation. The reliability and validity of the Chinese version of the CAF-R (CAF-R-CN) were tested among 448 patients with COPD (mean age =71.42±9.33 years, 17.2% female) from four medical institutions in Suzhou, Jiangsu Province, using convenience sampling, from April 2022 to June 2023. The CAF-R-CN included six dimensions with a total of 25 items. The item-level content validity index was 0.860-1.000; the scale-level content validity index was 0.920. The structural validity χ2/df was 2.326, the root mean square error of approximation was 0.077, the comparative fit index was 0.924, and the Tucker-Lewis index was 0.912. The six-dimensional internal consistency index Cronbach's α coefficient was 0.696-0.910, and the test-retest reliability was 0.949. An optimal cut-off score of 50.5 was selected with a sensitivity of 0.786 and specificity of 0.870. The CAF-R-CN had satisfactory reliability and validity and can be used to identify and assess anxiety in COPD patients with a Chinese cultural background.