Relevant Items Research Articles

The Aberrant Behavior Checklist for Fragile X Syndrome: A Qualitative Clinician Evaluation of Content Validity.

Objective: The current intense period of drug development for fragile X syndrome (FXS) and other neurodevelopmental disorders (NDDs) indications has highlighted the importance of behavioral outcome measures with strong psychometric properties and specifically content validity. The Aberrant Behavior Checklist-Community Edition (ABC-C), which has successfully been applied to autism spectrum disorder drug trials, has been revised for FXS (ABCFX) and is widely used for both clinical and research purposes. Despite its strong psychometric validation, the ABCFX and its parent measure have not been subjected to qualitative content validity evaluations. The present study intended to fill this gap. Methods: Using two surveys administered sequentially and developed with guidance and review from the Food and Drug Administration (FDA), we asked 10 clinicians experienced in FXS and related NDDs to determine the adequacy of the ABCFX for assessing its behavioral constructs, its relevance to FXS, and its potential for detecting response to interventions. Various descriptive statistic parameters and ad hoc metrics were used to analyze categorical and Likert-like scale responses. Results: Experts considered that most items and all six ABCFX subscales indeed evaluated their explicit or implicit behavioral constructs. However, item and subscale specificity were relatively low (∼25%-30%). Relevance of items of the Hyperactivity subscale was relatively high while low for many items of the Socially Unresponsive/Lethargic subscale. These items were also considered of low responsiveness potential. Irritability, Hyperactivity, Stereotypy, and Social Avoidance were the subscales with the strongest profiles, although the experts estimated that Stereotypy items may not be that responsive to treatment. A novel Anxiety construct, representing mainly recently reported observable behaviors, contributed mainly by Irritability items, emerged as a potential measure. Conclusions: The present study demonstrated the overall adequacy of the ABCFX for its behavioral constructs, its relevance to FXS, and its potential for detecting response to treatment. It also showed that anxiety, a distinctive feature of FXS and other genetic NDDs, can also be measured by the ABCFX. These findings can help with the implementation and interpretation of the ABCFX, as well as with potential improvements to the measure in FXS and other NDDs.

Development and Testing of a Patient Outcome Measure for Interprofessional Tuberculosis Care: A Delphi Study

Background: A chronic medical condition such as tuberculosis can be physically and emotionally challenging for both health practitioners and patients and their families. Tuberculosis requires a team-based care model that provides resilience and coordinated work, such as the one offered by an interprofessional collaborative practice team. Despite the increasing interest in interprofessional-based care globally, there is a notable lack of measures to assess patient impact. We aimed to develop a patient outcome measure to quantify the functional impact of interprofessional care on tuberculosis patients. Methods: The study involved four phases: 1) developing a conceptual framework and creating items, 2) evaluating the construct through Delphi studies to obtain international consensus, 3) back-to-back translation into Indonesian, and 4) re-evaluating the construct with Delphi study to obtain Indonesian consensus. The consensus was reached if the Content Validity Index covers at least 70% agreement from experts, an interquartile range <1, and a median score of 4 or 5 on a 5-point Likert-type scale. The COnsensus-based Standards for the Selection of Health Measurement INstruments (COSMIN) guidelines were used to assess item relevance, comprehensibility, and comprehensiveness. Results: A total of 65 international and 61 Indonesian participants in the Delphi studies. The final instrument consists of 44 items organized into five domains. All items were relevant to the construct being measured and deemed understandable, and significant concerns related to TB care were comprehensively addressed in the instrument. Conclusion:The findings indicate that the instrument content validity was good, fulfilling COSMIN requirements for items' relevance, comprehensibility, and comprehensiveness. Doi: 10.28991/ESJ-2025-09-01-08 Full Text: PDF

Qualitative Exploration and Proof of Concept Toward the Development of the Burnout Assessment for Developmental Disability Settings (BADDS) for Behavioral Health Providers.

The present evaluation aimed to begin development of a survey tool for measuring workplace stressors specific to behavioral health providers in clinical settings for autism and related developmental disabilities: the Burnout Assessment for Developmental Disability Settings (BADDS). BADDS development was guided by Patient-Reported Outcomes Measurement Information System (PROMIS®; Cella et al., (Journal of Clinical Epidemiology, 63(11), 1179-1194, 2010) procedures. We used a qualitative analysis to define the target conceptual model (Phase 1). Using the analysis and reported lived experiences, we generated individual items for the BADDS. We then piloted these items in an online survey study to examine correlations with established measures of burnout (Phase 2). Finally, we used a modified Delphi approach to refine items with an expert panel, resulting in a preliminary item pool for the BADDS (Phase 3). Qualitative interviews produced a framework of four themes and nine sub-themes for analysis. Initial items were written across each theme and sub-theme. Findings from preliminary psychometric evaluation in Phase 2 demonstrated promising internal consistency, score stability, and positive associations with validated measures of burnout level. Finally in Phase 3, an expert panel edited items for relevance and clarity across three iterations of feedback. Though further analysis is needed, the BADDS tool has the potential to provide a conceptual analysis of burnout by identifying workplace stressors impacting behavioral health providers in autism service settings. This is in contrast to existing measures that solely inquire burnout level, but do not identify causes of job stress. Organizations may develop more effective strategies for mitigating burnout within their specific setting by incorporating assessments such as the BADDS into burnout interventions for providers.

Refined methodologies for probabilistic dietary exposure assessment for food contaminants based on the observed individual means methodology.

The Observed Individual Means (OIM) methodology, based on the non-parametric bootstrap, is usually employed to perform basic probabilistic dietary chronic exposure assessment, and assumes independence and identical distribution of occurrence data within food category. However, this assumption may not be valid if several expected distributions of occurrence can be a priori identified within food category. Moreover, OIM assumes each analysed food sample to equally contribute to mean occurrence, as information about relevance of each food item cannot be incorporated into exposure assessment. In this paper we address the above-mentioned violations and develop two statistical methodologies to accommodate for them into OIM. The stratified non-parametric bootstrap and weighted mean occurrence are employed to correct for such violations. As a case study, we compare the methodologies by estimating the exposure of the adult Italian population to the process contaminant 3-monochloropropane-1,2-diol. We propose strategies to interpret their results and show their relevance in conducting exposure assessment. For the first time in the literature, we critically examine a widely used methodology for Probabilistic Dietary Exposure Assessment from a statistical perspective, focusing on the underlying assumptions and their potential violations in real-world scenarios. We then develop techniques to address these violations, providing a more accurate and robust approach to exposure assessment. This work is particularly relevant for risk assessors and managers, since it offers a refined toolset for more precise exposure assessments.

Prioritizing working memory resources depends on prefrontal cortex.

How the prefrontal cortex contributes to working memory remains controversial, as theories differ in their emphasis on its role in storing memories versus controlling their content. To adjudicate between these competing ideas, we tested how perturbations to the human (both sexes) lateral prefrontal cortex impact the storage and control aspects of working memory during a task that requires human subjects to allocate resources to memory items based on their behavioral priority. Our computational model made a strong prediction that disruption of this control process would counterintuitively improve memory for low-priority items. Remarkably, transcranial magnetic stimulation of retinotopically-defined superior precentral sulcus, but not intraparietal sulcus, unbalanced the prioritization of resources, improving memory for low-priority items as predicted by the model. Therefore, these results provide direct causal support for models in which the prefrontal cortex controls the allocation of resources that support working memory, rather than simply storing the features of memoranda.Significance statement Although higher-order cognition depends on working memory, the resources that support our memory are severely limited in capacity. To mitigate this limitation, we allocate memory resources according to the behavioral relevance of items. Nonetheless, the neural basis of these abilities remains unclear. Here, we tested the hypothesis that a region in lateral prefrontal cortex controls prioritization in working memory. Indeed, perturbing this region with transcranial magnetic stimulation disrupted the prioritization of working memory resources. Our results provide causal evidence for the hypothesis that prefrontal cortex primarily controls the allocation of memory resources, rather than storing the contents of working memory.

Development of a Patient Reported Outcome Measure of Side Effects for Patients Taking Calcineurin Inhibitors: The FACIT-CNI-Ntx.

Valid measures of side effects are important to inform clinical use of calcineurin inhibitors (CNIs). This study sought to develop and establish the content validity of a PRO measure to capture side effects among kidney transplant recipients taking CNIs. Qualitative interviews for concept elicitation and cognitive debriefing. Participants enrolled in the qualitative study were adults who received a kidney transplant ≤5 years earlier and were currently taking a CNI for immunosuppression. Concept elicitation interview data were analyzed by developing a codebook from a list of symptoms described by participants that they attributed to CNIs or their immunosuppression regimen and by applying the constant comparative approach separately by two coders. The most bothersome and important side effects reported by participants were used to select existing PRO items. Cognitive debriefing examined item comprehensibility, comprehensiveness, and relevance. Among 24 participating patients, 12 underwent concept elicitation interviews. Most (n=10) participants reported neurological or cognitive CNI side effects and a majority of those (n=6) reported that neurological and cognitive side effects were the most bothersome adverse consequences of therapy. Based on these findings, 16 items were either selected from the Functional Assessment for Chronic Illness Therapy (FACIT) PRO item library or were newly written. These items were refined and reduced to 13 for cognitive debriefing that was completed by 18 participants. These items were organized into two scales: Tremors and Cognitive Side Effects. Though a diverse set of patients participated, they were not representative of all recipients of kidney transplants. The PRO's reliability, convergent and known-groups validity, and responsiveness to change were not evaluated. Symptoms could not be definitively attributed to CNIs. A newly developed PRO measure, the Functional Assessment of Chronic Illness Therapy-Calcineurin Inhibitor-Neurotoxicity (FACIT-CNI-Ntx), captures important side effects among patients receiving CNIs.

Intentions to Use PrEP Among a National Sample of Transgender and Gender-Expansive Youth and Emerging Adults: Examining Gender Minority Stress, Substance Use, and Gender Affirmation.

Transgender and gender-expansive young people, ages 13-24 years, experience disproportionate HIV risk yet are among those with the lowest US PrEP uptake rates (< 10%). Factors influencing PrEP outcomes for this population are poorly understood. This study examines the effects of gender minority stressors, gender affirmation, and heavy substance use on their PrEP outcomes using data from the CDC's 2018 START study (N = 972). A conceptual model integrating the gender minority stress and gender affirmation models was developed, mapping relevant START items onto it. Structural equation modeling (Mplus-8.9) was used to examine factors related to their PrEP intentions. Most participants were 18-24 (68%), trans-female (46%), white (45%), and reported heavy substance use (40%). Medical discrimination increased internalized transphobia (b = 0.097, SE = 0.034, p = 0.005) and perceived stigma (b = 0.087, SE = 0.034, p = 0.010). Family rejection increased perceived stigma (b = 0.181, SE = 0.032, p < 0.001) and heavy substance use (b = 0.260, SE = 0.053, p < 0.001). Perceived stigma also increased heavy substance use (b = 0.106, SE = 0.037, p = 0.004). Perceived stigma (b=-0.085, SE = 0.027, p = 0.002) and heavy substance use (b=-0.161, SE = 0.031, p < 0.001) decreased PrEP intentions, while gender affirmation increased them (b = 0.045, SE = 0.019, p = 0.020). A 1-point increase in gender affirmation reduced heavy substance use risk by -0.179 (SE = 0.030, p < 0.001) in the presence of family rejection and by -0.074 (SE = 0.041, p = 0.074) when perceived stigma was present. This study underscores heavy substance use as a potential barrier to PrEP uptake for transgender/gender-expansive youth. Future research could explore how gender affirmation acts as a protective factor against the negative impact of family rejection and perceived stigma on heavy substance behaviors among these populations.

Younger adults may be faster at making semantic predictions, but older adults are more efficient.

While there is strong evidence that younger adults use contextual information to generate semantic predictions, findings from older adults are less clear. Age affects cognition in a variety of different ways that may impact prediction mechanisms; while the efficiency of memory systems and processing speed decrease, life experience leads to complementary increases in vocabulary size, real-world knowledge, and even inhibitory control. Using the visual world paradigm, we tested prediction in younger (n = 30, between 18 and 35 years of age) and older adults (n = 30, between 53 and 78 years of age). Importantly, we differentiated early stage predictions based on simple spreading activation from the more resource-intensive tailoring of predictions when additional constraining information is provided. We found that older adults were slower than younger adults in generating early stage predictions but then quicker than younger adults to tailor those predictions given additional information. This suggests that while age may lead to delays in first activating relevant lexical items when listening to speech, increased linguistic experience nonetheless increases the efficiency with which contextual information is used. These findings are consistent with reports of age having positive as well as negative impacts on cognition and suggest conflation of different stages of prediction as a basis for the inconsistency in the aging-related literature to date. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Affective Computing for Learning in Education: A Systematic Review and Bibliometric Analysis

Affective computing is an emerging area of education research and has the potential to enhance educational outcomes. Despite the growing number of literature studies, there are still deficiencies and gaps in the domain of affective computing in education. In this study, we systematically review affective computing in the education domain. Methods: We queried four well-known research databases, namely the Web of Science Core Collection, IEEE Xplore, ACM Digital Library, and PubMed, using specific keywords for papers published between January 2010 and July 2023. Various relevant data items are extracted and classified based on a set of 15 extensive research questions. Following the PRISMA 2020 guidelines, a total of 175 studies were selected and reviewed in this work from among 3102 articles screened. The data show an increasing trend in publications within this domain. The most common research purpose involves designing emotion recognition/expression systems. Conventional textual questionnaires remain the most popular channels for affective measurement. Classrooms are identified as the primary research environments; the largest research sample group is university students. Learning domains are mainly associated with science, technology, engineering, and mathematics (STEM) courses. The bibliometric analysis reveals that most publications are affiliated with the USA. The studies are primarily published in journals, with the majority appearing in the Frontiers in Psychology journal. Research gaps, challenges, and potential directions for future research are explored. This review synthesizes current knowledge regarding the application of affective computing in the education sector. This knowledge is useful for future directions to help educational researchers, policymakers, and practitioners deploy affective computing technology to broaden educational practices.

Updating an HIV Knowledge Questionnaire With Pre-exposure Prophylaxis Through Expert Opinions in the United States Using Delphi Methodology: A Qualitative Study.

Our study was designed to update the HIV Knowledge Questionnaire by incorporating pre-exposure prophylaxis (PrEP) knowledge questions, as previous HIV knowledge tools lack this focus. Four rounds of Delphi surveys were conducted with 47 expert participants, each with extensive HIV-related expertise (mean experience: 18.94 years). Expert participants rated item relevance on a scale of 0-3 and provided feedback. An item was removed if over 70% scored it two or less. The process continued until consensus was reached, defined as 80% of items scoring above two by more than 70% of expert participants, with no new suggestions. The final measure included 31 items covering general HIV knowledge, transmission modes, treatment, risk, and PrEP definitions, types, and dosages. Future research is essential to validate this tool for research and clinical settings, ensuring it accurately measures patients' diverse knowledge levels.

Development and testing the psychometric properties of 20 bolt-on items for the EQ-5D-5L across 31 rare diseases.

Our objective was to develop and assess the psychometric properties of relevant bolt-on items for the EQ-5D-5L in patients with rare diseases (RDs). Nineteen new EQ-5D-5L bolt-ons were developed based on literature review, expert input and qualitative interviews and focus groups with patients, caregivers and representatives of patient associations. A nationwide, cross-sectional, web-based survey in China included patients or caregivers of patients with 31 RDs in China (n=9,190). In each RDs, participants completed the EQ-5D-5L and three out of 20 [one existing and 19 newly-developed] bolt-ons. Ceiling, explanatory power, convergent, divergent and known-group validity were examined. Among the bolt-ons, itching had the lowest ceiling (6.5%), while social relationships had the highest (42.2%). The absolute reduction in the ceiling of the EQ-5D-5L with the addition of any bolt-ons was limited, ranging from 0 (respiratory problems) to 8.3%-points (isolation). Dignity and vitality resulted in the largest increase in explained variance in EQ VAS. The isolation, fertility and visual acuity bolt-ons showed good divergent validity from the EQ-5D-5L items. There was strong convergent validity between SF-12 and conceptually-related bolt-ons (e.g., physical health composite and muscle problems bolt-on). Various bolt-ons improved the known-groups validity in specific patient groups, e.g., Huntington's disease (oral expressions), scleroderma (dexterity), myasthenia gravis (muscle problems), neuromyelitis optica and multiple sclerosis (fatigue), Marfan syndrome (self-image) and Pompe disease (safety). The EQ-5D-5L shows sufficient validity in most RDs, but incorporating relevant specific bolt-ons could enhance its ability to more comprehensively assess health-related quality of life in these patients.

Social Media as an Effective Tool for Remote Services of Digital Libraries

The aim of the article is to reveal peculiarities of using social media (social networks, video hosting, etc.) as a modern toolkit of digital libraries in the context of the remote services development. Research methods. The methods of analysis and synthesis, logical, system-structural and comparative methods are applied, which contribute to systematising and generalising theoretical and methodological foundations of the remote services development of digital libraries; studying of popular practices of Ukrainian libraries in social media; identifying peculiarities of using different types of social media in library activities. The method of cognitive analysis is applied in order to highlight basic characteristics of social media as tools of remote services of digital libraries. Using the methods of deduction and generalisation contributes to the formulation of research conclusions. Scientific novelty. Features of applying various types of social media in library activity at the current stage are studied; the basic characteristics of social media as tools of remote services of digital libraries are clarified; the specifics of using social media (social networks, video hosting, podcasts, etc.) as a modern toolkit of digital libraries in the context of the development of remote services is clarified. The most effective types of social media in the context of the specifics of the remote services development of digital libraries in Ukraine are identified. Main conclusions. Having led to revolutionary changes in information and communication practice, social media becomes an integral part of library activity at the present stage. Social media provides libraries with an opportunity to engage users in multifaceted communication while promoting library services and resources beyond geographic boundaries and physical library spaces. Features of social media usage (social networks, video hosting, podcasts, etc.) as a modern toolkit of digital libraries in the context of the development of remote services are the following: promotion of services (notifications about news, relevant items from the collection and library events); connections with library users; provision of library programmes and services 24/7 regardless of territorial location; possibilities of creating corporate communication in order to improve the library service, etc.

The Role of Hispanic Women’s Marital Status on Intimate Partner Violence and Reproductive Coercion Resulting in Unintended Pregnancy

The present study investigates the impact of Hispanic women’s marital status on the occurrence of intimate partner violence (IPV) and reproductive coercion (RC), resulting in unintended pregnancy (UIP). This is a significant public health concern as prior research has shown Hispanic women are disproportionately affected by UIP more than non-Hispanic White women. Data were drawn from the 2018 to 2020 Pregnancy Risk Assessment Monitoring System dataset of Hispanic women ( n = 3,725) who have just given birth within the last 9 months and responded to all relevant survey items. The reporting of preconception IPV or any IPV exacerbated UIP, whereas RC reporting reduced UIP. When stratified by marital status, the association remained between IPV and UIP while it disappeared between RC and UIP. Married Hispanic participants did, however, show an association between RC and UIP. These findings have important implications for public health professionals serving marginalized populations in relationships to identify pregnancy prevention strategies such as discreet contraception use to provide IPV victims with support, resources, and care.

Development and Validation of the Self-Objectification Scale for Assessing Psychological Well-Being in Educational Context

Presently, the youth suffer from much psychological distress due to overly emphasized outlooks and physical appearances by the media and society. This study aimed at the development and validation of the Self-Objectification Scale (SOS). The first phase involved conceptualizing the scale and generating relevant items. The interviews were conducted, transcribed, and analyzed, leading to the creation of items aligned with McKinley and Hyde's self-objectification theory. In the second phase, the scale items underwent content validity by expert evaluation. The third phase involved a try-out study. In the fourth phase, Exploratory Factor Analysis (EFA) was conducted on a sample of 306 adolescents selected by random sampling, aged between 19 and 25 years. A Confirmatory Factor Analysis (CFA) was conducted on another sample of 256 participants by random sampling. Results for EFA showed KMO yielded a value of .873 and Bartlett's Test of Sphericity was statistically significant. The CFA yielded a Normed Fit Index (NFI) of .95, a Comparative Fit Index (CFI) of .97, a Goodness Fit Index (GFI) of .97, and a Root Mean Square Error of Approximation (RMSEA) of .07. These results suggested that the model fully meets the conventional criteria for the good fit indices. Cronbach's alpha was found to be 0.70. The Pearson correlation for concurrent validity between the SOS and Objectified Body Consciousness Scale is 0.24, a significant positive relationship. Conclusively, to measure the phenomenon of body objectification, a reliable and valid instrument of SOS is developed for the Pakistani youth.

Enhanced Recovery After Surgery for patients undergoing radical cystectomy: Surgeons' perspectives and recommendations ten years after its implementation.

Enhanced Recovery After Surgery (ERAS) guidelines for Radical Cystectomy (RC) were published over ten years ago. Aim of this systematic review is to update ERAS recommendations for patients undergoing RC and to give an expert opinion on the relevance of each single ERAS item. A systematic review was performed to identify the impact of each single ERAS item on RC outcomes. Embase and Medline (through Pubmed) were searched systematically. Relevant articles were selected and graded. For each ERAS item, a level of evidence was determined. An e-Delphi consensus was then performed amongst an international panel with renowned experience in RC to provide recommendations based on expert opinion. Preoperative medical optimization and avoiding bowel preparation are highly recommended. Robotic-assisted RC with intracorporeal urinary diversion is moderately recommended and can help in applying other ERAS items, such as early mobilization. Medical thromboprophylaxis should be administered and nasogastric tube should be removed at the end of surgery. Perioperative fluid restriction as well as opioid-sparing anesthesia protocols should be implemented. Generally, consensus was reached on most ERAS items, with the exception of epidural anesthesia (no consensus), resection site drainage (consensus against), and type of urinary drainage. Limitations include the lack of a multidisciplinary approach to the present consensus, giving however a highly specialized surgical opinion on ERAS. and clinical implications: The current study updates ERAS recommendations for patients undergoing RC and suggests application of ERAS by a panel of experts in the field.

Diet and seasonal distribution of piranha populations in the São Miguel River, Rondônia, Brazil

This study analyzed the spatial and seasonal distribution of piranha species and their respective diets. Samples were collected monthly from August 2020 to July 2021 using various types of fishing gear in different sections of the river. Limnological data were also analyzed to assess correlations with the distribution of piranha species. A total of 326 fish were identified, encompassing nine species and three genera. The most abundant species were Serrasalmus rhombeus (N = 155), Pygocentrus nattereri (N = 89), and Serrasalmus spilopleura (N = 23), which were found in the headwaters, intermediate section and river mouth, respectively. The stomach contents of 56 piranhas were analyzed and revealed that 55.35% of the stomachs were full and 44.65% were empty. The results indicated that fish remains were the most relevant food items at all the collection points. The results demonstrated spatial effects among the fish communities in the headwaters, intermediate section and river mouth, along with variations in water levels, with differences between high- and low-water periods. The redundancy analysis indicated significant effects for temperature, but not for other water parameters. It can be concluded that the piranha populations of the São Miguel River are distributed according to the water levels and the different sections of the river, though they utilize the same type of food resource.

Schema Retrieval for Korean Geographic Knowledge Base Question Answering Using Few-Shot Prompting

Geographic Knowledge Base Question Answering (GeoKBQA) has garnered increasing attention for its ability to process complex geographic queries. This study focuses on schema retrieval, a critical step in GeoKBQA that involves extracting relevant schema items (classes, relations, and properties) to generate accurate operational queries. Current GeoKBQA studies primarily rely on rule-based approaches for schema retrieval. These predefine words or descriptions for each schema item. This rule-based method has three critical limitations: (1) poor generalization to undefined schema items, (2) failure to consider the semantic meaning of user queries, and (3) an inability to adapt to languages not used in the predefined step. In this study, we present a schema retrieval model by using few-shot prompting on GPT-4 Turbo to address these issues. Using the SKRE dataset, we searched for the best prompt in terms of enabling the model to handle Korean geographic questions across various generalization levels. Notably, this method outperformed fine-tuning in zero-shot scenarios, underscoring its adaptability to unseen data. To our knowledge, this is the first attempt to develop a schema retrieval model for GeoKBQA that purely utilizes a language model and is capable of processing Korean geographic questions.

Development and validation of a tool for ambulatory monitoring of peripherally inserted central catheter-associated complications.

Peripherally inserted central catheters (PICC) are the preferred vascular access for Outpatient Parenteral Antimicrobial Therapy (OPAT) due to user-friendliness and high safety level. Nevertheless, the lack of a validated tool hampers the yet ill-charted epidemiology and monitoring of PICC related complications in ambulatory care. A sequential exploratory mixed-method three phase research design was used to develop and validate a monitoring tool for PICC complications in OPAT. A literature review and co-design approach allowed its development, followed by Delphi panel content validation. In a third phase, the tool was piloted and implemented for further evaluation, including adherence. Twelve and nine experts respectively participated in the first and second Delphi round (response rate: 92% resp. 69%). Scale-level Content Validity Index based on the Average Method was 0.99 and 0.90 in the first and the second Delphi round respectively. After the Delphi procedure, the tool consisted of the following relevant items: (1) functionality (injection and aspiration), (2) insertion site, (3) catheter fixation, (4) infection and (5) thrombosis. After positive pilot testing, the tool was implemented in 17 participants with outcomes measured in 15 participants. Two participants were readmitted and three experienced PICC complications. As for adherence, the monitoring tool was partially or fully completed 285 times (74,8%); external catheter length was rarely or never reported and systematic follow-up of the temperature scored poorly. A tool for ambulatory monitoring of PICC-associated complications with a solid content validity was obtained. Future research should consist of a multicentric larger size assessment and digitalization.

Variational Autoencoders-Based Algorithm for Multi-Criteria Recommendation Systems

In recent years, recommender systems have become a crucial tool, assisting users in discovering and engaging with valuable information and services. Multi-criteria recommender systems have demonstrated significant value in assisting users to identify the most relevant items by considering various aspects of user experiences. Deep learning (DL) models demonstrated outstanding performance across different domains: computer vision, natural language processing, image analysis, pattern recognition, and recommender systems. In this study, we introduce a deep learning model using VAE to improve multi-criteria recommendation systems. Specifically, we propose a variational autoencoder-based model for multi-criteria recommendation systems (VAE-MCRS). The VAE-MCRS model is sequentially trained across multiple criteria to uncover patterns that allow for better representation of user–item interactions. The VAE-MCRS model utilizes the latent features generated by the VAE in conjunction with user–item interactions to enhance recommendation accuracy and predict ratings for unrated items. Experiments carried out using the Yahoo! Movies multi-criteria dataset demonstrate that the proposed model surpasses other state-of-the-art recommendation algorithms, achieving a Mean Absolute Error (MAE) of 0.6038 and a Root Mean Squared Error (RMSE) of 0.7085, demonstrating its superior performance in providing more precise recommendations for multi-criteria recommendation tasks.

P103 Analysis of cumulative life course impairment in tertiary psoriasis care: insights from the initial delivery of the DermCLCI-r questionnaire in an English cohort

Abstract Chronic diseases such as psoriasis place an ongoing and aggregate burden on patients throughout their life, leading to a negative life-changing impact on decisions and opportunities in patients’ lives. This phenomenon is known as Cumulative Life Course Impairment (CLCI), yet no tools which measure CLCI in a standardized way in patients exist. The DermCLCI-r questionnaire is a novel 25-item questionnaire assessing the impact of psoriasis over the whole course of a patients’ disease journey. This questionnaire is undergoing simultaneous validation in German and English language between centres in Germany and England in a 1-year longitudinal study against existing quality of life tools. This study explores CLCI measured in psoriasis patients from a large tertiary psoriasis clinic in England at the initial assessment with the DermCLCI-r questionnaire and correlates it with clinical and quality of life data. The English data (n = 98) showed 60.2% male; mean age, 51.37 years; mean, 27.98 years since psoriasis diagnosis; mean age of diagnosis, 23.0; mean psoriasis area and severity index (PASI), 3.3; 94% on systemic therapy; 44% PASI &amp;gt; 2; mean DLQI 5.1. 55.1% of patients reported experiencing at least one life-changing experience due to their disease, with a mean number of 4.35 life-changing experiences per patient. The most common life-changing experiences were ‘feeling stressed by the disease’ (31.6%), ‘nervousness, anxiety or tenseness’ (27.6%), ‘impairments regarding choice of clothing’ (26.5%), ‘effort with the treatment of the disease’ (26.5%) and ‘limitations in physical performance’ (25.5%). Ongoing cumulative life stress was experienced by 65.3% of patients, with a mean of 5.53 separate items contributing to their current disease burden. Relevant items in the DermCLCIr tool correlated significantly with total DLQI score, e.g. ‘impairments in quality of life’ (0.568), ‘feeling stressed by the disease’ (0.519), and ‘limitations in physical performance’ (0.492), P &amp;lt; 0.001 respectively. CLCI significantly impacts the majority of patients in tertiary psoriasis care and has contributed to multiple ongoing and life-changing experiences in this patient group; the DermCLCI-r questionnaire is able to identify these. The ability to detect CLCI could allow earlier conservative or therapeutic management of life-changing elements of the psoriasis disease experience, and could potentially reduce the negative personal and social impact of psoriasis. Completion of the longitudinal validation study will further assess the accuracy of the DermCLCI-r questionnaire in aiding clinical decision-making on the holistic management of psoriasis patients.