Relevant Assessment Research Articles

Problem-based learning and the integration of sustainable development goals

PurposeThis study explores how problem-based learning (PBL) programs can address Sustainable Development Goals (SDGs) via the higher education (HE) curriculum, teaching materials and relevant assessments, supporting learning at scale for HE institutions.Design/methodology/approachEmploying SDGs and their indicators as the coding framework, our two-phase study evaluates the curriculum and teaching materials of seven PBL programs at a leading higher education institution (HEI). The first phase involved a content analysis to assess the degree of sustainability integration in 156 relevant courses. The second phase applied a semi-automated mapping protocol to analyze learning and teaching materials in 120 relevant courses.FindingsThe school aligns with 17 SDGs (100%), covering 94 indicators (55.62%). On average, each program within the school addresses over ten of these goals and incorporates more than 24 associated indicators. However, the study reveals an imbalance in the incorporation of SDGs, with some goals not yet deeply and comprehensively embedded in the curriculum. While there is a substantial focus on sustainability theories, the practical implications of SDGs in emerging countries, particularly through case studies and assessments, require significant enhancement.Practical implicationsMapping SDGs allows HEIs to identify strengths and gaps in SDG integration, thereby improving the PBL approach to enhance student work readiness in sustainability-focused careers.Originality/valueThrough the lens of transformative learning theory, this study provides evidence of SDG integration into PBL curricula. It highlights a mapping methodology that enables HEIs to evaluate their sustainability readiness in curriculum, teaching materials and relevant assessments.

Assessment of management reasoning: Design considerations drawn from analysis of simulated outpatient encounters

Purpose Management reasoning is a distinct subset of clinical reasoning. We sought to explore features to be considered when designing assessments of management reasoning. Methods This is a hybrid empirical research study, narrative review, and expert perspective. In 2021, we reviewed and discussed 10 videos of simulated (staged) physician-patient encounters, actively seeking actions that offered insights into assessment of management reasoning. We analyzed our own observations in conjunction with literature on clinical reasoning assessment, using a constant comparative qualitative approach. Results Distinguishing features of management reasoning that will influence its assessment include management scripts, shared decision-making, process knowledge, illness-specific knowledge, and tailoring of the encounter and management plan. Performance domains that merit special consideration include communication, integration of patient preferences, adherence to the management script, and prognostication. Additional facets of encounter variation include the clinical problem, clinical and nonclinical patient characteristics (including preferences, values, and resources), team/system characteristics, and encounter features. We cataloged several relevant assessment approaches including written/computer-based, simulation-based, and workplace-based modalities, and a variety of novel response formats. Conclusions Assessment of management reasoning could be improved with attention to the performance domains, facets of variation, and variety of approaches herein identified.

Assessment of relevance and actual implementation of person-centeredness in healthcare and social support services for women with unintended pregnancy in Germany (CarePreg): results of expert workshops

IntroductionPerson-centeredness is a key principle in the German healthcare system. However, access to high-quality care for women with unintended pregnancy is limited due to social stigma and legal restrictions. There is little research on the adoption of person-centeredness in care for women with unintended pregnancy. The aim of this study was to analyze relevance and actual implementation of dimensions of person-centeredness in psycho-social and medical abortion care from the view of abortion care providers.MethodsCounselors and gynecologist working in psycho-social or medical abortion care participated in one of two digital workshops. Discussions were semi-structured based on the 16 dimensions of an integrative model of person-centeredness, audio-recorded and transcribed verbatim. During qualitative content analysis, deductive categories based on the integrative model of person-centeredness were applied and inductive categories were developed. Additionally, participants rated relevance and actual implementation of the dimensions in an online survey.ResultsThe 18 workshop participants most intensively discussed the dimensions “access to care”, “person-centered characteristics of healthcare providers” and “personally tailored information”. Four additional categories on a macro level (“stigmatization of women with unintended pregnancy”, “stigmatization of healthcare providers”, “political and legal aspects” and “corona pandemic”) were identified. Most dimensions were rated as highly relevant but implementation status was described as rather low.ConclusionsIn Germany, high quality person-centered care for women with unintended pregnancy is insufficiently implemented through limited access to information, a lack of abortion care providers, and stigmatization. There is a need for changes in health care structures to enable nationwide person-centered care for women with unintended pregnancy. Those changes include a more easy access to evidence-based information and person-centered abortion care, more education on abortion care for healthcare providers, integration of topics of abortion care in medical schools and promotion of de-stigmatizing actions to enable abortions as part of the general healthcare.

Analysis of the impacts of financial development on economic growth in East Africa: How do the institutional qualities matter?

The financial sector plays a vital role in fostering economic growth, regardless of a nation's development stage. However, East Africa, compared to other regions, faces unique challenges in advancing its financial landscape. While the existing body of research acknowledges the significance of financial development in promoting economic growth, some studies need more regional specificity, focusing on broader frameworks that may neglect specific factors like the quality of institutions within East Africa. This research addresses this gap by investigating the relationship between financial development and economic growth in 18 East African countries from 1995 to 2021. Employing dynamic panel estimation (GMM) to address potential Endogeneity and reverse causality concerns, the study delves into the moderating effect of institutional quality on this relationship. Factors like government stability, rule of law, presence of the military in politics, and corruption control measure institutional quality.Additionally, the study controls for other relevant factors influencing economic growth. Data sourced from reputable international organizations such as the World Bank, International Monetary Fund, and relevant risk assessment institutions serves as the basis for analysis. The findings reveal that the impact of financial development on economic growth in East Africa is multifaceted. While financial development itself demonstrates a positive influence on growth, this effect is significantly amplified in countries with stronger institutional frameworks. This suggests that robust institutions act as a catalyst, maximizing the positive impact of financial development on economic growth.

Recommendations for asthma monitoring in children: A PeARL document endorsed by APAPARI, EAACI, INTERASMA, REG, and WAO.

Monitoring is a major component of asthma management in children. Regular monitoring allows for diagnosis confirmation, treatment optimization, and natural history review. Numerous factors that may affect disease activity and patient well-being need to be monitored: response and adherence to treatment, disease control, disease progression, comorbidities, quality of life, medication side-effects, allergen and irritant exposures, diet and more. However, the prioritization of such factors and the selection of relevant assessment tools is an unmet need. Furthermore, rapidly developing technologies promise new opportunities for closer, or even "real-time," monitoring between visits. Following an approach that included needs assessment, evidence appraisal, and Delphi consensus, the PeARL Think Tank, in collaboration with major international professional and patient organizations, has developed a set of 24 recommendations on pediatric asthma monitoring, to support healthcare professionals in decision-making and care pathway design.

The Impact of Carbon Emission Trading System on ESG of Agricultural Enterprises: Evidence from 24 Listed Agricultural Companies in China

With China’s dual carbon goals of carbon peaking and carbon neutrality, the carbon emission trading system will play a crucial role. In addition, agriculture, which is closely linked to carbon emissions, is a foundational industry in China. It is worth paying attention to how it responds to carbon emission trading policies. This study uses data from agricultural listed enterprises from 2009 to 2022, and employs the Difference-in-Differences (DID) method and the intermediary effect model. The evidence suggests that the the carbon emission trading system will significantly improve the the ESG evaluation of agricultural enterprises. Furthermore, green management innovation, green total factor productivity, and CSR information disclosure quality of enterprises will act as intermediaries. The study calls for the government to accelerate the establishment of a national carbon trading market, improve reward and penalty systems, and evaluation frameworks for green innovation in agricultural enterprises. It also emphasizes the need to strengthen pre-subsidies for small-scale enterprises, encourage environmental literacy training for management personnel in agricultural enterprises, intensify green innovation efforts, and establish relevant department assessments of corporate social responsibility.

Target identification and validation in research

Target identification is a critical step in biomedical research because it lays the groundwork for the development of new therapies and drugs. Genetic research, including genome-wide association studies (GWAS), genomic sequencing, functional genomics, and data integration, is crucial for understanding disease genetics and potential treatment targets. Transcriptomics and proteomics give data on gene and protein expression, making it easier to identify targets in dysregulated diseases. Target identification is essential for drug discovery, precision medicine, lowering medication attrition, increasing therapeutic efficacy, and, eventually, transforming patient care and drug development. Target validation is a critical stage in drug development because it verifies that revealed molecular targets play a substantial role in disease progression and are therefore suitable for treatment. It employs a range of approaches, including genetic validation, pharmacological validation, and animal model validation. Target validation assures that discovered targets are physiologically relevant, druggable, and have a direct impact on disease processes, thereby reducing pharmaceutical attrition, promoting precision medicine, and hastening therapeutic development. Historically, target identification relied on limited knowledge, typically through candidate-based techniques based on assumptions or prior observations. Target validation experiments looked into how gene knockdown or RNA interference affected illness symptoms. Genomics, proteomics, and functional genomics have all made advances in recent years, as have high-throughput screening and data integration. CRISPR-based technologies and high-throughput sequencing have assisted in the validation of targets. Single-cell validation, machine learning and artificial intelligence, advanced in vitro models like organoids, and patient-derived models will all help to make future assessments of target relevance and treatment responses more precise and individualized. These developments have the potential to dramatically revolutionize research target identification and validation.

Ontological scenario model for learners with disabilities in a recommender framework based on assessment analytics

Technology Enhanced Learning Environments (TELE) have attracted many learners to acquire knowledge and skills at their own pace. But the majority of these environments are not accessible for all categories of learners including learners with disabilities. In fact, some environments may provide content during the learning process that does not meet the profiles of every type of disability. Much research has been developed in the area of personalizing e-learning for people with disabilities. The use of assessment analytics, on the other hand, remains largely unexploited despite its great informative potential, which is elated to assessment data generated by online learning environment. Our proposal focuses on the design of a scenario model for Assessment Analytics to develop a recommendation framework for learners with disabilities. This framework is conceived to retrieve and select relevant learning and assessment resources to learners with disabilities based on their preferences, accessibility needs, and assessment trace data in the context of online learning.

An assessment of the clinical relevance of coracoid graft osteolysis following the Latarjet procedure: a clinical and radiological review

The Latarjet procedure was developed for the treatment of anterior shoulder instability in young, high-demand patients with attritional glenoid bone loss, whose risk of redislocation following primary dislocation may exceed 90%. Coracoid graft osteolysis and prominent screws are commonly observed in late computed tomography (CT) scans of patients who re-present following the procedure, but the clinical relevance of osteolysis in the overall Latarjet cohort is undetermined. We aimed to evaluate clinical and radiological outcomes in patients who underwent the Latarjet procedure, and to determine if severe coracoid graft osteolysis compromised clinical outcomes. This was a retrospective analysis of patients who underwent the open Latarjet procedure. Patients were invited via an e-questionnaire that contained a Western Ontario Shoulder Instability Index (WOSI), and queried about redislocation and reoperation since index surgery. Preoperative glenoid bone loss was calculated on CT using the best-fit circle method. Osteolysis was graded (0, screw head buried in graft; 1, screw head exposed; 2, threads exposed; 3, complete resorption/severe osteolysis) at the level of the proximal and distal screws respectively, on axial CT scans performed ≥ 12 months postoperatively. Between 2011 and 2022, a single surgeon performed 442 Latarjet procedures. One hundred fifty eight patients responded to the questionnaire at median (interquartile range [IQR]) 44 (27-70) months postoperatively, among whom the median (IQR) WOSI score was 352 (142-666) points (0=best, 2100=worst). Recurrent anterior instability occurred in 3/158 (2%) patients. One patient required reoperation for this indication. Among patients who had CT scans ≥ 12 months postoperatively (median [IQR] 40 [29-69] months), 1 patient developed severe osteolysis around both screws (WOSI=90), 17/62 (27%) patients developed severe osteolysis around 1 screw, all of which were proximal (median [IQR] WOSI=235 [135-644]), and 44/62 (71%) patients did not develop severe osteolysis around either screw (median [IQR] WOSI=487 [177-815]). There were no statistically significant differences in WOSI scores between groups based on the presence of severe osteolysis. The Latarjet is reliable procedure that has a low rate of redislocation and reoperation. Severe coracoid graft osteolysis occurs with time, and always affects the proximal graft first. The presence of severe osteolysis did not compromise clinical outcomes.

Pluripotent stem cells for target organ developmental toxicity testing.

Prenatal developmental toxicity research focuses on understanding the potential adverse effects of environmental agents, drugs, and chemicals on the development of embryos and fetuses. Traditional methods involve animal testing, but ethical concerns and the need for human-relevant models have prompted the exploration of alternatives. Pluripotent stem cells (PSCs) are versatile cells with the unique ability to differentiate into any cell type, serving as a foundational tool for studying human development. Two-dimensional (2D) PSC models are often chosen for their ease of use and reproducibility for high-throughput screening. However, they lack the complexity of an in vivo environment. Alternatively, three-dimensional (3D) PSC models, such as organoids, offer tissue architecture and intercellular communication more reminiscent of in vivo conditions. However, they are complicated to produce and analyze, usually requiring advanced and expensive techniques. This review discusses recent advances in the use of human PSCs differentiated into brain and heart lineages and emerging tools and methods that can be combined with PSCs to help address important scientific questions in the area of developmental toxicology. These advancements and new approach methods align with the push for more relevant and predictive developmental toxicity assessment, combining innovative techniques with organoid models to advance regulatory decision-making.

Tools to measure the burden on informal caregivers of cancer patients: A literature review.

(1) To describe existing tools to assess the burden of informal caregivers of people with cancer, (2) to describe how these tools have been validated and (3) to describe the areas of interest of existing assessment tool entries. The caregiver burden of informal caregivers of people with cancer greatly affects their lives. There is a wide variety of relevant assessment tools available, but there are no studies to help researchers to select tools. A search was conducted using the keywords 'cancer', 'caregiver', 'burden' and 'scale' in Medline (PubMed), CINAHL and EMBASE to include articles that developed or applied tools to assess the burden on informal caregivers of cancer patients. Once eligible tools were identified, we searched their 'primary reference' studies. If the original scale was assessed in a population other than informal caregivers of cancer patients, we again searched for psychometric measures in the population of caregivers of cancer patients. This study retrieved 938 articles on developing or applying the informal caregiver burden instrument for cancer patients, including 42 scales. Internal consistency of the original scales ranged from 0.53 to 0.96. Nineteen scales initially developed to assess caregiver burden for patients with dementia, stroke and other disorders were later used for caregivers of cancer patients, eight of which have not yet been validated. Reclassifying all scale domains of concern revealed that scale assessments focused more on caregivers' physical health, emotional state and caregiving tasks. This review identifies many scales for assessing informal caregiver burden in cancer patients and gives scales recommended. However, a portion still needs to be validated. The development of a new scale proposes to be based on a theoretical framework and to consider dimensions for assessing support resources. What problem did the study address?: This paper collates assessment tools on the burden of informal carers of people with cancer. It also provides information on the applicable population, reliability and validity. What were the main findings?: 41 scales could be considered for use, eight of which have not been validated. The scales focus more on assessing caregivers' physical health, emotional state and caregiving tasks, and less on the dimension of support resources. Where and on whom will the research have an impact?: There are implications for informal carers of cancer patients in hospitals or in the community, as well as for relevant researchers. Retrieved with reference to systematic evaluation. No patient or public contribution.

A Perspective-Changing Teaching Experience in Araimiri

The study underscores the remarkable human capacity for resilience and determination when confronted with challenging life situations. Specifically, this research delves into a teacher's interactions with a group of high school students who, due to their unique circumstances, embarked on a transformative journey, overcoming obstacles in the realm of education. The research focused on a private school in Araimiri in the Gulf Province of Papua New Guinea. Employing a qualitative methodology, the study specifically adopts an autoethnographic approach. This autoethnography unfolds against the backdrop of a unique and immersive experience, exposing the researcher to the intricate social dynamics, behaviors, and practices of a group of students. Through keen observations, profound conversations, shared experiences, and the examination of artifacts, the study offers an in-depth and distinctive perspective on the educational landscape during the specified period. The study sought to determine the circumstances that made the experiences of students and teachers significant, to identify key elements of the initial education-related situations of students, to determine the initiatives made to help students improve academically, and to reveal significant findings that manifested through the analyses of the experience. These are the conclusions of the study. First, teachers’ awareness of students' struggles and unique conditions helps them strengthen their teaching approaches. Second, students’ commitment to their lead role in the education process is imperative. Third, teachers’ depth in the understanding of topics and their commitment to teaching help in the ability to simplify complex concepts. Fourth, students’ prerequisite capabilities when introducing new lessons reinforce learning. Fifth, the implemented curriculum should match with relevant assessments that are often provided by the government or industry. These conclusions imply that educational processes are multifaceted and interconnected with components that have to be harmonized to ensure effectiveness.

Aboveground hydrogen storage – Assessment of the potential market relevance in a Carbon-Neutral European energy system

Hydrogen storage is expected to play a crucial role in the comprehensive defossilization of energy systems. In this context, the focus is typically on underground hydrogen storage (e.g., in salt caverns). However, aboveground storage, which is independent of geological conditions and might offer other technical advantages, could provide systemic benefits and, thereby, gain shares in the hydrogen storage market. Against this background, this paper examines the market relevance of aboveground compared to underground hydrogen storage. Using the open-source energy system model and optimization framework of Europe, PyPSA-Eur, the influence of geological independence, storage cost relations, and technical storage characteristics (i.e., efficiencies) on mentioned market relevance of aboveground hydrogen storage are investigated. Further, the expectable market relevance based on current cost projections for the future is assessed. The studies show that in terms of hydrogen capacities, aboveground hydrogen storage plays a considerably smaller role compared to underground hydrogen storage. Even when assuming comparatively low aboveground storage cost, it will not exceed 1.7% (1.9TWhH2,LHV) of total hydrogen storage capacities in a cost-optimal European energy system. Regarding the amounts of annually stored hydrogen, aboveground storage could play a larger role, reaching a maximum share of 32.5% (168TWhH2,LHVa-1) of total stored hydrogen throughout Europe. However, these shares are only achievable for low cost storage in particularly suited energy system supply configurations. For higher aboveground storage costs or lower efficiencies, shares drop below 10% sharply. The analysis identifies some especially influential factors for achieving higher market relevance. Besides storage costs, the demand-orientation of a particular aboveground storage system (e.g., hydrogen storage at demand pressure levels) plays an essential role in market relevance. Further, overall efficiency can be a beneficial factor. Still, current projections of future techno-economic characteristics show that aboveground hydrogen storage is too expensive or too inefficient compared to underground storage. Therefore, to achieve notable market relevance, rather drastic cost reductions beyond current expectations would be needed for all assessed aboveground hydrogen storage technologies.

Immobilisation remediation of arsenic-contaminated soils with promising CaAl-layered double hydroxide and bioavailability, bioaccessibility, and speciation-based health risk assessment

Arsenic (As)-contaminated soil poses great health risk to human mostly through inadvertent oral exposure. We investigated CaAl-layered double hydroxide (CaAl-LDH), a promising immobilising agent, for the remediation of As-contaminated Chinese soils. The effects on specific soil properties and As fractionation were analyzed, and changes in the health risk of soil As were accurately assessed by means of advanced in vivo mice model and in vitro PBET-SHIME model. Results showed that the application of CaAl-LDH significantly increased soil pH and concentration of Fe and Al oxides, and effectively converted active As fractions into the most stable residual fraction, guaranteeing long-term remediation stability. Based on in vivo test, As relative bioavailability was significantly reduced by 37.75%. Based on in vitro test, As bioaccessibility in small intestinal and colon phases was significantly reduced by 25.65% and 28.57%, respectively. Furthermore, As metabolism (reduction and methylation) by the gut microbiota inhabiting colon was clearly observed. After immobilisation with CaAl-LDH, the concentration of bioaccessible As(Ⅴ) in the colon fluid was significantly reduced by 61.91%, and organic As (least toxic MMA(V) and DMA(V)) became the main species, which further reduced the health risk of soil As. In summary, CaAl-LDH proved to be a feasible option for immobilisation remediation of As-contaminated soils, and considerable progress was made in relevant health risk assessment.

Abstract 2817: Establishment of KRAS G12C mutant brain metastasis models for pre-clinical evaluation of KRAS G12C targeted anticancer therapy

Abstract KRAS is one of the most frequently mutated oncogenes in cancers, especially in lung cancer. Clinical research has shown that about 14% of non-small-cell lung cancers (NSCLCs) carry the KRASG12C mutation, and brain metastases are a relatively common occurrence in KRASG12C-mutated NSCLC. Approximately 30% of patients with KRASG12C mutations develop brain metastases, and those with KRAS-mutated NSCLC and untreated brain metastases have limited treatment options and poor clinical outcomes. AMG510 (Sotorasib) is a small molecule inhibitor of KRASG12C that specifically binds to inactive GDP-bound KRASG12C, preventing its oncogenic signaling. It has been approved for NSCLC by the FDA. Recent clinical studies have shown that Sotorasib exhibits some activity against KRASG12C NSCLC brain metastasis. To evaluate the in vivo activity of AMG510 for NSCLC brain metastasis treatment and provide insights for the preclinical development of new KRAS targeted inhibitors, we established advanced orthotopic models, including intracranial, intracarotid, and intracardiac metastatic models, using the NCI-H358-luc cell line, which harbors the KRASG12C mutation. We validated these models with AMG510 as a single agent or in combination with radiation, which is commonly used in brain tumor therapeutic strategies, to reveal the efficacy and brain concentration of AMG510 in KRASG12C brain metastasis models. Tumor growth and metastasis incidences were assessed using bioluminescence imaging (BLI). All animal studies were performed in an AAALAC accredited facility and aligned with animal welfare regulations. Our preliminary results reveal that AMG510 could penetrate the blood-brain barrier (BBB) and show therapeutic activity for KRASG12C brain metastatic tumors. These models represent powerful tools for clinically relevant assessment of the efficacy of novel KRAS G12C inhibitors and can be expanded for other KRAS mutations-associated brain metastasis or inhibitors. Citation Format: Qikuan Chen, Guilan Wang, Yingfei Yin. Establishment of KRAS G12C mutant brain metastasis models for pre-clinical evaluation of KRAS G12C targeted anticancer therapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2817.

Assessment of suicide risk in people with borderline personality disorder: a qualitative analysis of risk protocols

ABSTRACT Objective The prominence of suicidal ideation, suicide attempts and death by suicide among people diagnosed with Borderline Personality Disorder (BPD) underscores the importance of conducting relevant and informative risk assessment. The purpose of this study was to examine risk assessment protocols used in state public mental health services to assess whether and in what manner they include factors specific to suicidality/self-harm risk in people with BPD. Method A qualitative evaluation of risk assessment protocols from nine of the thirteen (70%) of Victoria’s public mental health was undertaken. Content analysis methodology was utilised to identify themes and compare these to recommendations for risk assessment of BPD as outlined in Australian clinical guidelines Results The risk assessment protocols comprised suicide risk factors generally relevant to psychiatric disorders. Only one protocol incorporated BPD-specific risk assessment principles. Conclusions Fully incorporating BPD-specific risk factors into mental health service risk assessment protocols will better inform service responses and potentially improve clinical outcomes for people with BPD whose presentation includes chronic suicidality and/or high lethality non-suicidal self-injury.

Walking performance in individuals with lumbar spinal stenosis—possible outcome measures and assessment of known-group validity

BACKGROUND CONTEXTOne of the primary goals of treatments received by individuals with lumbar spinal stenosis with neurogenic claudication is to improve walking ability. Thus, a thorough and valid assessment of walking ability in patients with lumbar spinal stenosis is needed. Duration of continuous walking and steps per day could be relevant when evaluating walking ability in daily living. PURPOSETo describe and evaluate a method for estimating continuous walking periods in daily living and to evaluate the known-group validity of steps per day in individuals with lumbar spinal stenosis. STUDY DESIGNThis is a cross-sectional observational study. PATIENT SAMPLEThe study contains three study groups: individuals with lumbar spinal stenosis, individuals with low back pain, and a background population from the Lolland-Falster Health Study (LOFUS). OUTCOME MEASURESParticipants in all three study groups wore an accelerometer on the thigh for seven days. METHODSAccelerometer data were processed to summarize the continuous walking periods according to their length: the number of short (4–9 seconds), moderate (10–89 seconds), and extended (≥90 seconds) continuous walking periods per day, and the number of steps per day. Results from the three groups were compared using negative binomial regression with lumbar spinal stenosis as the reference level. RESULTSContinuous walking periods of moderate length were observed 1.48 (95% CI 1.27, 1.72) times more often in individuals from the background population than in individuals with LSS. Continuous walking periods of extended length were observed 1.53 (95% CI 1.13, 2.06) times more often by individuals with low back pain and 1.60 (95% CI 1.29, 1.99) times more often by individuals from the background population. The number of steps per day was 1.22 (95% CI 1.03, 1.46) times larger in individuals with LBP and 1.35 (95% CI 1.20, 1.53) times larger in individuals from background population. CONCLUSIONSThe impact of neurogenic claudication on walking ability in daily living seems possible to describe by continuous walking periods along with steps per day. The results support known-group validity of steps per day. This is the next step toward a clinically relevant and comprehensive assessment of walking in daily living in individuals with lumbar spinal stenosis.

Distribution patterns of molecular markers of antimalarial drug resistance in Plasmodium falciparum isolates on the Thai-Myanmar border during the periods of 1993–1998 and 2002–2008

BackgroundPolymorphisms of Plasmodium falciparum chloroquine resistance transporter (pfcrt), Plasmodium falciparum multi-drug resistance 1 (pfmdr1) and Plasmodium falciparum kelch 13-propeller (pfk13) genes are accepted as valid molecular markers of quinoline antimalarials and artemisinins. This study investigated the distribution patterns of these genes in P. falciparum isolates from the areas along the Thai-Myanmar border during the two different periods of antimalarial usage in Thailand.ResultsPolymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were used to detect pfcrt mutations at codons 76, 220, 271, 326, 356, and 371 as well as pfmdr1 mutation at codon 86. The prevalence of pfcrt mutations was markedly high (96.4–99.7%) in samples collected during both periods. The proportions of mutant genotypes (number of mutant/total isolate) at codons 76, 220, 271, 326, 356 and 371 in the isolates collected during 1993–1998 (period 1) compared with 2002–2008 (period 2) were 97.9% (137/140) vs. 97.1% (401/413), 97.9% (140/143) vs. 98.8% (171/173), 97.2% (139/143) vs. 97.1% (333/343), 98.6% (140/142) vs. 99.7% (385/386), 96.4% (134/139) vs. 98.2% (378/385) and 97.8% (136/139) vs. 98.9% (375/379), respectively. Most isolates carried pfmdr1 wild-type at codon 86, with a significant difference in proportions genotypes (number of wild type/total sample) in samples collected during period 1 [92.9% (130/140)] compared with period 2 [96.9% (379/391)]. Investigation of pfmdr1 copy number was performed by real-time PCR. The proportions of isolates carried 1, 2, 3 and 4 or more than 4 copies of pfmdr1 (number of isolates carried correspondent copy number/total isolate) were significantly different between the two sample collecting periods (65.7% (90/137) vs. 87.8% (390/444), 18.2% (25/137) vs. 6.3%(28/444), 5.1% (7/137) vs. 1.4% (6/444) and 11.0% (15/137) vs. 4.5% (20/444), for period 1 vs. period 2, respectively). No pfk13 mutation was detected by nested PCR and nucleotide sequencing in all samples with successful analysis (n = 68).ConclusionsThe persistence of pfcrt mutations and pfmdr1 wild-types at codon 86, along with gene amplification in P. falciparum, contributes to the continued resistance of chloroquine and mefloquine in P. falciparum isolates in the study area. Regular surveillance of antimalarial drug resistance in P. falciparum, incorporating relevant molecular markers and treatment efficacy assessments, should be conducted.

Real-World Data Quality Framework for Oncology Time to Treatment Discontinuation Use Case: Implementation and Evaluation Study.

The importance of real-world evidence is widely recognized in observational oncology studies. However, the lack of interoperable data quality standards in the fragmented health information technology landscape represents an important challenge. Therefore, adopting validated systematic methods for evaluating data quality is important for oncology outcomes research leveraging real-world data (RWD). This study aims to implement real-world time to treatment discontinuation (rwTTD) for a systemic anticancer therapy (SACT) as a new use case for the Use Case Specific Relevance and Quality Assessment, a framework linking data quality and relevance in fit-for-purpose RWD assessment. To define the rwTTD use case, we mapped the operational definition of rwTTD to RWD elements commonly available from oncology electronic health record-derived data sets. We identified 20 tasks to check the completeness and plausibility of data elements concerning SACT use, line of therapy (LOT), death date, and length of follow-up. Using descriptive statistics, we illustrated how to implement the Use Case Specific Relevance and Quality Assessment on 2 oncology databases (Data sets A and B) to estimate the rwTTD of an SACT drug (target SACT) for patients with advanced head and neck cancer diagnosed on or after January 1, 2015. A total of 1200 (24.96%) of 4808 patients in Data set A and 237 (5.92%) of 4003 patients in Data set B received the target SACT, suggesting better relevance of the former in estimating the rwTTD of the target SACT. The 2 data sets differed with regard to the terminology used for SACT drugs, LOT format, and target SACT LOT distribution over time. Data set B appeared to have less complete SACT records, longer lags in incorporating the latest data, and incomplete mortality data, suggesting a lack of fitness for estimating rwTTD. The fit-for-purpose data quality assessment demonstrated substantial variability in the quality of the 2 real-world data sets. The data quality specifications applied for rwTTD estimation can be expanded to support a broad spectrum of oncology use cases.

Development of a novel in vitro model for non-cavitated carious lesion formation reflecting carious lesion activity

BackgroundOral biofilms are a critical component in dental caries formation. However, current remineralization studies often overlook the impact of microbial factors. Therefore, a comprehensive clinically relevant assessment of caries is needed. This study aimed to develop a novel in vitro model capable of generating non-cavitated carious lesions that incorporates both mineral loss and microbial activity using quantitative light-induced fluorescence-digital (QLF-D) technology. MethodsA total of 44 artificial early carious lesions were formed using bovine incisors. The extent of fluorescence loss (ΔF) was analyzed using a QLF-D camera. Oral microcosm biofilms were then employed to construct 22 active and 22 inactive carious lesions. The red fluorescence emission rate (ΔR) and bacterial viability (RatioG/G+R) was measured using QLF-D camera and a live-dead bacterial assay, respectively. Independent t-tests were performed to compare ΔF, ΔR, and bacterial viability of artificial carious lesions according to their activity status. ResultsNo significant difference in ΔF between the lesions was found based on activity status (p = 0.361). However, the ΔR of active lesions was 1.82 times higher than that of inactive lesions, and the RatioG/G+R was 1.49 times higher in active lesions than in inactive lesions (both p < 0.001). ConclusionsThe significant differences observed in ΔR and RatioG/G+R between active and inactive lesions emphasize the importance of considering lesion activity status when evaluating the potential efficacy of remineralization agents. This study presents a novel in vitro remineralization assessment model that reflects carious lesion activity while controlling baseline mineral distributions of lesions.