Reliability Of Scores Research Articles

EVALUATION OF READABILITY AND RELIABILITY OF TURKISH WEBSITES ON LOW BACK PAIN

OBJECTIVE: In this study, we investigated the readability and readability of Turkish websites containing information about low back pain. MATERIALS AND METHODS: In February 2022, a search was performed by typing the word "low back pain" into Google's search engine (https://www.google.com). Commercial websites, advertising sites, chat sites, forum sites, magazine sites, sites containing only images or videos, and sites with fewer than 10 sentences were excluded from the study. Reliability scores were calculated using the mean syllable count, the mean number of words with 4 or more syllables, and Ateşman's and Bezirci-Yılmaz's scores for readability, JAMA, and DISCERN. RESULTS: The mean number of syllables and words with 4 or more syllables was 2.78 (1.68-3.20) and 3.74 (0.36-6.31), respectively. The mean Ateşman, Bezirci-Yılmaz, and readability scores were 56.10 (29.77-100.00) and 12.80 (1.88-20.01), respectively, and the JAMA and DISCERN reliability scores were 1.06 (0-2) and 43.00 (26.00-67.00), respectively. CONCLUSION: As a result of this study, it was found that the readability, quality, and reliability of texts on Turkish websites containing information about low back pain are at a very low level.

Evaluation of Ema, Töllner and Rodwell scores in the diagnosis of neonatal sepsis

Introduction: There are no specific signs, symptoms and rapid laboratory tests to definitively diagnose sepsis in the neonatal period. This makes it difficult to diagnose sepsis in newborns in a timely manner and initiate appropriate treatment, or causes babies without sepsis to receive unnecessary antibiotics. Purpose: Therefore, in this study, we planned to investigate the clinical adequacy and reliability of EMA (European Medicines Agency), Töllner and Rodwell hematological scoring in the early diagnosis of neonatal sepsis. Method: EMA, Töllner and Rodwell hematological scoring was performed on each patient. Complete blood count, peripheral smear, C-reactive protein, procalcitonin, blood gas and blood sugar values of newborn babies with suspected sepsis were recorded, blood culture, urine culture and cerebrospinal fluid examination and cultures taken when necessary were evaluated. Using statistical analysis, the 'Positive Expected Value and Negative Expected Values' ratios of the scores were obtained, and the performance results were examined. Results: 95 newborns with a preliminary clinical diagnosis of sepsis were included in the study. These babies were divided into two groups: clinical (n:71) and proven sepsis (n:24) according to blood culture results. Positive and negative predictive values of scoring systems in definitive sepsis diagnosis; for EMA respectively; 21.5%, 56.3% for Töllner; It was determined as 31.3%, 77.8%, and 100%, 77.8% for Rodwell. Conclusion: Our study showed that clinician opinion and standard laboratory tests are limited in the diagnosis of neonatal sepsis, and Rodwell hematological scoring is more prominent in recognizing proven sepsis compared to the other two scores .

Examining a Preclinical Alzheimer's Cognitive Composite for Telehealth Administration for Reliability Between In-Person and Remote Cognitive Testing with Neuroimaging Biomarkers.

The preclinical Alzheimer's cognitive composite (PACC) was developed for in-person administration to capture subtle cognitive decline. At the outset of the COVID-19 pandemic, cognitive testing was increasingly performed remotely by telephone or video administration. It is desirable to have a harmonized composite measurement derived from both in-person and remote assessments for identifying cognitive changes and to examine its relationship with common neuroimaging biomarkers. We defined a telehealth compatible PACC (tPACC) and examined its relationship with neuroimaging biomarkers related to neurodegeneration, brain function and perfusion, white matter integrity, and amyloid-β. We examined 648 participants' neuroimaging and in-person and remote cognitive testing data from the Wake Forest Alzheimer's Disease Research Center's Clinical Core cohort (observational study) to calculate a modified PACC (PACC5-RAVLT) score and tPACC scores (in-person and remote). We performed Spearman/intraclass correlation coefficient (ICC) analyses for reliability of tPACC scores and linear regression models to evaluate associations between tPACC and neuroimaging. Bland-Altman plots for agreement were constructed across cognitively normal and impaired (mild cognitive impairment and dementia) participants. There was a significant positive relationship between tPACCin-person and PACC5-RAVLT (Overall group: r2 = 0.94, N = 648), and tPACCin-person and tPACCremote (validation subgroup: ICC = 0.82, n = 53). Overall, tPACC showed significant associations with brain thickness/volume, gray matter perfusion, white matter free water, and amyloid-β deposition. There is a good agreement between tPACCand PACC5-RAVLTfor cognitively normal and impaired individuals. The tPACC is associated with common neuroimaging markers of Alzheimer's disease.

Pan-Enteric Crohn's Capsule [Eliakim] Score Reliability and Responsiveness to Change in Active Crohn's Disease.

Pan-enteric capsule endoscopy (PillCam Crohn's capsule [PCC]) is a useful tool in diagnosing and monitoring Crohn's disease [CD]. Eliakim score [ES] reliability and its strong correlation to Lewis score [LS] and to inflammatory biomarkers have been previously demonstrated using PCC in quiescent CD. We aimed to examine ES performance in active CD and its responsiveness to clinical/biochemical change over time. Patients with CD who have started biologics were included, and were prospectively followed based on clinical visits, biomarkers, and PCC at baseline, after 14 and 52 weeks. Crohn's disease activity index [CDAI], C-reactive protein [CRP], and faecal calprotectin [FC] levels were determined, and LS and ES were calculated [independently reviewed by two experienced readers]. Inter-class classification [ICC], Spearman's baseline correlation, and repeated-measures correlation [RMC] analyses were performed. Seventy-four patients were included (age: 30.5 [range 23.3-45.0] years old, male 50%). In total, 142 PCCs were read [baseline, 62; week 14, 58; week 52, 22]. Inter-rater agreement was high for both LS and ES (ICC: 0.872 [p < 0.001] and 0.925 [<0.001], respectively). Baseline correlations between FC&ES [r = 0.509 [p < 0.001]) and FC&LS (r = 0.467 [p < 0.001]) were comparable [p = 0.56]. RMCs between the inflammatory biomarkers and ES were higher than between the former and LS (Reader 1: CRP r = 0.306 vs r = 0.138 [p = 0.057], FC r = 0.479 vs r = 0.297 [p = 0.034]; Reader 2 CRP r = 0.376 vs r = 0.204 [p = 0.035], FC r = 0.549 vs r = 0.412 [p = 0.075]). Moreover, ES was better correlated to CDAI than LS [p = 0.036]. ES is a reliable scoring system in assessing pan-enteric mucosal inflammation in active CD, and might have a better responsiveness to clinical/biochemical change over time compared to LS.

Neuropsychiatric symptoms and metamemory across the life span: psychometric properties of the German Multifactorial Memory Questionnaire (MMQ)

ObjectiveWe assessed the psychometric properties, established normative data for the German Multifactorial Memory Questionnaire (MMQ), and analyzed its association with neuropsychiatric factors across the life span to provide a validated metamemory assessment for a German-speaking population.MethodsThe three MMQ scales (memory satisfaction, self-rated ability, and strategy application) were translated into German, considering cultural, linguistic, and conceptual aspects. To validate the MMQ and assess associations with neuropsychiatric factors, the Complainer Profile Identification, Geriatric Depression Scale, Beck Anxiety Inventory, Pittsburgh Sleep Quality Index, and Short-Form-Health Survey were applied in an online study in 336 healthy participants with follow-up after 8 months.ResultsPsychometric evaluation of the German MMQ showed normal distribution of all scales and good to excellent validity, internal consistency, and retest reliability. We provide percentiles and normative data for z-score conversion. Importantly, even subclinically elevated scores in depressiveness and anxiety were associated with decreased memory satisfaction and self-rated ability. Furthermore, although the influence of age on the German MMQ scales was minimal, effects of neuropsychiatric factors such as sleep quality, anxiety, and depressiveness on MMQ Satisfaction and Ability varied across the life span.ConclusionsOur study provides a validated German translation of the MMQ with normative data and reliability measures, including reliable change scores. We show the impact of neuropsychiatric factors on the MMQ scales across the life span and emphasize the relevance of a multifactorial approach to metamemory as a measure of individualized everyday functionality and the importance of including neuropsychiatric factors into both research and clinical assessments of metamemory.

Evaluating the factor structure, reliability and validity of the Copenhagen Burnout Inventory-Student Survey (CBI-SS) among faculty of arts students of Ekiti State University, Ado-Ekiti, Nigeria

The Copenhagen burnout inventory-student survey (CBI-SS) has shown promising psychometric properties in diverse student populations. This study aims to investigate the psychometric properties of the Nigerian version of the CBI-SS. This was a cross-sectional study of 635 students from Ekiti State University, Ado-Ekiti, Nigeria. Confirmatory factor analysis (CFA) was utilized to assess the CBI-SS validity. The reliability score of the CBI-SS was 0.957, ranging from 0.862 to 0.914 for the subscales. Correlation coefficients among the four CBI-SS factors ranged from 0.507 to 0.713. The CFA indicated an adequate goodness-of-fit for the four-factor model of the CBI-SS with the sample data. However, Item 10 was removed due to unacceptably low Average Variance Extracted score. The four factors demonstrated a negative correlation with both General Academic Self-Efficacy Scale and Cumulative Grade Point Average. Furthermore, both self-reported burnout and perceived course stress showed associations with the CBI-SS, where lower levels of burnout corresponded with lower median scores on the CBI-SS scales. This study underscores the significance of the CBI-SS in evaluating student burnout within our student population. The findings indicate that the CBI-SS is a highly reliable and valid instrument for assessing student burnout, suggesting its potential for effective utilization in the Nigerian academic context.

YouTube Videos Are a Moderately Comprehensive, Reliable, and Quality Option to Learn About “Multiple Sclerosis and Sexuality”

Objectives This study aimed to evaluate the performance, comprehensiveness, reliability, and quality of English-language YouTube videos addressing the subject of multiple sclerosis and sexuality. Methods In August 2023, a search was conducted on a computer using the keywords “multiple sclerosis and sexuality,” “multiple sclerosis and sexual health,” “multiple sclerosis and sexual health problems,” and “multiple sclerosis and sexual dysfunction” for this descriptive study. According to predetermined inclusion and exclusion criteria, 38 videos that met the research purpose were examined. The related URLs were recorded. For each video, the following information was collected: content producers, performance with YouTube statistics, comprehensiveness with a form developed by researchers, reliability with Singh’s Reliability Evaluation Form, and quality with Global Quality Scale. Two researchers independently evaluated the videos. Results Eighty-nine and a half percent of the videos contained information presented by professionals. The average number of views was 2699.132 ± 3382.848, the comprehensiveness score was 4.2 ± 1.711, the reliability score was 3.184 ± 1.182, and the quality score was 3.421 ± 1.2. Nearly half (42.2%) contained good and useful information for viewers, and half (50%) had high video quality. The reliability and quality scores of videos containing each item in terms of comprehensiveness were higher compared to videos that did not include that item (p < 0.05). In addition, the videos with higher comprehensiveness scores had higher quality and reliability scores (p < 0.001). Conclusion These results underscore the constrained performance attributes of YouTube videos addressing multiple sclerosis and sexuality, with their content exhibiting a moderate level of comprehensiveness, reliability, and quality. These results may provide a basis for increasing the effectiveness of YouTube videos on multiple sclerosis and sexuality.

“Quasi-Metacognitive Machines: Why We Don’t Need Morally Trustworthy AI and Communicating Reliability is Enough”

Many policies and ethical guidelines recommend developing “trustworthy AI”. We argue that developing morally trustworthy AI is not only unethical, as it promotes trust in an entity that cannot be trustworthy, but it is also unnecessary for optimal calibration. Instead, we show that reliability, exclusive of moral trust, entails the appropriate normative constraints that enable optimal calibration and mitigate the vulnerability that arises in high-stakes hybrid decision-making environments, without also demanding, as moral trust would, the anthropomorphization of AI and thus epistemically dubious behavior. The normative demands of reliability for inter-agential action are argued to be met by an analogue to procedural metacognitive competence (i.e., the ability to evaluate the quality of one’s own informational states to regulate subsequent action). Drawing on recent empirical findings that suggest providing reliability scores (e.g., F1-scores) to human decision-makers improves calibration in the AI system, we argue that reliability scores provide a good index of competence and enable humans to determine how much they wish to rely on the system.

Reliability of the Hand-Eye Coordination Test among Adults Using a Software: A Longitudinal Follow-up Study

This study aims to determine the reliability of the hand-eye coordination Software. The integrated control of hand and eye movements, as well as the processing of visual information to support attainment and acquisition and the use of hand proprioception to guide the eyes, are known as hand-eye coordination. Thus, this study aims to determine the reliability of the tests, so the research was conducted thrice with an interval of 6-7 days (test-retest). 28 Young Adults (18- 35 years of age) have participated in the study. The analysis includes finger-pointing tasks performed only with the use of Hand-eye coordination software prepared by the Software engineer.In this Software, Visual targets in the form of a ball then appeared on the screen on the left, on the right, or in the center in random order., and participants were asked to point an index finger of the leading hand as rapidly and precisely as possible at all targets on the screen. After touching the target (indicated by its disappearance), the participant immediately placed his/her hand back in the designated starting position (touchpad).Each participant was required to repeat this finger-pointing task. The accuracy value after 1 minute was recorded and the average accuracy value was calculated and used in the analysis A smaller value indicates greater touch accuracy. In addition, the average reaction time (in milliseconds) was also measured. Based on the data analysis, the reliability score is 0.806 (Cronbach’s Alpha), which indicates a high level of internal Consistency.

Are serious games an alternative to traditional personality questionnaires? Initial analysis of a gamified assessment.

Personality questionnaires stand as crucial instruments in personnel selection but their limitations turn the interest towards alternatives like game-related assessments (GRAs). GRAs developed for goals other than fun are called serious games. Within them, gamified assessments are serious games that share similarities with traditional assessments (questionnaires, situational judgment tests, etc.) but they incorporate game elements like story, music, and game dynamics. This paper aims to contribute to the research on serious games as an alternative to traditional personality questionnaires by analyzing the characteristics of a gamified assessment called VASSIP. This gamified assessment, based on an existing measure of the Big Five personality traits, incorporates game elements such as storyfication, immersion, and non-evaluable gamified dynamics. The study performed included 98 university students (77.6% with job experience) as participants. They completed the original personality measure (BFI-2-S), the gamified evaluation of personality (VASSIP), a self-report measure of the main dimensions of job performance (task performance, contextual performance, and counterproductive work behaviors), and measures of applicant reactions to BFI-2-S and VASSIP. Results showed that the gamified assessment behaved similarly to the original personality measure in terms of reliability and participants' scores, although the scores in Conscientiousness were substantially higher in VASSIP. Focusing on self-reports of the three dimensions of job performance, regression models showed that the gamified assessment could explain all of them. Regarding applicant reactions, the gamified assessment obtained higher scores in perceptions of comfort, predictive validity, and attractiveness, although the effect size was small except for the latter. Finally, all applicant reactions except for attractiveness were related to age and personality traits. In conclusion, gamified assessments have the potential to be an alternative to traditional personality questionnaires but VASSIP needs more research before its application in actual selection processes.

Role of ferroptosis in neuroimmunity and neurodegeneration in multiple sclerosis revealed by multi-omics data.

Previous studies have found that ferroptosis plays an important role in a variety of neurological diseases. However, the precise role of ferroptosis in the multiple sclerosis patients remains uncertain. We defined and validated a computational metric of ferroptosis levels. The ferroptosis scores were computed using the AUCell method, which reflects the enrichment scores of ferroptosis-related genes through gene ranking. The reliability of the ferroptosis score was assessed using various methods, involving cells induced to undergo ferroptosis by six different ferroptosis inducers. Through a comprehensive approach integrating snRNA-seq, spatial transcriptomics, and spatial proteomics data, we explored the role of ferroptosis in multiple sclerosis. Our findings revealed that among seven sampling regions of different white matter lesions, the edges of active lesions exhibited the highest ferroptosis score, which was associated with activation of the phagocyte system. Remyelination lesions exhibit the lowest ferroptosis score. In the cortex, ferroptosis score were elevated in neurons, relevant to a variety of neurodegenerative disease-related pathways. Spatial transcriptomics demonstrated a significant co-localization among ferroptosis score, neurodegeneration and microglia, which was verified by spatial proteomics. Furthermore, we established a diagnostic model of multiple sclerosis based on 24 ferroptosis-related genes in the peripheral blood. Ferroptosis might exhibits a dual role in the context of multiple sclerosis, relevant to both neuroimmunity and neurodegeneration, thereby presenting a promising and novel therapeutic target. Ferroptosis-related genes in the blood that could potentially serve as diagnostic and prognostic markers for multiple sclerosis.

A comparison of frailty measures in population-based data for patients with colorectal cancer.

Numerous studies have revealed age-related inequalities in colorectal cancer care. Increasing levels of frailty in an ageing population may be contributing to this, but quantifying frailty in population-based studies is challenging. To assess the feasibility, validity and reliability of the Hospital Frailty Risk Score (HFRS), the Secondary Care Administrative Records Frailty (SCARF) index and the frailty syndromes (FS) measures in a national colorectal cancer cohort. Retrospective population-based study using 136,008 patients with colorectal cancer treated within the English National Health Service. Each measure was generated in the dataset to assess their feasibility. The diagnostic codes used in each measure were compared with those in the Charlson Comorbidity Index (CCI). Validity was assessed using the prevalence of frailty and relationship with 1-year survival. The Brier score and the c-statistic were used to assess performance and discriminative ability of models with included each measure. All measures demonstrated feasibility, validity and reliability. Diagnostic codes used in SCARF and CCI have considerable overlap. Prevalence of frailty determined by each differed; SCARF allocating 55.4% of the population to the lowest risk group compared with 85.1% (HFRS) and 81.2% (FS). HFRS and FS demonstrated the greatest difference in 1-year overall survival between those with the lowest and highest measured levels of frailty. Differences in model performance were marginal. HFRS, SCARF and FS all have value in quantifying frailty in routine administrative health care datasets. The most suitable measure will depend on the context and requirements of each individual epidemiological study.

Improving clinical reasoning and communication during handover: An intervention study of the BRIEF-C tool

BackgroundExisting handover communication tools often lack a clear theoretical foundation, have limited psychometric evidence, and overlook effective communication strategies for enhancing diagnostic reasoning. This oversight becomes critical as communication breakdowns...

Comprehensive evaluation of a new automatic scoring system for cleanliness assessment in video capsule endoscopy

AbstractA reliable, quick‐to‐assess, and automatic scoring system for cleanliness assessment in video capsule endoscopy (VCE) is presently not available. The present study proposes an approach to automatically assess the cleanliness in VCE frames as per the latest scoring system, that is, Korea‐Canada (KODA). First, a new multi‐label frame dataset containing medical scores of 28 VCE videos was generated through the proposed mobile‐based application called Artificial Intelligence‐KODA (AI‐KODA) score. The scores were saved automatically in real‐time through the application. The generated dataset was transformed into three datasets based on the scores, and each of the dataset was then randomly split into train:validate:test ratio of 60:20:20. Second, a comprehensive evaluation, interpretation, and benchmarking of the three classification tasks were performed with the help of eight transfer learning algorithms on NVIDIA RTX A5000 workstation. Thorough analysis indicates that AI‐KODA utilized with AI is reliable, quick‐to‐access, and free from observer bias. It promotes automatic scoring system for cleanliness assessment in VCE. The meta‐data is available here (link).

Validation of a Rubric to Assess Physiology Exam Multiple Choice Questions to Create Fair and Equitable Assessments

Inequities and achievement gaps exist for students from groups underrepresented in medicine (URiM) and for English language learners (ELLs). This is particularly evident with multiple choice assessments which are prevalent in health professions and medical education. Increasing the linguistic accessibility of test items by simplifying the language used while keeping the content diffculty was perceived as helpful to ELLs in an undergraduate Chemistry course (Lee &amp; Orgill, 2022). Following best practices when writing exam questions provides consistent and valid measures of student comprehension. Across institutions we face similar challenges when forming and assessing multiple choice questions for our physiology exams. Some major flaws include long complex options; using vague terms; negatively structured stems; grammatical cues; word repeats. Lopez (2023) found that 56% items contained at least one flaw. The most common flaws identified were those in which the items were not approximately the same length and item options that did not have parallel grammatical form and structure. In order to address these issues in an objective way, we collectively modified the previously detailed rubric (Lopez, 2023) for identifying common flaws based on the “Item-Writing Guide” from the National Board of Medical Education (NBME®) and one formed in the context of general chemistry by Breakall et al. (2019). Twenty-six questions from physiology exams at three different institutions were evaluated by three faculty using the newly created rubric. After analyzing the questions, we returned as a group and compared our individual ratings, clarified any discrepancies and modified the rubric accordingly. We will conduct statistical analysis to assess our inter-rater reliability score before using this rubric to analyze the full question banks for physiology exams at each institution. This process is not limited to physiology educators since it can be utilized by teachers in any program or discipline. The significance of the work will not only benefit our validation of learning but it will also address specific equity issues by eliminating flaws that provide irrelevant diffculty or benefit test wise students. Furthermore, this rubric is also helpful in generating new questions for future exams, ensuring equitable assessments.

Utility of the ACD-GENE-CLI Score in Asian Patients with Critical Limb Ischemia Undergoing Endovascular Interventions.

Critical limb ischemia (CLI) is an emerging public health threat and lacks a reliable score for predicting the outcomes. The Age, Body Mass Index, Chronic Kidney Disease, Diabetes, and Genotyping (ABCD-GENE) risk score helps identify patients with coronary artery disease who have cytochrome P450 2C19 (CYP2C19) polymorphism-related drug resistance and are at risk for cardiovascular adverse events. However, its application to CLI remains unknown. In this study, we aim to validate a modified ACD-GENE-CLI score to improve the prediction of major adverse limb events (MALEs) in patients with CLI receiving clopidogrel. Patients with CLI receiving clopidogrel post-endovascular intervention were enrolled prospectively in two medical centers. Amputation and revascularization as MALEs were regarded as the outcomes. A total of 473 patients were recruited, with a mean follow-up duration of 25 months. Except for obesity, old age, diabetes, chronic kidney disease (CKD), and CYP2C19 polymorphisms were significantly associated with MALEs. Using bootstrap regression analysis, we established a modified risk score (ACD-GENE-CLI) that included old age (≥ 65 years), diabetes, CKD, and CYP2C19 polymorphisms. At a cutoff value of 8, the ACD-GENE-CLI score was superior to the CYP2C19 deficiency only, and the conventional ABCD-GENE score in predicting MALEs (area under the curve: 0.69 vs. 0.59 vs. 0.67, p=0.01). The diagnostic ability of the ACD-GENE-CLI score was consistent in the external validation. Also, Kaplan-Meier curves showed that in CYP2C19 deficiency, the ABCD-GENE and ACD-GENE-CLI scores could all differentiate patients with CLI who are free from MALEs. The modified ACD-GENE-CLI score could differentiate patients with CLI receiving clopidogrel who are at risk of MALEs. Further studies are required to generalize the utility of the score.

The Effectiveness of Problem-Based Learning Assisted by Articulate Storyline Interactive Students' Critical Thinking Skills

This study aims to reveal the impact of a problem-based learning model assisted by articulate storyline interactive media on high school biology students' critical thinking skills. This research was conducted in April-July 2023. The research method used was a quasi-experiment with a nonequivalent control group design. The population is all grade X science students (grade X IPA) of SMA Negeri 1 Kawali, West Java in the 2022/2023 school year as many as 6 classes. The sampling technique used was the purposive sampling technique, with grade X IPA 1 class as the experimental class and X IPA 3 as the control class each containing 36 students. The data collecting instrument is a critical thinking skill test consisting of 13 description questions that had gone through validity and reliability tests with the results of the instrument validity test, namely eight significant questions and five very significant questions, and the reliability score r = 0.84 including the high category. The data analysis technique used was the one-way ANOVA test at a significance level of 0.05. The average N-gain score of critical thinking skills of the experimental class is 0.45 (medium) higher than the control class which is 0.19 (low). Based on the results of testing the research hypothesis, it can be concluded that there is an effect of a problem-based learning model assisted by articulate storyline interactive media on critical thinking skills at a significance level of 0.000. The theoretical implication is that critical thinking skills can be improved by using a problem-based learning model assisted by interactive learning media so that the problem-based learning model assisted by articulate storyline interactive media can be used as a teaching method to improve critical thinking skills.

Validity evidence for a team-leading assessment tool in pediatric emergency resuscitations using video review.

Effective leadership of health care action teams has demonstrated positive influence on team performance and patient care, but there is no consensus on how to assess these skills. We developed a novel team leadership assessment tool for leaders of interprofessional pediatric resuscitation teams and collected validity evidence for this tool using video review. This was a prospective cohort study from November 2021 to October 2022. A novel team leadership assessment tool was developed using literature review and local expertise and then piloted and refined using medical simulation. Pediatric emergency medicine (PEM) fellows from a single tertiary care pediatric medical center were enrolled, and videos of one medical resuscitation and one trauma resuscitation were collected per fellow each month. Three reviewers underwent reviewer training and then scored the videos using the assessment tool. Raters provided feedback on feasibility and ease of use using a 5-point Likert scale. Inter-rater reliability for the assessment tool using Gwet's agreement coefficient and the association between performance and clinical level of training using generalized linear mixed model were calculated. Twelve PEM fellows enrolled and 146 videos were reviewed. The inter-rater reliability for each domain ranged from 0.45 (p < 0.0001) to 0.59 (p < 0.0001), with the inter-rater reliability of the total score being 0.49 (p < 0.0001). The reviewers' mean ratings of the elements of the tool were as follows: clarity of the domains (4.6/5), the independence of each domain from each other (3.9/5), the ease of use of the 5-point Likert scale (4.5/5), the usefulness of the provided examples for each domain (4.6/5), and the ability to assess each domain without having to rewatch (4.5/5). The tool differentiated between levels of clinical training for two of the six domains (p < 0.02). We developed a novel team leadership assessment tool for pediatric resuscitation team leaders that demonstrated moderate inter-rater reliability. The tool was easy to use and feasible for educators to assess the performance of PEM trainees in complex high-stakes clinical situations.

Endoscopic assessment of the J pouch in ulcerative colitis: A narrative review.

Patients with ulcerative colitis sometimes need a total colectomy with ileal pouch-anal anastomosis due to medically refractory disease or colitis-associated neoplasia. Up to 50% of patients with ulcerative colitis postoperatively develop pouchitis and the rate of chronic inflammatory pouch conditions requiring pouch excision or diverting ileostomy is reported to be 10%. In order to diagnose and monitor pouchitis, pouchoscopy is essential to assess endoscopic inflammatory findings of the J pouch and to survey neoplasia development, particularly in the remnant distal rectum. However, endoscopic protocols for the evaluation of the pouch may not be standardized worldwide and the reliability of existing disease activity indices for pouchitis has been questioned due to the lack of validation. Recently, reliable endoscopic scoring systems based on an observation of the anatomical location of the J pouch were reported and a significant association between the distribution pattern of endoscopic inflammation (i.e., endoscopic phenotype) and pouch outcomes was also uncovered. In this review, we discuss how to survey the J pouch using pouchoscopy, endoscopic indices for pouchitis disease activity, endoscopic phenotypes and classification, and the pathological mechanisms of pouchitis phenotype in patients with ulcerative colitis.

Quantifying Coloring Skills Among Preschoolers.

Coloring is popular with preschool children and reveals their developmental state. However, interpreting coloring performances is challenging because descriptive and subjective evaluations are commonly used with large variations. To develop a scoring method to objectively quantify children's coloring skills. Colored blank train templates were analyzed using four indicators (entropy, complexity, coloring outside the lines, and unexpected blank areas) to form a summed score. Kindergarten in a urban city (Tainan, Taiwan). Two hundred thirty-nine typically developing children ages 3 to 6 yr. A newly developed method to assess coloring skill on the basis of a colored picture of a train. The summed score exhibited good internal consistency (Cronbach's α = .80), discriminative validity (p = .04), convergent validity (rs = .66 and .59 with age and visual-motor integration), and acceptable factorial validity (comparative fit index = .99, standardized root-mean-square residual = .04, and root-mean-square error of approximation = .13). Moreover, three coloring patterns (mature, transitional, and immature) were identified. The new method provides objective, reliable, and valid scores representing coloring skills in typically developing children. In addition, the coloring patterns can be recognized. This method can be used to facilitate comparisons of children's coloring skills with peers and provide valuable insight into children's development. Plain-Language Summary: This study proposes a new method to objectively quantify children's coloring skills with sound reliability and validity in typically developing children. The method can be used to evaluate children's coloring skills and patterns to shed light on their developmental stages.