Reliable Index Research Articles

Association of Triglyceride Glucose-Derived Indices with Recurrent Events Following Atherosclerotic Cardiovascular Disease.

Triglyceride glucose (TyG) and TyG-body mass index (TyG-BMI) are reliable surrogate indices of insulin resistance and used for risk stratification and outcome prediction in patients with atherosclerotic cardiovascular disease (ASCVD). Here, we inserted estimated average glucose (eAG) into the TyG (TyAG) and TyG-BMI (TyAG-BMI) as derived parameters and explored their clinical significance in cardiovascular risk prediction. This was a population-based cohort study of 9,944 Chinese patients with ASCVD. The baseline admission fasting glucose and A1C-derived eAG values were recorded. Cardiovascular events (CVEs) that occurred during an average of 38.5 months of follow-up were recorded. We stratified the patients into four groups by quartiles of the parameters. Baseline data and outcomes were analyzed. Distribution of the TyAG and TyAG-BMI indices shifted slightly toward higher values (the right side) compared with TyG and TyG-BMI, respectively. The baseline levels of cardiovascular risk factors and coronary severity increased with quartile of TyG, TyAG, TyG-BMI, and TyAG-BMI (all P<0.001). The multivariate-adjusted hazard ratios for CVEs when the highest and lowest quartiles were compared from low to high were 1.02 (95% confidence interval [CI], 0.77 to 1.36; TyG), 1.29 (95% CI, 0.97 to 1.73; TyAG), 1.59 (95% CI, 1.01 to 2.58; TyG-BMI), and 1.91 (95% CI, 1.16 to 3.15; TyAG-BMI). The latter two showed statistical significance. This study suggests that TyAG and TyAG-BMI exhibit more information than TyG and TyG-BMI in disease progression among patients with ASCVD. The TyAG-BMI index provided better predictive performance for CVEs than other parameters.

Biophysical characterization of summer Arctic sea-ice habitats using a remotely operated vehicle-mounted underwater hyperspectral imager

The impact of a rapidly shifting sea-ice cover on climate, ecosystem processes and biophysical habitat properties is not yet fully understood, particularly in the central Arctic Ocean, due to a lack of spatially representative observations. From June to July 2020 during the year-long Multidisciplinary drifting Observatory for the Study of Arctic Climate (MOSAiC, leg 4) in the Transpolar Drift, we deployed an underwater hyperspectral imager (UHI) mounted on a remotely operated vehicle (ROV) to characterize the biophysical properties of different sea-ice habitats. We conducted UHI surveys along two transects: i) under level first-year sea ice (FYI), which had a mean sea-ice draft of 1.4 m and was composed of primarily level FYI but also had a relatively shallow ridge (keel depth ∼2.6 m); and ii) under the flank of a ridge, named Jaridge, with a mean ice draft of 1.7 m, which was composed of a mix of level ice and thicker ridge blocks with over 3 m draft. We present a new unsupervised bio-optical quantification algorithm for hyperspectral surveys, the relative ice algal biomass index (RBI), using spectral mixture analysis (SMA). We compare this method to the supervised machine learning habitat classification algorithm, Support Vector Machine (SVM). The RBI showed good agreement to literature-based normalized difference indices (NDI) and PCA analyses, which confirm the RBI as a reliable unsupervised index for ice algal biomass. Our biophysical characterization of the two surveyed regions showed an association of sea-ice algal biomass with sea-ice ridge features. Our surveys also indicate that ice algal spatial distribution may be influenced by ice melt rates, and the formation of under ice meltwater layers and false bottoms. With high spatial coverage (>100 m) at microscale resolution (∼cm) we documented large spatial variability of summer Arctic sea-ice algal biomass and different patterns between adjacent ice habitats. We further demonstrate the need for improved understanding of sea-ice algal spatial variability as a complementary tool for sea-ice biogeochemical sampling using destructive ice core sampling.

A Corpus-Based Study on Cohesion Development in Writing by EFL Novices

This corpus-based study explored the development of cohesive devices in the writing of Chinese beginner learners of English as a foreign language (EFL) over a three-year span. Quantitative analysis utilizing the Tool for Automatic Analysis of Cohesion (TAACO) was conducted on a longitudinal learner corpus comprising over 500 exam essays. Lexical, syntactic, semantic, and discourse features were examined to identify reliable indices for tracking learners’ progressive mastery of cohesion. Results revealed that pronoun-related features, including pronoun density and repetition, significantly differed across year pairs and robustly predicted writing development. However, most lexical and connective indices showed ambiguous trajectories over time. The findings highlight the vital role of pronouns in building coherence for novice writers and underscore persistent difficulties in acquiring sophisticated content words and their collocations. This study contributes data-driven insights into the nonlinear processes and enduring challenges shaping EFL beginners’ cohesive competence. It demonstrates the value of computational tools and learner corpora in exploring discourse acquisition.

State Capacity and Industrial Development: A Comparative Study of Iran and Egypt (1990–2010)

Despite pursuing industrial development to solve various socioeconomic and sociopolitical issues, such as the urgent need to reconstruct war damages in Iran, the foreign debt crisis in Egypt, and population growth in both countries, statistical data show only slight progress. The graphs of the gross domestic product (GDP) growth and exports of goods and services as a percentage of GDP, which are reliable indexes for measuring industrial output, along with the rate of foreign direct investment, demonstrate numerous fluctuations and instability in the economic growth rate for both cases under the period under review. Failing to diversify the economy, Iran and Egypt still relied heavily on unproductive rents, mostly from hydrocarbon exports, at the end of this era. Why is this the case despite the national leadership putting industrial development on the agenda? This article addresses this question by examining state capacity, focusing on the internal cohesion of state authority and its relation to society. In so doing, comparative historical analysis and causal narrative method are used.

Predictive values of relative fat mass and body mass index on cardiovascular health in community-dwelling older adults: Results from the Longevity Check-up (Lookup) 7+

ObjectivesTo assess the predictive value of relative fat mass compared to body mass index for hypertension, diabetes, hyperlipidemia, and heightened cardiovascular risk in a cohort of community-dwelling older adults from the Longevity Check-up 7+ cohort. Study designRetrospective cross-sectional study. Main outcome measuresHyperlipidemia was defined as total cholesterol ≥200 mg/dL or ongoing lipid-lowering treatment. Diabetes was defined either as self-reported diagnosis or fasting blood glucose >126 mg/dL or a random blood glucose >200 mg/dL. Hypertension was defined as blood pressure ≥ 140/90 mmHg or requiring daily antihypertensive medications. Heightened cardiovascular risk was operationalized as having at least two of these conditions. ResultsAnalyses were conducted in 1990 participants (mean age 73.2 ± 6.0 years; 54.1 % women). Higher proportions of men than women had hypertension and diabetes, while hyperlipidemia was more prevalent in women. Receiver operating curve analysis indicated relative fat mass was a better predictor of hypertension in women and diabetes in both sexes. Body mass index performed better in predicting hyperlipidemia in women. Relative fat mass thresholds of ≥27 % for men and ≥40 % for women were identified as optimal indicators of heightened cardiovascular risk and so were used to defined high adiposity. Moderate correlations were found between high adiposity or body mass index ≥25 kg/m2 and the presence of hypertension, hyperlipidemia and heightened cardiovascular risk, while a strong correlation was found with diabetes. Logistic regression analysis highlighted significant associations between high adiposity and increased odds of hypertension, diabetes, and heightened cardiovascular risk. ConclusionsProposed cut-offs for relative fat mass were more reliable indices than the usual cut-offs for body mass index for identifying individuals at heightened cardiovascular risk. Our findings support the role of anthropometric measures in evaluating body composition and the associated metabolic and cardiovascular conditions in older adults.

Increase in Plasma S100B Concentration Is Associated With Decrements in Spatial Processing During Acute High-Altitude Exposure

Vasogenic edema consequent to blood-brain barrier (BBB) permeability may contribute to cognitive performance decrements during acute exposure to high altitude. S100B is a putative marker of BBB permeability, but S100B responses to high altitude are poorly characterized and the relation to cognitive performance is unknown. To test the hypothesis that S100B increases upon ascent to high altitude and that increase is associated with changes in cognitive performance, 41 healthy Soldiers (mean±SD; age=26±5yr) were tested at their baseline residence (SL, 331m), transported to Taos, NM (2845m), then immediately hiked (n=21) or were driven (n=20) to a high-altitude (HA, 3600m) facility. Plasma S100B was measured at 06:00 throughout the study; twice at SL and again after the first night at HA (16h exposure). The automated neuropsychological assessment metric (ANAM) was administered four times at SL and once at HA to assess sustained attention, working memory, spatial processing, computation, executive function, and reaction time. ANAM performance was assessed using throughput scores, a metric considering both response speed and accuracy. The last SL morning assessment and the HA morning assessment (19h exposure) were used to generate ΔANAM scores. Correlations between ΔS100B and ΔANAM scores were significant for 1 of 9 modules, simultaneous spatial processing (SPD; r=-0.401; p=0.009). S100B increased (5.3%, p=0.02) from SL to HA while SPD scores decreased (8.2%, p=0.05). Using the reliable change index (RCI) to dichotomize individuals into those demonstrating a decrease in performance that exceeded measurement error and day-to-day variability (responders; RCI &lt;-1.64; n=7) and those who did not (non-responders; RCI &gt;-1.64; n=34) revealed that responders experienced a greater increase (+12.3%, p=0.01) in S100B from SL to HA relative to non-responders (+3.4%, p=0.14) Findings suggest that acute exposure to 3600m may increase BBB permeability, as indicated from plasma S100B concentrations, and the increased BBB permeability may be mechanistically associated with spatial processing decrements. Funding: USAMRDC, PRMRP. Authors’ views not offcial U.S. Army or DoD policy. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Association of socioeconomic disadvantage and ethnicity with perinatal neonatal, and infant mortality in Slovakia

BackgroundInfant mortality rates are reliable indices of the child and general population health status and health care delivery. The most critical factors affecting infant mortality are socioeconomic status and ethnicity. The aim of this study was to assess the association between socioeconomic disadvantage, ethnicity, and perinatal, neonatal, and infant mortality in Slovakia before and during the COVID-19 pandemic.MethodsThe associations between socioeconomic disadvantage (educational level, long-term unemployment rate), ethnicity (the proportion of the Roma population) and mortality (perinatal, neonatal, and infant) in the period 2017–2022 were explored, using linear regression models.ResultsThe higher proportion of people with only elementary education and long-term unemployed, as well as the higher proportion of the Roma population, increases mortality rates. The proportion of the Roma population had the most significant impact on mortality in the selected period between 2017 and 2022, especially during the COVID-19 pandemic (2020–2022).ConclusionsLife in segregated Roma settlements is connected with the accumulation of socioeconomic disadvantage. Persistent inequities between Roma and the majority population in Slovakia exposed by mortality rates in children point to the vulnerabilities and exposures which should be adequately addressed by health and social policies.

Lessons from long-term monitoring of tropical rock lobsters to support fisheries management

Fishery-independent scientific surveys are highly valuable for monitoring lobsters and other fisheries. Yet, there are relatively few long-term monitoring surveys to support the provision of management advice. A number of challenges can prevent the continuity of long-term monitoring series. This paper uses the 35-year continuous annual dive surveys for Australia’s Torres Strait tropical rock lobster (TRL) to overview strengths and limitations of a long-term scientific survey, as well as lessons learnt from having overcome a range of challenges. Fishery-independent surveys are more reliable than fishery-dependent data and are more robust to external shocks such as market drivers and fuel prices. The primary purpose of the surveys is to provide a reliable index of stock abundance together with data to inform on size and age structure, plus model parameters and reference points. Here, we also highlight additional survey benefits including: yielding positive gains relative to cost, facilitating an adaptive management approach that serves as an early warning system, reducing and resolving inter-sector conflicts, reduced frequency of stock assessments, providing data from associated habitat monitoring, improved stakeholder buy-in, utility for development of Operating Models for Management Strategy Evaluation, contribution to achieving certification, contributing to biodiversity agreements and consistent cross-jurisdictional monitoring. We analyse lessons learnt from challenges such as changes in resource management, budget cuts, increased health and safety requirements, maintenance of capability and staff capacity, stakeholder buy-in, need to validate survey results, a pandemic and changing climate. Our experiences highlight why long-term scientific surveys are considered the gold standard for fisheries monitoring and we provide insights for building and maintaining key marine monitoring series.

Dose-response association between Chinese visceral adiposity index and cardiovascular disease: a national prospective cohort study.

Chinese visceral adiposity index (CVAI) is a reliable visceral obesity index, but the association between CVAI and risk of cardiovascular disease (CVD) remains unclear. We explored the associations of CVAI with incident CVD, heart disease, and stroke and compared the predictive power of CVAI with other obesity indices based on a national cohort study. The present study included 7,439 participants aged ≥45 years from China Health and Retirement Longitudinal Study (CHARLS). Cox regression models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Restricted cubic splines analyses were adopted to model the dose-response associations. Receiver operator characteristic (ROC) analyses were used to compare the predictive ability of different obesity indices (CVAI, visceral adiposity index [VAI], a body shape index [ABSI], conicity index [CI], waist circumference [WC], and body mass index [BMI]). During 7 years' follow-up, 1,326 incident CVD, 1,032 incident heart disease, and 399 stroke cases were identified. The HRs (95% CI) of CVD, heart disease, and stroke were 1.50 (1.25-1.79), 1.29 (1.05-1.57), and 2.45 (1.74-3.45) for quartile 4 versus quartile 1 in CVAI. Linear associations of CVAI with CVD, heart disease, and stroke were observed (P nonlinear >0.05) and per-standard deviation (SD) increase was associated with 17% (HR 1.17, 1.10-1.24), 12% (1.12, 1.04-1.20), and 31% (1.31, 1.18-1.46) increased risk, respectively. Per-SD increase in CVAI conferred higher risk in participants aged<60 years than those aged ≥60 years (P interaction<0.05). ROC analyses showed that CVAI had higher predictive value than other obesity indices (P<0.05). CVAI was linearly associated with risk of CVD, heart disease, and stroke and had best performance for predicting incident CVD. Our findings indicate CVAI as a reliable and applicable obesity index to identify higher risk of CVD.

Bridging the feedback implementation gap: A comparison of empirical and rational decision rules in naturalistic psychotherapy

Objective: Previous research indicates positive effects of feedback based on rational or empirical decision rules in psychotherapy. The implementation of these usually session-to-session-based feedback systems into clinical practice, however, remains challenging. This study aims to evaluate decision rules based on routine outcome monitoring with reduced assessment frequency. Method: Data routinely collected every 5–20 sessions of N = 3758 patients treated with CBT in an outpatient clinic (M sessions = 42.8, SD = 15.4) were used to develop feedback decision rules based on the expected treatment response and nearest neighbors approach, the reliable change index, and method of percental improvement. The detection of patients at risk of treatment failure served as primary endpoint. Results: Significantly lower reliable improvement, higher reliable deterioration rates, and smaller effect sizes were found for patients identified at risk of treatment failure by all rules. The nearest neighbors-based approach showed the highest sensitivity regarding the detection of reliably deteriorated cases. Conclusion: Consistent with previous research, the empirical models outperformed the rational rules. Still, the first-time used percental improvement-based rule also showed satisfactory results. Overall, the results point to the potential of basic feedback systems that might be easier to implement in practice than session-to-session based systems.

When (not) to rely on the reliable change index: A critical appraisal and alternatives to consider in clinical psychology.

When (not) to rely on the reliable change index: A critical appraisal and alternatives to consider in clinical psychology.

Exploring and evaluating the index for interdisciplinary breakthrough innovation detection

PurposeThis study aims to establish a reliable index to identify interdisciplinary breakthrough innovation effectively. We constructed a new index, the DDiv index, for this purpose.Design/methodology/approachThe DDiv index incorporates the degree of interdisciplinarity in the breakthrough index. To validate the index, a data set combining the publication records and citations of Nobel Prize laureates was divided into experimental and control groups. The validation methods included sensitivity analysis, correlation analysis and effectiveness analysis.FindingsThe sensitivity analysis demonstrated the DDiv index’s ability to differentiate interdisciplinary breakthrough papers from various categories of papers. This index not only retains the strengths of the existing index in identifying breakthrough innovation but also captures interdisciplinary characteristics. The correlation analysis revealed a significant correlation (correlation coefficient = 0.555) between the interdisciplinary attributes of scientific research and the occurrence of breakthrough innovation. The effectiveness analysis showed that the DDiv index reached the highest prediction accuracy of 0.8. Furthermore, the DDiv index outperforms the traditional DI index in terms of accuracy when it comes to identifying interdisciplinary breakthrough innovation.Originality/valueThis study proposed a practical and effective index that combines interdisciplinary and disruptive dimensions for detecting interdisciplinary breakthrough innovation. The identification and measurement of interdisciplinary breakthrough innovation play a crucial role in facilitating the integration of multidisciplinary knowledge, thereby accelerating the scientific breakthrough process.

Intervention for an Australian carer of a person with dementia: A single case study

Caring for a person with dementia can negatively impact the physical, mental, and social wellbeing of an informal carer. Providing complex and challenging care often results in carer burden, stress, and distress, which can continue even when the care recipient transitions into an aged care facility. This case study aims to demonstrate that optimising carer support, knowledge, skill acquisition, and promotion of wellbeing benefits carers and those they care for across contexts. It provides a weekly account of an informal Australian carer’s experience with the STrAtegies for RelaTives (START) manualised intervention program. The study used reliable change indices, standardised measures, and carer surveys to provide insights into the carer’s experience of the program and outcomes during and after the therapy. The results showed reliable and clinically significant change, demonstrating an improvement in all measures. The carer’s mood symptoms and their perceived burden of care decreased. The carer also reported decreased dementia symptoms in their care recipient. Both the carer and the care recipient experienced increased quality of life. These findings are consistent with recent literature on the feasibility of the START program and are aligned with the National Dementia Plan.

Hierarchical Integration of UAS and Sentinel-2 Imagery for Spruce Bark Beetle Grey-Attack Detection by Vegetation Index Thresholding Approach

This study aimed to examine the efficiency of the vegetation index (VI) thresholding approach for mapping deadwood caused by spruce bark beetle outbreak. For this, the study used upscaling from individual dead spruce detection by unmanned aerial (UAS) imagery as reference data for continuous spruce deadwood mapping at a stand/landscape level by VI thresholding binary masks calculated from satellite Sentinel-2 imagery. The study found that the Normalized Difference Vegetation Index (NDVI) was most effective for distinguishing dead spruce from healthy trees, with an accuracy of 97% using UAS imagery. The study results showed that the NDVI minimises cloud and dominant tree shadows and illumination differences during UAS imagery acquisition, keeping the NDVI relatively stable over sunny and cloudy weather conditions. Like the UAS case, the NDVI calculated from Sentinel-2 (S2) imagery was the most reliable index for spruce deadwood cover mapping using a binary threshold mask at a landscape scale. Based on accuracy assessment, the summer leaf-on period (June–July) was found to be the most appropriate for spruce deadwood mapping by S2 imagery with an accuracy of 85% and a deadwood detection rate of 83% in dense, close-canopy mixed conifer forests. The study found that the spruce deadwood was successfully classified by S2 imagery when the spatial extent of the isolated dead tree cluster allocated at least 5–7 Sentinel-2 pixels.

299 Predictors of Unplanned Readmission in Patients Undergoing Intracranial Tumor Resection: A Multi-center Analysis of 31,776 Patients

INTRODUCTION: Although unplanned readmission is a postoperative outcome metric associated with significant morbidity and financial burden, precise assessment tools for its prediction are yet to be developed. The Revised Risk Analysis Index (RAI) has been recently endorsed as a robust frailty index for predicting surgical outcomes. Hence, the RAI could potentially be utilized to help improve prediction unplanned readmission in patients undergoing intracranial tumor resection (ITR). METHODS: Data of patients undergoing ITR were obtained from the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database from the years 2012-2019 using the ICD-9 and ICD-10 codes, indicating ITR. Baseline characteristics, preoperative clinical status, and outcomes were compared between patients with and without unplanned readmission. Frailty, as a measure of baseline physiological reserve, was calculated using the RAI. Univariate and multivariate logistic regression analyses were performed to identify independent associations between unplanned readmissions and patient characteristics. RESULTS: The unplanned readmission rate of this cohort (N = 31,776) was 10.8% (N = 3,420). Among the readmitted patients, 958 required unplanned reoperation. Multiple characteristics were significantly different between the readmitted and non-readmitted patients, including age, BMI, comorbidities, and RAI groups (p &lt; 0.05). The most common causes of unplanned readmission were infection (9.4%), seizures (6%), and pulmonary embolism (4%). Patient characteristics identified as reliable predictors of unplanned readmission, included age, body mass index (BMI), functional status, diabetes, hypertension, hyponatremia, and their RAI score (p &lt; 0.05). In multivariate analysis, RAI “frail” patients had an unplanned readmission odds ratio (OR) of 1.3(95%CI; 1.2-1.4), and RAI “severely frail” patients had an OR of 1.6 (95%CI; 1.3-2.1) (p &lt; 0.001). CONCLUSIONS: The RAI is a reliable pre-operative frailty index for predicting unplanned readmission following ITR. Utilizing the RAI to identify high risk patients may decrease unplanned readmission through implementation of appropriate management guidelines.

178 Brains on the Pitch: Investigating the Neurophysiological and Neurocognitive Effects of Repetitive Head Impacts in Adolescent Female Soccer Players During a Single Season

INTRODUCTION: Repetitive exposure to head impact in contact sports has raised concerns for potential long-term structural and functional neurologic effects. This relationship has been minimally explored in female athletes, with conflicting results arising from the limited reports on this topic. METHODS: Prospective cohort design with pre- and post-season assessments of neurocognitive function, transcranial magnetic stimulation (TMS), and diffusion tensor imaging (DTI). Neurocognitive battery evaluated processing speed, memory, and executive function domains via computerized (ImPACT) and paper-and-pencil testing. TMS assessments included motor evoked potential onset; interhemispheric conduction times; intercortical and intracortical inhibition. DTI measures included fractional anisotropy (FA) for white matter tracts of interest, including: posterior limb of internal capsule; cortical spinal tract; corpus callosum - selected for common involvement in traumatic brain injury within other studies. RESULTS: One player was officially diagnosed with concussion and was included in analysis. Neurocognitive performance was intact relative to same aged peers, and there were no significant differences over the season based on mean reliable change indices (-0.79-0.93). Paired t-test analysis indicated that the TMS measures were not significantly different between the two timepoints. Furthermore, DTI FA values and TMS measures were not notably different pre- versus postseason. CONCLUSIONS: In this cohort of high school female athletes, we did not observe significant anatomic, physiologic, or functional effects from repetitive head impacts. Our findings contradict previous studies that showed significant neurophysiologic and neurocognitive changes, even in the absence of clinically-observed concussion. Further research is needed to fully understand the long-term consequences of repetitive head impacts in female athletes and to develop effective strategies for mitigating potential risks.

APPLICATION OF BENTHIC MACROINVERTEBRATES AS POTENTIAL BIO-INDICATORS IN MALAYSIAN'S RIVERS: GAP AND BIBLIOMETRIC ANALYSES

The literature on reliable indices, suitable bio-indicators, taxonomic level, frequency of measurements, and replications on benthic macroinvertebrates remains scarce in Malaysia. In addition, no review study was conducted using bibliometric analysis related to this discipline. Thus, this review aimed at gap and bibliometric analysis of publications on benthic macroinvertebrates as potential biological indicators. Sixty-six relevant scientific research papers from 2011 to 2022 were selected from the different databases. Then, descriptive and inferential statistical analyses were performed to assess the most reliable potential bio-indicators for river assessment and monitoring. Visualized statistics regarding bibliographic coupling analysis of authors, journal proceedings, and organizations were analyzed. The findings revealed that publications on invertebrates had no significant relationship in the last ten years (r = 0.241; p &gt; 0.05). Most publications on macroinvertebrates in Malaysian rivers were found in the Scopus database (53.57%). Therefore, research articles must be published in journals included in the Journal Citation Report (JCR) to improve their quality further. Besides, benthic macroinvertebrates are commonly identified only up to the family level (47%) due to incomplete tropical benthic macroinvertebrates identification keys. As such, using environmental DNA methods with the power of next-generation sequencing has come in handy in bio-indicator species identification. Among the potential bio-indicators found in Malaysian rivers are Chironomidae (9.11%), Baetidae (8.87%), and Hydropsychidae (8.62%). Based on the approaches utilized in analyzing benthic macroinvertebrates as bio-indicators, in-depth research such as bioassay and toxicology tests is necessary to realize the potential bio-indicators fully. Many studies focused on recreational rivers in Peninsular Malaysia. Therefore, research studies would be expanded to urban rivers and rivers in Sabah and Sarawak. Also, to overcome the limitation of the single biotic index, developing a multimetric index to evaluate the water quality by selecting many river basins is essential. Bibliographic analysis showed that the Institute for Tropical Biology and Conservation, Universiti Malaysia Sabah, made the greatest total link strength. The Serangga Journal published the highest number of research articles. Finally, utilizing advanced technologies is recommended to address Malaysia's lack of potential bio-indicator studies.

Individualized trajectories in postradiotherapy neurocognitive functioning of patients with brain metastases.

The increasing incidence of brain metastases (BMs) and improved survival rates underscore the necessity to investigate the effects of treatments on individuals. The aim of this study was to evaluate the individual trajectories of subjective and objective cognitive performance after radiotherapy in patients with BMs. The study population consisted of adult patients with BMs referred for radiotherapy. A semi-structured interview and comprehensive neurocognitive assessment (NCA) were used to assess both subjective and objective cognitive performance before, 3 months and ≥ 11 months after radiotherapy. Reliable change indices were used to identify individual, clinically meaningful changes. Thirty-six patients completed the 3-month follow-up, and 14 patients completed the ≥ 11-months follow-up. Depending on the domain, subjective cognitive decline was reported by 11-22% of patients. In total, 50% of patients reported subjective decline in at least one cognitive domain. Intracranial progression 3 months postradiotherapy was a risk-factor for self-reported deterioration (P = .031). Objective changes were observed across all domains, with a particular vulnerability for decline in memory at 3 months postradiotherapy. The majority of patients (81%) experienced both a deterioration as well as improvement (eg, mixed response) in objective cognitive functioning. Results were similar for the long-term follow-up (3 to ≥11 months). No risk factors for objective cognitive change 3 months postradiotherapy were identified. Our study revealed that the majority of patients with BMs will show a mixed cognitive response following radiotherapy, reflecting the complex impact. This underscores the importance of patient-tailored NCAs 3 months postradiotherapy to guide optimal rehabilitation strategies.

Operating Properties of Disease Activity Indices in Pediatric Inflammatory Bowel Disease: A Systematic Review.

Accurate, reliable, and responsive disease activity indices are important to streamline drug approval and treatment modalities for pediatric inflammatory bowel disease (pIBD). We aimed to identify all scoring indices used in pIBD randomized controlled trials (RCTs) and to evaluate their operating properties. MEDLINE, EMBASE, and CENTRAL were searched on December 6, 2022, to identify studies evaluating clinical, endoscopic, imaging, or patient-reported outcome measures (PROMs) in pIBD including Crohn's disease (CD) and ulcerative colitis (UC). Validity, reliability, responsiveness, and feasibility were summarized. Seventy RCTs evaluating pIBD indices were identified. Forty-one studies reported on the operating properties of 14 eligible indices (n = 9 CD, n = 5 UC). The Pediatric Crohn's Disease Activity Index (PCDAI) varied widely in terms of validity and reliability and was less feasible overall. In contrast, the Mucosal Inflammation Noninvasive Index, which includes fecal calprotectin, had better operating properties than the PCDAI. The Simplified Endoscopic Mucosal Assessment of Crohn's Disease appears more feasible and had similar operating properties than the longer Simple Endoscopic Score for Crohn's Disease. The Pediatric Ulcerative Colitis Activity Index was feasible, valid, and reliable, but responsiveness needs to be evaluated further. The Endoscopic Mayo score and the Ulcerative Colitis Endoscopic Index of Severity were reliable, but validity and responsiveness need to be evaluated further. Imaging and PROMs/quality of life indices need further evaluation. The operating properties of pIBD clinical trial end points varied widely. These results highlight the need for further validation and development of novel indices.

Teleneuropsychology intervention in phonological awareness for children with specific learning disorder with reading and mathematical difficulties

Specific learning disorder (SLD) is a neurodevelopmental disorder that affects 5–15% of school-aged children worldwide. Often, difficulties in reading (SLD-RD) and mathematics (SLD-MD) occur together. Deficits in phonological awareness (PA) have been identified as the common factor between the two difficulties. Intervention in PA has been shown to be effective in SLD-RD; however, it is not clear whether it is also effective in SLD-MD. Neuropsychological intervention is usually conducted face-to-face, but when the patient is in a remote location or during extraordinary situations such as the COVID-19 pandemic, tele neuropsychology (TeleNP) may be a suitable alternative. The objective of this study was to evaluate the efficacy of a telerehabilitation program for PA to improve math skills in children with SLD-RD/SLD-MD. The study had an N-of-1 SCED design, and included six children aged 10–12 years with SLD-RD/SLD-MD. After four baseline measurements with an arithmetic verification paradigm, they were treated with TeleNP-PA. The effect on each participant was evaluated using visual analysis and the reliable change index. After the intervention, all participants showed improvement in arithmetic tasks, suggesting that the PA intervention had a positive influence on these skills.