Reliable Screening Tool Research Articles

Development and Evaluation of the Global Appraisal of Individual Needs Quick Version 4 (GAIN-Q4) for ASAM Dimension Ratings and Placement Recommendations for Adolescents and Adults.

This article describes the development and evaluation of the Global Appraisal of Individual Needs Quick Version 4 (GAIN-Q4) for the American Society of Addiction Medicine (ASAM) 4th edition patient placement dimension ratings and level of care placement recommendations. The research questions are as follows: (1) Can the GAIN-Q4 replicate recommendations from the prior longer instrument within adolescents and adults? (2) What are the substantive differences in the results by age? The 35- to 45-minute GAIN-Q4 was developed through modification of the GAIN-Q3 and evaluated in terms of its ability to predict ASAM dimensional ratings and level of care placement recommendations from the 60- to 120-minute GAIN-I instrument. Data were obtained from participants who are adolescents aged 12 to 17 years (n = 101,897) and adults 18 years and older (n = 204,711) interviewed between 2002 and 2018 across 530 US sites. Reliability between measures was assessed with Cohen's κ statistic within age group; substantive differences by age were evaluated with logistic regression and χ2. The ability of the 35- to 45-minute GAIN-Q4 measure to predict ASAM 6 dimensional ratings from the 60- to 120-minute GAIN-I was excellent (κ > 0.8) for 4 dimensions, good (0.6-0.79) for 1, and fair for 1 (0.4-0.59) - both for adolescents and young adults. κ for general level of care placement to ASAM levels of care was excellent for both adolescents and young adults. The GAIN-Q4 demonstrates the ability to predict ASAM dimensional ratings and general level of care placement reliably when compared to the lengthier GAIN-I measure. These results highlight that clinicians using the GAIN-Q4 measure will be equipped to evaluate patients from a wide variety of sources with an accurate and reliable screening tool.

Evaluation of different screening tools for detection of malnutrition in hospitalised patients.

To assess the prevalence of malnutrition in hospitalised adult patients, and to evaluate the accuracy of the most commonly used nutritional screening tools for identifying individuals at risk of malnutrition. A prospective cross-sectional study was conducted on a total of 248 hospitalised patients in internal medicine wards (mean age: 75.2 years; 39.5% females). Nutritional screening was performed within 48 h of admission using the following tools: Malnutrition Universal Screening Tool (MUST), Nutrition Risk Screening Tool (NRS-2002), Malnutrition Screening Tool (MST), Short Nutritional Assessment Questionnaire (SNAQ), and Mini Nutritional Assessment Short Form (MNA-SF). The criteria of the European Society for Clinical Nutrition and Metabolism (ESPEN) were used as the gold standard for defining malnutrition. Patients were also evaluated using the Subjective Global Assessment (SGA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Accuracy was determined by examining sensitivity, specificity, and positive and negative predictive values, and diagnostic agreement was determined by calculation of Cohen's kappa (κ). The study is reported as per the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The ESPEN criteria classified 20.2% of the hospitalised patients as malnourished. Overall, the MUST had the highest sensitivity (80.0%), specificity (74.7%) and positive predictive value (44.4%). For the subgroup of patients aged >65 years, the MNA-SF had high sensitivity (94.4%) but low specificity (39.0%). Based on Cohen's κ, the SGA and GLIM criteria showed low agreement with the ESPEN criteria. The MUST was the most accurate nutritional screening tool, through the MST is more easily applied in many clinical settings. A comprehensive assessment of malnutrition that considers muscle mass is crucial for the reliable diagnosis of malnutrition. The present findings underscore the importance of accurate assessment of the malnutrition status of hospitalised patients and the need for a reliable screening tool. No patient or public contribution.

Implementing the Ages and Stages Questionnaires in a Montessori Setting

Montessori educators face increasing demands to support growing numbers of students who have developmental delays or disabilities, and early detection and support are essential. Yet, detecting developmental delays is a complex task, and early childhood educators do not typically receive specialized training. The Ages and Stages Questionnaires (ASQ) is a set of valid and reliable developmental screening tools widely used in education and health settings, but ASQ use has not been assessed in Montessori settings. In a pre/post, multimethod design, this study examined the perceptions and impact of an ASQ training—adapted for Montessori settings—for guides and administrators. The results suggest the ASQ training and implementation of its tools were perceived as beneficial and valuable. The training positively influenced participants’ attitudes and beliefs, skills and knowledge, confidence and self-efficacy, and access to resources. Alumni of the training had similar attitudes and beliefs, as well as confidence and self-efficacy, compared to recent trainees, although alumni’s skills and knowledge, as well as access to resources, were more advanced than the recent trainees. Qualitative findings also point to the benefits of the training while highlighting the realities, needs, and challenges Montessori educators face. This study provides evidence that Montessori educators benefit from ASQ developmental screening training. Through ASQ training and implementation, Montessori educators can gain a better understanding of students’ developmental milestones, more effectively observe their students’ behaviors, and more confidently advocate for students’ support needs.

Laryngopharyngeal Reflux in Otolaryngology-Head and Neck Surgery Clinic: An Epidemiological Survey.

Background and Objectives: Laryngopharyngeal reflux disease (LPRD) has been implicated in the etiology of many laryngeal disorders and is also closely related to the occurrence and progression of a variety of throat diseases, including chronic cough, leukoplakia of the larynx, dysphonia, and even laryngeal tumors. LPRD can significantly reduce the quality of life of patients and cause substantial medical and economic burdens to the society. Reflux Symptom Index (RSI), a self-administered 9-item outcomes instrument for laryngopharyngeal reflux (LPR), has been widely used to screen for LPRD, but there is a lack of feasibility studies on the use of RSI for LPRD screening and alternative diagnostic tools in otolaryngology-head and neck surgery (OHNS) clinics. To study the incidence, clinical characteristics, diagnostic status, and influencing factors of LPRD at OHNS clinics, RSI as an alternative diagnostic tool has also been studied. LPRD was defined as RSI > 13. Methods: Systematic collection of data by the RSI questionnaire was used to identify patients in the outpatient clinic suffering from LPRD; in addition, the personal history of participants was collected. Follow-up observation was carried out for 6 months for patients with suspected LPRD (RSI > 13), including whether they were treated with standardized anti-reflux therapy, and the questionnaire based on RSI was completed again after treatment. Results: The LPRD rate was 7.92% (94/1187) in this survey. The proportions of LPRD patients with smoking history (vs no smoking) and alcohol consumption history (vs. no alcohol consumption) were significantly higher (χ2 values: 7.025 and 4.562, and P values: .008 and .033; respectively). Smoking significantly increased the risk of LPRD (OR: 2.140, 95% CI: 1.058-4.331, P = .034). Among patients with LPRD positive, the incidence of "foreign body sensation in the throat" (symptom 8) score equal to 5 was the highest (19.15%). The severity of "excess mucus in the throat or postnasal drip" (symptom 3) contributed mostly to the total RSI score in patients with LPRD (r = .409, P < .001). ROC curve analysis showed that RSI ≥ 14 had a sensitivity of 72.9% and a specificity of 71.4% for the diagnosis of LPRD, with AUC = 0.797 (95% CI: 0.577-0.884, P < .001). Conclusions: The incidence of LPRD was high in patients we examined in OHNS clinics. We recommend that RSI can be used by otolaryngologists as a reliable tool for screening and diagnosing LPRD in OHNS clinics, which is beneficial for clinical practice.

Clinical and Laboratory Positive Predictive Value of Symptom Management of STI in Iran: A Community-Based Survey

Background: The correct diagnosis of sexually transmitted infections (STIs) is the first step in the monitoring and management of these diseases. Objectives: This study was conducted to investigate the clinical and laboratory positive predictive value (PPV) of STI symptom management in Iran. Methods: This cross-sectional study was conducted on 5986 individuals (aged 18 to 50 years) from the general population of Marovdasht (Iran) in several stages: (1) self-reported symptoms of sexually transmitted diseases, (2) evaluation by a doctor, and (3) laboratory examination. Results: Among the population sample, 686 (17.68%) individuals reported at least one of the predefined symptoms. The clinical-based PPV of syndromes in men and women were 67.74 (62.34 - 73.14) and 85.36 (82.76 - 87.96), respectively. In men and women, the highest PPV was observed for abnormal discharge from the anus 32.35 (25.35 - 39.35) and abnormal secretions from the cervix 59.39 (56.39 - 62.39), respectively. The laboratory-based PPV for men and women was 0 and 5.04 (3.04 - 7.4), respectively. Conclusions: The clinical and laboratory-based PPV of STI symptoms in the general population is extremely low. Accordingly, a syndromic-based screening or monitoring approach for STIs is not a reliable tool for screening or monitoring in the Iranian general population. We suggest focusing on special (core) groups for monitoring STIs using laboratory-based methods.

Tri-Ponderal Mass Index (TMI)- A Reliable Anthropometric Indices for Early Screening of Adolescent Obesity in a School-Based Setting: A Cross-Sectional Study

ObjectiveThis study aimed to examine the reliability of Tri-Ponderal Mass Index (TMI) for early screening of adolescent obesity in comparison to anthropometric measures such as hip-circumference, neck-circumference, waist-circumference, waist-height-ratio, waist-hip-ratio, and body mass index. MethodsA school-based, cross-sectional study was conducted between July-December 2019 among 1101 school-going adolescents (both genders), aged 12 to 17 years in Rudrapur city of Uttarakhand. Data on anthropometric measurements was collected by using well calibrated equipment's, and age- and gender-specific BMI percentile cut-off values recommended by the Indian Academy of Pediatrics (IAP) were used to define the overweight and obesity. Statistical analysis was done using SPSS software version 16.0. Receiver operating characteristic (ROC) curve analysis was conducted, and optimal cut-off values for anthropometric measurements were determined using the Youden Index (sensitivity + specificity -1). ResultsOut of 1101 study participants 71.5% (n=787) and 28.5% (n=314) were boys and girls, respectively. The prevalence of overweight and obesity amongst adolescents was 10.4% and 4.1%, respectively. ROC curve analysis was conducted and TMI exhibited the highest Youden index both in terms of overweight (0.835) and obesity (0.869) among adolescents. The optimal TMI cut-off values for overweight and obese boys and girls were determined to be >12 kg/m³ and >14 kg/m³; >13 kg/m³ and >16 kg/m³, respectively. TMI demonstrated superior predictive capacity for early screening of adolescent obesity, as indicated by high discriminative power, sensitivity, and specificity. ConclusionsTMI can be used as the simple reliable screening tool for early screening of overweight and obesity among adolescents.

Validating the Child Behavior Checklist 1.5-5 as a screening tool for autism spectrum disorder.

Early identification of Autism Spectrum Disorder is very important, especially in low and middle-income countries, where access to resources is often limited. The Child Behavior Checklist 1.5-5 is a tool that has been used to help identify children with autism spectrum disorder through specific behavior patterns. However, its effectiveness in low- and middle-income country settings has not been thoroughly studied. This research focused on evaluating the Child Behavior Checklist 1.5-5 as a screening tool for autism spectrum disorder among Brazilian children. The study involved 1292 children aged 3-5 years from the general population and 70 children with autism spectrum disorder aged 1-5 years. Using advanced statistical methods, the study tested how well the Child Behavior Checklist identified children with autism spectrum disorder and how reliable it was in this context. The findings showed that the Child Behavior Checklist 1.5-5 performed well in identifying autism spectrum disorder, with high reliability and consistency in the results. Although one item in each of the autism spectrum problems and withdrawn syndrome subscales did not perform as strongly, the overall tool was effective. In summary, the Child Behavior Checklist 1.5-5 proves to be a reliable and valid tool for early autism spectrum disorder screening in Brazilian children. This can help ensure that more children in low- and middle-income country settings are identified early and receive the necessary support and interventions to help them thrive. Future research should continue to test this tool in different contexts to confirm its usefulness across various populations.

The Impact of Sleep Deprivation on Video Head Impulse Test Results.

To investigate the association between sleep deprivation and vestibular dysfunction by Video Head Impulse Test (vHIT). This prospective clinical trial explores the impact of acute sleep deprivation on the vestibular-ocular reflex (VOR) in medical residents. The study involved healthy physicians from diverse medical disciplines. Participants underwent vHIT assessments before and after a 26-h shift. The examinations focused solely on the right lateral semicircular canal. Participants further completed a demographics and fatigue questionnaire, including the Fatigue Severity Scale (FSS) questionnaire and a Visual Analog Fatigue Score (VAFS). The study involved 30 medical residents. Participants experienced a statistically significant decrease in VOR gain in the right horizontal semicircular canal during a 26-h shift (p < 0.01). While the FSS and VAFS questionnaires showed no significant difference before and after the shift, the analysis of ∆VOR gain indicated a statistically significant increase associated with decreased sleep time during the shift (p = 0.018, 95% Confidence Interval [0.08, 0.68]). The most substantial increase in ∆VOR occurred between 22-26 h of sleep deprivation. No significant differences were observed in ∆VOR between genders, ages, disciplines, department shifts versus emergency room shifts, or years of residency. vHIT can be used as an objective, reliable screening tool for severe sleep deprivation among physicians. The decrease in the VOR gain may indicate that vestibular function is influenced by sleep deprivation. The clinical significance of these findings is still questioned, more studies may help to assess this effect. 3 Laryngoscope, 2024.

Practices and Perception of Paediatric Obstructive Sleep Apnea Among Orthodontists and Paediatric Dentists in Brazil: A Mixed-Methods Study.

To explore orthodontists' (OTs) and paediatric dentists' (PDs) practices and perceptions regarding the screening and management of paediatric obstructive sleep apnea (OSA). This explanatory sequential mixed methods design included OTs and PDs with active clinical practice in Brazil and encompassed a quantitative phase followed by a qualitative phase. In the quantitative phase, a survey assessing OSA screening and management practices was administered to OTs and PDs practicing in Brazil. Information-rich OTs and PDs were interviewed in the qualitative phase. Descriptive statistics and the chi-square test were used to analyse the survey data, while inductive content analysis was applied to the interview data. The results from both phases were integrated and reported narratively. Three hundred eighty-one OTs and PDs completed the survey, and ten of them were interviewed. Nearly half of OTs and PDs administered sleep questionnaires and demonstrated some knowledge about paediatric OSA signs and symptoms. PDs and OTs primarily offered rapid maxillary expansion and functional mandibular advancement for managing selected children with OSA, with OTs being more frequently involved in this task than PDs. OTs and PDs identified several barriers and expressed the need for support regarding access to reliable screening tools and interprofessional care. Brazilian OTs and PDs were aware of the main signs and symptoms of paediatric OSA and were somewhat involved in offering oral appliance management options. To further define the role of these professionals, increasing support for dental professionals in OSA management and updating existing clinical guidelines is warranted.

Cross-cultural adaptation and psychometric properties of the Arabic version of the Central Sensitization Inventory in people with chronic musculoskeletal pain.

The Central Sensitization Inventory (CSI) is a patient-reported screening instrument that can be used to identify and assess central sensitization (CS)/Central Sensitization Syndrome (CSS)-related symptoms. The aim was to translate the CSI into Arabic (CSI-Ar) and to subsequently validate its psychometric properties. Cross-sectional. The CSI was translated and cross-culturally adapted into Arabic, and validated following international standardized guidelines. This study included patients with chronic musculoskeletal pain (n = 264) and healthy control participants (n = 56). Patients completed the CSI-Ar, Pain Catastrophizing Scale (PCS), Depression, Anxiety, and Stress scale (DASS-21), Tampa Scale of Kinesiophobia (TSK), and 5-level EuroQol-5D (EQ-5D). Patients completed the CSI-Ar twice to assess test-retest reliability. To evaluate discriminative validity, healthy controls participants completed the CSI-Ar. Statistical analyses were conducted to test the internal consistency, reliability, and structural, construct and discriminant validity of CSI-Ar. The CSI-Ar showed acceptable internal consistency (Cronbach's alpha = 0.919) and excellent test-retest reliability (intraclass correlation coefficient = 0.874). The CSI-Ar scale had significant correlations (P < 0.001) with all PCS subscales and total score (Spearman's rho = 0.459-0.563, P < 0.001), all DASS-21 subscales and total score (Spearman's rho = 0.599-0.685, P < 0.001), the TSK (Spearman's rho = 0.395, P < 0.001), and the EQ-5D (Spearman's rho = -0.396, P < 0.001). The Mann-Whitney U-test showed a statistically significant difference between the patient group and the healthy control group (P < 0.001), with the healthy controls displaying a lower average CSI-Ar score (12.27 ± 11.50) when compared to the patient group (27.97 ± 16.08). Factor analysis indicated that the CSI-Ar is a unidimensional tool. The CSI-Ar is a reliable and valid screening tool that can be used to assess CS/CSS-related symptoms in Arabic-speaking people with chronic musculoskeletal pain.

B-254 Analytical and Clinical Performance Evaluation of Plasma pTau217 in a Clinical Diagnostic Laboratory

Abstract Background Blood-based biomarkers provide an accessible and cost-effective tool for diagnosing Alzheimer’s disease (AD). Among these biomarkers, phosphorylated tau 217 (pTau217) shows promise for both AD diagnosis and differential diagnosis, as well as for facilitating access to emerging disease-modifying therapies. The ALZpath SIMOA pTau-217 v2 assay is a digital immunoassay designed for quantifying pTau-217 in human EDTA plasma samples. This study assesses the analytical performance of plasma pTau217 assays as a Laboratory Developed Test (LDT) appropriate for diagnostic application. Methods In this analytical study, we evaluate accuracy, precision, detection limits, linearity, and analyte stability. Plasma pTau217 levels were measured using the ALZpath pTau217 v2 assay on a single Quanterix HD-X SIMOA Analyzer platform at BC Neuroimmunology Lab. Inc. Vancouver, British Columbia, Canada. As a clinical testing laboratory, our validation procedures are in accordance with CAP and CLIA requirements, with a primary focus on adhering to CLSI guidelines for both analytical and clinical performance testing. To determine a reference range and cut-off, samples of Amyloid PET-confirmed cases (n=263) and healthy subjects between the ages of 55 and 95, with a roughly equal ratio of males to females (n=219), were tested. Results The ALZpath pTau217 assay demonstrates an analytical measurement range of 0.0046 - 3.4056 ng/L, with a limit of blank (LoB) of 0.0019 ng/L, a limit of detection (LoD) of 0.0046 ng/L, and a limit of quantification (LoQ) of 0.03 ng/L. Linearity spans from 0.06 to 1.75 ng/L, with repeatability showing intra-laboratory precision above LoQ ≤ 20% CV. Stability is maintained at 4⁰C for ≤ 1 week, at room temperature for ≤ 72 hrs, at -20⁰C for ≤ 2 weeks, and at -70⁰C for ≤ 3 weeks, with freeze/thaw cycles tolerated up to 6 times. Moreover, interference is not detected at the maximum concentrations tested for albumin, unconjugated bilirubin, biotin, hemoglobin, creatinine, and heterophilic antibodies. The reference range was determined using the 95% reference interval, resulting in 0.398 ng/L. ROC analysis yielded an AUC of 0.932 with a Youden index of 0.338 ng/L. At the Youden index, sensitivity was 90.0% with a specificity of 85.6%. Specificity reached 95.5% at the upper cut point of 0.471 ng/L, while sensitivity was 94.8% at the lower cut point of 0.242 ng/L. Conclusions The outstanding analytical performance of pTau217 supports its adoption as a reliable screening and diagnostic tool in clinical practice, aiding clinicians in the accurate diagnosis of AD.

Clinical Validation of a Mobile-Based ACR (Urine Albumin-to-Creatinine Ratio) Test Kit: Comparative Analysis with Benchtop Devices

Background: Albuminuria, a marker for diabetes complications and kidney disease, is typically tested in hospitals, limiting patient monitoring. The mobile-based ACR (urine albumin-to-creatinine ratio) test, QSCheck-UISACR, was developed for easy detection of albuminuria. This study aimed to validate its clinical efficacy compared to a conventional benchtop device (Cybow R-50S) for early kidney disease diagnosis. Methods: Conducted in three hospitals with 303 kidney disease patients, urine samples were tested using both the mobile ACR kit and the benchtop device. Parameters measured included microalbumin, creatinine, and their ratio (albumin-to-creatinine ratio). Exact Agreement and Within One Block Agreement were calculated to compare methods.Results: Data collected from three university hospitals were aggregated and analyzed, showing that the microalbumin Exact Agreement was 73.3%, with a Within One Block Agreement of 96.0%. For creatinine, the Exact Agreement was 75.6%, and the Within One Block Agreement was 95.7%. Based on these two test results, the albumin-to-creatinine ratio analysis demonstrated an Exact Agreement of 78.5% and a Within One Block Agreement of 98.0%. These findings highlight the robust performance of the tests across the evaluated biomarkers.Conclusions: The mobile-based ACR test kit demonstrated high accuracy and comparability to the benchtop device, suggesting its potential as a reliable tool for early kidney disease screening in primary care settings, enhancing patient accessibility and reducing healthcare costs.

Screening tools for autism in culturally and linguistically diverse paediatric populations: a systematic review

BackgroundAutism Spectrum Disorder (ASD) has varying prevalence rates worldwide, often higher in culturally diverse populations. Cultural differences can affect autism symptom recognition. Language barriers and differing healthcare attitudes may delay diagnosis and intervention. Most autism screening tools were developed in Western, predominantly Caucasian populations, and their appropriateness in culturally and linguistically diverse (CALD) contexts remains uncertain. There is a lack of comprehensive data on the accuracy of these tools in identifying autism in culturally and linguistically diverse groups. Consequently, it is unclear whether current screening tools are culturally sensitive and appropriate.MethodsA research protocol was registered in PROSPERO (CRD42022367308). A comprehensive search of literature published from inception to October 2022 was conducted using the following databases: PubMed, Medline Complete, Scopus, PsychInfo and CINAHL Complete. The articles were screened using pre-determined inclusion and exclusion criteria. Data extracted included participant demographics, screening tool psychometric properties (validity, reliability, accuracy) and acceptability. A narrative synthesis approach was used.ResultsFrom the initial retrieval of 2310 citations, 51 articles were included for analysis. The studies were conducted in 32 different countries with screening tools in the following languages: Chinese, Spanish, Korean, Turkish, Arabic, Kurdish, Persian, Serbian, Italian, French, Sinhala, Taiwanese, Finnish, Northern Soho, Albanian, German, Japanese, Vietnamese, Farsi, Greek and English. There was no data on acceptability of the screening tools in CALD populations. Validity, reliability, and accuracy ranged from poor to excellent with consistently high performance by screening tools devised within the populations they are intended for.ConclusionsThe review evaluated autism screening tools in culturally diverse populations, with a focus on validity, reliability, and acceptability. It highlighted variations in the effectiveness of these tools across different cultures, with high performance by tools devised specifically for the intended population, emphasizing the need for culturally sensitive screening tools. Further research is needed to improve culturally specific, reliable autism screening tools for equitable assessment and intervention in diverse communities.

Gender differences in neurocognitive assessments: insights from apilot study with the International Neurocognitive Test Profile (INCP) digital battery.

The aging global population has led to an increase in the number of dementia diagnoses, with projections indicating acontinued upward trend. This demographic change presents profound challenges for patients, their families, and healthcare systems worldwide. Consequently, the demand for reliable and user-friendly screening tools that can detect dementia at early stages and monitor its progression is more critical than ever. The International Neurocognitive Test Profile (INCP), developed at the Medical University of Vienna, aims to address this need by offering adigital test battery for the early detection of dementia. This study forms apart of the INCP's ongoing development and evaluation, specifically investigating the influence of gender on test outcomes. Seventy participants, recruited through flyers at the Vienna General Hospital, completed the INCP assessment using tablets as part of the study. The effect of gender on performance across various INCP subtests was analyzed using Mann-WhitneyU tests. For further exploratory analysis, acorrelation matrix was calculated encompassing demographic variables (age and education), screening data, and all INCP subtests. The analysis revealed significant gender differences in two INCP subtests related to executive functions. Males outperformed females on the Figure Fluency Test (r = 0.30, indicating amoderate effect) and the Dice 2‑n Back Test (r = 0.29, indicating asmall effect). However, when correcting for multiple comparisons, no significant gender disparities were observed in the scores of the subtests. The identification of possible gender differences in specific subtests underscores the importance of considering gender as avariable in the further development and evaluation of the INCP. These findings offer valuable insights for the design and planning of future studies involving the INCP.

GexMolGen: cross-modal generation of hit-like molecules via large language model encoding of gene expression signatures.

Designing de novo molecules with specific biological activity is an essential task since it holds the potential to bypass the exploration of target genes, which is an initial step in the modern drug discovery paradigm. However, traditional methods mainly screen molecules by comparing the desired molecular effects within the documented experimental results. The data set limits this process, and it is hard to conduct direct cross-modal comparisons. Therefore, we propose a solution based on cross-modal generation called GexMolGen (Gene Expression-based Molecule Generator), which generates hit-like molecules using gene expression signatures alone. These signatures are calculated by inputting control and desired gene expression states. Our model GexMolGen adopts a "first-align-then-generate" strategy, aligning the gene expression signatures and molecules within a mapping space, ensuring a smooth cross-modal transition. The transformed molecular embeddings are then decoded into molecular graphs. In addition, we employ an advanced single-cell large language model for input flexibility and pre-train a scaffold-based molecular model to ensure that all generated molecules are 100% valid. Empirical results show that our model can produce molecules highly similar to known references, whether feeding in- or out-of-domain transcriptome data. Furthermore, it can also serve as a reliable tool for cross-modal screening.

Intrarater and Interrater Reliability of Quantitative Ultrasound Speed of Sound by Trained Raters at the Distal Radius in Postmenopausal Women.

Quantitative ultrasound (QUS) performed at the distal radius shows potential as an effective tool for evaluating fracture risk, especially in postmenopausal women, but the reliability of this tool has not been reported in this patient population. This study investigated the within-day intrarater and interrater reliability of trained raters performing QUS measures at the distal radius of postmenopausal community-dwelling women. Eighteen women between the ages of 56 and 87years were recruited from senior centers in the Greenville area of South Carolina and consented to participate. A QUS bone sonometer was used in this study; the trained raters performed 3 repeated speed of sound (SOS) measures at the nondominant radius of each participant on the same day. Intraclass correlation coefficients (ICCs) were calculated (model 3,1 for intrarater and 2,3 for interrater reliability) to determine the reliability within and between raters. In addition, we calculated the standard error of measurement (SEM) and the minimal detectable change at 95% confidence interval (MDC 95 ). The within-day intrarater reliability was excellent for both physical therapist raters (ICC (3,1) ranging from 0.93 to 0.91). The SEM and MDC for the within-day intrarater reliability measures were small for both raters (SEM=36.79-38.75 or 0.92%-0.97% of the pooled mean; MDC 95 =101.99-107.40). The interrater reliability for SOS measurements using radial QUS was good with an ICC (2,3) of 0.77 (95% CI, 0.36-0.92) for 3 averaged measures. The SEM and MDC were larger for the interrater reliability measures (SEM=62.79 or 1.57% of the pooled mean; MDC 95 =174.05). Quantitative ultrasound SOS measurement at the distal radius showed excellent within-day intrarater and good interrater (when 3 measures were averaged) reliability in community-dwelling postmenopausal women. The SEM and MDC 95 were also low for interrater reliability when a mean of 3 trials was used. This study is the first to demonstrate that this particular QUS device at the radius may be a reliable fracture risk screening tool for postmenopausal women.

Abstract A013: Advanced Gene Signatures for the Diagnosis and Personalized Treatment of Pancreatic Ductal Adenocarcinoma

Abstract Pancreatic ductal adenocarcinoma (PDA) is among the most lethal tumors, with limited treatment options. The absence of reliable screening and diagnostic tools (biomarkers or procedures) significantly contributes to its poor prognosis. Biomarkers that can diagnose PDA, select optimal therapy combinations, and predict the risk of occult metastases are crucial for enhancing treatment outcomes. Previously, we identified methylation signatures capable of predicting outcomes and diagnosing PDA, focusing on genes/proteins with preclinical evidence of influencing key drugs (gemcitabine [Gem], 5-fluorouracil [5FU], oxaliplatin, cisplatin, paclitaxel, and irinotecan) used in treatment. To make these findings more clinically applicable and propose a novel approach for personalized treatment selection between Gem-based (Gem/nab-paclitaxel) and 5FU-based (FOLFIRINOX) combinations, we explored the diagnostic value of genes associated specifically with Gem and 5FU. The objective was to develop a gene signature for diagnosing PDA and aiding in treatment selection. Based on recent literature, we updated our previous gene panels (from 55 to 93 for Gem, and from 20 to 28 for 5FU). We analyzed RNA and gene expression differences between normal (NT) and PDA tissues using TNMplot.com, a web tool that leverages data from the Gene Expression Omnibus (NCBI-GEO), Cancer Genome Atlas (TCGA), Therapeutically Applicable Research to Generate Effective Treatments (TARGET), and The Genotype-Tissue Expression (GTEx) repositories, employing Mann-Whitney or Kruskal-Wallis tests for statistical significance. For the Gem-specific gene panel, the combined RNA expression of 90 out of 93 genes was significantly higher in PDA compared to NT (2.59, p=6.48e-61), while the combined gene expression of 80 out of 93 genes was also significantly higher in PDA tissues (1.62, p=3.48e-29). For the 5FU-specific gene panel, the combined RNA expression of 27 out of 28 genes was significantly elevated in PDA (2.00, p=5.44e-57), and the combined gene expression of 23 out of 28 genes was significantly higher in PDA tissues (1.21, p=1.44e-7). Our preliminary findings suggest that this approach has the potential to serve as an effective tool for diagnosing PDA and guiding treatment selection. However, these results must be validated through larger prospective studies. Additionally, this application could serve as a screening tool for high-risk populations, such as individuals with potentially malignant lesions like intraductal papillary mucinous neoplasms, first-degree relatives of PDA patients, or those with concerning genetic risks (e.g., BRCA1 or BRCA2 mutations). Citation Format: Harshitha Puram, Deepak Sherpally, Sravan Jeepalyam, Ashish Manne. Advanced Gene Signatures for the Diagnosis and Personalized Treatment of Pancreatic Ductal Adenocarcinoma [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr A013.

Psychometric evaluation of the Indonesian version of paternal breastfeeding self-efficacy scale- short form: A confirmatory factor analysis

BackgroundFathers play a significant role in supporting sustaining exclusive breastfeeding. It is crucial to assess paternal confidence in assisting mothers during breastfeeding. Research aimThis study evaluated the psychometric properties of the Paternal Breastfeeding Self-Efficacy Scale- Short Form among Indonesian fathers. MethodsA cross-sectional study was conducted among 462 fathers whose wives gave birth to the baby in public hospitals in Indonesia. The internal consistency and test-retest reliability were examined using Cronbach's alpha and intraclass correlation coefficient. We evaluated the convergent, divergent, predictive, and construct validity. ResultsConfirmatory factor analysis demonstrated a one-factor structure model with satisfactory fit indices. The Cronbach's alpha (0.96), McDonald's Omega coefficient (0.97), and intraclass correlation coefficient (0.99) indicated an excellent reliability of the scale. The father's breastfeeding self-efficacy was positively correlated with the mother's breastfeeding self-efficacy (r= 0.251, p < .001), and negatively associated with symptoms of depression (r = -0.150, p < .01) and anxiety (r = -0.314, p < .001). We also found a positive correlation between BSES-SF and exclusive breastfeeding at two weeks postpartum (r = 0.538, p < .001). Fathers who were employed and their partner was multipara, had a vaginal birth, practiced skin-to-skin contact and rooming-in, and exclusive breastfeeding were more confident to support their partner's breastfeeding. ConclusionsThe Indonesian version of the paternal Breastfeeding Self-Efficacy Scale- Short Form is a reliable and valid tool for screening and assessing fathers’ confidence in assisting mothers in breastfeeding.

Validity and Diagnostic Ability of Pancreatic Exocrine Insufficiency Questionnaire in Turkish Patients.

Pancreatic exocrine insufficiency (PEI) is a prevalent disease that is often underdiagnosed and undertreated, leading to resulting in diminished health-related quality of life. The PEI questionnaire (PEI-Q), a patient-reported outcome questionnaire developed to diagnose and evaluate PEI, is available only in English. The study aimed to provide a Turkish translation of PEI-Q and validate its reliability and diagnostic performance in a Turkish-speaking population with PEI. This study included 161 participants: 98 patients with PEI and 63 healthy controls. Participants underwent the PEI-Q test, and the results were statistically analyzed for reliability and validity. The diagnostic value of PEI-Q was determined using receiver operating characteristic (ROC) curves. Cronbach's alpha was used to assess internal consistency, while exploratory factor analysis was performed to determine construct validity and reveal the factor structure. The mean age of participants was 45.0 years, and 60.2% were male. Participants with PEI were significantly older than those without. Scores for abdominal, bowel movement, and total symptoms were significantly higher in patients with PEI than in controls. ROC analysis revealed good diagnostic value for PEI-Q, with areas under the curve ranging from 0.798 to 0.851 for different symptom scores. Cronbach's alpha coefficients were above 0.70, indicating good internal consistency, and exploratory factor analysis supported a 4-factor structure, accounting for 68.9% of the total variance. The Turkish version of the PEI-Q is a reliable, easy-to-use, and valid screening tool for diagnosing PEI. It consistently assesses symptoms and quality of life in patients with PEI, helping to inform diagnosis and treatment.

Validation and reliability of the Malay version of the painDETECT questionnaire (PDQ-M) among patients with neuropathic and nociceptive pain

Background: Neuropathic pain is chronic and debilitating. Early and accurate diagnosis is important for appropriate management. The painDETECT questionnaire (PDQ) is an effective screening tool for presence of neuropathic pain. We tested the validity and reliability of the translated Malay version of PDQ (PDQ-M). Methods: This was a multi-center cross-sectional study conducted over 24 months. The original English version of PDQ was translated into Malay version following international guidelines. Subsequently, patients with chronic pain were administered PDQ-M and Malay version of SF36 at baseline and 2-4 weeks later. The reliability, construct and criterion validity of PDQ-M were evaluated. Clinician diagnoses were used as gold standard for comparison of diagnostic accuracy. Multiple regression analysis was performed to determine correlation between PDQ-M and SF-36 scores. Results: A total of 97 patients were included in the study (53 with neuropathic pain, 44 with nociceptive pain). The EFA of PDQ-M produced three factors which explained 58.3% of the variance. It exhibited fair consistency with Cronbach’s alpha coefficient of 0.719 (for all 9 items) and 0.755 (for 7-item with Likert scale). PDQ-M is reliable with Cronbach’s alpha coefficient of 0.719 and 0.852 for test-retest reliability. A score of ≥17 was the best cut-off value for discriminating between neuropathic and non-neuropathic pain in PDQ-M (79.2% sensitivity, 50.0% specificity). Multiple regression analysis exhibited total PDQ-M score to have significant negative correlation with all components of SF-36 scores except role limitation due to physical health. Conclusions: PDQ-M is a reliable and valid self-administered screening tool for neuropathic pain.