Scale Criteria Research Articles

Influence of an Alternative Diagnosis on the Diagnosis of Pulmonary Thromboembolism

Background: The diagnosis of pulmonary embolism (PE) is based on the application of a priori probability scales such as the Wells scale or PERC. However, the clinical heterogeneity of this pathology results in the absence of a target population to apply these algorithms. The Wells score does consider the possibility of an alternative diagnosis, awarding an additional point if no other diagnosis is likely, yet the presence of objective alternative diagnoses can still complicate clinical assessment and lead to unnecessary testing or missed diagnoses. Objective: The aim of this study is to evaluate the discrimination capacity of clinical objective factors with a high negative predictive value for PE, compared to PERC in terms of reducing unnecessary testing across different risk strata of the Wells scale. Materials and Methods: This was a single-center retrospective cohort study, including patients who underwent chest CT angiography to rule out PE at a university hospital between 2008 and 2017, considering the presence of PE as the study outcome. The study collected demographic data, comorbidities, and clinical presentation data. The presence of objective criteria for pneumonia, heart failure, exacerbation of COPD, or the use of anticoagulation in non-oncological patients were considered a priori criteria with a high negative predictive value. Results: The analyses were performed on a cohort of 399 patients with an average age of 65 years and 53% females. A total of 139 patients were diagnosed with PE by CT angiography. The presence of factors with a high NPV showed a sensitivity of 100% in low-risk patients according to Wells, with sensitivity dropping below 50% in other populations. The association of these factors in the PERC plus criteria would allow a reduction of up to 34% in CT angiographies in patients with low risk according to the Wells scale. Conclusions: The combination of risk stratification of the Wells scale and PERC plus criteria allows an absolute reduction of 34.3% in the performance of CT angiographies in patients classified as low risk with a sensitivity and a negative predictive value of 100%. The preexistence of an alternative diagnosis does not allow ruling out PE in patients with intermediate or high risk according to the Wells scale.

Establishing the Institute of Independent Evaluation of Higher Education in the Russian Federation

The paper presents the results of the search, systematization and analysis of independent higher education evaluation systems that have been developed in the country in the recent decade. The research has been carried out using standardised evaluation mechanisms that adhere to the criteria of mass scale, openness, and stability. The analysis of the independent evaluation of higher education’s present situation revealed certain inconsistencies between the legislative and regulatory framework and real practice. It should be emphasised that, while different processes have now been developed for this type of evaluation, they still require enhancement. The assessment mechanisms themselves need to undergo an external, independent evaluation to ensure their reliability, integrity, and trustworthy evidence. It has been indicated that independent evaluation procedures have jointly developed into a system: the institution of independent evaluation. This system is characterised by integrity, orderliness, and definite linkages. One may consider the aggregating technology of the aforementioned evalu-ations to be the synergistic outcome of the system’s establishment. In order to achieve a synergistic effect on the evaluation of all higher education institutions and educational programmes in the country, the authors suggest a method for aggregating the outcomes of the described evaluation procedures. The obtained research outcomes prove their applicability to the internal and external evaluation of a higher education institution’s performance and to the strategic planning of the development of both the institution and the higher education system.

Development and Application of a Tornado Database for the Chinese Mainland

This study develops a preliminary tornado database for the Chinese mainland using information provided by the Yearbook of Meteorological Disasters in China (YMDC) from 2003 to 2019 and other public media report data. This database includes tornado occurrence time, geographical location, intensity, and damage descriptions. A modified Enhanced Fujita (EF) scale criterion adapted to the description of the damage indicator (DI) and degree of damage (DOD) in the YMDC and media reports is presented to better estimate the tornado intensity. The spatial and temporal distribution characteristics of tornadoes in Chinese mainland are examined. A stochastic simulation algorithm is proposed to perform a risk assessment of tornado hazards. The occurrence of tornadoes is randomly sampled using negative binomial distribution. The kernel density estimation (KDE) method based on the Gaussian kernel is applied to estimate the probability density of geographically dependent tornado occurrence before randomly generating tornado occurrence locations. The probability and conditional probability of tornado occurrence with different intensity levels are calculated for different counties in Jiangsu and Guangdong Provinces using Bayes’ theorem. The database provides a forward step toward rational assessment of tornado-induced disasters in Chinese mainland. The database can be accessed at https://doi.org/10.4121/19801633.v1 (Zhang et al., 2022).

Silent Struggles Within: Alexithymia Unveiled in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis.

In recent years, the presence of alexithymia in patients with irritable bowel syndrome (IBS) has gained more attention, and several studies have evaluated this relationship. However, no clear conclusion has been reported yet. Therefore, we conducted a systematic review and meta-analysis to better understand the association between IBS and alexithymia. We performed a systematic search on the medical databases PubMed, EMBASE, and Scopus using predefined keywords to identify observational studies assessing the association between IBS and alexithymia. The included studies diagnosed IBS using the Rome criteria, and alexithymia was evaluated using the 20-item Toronto Alexithymia Scale (TAS-20) score. We used The Newcastle-Ottawa Scale to evaluate the quality of included studies. The primary summary outcome was the mean difference in TAS-20 scores. We included 7 studies involving 1,513 individuals in our qualitative analysis, with 6 of them included in our quantitative analysis. All studies were considered to be of satisfactory quality according to the Newcastle-Ottawa Scale criteria. We found significantly higher TAS-20 scores in IBS patients compared to controls (8.063 [95% CI, 2.554-13.572]). However, no significant mean difference in TAS-20 scores was observed in IBS vs inflammatory bowel disease patients (0.884 [95% CI -2.536-4.304]). We demonstrated that IBS is associated with an increased risk of developing alexithymia. However, our study did not show a significant difference in TAS-20 scores between patients with IBS compared to inflammatory bowel disease.

Refining Research Diagnostic Criteria for Catatonia Among Delirium, Medical, Affective, and Psychosis Patient Groups.

The authors proposed catatonia diagnostic criteria that require the presence of three neuropsychiatric symptom clusters, rated over 24 hours; this system differs from other symptom clustering proposals and is intended to increase diagnostic rigor over Bush-Francis Catatonia Rating Scale (BFCRS) or DSM-5 criteria. By applying new BFCRS item score thresholds, symptoms were clustered into three categories to comprise the Research Diagnostic Criteria for Catatonia (RDCC): akinesia (criterion A), unusual motor signs (criterion B), and behavioral signs (criterion C). RDCC symptom clusters were analyzed in four prospectively evaluated patient groups (delirium, medical, affective, and psychosis) (N=341). Use of the RDCC, compared with the DSM-5-TR and BFCRS, resulted in far fewer diagnoses of catatonia in the four patient groups: medical, N=1 out of 42 (2%); affective, N=1 out of 45 (2%); psychosis, N=3 out of 53 (6%); and delirium, N=0 out of 201. Permutations of the RDCC with more relaxed criteria were assessed, requiring either symptom thresholds or numbers of symptoms to meet criteria, resulting in catatonia rate gradations between those obtained with the RDCC and those obtained with current systems. The Cochrane Q test found that the DSM-5-TR was not dissimilar to the RDCC, if fulfilling numerical thresholds for criteria A-C, although any level of symptom severity was allowed. Confirmatory factor analysis with three goodness-of-fit indexes validated the RDCC. The RDCC requires akinetic symptoms on the basis of literature demonstrating their high BFCRS prevalence and exploratory factor analysis co-loadings, plus symptoms from unusual motor and behavioral signs. Compared with current lenient diagnostic approaches, having the symptoms required by the RDCC produced lower catatonia rates in the psychosis, affective, and medical groups and revealed no patients with catatonia in the delirium group. Subdividing DSM-5-TR symptoms into several different criteria may improve diagnosis. RDCC symptom clusters are both research data-based and amenable to further research for validation.

The Prevalence of Frailty Among People Experiencing Homelessness Attending a Primary Care Clinic: A Service Evaluation and Quality Improvement Initiative

Abstract Background Frailty is traditionally considered a geriatric syndrome though can present at a younger chronological age among people experiencing homelessness (PEH) due to risk factors such as poor nutrition, addiction and loneliness. Our walk-in primary care clinic for PEH has not previously recorded frailty status or prevalence among attendees, which would provide an opportunity to offer effective, evidence-based interventions. As part of a quality improvement initiative (QI), we evaluated frailty prevalence to improve our service to PEH. Methods The frailty status of adults presenting consecutively to a general practitioner at an urban, walk-in primary care clinic in Ireland dedicated to PEH was measured each Monday during a service evaluation in the first two months of 2024. Frail Scale (criteria: fatigue, resistance, ambulation, illness and weight loss; 0=robust, 1-2=pre-frail, 3-5=frail)) and the Clinical Frailty Scale (CFS) were used. Results 73 adults presented (median age 41.5), 21 female (28.8%)). 24 were frail on the Frail Scale (32.9% of total presenting), of which 4 were female (19.0% of females presenting) and 20 were male (38.5% of males presenting). 43 were pre-frail on the Frail Scale (58.9% of total presenting), of which 15 were female (71.4% of females presenting) and 28 were male (53.8% of males presenting). The median CFS was 4 (vulnerable). The most common frailty indicators were fatigue (68.5%) and weight loss (64.4%). Conclusion Frailty and pre-frailty were highly prevalent among PEH at our primary care clinic. A third were frail and over half pre-frail. The prevalence of this reversible syndrome had not previously been evaluated. Our findings underline the opportunity to improve our service by screening for frailty among PEH and offer appropriate interventions to reverse frailty and build resilience. Service evaluation and QI initiatives can enable application of research evidence and improvement of real-world clinical care.

Scaling-Up for the Counter-Rotating Twin Screw Extrusion of Polymers.

A novel and original computer scaling-up system for the counter-rotating twin screw extrusion of polymers was developed. In the system, each scaling parameter (scaling criterion) may be considered as an objective function to be minimized for the single parameters or the functional relationships along the length of the screw. Scaling was based on the process simulation, which was performed using the comprehensive (or global) counter-rotating twin screw extrusion program called TSEM (Twin Screw Extrusion Model). The extrusion process was scaled by applying GASESTWIN (Genetic Algorithms Screw Extrusion Scaling) software developed for this purpose using genetic algorithms. Scaling up the extrusion process was carried out to enhance extrusion process throughput according to the scaling criteria specified by the single quantities of polymer melt temperature at the die exit and relative melting length, and by distributions along the screw length of the extrusion parameters of the polymer melt temperature and polymer plasticating. The global objective function had the lowest value for the selected extrusion parameters, which means the minimal differences between the values of the scaled-up processes and extrusion throughput was significantly increased. The solution to the problem of scaling the counter-rotating process presented in this paper complements the existing solutions for optimizing and scaling basic variants of the extrusion process, i.e., flood-fed and starve (metered)-fed single-screw extrusion, as well as co-rotating and counter-rotating twin-screw extrusion.

The effects of stretching on running economy – A systematic review with meta-analysis

Introduction While all running athletes aim to cover the prescribed distance as fast as possible, the physiological and anatomical profiles of athletes are completely different between the disciplines. While sprint athletes have to exert maximal force in the smallest possible time window, the long-distance runner strives for the most economical movement pattern possible (Barnes & Kilding, 2015). Therefore, defined as oxygen uptake at a velocity at a prescribed percentage of the vVO2max, running economy (RE) has been identified as a decisive performance parameter (Saunders et al., 2004). One identified parameter which moderates RE was Achilles tendon stiffness. While stretching frequently used in warm-ups, it also decreases tissue stiffness. Objective: While some authors recommended the avoidance of stretching prior to running (Wilson et al., 2010), others found no affected economy in response to stretching. To address this research gap, this study was conducted to pool available stretching effects on RE. Methods A systematic search was conducted using MEDLINE/PubMed, Web of Science and Scopus (inception to April, 2024), which was supplemented by a manual search in Google Scholar and reference lists of identified studies. To account for multiple dependent study outcomes, robust variance estimation meta-analysis model was chosen to quantify pooled effect sizes. Controlled acute and chronic studies were included if they were performed in young, healthy participants on RE-parameter (energy/O2-consumption at a prescribed velocities determined at a percentage of VO2max (vVO2). Studies without a control group, patients or without the metabolic parameters were excluded. The PEDro scale and GRADE criteria were applied to evaluate the risk of bias and certainty of evidence, respectively. Results A total of 16 studies were investigated, with 14 studies (6 static stretching, 6 dynamic stretching and 2 static/dynamic stretching) addressing acute effects with 169 participants and 33 effect sizes (ES) matched the inclusion criteria. With a PEDro score of 4.88, study quality was rated fair. Overall, there was a low certainty of evidence without confirming any effect of stretching on RE, with overall group effect of ES = 0.007, −0.15 to 0.17 [95% CI], p = 0.93, τ2 = 0, W2 = 0, static group effect of ES = –0,22, –0,40 to 0,70 [95% CI], p = 0.3, τ2 = 0.18, W2 = 0 and dynamic group effect of ES = –0,07, −0.22 to 0.09 [95% CI], p = 0.35, τ2 = 0, W2 = 0, determined at vVO2 65% - 90%. Discussion Currently, there is no evidence supporting previous recommendations to avoid stretching before running due to reduced RE. However, several methodological limitations, such as high heterogeneity in the velocity used in RE determination, small study sample sizes and comparatively short stretching durations without intensity quantification and a lack of pre-post comparisons bias the certainty of evidence. Accordingly, there is a demand for high quality research that controls underlying mechanisms. References Barnes, K. R., & Kilding, A. E. (2015). Running economy: Measurement, norms, and determining factors. Sports Medicine – Open, 1, Article 8. https://doi.org/10.1186/s40798-015-0007-y Saunders, P., Pyne, D., Telford, R., & Hawley, J. (2004). Factors affecting running economy in trained distance runners. Sports Medicine, 34, 465–485. https://doi.org/10.2165/00007256-200434070-00005 Wilson, J. M., Hornbuckle, L. M., Kim, J.-S., Ugrinowitsch, C., Lee, S.-R., Zourdos, M. C., Sommer, B., & Panton, L. B. (2010). Effects of atatic atretching on wnergy cost and running endurance performance. The Journal of Strength & Conditioning Research, 24(9), 2274-2279. https://doi.org/10.1519/JSC.0b013e3181b22ad6

Examining Facade Adaptability: A Study of Adaptive Facade Classification Criteria

In this research, the facade classification of three different buildings located in Europe, Asia and Australia is carried out by using a classification model developed by utilising the criteria of some adaptive facade classification models in the literature. The control parameters affecting the facade design, physical environment criteria, facade adaptation method, control system and technique, visibility of adaptation and time scale criteria in the model are discussed in detail. Besides, the historical development, contemporary trends and basic parameters on architecture are analysed comprehensively. The emergence of adaptive architecture is discussed, as well as efforts to demonstrate changes in the design of elements sensitive to dynamic environmental and user needs. Furthermore, how adaptability is integrated with the building envelope and facade, the historical evolution of adaptive facades, and the development of key components are also examined. Thus, this study aims to make an important contribution to understanding adaptive architecture and adaptive facades while categorising examples of adaptive facades across three continents, including cultural and geographical differences.

The prevalence of oral mucositis after radiotherapy in patients with Head and Neck Cancer and its associated factors: a meta-analysis.

Although the discussion about oral mucositis in Head and Neck Cancer (HNC) patients has become a prominent issue, its incidence and influencing factors have not been thoroughly synthesized. This meta-analysis aims to integrate the prevalence and associated factors of radiation-induced oral mucositis among HNC patients. This study searched the following electronic databases: PubMed, the Cochrane Database, the Web of Science, EMBASE, CNKI, the Wanfang Database, and the VIP Database. The publication timeframe for the included studies ranged from January 2005 until January 2024. Two investigators used the NOS scale and AHRQ evaluation criteria for quality evaluation. All qualified studies and statistical analyses were conducted using RevMan 5.2 and Stata 17.0. Thirty eligible studies were included in the analysis. The results show that the prevalence of radiation-induced oral mucositis in HNC patients was 94% [95% CI (89%, 98%)]. Furthermore, the prevalence of severe radiation-induced oral mucositis in HNC patients is 37% [95%CI (29%, 45%)]. Chemotherapy, smoking history, diabetes, oral PH ≤ 7.0, and alcohol consumption are the main risk factors for radioactive oral mucositis. In addition, BMI > 24.0 kg/m2, no use of antibiotics, and no use of oral mucosal protective agents are associated with radioactive oral mucositis. This meta-analysis underscores a significantly high prevalence of radiation-induced oral mucositis in HNC patients. Establishing healthy lifestyle habits and maintaining a healthy oral environment are pivotal in preventing radiation-induced oral mucositis.

Acute-phase proteins as indicators of disease severity and mortality in COVID-19 patients

The aim of the study was to conduct of relationship of acute-phase proteins (APPs) with the severity of COVID-19 defined by National Institutes of Health and according to the criteria of MEWS scale, with the presence of a cytokine storm, oxygen therapy and patient survival. We enrolled 96 patients with COVID-19 and 30 healthy people. The samples were taken on the day of admission and after 9 days on average. Not only commonly used APPs such as CRP, procalcitonin and ferritin and also rarely assayed proteins such as transferrin, haptoglobin, α1-acid glycoprotein and α1-antitrypsin, were tested in the study. The levels of APPs depends on the severity of COVID-19 disease, on the presence of cytokine storm and used oxygen therapy. The greatest APPs changes occurred in the most advanced form of the disease, with the presence of a cytokine storm and the most intense oxygen therapy. The results obtained from MEWS scale were not consistent with National Institutes of Health scores. Studies in the second samples showed the quenching of the acute phase reactions and the effectiveness of oxygen therapy. Only two of the examined APPs i.e. procalcitonin and transferrin, differed between surviving and non-surviving patients, and these two predispose to the role of prognostic factors in Covid-19. In conclusion, the concentration of not all acute-phase proteins depends on the severity of COVID-19 disease, presence of cytokine storm, the used of oxygen therapy and only some of them (procalcitonin and transferrin) are related to the survival outcomes. Of the newly tested acute-phase proteins, only transferrin shows significance as a marker of disease severity and mortality in COVID-19 disease.

Evaluation of the quality of oral hygiene mobile apps for children using the mobile app rating scale

BackgroundWith the increased use of smartphones, mobile applications (apps) aimed at promoting healthy behaviors have experienced exponential growth. ObjectivesThis study aimed to provide an overview of mobile apps that use gamification to motivate children to maintain optimal oral hygiene and to evaluate the quality of the oral hygiene apps for children (OHACs) available in the Turkish Google Play Store and the Apple Store. MethodsBetween January 20 and February 2, 2024, OHACs were searched in the Turkish Google Play Store and the Apple Store. Seven apps were assessed using the Mobile Application Rating Scale (MARS) and evidence-based dentistry criteria (EBD). We used Microsoft Office Professional 2016 (Microsoft Excel 2016; Microsoft Corp, Redmond, WA, USA) and IBM SPSS Statistics version 29 for Windows (IBM Corp, Armonk, NY, USA) for all the data analyses and visualizations. ResultsThe best overall MARS scores were obtained for Diş Doktoru: Dentist (3.53 ± 0.15) and Diş Hekimi Oyunları: Dentist Game (3.72 ± 0.33). The worst overall MARS scores were obtained for Truthbrush (2.76 ± 0.06) and Mimizaur (2.85 ± 0.09). Hayvan Diş Hekimi: Animal Dentist, Diş Hekimi Oyunları, and the Brush Teeth Game: Kids Dentist included the most evidence-based content. ConclusionMost OHACs achieved moderate MARS scores for promoting oral hygiene habits among children. Improving the quality and educational content of OHACs could increase personal oral care motivation in children. More research is required to determine the long-term effects of the apps and whether they align with oral hygiene guidance.

Effect of cognitive behavior-aided counseling on entrepreneurial self-efficacy of students of home economics education in South-East Nigeria.

Raising potential entrepreneurs to advance the economy of nations through education has been projected by scholars. On the contrary, Nigerian students lack the enthusiasm and internal force to pursue the aims enshrined in their courses of study. Rather they prefer white-cola jobs to the entrepreneurial intention of the institutions. Given this reason, we tested the effect of cognitive behavior-aided counseling on entrepreneurial self-efficacy of students of Home Economics in South-East Nigeria. This is a pretest and posttest with a follow-up group randomized control design. A total of 119 Home Economics Education students from Universities and Colleges of Education were measured and screened using an entrepreneurial self-efficacy scale and inclusion criteria. Data collected from the pretest, post-test, and follow-up test were statistically analyzed using repeated measures of Analysis of Variance statistical method. The effect size of the cognitive behavior-aided counseling intervention on entrepreneurial self-efficacy was reported using partial eta square. The follow-up data was tested using a Univariate analysis. The result showed that cognitive behavior-aided counseling intervention had a significant effect on entrepreneurial self-efficacy among the Universities and Colleges of Education in South-East Nigeria. A follow-up result also showed that intervention had a significant effect on participants' entrepreneurial self-efficacy.

How reliable is the artificial intelligence product large language model ChatGPT in orthodontics?

To evaluate the reliability of information produced by the artificial intelligence-based program ChatGPT in terms of accuracy and relevance, as assessed by orthodontists, dental students, and individuals seeking orthodontic treatment. Frequently asked and curious questions in four basic areas related to orthodontics were prepared and asked in ChatGPT (Version 4.0), and answers were evaluated by three different groups (senior dental students, individuals seeking orthodontic treatment, orthodontists). Questions asked in these basic areas of orthodontics were about: clear aligners (CA), lingual orthodontics (LO), esthetic braces (EB), and temporomandibular disorders (TMD). The answers were evaluated by the Global Quality Scale (GQS) and Quality Criteria for Consumer Health Information (DISCERN) scale. The total mean DISCERN score for answers on CA for students was 51.7 ± 9.38, for patients was 57.2 ± 10.73 and, for orthodontists was 47.4 ± 4.78 (P = .001). Comparison of GQS scores for LO among groups: students (3.53 ± 0.78), patients (4.40 ± 0.72), and orthodontists (3.63 ± 0.72) (P < .001). Intergroup comparison of ChatGPT evaluations about TMD was examined in terms of the DISCERN scale, with the highest value given in the patients group (57.83 ± 11.47) and lowest value in the orthodontist group (45.90 ± 11.84). When information quality evaluation about EB was examined, it GQS scores were >3 in all three groups (students: 3.50 ± 0.78; patients: 4.17 ± 0.87; orthodontists: 3.50 ± 0.82). ChatGPT has significant potential in terms of usability for patient information and education in the field of orthodontics if it is developed and necessary updates are made.

Uncertainty analysis of impact factors for a comprehensive assessment of dam failure consequence under earthquake effects

ABSTRACT Utilizing cloud models to analyze the uncertainty and consequences of dam failure factors. Enhanced Analytic Hierarchy Process (AHP) with a scale criterion based on index scale and an expert score constraint mechanism. Focus on the downstream area of the Zipingpu Dam for assessing the uncertainty of dam comprehensive evaluation factors. The final outcome is represented by three numerical eigenvalues of the cloud model, determining the weights of each factor in the evaluation index system. This approach offers a novel method for the comprehensive evaluation of dam failure consequences.

Impact of the COVID pandemic on melanoma thickness and ulceration: a meta-analysis.

The global healthcare sector faced immense challenges due to the COVID-19 pandemic. Oncologists noted reduced cancer screening, which impacted melanoma diagnosis and treatment, leading to concerns about delayed care and poorer outcomes. This review analyzes how the pandemic influenced melanoma ulceration risk and Breslow thickness index through a meta-analysis of published studies. Following PRISMA guidelines, we conducted a systematic review of literature from January 2021 to December 2022 on cutaneous melanoma before and during the COVID-19 pandemic. Upon screening 1854 manuscripts, the review led to 13 studies meeting inclusion standards. The quality assessment followed MINORS and Newcastle-Ottawa Scale criteria. Regarding ulceration, post-COVID ulceration surpassed pre-COVID levels significantly, with a risk ratio of 1.31 and an estimated odds ratio of 1.41, indicating a 44% rise post-COVID. As for Breslow thickness, studies show a rising trend in the Breslow index post-COVID, but less significantly, with an effect size of 0.08 regarding the meta-analysis model (P = 0.02) with a pre-COVID mean Breslow of 1.56 mm and post-COVID of 1.84 mm. This meta-analysis concluded that post-COVID ulceration rates significantly surpassed pre-COVID levels. Considering that ulcerated melanomas usually undergo sentinel lymph node biopsy and are more likely to benefit from adjuvant therapies, this indicates important implications, as many patients might have missed the opportunity to start therapy appropriately, regardless of their Breslow thickness status.

Total magnesium intake and risk of frailty in older women.

An adequate magnesium intake might lower the risk of frailty through its role in muscle function. We analysed data from 81524 women aged ≥60years participating in the Nurses' Health Study. Total magnesium intake was obtained from repeated food frequency questionnaires administered between 1984 and 2010 and self-reported information on supplementation. Frailty was defined as having at least three of the following five FRAIL scale criteria: fatigue, low strength, reduced aerobic capacity, having ≥5 chronic illnesses and weight loss≥5%. The occurrence of frailty was assessed every 4years from 1992 to 2018. Cox proportional hazards models adjusted for lifestyle factors, medication use and dietary factors were used to assess the association between magnesium intake and frailty. During a median follow-up of 16years, we identified 15477 incident cases of frailty. Women with a higher intake of total energy-adjusted magnesium had a decreased risk of frailty after adjustment for lifestyle factors, medication use and dietary factors. The relative risk (95% confidence interval) for Quintile 5 (Q5) versus Quintile 1 (Q1) was 0.88 (0.82, 0.94) (P-trend<0.001). When only energy-adjusted magnesium from the diet was considered, the inverse association was stronger (Q5 vs. Q1: 0.68 [0.56, 0.82]; P-trend<0.001). Those reaching the recommended daily allowance (RDA) of magnesium through diet had a 14% (9%, 19%) lower risk of frailty compared with those not meeting the RDA. Increased intake of foods rich in magnesium was associated with a decreased risk of frailty.

Prognostic value of CT scan-based radiomics in intracerebral hemorrhage patients: A systematic review and meta-analysis

ObjectivesWe conducted a systematic review and meta-analysis of current publications on the potential role of non-contrast-enhanced computed tomography (NCCT) radiomics as a prognostic indicator in patients with intracerebral hemorrhage (ICH). MethodsWe systematically searched PubMed, EMBASE, and the Web of Science from inception until January 8, 2024. Studies with NCCT-based radiomics features for predicting the prognostic outcomes of ICH patients were included. We calculated the pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under curve (AUC) values. The radiomics quality score (RQS), METhodological RadiomICs Score (METRICS), and the quality assessment of diagnostic accuracy studies (QUADAS-2) were used for quality assessment. ResultsTwenty-two studies were included. The pooled sensitivity, specificity, DOR, and AUC of radiomics models were 0.73, 0.78, 10.03, and 0.83, respectively, while on the combined radiomics models with other non-radiomics features were 0.80, 0.80, 16.28, and 0.86. Subgroup analysis showed that studies with the following covariates have a higher accuracy: single center, modified Rankin Scale (mRS) criteria for the ICH outcomes assessment, following patients for evaluation of ICH outcomes for more than a month, automatic segmentation, capturing the radiomics feature from the only intra-hematomal region, using PyRadiomic tool for features extraction, and using non-logistic regression for modeling. The quality of literature using QUADAS-2 and METRICS tools was good and was under-average using the RQS tool. No publication bias was detected. ConclusionsRadiomics features showed moderate to high accuracy for predicting ICH prognostic outcomes. Although the QUADAS-2 and METRICS assessments indicated good quality, the radiomics pipeline quality was under-average. Clinical RelevanceNCCT-based radiomics features can provide information about the prognostic outcomes of ICH patients after patient admission. This study exploits the value of current evidence on NCCT-based radiomics methodology in the prediction of ICH prognosis.

Development of the Chinese coaches' autonomy-supportive-laissez-faire coaching style scale.

The autonomy-supportive coaching style is recognized for its positive impact on athletes' well-being and performance. However, the transition of excessive autonomy into a laissez-faire coaching style has not been thoroughly examined within the context of coach evaluation scales. Existing scales focus predominantly on the positive dimensions of autonomy support, and do not possess the capabilities to measure outcomes which may be viewed as negative or other outcomes. This study aims to integrate the autonomy-supportive and laissez-faire coaching styles within the same measurement framework. Our study developed a comprehensive scale to assess both the autonomy-supportive and laissez-faire coaching styles, drawing on items from the Sport Climate Questionnaire for autonomy support and adapting items from leadership research for laissez-faire coaching. We conducted two studies: the first with 148 athletes to refine the laissez-faire items and the second with 460 athletes to validate the full scale, utilizing exploratory factor analysis, confirmatory factor analysis, and correlation analysis. We also measured internal consistency and split-half reliability. The finalized scale includes a 6-item autonomy-supportive subscale and a 5-item laissez-faire subscale. Validation processes confirmed the scale's construct and criterion validity, alongside its reliability. The Chinese Coaches' Autonomy-Supportive-Laissez-Faire Coaching Style Scale effectively captures both the beneficial and potentially detrimental aspects of coaching styles, addressing a critical gap in the literature and providing a reliable tool for evaluating coaching approaches.

Assessing the Quality and Reliability of Videos Related to Fibromyalgia on TikTok: A Comprehensive Analysis.

Introduction Fibromyalgia, characterized by chronic musculoskeletal pain and associated symptoms, poses significant challenges in diagnosis and management. While social media platforms like TikTok have emerged as popular sources of health information, their variable content quality necessitates critical evaluation. This study aimed to assess the quality and reliability of TikTok videos related to fibromyalgia, thereby enhancing the understanding of their impact on patient education and self-management. Methods A cross-sectional observational study was conducted in June 2024, which analyzed 150 TikTok videos using search terms like "Fibromyalgia", "Fibromyalgia Symptoms", and "Fibromyalgia Treatment". Videos were evaluated for inclusion based on relevance and language (English), by employing the Global Quality Scale (GQS) and Quality Criteria for Consumer Health Information (DISCERN) score for assessment. Statistical analysis was performed by using IBM SPSS Statistics v21.0 (IBM Corp., Armonk, NY). The Kruskall-Wallis test was employed, and a p-valueless than 0.05 was deemed statistically significant. Results Of the 150 videos initially reviewed, 96 (64%) met the inclusion criteria. Content categories included disease description (34, 35.42%), symptoms (81, 84.38%), management (64, 66.67%), and personal experiences (63, 65.63%). The videos were uploaded by doctors (8, 8.33%), patients (63, 65.63%), healthcare workers ( 7, 7.29%), and others (18, 18.75%). Mean GQS scores varied significantly by uploader type: doctors (4.63 ± 0.52), healthcare workers (3.43 ± 0.79), patients (2.37 ± 0.81), and others (2.11 ± 0.47) (p<0.001). DISCERN scores followed a similar trend: doctors (3.88 ± 0.64), healthcare workers (2.14 ± 1.46), patients (1.08 ± 0.27), and others (1.61 ± 0.50) (p<0.001). Conclusions TikTok serves as a pivotal platform for fibromyalgia-related discourse, predominantly shaped by patient-generated content. However, even though it provides insights into symptoms and management strategies, gaps exist in comprehensive medical guidance and preventive measures. The study underscores the critical role of healthcare professionals in enhancing content reliability and educational value on social media. Future research should explore cultural and linguistic diversity to broaden the accessibility and relevance of health information on platforms like TikTok.