Scale Domain Research Articles

한국 영유아를 위한 일과기반 발달검사 MEISR 타당화

Objective: The Measure of Engagement, Independence, and Social Relationships (MEISR) is a tool designed to assess the engagement, independence, and social interactions of infants and toddlers during daily activities. This study aimed to develop Korean version of MEISR (K-MEISR) and evaluate its reliability and validity. Methods: Korean version of MEISR was developed through the translation and modification of items of the MEISR following a pilot study (N = 44). Two studies were conducted with parents of infants and toddlers up to 36 months old using online (N = 124) and offline (N = 134) versions. Data were analyzed using SPSS 27.0 and AMOS 25.0. Item difficulty and discrimination, as well as passing rates were calculated; and internal consistency, correlations among the routine and total scales, factor analyses, and correlations with K-DST ratings were analyzed to determine the reliability and validity of K-MEISR. Results: Analyses of item difficulty and passing rates identified characteristics of items for determining the item order for K-MEISR. High correlations between the total of each routine and the total of all items were found in both the online (r = .896~.992) and the offline (r = .874~.988) versions. Reliabilities of all total scale items were high for both the online (r = .998) and the offline (r = .997) versions. Reliabilities of routine items were also high, ranging from .913 to .985 for the online and .914 to .985 for the offline version. Correlations between K-DST and K-MEISR were high for both the online (r = .981) and offline (r = .959), showing high concurrent validity. Conclusions: The items of the total scale, and routines and functional domains showed high internal consistency and high correlations with K-DST, revealing the concurrent validity of K-MEISR. Recommendations for further research and clinical use of the assessment tool are discussed.

Development of a Medical Social Media Ethics Scale and Assessment of #IRad, #CardioTwitter, and #MedTwitter Posts: Mixed Methods Study.

Social media posts by clinicians are not bound by the same rules as peer-reviewed publications, raising ethical concerns that have not been extensively characterized or quantified. We aim to develop a scale to assess ethical issues on medical social media (SoMe) and use it to determine the prevalence of these issues among posts with 3 different hashtags: #MedTwitter, #IRad, and #CardioTwitter. A scale was developed based on previous descriptions of professionalism and validated via semistructured cognitive interviewing with a sample of 11 clinicians and trainees, interrater agreement, and correlation of 100 posts. The final scale assessed social media posts in 6 domains. This was used to analyze 1500 Twitter posts, 500 each from the 3 hashtags. Analysis of posts was limited to original Twitter posts in English made by health care professionals in North America. The prevalence of potential issues was determined using descriptive statistics and compared across hashtags using the Fisher exact and χ2 tests with Yates correction. The final scale was considered reflective of potential ethical issues of SoMe by participants. There was good interrater agreement (Cohen κ=0.620, P<.01) and moderate to strong positive interrater correlation (=0.602, P<.001). The 6 scale domains showed minimal to no interrelation (Cronbach α=0.206). Ethical concerns across all hashtags had a prevalence of 1.5% or less except the conflict of interest concerns on #IRad, which had a prevalence of 3.6% (n=18). Compared to #MedTwitter, posts with specialty-specific hashtags had more patient privacy and conflict of interest concerns. The SoMe professionalism scale we developed reliably reflects potential ethical issues. Ethical issues on SoMe are rare but important and vary in prevalence across medical communities.

Flow Analyses of Integrated Liquid Fuel RAMJET Propulsion System

A CFD study is performed to check the seamless flow behaviour of the Liquid Fuel Ramjet Propulsion system which includes, air intakes, combustor and nozzle. Resolving both supersonic and subsonic flow scales in the same domain makes the simulations complex. Addition of combustion with stiff chemistry makes the simulations more difficult. CFD simulations are carried out using commercially available CFD software. Liquid fuel is injected as discrete phase and the flow turbulence is modelled using Realizable k-ε turbulence model. Jet-A + air combustion has been simulated using combined finite rate / eddy dissipation model. Finite rate chemistry was modelled using three step chemistry which was obtained from the published literature. Flow structures such as oblique shocks, normal shocks and combustion are observed.

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

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

Beaches in a semi-insulated compartment: Engineering tools from the diffusion theory

Beaches can serve as a valuable asset to any community, which can gain a massive source of income from them; in fact, beach tourism is ever more frequently the essential target of countries, aimed at attracting foreign investment or exchange. In this frame, prediction of coastal evolution at large scales is very important for coastal management and first conceptual design. Management strategies, almost at the early stages of the projects, may likely involve numerical simulations, but they can be extremely laborious, computing demanding and intensely time-consuming especially when involving either wider coastal domain or longer time scales that basically encompasses the majority of coastal projects by now. Analytical solutions of the Diffusion Shoreline Equation (DSE) can be a valid alternative. In these frames, given the surprisingly good predictive capabilities, they can isolate essential features of the processes, making them more readily comprehended, and can avoid cumulative errors associated with the accuracy of computational time-stepping models. Nevertheless, the rather complex mathematical form makes their use extremely challenging and confines them in the realm of high mathematics. Ciccaglione et al. (2023) provided analytical solutions of the DSE for finite beaches bounded by outcrops of whatever length (bypassing or non-bypassing groin compartments). Differently from the other studies, the authors checked the applicability range of the solutions through the comparison with reliable numerical models; furthermore, using curve fitting analysis simple design tools were suggested to aid engineers in the practical applications. In this paper, a deep focus is given on the case of a bypassing groin compartment, and easy-to-use formulae are given to assess the lifetime of beach fill projects. A simple semi-theoretical solution is also given for the case of a compartment bounded by a very short groin, by introducing a “convective term” modelled via a Heavy-side function, H(x). The practical usefulness of this solution is proved through an application to the evolution of a real beach along Italy's Adriatic coast.

Research on Dynamic Quaternion Ship Domain Model in Open Water Based on AIS Data and Navigator State

During the process of establishing the analytical quaternion ship domain model, the impact of ship traffic conditions and navigator state was not taken into consideration. However, the significance of these factors in the ship domain cannot be ignored. To create a more realistic representation of changes in the ship domain in real navigation environments, this study further considers the influence of ship encounter course, waterway traffic intensity, relative ship velocity, and the navigator state based on the quaternion ship domain model. As a result, a new dynamic quaternion ship domain model is proposed. To assess the changes in the size and shape of the ship domain under various navigation environments, ship domain scaling and shape transformation functions are introduced. Specifically, this study focuses on analyzing the ship traffic near the Lao Tie Shan Waterway, simulating the size and shape changes of the ship domain during the navigation process in this area. The findings indicate that the size of the ship domain dynamically adjusts to the traffic conditions. Additionally, when the navigator state is excellent, the ship domain takes on an irregular diamond shape with the smallest area, whereas when the navigator state is poor, the shape approximates a rectangle with the largest area. Furthermore, the dynamic quaternion ship domain model proposed in this study is compared to the ship domain models put forth by Goodwin, Davis, and co-authors. The results demonstrate that the dynamic quaternion ship domain model is more compatible and suitable for open waters compared to the static quaternion ship domain model.

Reproduction-mobility trade-off in rock-paper-scissors models in changing environmental conditions

We investigate a tritrophic system in which organisms’ energy depletion, resulting from failed selection attempts, leads to a partial loss of capacity to win the cyclic spatial game. The energy required to maintain optimal organism fitness may be impacted by changes in environmental conditions, increasing the death risk due to accelerated deterioration of health. We simulate the evolutionary behavioural strategy performed by individuals of one species, which consists in balancing efforts dedicated to reproduction and mobility to minimise the chances of death by lack of energy. We show that the unevenness introduced by the trade-off strategy unbalances the rock-paper-scissors model, with the predominant species profiting from enemies’ lower birth rate. Quantifying the spatial patterns, we demonstrate that the characteristic length scale of single-species domains decreases as energy loss accelerates due to environmental changes. The erosion in the spatial patterns provoked by the reproduction-mobility trade-off benefits biodiversity, with coexistence probability rising for faster energy depletion and higher trade-off factors. The findings have implications for ecologists seeking to understand the impact of survival behaviour on biodiversity promotion.

Gamma Knife radiosurgery for the management of glomus jugulare tumors: A systematic review and report of the experience of a radioneurosurgery unit in Latin America.

Glomus jugulare tumors (GJTs) are rare and mainly affect women between the 5th and 6th decades of life. Its localization and anatomic relationships make conventional surgical treatment difficult and with a considerable risk of complications. This manuscript aims to describe the results of Gamma Knife radiosurgery (GKR) in patients with GJT treated in a single center in Latin America, as well as to systematically review the literature to determine the clinical and radiological effectiveness of this technique. A search of information from January 1995 to June 2023 was performed. Twenty-two articles reporting 721 GJT patients treated with GKR were included in the study. Variables such as symptomatic control, control of tumor size, and complications were evaluated. These variables were described using measures of central tendency and proportions. For the institutional experience, 77 patients with GJT tumors were included in the study. Pre-treatment clinical variables and follow-up data were collected from medical charts and phone interviews. The Short Form-36 scale was applied to assess the quality of life. The data were analyzed using the statistical program STATA17.0. A total of 721 patients were considered. The median of patients included in these studies was 18.5. The mean age was 58.4 years. The median of symptom control was 89%, and the median of imaging control was 95.7%. In our institution, 77 patients were included in the study. The mean age was 53.2 years. The median hospital stay was 4.92 hours. For the clinical follow-up, information on 47 patients was obtained. An improvement in pre-treatment symptoms was described in 58%, with general symptomatic control of 97%. The tumor-control rate was 95%, and there were statistically significant differences in six of the nine Short Form-36 scale domains. GKR is an effective, safe, and cost-effective technique that offers a high degree of symptomatic and tumor size control in patients with GJT.

(056) The Association Between Disgust Sensitivity, Sexual Desire, Relationship Satisfaction in Finland

Abstract Introduction Disgust is a basic emotion directed towards certain objects to avoid harm (Angyal, 1941), mainly pathogens. Research, however, has proposed a heterogeneity of disgust beyond pathogen avoidance to generate the functional model, which proposed the functionally distinct domains of disgust: moral, pathogen, and sexual. This model proposes that sexual disgust is an avoidance of sexual contact with unfit partners that may yield unfit offspring (Tybur &amp; de Vries, 2013), this may be due to other anxiety related disorders (Davey, 2011 and Troop et al., 2002) Objective This study focuses on the association between disgust sensitivity with sexual desire, and relationships satisfaction. Hypothesis: elevated levels of disgust sensitivity are negatively associated with sexual desire and relationship satisfaction. Methods Invitation letters were sent out to the registered Finnish population in the Finnish Central Population Registry to participate in a(n) (online) survey, 9,319 individuals responded to the invitation and completed the survey and agreed to participate in the research. The tools used in this study were Perceived Relationship Quality Component (PRQC), Sexual Desire Inventory (SDI), and the Three-Disgust Domain Scale (TDDS). Results The results indicate that the sexual desire and sexual disgust sensitivity, are negatively correlated, the relationship satisfaction correlations are positive except the men pathogen disgust which is a negative correlation between pathogen disgust sensitivity and relationship satisfaction. The correlation between the study variables indicated that among men and women sexual disgust is negatively correlated with sexual desire, and the correlation of relationship satisfaction and sexual disgust was positively correlated. Conclusions The results show the negative association of sexual disgust with sexual desire, but there is a positive relationship between sexual disgust and relationship satisfaction. Disclosure No.

Cross-sectional analyses of factors associated with the presence and aggravation of chronic insomnia by symptom subtypes.

The aim of this study was to investigate the association of psychological and chronobiological factors with the presence and severity of chronic insomnia by symptom subtypes and their impacts on daytime dysfunctions. Participants of the present web-based epidemiological study were classified as follows: difficulty initiating sleep (DIS) (n = 91); difficulty maintaining sleep (DMS) (n = 13); early morning awakening (EMA) (n = 48); DIS + DMS (n = 67); DIS + EMA (n = 23); DMS + EMA (n = 24); triplet of DIS, DMS, and EMA symptoms (TRP) (n = 69); and normal sleepers (n = 4590). The Insomnia Severity Index (ISI), Hospital Anxiety and Depression Scale (HADS), Munich Chronotype Questionnaire (MCTQ), insomnia-related psychological measures (including the Ford Insomnia Response to Stress Test [FIRST] and the Dysfunctional Beliefs and Attitudes about Sleep Scale [DBAS]), and the cognitive and somatic domains of the Pre-Sleep Arousal Scale (PSAS) were evaluated. The presence of DIS and DIS + DMS were significantly associated with an evening preference, and EMA and EMA + DMS with a morning preference, while TRP showed no significant association with either chronotype. The increase in DBAS scores was associated with higher ISI scores in all subtypes. Meanwhile, the associations of each psychological measure varied among insomnia subtypes, with the association of PSAS cognitive arousal to DIS and PSAS somatic arousal to both DMS + EMA and TRP. Pathological HADS score was associated with all subtypes. Chronotypes may be associated with the presence of some insomnia subtypes; however, only psychological factors were speculated to contribute to the aggravation of all subtypes. All insomnia subtypes possibly contribute to the formation of depression.

A close analysis of eight flourishing measures

ABSTRACT Scholarly interest in flourishing has recently burgeoned, leading many scholars to develop measures of flourishing. We closely analyzed the content of eight systematically chosen, prominent inventories of flourishing, thriving, or rich well-being. Some instruments contain subscales, and some consist of lists of items. Therefore, we utilized a set of categories to compare the larger components of the eight inventories based primarily on the domains of the Psychological Well-Being Scales, one of the first modern measures of flourishing. Then we compare items across inventories in the most common components. Despite apparent structural similarity, we argue that flourishing instruments demonstrate significant variation at both the component and the item-levels. This indicates a lack of consensus among flourishing scholars as to what flourishing is, and this absence of consensus may lead to an unnecessarily fragmented research domain. We conclude by advocating for consensus building and addressing what a consensus on flourishing might require.

Local density distribution of confined fermi gas in various nano-scale geometries

This study aims to investigate local density variations of Fermi gases confined in various geometries at the nano-scale, revealing irregularities even in thermodynamic equilibrium. Calculations show that density of the confined gas in a nano scale domain, decreases towards zero near domain boundaries due to a quantum boundary layer linked to the Planck constant. Additionally, Friedel-like density oscillations are observed in nano-confined Fermi gases. Analytical expressions for the local density distribution are derived for degenerate and one-dimensional scenarios, while numerical computations are conducted for complex geometries and weak degeneracy conditions. In line with existing literature, it is understood that the quantum-size effects observed in the global thermodynamic properties of confined gases are attributed to these local irregularities. It becomes evident that in areas smaller than the threshold determined by the quantum boundary layer, the gas empties the part of the domain or reaches lower densities in the considered part relative to other parts of the domain, despite being in thermodynamic equilibrium. The results indicate the potential for gases to benefit from these behaviors and suggest the possibility of designing and manufacturing new nano-scale machines that are not feasible on a macro-scale.

Investigation of the Impact of Wellinks on the Quality of Life and Clinical Outcomes in Patients With Chronic Obstructive Pulmonary Disease: Interventional Research Study.

Wellinks is a remote disease management solution that provides novel chronic obstructive pulmonary disease (COPD) care delivery. This study evaluated the satisfaction, engagement, and clinical outcomes of Wellinks participants. This study also investigated the cadence of health coaching for patients with COPD. A 24-week interventional study was conducted by Wellinks and the COPD Foundation in 2022. Adults with COPD were recruited by the COPD Foundation in the United States and determined to be eligible if they had phone and internet access, owned a smartphone, and were not currently participating in pulmonary rehabilitation. All study participants provided written informed consent. The Wellinks solution included remote health coaching, pulmonary rehabilitation, and group education; participants were provided the Wellinks app and smart spirometry and pulse oximetry devices. Participants were offered 6 coaching sessions in the first 12 weeks. For the second 12-week period, participants either reduced frequency or discontinued coaching; all other components of the Wellinks solution remained unchanged. The COPD Self-Efficacy Scale, Modified Medical Research Council dyspnea scale, pulmonary function, pulse oximetry, and patient-reported healthcare resource utilization were the clinical outcome measures. Nonclinical outcomes included engagement and satisfaction with Wellinks and net promoter score. In total, 141 adults consented and completed Wellinks onboarding; 84.4% (n=119) of whom remained engaged throughout the 24-week study. Participants had a mean age of 70 (SD 7.8; range 48-88) years, and 55.7% (n=78) were female. Most participants (n=119, 84.4%) completed all 6 coaching sessions during the first 12-week period. Compliance with spirometer and pulse oximeter use was 82.3% and 89.4%, respectively, at week 1 but waned over the study period to 8.5% and 9.2%, respectively, at the end of the study. Participants indicated a high degree of satisfaction with Wellinks, with 95.5% (n=85) and 91% (n=81) of participants indicating that they agreed or strongly agreed that the educational content and health coaching, respectively, were valuable. At the end of the study, the net promoter score was +64 and +55 in the coaching continuation and discontinuation arms, respectively. A significant improvement from baseline to end of the study was observed in the COPD Self-Efficacy Scale total score (P<.001) and domain scores (P<.001 for each domain). In total, 35.1% (n=27) of participants improved by at least 1 category of change on the 5-point Modified Medical Research Council dyspnea scale from baseline to week 24. This study confirmed the feasibility of using a remote model of care delivery to support people living with COPD. The insights gained in this study have allowed for further refinement and personalization of the Wellinks care model. Findings related to the combined use of technology and personal care delivery should be considered by others developing remote disease management tools. ClinicalTrials.gov NCT05259280; https://clinicaltrials.gov/ct2/show/NCT05259280.

Validation testing of OUTPATSAT-35RT questionnaire to assess satisfaction in patients on outpatient radiotherapy in a large Indian cohort

ABSTRACT Background: This study reports the psychometric properties of OUTPASAT-35RT questionnaire from a large Indian cancer cohort treated with ambulatory radiotherapy (RT) at a tertiary-care comprehensive cancer center. Materials and Methods: Adults with a pathologically proven diagnosis of cancer undergoing fractionated RT (≥10 fractions) with the ability to read and understand English, Hindi, or Marathi were accrued after written informed consent. Patients were administered a language-appropriate version of OUTPATSAT-35RT along with European Organization for Research and Treatment of Cancer (EORTC) generic quality-of-life questionnaire (QLQ-C30) at conclusion of RT (±3 days). Psychometric properties of OUTPATSAT-35RT were analyzed. Results: A total of 314 patients were accrued between 2018 and 2020. A negligible floor effect (&lt;2%) but a high ceiling effect (&gt;15%) was observed for OUTPATSAT-35RT. Multi-trait analysis revealed satisfactory validity and reliability of the questionnaire. Pearson’s correlation coefficient (PCC) of individual item score with own scale was &gt;0.4 suggesting good convergent validity. Discriminant validity was satisfactory as the PCC with its own scale/own domain was greater than with other scales of the same domain and other domains of OUTPATSAT-35RT, respectively. Correlation of scales of OUTPATSAT-35RT with scales of QLQ-C30 demonstrated acceptable divergent validity (all values of PCC &lt;0.3). Cronbach’s alpha was &gt;0.7 suggesting good internal consistency. Test–retest reliability was good with intra-class coefficient being &gt;0.7. Economic status was the only socio-demographic factor correlating significantly with OUTPATSAT-35RT scores; satisfaction of patients with the delivery of care increased with increasing family income. Conclusion: The psychometric properties of OUTPATSAT-35RT were found to be acceptable and satisfactory during validation testing in a large Indian cohort.

Temperature Effect Separation of Structure Responses from Monitoring Data Using an Adaptive Bandwidth Filter Algorithm.

Temperature is one of the most important factors significantly affecting damage detection performance in civil engineering. A new method called the Adaptive Bandwidth Filter Algorithm (ABFA) is proposed in this paper to separate the temperature effect from quasi-static long-term structural health monitoring data. The Adaptive Bandwidth Filter Algorithm (ABFA) is referred to as an algorithm of automatically adjusting the frequency bandwidth filter via the particle swarm optimization (PSO) algorithm. Considering the obvious multi-scale feature of the collected data of civil structure, the acquired time series are divided into different time scales (for example, day, month, year, etc.), and these scales in the frequency domain correspond to the center frequencies of the adaptive bandwidth filter. The temperature effect on structure responses across different time scales is thereafter explored by adaptively adjusting the frequency bandwidth of the filter based on the known center frequencies of different scales. The relationship between the temperature and the structure responses is established through statistical regression facilitated by sufficient in situ monitoring data. Simulation and experiment results show the very promising performance of the proposed algorithm and decouple the temperature effect accurately from the contaminated data; thus an enhanced capability of damage detection is achieved.

The Effect of Social Isolation on 1-Year Outcomes After Surgical Repair of Low-Energy Hip Fracture.

To evaluate whether social isolation or loneliness is associated with outcomes 1 year after low-energy hip fracture. Prospective inception cohort study. Academic level I trauma center. Participants were 65 years or older and enrolled 2-4 days after surgery for a first low-energy hip fracture. Exclusion criteria were bilateral or periprosthetic hip fracture, previous hip fracture, non-English speaking, international address, active cancer, stage 4 cancer in the past 5 years, radiation to the hip region, and cognitive impairment. Participants were followed longitudinally for 1 year. The patient-reported outcomes measurement information system (PROMIS)-29 was elicited 2-4 days postoperatively and 1 year later. Patient-reported risk factors included the Lubben Social Networks Scale and the University of California, Los Angeles Loneliness Scale, which were compared with the lower extremity activity scale and PROMIS-29 domains. Three hundred and twenty-five patients were enrolled. Participants had a median age of 81.7 years, were 70.9% female, and were 85.9% White. In total, 31.6% of patients were socially isolated at the time of fracture. At 1 year, 222 of the 291 subjects who were confirmed alive at 1 year provided data. Multivariable linear models were performed separately for each outcome, including lower extremity activity scale and PROMIS-29 domains. Controlling for age, sex, education, and body mass index, those who were socially isolated at the time of fracture had worse PROMIS-29 function (β = -3.83; P = 0.02) and ability to participate in social roles (β = -4.17; P = 0.01) at 1 year. Secondary analyses found that prefracture loneliness was associated with clinically meaningfully worse function, anxiety, depression, fatigue, sleep, pain, and ability to participate in social roles at 1 year (all P < 0.01). Prefracture social isolation was associated with worse outcomes 1 year after surgical repair of low-energy hip fracture. These data suggest loneliness may be more strongly associated with important patient-centric metrics than prefracture social isolation. Given the dearth of modifiable risk factors in this population, future studies are needed to evaluate whether improving social connections could affect outcomes in this rapidly growing demographic. Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.

Exploring concurrent validity of the CLN2 Clinical Rating Scale: Comparison to PedsQL using cerliponase alfa clinical trial data.

The CLN2 Clinical Rating Scale evaluates disease progression in CLN2 disease, an ultra-rare, neurodegenerative disorder with late infantile onset. To validate the Clinical Rating Scale, a comparison with the Pediatric Quality of Life Inventory (PedsQL) was conducted utilising clinical trial data investigating cerliponase alfa use in CLN2 disease. Linear regression and mixed effects models were used to investigate the relationship between the Clinical Rating Scale and PedsQL using open-label, single-arm, phase 1/2 (NCT01907087) and ongoing extension study (NCT02485899) data of 23 children with CLN2 disease treated with cerliponase alfa for ≥96 weeks. Correlations between the four Clinical Rating Scale domains were low. Linear mixed effects analyses showed significant correlation between PedsQL and Clinical Rating Scale (Total score or motor-language [ML] score adjusted p-values <0.05), driven by the relationship with the PedsQL Physical domain. A statistically significant relationship was identified between the Clinical Rating Scale motor domain and PedsQL (Total score: adjusted p-value = 0.048, parameter estimate [PE] = 8.10; Physical domain score: adjusted p-value = 0.012; PE = 13.79). Each domain of the Clinical Rating Scale provides unique information on disease state. Validity of the scale is supported by its relationship with the PedsQL. Among the four domains of the Clinical Rating Scale, motor has the highest correlation to PedsQL, suggesting motor function as a driver of patients' quality of life. The lack of association between the remaining domains of the Clinical Rating Scale and PedsQL suggests that additional disease-specific measures may be needed to fully capture the quality of life impact of CLN2 disease. NCT01907087, NCT02485899.

Prevalence and associated risk factors of carpal tunnel syndrome among orthopedic surgeons working in Riyadh, KSA

Objective: This study aimed to investigate the prevalence of carpal tunnel syndrome (CTS) and its associated risk factors among orthopedic surgeons working in Riyadh, Saudi Arabia. Methods: This cross-sectional study was conducted among orthopedic surgeons working in multiple hospitals in Riyadh, Saudi Arabia. The data were collected from the participants through Boston Carpal Tunnel Syndrome Questionnaire (BCTQ). Results: This study enrolled 151 orthopedic surgeons. Around 39.1% were aged between 25 and 29 years old, with males being dominant (88.1%). And 39.7% were overweight (25 – 29.9 kg/m2). Most of them were right-handed (93.4%). The prevalence of surgeons who were diagnosed with CTS was 3.3%. Around 20.5% were consultant surgeons with 57.6% had 1 to 5 years of experience and 55.6% had 5 or less performed surgeries per week. The overall mean score of the Symptom Severity Scale (SSS) domain was 13 (SD 4.12), with 62.3% considered as having no symptoms. Regarding the Functional Status Scale (FSS) domain, the total mean score was 8.38 (SD 1.49), with nearly all categorized as no difficulty (83.4%). It was observed that increasing SSS score was associated with increasing BMI level (Z=2.164; p=0.030) and performing arthroscopic procedures (Z=2.653; p=0.008), while a higher FSS score was more associated with conducting arthroscopic procedures (Z=1.438; p=0.021) Conclusion: The prevalence of mild to severe CTS symptoms among orthopedic surgeons was 37.7%. Increased severity was more prevalent among surgeons with elevated body mass index, while those regularly dealing with arthroscopic procedures had increased symptom severity and functional difficulties.

Effect of ionic groups on the morphology and transport properties in a novel perfluorinated ionomer containing sulfonic and phosphonic acid groups: a molecular dynamics study.

Combining the phosphonic acid group with the sulfonic acid group in PEMs has been shown to be an effective strategy for improving the fuel cell performance. However, the interplay of two different ionic groups and the resulting effect on the membrane properties have not been fully elucidated. Here, we used classical molecular dynamics simulation to investigate the morphologies, transport properties and effects of ionic groups in a novel perfluorinated PEM containing two ionic groups (PFSA-PFPA) in comparison to the corresponding homopolymers. Phase separations between hydrophilic and hydrophobic domains are confirmed in these PEMs and result from the evolution of water clusters formed around the ionic groups. The combination of both ionic groups brings a complicated morphological feature in PFSA-PFPA, with near-cylindrical aqueous domains of large length scales interconnected by tortuous domains of small sizes. And we found that the self-diffusion coefficients of water molecules are strongly related to morphologies, with the water transport in PFSA-PFPA lying between two analogous homopolymers. At the molecular level, we found that the sulfonic and phosphonic acid groups have distinct effects on the coordination behaviors and the dynamics of water molecules and hydronium ions. Strong electrostatic interactions lead to compact coordination structures and sluggish dynamics of hydronium ions around phosphonic acid groups, which determine the morphological evolution and transport properties in PFSA-PFPA. Our study affords insights into the relationship between molecular characteristics and transport properties bridged by phase-separated morphologies in a novel PEM containing both sulfonic acid and phosphonic acid groups, which deepens the understanding of the interplay between two ionic groups and may inspire the rational design of high-performance PEMs.

Assessing the Impact of Oral Disorders on the Oral Health-Related Quality of Life of Preschool Children and their Families: A Cross-sectional Study

Introduction: Oral disorders such as Traumatic Dental Injury (TDI) and Early Childhood Caries (ECC) can significantly impact the functional, social, and psychological well-being of growing children and their families. The Early Childhood Oral Health Impact Scale (ECOHIS) serves as a proxy assessment of Oral Health-Related Quality of Life (OHRQoL) in children, developed to evaluate the effects on the quality of life of preschool children. Aim: To assess the impact of oral disorders on the OHRQoL of children aged two to six years and their families. Materials and Methods: In this cross-sectional study, a total of 1000 children aged 2 to 6 years from various preschools in South Bangalore were selected. All children underwent examinations for caries, stains, and fractures. A modified questionnaire survey based on ECOHIS, consisting of 26 questions, was completed by the parents of the children. The answered questionnaire was then evaluated to assess the impact of dental conditions on the quality of life of both children and parents. Kruskal-Wallis Test, Dunn’s post-hoc Test, and Mann-Whitney Test were used to compare the mean scores of different domains of the OHRQoL scale based on ECC and dental trauma, respectively. Results: The severity of ECC demonstrated an adverse effect on the symptom domain (p&lt;0.001), function domain (p=0.002), psychology domain (p=0.03), and the entire score of the Child Impact Section (CIS) (p&lt;0.001). In the Family Impact Section (FIS), the mean scores of the family distress domain and the overall FIS were statistically significant (p&lt;0.001). Dental trauma also showed an adverse effect on the symptoms domain (p&lt;0.001) and the entire scores of the CIS (p=0.001). Additionally, the mean scores of the family distress domain and the overall FIS were statistically significant (p&lt;0.001). Conclusion: The presence of ECC and dental trauma is likely to have a negative impact on the physical, psychological, and emotional well-being of preschool-aged children and their families.