Scoring Criteria Research Articles

ChatGPT-3.5 Responses Require Advanced Readability for the General Population and May Not Effectively Supplement Patient-Related Information Provided by the Treating Surgeon Regarding Common Questions About Rotator Cuff Repair

The purpose of this study was to investigate the accuracy of ChatGPT's responses to frequently asked questions (FAQ) prior to rotator cuff repair surgery. The ten most common FAQs related to rotator cuff repair were compiled from four institution websites. Questions were then input into ChatGPT-3.5 in one session. The provided ChatGPT-3.5 responses were analyzed by two orthopedic surgeons for reliability, quality, and readability using The Journal of the American Medical Association (JAMA) Benchmark criteria, the DISCERN score, and the Flesch-Kincaid Grade Level. The JAMA Benchmark criteria score was 0, indicating the absence of reliable source material citations. The mean Flesch-Kincaid Grade Level was 13.4 (range, 11.2-15.0). The mean DISCERN score was 43.4 (range, 36-51) indicating that the quality of the responses overall was considered fair. All responses cited making final decision-making to be made with the treating physician. ChatGPT-3.5 provided substandard patient-related information in alignment with recommendations from the treating surgeon regarding common questions around rotator cuff repair surgery. Additionally, the responses lacked reliable source material citations and the readability of the responses was relatively advanced with a complex language style. The findings of this study suggest that ChatGPT-3.5 may not effectively supplement patient-related information in the context of recommendations provided by the treating surgeon prior to rotator cuff repair surgery.

Apgar score comprehension in clinical practice: A cross-sectional study of healthcare professionals in Dhaka, Bangladesh

Introduction: The Apgar score is a critical tool for assessing the health of newborns immediately after birth, with implications for immediate clinical care decisions. Despite its established importance, variations in the comprehension and application of the Apgar score among healthcare professionals can significantly affect neonatal outcomes. Objective: This cross-sectional study aimed to assess the comprehension and application of the Apgar score among healthcare professionals in Dhaka, Bangladesh, to identify gaps in knowledge and practice that could impact neonatal care outcomes. Methods: Conducted between September and December 2022 at a tertiary medical college and hospital in Dhaka, this study involved 80 nurses from the labor room, selected through purposive sampling. Data were collected via face-to-face interviews using a pre-tested semi-structured questionnaire, with knowledge assessed on a 24-point scale and categorized as good (>15) or poor (<15). Statistical analysis was performed using SPSS 26.0. Results: Most respondents (31.78% aged 27-33 years and 32.63% aged 34-39 years) were nursing college graduates (40.69%). A significant knowledge gap was identified, with only 25.33% demonstrating a good level of understanding of the APGAR score. Notable discrepancies were found in the recognition of the Apgar score's components, criteria, and clinical implications. Educational level significantly influenced Apgar score knowledge (p=0.046), with nursing college graduates showing greater understanding. Recent training appeared to impact knowledge positively, suggesting the need for continuous professional development. Conclusion: The study highlights a concerning gap in the understanding and application of the Apgar score among healthcare professionals in Dhaka, emphasizing the need for enhanced neonatal care education and training. Addressing these gaps through comprehensive educational programs and continuous professional development is crucial for improving neonatal assessment practices and outcomes in Bangladesh.

The study of outcome in fractures of proximal third of tibia in adults treated by expert tibia nail

This study aims to evaluate the clinical, functional outcome and complications of fracture proximal third of tibia treated with expert tibia nail in terms of radiological union, functional outcomes by short form -36 (SF-36) score, Johner and Wruhs criteria, visual analogue score and patient satisfaction score. Twenty-five patients with fracture proximal third of tibia treated with expert tibia nail in SNMC and HSK hospital and research centre, Bagalkot were enrolled in this study. The radiological union was assessed by plain radiograph and functional outcome by SF-36 score, Johner and Wruhs criteria, visual analogue score and patient satisfaction score. The radiological union was achieved in all the patients between 14 to 26 weeks duration (mean of 19.6±2.82 weeks). The mean SF-36 score was 84.9±4.06 and the mean visual analogue score was 2±1.78 at the 22nd week of follow-up. Results based on Johner and Wruhs criteria, 17 patients had excellent, 6 had good, 1 had fair and 1 had poor results. The average patient satisfaction score was 8.88 out of 10. There were 8 cases of post-operative knee pain, 5 cases of infection, 2 cases of malunion, 1 case of shortening and 1 case of the delayed union in our study. Intramedullary fixation with expert tibia nail for fracture proximal third tibia is a safe and less invasive technique. The radiological union was achieved in all the cases. This technique ensures excellent functional outcomes and a low incidence of complications.

Treatment and Outcome of Supracondylar Humeral Fractures in Children Over 10 Years of Age at the Time of Injury: A Review of 60 Cases.

To assess the treatment and outcomes of supracondylar humeral fractures (SHFs) in children older than 10 years of age at the time of injury. The study analyzed clinical data from 60 patients who sustained SHF, all over the age of 10 years, were analyzed. The patients included 49 males and 11 females with a mean age of 10.9 ± 0.9 years (range, 10 to 14.5). All patients underwent surgical treatment under general anesthesia. Closed reduction (CR) and percutaneous fixation were the primary treatment, with open reduction and internal fixation being employed only in cases CR was unsuccessful. The study assessed the healing of fractures by measuring the radiographic angles, including the carrying angle (RCA), Baumann's angle (BA), and metaphyseal-diaphyseal angle (MDA) on anteroposterior radiographs of the elbow joint. In addition, the study evaluated whether the anterior humeral line (AHL) appropriately passed through the middle third of the capitellum. The final follow-up visit used the Mayo Elbow Performance Index score (MEPI) and Flynn's criteria to analyze the recovery of elbow function. There were 15 (25%) SHF type II, 17 (28.3%) type III and 28 (46.7%) type IV. Of the 60 patients, 56 (93.3%) underwent successful CR, whereas 4 (6.7%) required open reduction and internal fixation because of an unsuccessful CR. The final follow-up showed the average BA as 72° ± 5.3°, the average MDA as 88.3° ± 2.8°, and the average RCA as 9.6° ± 3.9°. The AHL bisected accurately the capitellum in 59 cases (98.3%). The average range of elbow flexion-extension was 146.6° ± 8.6°, whereas the average MEPI score was 99.9 ± 0.6; 98.3% (n=59) were rated as excellent and 1.7% (n=1) were rated as good. According to Flynn's criteria, 86.7% had an excellent outcome (n=52), 10% had a good outcome (n=6), and 3.3% had a poor outcome (n=2). Only 1 patient (1.7%) experienced redisplacement. Eight cases of nerve injury were reported, with 7 involving the radial nerve and 1 involving the ulnar nerve; all resolved spontaneously. CR and percutaneous fixation have been shown to be effective in treating SHF in 93.3% of children aged 10 years old and older at the time of injury, with favorable radiographic and functional outcomes and a low risk of secondary displacement. Open reduction should only be considered when CR is ineffective.

Gesture Scoring Based on Gaussian Distance-Improved DTW

The power industry has been dedicated to applying virtual reality (VR) technology to build training systems in virtual environments, enabling personnel to complete skill training in real simulated environments while ensuring their safety. Conventional action scoring systems struggle to provide accurate scores for fine movements. Accurate scoring of fine movements can help workers identify their shortcomings during power operations, thus improving learning efficiency. This is of great significance for training on virtual environment-based power operation. This paper proposes a power operation-orientated VR action evaluation method based on the Gaussian distance-improved dynamic time warping (DTW) algorithm and the temporal convolutional network (TCN) model. First, the adaptive adapter is used to extract one-dimensional features from the three-dimensional data of the data gloves. Then, based on the TCN model, action data with significant discrepancies are filtered out. Finally, the obtained data are input into the Gaussian distance-improved DTW algorithm, where the path size is calculated. Corresponding scoring criteria are established on the basis of the path size to evaluate the actions. The results demonstrate that the VR action evaluation method based on the Gaussian distance-improved DTW algorithm and the TCN model significantly improves the accuracy of evaluating fine movements compared to traditional evaluation algorithms.

Wrist Circumference Cutoff Points for Determining Excess Weight Levels and Predicting Cardiometabolic Risk in Adults.

(1) Background: An elevated wrist circumference may indicate excess weight and cardiometabolic risk. The present study aims to identify wrist circumference cutoff points (WrC) to determine excess weight levels and predict cardiometabolic risk in adults. (2) Methods: A cross-sectional study was conducted with adults aged 20 to 59 years old, attending the outpatient clinic at University Hospital/Federal University of Sergipe HU/UFS-EBSERH. Demographic, anthropometric, biochemical, and blood pressure (BP) data were collected. Cardiometabolic risk was assessed, according to the global risk score (ERG) and Framingham score criteria. The descriptive analysis included calculating medians and frequencies of anthropometric, demographic, biochemical, and blood pressure variables. The gender and age of adult groups were compared using the Mann-Whitney test. Spearman's correlation coefficient and multiple regression analysis were used to assess the association between wrist circumference (WrC) and the variables mentioned above. The predictive validity of WrC in identifying excess weight levels and cardiometabolic risk was analyzed using the ROC curve. The sample consisted of 1487 adults aged 20 to 59 years, 55.7% of whom were female; (3) Results: WrC correlated positively with other adiposity indicators such as waist circumference and Body Mass Index. WrC was the anthropometric indicator most significantly associated with cardiometabolic risk factors. WrC cutoff points identified by the study for determining excess weight were categorized by gender and age group. For males aged 20 to 40 years and >40 years, respectively, the cutoff points for overweight were 17.1 cm and 17.3 cm, and for obesity, 17.9 cm and 17.5 cm. For females aged 20 to 40 years and >40 years, respectively, the cutoff points for overweight were 15.6 cm and 15.4 cm, and for obesity, 16.1 cm and 16 cm (4). Conclusions: Wrist circumference showed a significant correlation with other adiposity indicators and can be used to identify adults with excess weight and predict cardiometabolic risk.

Acetabular Fracture Outcomes and Complications: An International Comparison

Introduction While there have been many technological advances in the treatment of acetabular fractures since the landmark article by Judet and Letournel, the effectiveness of many of these advances have not been definitively determined. Comparing patient outcomes between two countries with differing amounts of technological resources may identify the efficacy of such resources. Methods This study retrospectively compared 489 patients (373 US, 116 Romania) who underwent open reduction and internal fixation (ORIF) for acetabular fracture(s) in a Romanian trauma center and a United States (US) trauma center between February 2011 and August 2018. Results US patients had a higher rate for the following comorbidities: diabetes (p=.0268), obesity (p<.0001), and hypertension (p<.0001). US patients had a significantly shorter pre-op delay (p<.0001). Matta’s criteria for initial quality of reduction did not vary significantly between countries (p=.1101). No significant difference was found in rates of DVT (p=.0722), postoperative infections (p=.2819), sciatic nerve lesions (p=.9999), or loss of reduction (p=.9999). US patients had significantly higher Brooker criteria scores for heterotopic ossification (p<.0001). Conclusions There were no significant differences in outcomes between US and Romanian patients even though US patients received treatment using the latest technology while Romanian patients were treated using substantially fewer resources. Given that technological advances in surgical technique come at a considerable price, it makes sense to build upon this study to gain a more precise understanding of how these advances improve outcomes for patients, and whether or not they are worth the added cost.

Spontaneous intracranial hypotension: Exploring the viability of non-contrast FLAIR as a substitute for contrast-enhanced T1WI in assessing pachymeningeal thickening.

To avoid contrast administration in spontaneous intracranial hypotension (SIH), some studies suggest accepting diffuse pachymeningeal hyperintensity (DPMH) on non-contrast fluid-attenuated inversion recovery (FLAIR) as an equivalent sign to diffuse pachymeningeal enhancement (DPME) on contrast-enhanced T1WI (T1ce), despite lacking thoroughperformance metrics. This study aimed to comprehensively explore its feasibility. In this single-center retrospective study, between April 2021 and November 2023, brain MRI examinations of 43 patients clinically diagnosed with SIH were assessed using 1.5 and 3.0 Tesla MRI scanners. Two radiologists independentlyassessed the presence or absence of DPMH on FLAIR and DPME on T1ce, with T1ce serving as a gold-standard for pachymeningeal thickening. The contribution of the subdural fluid collections to DPMH was investigated with quantitative measurements. Using Cohen's kappa statistics, interobserver agreement was assessed. In 39 out of 43 patients (90.7%), pachymeningeal thickening was observed on T1ce. FLAIR sequence produced an accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 72.1%, 71.8%, 75.0%, 96.6%, and 21.4% respectively, for determining pachymeningeal thickening. FLAIR identified pachymeningeal thickening in 28 cases; however, among these, 21 cases (75%) revealed that the pachymeningeal hyperintense signal was influenced by subdural fluid collections. False-negative rate for FLAIR was 28.2% (11/39). The lack of complete correlation between FLAIR and T1ce in identifying pachymeningeal thickening highlights the need for caution in removing contrast agent administration from the MRI protocol of SIH patients, as it reveals a major criterion (i.e., pachymeningeal enhancement) of Bern score.

Effect of electroacupuncture on proBDNF/mBDNF and synaptic plasticity in rats with learning and memory impairment after cerebral ischemia-reperfusion.

To observe the effect of electroacupuncture (EA) at "Baihui" (GV20) and "Shenting" (GV24) on the rats' behavior and the transforming precursor of brain-derived neurotrophic factor (proBDNF) into mature brain-derived neurotrophic factor (mBDNF) in the hippocampus of rats with learning and memory impairment induced by cerebral ischemia-reperfusion (IR), so as to explore its mechanisms underlying improvement of learning and memory ability. SD rats were randomly divided into blank, sham operation, model, and EA groups, with 6 rats in each group. The model of IR was established by occlusion of the middle cerebral artery. EA (1 Hz/20 Hz) was applied to GV24 and GV20 for 30 min, once daily for 14 days. The neurological function was evaluated according to the Zea Longa's score criteria 24 h after modeling and after intervention. Morris water maze test was used to detect the learning and memory function of the rats. TTC staining was used to evaluate the cerebral infarction volume on the affected side. The protein expression levels of proBDNF, mBDNF, tissue plasminogen activator (tPA), tyrosine kinase receptor B (TrkB) and p75 neurotrophin receptor (p75NTR) in hippocampal tissue were detected by Western blot. Compared with the sham operation group, the neurological function score, the percentage of cerebral infarction volume and the expression levels of proBDNF and p75NTR protein in hippocampus were increased (P<0.01), while the times of crossing the original platform and the total distance in the target quadrant, the expression levels of mBDNF, TrkB and tPA protein and the ratio of mBDNF/proBDNF were decreased (P<0.01, P<0.05) in the model group. Compared with the model group, the neurological function score, the percentage of cerebral infarction volume, and the expression levels of proBDNF and p75NTR protein in hippocampus were decreased (P<0.01, P<0.05), while the times of crossing the original platform, the total distance in the target quadrant, and the expression levels of mBDNF, TrkB and tPA protein and the ratio of mBDNF/proBDNF were increased (P<0.05, P<0.01) in the EA group. EA can alleviate learning and memory impairment in IR rats, which may be related to its function in up-regulating the expression of tPA protein and promoting the transformation of proBDNF to mBDNF, thus improving the synaptic plasticity.

To develop a prognostic model for neoadjuvant immunochemotherapy efficacy in esophageal squamous cell carcinoma by analyzing the immune microenvironment.

The choice of neoadjuvant therapy for esophageal squamous cell carcinoma (ESCC) is controversial. This study aims to provide a basis for clinical treatment selection by establishing a predictive model for the efficacy of neoadjuvant immunochemotherapy (NICT). A retrospective analysis of 30 patients was conducted, divided into Response and Non-response groups based on whether they achieved major pathological remission (MPR). Differences in genes and immune microenvironment between the two groups were analyzed through next-generation sequencing (NGS) and multiplex immunofluorescence (mIF). Variables most closely related to therapeutic efficacy were selected through LASSO regression and ROC curves to establish a predictive model. An additional 48 patients were prospectively collected as a validation set to verify the model's effectiveness. NGS suggested seven differential genes (ATM, ATR, BIVM-ERCC5, MAP3K1, PRG, RBM10, and TSHR) between the two groups (P < 0.05). mIF indicated significant differences in the quantity and location of CD3+, PD-L1+, CD3+PD-L1+, CD4+PD-1+, CD4+LAG-3+, CD8+LAG-3+, LAG-3+ between the two groups before treatment (P < 0.05). Dynamic mIF analysis also indicated that CD3+, CD8+, and CD20+ all increased after treatment in both groups, with a more significant increase in CD8+ and CD20+ in the Response group (P < 0.05), and a more significant decrease in PD-L1+ (P < 0.05). The three variables most closely related to therapeutic efficacy were selected through LASSO regression and ROC curves: Tumor area PD-L1+ (AUC= 0.881), CD3+PD-L1+ (AUC= 0.833), and CD3+ (AUC= 0.826), and a predictive model was established. The model showed high performance in both the training set (AUC= 0.938) and the validation set (AUC= 0.832). Compared to the traditional CPS scoring criteria, the model showed significant improvements in accuracy (83.3% vs 70.8%), sensitivity (0.625 vs 0.312), and specificity (0.937 vs 0.906). NICT treatment may exert anti-tumor effects by enriching immune cells and activating exhausted T cells. Tumor area CD3+, PD-L1+, and CD3+PD-L1+ are closely related to therapeutic efficacy. The model containing these three variables can accurately predict treatment outcomes, providing a reliable basis for the selection of neoadjuvant treatment plans.

P014 Treatment response in psoriatic arthritis: a comparison between the disease activity scores psoriatic arthritis response criteria and disease activity score-28

Abstract Background/Aims Despite NICE guidelines recommending the use of the PsA response criteria (PsARC), to assess response to biologic therapies in patients with psoriatic arthritis (PsA), some clinicians use the Disease Activity Score (DAS-28) criteria, developed for rheumatoid arthritis. However, whether the two scores are interchangeable and/or capture similar information has not yet been explored. Here, we investigate the differences and overlap between these two disease activity scores, in identifying good/poor responders, in PsA. Methods Utilising treatment response data from the OUTPASS cohort; a UK based multi-centre observational study, PsA patients assessed with PsARC and DAS-28 scores were calculated at baseline (pre-treatment), 3-months and 6-months (3M),(6M), following treatment, where available. EULAR good/moderate response was combined and compared with PsARC responder status. Subgroup analysis of patients with both PsARC and DAS-28 scores at either 3M or 6M, were tested for agreement using the Cohen’s Kappa test. Statistical tests were also used, as appropriate, to investigate differences between the baseline subcomponents, in the observed concordant and discordant data. Results Response data from 418 patients was available. An average of 76% were classified as responders according to PsARC, and 80% according to the EULAR response criteria, for both 3M and 6M, with 12% discordance. A subgroup analysis of 218 patients assessed with both scores, (up to 6M), revealed 17.9% responder discordance between PSARC and DAS-28, and 82.1% concordance. The Cohen’s Kappa test defined the assessment of responder/non-responder outcome, as an ‘almost perfect agreement’ (0.82) between the two criteria. Further statistical analyses, of baseline subcomponents, of both response criteria, between these discordant/concordant subsets, showed no significant difference, except for PsARC Physician’s and Patient’s Global Assessments (PhGA), (PGA), (P = 0.01, P = 0.02, Table 1). Conclusion PsARC and EULAR response criteria show ‘almost perfect agreement’, strongly supporting clinical use for either score. PhGA, (not a subcomponent of DAS-28) and PsARC PGA were the only significantly different (P &amp;lt; 0.05) components between the discordant and concordant groups, highlighting the importance of considering psychosocial factors which may affect pain tolerance and treatment response. Comparative analyses with other widely used scores, such as DAPSA, would also be informative for future work. Disclosure K. Patel: Grants/research support; This project has received support from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No 101007757 (HIPPOCRATES), the JU receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA, the results reflect only the author's view and the JU are not responsible for any use that may be made of the information it contains.. N. Nair: None. M. Jani: None. H. Chinoy: Consultancies; H.C. has received Consulting for PTC Therapeutics. Member of speakers’ bureau; H.C. has received fees as a speaker for GSK, UCB. Other; H.C. for Advisory Board member for Astra Zeneca, Pfizer, Argenx, Galapagos; Data and Science Monitoring Board chair for Horizon Therapeutics. J. Bluett: Grants/research support; J.B. has received a research grant award from Pfizer and travel/conference fees from UCB, Fresenius Kabi, Pfizer and Eli Lilly. (Pfizer: WI239449). A. Barton: Grants/research support; A.B. has received research grants from Bristol Myers Squibb and Pfizer and speaker fees from Galapagos.. P. Curry: None.

The Potential of ChatGPT for High-Quality Information in Patient Education for Sports Surgery.

Artificial intelligence (AI) advancements continue to have a profound impact on modern society, driving significant innovation and development across various fields. We sought to appraise the reliability of the information offered by Chat Generative Pre-Trained Transformer (ChatGPT) regarding diseases commonly associated with sports surgery. We hypothesized that ChatGPT could offer high-quality information on sports-related diseases and be used in patient education. On September 11, 2023, specific sports surgery-related diseases were identified to ask ChatGPT-4 (personal communication, March 4, 2023). The informative texts provided by ChatGPT were recorded by a non-observer senior orthopedic surgeon for this study. Ten texts provided by ChatGPT related to sports surgery diseases were evaluated blindly by two observers. Observers assessed and scored these texts based on the sports surgery-specific scoring (SSSS) and DISCERN criteria. The precision of the disease-related information offered by ChatGPT was evaluated. The calculated average DISCERN score of the texts in the study was 44.75 points and the average SSSS score was 13.3 points. In the interclass correlation coefficient analysis of the measurements made by the observers, the agreement was found to be excellent (0.989; p < 0.001). ChatGPT has the potential to be used in patient education for sports surgery-related diseases. The potential to provide quality information in this regard seems to be an advantage.

Inactivation kinetic parameters of hydrogen peroxide application in commercial sterility of aseptic processing systems

Hydrogen peroxide (H2O2) is a commonly used sterilant for aseptic processing and packaging systems. Surrogate bacterial spores are commonly used for the microbiological validation of the sterilization process. However, limited information is available on the resistance of these surrogate spores in liquid H2O2 (LHP) and vapor H2O2 (VHP). This study aims to fill the gaps in understanding of microbial inactivation parameters and the impact of temperature on VHP effectiveness. 35 % LHP experiments were conducted at temperatures ranging from 25 to 70 °C, while VHP tests were performed using vaporized sterilant technology (VST) and temperatures ranging from 43.3 to 60 °C. Exposure times ranged from 1 to 18 s, and VHP concentrations of 2500 and 4450 PPM were used while maintaining a relative humidity of 0.5%. The model performance of the log-linear and Weibull model was assessed using Root Mean Square Error (RMSE), the sum of the square, and Akaike Information Criterion (AIC) scores. The Weibull model outperformed the log-linear model in terms of parameter estimation and statistical indices.

Evaluating the impact of ELSO guideline adherence on favorable neurological outcomes among patients requiring extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest

AimSelecting the appropriate candidates for extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) is challenging. Previously, the Extracorporeal Life Support Organization (ELSO) guidelines suggested the example of inclusion criteria. However, it is unclear whether patients who meet the inclusion criteria of the ELSO guidelines have more favorable outcomes. We aimed to evaluate the relationship between the outcomes and select inclusion criteria of the ELSO guidelines. MethodsWe conducted a post-hoc analysis of a multicenter prospective study conducted between 2019 and 2021. Adult patients with OHCA treated with ECPR were included. The primary outcome was a favorable neurological outcome (Cerebral Performance Category of 1 or 2) at 30 days. An ELSO criteria score was assigned based on four criteria: (i) age < 70 years; (ii) witness; (iii) bystander CPR; and (iv) low-flow time (<60 min). Subgroup analysis based on initial cardiac rhythm was performed. ResultsAmong 9,909 patients, 227 with OHCA were included. The proportion of favorable neurological outcomes according to the number of ELSO criteria met were: 0.0% (0/3), 0 points; 0.0% (0/23), 1 point; 3.0% (2/67), 2 points; 7.3% (6/82), 3 points; and 16.3% (7/43), 4 points. A similar tendency was observed in patients with an initial shockable rhythm. However, no such relationship was observed in those with an initial non-shockable rhythm. ConclusionPatients who adhered more closely to specific inclusion criteria of the ELSO guidelines demonstrated a tendency towards a higher rate of favorable neurological outcomes. However, the relationship was heterogeneous according to initial rhythm.

Diagnosis and presenting features of autoimmune hepatitis at a central referral hospital in South Africa.

Introduction Autoimmune hepatitis (AIH) has scarcely been reported on in patients of black African descent. Similarly, few studies have focused on the relationship between AIH and Human-Immunodeficiency Virus (HIV) infection. Aim We aim to describe the presenting features of AIH from a single referral centre in a Sub-Sahara African setting. We also compare the presenting features of HIV-infected and HIV-uninfected patients. Methods This study was a retrospective chart review. Patients were included if they fulfilled criteria for the International AIH Group simplified score for probable or definite AIH, were 18 years or older at inclusion, and attended the adult Gastroenterology clinic at Inkosi Albert Luthuli Central Hospital (IALCH) for the period 1/1/2015 to 31/12/2020 on at least 2 occasions. Results Forty cases were included, of which 33 (82.5%) were female and 33 (82.5%) were black African. Median age at diagnosis was 26 years. A diagnosis of a coexistent autoimmune disease was made in 22.5% of patients, with Systemic Lupus Erythematosus (SLE) being the most common (12.5%). Sixteen patients were HIV-infected, all of whom were female (p =0.03), with a significantly older age of disease onset as compared to their HIV-uninfected counterparts (median age 38 vs 17.5 years, p <0.001). Conclusion AIH is a disease most commonly affecting young females. Female sex and older age of onset is associated with AIH in HIV-infected individuals.

Association between morphological features in the cochlear promontory and mastoid Process: Implications for Identifying middle ear diseases in human skeletal remains

Infectious Middle Ear Disease (IMED) is a group of infections that frequently afflict individuals across all age groups worldwide. Although in today’s clinical practice IMED is efficiently managed, in the past it probably caused severe complications (e.g., hearing loss, balance problems, and facial nerve paralysis), heavily impacting the everyday life of many people. However, despite the valuable insights that studying ear infections in the past can bring, bioarcheology presently lacks a standardized methodology to assess their prevalence in skeletal populations. This can lead to several issues, including incomparability of results, difficulties in replications, and methodological biases.Recently, straightforward and accessible criteria for the observation of the cochlear promontory were presented to successfully assess IMED on skeletal remains. Yet, as otologists rarely examine the impact of ear infections on the bony structures of the middle ear, the results were not supported clinically, and could therefore not be validated. To fill this gap, we propose a study in which computed tomography (CT) of the mastoid process was utilized on the skulls of 50 individuals to verify the results obtained through gross observation of the cochlear promontory. Statistical analysis revealed significant correlation between hypopneumatization (indicative of childhood IMED) and bony changes of the promontory at the level of the individual. This suggests a potential correlation that warrants further investigation to determine whether the observation of the cochlear promontory should be used as a method for IMED assessment. Overall, our study contributes to the study of IMED in past populations, and underscores the importance of clear, standardized scoring criteria in paleopathology.

User tendency-based rating scaling in online trading networks.

Social networks often involve the users rating each other based on their beliefs, abilities, and other characteristics. This is particularly common in e-commerce platforms where buyers rate sellers based on their trustworthiness. However, the rating tends to vary between users due to differences in their individual scoring criteria. For example, in a transaction network, a positive user may give a high rating unless the transaction was unsatisfactory while a neutral user may give a mid-rating, consequently giving the same numeric score to different levels of satisfaction. In this paper, we propose a novel method called user tendency-based rating scaling, which adjusts the current rating (its score) based on the pattern of past ratings. We investigate whether this rating scaling method can classify between "good users" and "bad users" in online trade social networks better when compared with using the original rating scores without scaling. Classifying between good users and bad users is especially important for anonymous rating networks like Bitcoin transaction networks, where users' reputations must be recorded to preclude fraudulent and risky users. We evaluate the proposed rating scaling method by performing user classification, link prediction, and clustering tasks, using three real-world online rating network datasets. We use both the original ratings and the scaled ratings as weights of graphs and use a weighted graph embedding method to find node representations that reflect users' positive and negative information. The experimental results showed that using the proposed rating scaling method outperformed using the original (i.e., unscaled) ratings by up to 17% in classification accuracy, and by up to 2.5% in link prediction based on the AUC ROC measure, and by up to 21% in the clustering tasks based on the Dunn-index.

Bayesian Non-Parametric Inference for Multivariate Peaks-over-Threshold Models.

We consider a constructive definition of the multivariate Pareto that factorizes the random vector into a radial component and an independent angular component. The former follows a univariate Pareto distribution, and the latter is defined on the surface of the positive orthant of the infinity norm unit hypercube. We propose a method for inferring the distribution of the angular component by identifying its support as the limit of the positive orthant of the unit p-norm spheres and introduce a projected gamma family of distributions defined through the normalization of a vector of independent random gammas to the space. This serves to construct a flexible family of distributions obtained as a Dirichlet process mixture of projected gammas. For model assessment, we discuss scoring methods appropriate to distributions on the unit hypercube. In particular, working with the energy score criterion, we develop a kernel metric that produces a proper scoring rule and presents a simulation study to compare different modeling choices using the proposed metric. Using our approach, we describe the dependence structure of extreme values in the integrated vapor transport (IVT), data describing the flow of atmospheric moisture along the coast of California. We find clear but heterogeneous geographical dependence.

Biomarker discovery with quantum neural networks: a case-study in CTLA4-activation pathways

BackgroundBiomarker discovery is a challenging task due to the massive search space. Quantum computing and quantum Artificial Intelligence (quantum AI) can be used to address the computational problem of biomarker discovery from genetic data.MethodWe propose a Quantum Neural Networks architecture to discover genetic biomarkers for input activation pathways. The Maximum Relevance-Minimum Redundancy criteria score biomarker candidate sets. Our proposed model is economical since the neural solution can be delivered on constrained hardware.ResultsWe demonstrate the proof of concept on four activation pathways associated with CTLA4, including (1) CTLA4-activation stand-alone, (2) CTLA4-CD8A-CD8B co-activation, (3) CTLA4-CD2 co-activation, and (4) CTLA4-CD2-CD48-CD53-CD58-CD84 co-activation.ConclusionThe model indicates new genetic biomarkers associated with the mutational activation of CLTA4-associated pathways, including 20 genes: CLIC4, CPE, ETS2, FAM107A, GPR116, HYOU1, LCN2, MACF1, MT1G, NAPA, NDUFS5, PAK1, PFN1, PGAP3, PPM1G, PSMD8, RNF213, SLC25A3, UBA1, and WLS. We open source the implementation at: https://github.com/namnguyen0510/Biomarker-Discovery-with-Quantum-Neural-Networks.

Value of modified qSOFA, glucose and lactate in predicting prognosis in children with sepsis in the PICU

The purpose was to investigate how well age-adjusted modified quick Sequential Organ Failure Assessment (qSOFA) scores paired with blood glucose and lactate levels predict the outcomes of septicemic children in the pediatric intensive care unit (PICU). One hundred children who were diagnosed with sepsis and septic shock in the PICU of Henan Children’s Hospital were eligible, and other 20 patients in the same hospital at different times were selected as a validation set. Respiratory rate (RR), heart rate (HR), capillary refill time (CRT), and Alert, Voice, Pain, Unresponsive (AVPU) scale were included in the age-adjusted modified qSOFA scoring criteria for scoring. The primary outcome was 28-day all-cause mortality. The predictive values were evaluated by the ROC curve. In the sepsis group, 50 patients were male, and 50 patients were female. The 28-day all-cause mortality rate was 52%. Fifty-one patients with age-adjusted modified qSOFA scores >1. The serum lactate level was 2.4 mmol/L, and the blood glucose level was 9.3 mmol/L. The AUCs for the age-adjusted modified qSOFA score, serum lactate and blood glucose levels for the prediction of 28-day all-cause mortality in children with sepsis were 0.719, 0.719 and 0.737, respectively. The cut-off values were one point, 3.8 mmol/L and 10 mmol/L, respectively. The AUC of the age-adjusted modified qSOFA score for the validation set of was 0.925. When the three indices were combined, the AUC was 0.817, the Hosmer–Lemeshow goodness-of-fit test showed χ 2 = 2.428 and p = .965. When children with sepsis are admitted to the ICU, we recommend performing rapid scoring and rapid bedside lactate and glucose testing to determine the early prognosis.