Response Score Research Articles

New prognostic index for neoadjuvant chemotherapy outcome in patients with advanced high-grade serous ovarian cancer

BackgroundA validated prognostic index for the outcome of patients with advanced high-grade serous ovarian cancer (HGSOC) undergoing neoadjuvant chemotherapy (NACT) remains elusive. To address this need, we developed an ovarian neoadjuvant chemotherapy prognostic index (ONCPI) to improve predictive accuracy.MethodsWe encompassed an analysis of the clinicopathological characteristics of patients with advanced HGSOC who were administered platinum-based NACT. Blood inflammatory composite markers were calculated and converted into binary values using optimal cutoffs. Omental hematoxylin and eosin (H&E) stained slides were selected for the assessment of chemotherapy response score (CRS), which served as a measure of NACT efficacy. Logistic regression analysis and Cox proportional hazards regression model were utilized to construct a prognostic index.ResultsMultivariate logistic analysis showed that both CRS and neutrophil-to-lymphocyte ratio (NLR) independently influenced the response to platinum-based chemotherapy. Meanwhile, Kaplan–Meier and Cox regression analysis revealed that CRS score was significantly correlated with progression-free survival (PFS) and overall survival (OS), and patients with high NLR showed poor OS. We further developed an ovarian neoadjuvant chemotherapy prognostic index (ONCPI) based on the CRS and NLR. The area under the curve (AUC) value of ONCPI was 0.771 (P < 0.001, 95% CI: 0.656–0.887) for the prediction of platinum resistance. This AUC value surpasses that of the individual NLR and CRS, which were 0.670 (P = 0.018, 95% CI: 0.547–0.793) and 0.714 (P = 0.003, 95% CI: 0.590–0.839), respectively. Moreover, survival analysis suggested that patients with ONCPI of 0 and 1 were significantly associated with improved PFS and OS.ConclusionsThe ONCPI emerges as a significant prognostic marker for predicting NACT outcome in advanced HGSOC patients and holds promise for integration into clinical practice and risk-stratified trial design.

Knowledge, attitude, and practices of the community about Chikungunya in selected Districts of Afar Region, Northeast Ethiopia; its implications for controlling the disease: a community-based quantitative and qualitative cross-sectional study

BackgroundChikungunya (CHIK) is a viral disease spread by Aedes mosquitoes in tropical and subtropical countries, including Ethiopia. It is important to educate communities and implement behavioral and social interventions to prevent and control the spread of disease. This study assessed the community’s knowledge, attitude, and practices (KAP) about CHIK disease in the Afar Region, Northeast Ethiopia.MethodsA community-based quantitative and qualitative cross-sectional study was conducted between September 2022 and January 2023 in two districts in the Afar Region, Ethiopia. A household survey (HHS) using a structured questionnaire was conducted through face-to-face interviews for the quantitative study. For the qualitative research, focus group discussions (FGDs) were conducted using a semi-structured questionnaire. Data was analyzed using descriptive statistics, Pearson’s correlation coefficient, and multiple linear regressions.ResultsThe study included 296 and 116 adult community members for quantitative and qualitative studies, respectively. Of 296 respondents, 67.3% had previously heard of CHIK, and of those who heard of it, 44.7% knew that CHIK is caused by a virus. While a majority (68.8%) of participants believed that CHIK could be prevented, only 45.6% considered it a serious illness. Additionally, over half (56.8%) of the respondents knew that not all mosquitoes transmit CHIK. About 48.7% were able to identify the Aedes mosquito, but only 16.5% of those knew that Aedes mosquitoes bite during the daytime. The overall mean correct/positive response scores for knowledge, attitudes, and practices were 63.2%, 60.0%, and 60.0%, respectively. Being a student and having educational levels of grade 9-12th and college or above were associated with good knowledge while being single, having an educational level of 9-12th, and being within the age group of 45–59 years old were found to be associated with positive attitude scores.ConclusionThe study revealed a limited understanding of CHIK and the role of the Aedes mosquito in the study area. The community had uncertainty about the disease, its transmission, and prevention measures. The lack of understanding may affect attitudes towards the disease and risk perceptions, leading to less practice in prevention and control measures. The findings suggest the need for community-based educational initiatives to improve awareness and promote prevention and control measures.

Health systems responsiveness towards needs of pregnant women in Vietnam

BackgroundHealth systems that are responsive to maternal mental health recognise the importance of integrating mental health services into maternal care. Studies from Vietnam have reported particularly high rates of common perinatal mental health disorders (CPMDs) in both rural and urban areas of the country. Despite the increasing burden of maternal mental health conditions, there is currently no guidance on the screening for CPMDs within maternal care, both antenatal and postnatal. In this paper, we report the findings from a survey that examined health systems responsiveness to the needs of pregnant women at the primary care-level in Vietnam, utilising the WHO’s validated responsiveness questionnaire.MethodsCluster sampling was used in two districts, in Bac Giang Province. Data were collected using the WHO responsiveness tool, including questions on the domains of responsiveness relating to pregnant women’s last antenatal visit. SPSS (version 24) software was used for data entry and analysis, respectively. Bivariate and multivariable logistic regression were computed to identify the associated factors of health system responsiveness in maternity care at 95% CI.ResultsWe found that the overall mean health systems responsiveness score was 2.86 (out of maximum 4), with 30.4% pregnant women rating responsiveness as “poor” for maternal health care (based on the cutoff point of 60 for overall score). The three highest scoring domains were “social support”, “trust”, and “dignity” and lowest scoring domains were “choice of providers”, “prompt attention”, and “communication”. There is a strong preference for seeking maternal health care at private facilities which meet women’s needs of “confidentiality” and “basic amenities”. Household income was found to have a significant impact on the six responsiveness domains. Finally, only a small proportion of pregnant women self-reported having CPMDs and accessed mental health facilities.ConclusionsThese findings highlight the need to improve the responsiveness of the Vietnamese health system to meet pregnant women’s expectations, mainly in relation to prompt attention and communication. This study also highlights the importance of specifically targeting efforts towards improving the responsiveness of the public health sector. Integrating maternal and mental health at the primary care-level can be one approach to tackle the mental health treatment gap experienced by pregnant women in Vietnam. This can promote early detection and intervention of CPMDs, but may also contribute towards reducing mental health-related stigma.

Evaluation of a Computer-Based Morphological Analysis Method for Free-Text Responses in the General Medicine In-Training Examination: Algorithm Validation Study.

The General Medicine In-Training Examination (GM-ITE) tests clinical knowledge in a 2-year postgraduate residency program in Japan. In the academic year 2021, as a domain of medical safety, the GM-ITE included questions regarding the diagnosis from medical history and physical findings through video viewing and the skills in presenting a case. Examinees watched a video or audio recording of a patient examination and provided free-text responses. However, the human cost of scoring free-text answers may limit the implementation of GM-ITE. A simple morphological analysis and word-matching model, thus, can be used to score free-text responses. This study aimed to compare human versus computer scoring of free-text responses and qualitatively evaluate the discrepancies between human- and machine-generated scores to assess the efficacy of machine scoring. After obtaining consent for participation in the study, the authors used text data from residents who voluntarily answered the GM-ITE patient reproduction video-based questions involving simulated patients. The GM-ITE used video-based questions to simulate a patient's consultation in the emergency room with a diagnosis of pulmonary embolism following a fracture. Residents provided statements for the case presentation. We obtained human-generated scores by collating the results of 2 independent scorers and machine-generated scores by converting the free-text responses into a word sequence through segmentation and morphological analysis and matching them with a prepared list of correct answers in 2022. Of the 104 responses collected-63 for postgraduate year 1 and 41 for postgraduate year 2-39 cases remained for final analysis after excluding invalid responses. The authors found discrepancies between human and machine scoring in 14 questions (7.2%); some were due to shortcomings in machine scoring that could be resolved by maintaining a list of correct words and dictionaries, whereas others were due to human error. Machine scoring is comparable to human scoring. It requires a simple program and calibration but can potentially reduce the cost of scoring free-text responses.

Use of Online Large Language Model Chatbots in Cornea Clinics

Purpose: Online large language model (LLM) chatbots have garnered attention for their potential in enhancing efficiency, providing education, and advancing research. This study evaluated the performance of LLM chatbots—Chat Generative Pre-Trained Transformer (ChatGPT), Writesonic, Google Bard, and Bing Chat—in responding to cornea-related scenarios. Methods: Prompts covering clinic administration, patient counselling, treatment algorithms, surgical management, and research were devised. Responses from LLMs were assessed by 3 fellowship-trained cornea specialists, blinded to the LLM used, using a standardized rubric evaluating accuracy, comprehension, compassion, professionalism, humanness, comprehensiveness, and overall quality. In addition, 12 readability metrics were used to further evaluate responses. Scores were averaged and ranked; subgroup analyses were performed to identify the best-performing LLM for each rubric criterion. Results: Sixty-six responses were generated from 11 prompts. ChatGPT outperformed the other LLMs across all rubric criteria, scoring an overall response score of 3.35 ± 0.42 (83.8%). However, Google Bard excelled in readability, leading in 75% of the metrics assessed. Importantly, no responses were found to pose risks to patients, ensuring the safety and reliability of the information provided. Conclusions: ChatGPT demonstrated superior accuracy and comprehensiveness in responding to cornea-related prompts, whereas Google Bard stood out for its readability. The study highlights the potential of LLMs in streamlining various clinical, administrative, and research tasks in ophthalmology. Future research should incorporate patient feedback and ongoing data collection to monitor LLM performance over time. Despite their promise, LLMs should be used with caution, necessitating continuous oversight by medical professionals and standardized evaluations to ensure patient safety and maximize benefits.

Obstacles for self-management practices among diabetes patients: A facility-based study from Coastal South India.

Background The purpose of the study was to assess the obstacles faced by diabetes patients in their self-care and determine the factors associated with these obstacles. The management of diabetes mellitus (DM) extends beyond the clinician’s efforts, with the responsibility of the care also being shared by the patient to achieve better treatment outcomes and prevent complications. Self-care management is the most important part of DM treatment, which includes diet, regular exercise, blood glucose monitoring, medication and foot care. Methods A facility-based cross-sectional study was conducted among 107 type 2 DM patients aged &gt;18 years using the Diabetes Obstacles Questionnaire-30. Patients scoring a mean response score &gt;3 were considered to have an obstacle. We included age, gender, socioeconomic status (SES), duration of DM and blood glucose levels as factors for regression analysis and a P value &lt;0.05 was considered to be statistically significant. Results A large majority (64.5%, n = 69) of our participants were aged above 55 years and belonged to lower socio-economic status (65.4%, n = 70). Family history of DM was present in 41% (n=44) of the participants. The median duration of DM among the participant was 10 (4 – 7) years. In our study, the participants faced obstacles for two items in the domains: Support from Friends &amp; Family (mean score: 3.73) and Knowledge of the Disease (mean score: 3.58). A multinominal regression analysis revealed SES was predictive of participants who could not understand information from literature with a P. value of 0.002 (OR: 3.65, CI: 1.60-8.338). Conclusion The two major obstacles to self-management practices that were identified were in the domains of Support from Friends and Family, and Knowledge of the Disease. Socioeconomic status was identified to be a predictive factor associated with the participants who are not able to understand information from the literature.

Single-point ultrasound-guided iliohypogastric-ilioinguinal-genitofemoral nerve block for inguinal hernia surgery in older adult patients: a randomized controlled trial.

Ultrasound-guided nerve block can be used for perioperative analgesia and can potentially improve the course of recovery. Although iliohypogastric-ilioinguinal nerve block has been successfully used for inguinal hernia surgery, the poor blocking effect of intraoperative traction reflex remains a major drawback of this technique. The main objective of this study was to investigate the feasibility of single-point ultrasound-guided iliohypogastric-ilioinguinal-genitofemoral nerve (GFN) blockage for open anterior inguinal hernia repair in older adults. A total of 40 older adult patients [categorized as American Society of Anesthesiologists (ASA) I-III, body mass index (BMI) ≤28 kg/m2, age ≥60 years] undergoing open anterior inguinal hernia repair (the Lichtenstein technique) from June 2018 to December 2019 were recruited and randomly separated into an iliohypogastric-ilioinguinal nerve block group (group A; n=20) and an iliohypogastric-ilioinguinal-GFN block group (group B; n=20). The numerical rating scale (NRS) score in the post-anesthesia care unit (PACU) was the primary endpoint. Moreover, the following secondary indicators were recorded: the NRS score at 4 and 12 h after surgery and the duration of the nerve block; the total consumption of anesthetics; the occurrence of perioperative complications; and the mean arterial pressure (MAP), heart rate (HR), and respiration rate (RR), and oxygen saturation (SpO2) at baseline (T0), before skin incision (T1), 1 min after skin incision (T2), after dissection of the hernial sac (T3), at mesh placement (T4), and at the end of surgery (T5). Patients in Group B had lower NRS scores in the PACU (0.9±0.7 vs. 2.1±0.9), at 4 hours post-operation (1.9±1 vs. 2.7±0.7), lower intraoperative traction response scores (0.6±0.8 vs. 1.7±1.2), and fewer postoperative complication scores (0.1±0.3 vs. 0.8±0.9) compared to group A (P<0.05). In addition, the MAP in group A was significantly higher than that in group B (P<0.01) at T2 (89.3±6.7 vs. 83.8±4.9), T3 (92.4±6.9 vs. 86.6±4.8), and T4 (87.8±5.2 vs. 83.1±4.6). The HR in group A was also higher than that in group B (P<0.05) at T2 (73.3±8.4 vs. 68.4±5.4) and T3 (77.0±14.7 vs. 68.7±6.9). Finally, compared to group B, group A showed a higher consumption of sufentanil (5.5±3.9 vs. 2.4±2.8) and lidocaine (3.4±2.3 vs. 1.0±2.0) (P<0.05). Performing an ultrasound-guided iliohypogastric-ilioinguinal-GFN block through a single puncture point is a feasible clinical approach. This strategy provides appropriate intraoperative and postoperative analgesia in older adult patients undergoing open anterior inguinal hernia repair and significantly reduces postoperative complications and thus has the potential to emerge as a novel analgesic option for inguinal hernia surgery. Chinese Clinical Trial Registry identifier: ChiCTR2200066573.

Liver metastases from colorectal carcinoma: performance of pathological response scores

Background Pathological response of liver metastases (LM) from colorectal carcinoma (CRC) to neoadjuvant therapy is a known prognostic factor associated with recurrence and survival. The aim of this study was to compare the performance of two prognostic scores in patients who underwent surgery for colorectal cancer liver metastases (CRCLM), specifically in stage IV disease. Methods We conducted a study on patients with stage IV colorectal cancer who received preoperative chemotherapy (CT) followed by liver metastasis (LM) resection between 2015 and 2021. Among these patients, 57% had synchronous metastases (diagnosed at the same time as the primary tumor), while the remaining cases were metachronous (diagnosed after the primary tumor). Pathological response was evaluated using both the Rubbia-Brandt tumor regression grade (TRG) and the Blazer scoring system. We then assessed the performance of these two prognostic scores based on homogeneity (using the likelihood ratio, LR+), monotonicity, and discriminative ability (using the area under the receiver operating characteristic [ROC] curve, AUC). Results 70 cases were included in the study. Mean age was 56 years. The sex ratio (males/females) was 2.2. Forty patients were stage IV (57%) with synchronous all CRCLMs. The overall survival, all stages combined, was 85.5% at 12 months, 41.7% at 24 months and 19.3% at 36 months. The median survival was better in case of major response (TRG1/TRG2) evaluated at 40.1 and 41.1 months after diagnosis. In cases of partial response (TRG3), the median survival was 32.1 months. In cases with no response (TRG4/TRG5), survival was estimated at 29.9 and 18.5 months. The Rubbia-Brandt TRG had the highest LR+ (10.95). The LR+ of the Rubbia-Brandt score was greater than 10, so it was a test with very strong contribution. The LR+ of the Blazer score was between 5 and 10, it was a test with strong contribution. The Rubbia-Brandt TRG had the highest linearity value (10.73). With a higher AUC of the ROC curve (0.8), the Rubbia-Brandt TRG was better at predicting survival than the Blazer score. Conclusion Surgical resection is the gold standard for CRCLM, with improved prognosis from neoadjuvant chemotherapy. Pathological response to CT is a key prognostic factor, and the Rubbia Brandt TRG system enhances survival predictivity when combined with ypTN stage.

Exploring the Evidence to Interpret Differential Item Functioning via Response Process Data.

Evaluating differential item functioning (DIF) in assessments plays an important role in achieving measurement fairness across different subgroups, such as gender and native language. However, relying solely on the item response scores among traditional DIF techniques poses challenges for researchers and practitioners in interpreting DIF. Recently, response process data, which carry valuable information about examinees' response behaviors, offer an opportunity to further interpret DIF items by examining differences in response processes. This study aims to investigate the potential of response process data features in improving the interpretability of DIF items, with a focus on gender DIF using data from the Programme for International Assessment of Adult Competencies (PIAAC) 2012 computer-based numeracy assessment. We applied random forest and logistic regression with ridge regularization to investigate the association between process data features and DIF items, evaluating the important features to interpret DIF. In addition, we evaluated model performance across varying percentages of DIF items to reflect practical scenarios with different percentages of DIF items. The results demonstrate that the combination of timing features and action-sequence features is informative to reveal the response process differences between groups, thereby enhancing DIF item interpretability. Overall, this study introduces a feasible procedure to leverage response process data to understand and interpret DIF items, shedding light on potential reasons for the low agreement between DIF statistics and expert reviews and revealing potential irrelevant factors to enhance measurement equity.

Development of Merdeka Flow-Based Physics Teaching Modules to Improve Physics Learning Outcomes

This research is a type of Research and Development (R&amp;D) study utilizing the 4D model development method (Define, Design, Development, and Dissemination). The study was conducted at MAN 1 Buton Selatan with the aim of designing and analyzing a valid, practical, and effective Merdeka flow-based physics teaching module that can improve student learning outcomes. The developed Merdeka flow-based physics teaching module was then tested on 25 students of class X-1 and evaluated by 10 practitioners or physics teachers from Siompu District and West Siompu District, Buton Selatan. The instruments used in this study included a validation sheet for the physics teaching module, practitioner assessment questionnaires, and a validated student learning outcomes test. The results showed that the Merdeka flow-based physics teaching module at MAN 1 Buton Selatan was valid, with an Aiken's V value of 0.74, practical, with a practitioner response score of 92.44%, and effective, with 80% of students showing a high category improvement in physics learning outcomes based on the N-gain calculation. Based on the results, the Merdeka Flow-based physics teaching module is overall considered valid, practical, and effective for use in the physics learning process.

Discovery Learning-Based Worksheets as a Tool for Enhancing Science Process Skills and Environmental Literacy in Middle School Students

The aim of this study is to develop Discovery Learning-based Learner Worksheets (LKPD) using the ADDIE model with the objective of enhancing the science process skills and environmental literacy of secondary school students. This research employs a one-group pretest-posttest design within the context of a research and development (R&amp;D) project conducted in class VII of SMP Negeri 2 Bungku, comprising 29 students, of whom 13 are male and 16 are female. The research instruments included validation sheets, Discovery Learning-based learner worksheets, observation sheets for science process skills, environmental literacy tests, and questionnaires for teachers and students regarding their responses to the product. The results demonstrated the validity of this development, with a score of 88%, a figure that was additionally supported by the teacher response score, which fell within the "very practical" category. The product of this development has a positive effect on students' science process skills, with an N-gain of 0.60 in the moderate category, indicating a significant improvement. The effect size of 0.47 in the moderate category indicates that this improvement is very significant. Furthermore, the development results had a significant impact on students' environmental literacy, with an N-gain of 0.35 in the medium category. The effect size of environmental literacy was 0.47 in the medium category.

The predictive role of PD-L1 expression and CD8 + TIL levels in determining the neoadjuvant chemotherapy response in advanced ovarian cancer

ObjectiveTo analyze how the PD-L1 expression and CD8 + tumor infiltrating lymphocyte (TIL) levels in biopsy samples before neoadjuvant chemotherapy (NACT) can predict chemotherapy response score and survival for advanced high-grade serous ovarian cancer (HGSC).MethodsWe retrospectively analyzed 45 patients with advanced epithelial ovarian cancer between 2010 and 2018, who had received at least three cycles of NACT. PD-L1 expression and CD8 + TIL levels were evaluated by immunohistochemical staining in the pre-NAC tumor samples from which the patients had been diagnosed. The post-NACT tissue samples taken during interval debulking surgery (IDS) were used to evaluate the chemotherapy response score (CRS).ResultsAmong all the patients, CRS 1 (no response) was found in 8 patients, CRS 2 (partial response) in 28 patients, and CRS 3 (complete response) in 9 patients. A total of 20 (44.4%) patients had high intratumoral CD8 + TILs (iCD8 + TILs) levels, and 35 (77.8%) patients had high expression stromal CD8 + TILs (sCD8 + TILs). No statistically significant relationship was found between high and low expression of i/s CD8 + TILs levels with PFS and CRS. The study found that 33 (73.3%) patients had high levels of stromal PD-L1 (sPD-L1) expression and 28 (62.2%) patients had high levels of intratumoral PD-L1 (iPD-L1) expression. In the iPD-L1 group, patients with low expression had a PFS of 28 months, whereas those with high expression had a PFS of 17 months (p = 0.028). Among the patients with high iPD-L1 expression, 23 (82.1%) patients showed CRS2, 4 (14.3%) showed CRS3, and only 1 (3.6%) showed CRS1 (p < 0.001). However, high or low expression sPD-L1 did not significantly affect PFS and CRS (p = 0.928 and p = 0.305; respectively).ConclusionsWe found that iPD-L1 expression levels in diagnostic biopsy in ovarian cancer can predict the chemotherapy response score in interval debulking surgery.

Predictive impact of clinical factors on chemosensitivity in advanced high-grade serous ovarian carcinoma according to chemotherapy response score

The use of neoadjuvant chemotherapy (NAC) as a first-line therapy for advanced high-grade serous ovarian carcinoma (HGSOC) has increased. However, several studies have reported NAC-induced platinum resistance. This study aimed to evaluate the predictive impact of clinical factors on chemotherapy response score (CRS) and to select patients who would respond well to NAC. This multicenter retrospective (study included patients treated between January 2016 and December 2021). International Federation of Gynecology and Obstetrics stage IIIC and IV HGSOC patients were eligible. Institutionally strict complete resectability criteria were used in the present study. Pathological slides were scored according to the CRS criteria. Among 172 patients with HGSOC, 87 (50.6%) had stage IIIC disease and 85 (49.4%) had stage IV disease. And 35 (20.4%) had CRS1, 103 patients were CRS2 (59.9%), and 34 patients were CRS3 (19.7%). Compared with CRS1, simultaneous metastases to distant lymph nodes and solid organs confirmed by imaging were associated with a 75% reduction in CRS2 (odds ratio = 0.25; 95% confidence interval: 0.09–0.70; P = .008). And breast cancer susceptibility gene 1/2 mutation was positively (odds ratio = 8.41; 95% confidence interval: 2.25–31.52; P = .002) associated with CRS3 compared to CRS1. Patients with CRS3 had significantly longer progression-free survival (PFS), with median PFS of 9.8, 14.8, and 27.0 months for CRS of 1, 2, and 3, respectively (P &lt; .001). Overall survival was also prolonged in patients with CRS3 (P &lt; .001). Germline breast cancer susceptibility gene 1/2 mutation was a predictor of CRS3 and a good prognostic factor for the survival rate. Simultaneous metastasis to distant lymph nodes and solid organs is a predictor of CRS1. CRS inversely correlated with PFS and overall survival.

Comparison of diagnostic accuracy of the acute appendicitis inflammatory response score with the adult appendicitis score in Diagnosis of Acute Appendicitis

Comparison of diagnostic accuracy of the acute appendicitis inflammatory response score with the adult appendicitis score in Diagnosis of Acute Appendicitis

Examining the Readability of AtlasGPT, The Premiere Resource for Neurosurgical Education

AtlasGPT represents an innovative generative pre-trained transformer (GPT), trained using neurosurgery literature. Its ability to contour its response according to the training level of the user is unique; however, whether its responses can be comprehended at each user's training level remains unknown. This study aimed to analyze the readability of responses provided by AtlasGPT. Ten queries were presented to AtlasGPT across its four user profiles (i.e., surgeon, resident, medical student, patient). A readability analysis was performed using multiple instruments on Readability Studio. Readability scores of user-specific responses were compared using ANOVA testing and post-hoc pairwise t-tests with Bonferroni correction. P-value < 0.05 was considered to be significant. Across the readability instruments that were leveraged, significant differences in reading ease were observed across all user profiles on comparisons to the patient (p < 0.005). Readability scores for the medical student profile tended to show greater reading ease than the surgeon and resident profiles; these differences, however, were not significant. The mean grade levels for patient responses across multiple instruments ranged from 8.8-11.51. Only one output via the New Dale-Chall assessment was written at the level of 5th-6th grade. AtlasGPT-generated content demonstrates readability variations according to the user profile selected; however, the readability of patient content still exceeds recommendations set by United States departmental agencies, necessitating a call to action.

M2ara: unraveling metabolomic drug responses in whole-cell MALDI mass spectrometry bioassays.

Fast computational evaluation and classification of concentration responses for hundreds of metabolites represented by their mass-to-charge (m/z) ratios is indispensable for unraveling complex metabolomic drug actions in label-free, whole-cell Matrix-Assisted Laser Desorption/Ionization Mass Spectrometry (MALDI MS) bioassays. In particular, the identification of novel pharmacodynamic biomarkers to determine target engagement, potency and potential polypharmacology of drug-like compounds in high-throughput applications requires robust data interpretation pipelines. Given the large number of mass features in cell-based MALDI MS bioassays, reliable identification of true biological response patterns and their differentiation from any measurement artefacts that may be present is critical. To facilitate the exploration of metabolomic responses in complex MALDI MS datasets, we present a novel software tool, M2ara. Implemented as a user-friendly R-based shiny application, it enables rapid evaluation of Molecular High Content Screening (MHCS) assay data. Furthermore, we introduce the concept of Curve Response Score (CRS) and CRS fingerprints to enable rapid visual inspection and ranking of mass features. In addition, these CRS fingerprints allow direct comparison of cellular effects among different compounds. Beyond cellular assays, our computational framework can also be applied to MALDI MS-based (cell-free) biochemical assays in general. The software tool, code and examples are available at https://github.com/CeMOS-Mannheim/M2ara and https://dx.doi.org/10.6084/m9.figshare.25736541. Supplementary material is available at Bioinformatics online.

Germline BRCA1/2 status and chemotherapy response score in high-grade serous ovarian cancer

BackgroundHigh-grade serous ovarian cancer (HGSOC) can be treated with platinum-based neoadjuvant chemotherapy (NACT) and delayed primary surgery (DPS). Histopathological response to NACT can be assessed using Böhm’s chemotherapy response score (CRS). We investigated whether germline BRCA1/2 (gBRCA1/2) genotype associated with omental CRS phenotype.MethodsA retrospective study of patients with newly diagnosed FIGO stage IIIC/IV HGSOC prescribed NACT and tested for gBRCA1/2 pathogenic variants (PVs) between September 2017 and December 2022 at The Christie Hospital. The Cox proportional hazards model evaluated the association between survival and key clinical factors. The chi-square test assessed the association between CRS3 (no/minimal residual tumour) and gBRCA1/2 status.ResultsOf 586 eligible patients, 393 underwent DPS and had a CRS reported. Independent prognostic factors by multivariable analysis were gBRCA1/2 status (PV versus wild type [WT]), CRS (3 versus 1 + 2), surgical outcome (complete versus optimal/suboptimal) and first-line poly (ADP-ribose) polymerase-1/2 inhibitor maintenance therapy (yes versus no) (all P < 0.05). There was a non-significant trend for tumours with a gBRCA2 PV having CRS3 versus WT (odds ratio [OR] = 2.13, 95% confidence intervals [CI] 0.95–4.91; P = 0.0647). By contrast, tumours with a gBRCA1 PV were significantly less likely to have CRS3 than WT (OR = 0.35, 95%CI 0.14–0.91; P = 0.0291).ConclusionsGermline BRCA1/2 genotype was not clearly associated with superior omental CRS. Further research is required to understand how HGSOC biology defines CRS.

Abstract 4136654: Urine Output Response to a Furosemide Infusion is Associated with Acute Kidney Injury in Infants Following Cardiac Surgery

Background: Acute kidney injury (AKI) following cardiac surgery in infants is common and associated with longer mechanical ventilation times and length of stay. Prior studies have shown that a lack of responsiveness to bolus dose furosemide has been associated with increased incidence of AKI. However, these studies have excluded patients on continuous furosemide infusions who are often younger, more hemodynamically unstable, and at higher risk for AKI. Hypothesis: Decreased urine output after initiation of a furosemide infusion predicts development of AKI. Methods: A retrospective cohort study of infants (&lt;1 year of age) was conducted who underwent cardiac surgery requiring cardiopulmonary bypass from 2020-2023 and were on a furosemide infusion post-operatively. The primary outcome was post-operative AKI as defined using KDIGO (Kidney Disease: Improving Global Outcomes) guidelines. A furosemide response score (FRS) was calculated using the total urine output divided by the total dose of furosemide administered over a given time. Univariate and multivariate analyses were performed, and receiver operating characteristic curves used to determine the discriminatory ability of the FRS with regards to the primary outcome. Results: A total of 155 infants (median age at surgery 9 days) were included. Overall, 77% of infants met definition for the primary outcome of AKI; 32% stage 1, 30% stage 2, and 15% stage 3. Lower FRS at 4, 10, and 24 hours after infusion initiation were associated with AKI development (p&lt;0.0001). Younger age, smaller weight at surgery, lack of pre-operative feedings, pre-operative inotropic use and higher surgical complexity were also associated with a higher risk of AKI. An FRS (mL/mg/kg) cutoff of &lt;11.3 at 4 hours, &lt;25.5 at 10 hours, and &lt;55.3 at 24 hours had good discriminatory ability (area under the curve 0.7-0.75) in predicting AKI stage 2 or 3 (p&lt;0.001). Controlling for the significant univariate variables listed above, the FRS cutoffs remained an independent risk factor for the development of AKI stage 2 or 3, (p&lt;0.01) and were significantly associated with longer mechanical ventilation days and length of stay. Conclusion: Lack of responsiveness to a furosemide infusion (as measured by urine output corrected for dose of furosemide) is associated with the development of AKI in a high-risk cohort of infants. These novel findings may be helpful to predict those at risk and allow for further investigations for modifiable risk factors.

Influence of Mental Model-derived Themes on the Quality of Radiological Emergency Response by HAZMAT Technicians: Insights from a Case Study.

This paper investigates the link between gaps in emergency responders' notions of mental model regarding radiation and risk and their effectiveness in responding to radiological incidents. Particularly, this work focused on exploring themes that emerged in prior work related to improper understanding and application of knowledge concepts related to radiation risks and Radiological Dispersal Device (RDD) scenarios (Leek et al., 2024b). The research uses a quantitative approach to correlate various thematic elements, such as responders' confidence levels, comprehension, and application of radiation risk principles, with the quality of the emergency response score gained through a virtual reality simulation. The results underscore a strong effect of responders' confidence level on response quality scores. Additionally, the study identifies that improper understanding of knowledge concepts and incorrect application of radiation risk and RDD concepts are factors that detract from the quality of response, especially the tendency to overestimate health risks associated with a 25-rem (0,25 Sv) dose and to misapply principles of radiation risk. The implications of this research are significant for the development and refinement of training programs for hazardous materials (HAZMAT) technicians and other emergency responders. The findings suggest the need for a comprehensive review of current training methodologies to address the identified deficiencies that had impacts on the quality of response. The findings provide a foundation for reshaping training priorities and operational readiness, driving the development of training that is both grounded in empirical evidence and that directly addresses the knowledge gaps influencing response quality. The methodological framework developed and employed, including the quality scoring system and the Expected Mental Model State (EMMS) Diagnostic Matrix, also hold potential for broader application in future investigations, extending to diverse types of responders and emergency scenarios.

Psychometric validation of the French version of two scales measuring general (HLS19-Q12) and navigational (HLS19-NAV) health literacy using the Rasch model

BackgroundTo examine the psychometrics properties of the French version of two scales measuring general (HLS19-Q12) and navigational (HLS19-NAV) health literacy (HL) using validation methods based on modern psychometric test theories: a Rasch model analysis.MethodsThe data on representative samples of the French adult population came from the Health Literacy Survey (N = 2 003), conducted in France in two waves (2020 and 2021), and from the third wave of SLAVACO study (N = 2 022), conducted in December 2021. A Rasch analysis was performed using a partial credit model with marginal maximum likelihood estimation adapted to polytomous data. Category probability curves were used to examine whether participants found it consistently difficult to distinguish between response options. Differential item functioning (DIF) was also examined for each item in the two scales as a function of age, gender, and economic status. A Person Separation Index (PSI) of 0.7 has conventionally been considered to be the minimum acceptable PSI level. Chi-square fit statistics, expressed as infit and outfit mean square statistics, were calculated for each item in the two scales. An acceptable fit corresponded to average values between 0.7 and 1.3. The dimensionality of the scales was assessed using Principal Components Analysis (PCA) on the residual correlation matrix to identify whether items are locally independent. Additionally, Smith’s method was employed to detect potential multidimensionality.ResultsThe PSI values for both scales were greater than 0.90. No disordered categories were observed. No evidence of significant DIF was found when associated with gender and economic status. However, two items for both scales had a DIF which was dependent on age but did not have a significant impact on scale scores between younger and older people. Minor local dependence was noted on the HLS19-NAV scale. However, a PCA and Smith’s method demonstrated the unidimensionality of the French version of the scales measuring general and navigational HL.ConclusionsOur results, based on a rigorous statistical analysis, verified the psychometric parameters of the French version of the HLS19-Q12 and HLS19-NAV scales. Despite strong correlation between both scales, each measured a different latent trait. Moreover, despite the fact that presence of DIF was weak, attention must nonetheless be paid when comparing scale response scores between young and older respondents.