Set Criteria Research Articles

Verification of bile acid determination method and establishing reference intervals for biochemical and haematological parameters in third-trimester pregnant women.

The aims of this study were to verify the bile acids (BA) method and to establish reference intervals (RIs) for bile acids (BA) and biochemical and haematological parameters in Croatian pregnant women. BA spectrophotometric method verification was performed on Siemens Atellica Solution CH 930 automated analyser using Sentinel reagent. Stability, precision, trueness, linearity, and RIs, as well as lipemia interference were tested according to CLSI guidelines. BA, biochemical, and haematological parameters were measured in serum (BA, biochemical) and whole blood (haematological) samples of fasting healthy third-trimester pregnant women from Croatia (n=121). The establishment of the RIs was done a priori according to the CLSI EP28-A3C:2010 guideline. Selected reference individuals' data were analysed using parametric, non-parametric, and robust methods. Stability study showed that BA are stable in serum samples for 2days at 20 °C, 14days at 4-8 °C, and 22days at-20 °C. The precision study and adult RIs verification met the criteria. Linearity was verified for the concentration range of 3.5-172.1 μmol/L whereas the lipemia interference test showed a positive bias (%) in BA concentration. The determined reference limits generally exhibited better precision for haematological parameters, being lower than the upper recommended value 0.2, unlike biochemical parameters. Haematological parameters showed notable differences between pregnant and non-pregnant women, while many biochemical parameters' RIs remained similar. Only ALT and GGT showed lower non-comparable RI upper limits in the population pregnant women. Spectrophotometric BA method showed satisfactory performance and all examined parameters were within the set criteria. Moreover, RIs for key biochemical and haematological parameters, including BAs, have been established for the first time in the population of Croatian pregnant women.

The Australian Traumatic Brain Injury Initiative: Statement of Working Principles and Rapid Review of Methods to Define Data Dictionaries for Neurological Conditions.

The Australian Traumatic Brain Injury Initiative (AUS-TBI) aims to develop a health informatics approach to collect data predictive of outcomes for persons with moderate-severe TBI across Australia. Central to this approach is a data dictionary; however, no systematic reviews of methods to define and develop data dictionaries exist to-date. This rapid systematic review aimed to identify and characterize methods for designing data dictionaries to collect outcomes or variables in persons with neurological conditions. Database searches were conducted from inception through October 2021. Records were screened in two stages against set criteria to identify methods to define data dictionaries for neurological conditions (International Classification of Diseases, 11th Revision: 08, 22, and 23). Standardized data were extracted. Processes were checked at each stage by independent review of a random 25% of records. Consensus was reached through discussion where necessary. Thirty-nine initiatives were identified across 29 neurological conditions. No single established or recommended method for defining a data dictionary was identified. Nine initiatives conducted systematic reviews to collate information before implementing a consensus process. Thirty-seven initiatives consulted with end-users. Methods of consultation were "roundtable" discussion (n = 30); with facilitation (n = 16); that was iterative (n = 27); and frequently conducted in-person (n = 27). Researcher stakeholders were involved in all initiatives and clinicians in 25. Importantly, only six initiatives involved persons with lived experience of TBI and four involved carers. Methods for defining data dictionaries were variable and reporting is sparse. Our findings are instructive for AUS-TBI and can be used to further development of methods for defining data dictionaries.

Cross Sectional Study on the Prevalence of Tuberculosis among the District of Sudhnuti, Azad Jammu and Kashmir

Globally, tuberculosis (TB) is a major health risk that is mostly caused by Mycobacterium tuberculosis, a member of the Mycobacterium Tuberculosis Complex (MTC). Ten million cases of tuberculosis and 1.3 million deaths from the disease occur each year, making Mycobacterium tuberculosis one of the leading causes of death globally. Pakistan is ranked fifth among high-burden countries for tuberculosis (TB) and is expected to rank fourth for the prevalence of multi-drug resistant (MDR) TB. As a result, tuberculosis poses a serious threat to public health in Pakistan. Tuberculosis is a common occurrence in Azad Jammu and Kashmir. Aims: The current study aimed to find out the prevalence of tuberculosis in the defined population. Study Design: The study was conducted in the District and Tehsil Headquarters Hospitals of District Sudhnuti AJK. Place and Duration of Study: Samples were collected from all the District and Tehsil headquarters hospitals of Sudhnuti district from January 2019 to December 2019. Methodology: Samples of sputum from suspected cases were gathered from district Sudhnuti hospitals and TB centers from January 2019 to December 2019. All the suspected cases were examined by sputum smear microscopy and then bacteriologically positive cases were further confirmed by GeneXpert. All positive cases were examined for multi-drug resistance by using GeneXpert. Results: In the current study during the year 2019, 201 TB cases were reported from district Sudhnuti out of which 107 (53.23%) were males and 94 (46.76%) were females. The value of P=0.51 which is >0.05 is insignificant shows that Tuberculosis has no selective effect on a specific gender. Pulmonary cases were 131 in number with 81 bacteriologically positive and 50 clinically diagnosed negative cases. Extra Pulmonary cases were 70 in number with 1 bacteriologically positive and 69 clinically diagnosed negative cases. Only 2 (0.99%) MDR cases were diagnosed and the case notification rate during 2019 was 66. Conclusion: The current study shows that males are slightly more prone to TB in district Sudhnuti AJK as compared to females. Individuals with age >64 are more susceptible to TB when compared to individuals with age <15. The CNR during 2019 is 66 which is far away from the WHO set criteria. The CNR indicates that there is a need for improvement in the surveillance system.

Nation-wide survey of oral care practice in Japanese intensive care units: A descriptive study.

Oral care for critically ill patients helps provide comfort and prevent ventilator-associated pneumonia. However, a standardized protocol for oral care in intensive care units is currently unavailable. Thus, this study aimed to determine the overall oral care practices, including those for intubated patients, in Japanese intensive care units. We also discuss the differences in oral care methods between Japanese ICUs and ICUs in other countries. This study included all Japanese intensive care units meeting the authorities' standard set criteria, with a minimum of 0.5 nurses per patient at all times and admission of adult patients requiring mechanical ventilation. An online survey was used to collect data. Survey responses were obtained from one representative nurse per intensive care unit. Frequency analysis was performed, and the percentage of each response was calculated. A total of 609 hospitals and 717 intensive care units nationwide participated; among these, responses were collected from 247 intensive care units (34.4%). Of these, 215 (87.0%) and 32 (13.0%) reported standardized and non-standardized oral care, respectively. Subsequently, the data from 215 intensive care units that provided standardized oral care were analyzed in detail. The most common frequency of practicing oral care was three times a day (68.8%). Moreover, many intensive care units provided care at unequal intervals (79.5%), mainly in the morning, daytime, and evening. Regarding oral care methods, 96 (44.7%) respondents used only a toothbrush, while 116 (54.0%) used both a toothbrush and a non-brushing method. The findings of our study reveal current oral care practices in ICUs in Japan. In particular, most ICUs provide oral care three times a day at unequal intervals, and almost all use toothbrushes as a common tool for oral care. The results suggest that some oral care practices in Japanese ICUs differ from those in ICUs in other countries.

Predictors of antiretroviral treatment failure to the first line therapy: a cross-sectional study among Iranian HIV-positive adults

BackgroundHIV virological failure is one of the main problems in HIV-infected patients, and identifying the main predictors of such treatment failure may help in combating HIV/AIDS.MethodologyThis cross-sectional study included 1800 HIV-infected patients with either virological failure or treatment response. HIV viral load, CD4 count, and other tests were performed. Statistical analysis was used to determine the predictors of virological failure.ResultsClinical stage, treatment with reverse transcriptase inhibitors (RTIs), under therapy for three years or more, suboptimal adherence to antiretroviral treatment (ART), age > 40 years, CD4 count < 200 cells/mm3, unemployment, being infected through sex, and the presence of symptoms were the predominant risk factors for virological failure. In addition, 55% of patients who experienced virological failure failed to experience immunological and/or clinical failure.ConclusionAs the first study in southern Iran and the second in Iran, Iranian policymakers should focus on intensive counseling and adherence support and emphasize more effective treatment regimens such as protease and integrase inhibitors (PIs and INTIs), to increase the chance of a treatment response to ART. The accuracy of identifying clinical and immunological criteria in resource-limited settings is not promising. The present findings can be used to determine effective measures to control HIV treatment failure and design efficient strategies for the ambitious 95–95–95 plan.

In Silico and Chromatographic Methods for Analysis of Biotransformation of Prospective Neuroprotective Pyrrole-Based Hydrazone in Isolated Rat Hepatocytes.

In the current study, chromatographic and in silico techniques were applied to investigate the biotransformation of ethyl 5-(4-bromophenyl)-1-(2-(2-(2-hydroxybenzylidene) hydrazinyl)-2-oxoethyl)-2-methyl-1H-pyrrole-3-carboxylate (11b) in hepatocytic media. The initial chromatographic procedure was based on the employment of the conventional octadecyl stationary phase method for estimation of the chemical stability. Subsequently, a novel and rapid chromatographic approach based on a phenyl-hexyl column was developed, aiming to separate the possible metabolites. Both methods were performed on a Dionex 3000 ThermoScientific (ACM 2, Sofia, Bulgaria) device equipped with a diode array detector set up at 272 and 279 nm for analytes detection. An acetonitrile: phosphate buffer of pH 3.5: methanol (17:30:53 v/v/v) was eluted isocratically as a mobile phase with a 1 mL/min flow rate. A preliminary purification from the biological media was achieved by protein precipitation with methanol. A validation procedure was carried out, where the method was found to correspond to all ICH (Q2) and M10 set criteria. Additionally, an in silico-based approach with the online server BioTransformer 3.0 was applied in an attempt to predict the possible metabolites of the title compound 11b. It was hypothesized that four CYP450 isoforms (1A2, 2C9, 3A4, and 2C8) were involved in the phase I metabolism, resulting in the formation of 12 metabolites. Moreover, docking studies were conducted to evaluate the formation of stable complexes between 11b and the aforementioned isoforms. The obtained data indicated three metabolites as the most probable products, two of which (M9_11b and M10_11b) were synthesized by a classical approach for verification. Finally, liquid chromatography with a mass detector was implemented for comprehensive and summarized analysis, and the obtained results revealed that the metabolism of the 11b proceeds possibly with the formation of glucuronide and glycine conjugate of M11_11b.

Exploring yarigai: The meaning of working as a physician in teaching medical professionalism

Introduction The shift in medical professionalism now considers the well-being of physicians, given the prevalence of burnout and the importance of work-life balance. To reconsider the question ‘Why do doctors work for the patient?’ and explore the meaning of working as a physician, this study adopts the concept of ‘yarigai,’ which represents fulfillment and motivation in meaningful work. The authors’ research questions are: How do doctors recount experiences of yarigai in caring for patients? What kind of values are embodied in their stories about yarigai? Method They adopted narrative inquiry as the methodology for this study. They interviewed 15 doctors who were recognized by their colleagues for their commitment to patient-centered care or had demonstrated yarigai in caring for patients. The semi-structured interviews were conducted face-to-face with each participant by the Japanese researchers, yielding 51 cases of patient-doctor interactions. After grouping the interview data, they translated the cases into English and identified four representative cases to present based on the set criteria. Results From the 51 case studies, they constructed four representative narratives about the yarigai as a physician. Each of them spoke of (1) finding positive meaning in difficult situations, (2) receiving gifts embodying ikigai, (3) witnessing strength in a seemingly powerless human being, and (4) cultivating relationships that transcend temporal boundaries, as being rewarding in working as a physician. The main results of the study, which are the narratives, are described in the main body of the paper. Conclusion The stories on yarigai gave intrinsic meanings to their occupational lives, which can be informative for students, residents, and young physicians when contemplating the meaning of their work as doctors. Rather than demanding selfless dedication from physicians towards patients, they believe it more important to foster yarigai, derived from the contribution to the well-being of others through patient care.

Music Therapy as a Complementary Treatment in Patients with Dementia Associated to Alzheimer's Disease: A Systematic Review.

Alzheimer's disease (AD) is a complex condition that affects various aspects of a patient's life. Music therapy may be considered a beneficial supplementary tool to traditional therapies, that not fully address the range of AD manifestations. The purpose of this systematic review is to investigate whether music therapy can have a positive impact on AD patients and on which symptoms. The main research databases employed have been PubMed and Cochrane, using the keywords "dementia", "music therapy", "Alzheimer", "fMRI", "music", and "EEG". After removing duplicates and irrelevant studies, 23 were screened using set criteria, resulting in the final inclusion of 15 studies. The total number of participants included in these studies has been of 1,196 patients. For the fMRI analysis the search resulted in 28 studies on PubMed, two of which were included in the research; the total number of participants was of 124 individuals. The studies conducted with EEG were found using PubMed. The initial search resulted in 15 studies, but after a more accurate evaluation only 2 have been included in the analysis. Even though the data currently available is not sufficient to draw conclusions supported by robust statistical power, the impact of music therapy on AD neuropsychiatric symptoms deserves great interest. Further research should be ushered, possibly multicentric studies, led with neuroimaging and other recent techniques, which can eventually open views on the music role in improving the cognitive status in AD.

Verification of Dichotomous Scored Junior Secondary Schools Certificate Examination in Mathematics Achievement Test Using Classical Test Theory

In educational assessment there are two major frameworks by which items contained in a test can be examined. These are classical test theory and item response theory. In this study, the author prove the applicability of the classical test theory to the assessment of the quality of multiple- choice junior secondary mathematics test items. Fifty multiple –choice general mathematics test items were administered to four hundred (400) students randomly selected from twenty (20) Junior Secondary schools three (JSS III) students. Ten (10) schools each were purposively selected from private and public schools in Ado local government area of Ekiti state, Nigeria. Three general questions were generated and answered, while two hypotheses were formulated and tested using t-test statistic at 0.05 level significant. Results showed that, out of the 50 items in the test on the basis of difficulty parameter, five (5) items (10%) failed to meet the set criteria for item qualify while on the basis of item discriminating index five items were of poor quality. However, 45 items based on the established standards were considered ‘good’ items. Finally on the basic of performance, there was no significant differences between students in private and public schools, and also between male and female students from the twenty schools considered for this study which led to the upholding of the two hypotheses formulated for the study at p &lt; 0.0.5. It is recommended that, general mathematics papers, that are to be used to examine students’ learning outcomes in Junior School Certificate Examination should be properly validated.

Collaborative Integration of Community Health Workers in Hospitals and Health Centers to Reduce Pediatric Asthma Disparities: A Quality Improvement Program Evaluation

To address pediatric asthma disparities on the South Side of Chicago, a community health worker (CHW) home visiting intervention was implemented collaboratively by academic institutions and community based health centers. This evaluation assessed the effectiveness of this longitudinal quality improvement CHW intervention in reducing asthma morbidity and healthcare utilization. All patients aged 2–18 who met the high-risk clinical criteria in outpatient settings or those who visited the ED due to asthma were offered the program. A within-subject study design analyzed asthma morbidity and healthcare utilization at baseline and follow-up. Multivariable mixed-effects regression models, adjusted for baseline demographic and asthma characteristics, were used to assess changes over time. Among 123 patients, the average age was 8.8 (4.4) years, and 89.3% were non-Hispanic black. Significant reductions were observed in the average daytime symptoms days (baseline 4.1 days and follow-up 1.6 days), night-time symptoms days (3.0 days and 1.2 days), and days requiring rescue medication (4.1 days and 1.6 days) in the past two weeks (all p < 0.001). The average number of emergency department visits decreased from 0.92 one year before to 0.44 one year after program participation, a 52% reduction (p < 0.001). No significant difference was found in hospital admissions. These results support the use of a collaborative approach to implement the CHW home visiting program as part of standard care for pediatric asthma patients in urban settings. This approach has the potential to reduce asthma disparities and underscores the valuable role of CHWs within the clinical care team.

Quantitative measurement of geodiversity uniqueness: research implications and conservation applications

Quantitative approaches are needed to complement qualitative explorations to identify sites with unique geodiversity and thereby guide geoconservation and geoheritage programmes. Here, we introduce the concept and associated index of ‘geodiversity uniqueness’. This index is based on a numerical analysis of geofeatures and allows the identification of sites with unique geodiversity in a study area. We applied this approach to geofeature data from three areas in Finland. Our results showed that patterns of geodiversity uniqueness varied profoundly among the three study areas and across sites within each area. This was due to different sets of geofeatures and distinct characteristics of each study area. More importantly, the approach presented here was robust across the datasets and selection criteria for sets of sites, showing potential for geoconservation in each study area. The geodiversity uniqueness approach is a promising starting point to identify and map sites with unique geodiversity that can be further verified using field observations. To improve our knowledge of geodiversity variation, complementary approaches providing objective information on contributions to total beta geodiversity are needed to advance geoconservation programmes across areas and different spatial scales. This article is part of the Theo Murphy meeting issue ‘Geodiversity for science and society’.

Severity and death

This article discusses the relationship between two theories about the badness of death, the Life-Comparative Account and the Gradualist Account, and two methods of operationalizing severity in health care priority setting, Absolute Shortfall and Proportional Shortfall. The aim is that theories about the badness of death can influence and inform the idea of the basis of severity as a priority setting criterion. I argue that there are strong similarities between the Life-Comparative Account and Absolute Shortfall, and since the Life-Comparative Account is one of the most reasonable accounts of the badness of death, this provides some support for using Absolute Shortfall. I also argue that it is difficult to find support for Proportional Shortfall from theories about the badness of death, and also, that it is difficult to find support for Gradualist Account from theories about severity.

LEXICAL COLLOCATIONS OF KEYWORDS USED IN BUSINESS NEWS: A CORPUS-BASED STUDY

This corpus-based study aims to facilitate the instruction of English for Specific Purposes (ESP) and benefit Thai undergraduate students majoring in Business English by investigating lexical collocations found in business news. A corpus of business news (COBN) was compiled, containing 678,373 running words sourced from 755 online business news. Employing AntConc version 3.5.9, the first 120 keywords were identified in accordance with the set criteria, with the majority being nouns (82.5%), followed by adjectives (12.5%), and verbs (5%). These keywords served as "nodes" to identify their "collocates," resulting in 330 pairs of lexical collocations with 5 combination types. Following a framework adapted from Benson, Benson, and Ilson, prominent combinations included Noun + Noun (54.02%), Adjective + Noun (26.86%), Noun + Verb (13.69%), Verb + Noun (4.47%), and Verb + Adverb (0.89%). The pedagogical implications and recommendations for future research were also discussed.&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0758/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Quality of antiretroviral, antimalarial and antituberculosis medicines in Zambia: Findings of routine post-marketing surveillance.

There is growing concern in sub-Saharan Africa that poor-quality antimicrobial medicines may negate management of infectious diseases of public health importance should they fail to meet the set criteria of quality, safety and efficacy. The objective was to ascertain the quality of antiretroviral, antimalarial and antituberculosis medicines supplied and available in the public health sector in Zambia. A descriptive cross-sectional study was conducted involving the analysis of data from the continuous routine in-country post-marketing surveillance programme in Zambia that assessed the quality of antiretroviral, antimalarial and antituberculosis medicines supplied to public healthcare facilities between January 2018 and June 2023. Data were extracted from laboratory quality analysis results from samples collected as part of routine post-marketing surveillance by the Zambia Medicines Regulatory Authority between January 2018 and June 2023. The samples were collected from various levels of the pharmaceutical supply chain across Zambia. Samples were analysed according to their respective pharmacopoeia standards at the Medicines Control Authority of Zimbabwe Quality Control Laboratory, a World Health Organization prequalified laboratory. Data were extracted using a structured Excel database and analysed using Microsoft Excel, and GraphPad Prism Software was used for visualizations. Of the 198 samples, 86 (43.43%) were antiretrovirals, 54 (27.27%) antimalarials and 58 (29.29%) antituberculosis medicines. Of these 198 samples, 171 (86.36%) originated from Asia, 19 (9.60%) Africa and 8 (4.04%) Europe. All sampled medicines met their respective quality specifications with respect to tests, which included appearance, identification, assay, uniformity of mass, weight variation, disintegration, dissolution, pH and specific gravity, giving a compliance rate of 100%. Antiretrovirals, antimalarials and antituberculosis medicines obtained from public healthcare facilities in Zambia through routine post-marketing surveillance met their quality standards. This might positively impact treatment outcomes for HIV/AIDS, malaria and tuberculosis. There is a need for large-scale continuous monitoring of the quality of medicines in order to ensure quality is maintained and substandard products removed from the pharmaceutical supply chain.

Improving students' interest in IPS lessons by Inquiring Minds Want to Know learning model

This study aims to determine the increase in student interest in social studies subjects through the Inquiring Minds Want to Know model. This research includes planning, implementation, observation, and reflection. The research took place in 2 cycles with a sample of 34 students of class IX G SMP Negeri 34 Batam. Data collection techniques using observation, interviews, documentation and questionnaires. The validity of the research data using data triangulation with quantitative analysis. The results of this study indicate that learning using the Inquiring Minds Want To Know method is able to increase student learning interest, this is supported by an increase in fun and competition during learning, this can be seen from the results of the pre-action questionnaire of 62.3% increasing to 68.03% in cycle I, and in cycle II it increased to 73.3% and was supported by observations from cycle I of 56.5% to cycle II of 73.8%, an increase of 17.3%. From the results of observations and questionnaires, it was obtained that the average student interest in the first cycle was 62.4% and 73.6% in the second cycle. This means that students' interest in learning has exceeded the success criteria of the action set, namely 70%.

A Statistical Analysis of Ship Accidents (1990–2020) Focusing on Collision, Grounding, Hull Failure, and Resulting Hull Damage

In this work, over a thousand maritime casualty reports were reviewed in order to fully investigate and assess selected 213 marine accidents concerning the collision, grounding, and hull failure of ships, which occurred during the time period of 1990–2020, worldwide. Ship type and vessels’ main characteristics, as well as the cause of accidents, were categorized and analyzed statistically. The statistical software IBM SPSS© Statistics v.29 was employed for the investigation of a possible association between the above set criteria. Furthermore, the location and the extent of hull damage was extracted for all incidents, providing valuable insights into the resulting consequences for vessel integrity. These data are essential for estimating the accident’s impact on the viability of the ship, crew, and cargo. According to the main results obtained, significant correlations are deduced regarding the analyzed parameters. In collision accidents, these include the ship type, the location of the damage, visibility and age of the ship, the impact of the accident, and the type of casualty. In the case of grounding incidents, correlations emerge involving the type of ships, day/night period, the width of the resulting damage, the type of casualty, and the cause of accidents.

Prognostic Value of Metastatic Lymph Node Ratio and Identification of Factors Influencing the Lymph Node Yield in Patients Undergoing Curative Colon Cancer Resection.

Due to the impact of nodal metastasis on colon cancer prognosis, adequate regional lymph node resection and accurate pathological evaluation are required. The ratio of metastatic to examined nodes may bring an additional prognostic value to the actual staging system. This study analyzes the identification of factors influencing a high lymph node yield and its impact on survival. The lymph node ratio was determined in patients with fewer than 12 or at least 12 evaluated nodes. The study included patients after radical colon cancer resection in UICC stages II and III. For the lymph node ratio (LNR) analysis, node-positive patients were divided into four categories: i.e., LNR 1 (<0.05), LNR 2 (≥0.05; <0.2), LNR 3 (≥0.2; <0.4), and LNR 4 (≥0.4), and classified into two groups: i.e., those with <12 and ≥12 evaluated nodes. The study was conducted on 7012 patients who met the set criteria and were included in the data analysis. The mean number of examined lymph nodes was 22.08 (SD 10.64, median 20). Among the study subjects, 94.5% had 12 or more nodes evaluated. These patients were more likely to be younger, women, with a lower ASA classification, pT3 and pN2 categories. Also, they had no risk factors and frequently had a right-sided tumor. In the multivariate analysis, a younger age, ASA classification of II and III, high pT and pN categories, absence of risk factors, and right-sided location remained independent predictors for a lymph node yield ≥12. The univariate survival analysis of the entire cohort demonstrated a better five-year overall survival (OS) in patients with at least 12 lymph nodes examined (68% vs. 63%, p = 0.027). The LNR groups showed a significant association with OS, reaching from 75.5% for LNR 1 to 33.1% for LNR 4 (p < 0.001) in the ≥12 cohort, and from 74.8% for LNR2 to 49.3% for LNR4 (p = 0.007) in the <12 cohort. This influence remained significant and independent in multivariate analyses. The hazard ratios ranged from 1.016 to 2.698 for patients with less than 12 nodes, and from 1.248 to 3.615 for those with at least 12 nodes. The LNR allowed for a more precise estimation of the OS compared with the pN classification system. The metastatic lymph node ratio is an independent predictor for survival and should be included in current staging and therapeutic decision-making processes.

Body Narratives from Posters and Popular Culture Article Sidebar

The dichotomy of physically fit to fit in physical standards has emerged as a new question. Does the bikini industry promote the idea of appealing sizes or competitions that show beauty pageants and bodybuilders on popular media? The body has always been the contested site of people as whenever we meet someone after the first acquaintance, they ask why you are so thin. Or why do you look so fat? This narration is now changing into the new mold of being fit into that new dress. What if it doesn’t, the detrimental effect of not losing or not fitting into the set criteria has emerged in new disorders. The most recurring is the body dysmorphia which evolves due to the rule created by these competitions. Double XL movie produced in 2022, showcases a narrative about the body and for the body. Fashion movie produced in (2008), on models and beauty pageants that tries to cover the deformity of being the best yet ruins the foundation of being human. Bodybuilders and beauty pageants either create history and fame through steroids, unnecessary medication, and surgeries or just distort themselves physically as well as mentally. Physical attractiveness, prowess, and aesthetic appeal are just words that would wipe but talent, capability, and personality would stay forever. Thus, the body is nude yet crude, and therefore, the paper attempts to unwrap the problems staying in the heads of pageants and bodybuilders.

Development of a robust parallel and multi-composite machine learning model for improved diagnosis of Alzheimer's disease: correlation with dementia-associated drug usage and AT(N) protein biomarkers.

Machine learning (ML) algorithms and statistical modeling offer a potential solution to offset the challenge of diagnosing early Alzheimer's disease (AD) by leveraging multiple data sources and combining information on neuropsychological, genetic, and biomarker indicators. Among others, statistical models are a promising tool to enhance the clinical detection of early AD. In the present study, early AD was diagnosed by taking into account characteristics related to whether or not a patient was taking specific drugs and a significant protein as a predictor of Amyloid-Beta (Aβ), tau, and ptau [AT(N)] levels among participants. In this study, the optimization of predictive models for the diagnosis of AD pathologies was carried out using a set of baseline features. The model performance was improved by incorporating additional variables associated with patient drugs and protein biomarkers into the model. The diagnostic group consisted of five categories (cognitively normal, significant subjective memory concern, early mildly cognitively impaired, late mildly cognitively impaired, and AD), resulting in a multinomial classification challenge. In particular, we examined the relationship between AD diagnosis and the use of various drugs (calcium and vitamin D supplements, blood-thinning drugs, cholesterol-lowering drugs, and cognitive drugs). We propose a hybrid-clinical model that runs multiple ML models in parallel and then takes the majority's votes, enhancing the accuracy. We also assessed the significance of three cerebrospinal fluid biomarkers, Aβ, tau, and ptau in the diagnosis of AD. We proposed that a hybrid-clinical model be used to simulate the MRI-based data, with five diagnostic groups of individuals, with further refinement that includes preclinical characteristics of the disorder. The proposed design builds a Meta-Model for four different sets of criteria. The set criteria are as follows: to diagnose from baseline features, baseline and drug features, baseline and protein features, and baseline, drug and protein features. We were able to attain a maximum accuracy of 97.60% for baseline and protein data. We observed that the constructed model functioned effectively when all five drugs were included and when any single drug was used to diagnose the response variable. Interestingly, the constructed Meta-Model worked well when all three protein biomarkers were included, as well as when a single protein biomarker was utilized to diagnose the response variable. It is noteworthy that we aimed to construct a pipeline design that incorporates comprehensive methodologies to detect Alzheimer's over wide-ranging input values and variables in the current study. Thus, the model that we developed could be used by clinicians and medical experts to advance Alzheimer's diagnosis and as a starting point for future research into AD and other neurodegenerative syndromes.

Evaluation of the quality and readability of ChatGPT responses to frequently asked questions about myopia in traditional Chinese language.

ChatGPT can serve as an adjunct informational tool for ophthalmologists and their patients. However, the reliability and readability of its responses to myopia-related queries in the Chinese language remain underexplored. This study aimed to evaluate the ability of ChatGPT to address frequently asked questions (FAQs) about myopia by parents and caregivers. Myopia-related FAQs were input three times into fresh ChatGPT sessions, and the responses were evaluated by 10 ophthalmologists using a Likert scale for appropriateness, usability, and clarity. The Chinese Readability Index Explorer (CRIE) was used to evaluate the readability of each response. Inter-rater reliability among the reviewers was examined using Cohen's kappa coefficient, and Spearman's rank correlation analysis and one-way analysis of variance were used to investigate the relationship between CRIE scores and each criterion. Forty-five percent of the responses of ChatGPT in Chinese language were appropriate and usable and only 35% met all the set criteria. The CRIE scores for 20 ChatGPT responses ranged from 7.29 to 12.09, indicating that the readability level was equivalent to a middle-to-high school level. Responses about the treatment efficacy and side effects were deficient for all three criteria. The performance of ChatGPT in addressing pediatric myopia-related questions is currently suboptimal. As parents increasingly utilize digital resources to obtain health information, it has become crucial for eye care professionals to familiarize themselves with artificial intelligence-driven information on pediatric myopia.