Simplified Version Research Articles

ASCVD risk scores versus a novel cancer-specific Machine Learning-based calculator among patients with breast, colorectal, lung or prostate cancer

Abstract Background Patients with cancer have up to a 3-fold higher risk for cardiovascular disease (CVD) than the general population. Consequently, traditional risk scores developed to predict CVD in the general population (i.e., Pooled Cohort Equations (PCE), Predicting Risk of cardiovascular disease EVENTs [PREVENT]) may provide less accurate risk prediction for this population. Purpose Compare cancer-specific Machine Learning (ML)-based score to PCE and PREVENT to predict 10-year CVD risk in patients with breast cancer (BC), colorectal cancer (CRC), lung cancer (LC), or prostate cancer (PC). Methods Patients aged ≥18 years, diagnosed with BC, CRC, LC, or PC between 2005-2012 at a large hybrid academic-community practice in Northeast Ohio, United States, were included. An ML Extreme Gradient Boosting (XGBoost) algorithm, adapted for survival modeling, was developed using a training subset of the cohort (55% train + 20% test) and ranked 40 to 50 covariates (including social determinants of health, cancer treatment) for predicting 10-year CVD risk for each cancer type using SHAP (SHapley Additive exPlanations) values. The top 10 ML predictors were utilized to create a predictive equation using logistic regression models. This equation was then tested in the cohort validation subset (25%) and subsequently compared to the PCE and PREVENT (both simple and enhanced versions) using the area under the curve (AUC) of the time-dependent receiver operating characteristic curve. The CVD events were identified using ICD codes corresponding to Acute Coronary Syndrome, Ischemic Stroke, and Heart Failure. CVD risk was assessed through Kaplan-Meier. Results We included 10,240 patients (Table 1). The actual 10-year CVD events were: BC 21% (95% CI 19-23), CRC 10% (95% CI 8-12), LC 27% (95% CI 24-30), and PC 20% (95% CI 17-23). The ACC/AHA PCE predicted mean 10-year CVD risks of 16% (95% CI 15-18) for BC, 19% (95% CI 17-21) for CRC, 28% (95% CI 25-32) for LC, and 19% (95% CI 19-20) for PC, with corresponding AUCs of 0.75, 0.65, 0.76, and 0.61, respectively. The PREVENT simple version predicted mean 10-year CVD risks of 13% (95% CI 13-14) for BC, 13% (95% CI 12-13) for CRC, 15% (95% CI 14-15) for LC, and 16% (95% CI 12-19) for PC, with AUCs of 0.55, 0.55, 0.55, and 0.53, respectively. The PREVENT enhanced equation predicted mean 10-year CVD risks of 17% (95% CI 17-18) for BC, 15% (95% CI 14-15) for CRC, 15% (95% CI 15-16) for LC, and 17% (95% 16-19) for PC, with AUCs of 0.75, 0.62, 0.79, and 0.63, respectively. The predictive equation derived from the top 10 ML predictors (Table 2) achieved AUCs of 0.84 for BC, 0.76 for CRC, 0.83 for LC, and 0.71 for PC. Conclusion(s) Conventional CVD equations inadequately assess the risk in patients with BC, CRC, LC, or PC, often resulting in underestimation or overestimation. Cancer-specific ML-derived equations show good performance and emphasize the importance of integrating cancer-related covariates for precise prediction.Table 1Table 2

Phantom Matter: A Challenging Solution to the Cosmological Tensions

The idea of composite dark energy (DE) is quite natural since on general grounds we expect that the vacuum energy density (associated with the cosmological term Λ) may appear in combination with other effective forms of DE, denoted X. Here we deal with model wXCDM, a simplified version of the old ΛXCDM model, and exploit the possibility that X behaves as “phantom matter” (PM), which appears in stringy versions of the running vacuum model (RVM). Unlike phantom DE, the PM fluid satisfies the strong energy condition like usual matter, hence bringing to bear positive pressure at the expense of negative energy. Bubbles of PM may appear in the manner of a transitory “phantom vacuum” tunneled into the late Universe before it heads toward a new de Sitter era, thereby offering a crop field for the growing of structures earlier than expected. Using Type Ia supernovae, cosmic chronometers, transversal baryon acoustic oscillations (BAO 2D), large-scale structure data, and the full cosmic microwave background likelihood from Planck 2018, we find that the H 0 and growth tensions virtually disappear, provided that BAO 2D are the only source of BAO data used in the fit. In contrast, our preliminary analysis using exclusively anisotropic BAO (BAO 3D) indicates that the ability to ease the H 0 tension is significantly reduced as compared to the scenario with BAO 2D, despite the fact that the overall fit to the cosmological data is still better than in the ΛCDM. Finally, our approach with BAO 2D favors quintessence-like behavior of the DE below z ≃ 1.5 at ≳3σ confidence level, which is compatible with the recent DESI measurements.

Research on X-ray security contraband identification technology based on lightweight YOLOv8

Aiming at the difficulty of identification and localization in the detection of contraband targets in X-ray images, as well as the demand for upgrading and deployment of security equipment during the peak flow stage, a lightweight X-ray security contraband detection algorithm is proposed and optimized for YOLOv8. Firstly, the number of channels in the original network is reduced according to a predetermined ratio, which effectively reduces model parameters and computational complexity and achieves better results than the current mainstream lightweight methods, such as model pruning and detection backbone optimization. Secondly, due to the presence of objects of various scales and sizes in X-ray security inspection images, we introduced the BiFPN feature extraction strategy in the neck. We designed a simplified version of BiFPN based on the YOLOv8 network structure to effectively integrate feature information from different levels and scales. Finally, we incorporated the idea of Focal Loss to address the issue of imbalance between positive and negative samples and proposed a new regression loss function, Focal-GIoU Loss, which combines GIoU Loss. This increases the loss weight for important but difficult-to-detect samples, such as small targets and overlapping targets, making the model more focused on these critical samples. Results show that our proposed YOLO-CBF improves mAP by 1.5%, 0.9%, and 0.5% on three datasets with different levels of occlusion in PIDray, while reducing the parameter count and computational cost from the original 3.0M and 8.1G to 2.1M and 6.3G.Moreover, it performs well in comparative experiments between different models and in generalization experiments across different datasets.

San Martín's accurate longitude measurements on Magellan's circumnavigation: luck or mastery?

Abstract During the 1519–1522 Magellan expedition, the astronomer Andrés de San Martín made two remarkably accurate longitude measurements, an order of magnitude better than what was typical for the 16th century. How he managed to do so remained shrouded in mystery for the past 500 years. Using modern ephemerides, we have retraced San Martín's observations and calculated their error signatures, clarifying the method he used (a simplified version of lunar distances) and why two out of his six measurements were accurate (a rather fortuitous cancellation of errors). It would be rash to dismiss San Martín's work as sheer luck though, as he was an exceedingly rare combination of a capable astronomer and a knowledgeable mariner.

Using Item Response Theory to Develop a Shortened Version of the Penn State Worry Questionnaire for Children.

The PSWQ-C is a widely used international scale to measure worry traits in children and adolescents. It has been translated into several versions for use in different countries. The purpose of this study was to examine the psychometric characteristics of the Penn State Worry Questionnaire for Children (PSWQ-C) particularly three reverse-scored items, and to develop a shorter version of the PSWQ-C based on Item Response Theory (IRT) methods. 903 children and adolescents of different ages from China participated in the study. This study used the Graded Response Model (GRM) to fit the data and examined the IRT parameters of each item, Item Characteristic Curve, Item Information Functions, and Differential Item Functioning. Eight items with undesirable functioning were removed, while six items with good functioning were retained, resulting in a simplified version of the PSWQ-C. The abbreviated version of the PSWQ-C was subsequently validated for its reliability and validity. The results confirmed that the abbreviated scale is reliable and effective, with a Cronbach's alpha coefficient of 0.84, indicating good reliability. Regarding validity, the abbreviated version of the PSWQ-C demonstrated significant correlations with IUS-12 and MASC, both exceeding 0.60, which closely resembles the correlation of the original PSWQ-C with these two scales. Furthermore, the correlation between the two versions was 0.96, indicating that the abbreviated PSWQ-C can effectively replace the original version and has a broader range of applications.

Use of a two-bag fluid administration protocol in the treatment of paediatric diabetic ketoacidosis: A retrospective review

ABSTRACT Objectives The ‘two-bag method’ for the treatment of diabetic ketoacidosis (DKA) uses two intravenous fluid bags, only one of which contains 10% dextrose. The bags are run concurrently with rates adjusted according to a rate change table to allow the relative amount of dextrose administered to be adjusted over time, without the need for bag replacements. The Children’s Hospital at London Health Sciences Centre (CHLHSC) two-bag protocol is a simplified version of that used by other centres. The objective of this study was to ensure implementation of the CHLHSC two-bag protocol continues to provide safe and effective treatment of paediatric DKA and decreases resource utilization. Methods This retrospective chart review compared treatment pre- and post-protocol implementation. Results A total of 22 admissions were included. No significant differences in efficacy or safety outcomes were found between the protocol groups. There was no statistically significant difference between the two and one-bag protocols in time to normalization of serum bicarbonate (13.80 ± 7.68 versus 15.01 ± 7.53 h, P = 0.714), blood glucose correction (8.75 ± 4.86 versus 11.85 ± 4.92 h, P = 0.152), and critical care unit length of stay (24.26 ± 9.94 versus 32.30 ± 13.36, P = 0.399). The nursing staff appeared to appropriately implement the rate change table, but the chart documentation was poor. Conclusions The CHLHSC simplified two-bag protocol provides a safe and effective alternative to the one-bag protocol for DKA correction in paediatric patients and may also result in decreased resource utilization.

Deep learning-based surgical step recognition for laparoscopic right-sided colectomy.

Understanding the complex anatomy and surgical steps involved in laparoscopic right-sided colectomy (LAP-RC) is essential for standardizing the surgical procedure. Deep-learning (DL)-based computer vision can achieve this. This study aimed to develop a step recognition model for LAP-RC using a dataset of surgical videos with annotated step information and evaluate its recognition performance. This single-center retrospective study utilized a video dataset of laparoscopic ileocecal resection (LAP-ICR) and laparoscopic right-sided hemicolectomy (LAP-RHC) for right-sided colon cancer performed between January 2018 and March 2022. The videos were split into still images, which were divided into training, validation, and test sets using 66%, 17%, and 17% of the data, respectively. Videos were manually classified into eight main steps: 1) medial mobilization, 2) central vascular ligation, 3) dissection of the superior mesenteric vein, 4) retroperitoneal mobilization, 5) lateral mobilization, 6) cranial mobilization, 7) mesocolon resection, and 8) intracorporeal anastomosis. In a simpler version, consecutive surgical steps were combined, resulting in five steps. Precision, recall, F1 scores, and overall accuracy were assessed to evaluate the model's performance in the surgical step classification task. Seventy-eight patients were included; LAP-ICR and LAP-RHC were performed in 35 (44%) and 44 (56%) patients, respectively. The overall accuracy was 72.1% and 82.9% for the eight-step and combined five-step classification tasks, respectively. The automatic surgical step-recognition model for LAP-RCs, developed using a DL algorithm, exhibited a fairly high classification performance. A model that understands the complex steps of LAP-RC will aid the standardization of the surgical procedure.

The CHD severity classification system: development of a tool to assist with disease stratification for CHD research.

Complexity stratification for CHD is an integral part of clinical research due to its heterogenous clinical presentation and outcomes. To support our ongoing research efforts into CHD requiring disease severity stratifications, a simplified CHD severity classification system was developed and verified, with potential utility for clinical researchers without specialist CHD knowledge or access to clinical/medical records. A two-tiered analysis approach was undertaken. First-tier analysis included the audit of a comprehensive system based on: i) timing of intervention, ii) cardiac morphology, and iii) cardiovascular physiology using real patient data (n = 30), across 10 common CHD lesions. Second-tier analysis allowed for a simplified version of the classification system using morphology as a stand-alone predictor. Twelve clinicians of varying specialities involved in CHD care ranked 10 common lesions from least to most severe based on typical presentation and clinical course. First-tier analysis identified that cardiac morphology was the principal driver of complexity. Second-tier analysis largely confirmed the ranking and classification of the lesions into the broad CHD severity groups, although some variation was noted, specifically among non-cardiac specialists. This simplified version of the classicisation system, with morphology as a stand-alone predictor of severity, allowed for effective stratification for the purposes of analysis. The findings presented here support this comprehensive and simple CHD severity classification system with broad utility in CHD research, particularly among clinicians and researchers with limited knowledge of CHD. The model may be applied to produce locally relevant research tools.

Skin-to-skin stabilisation and uninterrupted respiratory support for preterm infants after birth: feasibility of a new and simplified rPAP system

BackgroundThe rPAP respiratory support system, used for delivery room stabilisation with nasal prongs, has been shown to reduce the need for intubation in extremely preterm infants. A simplified version of...

ANALYSIS ON MULTIPLICATIVELY (P,m)-SUPERQUADRATIC FUNCTIONS AND RELATED FRACTIONAL INEQUALITIES WITH APPLICATIONS

In this work, we, for the first time, establish a class of multiplicatively [Formula: see text]-superquadratic function and look into its various features. In the light of these features, we come up with the several integer order integral inequalities in the frame of multiplicative calculus. Moreover, we develop the fractional version of Hermite–Hadamard’s type inequalities involving midpoints and end points for multiplicatively [Formula: see text]-superquadratic function with respect to multiplicatively [Formula: see text]-Riemann–Liouville fractional integrals. By choosing different values for the parameters of such integral operators, we acquire a simple version of integral inequalities of Hermite–Hadamard’s type as well as its fractional form via multiplicatively Riemann–Liouville fractional integrals for multiplicatively [Formula: see text]-superquadratic function. The findings are confirmed by graphical illustration by taking appropriate examples into account. The study is further enhanced by the addition of applications of special means and first-type modified Bessel functions. The new results clearly provide extensions and improvements of the work available in the literature.

The association between visual impairment, educational outcomes, and mental health: insights from eyeglasses usage among junior high school students in rural China

This study examined the association between visual impairment, visual impairment corrected by wearing eyeglasses, academic performance, and mental health among junior high school students in rural China. Visual acuity assessments were conducted on 19,425 junior high school students by trained medical and research professionals to determine the presence of visual impairment. All sample students were surveyed with a questionnaire that asked about individual and family characteristics, eyeglasses ownership, and educational aspirations and included a standardized math test. Students then completed an official Chinese simplified version of the Strengths and Difficulties Questionnaire (SDQ) to assess their mental health multidimensionally. Among our sample, 37.2% of them suffered from visual impairment, but only 43.4% of the visually impaired students wore proper eyeglasses. Approximately 9.3% of students were categorized as high risk for mental health problems based on their SDQ score. A significant positive association existed between impaired vision and poorer mental health, and eyeglasses usage was associated with better mental health among visually impaired students. For students with better academic performance, eyeglasses usage associated with better mental health. Eyeglasses usage shows a positive association with higher education aspiration both for students with better and worse academic performance. The significant positive relationship between eyeglasses usage and mental health may guide future interventions and policies designed to improve student mental health by supplying them with eyeglasses.

Effect of diffusivity of amyloid beta monomers on the formation of senile plaques.

Alzheimer's disease (AD) presents a perplexing question: why does its development span decades, even though individual amyloid beta (Aβ) deposits (senile plaques) can form rapidly in as little as 24 hours, as recent publications suggest? This study investigated whether the formation of senile plaques can be limited by factors other than polymerization kinetics alone. Instead, their formation may be limited by the diffusion-driven supply of Aβ monomers, along with the rate at which the monomers are produced from amyloid precursor protein (APP) and the rate at which Aβ monomers undergo degradation. A mathematical model incorporating the nucleation and autocatalytic process (via the Finke-Watzky model), as well as Aβ monomer diffusion, was proposed. The obtained system of partial differential equations was solved numerically, and a simplified version was investigated analytically. The computational results predicted that it takes approximately 7 years for Aβ aggregates to reach a neurotoxic concentration of 50 μM. Additionally, a sensitivity analysis was performed to examine how the diffusivity of Aβ monomers and their production rate impact the concentration of Aβ aggregates.

K-depth tests for testing simultaneously independence and other model assumptions in time series

We consider the recently developed K-depth tests for testing simultaneously independence and other model assumptions for univariate time series with a potentially related d-dimensional process of explanatory variables. Since these tests are based only on signs of residuals, they are easy to comprehend. They can be used in a full version and in a simplified version. While former investigations already showed that the full version is appropriate for testing model assumptions, we concentrate here on either testing the independence assumption on its own or on simultaneously testing independence and model assumptions with both types of tests. In an extensive simulation study, we compare these tests with several known independence test such as the runs test, the Durbin-Watson test, and the Von-Neumann-Rank-Ratio test. Finally, we demonstrate how the K-depth tests can be used for improved modeling of crack width time series depending on temperature measurements in a bridge monitoring.

Translation, Cross-Culture Adaptation and Measurement Properties of the Simplified Chinese Version of the Osteoarthritis Knowledge Scale.

The aim of this study was to culturally adapt the Osteoarthritis Knowledge Scale (OAKS) into a simplified Chinese version and to evaluate its measurement properties among Chinese-speaking populations. The OAKS scale was translated and cross-culturally adapted following COSMIN guidelines. A total of 368 participants were recruited, including individuals with knee or hip osteoarthritis (OA), healthcare professionals, and individuals without OA. The study evaluated the scale's internal consistency, test-retest reliability, and factor structure using Exploratory Factor Analysis (EFA). The translated OAKS scale demonstrated acceptable levels of reliability across different groups. Cronbach's alpha for the KOAKS was 0.70 overall, with subgroup values ranging from 0.70 to 0.71. For the HOAKS, Cronbach's alpha was 0.77 overall, with subgroup values ranging from 0.63 to 0.72. Test-retest reliability showed high Intraclass Correlation Coefficient (ICC) values for both scales (KOAKS: ICC=0.960; HOAKS: ICC=0.982). EFA revealed that the overall OAKS explained a substantial portion of the variance (60.51%), with KOAKS accounting for 59.35% and HOAKS accounting for 54.68% of the variance. The simplified Chinese version of the OAKS is a reliable tool for assessing OA knowledge among Chinese-speaking patients, healthcare professionals, and the general public. The findings highlight the necessity for continuous improvement and adaptation of educational interventions to address specific knowledge gaps within the Chinese context.

Validation of a dermatoscopy-based algorithm for the diagnosis of acral melanoma.

Diagnosis of acral melanocytic lesions can be challenging. The BRAAFF checklist was introduced as a tool to help differentiate between acral nevi and melanoma but has not been validated. We asked raters with varying expertise in dermatoscopy to diagnose dermatoscopic images of 533 acral nevi and 144 melanomas via an online platform with and without use of the BRAAFF checklist. From the ratings we calculated sensitivity, specificity, and interrater agreement. Additionally, a new simplified version of the checklist was also tested. We collected 6880 ratings from 175 readers. The BRAAFF checklist achieved a sensitivity of 92.5% and a specificity of 65.0%, which was similar to diagnosis from pattern recognition (sensitivity 90.0%, specificity: 72.1%). Interrater agreement for the BRAAFF criteria ranged from fair to moderate, with lowest agreement for parallel ridge and fibrillar pattern (alpha=0.31) and highest for asymmetry of colors and structures (alpha=0.46). Agreement and diagnostic accuracy were higher for more experienced readers. A simplified version with only two criteria achieved similar sensitivity (95.0%) and lower specificity (60.0%) as the original BRAAFF checklist. Conclusion: The BRAAFF checklist is a useful tool for the diagnosis of melanocytic acral lesions with acceptable sensitivity and reasonable specificity but is not superior to pattern recognition. A simplified version of the checklist could be easier to use with equal sensitivity while exhibiting a modest reduction in specificity.

12518 Development Of A Four-compartment, Dynamic (In Vivo) Model For Insulin Disposition In Healthy Humans: Use Of Fick’s Law To Model Plasma-interstitial Insulin Flux

Abstract Disclosure: R.I. Dorin: None. C.R. Qualls: None. Introduction: Metabolic elimination of insulin (I) in vivo includes pathways mediated by high-affinity and potentially saturable insulin receptor binding; endogenous insulin secreted into the portal vein is subject to first pass elimination. The rate of insulin flux between vascular (Vp) and interstitial (Vi) compartments is often modeled by first order rate constants; here we analyzed an alternative approach using Fick’s law. Methods: The four-compartment, insulin (I) model is expressed by four differential equations that represent I flow (mass/time) in 4 volumes (V) (or compartments) having 3 corresponding elimination rate functions (α): (i) vascular plasma (Vp), (ii) interstitial (Vi, αi), (iii) hepatic (Vh, αh), and (iv) kidney (Vk, αk). Fick’s law was used to model diffusion of insulin between Vp and Vi; Michaelis-Menten like functions were used for saturable elimination functions (αh and αi); rates of hepatic (HPF) and renal (KPF) plasma flow were from literature. Realistic bounds for solved parameters (insulin permeability constant [k, L/min] and αi [min-[1]]) were developed by test bed analysis of published plasma (Ip) and interstitial (Ii) insulin concentration data. The inverse problem (estimating parameters) used Ip data from insulin-modified, frequently sampled iv glucose tolerance (IM-FSIVGT) studies performed in 40 healthy, non-diabetic women (1). Parameter solutions for individual subjects were obtained by iterative least squares method minimizing differences between model-predicted and measured Ip. Results: For infusion of exogenous I (ZI) at a constant rate (e.g., insulin clamp), reported steady state Ii/Ip data suggest that interstitial insulin elimination (αi) is conditionally saturable. Together with non-steady state data for Ip and Ii, initial estimates of k and αi were obtained. Steady state solutions give rise to four algebraic equations: (1) Ii/Ip = a, where a < 1 is consistent with experimental data, (2) Ih is a reduced version of a linear combination of Ip and endogenous insulin secretion (Zβ), where the factor of reduction (b) is <1, (3) Ik/Ip = d, where d<1, and (4) Ip is a linear combination of (i) ZI and (ii) the reduced (by factor b) Zβ. For Ip, this linear combination of ZI and reduced Zβ is also normalized by factor c (weighted sum of k, HPF, and KPF). Conclusions: (i) The proposed insulin flow model using Fick’s law was advantageous in providing realistic parameters and solutions that are tractable to physiologic interpretation, (ii) a simplified version of this model is generalizable to C-peptide, and (iii) since measurement of Ii is impractical in the clinical setting, the proposed prediction model may provide useful modeling adjunct to personalize pharmacokinetic and pharmacodynamic strategies for insulin administered by subcutaneous, iv, and hybrid closed-loop insulin pump routes. 1. Gower et al. Nutrition & Metabolism (2016) 13:2 Presentation: 6/1/2024

Fully automated simplification of urban drainage models on a city scale

ABSTRACT The article presents an innovative method for simplifying urban drainage models. This approach strategically reduces complexity while preserving accuracy in large-scale, high-resolution models such as those of the city of Graz. It involves the selective removal and aggregation of sewer network elements like subcatchments and conduits, ensuring vital features like storage nodes and flow controls remain intact for precise simulations. Despite significant reductions in model components, the simplified version maintains high accuracy in hydrological and hydraulic aspects, including water balance components like infiltration loss, surface runoff, and external outflow. The method proves equally effective across both land cover and sewer shed-based models, offering computational efficiencies that speed-up processing by 20–45 times for the study site. This is particularly beneficial for rapid decision-making and resource optimization in urban planning. The model also adeptly predicts flood events, especially from larger, infrequent rainfall, although an overly restrictive flow capacity can refine flood predictions at the expense of other flow characteristics. Ultimately, this streamlined approach allows for the quick creation of simplified, yet accurate, models from high-resolution city-scale hydrodynamic data or digital twins, facilitating efficient and timely analyses in urban drainage management.

FEM simulation of vibrations in building: from volume to shell elements

The problem of vibrations in buildings situated in the proximity of railway tracks is a major concern for the resident's comfort. More and more studies focus on this problem using FEM models, with shell elements for the building's walls and floors. However, the validity of this simplification is never fully justified, and it raises questions concerning the dimensions to apply to the model. The model of a building made of 3D elastic elements is compared to its simplified version made of shell elements. Three geometries with different dimensions are tested to find the one closer to the reference model. Different shell offsets are also tested. The results show great differences of floor vibration levels, mostly for high frequencies, depending on the dimensions of the geometry and the offset. The shell configuration with the closest results to the reference model is discussed.

Integrating the Memory Support Intervention into the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C): can improving memory for treatment in midlife and older adults improve patient outcomes? Study protocol for a randomized controlled trial

BackgroundPoor memory for treatment is associated with poorer treatment adherence and poorer patient outcomes. The memory support intervention (MSI) was developed to improve patient memory for treatment with the goal of improving patient outcomes. The aim of this study protocol is to conduct a confirmatory efficacy trial to test whether a new, streamlined, and potent version of the MSI improves outcomes for midlife and older adults. This streamlined MSI is comprised of constructive memory supports that will be applied to a broader range of treatment content. The platform for this study is the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C). We will focus on midlife and older adults who are low income and experiencing mobility impairments.MethodsParticipants (N = 178) will be randomly allocated to TranS-C + MSI or TranS-C alone. Both intervention arms include eight 50-min weekly sessions. Assessments will be conducted at pre-treatment, post-treatment, 6-, and 12-month follow-up (6FU and 12FU). Aim 1 will compare the effects of TranS-C + MSI versus TranS-C alone on sleep and circadian functioning, daytime functioning, well-being, and patient memory. Aim 2 will test whether patient memory for treatment mediates the relationship between treatment condition and patient outcomes. Aim 3 will evaluate if previously reported poor treatment response subgroups will moderate the relationship between treatment condition and (a) patient memory for treatment and (b) treatment outcome. Exploratory analyses will compare treatment condition on (a) patient adherence, patient-rated treatment credibility, and patient utilization of treatment contents, and (b) provider-rated acceptability, appropriateness, and feasibility.DiscussionThis study has the potential to provide evidence for (a) the efficacy of a new simplified version of the MSI for maintaining health, well-being, and functioning, (b) the wider application of the MSI for midlife and older adults and to the treatment of sleep and circadian problems, and (c) the efficacy of the MSI for sub-groups who are likely to benefit from the intervention.Trial registrationClinicalTrials.gov NCT05986604. Registered on 2 August 2023.

Validity and Reliability of a Simplified Chinese Version of Cancer Survivors' Unmet Needs Scale (CaSUN).

To translate Cancer Survivors' Unmet Needs scale (CaSUN) into Simplified Chinese, and to assess the validity and reliability of this translated version among Chinese cancer survivors. Following the cross-cultural adaptation guidelines, the original CaSUN scale was translated from English into Simplified Chinese. To enhance the readability and comprehension of each item, a pilot study involving 40 cancer patients was carried out. Subsequently, 324 cancer survivors participating in follow-up appointments at a cancer hospital in Beijing, China completed the Simplified Chinese version of the CaSUN. The scale's validity was assessed through factor analysis. Indices including Satorra-Bentler scaled chi-square to degree of freedom ratio (χ2/df), comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean squared residual (SRMR) were employed for construct validity. Average variance extracted (AVE) of each category reflected the convergent validity. Reliability was confirmed with both Cronbach's α and Guttman split-half coefficient. Factor analysis suggested that a three-level hierarchical structure of the CaSUN with four first-order factors, nine second-order factors and all the 35 items assessing unmet need could fit our data well (χ2/df=2.833, CFI=0.902, RMSEA=0.076, SRMR=0.066), indicating sufficient construct validity for this model. For convergent validity, AVE of each second-order category were greater than 0.5. Regarding reliability, Cronbach's α of the 35 items was 0.968, and the Guttman split-half coefficient was 0.984. Both of these coefficients were higher than 0.8. The present Simplified Chinese version of CaSUN had good cultural adaptability, appropriate validity and reliability for assessing unmet needs in different cancer survivor groups in Chinese mainland. This Simplified Chinese version of CaSUN can assist health professionals in addressing individual survivor needs and bridge the gap between patients' experiences and their expectations, thereby improving the quality of cancer survivorship care.