Subjective Difficulty Research Articles

An analysis of influencing factors of oral frailty in the elderly in the community

ObjectiveThis study aimed to investigate the current situation of oral frailty (OF) in the elderly in the community in China and analyse its influencing factors.MethodsUsing convenience sampling, 380 elderly people from three communities in our city were selected as participants in the study. The Oral Frailty Index-8, the Frailty Scale, the Oral Health Assessment Tool, the Mini-nutritional Assessment Scale and the Pittsburgh Sleep Quality Index were used to investigate and analyse OF influencing factors.ResultsIn this study, the 380 elderly participants were categorized into three groups: frailty, pre-frailty, and non-physical frailty, based on their responses to the questionnaires.The influencing factor analysis showed that age, gender, education level, frailty score, frailty stage, number of dentures, dry mouth, subjective chewing difficulty, oral health score and sleep quality were the influencing factors of OF in the elderly in the community (R2 = 0.712, F = 434.73, P < 0.05). The evaluation of the prediction results showed that the frailty score (area under the curve [AUC]: 0.751, 95% confidence interval [CI]: 0.683–0.862), subjective chewing difficulty (AUC: 0.765, 95% CI: 0.655–0.831) and sleep quality (AUC: 0.736, 95% CI: 0.652–0.781) had a higher predictive value for OF.ConclusionThe main OF influencing factors in the elderly in the community are age, gender, education level, physical frailty (PF) score, PF stage, number of dentures, dry mouth, subjective chewing difficulties, oral health score and sleep quality. Nursing staff should pay attention to the OF of the elderly in the community and take targeted intervention measures in time to reduce and control OF occurrence and progression.

Effects of Miosis on the Visual Acuity Space under Varying Conditions of Contrast and Ambient Luminance in Presbyopia.

Background: Presbyopia is an age-related ocular condition, typically affecting individuals aged over 40 years, characterized by a gradual and irreversible decline in the eye's ability to focus on nearby objects. Correction methods for presbyopia encompass the use of corrective lenses, surgical interventions (corneal or lens based), and, more recently, the FDA-approved topical administration of 1.25% pilocarpine. While prior research has demonstrated the efficacy of daily pilocarpine eye drop application in enhancing near visual acuity by increasing the depth of focus leveraging the pinhole effect, limited knowledge exists regarding its influence on visual acuity under varying conditions of contrast and ambient luminance. Methods: This study aims to investigate the impact of these variables on visual acuity, employing the VA-CAL test, among 11 emmetropic and 11 presbyopic volunteers who reported subjective difficulties with near vision. This study includes evaluations under natural conditions with a pinhole occluder (diameter of 2 mm), and subsequent administration of 1% pilocarpine (Pilomann, Bausch + Lomb, Laval, Canada). Results: The VA-CAL results demonstrate the expected, statistically significant effects of contrast and ambient luminance on visual acuity in both emmetropic and presbyopic volunteers. Furthermore, in emmetropic individuals, the application of pilocarpine resulted in a statistically significant reduction in visual acuity. In contrast, presbyopes did not exhibit statistically significant differences in the visual acuity space under either the pinhole or pilocarpine conditions when compared to natural conditions. Conclusions: The pharmacological treatment of presbyopia with pilocarpine eye drops, intended to enhance near vision, does not adversely affect visual acuity in presbyopes. This suggests that pilocarpine may offer a viable alternative for individuals averse to wearing corrective eyewear.

Stress Detection and Mitigation through Discovery of Optimal Lecture Delivery Method for STEM-Enrolled University Students

The high availability of technology-related jobs is currently not fulfilled by enough supply of technology graduates, specifically the ones coming from science, technology, engineering, and mathematics (STEM) courses. This is related to the low enrolment rate of STEM-based courses at Universities. The notion that STEM subjects are intense and difficult to pass could be the reason of such phenomena. This research experimented different lecture delivery methods comprising of different seating arrangements, inclusion or exclusion of break, group size, and room size to investigate the generated levels of stress among STEM students, so that the method that would induce minimum stress could be discovered. The analysis of the generated heart rates as stress indication concludes that the level of difficulty of STEM subject’s topic is the one that most affected students’ level of stress, while inclusion of break during class is imperious to destress students. Class arrangement with far seating was discovered to be potentially more stressful for certain students indicated by the high level of resting heart rate in one of the experiments. Importantly, it was also found that regardless of lecture delivery method, STEM subjects in general remained challenging that was suggested by the consistently high recorded heart rates, which was also a sign of active learning engagement - besides implying the level of stress. Finally, gender-wise, there is no visible data pattern that could hint that certain gender is more vulnerable to stress when handling STEM subjects.

Symmetric bimanual coordination discrepancy and activities of daily living in individuals with autism spectrum disorder

Impairments in bimanual coordination are commonly observed in individuals with autism spectrum disorder (ASD). Bimanual coordination is essential for the performance of activities of daily living (ADLs). However, it remains unclear whether bimanual coordination impairment is associated with performing ADLs in adults with ASD. This study examined the relationship between bimanual tasks and subjective ADL difficulty in adults with ASD. Nineteen adults with ASD (41.95 ± 10.89) and 20 aged-matched (41.70 ± 11.07) controls completed a bimanual thumb–index finger opposition task and a questionnaire on subjective difficulty in ADL performance, which was evaluated using a visual analogue scale. The bimanual thumb–index finger opposition task was evaluated using a motion capture system, which quantified the coefficient of variation (COV) between bilateral finger movements. The subjective ADL difficulty scores were significantly higher in adults with ASD than in controls (p = 0.003). The COV in adults with ASD was also higher than in controls (p = 0.025). A moderate correlation was found between bimanual task COVs and subjective ADL difficulty scores in adults with ASD (r = 0.56, p = 0.013). Thus, a discrepancy in bimanual coordination may increase the effort required to perform ADLs in adults with ASD.

EEG Dataset Collection for Mental Workload Predictions in Flight-Deck Environment.

High mental workload reduces human performance and the ability to correctly carry out complex tasks. In particular, aircraft pilots enduring high mental workloads are at high risk of failure, even with catastrophic outcomes. Despite progress, there is still a lack of knowledge about the interrelationship between mental workload and brain functionality, and there is still limited data on flight-deck scenarios. Although recent emerging deep-learning (DL) methods using physiological data have presented new ways to find new physiological markers to detect and assess cognitive states, they demand large amounts of properly annotated datasets to achieve good performance. We present a new dataset of electroencephalogram (EEG) recordings specifically collected for the recognition of different levels of mental workload. The data were recorded from three experiments, where participants were induced to different levels of workload through tasks of increasing cognition demand. The first involved playing the N-back test, which combines memory recall with arithmetical skills. The second was playing Heat-the-Chair, a serious game specifically designed to emphasize and monitor subjects under controlled concurrent tasks. The third was flying in an Airbus320 simulator and solving several critical situations. The design of the dataset has been validated on three different levels: (1) correlation of the theoretical difficulty of each scenario to the self-perceived difficulty and performance of subjects; (2) significant difference in EEG temporal patterns across the theoretical difficulties and (3) usefulness for the training and evaluation of AI models.

An assistive listening device improves hearing following aneurysmal subarachnoid haemorrhage.

Hearing impairment is common following aneurysmal subarachnoid haemorrhage (aSAH). Previous studies have demonstrated that auditory processing disorder (APD) is the primary underlying pathology. Assistive listening devices (ALDs) can be used to manage APD but have not been explored in aSAH. The aim of this study was to assess the benefit of an ALD for patients reporting hearing difficulty after aSAH. This was a prospective pilot single-arm intervention study of an ALD for APD following aSAH. Patients who reported subjective hearing difficulty following aSAH were identified from the Wessex Neurological Centre aSAH database. Speech-in-noise was evaluated using the Bamford-Kowal-Bench (BKB) test under 60 and 65 dB noise conditions. BKB performance was compared with and without an ALD. Cognition was assessed using the Addenbrooke's Cognitive Examination-III. Fourteen aSAH patients with self-reported hearing loss were included in the analysis. Under both noise conditions the ALD significantly improved BKB performance (60 dB, Z = -3.30, p < 0.001; 65 dB, Z = -3.33, p < 0.001). There was no relationship between cognition and response to the ALD. This study demonstrates the marked benefit of ALDs to manage APD following aSAH, regardless of cognitive status. This finding has implications for the management of this common yet disabling deficit which impacts quality of life and employment. A further trial of ALDs in this patient group is needed to test whether these large, short-term benefits can be practically translated to the community for long-term benefit when used at home.

The Homophobia Course in the Life of Older Gay Men in Brazil: Their Social Representations

ABSTRACT This study aims at understanding the social representations of homophobia among older gay men. A number of 20 older gay men aged between 60 and 75 years old participated of the study; the average age was 63.25 years old (SD = 3.58). In the data collection, a semi-structured interview about homophobia was used; they were analyzed on IRAMUTEQ, which compiles the descendant hierarchical classification. The corpus was divided into three classes of social representations. The first representation comprises images of prejudice within society. The second one presents social representations involving reports of internalized homophobia and the experiencing of prejudice. The third one shows social representations about physical and identity violations. The social representations of homophobia show how the participants lead their actions in society, being based upon risk and protection issues to face the objective and subjective difficulties present in their social representations.

The Aha! experience is associated with a drop in the perceived difficulty of the problem.

The study investigated the correlation between the intensity of the Aha! experience and participants' subjective difficulty ratings of problems before and after finding their solutions. We assumed that the Aha! experience arises from a shift in processing fluency triggered by changing from an initially incoherent problem representation to a coherent one, which ultimately leads to the retrieval of a solution with unexpected ease and speed. First, we hypothesized that higher Aha! experience ratings would indicate more sudden solutions, manifesting in a reduced correlation between the initial difficulty ratings and solution times. Second, we hypothesized that higher Aha! experience ratings would correspond to a greater shift in the subjective difficulty ratings between the initial and retrospective assessments. To test our hypotheses, we developed a novel set of rebus puzzles. A total of 160 participants solved rebuses and provided initial (within 5 s of problem presentation) and retrospective difficulty ratings (following the generation or presentation of a correct solution). They also rated their Aha! experience (after solution generation or presentation), confidence in solutions, and the likability of each rebus. Our findings revealed that the initial ratings of the problem's subjective difficulty were positively correlated with the solution time and that this correlation decreased in the case of a stronger Aha! experience. Aha! experience ratings were positively correlated with the differences between initial and retrospective difficulty ratings, confidence, solution accuracy, and rebus likability. We interpreted our results to be in line with the processing fluency and metacognitive prediction error accounts.

Exploring Upper Limb Kinematics in Limited Vision Conditions: Preliminary Insights from 3D Motion Analysis and IMU Data

This study examined upper limb kinematics under simulated visually impaired conditions. By investigating how upper limb movements adapt in these circumstances, we aimed to gain insights that may prove valuable for both healthy populations and those with clinical conditions. Data, including 3D marker-based motion capture and accelerometer readings, were collected from seven healthy volunteers walking on a treadmill at 1.5 m/s under two conditions: without glasses (NG) and with stroboscopic glasses (G). Each walking condition lasted 2 minutes, and two 10-second recordings were analyzed from the midpoint of each session. Contrary to our hypothesis, simulated visual impairment with stroboscopic eyewear at 6Hz did not statistically affect upper limb kinematics, specifically in terms of wrist acceleration and hand distance in the frontal plane. Future research should explore varied visual impairment conditions, extend task durations, and investigate the relationship between subjective gait difficulties and biomechanical data.

Associations Between Auditory Working Memory, Self-Perceived Listening Effort, and Hearing Difficulty in Adults With Mild Traumatic Brain Injury.

Mild traumatic brain injury (TBI) can have persistent effects in the auditory domain (e.g., difficulty listening in noise), despite individuals having normal pure-tone auditory sensitivity. Individuals with a history of mild TBI often perceive hearing difficulty and greater listening effort in complex listening situations. The purpose of the present study was to examine self-perceived hearing difficulty, listening effort, and performance on an auditory processing test battery in adults with a history of mild TBI compared with a control group. Twenty adults ages 20 to 53 years old participated divided into a mild TBI (n = 10) and control group (n = 10). Perceived hearing difficulties were measured using the Adult Auditory Processing Scale and the Hearing Handicap Inventory for Adults. Listening effort was measured using the National Aeronautics and Space Administration-Task Load Index. Listening effort ratings were obtained at baseline, after each auditory processing test, and at the completion of the test battery. The auditory processing test battery included (1) dichotic word recognition, (2) the 500-Hz masking level difference, (3) the Listening in Spatialized Noise-Sentences test, and (4) the Word Auditory Recognition and Recall Measure (WARRM). Results indicated that individuals with a history of mild TBI perceived significantly greater degrees of hearing difficulty and listening effort than the control group. There were no significant group differences on two of the auditory processing tasks (dichotic word recognition or Listening in Spatialized Noise-Sentences). The mild TBI group exhibited significantly poorer performance on the 500-Hz MLD and the WARRM, a measure of auditory working memory, than the control group. Greater degrees of self-perceived hearing difficulty were significantly associated with greater listening effort and poorer auditory working memory. Greater listening effort was also significantly associated with poorer auditory working memory. Results demonstrate that adults with a history of mild TBI may experience subjective hearing difficulty and listening effort when listening in challenging acoustic environments. Poorer auditory working memory on the WARRM task was observed for the adults with mild TBI and was associated with greater hearing difficulty and listening effort. Taken together, the present study suggests that conventional clinical audiometric battery alone may not provide enough information about auditory processing deficits in individuals with a history of mild TBI. The results support the use of a multifaceted battery of auditory processing tasks and subjective measures when evaluating individuals with a history of mild TBI.

Screening for dysphagia in patients with relapsing-remitting multiple sclerosis

BackgroundIn multiple sclerosis (MS), dysphagia is an important and common clinical symptom. Although often overlooked and underdiagnosed, it can have a significant impact on a patient's life, including social integration, and it can lead to malnutrition, aspiration pneumonia, and suffocation, i.e., life-threatening complications. Early detection of dysphagia is essential to prevent these risks. However, the optimal screening method and the inter-relationship between different methods used for dysphagia screening are not clear. The aim of this study was to compare the diagnostic performance of a simple question about swallowing problems, the DYsphagia in MUltiple Sclerosis (DYMUS) swallowing questionnaire, and the Timed Water Swallowing Test (TWST) to detect dysphagia in people with relapsing-remitting MS (RRMS). MethodsPatients with MS were asked about subjective swallowing difficulties and, regardless of their response, completed the DYMUS questionnaire and underwent the TWST at their routine follow-up visit. Patients with at least one positive screening method were offered an objective assessment of swallowing function using the Fiberoptic Endoscopic Evaluation of Swallowing (FEES). The results were statistically analyzed and correlated with demographic and MS-related parameters. ResultsOf the 304 people with RRMS enrolled in the study, 46 (15.1 %) reported having subjective difficulty swallowing when asked a simple question. The DYMUS questionnaire was positive in 59 (19.4 %) of the 304 patients; 51 (16.8 %) had an abnormality on the TWST. A clear correlation (r = 0.351, p < 0.01) was found between the DYMUS and TWST results, but a significant proportion of patients (about half) had an abnormality on only one of these tests. The positivity of at least one of the screening methods used (DYMUS or TWST) had a better chance of identifying a patient with dysphagia than a simple question (p < 0.001). Of the patients with a positive result for difficulty swallowing, 37 underwent FEES, which confirmed dysphagia in 94.6% of this subgroup. Patients with higher Expanded Disability Status Scale (EDSS) scores, female gender, and older age were at higher risk of developing dysphagia. ConclusionThe DYMUS questionnaire and TWST had a confirmed potential to identify more patients with dysphagia than a simple question about swallowing problems. However, our study found only a partial overlap between DYMUS and TWST; a combination of these two methods was more sensitive in identifying patients with MS at risk of dysphagia. Furthermore, the screening showed excellent specificity: almost 95 % of the positively screened patients had dysphagia confirmed by objective methods. Age, female gender, and a higher EDSS score appear to be potential risk factors for dysphagia in patients with MS.

State-Aware Deep Item Response Theory using student facial features.

This paper introduces a novel approach to Item Response Theory (IRT) by incorporating deep learning to analyze student facial expressions to enhance the prediction and understanding of student responses to test items. This research is based on the assertion that students' facial expressions offer crucial insights into their cognitive and affective states during testing, subsequently influencing their item responses. The proposed State-Aware Deep Item Response Theory (SAD-IRT) model introduces a new parameter, the student state parameter, which can be viewed as a relative subjective difficulty parameter. It is latent-regressed from students' facial features while solving test items using state-of-the-art deep learning techniques. In an experiment with 20 students, SAD-IRT boosted prediction performance in students' responses compared to prior models without the student state parameter, including standard IRT and its deep neural network implementation, while maintaining consistent predictions of student ability and item difficulty parameters. The research further illustrates the model's early prediction ability in predicting the student's response result before the student answered. This study holds substantial implications for educational assessment, laying the groundwork for more personalized and effective learning and assessment strategies that consider students' emotional and cognitive states.

Subjective Functional Difficulties Were Associated With Subjective Cognitive Decline Among U.S. Older Adults: Mentally Unhealthy Days Mediation and Income Level Moderation Effects.

Subjective cognitive decline (SCD) is a self-perceived decline in cognition that may progress to mild cognitive impairment or Alzheimer's disease. SCD may be associated with difficulties in daily functioning and psychological distress. Previous research has shown the association between functional difficulties and SCD via mentally unhealthy days (MUDs). However, whether income levels influence the mediation effect of MUDs is less understood. This study examined the association between subjective functional difficulties and the odds of SCD through MUDs, and whether the mediation effect was moderated by income levels. Cross-sectional data were obtained from the 2019 Behavioral Risk Factor Surveillance System (N = 13,160 older adults aged 65+; 7,370 women). SCD was assessed by more frequent or worse memory loss and confusion in the past 12 months. Subjective functional difficulties represented difficulties with daily activities. MUDs denoted the days that a person felt mentally unwell within the past 30 days. We used path analysis with 5,000 bootstrapped confidence intervals and logistic regression to classify the risks of SCD based on subjective functional difficulties and MUDs. Subjective functional difficulties were positively associated with SCD through mediation by MUDs (b = 0.119, 95% CI 0.102, 0.137). After accounting for covariates, we found that greater subjective functional difficulties were associated with 2.50 times the odds of SCD (AOR = 2.50; 95% CI: 2.14, 2.91); MUDs were related to 1.06 times the odds of SCD reporting (AOR = 1.06; 95% CI: 1.05, 1.07). Income levels moderated the indirect effect of MUDs in the subjective functional difficulties-SCD relationship, with an income of <$15,000 showing the most prominent effect. Those earning ≥$50,000 self-reported a lower SCD than those earning <$15,000. Our study extends previous findings by demonstrating that greater subjective functional difficulties are associated with higher odds of SCD through more frequent MUDs, with higher income levels being associated with more SCD reporting.

Subjective Difficulty with Higher-Level Functional Capacity in Community-Dwelling Older People withMild Cognitive Impairment.

Mild cognitive impairment (MCI) is a predictor of future age-related dementia. We herein investigated associations of MCI with higher-level functional capacities, as well as with subjective difficulty regarding these functions, in community-dwelling older people, to identify a simple method for early MCI detection. We administered a test battery to 118 community-dwelling older people living in an urban area. The battery consisted of three tests;the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), the Touch Panel-type Dementia Assessment Scale (TDAS), and the Geriatric Depression Scale-15. We then excluded participants with possible dementia or depression symptoms, and divided the remainder (n = 67) into an MCI group (n = 16) and a non-MCI group (n = 51), according to TDAS performance. Logistic regression analysis with the MCI and non-MCI groups as dependent variables indicated that TMIG-IC was a significant variable. Male sex and the perception that preparing meals and filling out pension forms had become more difficult were significantly associated with MCI, each independently increasing the probability of MCI. Subjective difficulty with higher-level functions and impairment in higher-level functional capacity may serve as indices for mass screening for MCI.

Objective and Subjective Difficulties in Implementation Lend-Lease Programs Towards the Soviet Union

Objective and Subjective Difficulties in Implementation Lend-Lease Programs Towards the Soviet Union

ПРЕСТИЖНІСТЬ ФАХІВЦЯ З СОЦІАЛЬНОЇ РОБОТИ В УКРАЇНІ : ПРОБЛЕМИ ТА МОЖЛИВОСТІ ПІДВИЩЕННЯ

This article states that social work occupies a leading place in modern Ukrainian society, thereby determining the relevance of this scientific and professional issue. It is shown that social work is increasingly developing in various industries, acquiring a global scale and is an important component in solving many social and personal problems of a person. Based on the results of the analysis of scientific research, the foundations of the origin and development of social work are revealed. Recently, professions of the socionomic type have gained special importance in society. The authors show that the activities of specialists in socionomic specialties are directly related to the person, to the relationships between the person, social groups, society and the state and are aimed at the implementation of the process of socialization of the person. Being aimed at improving the quality of a person’s life, the realization of his aspirations, the profession of a social worker is also found. In the center of attention of the authors is the problem of the prestige of the professional activity of specialists in the social sector. The article is devoted to the analysis of society’s understanding of the profession of social work, as well as the determination of factors influencing the formation and maintenance of the image of social workers. In the article, the authors reflect a fairly wide range of issues: objective and subjective difficulties that prevent the formation of the prestige of the profession of social workers. In addition to structural problems that prevail due to the natural and historical formation of social work, there are also internal restrictive barriers to the development of social work in Ukraine. The authors note that the current challenges facing social work include low public awareness of its specifics, lack of professional distinctions and demarcations, as well as difficulties associated with the process of its status determination and professionalization. The article reflects the main conclusions and results of the research, as well as recommendations for improving the image of a social worker.

Evolving trends in neuropsychological profiles of post COVID-19 condition: A 1-year follow-up in individuals with cognitive complaints.

Cognitive difficulties are reported as lasting sequelae within post COVID-19 condition. However, the chronicity of these difficulties and related factors of fatigue, mood, and perceived health have yet to be fully determined. To address this, the current longitudinal study aimed to clarify the trends of cognitive test performance and cognitive domain impairment following COVID-19 onset, and whether hospitalization influences outcomes. 57 participants who reported subjective cognitive difficulties after confirmed COVID-19 infection were assessed at baseline (~6 months post COVID-19) and follow-up (~15 months later) visits. Assessments included measures across multiple cognitive domains and self-report questionnaires of fatigue, mood, and overall health. Analyses were conducted in three stages: at the test score level (raw and adjusted scores), at the cognitive domain level, and stratified by hospitalization status during infection. Results at the test-score level indicate that cognitive performance remains relatively stable across assessments at the group level, with no significant improvements in any adjusted test scores at follow-up. Cognitive domain analyses indicate significant reductions in attention and executive functioning impairment, while memory impairment is slower to resolve. On self-report measures, there was a significant improvement in overall health ratings at follow-up. Finally, those hospitalized during infection performed worse on timed cognitive measures across visits and accounted for a larger proportion of cases with short-term and working memory impairment at follow-up. Overall, our findings indicate that cognitive difficulties persist both at test score and cognitive domain levels in many cases of post COVID-19 condition, but evidence suggests some improvement in global measures of attention, executive functioning and overall self-rated health. Furthermore, an effect of hospitalization on cognitive symptoms post COVID-19 may be more discernible over time.

Enhancing Prediction of Myocardial Recovery After Coronary Revascularization: Integrating Radiomics from Myocardial Contrast Echocardiography with Machine Learning.

Chronic coronary artery disease (CAD) management often relies on myocardial contrast echocardiography (MCE), yet its effectiveness is limited by subjective interpretations and difficulty in distinguishing hibernating from necrotic myocardium. This study explores the integration of machine learning (ML) with radiomics to predict functional recovery in dyskinetic myocardial segments in CAD patients undergoing revascularization, aiming to overcome these limitations. This prospective study enrolled 55 chronic CAD patients, dividing into training (39 patients, 205 segments) and testing sets (16 patients, 68 segments). Dysfunctional myocardial segments were identified by initial wall motion scores (WMS) of ≥2 (hypokinesis or higher). Functional recovery was defined as a decrease of ≥1 grade in WMS during follow-up echocardiography. Radiomics features were extracted from dyssynergic segments in end-systolic phase MCE images across five cardiac cycles post- "flash" impulse and processed through a five-step feature selection. Four ML classifiers were trained and compared using these features and MCE parameters, to identify the optimal model for myocardial recovery prediction. Functional improvement was noted in 139 out of 273 dyskinetic segments (50.9%) following revascularization. Receiver Operating Characteristic (ROC) analysis determined that myocardial blood flow (MBF) was the most precise clinical predictor of recovery, with an area under the curve (AUC) of 0.770. Approximately 1.34 million radiomics features were extracted, with nine features identified as key predictors of myocardial recovery. The random forest (RF) model, integrating MBF values and radiomics features, demonstrated superior predictive accuracy over other ML classifiers. Validation of the RF model on the testing dataset demonstrated its effectiveness, evidenced by an AUC of 0.821, along with consistent calibration and clinical utility. The integration of ML with radiomics from MCE effectively predicts myocardial recovery in CAD. The RF model, combining radiomics and MBF values, presents a non-invasive, precise approach, significantly enhancing CAD management.

A new course difficulty index (CDf): Framework and application

A new framework for the quantification of course difficulty in academic curricula is proposed. The originality of the approach lies in its course-centric nature. A course difficulty index value is calculated (CDf), using difficulty indicators that characterize the course as a whole. The difficulty indicators can be tailored to reflect the academic domain considered. A weighting percentage is calculated and it is assigned to each course difficulty indicator, by systematically conducting Principal Component Analysis (PCA) on students? assessment data. Next, the weighted difficulty indicators are used to calculate CDf in the form of a composite indicator. In general, the value of the latter varies across courses, and across different offerings of a given course. The CDf framework is applied in the case of a university in Greece by utilizing course difficulty indicators which are objective in their nature, like course mean and median grades, passing grade percentages, etc. The dataset used spans a period of thirteen (13) academic years. The findings are used to identify courses that represent ?bottlenecks? in student study paths. Subjective course difficulty indicators may also be used, like students? questionnaire data. It is worth noting that the quantification of course difficulty by means of a single index can be used in the calculation of adjusted student scores and, as such, facilitate data mining operations on students? assessment data. All in all, the proposed CDf frame work and analysis comprise a useful tool for academic policy-making and quality assurance.

Contextual Interference Effect in Learning of Simulated Laparoscopic Tasks

Laparoscopy, a minimally invasive surgical technique involving fine motor movements of the hands and fingers, has proven to be an invaluable tool in surgical care. Expediting the learning process of surgeons to reach proficiency in this surgical technique directly impacts patient outcomes, recovery times, and time management in hospitals [1]. Within motor learning, blocked and random practice has been identified as having correspondingly low or high levels of contextual interference, with different effects on learning and retention of motor skills. Contextual interference can be described as the level of mental interference created during the practice of motor skills. So far, research has been equivocal in identifying the best practice schedule for optimizing the acquisition and retention of fine and gross motor skills. This study examines the role of contextual interference in the acquisition, short-term retention (10-minute), and long-term retention (10-day) of three variations of a simulated laparoscopic task in 60 adults aged 18-65, 30 males and 30 females. The index of performance was represented by the total time taken to complete each task using curved laparoscopic graspers. Results showed that both blocked and random practice groups significantly improved acquisition performance over 54 acquisition trials. Participants undergoing a blocked practice schedule improved their pattern time-to-completion by 46%, retaining most of their performance in the 10-minute retest while maintaining their skill as well after 10 days. The random practice group improved acquisition performance by 38%, maintaining most of their performance in the short-term retention test, with only a slight decrease in speed in the long-term retention test. No statistically significant differences in the efficiency of blocked versus random practice schedules were found for both acquisition and retention, suggesting that both practice schedules can be viable options for learning and retention of simulated laparoscopic surgical tasks. We suggest tailoring training programs to individual skill levels to provide each learner with the optimal amount of contextual interference to reach their optimal challenge point according to subjective task difficulty experienced.