Subjective Grading Research Articles

Fully automated computational measurement of noise in positron emission tomography

ObjectivesTo introduce an automated computational algorithm that estimates the global noise level across the whole imaging volume of PET datasets.Methods[18F]FDG PET images of 38 patients were reconstructed with simulated decreasing acquisition times (15–120 s) resulting in increasing noise levels, and with block sequential regularized expectation maximization with beta values of 450 and 600 (Q.Clear 450 and 600). One reader performed manual volume-of-interest (VOI) based noise measurements in liver and lung parenchyma and two readers graded subjective image quality as sufficient or insufficient. An automated computational noise measurement algorithm was developed and deployed on the whole imaging volume of each reconstruction, delivering a single value representing the global image noise (Global Noise Index, GNI). Manual noise measurement values and subjective image quality gradings were compared with the GNI.ResultsIrrespective of the absolute noise values, there was no significant difference between the GNI and manual liver measurements in terms of the distribution of noise values (p = 0.84 for Q.Clear 450, and p = 0.51 for Q.Clear 600). The GNI showed a fair to moderately strong correlation with manual noise measurements in liver parenchyma (r = 0.6 in Q.Clear 450, r = 0.54 in Q.Clear 600, all p < 0.001), and a fair correlation with manual noise measurements in lung parenchyma (r = 0.52 in Q.Clear 450, r = 0.33 in Q.Clear 600, all p < 0.001). Classification performance of the GNI for subjective image quality was AUC 0.898 for Q.Clear 450 and 0.919 for Q.Clear 600.ConclusionAn algorithm provides an accurate and meaningful estimation of the global noise level encountered in clinical PET imaging datasets.Clinical relevance statementAn automated computational approach that measures the global noise level of PET imaging datasets may facilitate quality standardization and benchmarking of clinical PET imaging within and across institutions.Key Points• Noise is an important quantitative marker that strongly impacts image quality of PET images.• An automated computational noise measurement algorithm provides an accurate and meaningful estimation of the global noise level encountered in clinical PET imaging datasets.• An automated computational approach that measures the global noise level of PET imaging datasets may facilitate quality standardization and benchmarking as well as protocol harmonization.

Meningkatkan Hasil Belajar PAK Dengan Model PBL Berbantuan Media Interaktif Kancing Gemerincing Tema Manusia Sebagai Pribadi Bagi Peserta Didik Kelas X Fase E SMA Negeri 1 Kudus

This research aimed to improve the student’s outcames of the X E 7 grade SMA Negeri 1 Kudus year of 2023/2024 in Catholic religious and morals subjects by implementating Problem Based Learning (PBL) model assisted by interactive media kancing gemerincing. This research is a classroom action research that included in two cycle with 2 confluence every cycle. Each cycle consist of planning, acting, observing, and reflecting. The first and second cycle discussed the subject of the unique human beings and gander equality. The subject of this research is the catholic student of X E 7 grade SMA Negeri 1 Kudus year of 2023/2024 which consist of 8 students. The main technique in data collecting used test, and observation, meanwhile the proponent technique used interview and documentation. The result of this research showed that the implementation of Problem Based Learning model assisted by interactive media kancing gemerincing can improve learning outcomes student of X E 7 grade in Catholic religious and morals subjects start from cycle I and cycle II is 81 in cycle I stage increase to be 89 in cycle II. The conclution of this research is the implementation of Problem Based Learning (PBL) model assisted by interactive media kancing gemerincing can improve learning outcomes student of X E 7 grade SMA Negeri 1 Kudus year of 2023/2024.

Application of enhanced recovery after surgery following liver transplantation

ObjectiveTo investigate the effect of an enhanced recovery after surgery (ERAS) programme following liver transplantation and to further clarify the safety and clinical application value of an ERAS programme.MethodsA retrospective analysis of 250 patients who underwent liver transplant at Beijing You’an Hospital affiliated to Capital Medical University between March 2019 and December 2021 was conducted. According to different perioperative management methods, patients were divided into a control group (120 cases) and an ERAS group (130 cases). Postoperative safety indicators, efficacy indicators and economic indicators were compared between the two groups.ResultsThere was no significant difference in the safety indicators between the two groups. The ERAS group showed significantly lower results compared with the control group in terms of ventilator-associated pneumonia, urinary tract infection, pressure injury of oral and nasal mucosa, postoperative pain score 5 days after surgery and the incidence of delirium, whereas the Barthel score 10 days after surgery was significantly higher. There was no significant difference between the two groups in skin pressure injury or the Subjective Global Assessment grade 10 days after surgery. The length of intensive care unit stay, the total length of stay after surgery and the 10-day medical expenses after surgery were significantly lower in the ERAS group than in the control group.ConclusionThe application of an ERAS programme after liver transplantation can effectively promote the postoperative recovery of patients and reduce medical costs. Studies have shown that the ERAS programme has important application value in improving the postoperative quality of life and reducing the economic burden of patients after liver transplantation. This programme provides a new concept for related clinical improvement and application.

A Reflective Revisit of The Standard Model of Indigenous Learning (SMIL): Turning a Theoretical Model Into Application

Academic support is a necessity for Indigenous and non-Indigenous learners, whether that be curriculum, theory, instructional design models, or resources. Western educational systems, by keeping European-American curriculum and pedagogies while disregarding Indigenous methodologies, have tragically failed Indigenous learners. Published in 2013, the Standard Model of Indigenous Learning (SMIL) was introduced as a theoretical framework to support Indigenous learners, teachers, curriculum developers, instructional designers, and researchers. This paper revisits the SMIL and meticulously examines it by reflective practice, practical experiences, evidence-based research, and applications of the model. Based on pre-contract learning and Indigenous values, the model has five threads: place, storytelling, intergenerational interaction, experience, and interconnectedness. As the only Indigenous instructional design model, the SMIL provides a robust framework for housing content and is applicable to any subject area and grade level in the academic arena across various platforms of delivery. Indigenous ways of knowing, worldviews, and methodologies such as the SMIL are needed in the Western educational systems. If systemic barriers such as academic resistance to culturally responsive teaching and assessments, white comfort, educational variation, and power are not addressed, Indigenous learners will continue to face inherent academic hurdles.

Change in objective bulbar redness and symptoms after refit of weekly and monthly lenses into a water-gradient daily disposable lens material

Purpose. The purpose of this pilot study is to identify if fine graduated differences in objective redness of the eye exist in a cohort of non-symptomatic contact lens wearers. The pri- mary objective is the evaluation of change in bulbar redness when a non-symptomatic, 2-4 week contact lens wearer, is refitted to a Delefilcon A lens material. Secondary objectives include the determination of limbal redness, corneal and bulbar staining, and wearing comfort. Material and Methods. 52 habitual, asymptomatic, full time soft contact lens wearers were enrolled in a multicenter study. At the baseline visit, bulbar and limbal redness were measured objectively using the Redness-Scan of the Keratograph 5M (K5M). Habitual lenses, lens care type, comfort ratings and staining data were captured at baseline visit. A wash out phase of 6 ± 1 days was conducted in which the subjects did not wear any lenses before Delefilcon A lenses were dispensed at visit 2 (V2) for a wearing period of 26 ± 5 days. A follow up visit was planned after 6 ± 1 days from V2 and a final visit after additional 20 ± 4 days. During visits 2, 3 and 4, the same objective measurements were carried out and corresponding subjective data was captured. ANOVA, t-test for paired sam- ples, homogeneity test and Wilcoxon signed rank test were used for the statistical analyses. Results. A total number of 49 complete data sets were suc- cessfully evaluated. Objectively measured bulbar redness decreased by 0.121 (p = 0.003) from the baseline compared to the final visit. In the same period, limbal redness reduced by 0.151 (p = 0.000). In addition, an increase from 36 at baseline to 47 at V4 grade 0 ratings regarding corneal staining, and from 32 to 39 regarding bulbar staining was found, respec- tively. The averaged comfort rating with habitual lenses was 79.7 ± 16.6 compared to the final visit 89.0 ± 10.8. Conclusion. In the context of classic subjective grading hab- its which use fully grades in 1.0 steps, the objective Red- ness-Scan was able to detect finely graduated differences in the cohort of non-symptomatic wearers. The daily disposable test product delivers benefits to wearers in the form of re- duced bulbar and limbal redness, reduced corneal and bulbar staining, and statistically and clinically increased contact lens wearing comfort. Keywords contact lens, bulbar redness, wearing comfort

Penerapan Strategi Mind Mapping dalam Meningkatkan Pemahaman Siswa pada Pembelajaran Sejarah Bani Umayyah di MAS Al-Washliyah P. Berandan

The research in based on the results of observations of students in class XI MAS Al-Washliyah P. Berandan, it was found that the daily grades of Islamic Cultural History subjects in class XI MAS Al-Washliyah were on average still low or under the KKM (Minimum Completeness Criteria).The shows that most students do not understand the material being taught so that if affects learning outcomes. The purpose of this study is to find out the application of mind mapping strategies in improving students’ understanding, especially in the Umayyad History lesson. The research sample is class XI Religion students, totaling 24 people. The type of research used is quantitative research with experimental methods with One Grup Pretest Posttest Design. Data collection techniques in this study were using observasion, tests, and documentation. The result showed that the application of mind mapping strategies could improve students’ understanding. Students’ understanding before (pretest) applied mind mapping strategy was 51,25 after being implemented with mind mapping strategy (posttest) was 81,88. Meanwhile, for the results of hypothesis testing, a value of 0,00 is obtained, this indicates that there is an effect of applying mind mapping strategies in increasing students’ understanding of the history of rhe Umayyads.

THE INTEGRATIVE APPROACH OF YOGIC SHUDHIKRIYA (JALADHAUTI) AND AYURVEDIC MEDICINE IN THE MANAGEMENT OF URDHWAG AMLAPITTA – A CASE REPORT

Lifestyle disorders are on the rise around the world in which Urdhwaga Amlapitta is occurring frequently due to improper diet and habits. A 14-year boy came in OPD with a complaint of a Burning Sensation in the Chest, sour belching, constipation, headache, loss of appetite, and heaviness in the abdomen for 8 months. Treatment was planned with 3 settings of Jaladhauti and internal medicine like Sutshekhar Rasa and Avipattikar Churna for 1 month. Lifestyle modifications were made, and Pathya Apthya Ahar Vihar was advised. The assessment was done by Subjective grading criteria before and after treatment in which symptoms reduce remarkably and no recurrence of disease occurs.

Performance in Kahoot! activities as predictive of exam performance

BackgroundGame-based learning (GBL) is effective for increasing participation, creativity, and student motivation. However, the discriminative value of GBL for knowledge acquisition has not yet been proven. The aim of this study is to assess the value of Kahoot! as a discriminative tool for formative assessment in medical education in two different subjects.MethodsA prospective experimental study was conducted on a sample of 173 students enrolled in neuroanatomy (2021–2022). One hundred twenty-five students individually completed the Kahoot! prior to the final exam. In addition, students enrolled in human histology during two academic courses were included in the study. The control group course (2018–2019) received a traditional teaching methodology (N = 211), while Kahoot! was implemented during 2020–2021 (N = 200). All students completed similar final exams for neuroanatomy and human histology based on theory tests and image exams.ResultsThe correlation between the Kahoot score and the final grade was analyzed for all students enrolled in neuroanatomy who completed both exercises. The correlation between the Kahoot exercise and the theory test, image exam and final grade was significantly positive in all cases (r = 0.334 p < 0.001, r = 0.278 p = 0.002 and r = 0.355 p < 0.001, respectively). Moreover, students who completed the Kahoot! exercise obtained significantly higher grades in all parts of the exam. Regarding human histology, the theory tests, image exams and final grades were significantly higher when using Kahoot! versus the “traditional” methodology (p < 0.001, p < 0.001 and p = 0.014, respectively).ConclusionsOur study demonstrates for the first time that Kahoot! can be used to improve and predict the final grade in medical education subjects.

A phase 1 dose escalation study of GCC19CART: A novel coupled CAR therapy for patients with metastatic colorectal cancer.

3547 Background: GCC19CART, the first clinical candidate from the CoupledCAR solid tumor platform, is designed to overcome the limitations of conventional CAR T-cells in solid tumor malignancies by pairing solid tumor CAR T-cells with CD19 targeting CAR T-cells to amplify the proliferation and activation of the solid tumor CAR T component. GCC19CART targets guanylate cyclase-C (GCC), which is expressed in the metastatic lesions of 70%-80% of subjects with colorectal cancers and largely restricted to the intestinal tract. A Phase 1 investigator-initiated clinical trial is underway in China for patients with relapsed or refractory metastatic colorectal cancer who have received at least 2 prior lines of therapy. As of a data cutoff on Jan 28, 2023 21 subjects have been enrolled in 2 dose escalation groups at 5 hospitals in China. Methods: Subjects are screened for GCC expression by immunohistochemistry. Eligible subjects undergo leukapheresis, a single dose of lymphodepleting chemotherapy (fludarabine 30mg/m2 and cyclophosphamide 300mg/m2) 3 days prior to infusion, and then administration of a single infusion of GCC19CART at one of two preassigned doses: 1x106 or 2x106 CAR T-cells/kg. All responses were confirmed by an independent third-party imaging contract research organization. Results: 13 subjects have been enrolled to dose level 1 (1x106 cells/kg) and 8 subjects have been enrolled to dose level 2 (2x106 cells/kg). The most common adverse events were cytokine release syndrome (CRS) in 21/21 subjects (Grade 1 19/21 (90.48%) or Grade 2 2/21 (9.52%)) and diarrhea in 21/21 subjects (Grade 1 6/21 (28.57%) Grade 2 5/21 (23.81%) Grade 3 9/21 (42.86%) or Grade 4 1/21 (4.76%)). All patients with grade 3 and higher side effects were well managed. Immune effector cell-associated neurotoxicity syndrome (ICANS) was observed in 2/21 (9.52%) subjects at Grade 3 or 4 and resolved with corticosteroids. The combined overall response rate (ORR) for both dose levels was 28.6% (6/21). For dose level 1, overall response rate (ORR) was 15.4% (2/13). Two subjects demonstrated a partial response (PR) while 3 additional subjects had partial metabolic response (PMR) on PET/CT with stable disease (SD) or progressive disease (PD) per RECIST 1.1. For dose level 2, The ORR was 50% (4/8). 4 subjects demonstrated a PR and 2 additional subjects had PMR on PET/CT with SD per RECIST 1.1.The median PFS was 1.9 months in the dose 1 group and 6.3 months in the dose 2 group. The median overall survival was 13.3 months in the dose 1 group and 18.3 months in the dose 2 group. Conclusions: Preliminary results demonstrate that GCC19CART has meaningful dose-dependent clinical activity and an acceptable safety profile in relapsed or refractory metastatic colorectal cancer. This trial is ongoing and updated data will be presented. A Phase 1 trial of GCC19CART in the US has opened for accrual and is expected to enroll patients in mid-2022. Clinical trial information: ChiCTR2000040645 .

Novel GUCY2C targeting CAR-T therapy: Efficacy in advanced colorectal cancer.

3559 Background: Chimeric antigen receptor (CAR) T cells have shown remarkable success in treating patients with hematologic malignancies. However, the majority of CAR-T cell clinical trials in solid tumors have limited success which is partially attributed to the detrimental tumor microenvironment and the lack of ideal target. Recently, GUCY2C emerges as an ideal therapeutic target which is highly expressed in colorectal cancer (CRC). Here, a novel nanobody-based GUCY2C targeting CAR-T cell developed by us is applied to treat advanced colorectal cancer patients who failed third-line therapy. Methods: In this open-label, single-arm, investigator-initiated exploratory trial (ChiCTR2100044831), we primarily explore the safety and the low-dose efficacy of the autologous anti-GUCY2C CAR-T cells. All patients screened by IHC met our criteria for GUCY2C positivity. All enrolled patients had received at least 3 prior lines of therapy and had multiple metastases at baseline. Totally, 13 advanced CRC patients aged 18 to 65 years were infused with the anti-GUCY2C CAR-T cells at a dose range of 0.5-3 x10e6/kg after standard Cy-Flu lymphodepletion. Adverse events (AE) were graded according to CTCAE 5.0, and objective tumor responses were assessed per RECIST 1.1 criteria. Results: Between November 2021 and December 2022, 13 subjects with refractory metastatic CRC (mCRC) were treated with the anti-GUCY2C-CAR-T cells infusions at a dose range of 0.5-3 x10e6/kg. There were no dose-limiting toxicities, treatment-related death or any form of neurotoxicity occurred in this study. The most common TEAEs were diarrhea in 9/13 (69%) subjects (Grade 1: 2/13 (15.38%) Grade 2: 3/13 (23.07%) Grade 3: 4/13 (30.77%)). 8/13 (62%) mCRC subjects experienced grade1 or grade 2 mouth ulcer generally appear as a single lesion lasting for a few days. All cytokine release syndromes (CRS) observed were grade 1. Totally 9 pts (69%) experienced grade 1 CRS and all resolved by supportive care without the need of tocilizumab. No grade 4 AEs except for decreased lymphocytes in 12/13 pts (92%), decreased white blood cells in 1/13 pts (7.7%) and decreased platelet in 1/13 pts (7.7%). Among 10 evaluable patients, 6 partial responses, 2 stable disease and 2 progressive disease were achieved. At all dose levels ORR and DCR were 60% and 80% respectively. Notably, all 3 patients infused at the dose level above 2x10e6/kg reached partial responses. Among the 3 non-evaluable patients, 1 patient lost follow-up, 1 patient died of bone marrow failure and 1 patient died of COVID-19 related complications before the first efficacy evaluation. Additional data will be presented at the meeting. Conclusions: This clinical study indicated that the anti-GUCY2C CAR-T cell therapy was well tolerated and had promising efficacy in heavily pretreated mCRC patients. Clinical trial information: ChiCTR2100044831 .

Complete Integration of Team Project-Based Learning Into a Database Syllabus

Team project-based learning (TPBL) combines two learning techniques: 1) project-based learning (PBL) and 2) teamwork. This combination leverages the learning outcomes of both methods and places students in a real work situation where they must develop and solve a real project while working as a team. TPBL has been used in two advanced database subjects in Jaume I University (UJI)’s Computer Science degree program. This learning method was used for four years (academic years from 2018/2019 to 2021/2022) with positive outcomes. This study presents the project development, which includes teamwork formation, activities, timetable, and exercised learning competencies (both soft and specific). Further, the project’s results were evaluated from three different perspectives: 1) teamwork evaluation by teammates; 2) students’ opinions on the subject and project; and 3) subject final grades.

Pengaruh Manajemen Kelas Terhadap Kualitas Pembelajaran Mata Pelajaran IPS Terpadu

The research aims to determine the effect of classroom management on the learning quality of Integrated Social Science subject in grade VIII at SMP Negeri 1 Tilamuta, Boalemo Regency. This study employs a quantitative method. The data collection is carried out through observation, questionnaires, and documentation. The population includes 121 students and 36 students, as samples are taken from the population. The analysismethod uses simple linear regression. The research finding shows that class managemment affects the learning quality in the Integrated Social Science Subject grade VIII at SMP Negeri 1 Tilamuta, Boalemo Regency, with a significant effect of 45,3%

Current status of patient-reported outcome measures and other subjective assessment grading tools in bladder pain syndrome.

Bladder pain syndrome (BPS) is characterised by chronic pain in the bladder area accompanied by urgency and/or frequency without the presence of other confusable diseases. Owing to a lack of gold standard diagnostic tests and definitive cure it is paramount to define treatment goals and validated measurements of outcomes. Patient-reported outcome measures (PROMs) are validated questionnaires completed by patients that can help to reduce ambiguity in the BPS patient treatment pathway, but they are currently underutilised. We present to our knowledge the first summary and analysis of all available PROMs in BPS patients. Review and critical evaluation of all relevant BPS guidelines presented in English language and a systematic search for PubMed database articles relating to PROMs and subjective assessment grading tools in BPS, interstitial cystitis and chronic pelvic pain syndrome. The ideal PROMs for BPS should assess urinary symptoms, pain, quality of life and sexual health. There are five PROMs designed specifically for BPS patients. The most universally used and quoted is the O'Leary-Sant questionnaire followed by the Pelvic Pain and Urgency Score and the Wisconsin Interstitial Cystitis scale. However, there is no single PROM for BPS that is ideal, and for comprehensive assessment several questionnaires are often used simultaneously. Patient-reported outcome measures are a valuable tool for use in the long-term management of patients burdened with BPS. There are now several disease-specific PROMs in use that have their respective advantages and disadvantages. Their use should be encouraged in future research as well as continued efforts to develop new PROMs that can address current shortcomings.

143 Factors affecting pregnancy rates on a commercial Thoroughbred breeding farm: A retrospective analysis of breeding shed data

Understanding the factors that affect per cover pregnancy rates on commercial breeding farms is important for efficient operation and improving breeding management. Breeding shed records for 9 seasons (2009–2017) from a commercial Thoroughbred breeding farm were used to evaluate factors influencing reproductive success. Observations of individual covers (n = 10,156) were recorded by the manager and trained staff and included information on mating demographics; cover and semen characteristics; and mare conformation and behavior. Incomplete records were removed from the data set providing 8,843 observations. The effect of each factor on pregnancy rate was analyzed using a generalized linear model and binomial distribution. Per cover pregnancy rate (PR) was different (P < 0.001) between stallions (n = 20) and ranged from 53 to 70% (mean average = 63%). PR was lower (P < 0.001) in barren mares compared with foaling and maiden mares; July covers (P < 0.001) compared with all other months; and when dismount samples contained urine (P < 0.001). Mares scoring 0 or 1 (on a 0–4 tease scale) were less likely (P < 0.05) to conceive than mares showing stronger estrous behaviors when teased before mating with LS means of 40.4, 54.4, 62.2, 62.6 and 65.9 % PR for tease scoresof 0, 1, 2, 3 and 4 respectively. There was a trend (P = 0.08) for lower PR in mares requiring tranquilization (57.1%) compared with non-tranquilized mares (62%) supporting the importance of estrous behavior for successful mating. Insemination post live cover was performed 15% of the time due to either a large dismount sample or per owner request, however there was no difference in PR. Pregnancy rate was higher (P < 0.05) in mares with vulva sutures (63.5%) or having acceptable vulvar conformation without sutures (64.1 %) compared with poor vulva conformation without sutures (59.3%). Mating quality assessed by a subjective cover grade (A, B+, B, B-, C) positively influenced PR (P < 0.001) while other factors including: number of mounts, number of semen pulses, time of day and presence of RBC and WBC in the dismount sample had no effect on PR, although there was a trend (P < 0.08) for lower PR when WBCs were noted in the dismount samples. Maintaining detailed breeding shed records can provide managers with useful information which could be used in making management decisions.

Self‐regulatory and demographic predictors of grades in online and face‐to‐face university cohorts: A multi‐group path analysis

AbstractPredictors of academic success at university are of great interest to educators, researchers and policymakers. With more students studying online, it is important to understand whether traditional predictors of academic outcomes in face‐to‐face settings are relevant to online learning. This study modelled self‐regulatory and demographic predictors of subject grades in 84 online and 80 face‐to‐face undergraduate students. Predictors were effort regulation, grade goal, academic self‐efficacy, performance self‐efficacy, age, sex, socio‐economic status (SES) and first‐in‐family status. A multi‐group path analysis indicated that the models were significantly different across learning modalities. For face‐to‐face students, none of the model variables significantly predicted grades. For online students, only performance self‐efficacy significantly predicted grades (small effect). Findings suggest that learner characteristics may not function in the same way across learning modes. Further factor analytic and hierarchical research is needed to determine whether self‐regulatory predictors of academic success continue to be relevant to modern student cohorts. Practitioner NotesWhat is already known about this topic Self‐regulatory and demographic variables are important predictors of university outcomes like grades. It is unclear whether the relationships between predictor variables and outcomes are the same across learning modalities, as research findings are mixed. What this paper adds Models predicting university students' grades by demographic and self‐regulatory predictors differed significantly between face‐to‐face and online learning modalities. Performance self‐efficacy significantly predicted grades for online students. No self‐regulatory variables significantly predicted grades for face‐to‐face students, and no demographic variables significantly predicted grades in either cohort. Overall, traditional predictors of grades showed no/small unique effects in both cohorts. Implications for practice and/or policy The learner characteristics that predict success may not be the same across learning modalities. Approaches to enhancing success in face‐to‐face settings are not automatically applicable to online settings. Self‐regulatory variables may not predict university outcomes as strongly as previously believed, and more research is needed.

Parental limit-setting decisions and adolescent subject grades

Parental limit-setting decisions and adolescent subject grades

Racial and Ethnic Bias in Medical School Clinical Grading: A Review

Improving diversity in healthcare is a widely recognized national goal. The diversity of medical student matriculants has increased, yet this trend is not seen in the composition of competitive residency programs.In this review, we examine racial and ethnic disparities in medical student grading during clinical years and explore the consequences of how this may exclude minority students from accessing competitive residency positions. Following PRISMA guidelines, we searched PubMed, Embase, Scopus, and ERIC databases using variations of the terms "race," "ethnicity," "clerkship," "rotation," "grade," "evaluation", or "shelf exam." Of 391 references found using the criteria, 29 were related to clinical grading and race/ethnicity and included in the review.The GRADE criteria were used to determine the quality of evidence. Johns Hopkins School of Medicine, Baltimore MD. Five studies examining a total of 107,687 students from up to 113 different schools found racial minority students receive significantly fewer Honors grades in core clerkships compared to White students. Three studies examining 94,814 medical student evaluations from up to 130 different schools found significant disparities in the wording of written clerkship evaluations based on race and/or ethnicity. A large body of evidence suggests the presence of racial bias in subjective clinical grading and written clerkship evaluations of medical students. Grading disparities can disadvantage minority students when applying to competitive residency programs and may contribute to a lack of diversity in these fields. As low minority representation has a negative impact on patient care and research advancement, strategies to resolve this issue must be further explored.

MP68-09 VALIDATION OF AN OBJECTIVE PRESSURE TEST FOR URETHROVESICAL ANASTOMOSIS IN A NON-BIOHAZARDOUS ROBOT ASSISTED RADICAL PROSTATECTOMY SIMULATION MODEL

You have accessJournal of UrologyCME1 Apr 2023MP68-09 VALIDATION OF AN OBJECTIVE PRESSURE TEST FOR URETHROVESICAL ANASTOMOSIS IN A NON-BIOHAZARDOUS ROBOT ASSISTED RADICAL PROSTATECTOMY SIMULATION MODEL Nathan Schuler, Alexis Steinmetz, Kit Yuen, Lauren Shepard, Tyler Holler, Christopher Wanderling, and Ahmed Ghazi Nathan SchulerNathan Schuler More articles by this author , Alexis SteinmetzAlexis Steinmetz More articles by this author , Kit YuenKit Yuen More articles by this author , Lauren ShepardLauren Shepard More articles by this author , Tyler HollerTyler Holler More articles by this author , Christopher WanderlingChristopher Wanderling More articles by this author , and Ahmed GhaziAhmed Ghazi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003331.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urethrovesical Anastomosis (UVA) is a critical step within Robot Assisted Radical Prostatectomy (RARP) which directly influences postoperative complication and continence recovery. The current standard for assessing UVA proficiency is mainly through the Robotic Anastomosis Competency Evaluation (RACE), a subjective video-based grading system. We have previously validated embedded force sensors within realistic RARP models as an objective method to measure torque during nerve sparing. Herein, we developed an adjacent pressure test with parallels to common urodynamic testing as an objective metric to evaluate UVA integrity in our RARP simulation. METHODS: 48 simulated robotic UVA were completed by urologists with varying experience levels: 6 experts (EXP), 16 intermediates (IM) and 26 novices (NOV)). Following simulation, bladders were dissected from surrounding tissue and subjected to a pressure leak test. Bladders were filled to predetermined volumes at a constant rate. Internal volume when leakage at the UVA site started and at end of filling were measured, then used to calculate maximum internal pressure (Pmax) and pressure at leakage start (Pleak). Flow Fractionation (FF) was calculated by allowing free fluid flow through both UVA site and urethra onto separate, tared scales and recorded throughout the test. RACE scores were assigned by two blinded expert video reviewers. RESULTS: EXP showed higher Pmax, FF, and Pleak versus NOV (p=.0009; p=.005; p=.011) as well as EXP vs IM (p=.028; p=.047; p=.047), however IM vs NOV lacked significance. Multivariate analysis found significant positive correlations between Knot Tying (KT), Suture Placement (SP) and Tissue Approximation (TA) with FF (p=.017; p=.051; p=.0007) and Pmax (p=0.01; p=.087; p=.0005). TA and KT had significant correlations with Pleak (p=.0027; p=.085) (Figure 1). CONCLUSIONS: The bladder pressure test and its parameters we have developed represent three objective metrics that can be used to assess the ability of a trainee to complete a UVA that would succeed in an intraoperative leak test. Stratification of test difficulty towards the upper end of the RACE score spectrum offers more granularity by which intermediates can assess performance vs experts. Source of Funding: n/a © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e956 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nathan Schuler More articles by this author Alexis Steinmetz More articles by this author Kit Yuen More articles by this author Lauren Shepard More articles by this author Tyler Holler More articles by this author Christopher Wanderling More articles by this author Ahmed Ghazi More articles by this author Expand All Advertisement PDF downloadLoading ...

PD27-11 COMPARISON OF PROSTATE BIOPSY GRADE OBTAINED BY HUMAN PATHOLOGISTS VERSUS AN ARTIFICIAL INTELLIGENCE ALGORITHM FOR PREDICTING BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY

You have accessJournal of UrologyCME1 Apr 2023PD27-11 COMPARISON OF PROSTATE BIOPSY GRADE OBTAINED BY HUMAN PATHOLOGISTS VERSUS AN ARTIFICIAL INTELLIGENCE ALGORITHM FOR PREDICTING BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY Claire de la Calle, Thiago Vidotto, Eric Erak, Daniela Salles, Oluwademilade Dairo, Christian Pavlovich, Misop Han, Joonyoung Cho, In Hye Suh, Hye Yoon Chang, Sun Woo Kim, Michael Gorin, and Tamara Lotan Claire de la CalleClaire de la Calle More articles by this author , Thiago VidottoThiago Vidotto More articles by this author , Eric ErakEric Erak More articles by this author , Daniela SallesDaniela Salles More articles by this author , Oluwademilade DairoOluwademilade Dairo More articles by this author , Christian PavlovichChristian Pavlovich More articles by this author , Misop HanMisop Han More articles by this author , Joonyoung ChoJoonyoung Cho More articles by this author , In Hye SuhIn Hye Suh More articles by this author , Hye Yoon ChangHye Yoon Chang More articles by this author , Sun Woo KimSun Woo Kim More articles by this author , Michael GorinMichael Gorin More articles by this author , and Tamara LotanTamara Lotan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003305.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Several artificial intelligence (AI) algorithms have been developed to streamline biopsy Gleason grading, but most have not been challenged with predicting oncologic outcomes. In this study, we leveraged a cohort of patients with biopsy-detected Grade Group (GG) 2 prostate cancer (PCa) and examined the association of biopsy grade by contemporary pathologist consensus grade or AI algorithm with time to biochemical recurrence (BCR) after radical prostatectomy (RP). METHODS: We identified 286 patients originally diagnosed with GG2 PCa on biopsy who underwent RP at our institution from 2000 to 2014. All biopsies were re-graded by two expert genitourinary pathologists (pathologist 1 and 2). For cases with discrepant reads, a third expert genitourinary pathologist determined the consensus pathology read. GG was also obtained using a previously validated and published AI algorithm. Concordance between pathologist and AI GG was quantified using the quadratic kappa. BCR was defined as two consecutive PSAs ≥0.2 ng/mL. Kaplan-Meier BCR free survival estimates by GG were compared using the log-rank test. RESULTS: After RP median follow-up was 4 years (range 1-14). To date, 16% of the men have had BCR and median time to BCR was 2 years (range 1-10). Biopsy grading between pathologist 1 and 2 generated a kappa of 0.17. Grading between the consensus pathology read and the AI algorithm generated a kappa of 0.33. Grading by consensus pathology read was associated with time to BCR-free survival (log-rank p=0.003) as was the grading by the AI algorithm (log-rank p=0.004; Figure 1). CONCLUSIONS: The AI algorithm Gleason grading demonstrated poor agreement with the consensus contemporary pathology read, but the agreement was also poor between the two pathologists. Yet, our cohort was only comprised of men originally diagnosed with GG2 PCa, a GG usually associated with poor inter-pathologist agreement. Remarkably, both the consensus pathology and the AI algorithm grades on the biopsy stratified patients well for subsequent BCR after RP, suggesting that AI algorithms could be developed to stratify for oncologic outcomes instead of attempting to replicate somewhat subjective human grading. Source of Funding: Research funding from Deep Bio © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e746 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Claire de la Calle More articles by this author Thiago Vidotto More articles by this author Eric Erak More articles by this author Daniela Salles More articles by this author Oluwademilade Dairo More articles by this author Christian Pavlovich More articles by this author Misop Han More articles by this author Joonyoung Cho More articles by this author In Hye Suh More articles by this author Hye Yoon Chang More articles by this author Sun Woo Kim More articles by this author Michael Gorin More articles by this author Tamara Lotan More articles by this author Expand All Advertisement PDF downloadLoading ...

Object Analysis of Multiple Choice Writing Test to Know Students' Understanding

This study aims to determine the understanding of students on thematic subject matter grade 1 theme 1 sub theme 3. This research is a form of item analysis using the form of multiple choice written tests packaged in daily tests. This research uses descriptive research quantitative approach. The subject of this research is grade 1 Madrasah Ibtidaiyah Negeri 1 Jember. This research analyzes the items by paying attention to: 1) Analysis of Problem Difficulty Level and 2) Analysis of Learning Completeness. From the above analysis it was found that of the 10 questions that had been given there were 5 easy questions, 4 medium questions and 1 difficult question. In addition, in this study there was 74% percentage of overall learning completeness. So it can be concluded that grade 1 students of Madrasah Ibtidaiyah Negeri 1 Jember understand students quite well in thematic subjects theme 1 (myself) sub theme 3.