Test Scores Research Articles

Artificial intelligence–enhanced electrocardiography analysis as a promising tool for predicting obstructive coronary artery disease in patients with stable angina

Abstract Aims The clinical feasibility of artificial intelligence (AI)-based electrocardiography (ECG) analysis for predicting obstructive coronary artery disease (CAD) has not been sufficiently validated in patients with stable angina, especially in large sample sizes. Methods and results A deep learning framework for the quantitative ECG (QCG) analysis was trained and internally tested to derive the risk scores (0–100) for obstructive CAD (QCGObstCAD) and extensive CAD (QCGExtCAD) using 50 756 ECG images from 21 866 patients who underwent coronary artery evaluation for chest pain (invasive coronary or computed tomography angiography). External validation was performed in 4517 patients with stable angina who underwent coronary imaging to identify obstructive CAD. The QCGObstCAD and QCGExtCAD scores were significantly increased in the presence of obstructive and extensive CAD (all P < 0.001) and with increasing degrees of stenosis and disease burden, respectively (all Ptrend < 0.001). In the internal and external tests, QCGObstCAD exhibited a good predictive ability for obstructive CAD [area under the curve (AUC), 0.781 and 0.731, respectively] and severe obstructive CAD (AUC, 0.780 and 0.786, respectively), and QCGExtCAD exhibited a good predictive ability for extensive CAD (AUC, 0.689 and 0.784). In the external test, the QCGObstCAD and QCGExtCAD scores demonstrated independent and incremental predictive values for obstructive and extensive CAD, respectively, over that with conventional clinical risk factors. The QCG scores demonstrated significant associations with lesion characteristics, such as the fractional flow reserve, coronary calcification score, and total plaque volume. Conclusion The AI-based QCG analysis for predicting obstructive CAD in patients with stable angina, including those with severe stenosis and multivessel disease, is feasible.

Single-value brain activity scores reflect both severity and risk across the Alzheimer's continuum.

Single-value scores reflecting the deviation from (FADE score) or similarity with (SAME score) prototypical novelty-related and memory-related functional magnetic resonance imaging (fMRI) activation patterns in young adults have been proposed as imaging biomarkers of healthy neurocognitive aging. Here, we tested the utility of these scores as potential diagnostic and prognostic markers in Alzheimer's disease (AD) and risk states like mild cognitive impairment (MCI) or subjective cognitive decline (SCD). To this end, we analyzed subsequent memory fMRI data from individuals with SCD, MCI, and AD dementia as well as healthy controls (HC) and first-degree relatives of AD dementia patients (AD-rel) who participated in the multi-center DELCODE study (N = 468). Based on the individual participants' whole-brain fMRI novelty and subsequent memory responses, we calculated the FADE and SAME scores and assessed their association with AD risk stage, neuropsychological test scores, CSF amyloid positivity, and ApoE genotype. Memory-based FADE and SAME scores showed a considerably larger deviation from a reference sample of young adults in the MCI and AD dementia groups compared to HC, SCD and AD-rel. In addition, novelty-based scores significantly differed between the MCI and AD dementia groups. Across the entire sample, single-value scores correlated with neuropsychological test performance. The novelty-based SAME score further differed between Aβ-positive and Aβ-negative individuals in SCD and AD-rel, and between ApoE ε4 carriers and non-carriers in AD-rel. Hence, FADE and SAME scores are associated with both cognitive performance and individual risk factors for AD. Their potential utility as diagnostic and prognostic biomarkers warrants further exploration, particularly in individuals with SCD and healthy relatives of AD dementia patients.

Design and Implementation of a Standardised Clinical Decision Support Algorithm for Fever

This study aims to design a decision support tool to assist in providing quality treatment that is consistent with World Health Organization (WHO) and Nigerian National guidelines. The system is designed to allow clinicians to administer care within their competent level working from one algorithm. The system will help them to identify emergencies associated with fever symptoms and to recommend stabilisation actions before a referral is made. This new system allows structured assessment of patients who should receive optimal care and improved data transmission to the next caregiver. In this study, we used an explanatory approach, starting with the quantitative data collection phase which is the administration of questionnaires and Pre and Post questionnaires followed by qualitative data from focus group discussions over the clinician experience using the Clinical Decision Support System (CDSS). Focus group discussions were performed to authenticate the quantitative data to have a more holistic view of the CDSS. Using elements of the decision support system together with the clinician's decision showed that the clinicians felt that they worked more systematically and communicated more effectively with others. They felt more professional when using the decision support system. 73% of clinicians reported using CDSS in almost every consultation and 93% used the CDSS in the majority of their consultations during the three-month testing period. The mean total test score before the CDSS was 2.5 and this increased by the end of the test period to a mean score of 9.6, an improvement of 74.4%. The results of this study showed that with the help of a decision support system, patients were properly identified and stabilised before they were referred, and the clinicians stayed on their competency level. It allowed caregivers to interact professionally without bias. However, the decision support system requires more extensive testing to enhance the evidence base relating to the vital parameters and the use of the decision support system.

How are social context factors related to epistemological beliefs, motivations, and achievement in science? A serial mediation model

How are social context factors related to epistemological beliefs, motivations, and achievement in science? A serial mediation model

The importance of regular physical activity in the mental health of the older adults

The present study had the general objective of evaluating the relationship between physical activity and mental health in the older adults. For this, a cross-sectional survey was carried out with 35 older adults aged between 60 and 76 years old (65.31 ± 4.50). To assess the level of physical activity, the six-minute walk test (6MWT) was used, while mental health was measured using the geriatric depression scale (GDS). A comparison was made between the physically active and inactive groups (classified by the 6MWT) using Student’s t test for GDS scores. In addition, the Ancova test was performed to compare groups for the mental health outcome (GDS). The results show us that the mean age of the individuals was 65.31 with a standard deviation of 4.50. Among the older adults, 12 were classified as physically active and 23 as inactive. However, the main finding of this study lies in the difference between the groups for the mental health outcome, since the physically active group had a mean GDS lower (Mean = 3.33) than the physically inactive group (Mean = 7.30), with statistical significance (p = 0.05). This is in line with the literature on the benefits of physical activity in preventing and reducing mental disorders. The study makes room for further studies, especially clinical and longitudinal trials, in order to better understand these real impacts of physical activity.

AlphaFold2 modeling and molecular dynamics simulations of an intrinsically disordered protein.

We use AlphaFold2 (AF2) to model the monomer and dimer structures of an intrinsically disordered protein (IDP), Nvjp-1, assisted by molecular dynamics (MD) simulations. We observe relatively rigid dimeric structures of Nvjp-1 when compared with the monomer structures. We suggest that protein conformations from multiple AF2 models and those from MD trajectories exhibit a coherent trend: the conformations of an IDP are deviated from each other and the conformations of a well-folded protein are consistent with each other. We use a residue-residue interaction network (RIN) derived from the contact map which show that the residue-residue interactions in Nvjp-1 are mainly transient; however, those in a well-folded protein are mainly persistent. Despite the variation in 3D shapes, we show that the AF2 models of both disordered and ordered proteins exhibit highly consistent profiles of the pLDDT (predicted local distance difference test) scores. These results indicate a potential protocol to justify the IDPs based on multiple AF2 models and MD simulations.

A quantitative feedback intervention to reduce binge drinking in young adults.

Existing binge drinking reduction interventions such as brief intervention and personalized normative feedback have shown modest impact. The purpose of this study was to evaluate the feasibility (recruitment and retention rates), acceptability, and preliminary efficacy testing of a short-term "know your numbers (KYN)" intervention on motivating young adults to reduce their engagement in binge drinking. Young adults (N=94, mean age 21 years) with a history of binge drinking received a 4-week KYN intervention that included information about their U.S. Alcohol Use Disorders Test (USAUDIT) scores and the alcohol biomarker phosphatidylethanol (PEth) level in relationship to different risk levels of alcohol use. At baseline and 4-weeks, measures included USAUDIT scores, PEth levels, motivation (Alcohol Contemplation Ladder) and other drinking measures. Focus groups were conducted at 4-weeks for feedback on the KYN approach. The recruitment rate was 82.26% (retention rate 76.9%). At 4-weeks there was a 62% increase in contemplation scores (indicating higher motivation), a decrease in USADUIT scores with an increase in the percent of participants classified as low-risk drinkers. No differences were found between baseline and 4-week PEth levels or number of binge episodes. Focus group results revealed satisfaction with the KYN approach but the need to understand how PEth levels and USAUDIT scores corresponded to health consequences and alcohol use levels. Results from this pilot study support the acceptability and potential use of a KYN approach in helping young adults understand their drinking levels.

Cognitive brain activity before and after surgery in meningioma patients.

Neuropsychological studies have demonstrated that meningioma patients frequently exhibit cognitive deficits before surgery and show only limited improvement after surgery. Combining neuropsychological with functional imaging measurements can shed more light on the impact of surgery on cognitive brain function. We aimed to evaluate whether surgery affects cognitive brain activity in such a manner that it may mask possible changes in cognitive functioning measured by neuropsychological tests. Twenty-three meningioma patients participated in a fMRI measurement using a verbal working memory task as well as three neuropsychological tests focused on working memory, just before and 3 months after surgery. A region of interest based fMRI analysis was used to examine cognitive brain activity at these timepoints within the central executive network and default mode network. Neuropsychological assessment showed impaired cognitive functioning before as well as 3 months after surgery. Neuropsychological test scores, in-scanner task performance as well as brain activity within the central executive and default mode network were not significantly different between both timepoints. Our results indicate that surgery does not significantly affect cognitive brain activity in meningioma patients the first few months after surgery. Therefore, the lack of cognitive improvement after surgery is not likely the result of compensatory processes in the brain. Cognitive deficits that are already present before surgery appear to be persistent after surgery and a considerable recovery period. Our study shows potential leads that comprehensive cognitive evaluation can be of added value so that cognitive functioning may become a more prominent factor in clinical decision making.

The Effective British Broadcasting Corporation’s (BBC) Optimal Pronunciation Vocational School's (OPVS) Podcast

The objective of this initiative is to improve pronunciation fluency in vocational schools by including a British accent. This study utilized the Wilcoxon signed-rank test as a component to collect both quantitative and qualitative data on product moment SPSS. The data was acquired by pronunciation evaluation test and analysis questions. The data employed in this study was gathered from a vocational school consisting of thirty students enrolled in a hospitality industry and cooking programme. The mean test score is 8.00, and the total amount of ranks is 120.00. According to the statistical test output provided, it is referred to as Asymp. The p-value (two-tailed) is 0.001. Based on the test statistics output above, it is known that Asymp. Sig. (2-tailed) has a value of 0.001, because the value of 0.001 is smaller than 0.05, it can be concluded there is a difference between learning outcomes using text transcripts and shadowing BBC Podcasts and those that do not use text transcripts and shadowing BBC Podcasts. The podcast produced by the BBC can enhance language acquisition by improving pronunciation skills, stimulating students' motivation to achieve English competence, and assisting listeners in developing a predominantly British accent

Enhancing Pragmatic Language skills for Young children with Social communication difficulties (E-PLAYS-2) trial: study protocol for a cluster-randomised controlled trial evaluating a computerised intervention to promote communicative development and collaborative skills in young children

BackgroundA number of children experience difficulties with social communication and this has long-term deleterious effects on their mental health, social development and education. The E-PLAYS-2 study will test an intervention (‘E-PLAYS’) aimed at supporting such children. E-PLAYS uses a dyadic computer game to develop collaborative and communication skills. Preliminary studies by the authors show that E-PLAYS can produce improvements in children with social communication difficulties on communication test scores and observed collaborative behaviours. The study described here is a definitive trial to test the effectiveness and cost-effectiveness of E-PLAYS delivered by teaching assistants in schools.MethodsThe aim of the E-PLAYS-2 trial is to establish the effectiveness and cost-effectiveness of care as usual plus the E-PLAYS programme, delivered in primary schools, compared to care as usual. Cluster-randomisation will take place at school level to avoid contamination. The E-PLAYS intervention will be delivered by schools’ teaching assistants. Teachers will select suitable children (ages 5–7 years old) from their schools using guidelines provided by the research team. Assessments will include blinded language measures and observations (conducted by the research team), non-blinded teacher-reported measures of peer relations and classroom behaviour and parent-reported use of resources and quality of life. A process evaluation will also include interviews with parents, children and teaching assistants, observations of intervention delivery and a survey of care as usual.The primary analysis will compare pragmatic language scores for children who received the E-PLAYS intervention versus those who did not at 40 weeks post-randomisation. Secondary analyses will assess cost-effectiveness and a mixed methods process evaluation will provide richer data on the delivery of E-PLAYS.DiscussionThe aim of this study is to undertake a final, definitive test of the effectiveness of E-PLAYS when delivered by teaching assistants within schools. The use of technology in game form is a novel approach in an area where there are currently few available interventions. Should E-PLAYS prove to be effective at the end of this trial, we believe it is likely to be welcomed by schools, parents and children.Trial registrationISRCTN 17561417, registration date 19th December 2022.Protocol version: v1.1 19th June 2023.

Magnesium citrate monotherapy improves RLS symptoms and multiple suggested immobilization test scores in an open-label pilot study.

An estimated 3% of the population suffers from clinically significant restless legs syndrome. Given the limited pharmacological options in the arsenal, there is a need for a therapeutic agent with a better side effect profile. Twelve treatment naïve adults (10 women and 2 men with a median age of 41.5 [32-48.5] years) with primary RLS were recruited in our open-label pilot study; magnesium citrate 200 mg was administered daily for eight weeks. Serum magnesium levels, IRLS, Kohnen QOL scale, and multiple suggested immobilization tests were performed before and after supplementation. Paired t-tests and Wilcoxon signed-rank tests were used for data analysis. Pearson and Spearman's analyses assessed the association between magnesium levels and RLS variables. Participants had a significant reduction in IRLS scores (- 6.67 [2.33-11] p=0.006) and improved Kohnen QOL scores (-8.5 [2.09-14], p=0.014) without notable differences in serum magnesium levels (p=0.3). Average PLMW across all SIT trials (30.40 [5.20, 122.40] to 8.63 [0.32, 17.47] p=0.043) and subjective measures on mSIT also demonstrated improvement. Serum magnesium levels negatively correlated with m-SIT self-reported scores and the PLMW indices. Despite the limitations of open-label design, our study's positive results indicate the need for a placebo-controlled trial with a larger sample size. clinicaltrials.gov (NCT04462796).

Predicting patients with dementia most at risk of needing psychiatric in-patient or enhanced community care using routinely collected clinical data: retrospective multi-site cohort study.

Dementia is a common and progressive condition whose prevalence is growing worldwide. It is challenging for healthcare systems to provide continuity in clinical services for all patients from diagnosis to death. To test whether individuals who are most likely to need enhanced care later in the disease course can be identified at the point of diagnosis, thus allowing the targeted intervention. We used clinical information collected routinely in de-identified electronic patient records from two UK National Health Service (NHS) trusts to identify at diagnosis which individuals were at increased risk of needing enhanced care (psychiatric in-patient or intensive (crisis) community care). We examined the records of a total of 25 326 patients with dementia. A minority (16% in the Cambridgeshire trust and 2.4% in the London trust) needed enhanced care. Patients who needed enhanced care differed from those who did not in age, cognitive test scores and Health of the Nation Outcome Scale scores. Logistic regression discriminated risk, with an area under the receiver operating characteristic curve (AUROC) of up to 0.78 after 1 year and 0.74 after 4 years. We were able to confirm the validity of the approach in two trusts that differed widely in the populations they serve. It is possible to identify, at the time of diagnosis of dementia, individuals most likely to need enhanced care later in the disease course. This permits the development of targeted clinical interventions for this high-risk group.

A Nonparametric Composite Group DIF Index for Focal Groups Stemming from Multicategorical Variables

AbstractThe purpose of this study is to develop a nonparametric DIF method that (a) compares focal groups directly to the composite group that will be used to develop the reported test score scale, and (b) allows practitioners to explore for DIF related to focal groups stemming from multicategorical variables that constitute a small proportion of the overall testing population. We propose the nonparametric root expected proportion squared difference (REPSD) index that evaluates the statistical significance of composite group DIF for relatively small focal groups stemming from multicategorical focal variables, with decisions of statistical significance based on quasi‐exact p values obtained from Monte Carlo permutations of the DIF statistic under the null distribution. We conduct a simulation to evaluate conditions under which the index produces acceptable Type I error and power rates, as well as an application to a school district assessment. Practitioners can calculate the REPSD index in a freely available package we created in the R environment.

Are Large-Scale Test Scores Comparable for At-Home Versus Test Center Testing?

The COVID-19 pandemic led to a proliferation of remote-proctored (or “at-home”) assessments. The lack of standardized setting, device, or in-person proctor during at-home testing makes it markedly distinct from testing at a test center. Comparability studies of at-home and test center scores are important in understanding whether these distinctions impact test scores. This study found no significant differences in at-home versus test center test scores on a large-scale admissions test using either a randomized controlled trial or an observational study after adjusting for differences in sample composition along baseline characteristics.

Different doses of hyaluronic acid injections in patients with knee osteoarthritis: A multicenter, randomized, prospective, single-blind, clinical study.

Many formulations and dosing regimens are available for hyaluronic acid (HA). To compare different doses of linear, high-molecular weight (HMW) HA injections among patients with knee osteoarthritis (OA). Hundred patients were included in this randomized, single-blinded trial and randomly divided into three HA injection groups. The first group received five weekly 20mg HA injections, the second group received three weekly 32mg HA injections, and the third group received a single 48mg HA injection. Patients were evaluated at baseline, 1, 3, and 6months after the last injection for pain, stiffness, and function using the visual analog scale (VAS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire. Quality of life, patient's global assessment, and Timed Up and Go (TUG) test scores were also evaluated. There was significant improvement in the WOMAC, VAS-pain, quality of life, patient's global assessment, and TUG test mean scores at all follow-up time points (p< 0.001). However, the groups showed no significant differences in WOMAC, VAS-activity pain, and patient global scores at any follow-up point. Intra-articular injections of different doses of linear HMW HA can improve pain, stiffness, function, and quality of life in patients suffering from knee OA over a six-month period.

An evaluation of written materials for supporting hypertensive patient education and counselling when performing a new medicine service in Poland

Background. The New Medicine Service (NMS) was developed in England more than ten years ago, as a three-stage consultation led by community pharmacists to support patients taking new medication for a chronic disease. In Poland, the scheme was officially introduced in January 2023. However, its implementation into common practice has been presented with various obstacles, including the need to develop relationships with general practitioners, resolve the payment structure, and provide training with adequate supporting materials. Hence, written materials have been designed for use as an optional tool for counselling patients receiving an NMS in community pharmacies. Methods. The present study evaluates the ability of these materials to inform patients about the need to adhere to anti-hypertensive medication. A group of 401 randomly-selected adult visitors to pharmacies and/or healthcare centres were surveyed; one third had hypertension in their history. Results. The structure, grammar and readability of the text achieved the required threshold of 40% according to the Plain Language Index. The designed materials effectively informed the patients about anti-hypertensive medication, reflected in an increased score in a knowledge test, and were rated positively regarding information level, comprehensibility and presentation. Conclusion. The proposed material may serve as an additional, “patient-friendly” educational tool for use as part of an NMS.

Abnormal EEG microstates in Alzheimer's disease: predictors of β-amyloid deposition degree and disease classification.

Electroencephalography (EEG) microstates are used to study cognitive processes and brain disease-related changes. However, dysfunctional patterns of microstate dynamics in Alzheimer's disease (AD) remain uncertain. To investigate microstate changes in AD using EEG and assess their association with cognitive function and pathological changes in cerebrospinal fluid (CSF). We enrolled 56 patients with AD and 38 age- and sex-matched healthy controls (HC). All participants underwent various neuropsychological assessments and resting-state EEG recordings. Patients with AD also underwent CSF examinations to assess biomarkers related to the disease. Stepwise regression was used to analyze the relationship between changes in microstate patterns and CSF biomarkers. Receiver operating characteristics analysis was used to assess the potential of these microstate patterns as diagnostic predictors for AD. Compared with HC, patients with AD exhibited longer durations of microstates C and D, along with a decreased occurrence of microstate B. These microstate pattern changes were associated with Stroop Color Word Test and Activities of Daily Living scale scores (all P < 0.05). Mean duration, occurrences of microstate B, and mean occurrence were correlated with CSF Aβ 1-42 levels, while duration of microstate C was correlated with CSF Aβ 1-40 levels in AD (all P < 0.05). EEG microstates are used to predict AD classification with moderate accuracy. Changes in EEG microstate patterns in patients with AD correlate with cognition and disease severity, relate to Aβ deposition, and may be useful predictors for disease classification.

Long-term clinical and radiographic outcomes of arthroscopic acromioclavicular stabilization for acute acromioclavicular joint dislocation.

Standard open acromioclavicular (AC) stabilization is associated with increased postoperative complications including deltoid injury, infection, tunnel complications, loss of reduction, and wound/cosmetic concerns. Arthroscopy may offer superior visualization and advantages that limit these risks. The aim of this prospective non-randomized study is to evaluate advantages and long-term reliability of arthroscopic AC stabilization. Thirty-two patients with acute grade III, IV and V AC dislocations underwent arthroscopic AC reconstruction with long-term assessment by clinical AC examination, Simple Shoulder Test, American Shoulder and Elbow Surgeons scores, visual analog scale, Specific AC Score and Quick Disabilities of the Arm, Shoulder and Hand scores. Radiographs verified conservation of initial reduction and presence of coracoclavicular (CC) ossifications. Complications, revision rate and satisfaction were assessed and compared to the literature. Mean follow-up time was 67.6 months. All clinical outcome scores improved and differences were statistically significant (P<0.001). Initial postoperative radiographs consistently showed complete reduction. Two patients experienced relapse to grade II AC dislocation without clinical implications. In total, 71.8% showed CC ossifications without functional impairment, and in 31.3% concomitant injuries were observed. Reintervention rate was 9.4% and 96.7% of patients were satisfied with procedure outcomes. Arthroscopic stabilization for acute AC joint dislocations offers satisfactory clinical and radiographic outcomes, and our results show that the arthroscopic technique is reliable in the long run. We report better reduction in maintenance, fewer complications and similar reoperation rates compared to other techniques.

Pembuatan Website REST API Ensiklopedia Tumbuhan dengan Kombinasi Framework Spring Boot dan MyBatis Generator

This research focuses on the development of the Plant Encyclopedia REST API, a website application designed using Java, HTML, Spring Boot, MyBatis Generator, and Swagger technologies, with PostgreSQL as the database used to store plant data from the API. This study highlights the declining abilities of the younger generation, especially in mathematics, literacy, and science. Statistical data from PISA test scores from 2003 to 2022 on 15-year-olds worldwide show a peak decline in 2022. The applied research methods include needs analysis, problem identification, system design, application design, implementation, and system testing. This research aims to overcome the lack of knowledge about plants that can have a negative impact on the ecosystem and provide various other benefits. The result of this research is a plant encyclopedia website application that can be accessed by various users to find information related to plants and a swagger website for administrators to manage plant data.

Effects of osteoarthritis grades on pain, function and quality of life.

Osteoarthritis (OA) is a pathology that frequently affects the geriatric population. To investigate the extent to which pain, functionality, and quality of life change over the progression of OA grades. The study included 161patients with bilateral OA, whose disease stages ranged from 1 to 4according to the Kellgren-Lawrence radiographic classification system. Pain was assessed using the Visual Analog Scale (VAS), functionality using the two-minute walk test and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, and quality of life using the Nottingham Health Profile (NHP). There were significant differences between the groups in terms of age, weight, and body mass index. The VAS, two-minute walk test, and WOMAC scores also significantly differed between the groups (p< 0.05). There was a significant difference between the groups in all domains of the NHP, except for energy (p< 0.05). The two-minute walk test score was negatively correlated with all the remaining evaluation parameters (p< 0.05). No correlation was found between the energy domain of the NHP and body mass index, the VAS score, the two-minute walk test distance, or the total WOMAC score (p> 0.05). After grade1, the functional impacts of OA on patients increased by an average of four times. Pain was one of the most basic symptoms, the severity of which started to increase in grade2. With the added effect of diminishing walking capacity over time, the reduction in the quality of life of the patients accelerated as the OA grade progressed.