Comprehensive Assessment Tool Research Articles

Validity Study of the Maladaptive Behavior Assessment Checklist for Children with Developmental Disabilities (MABAC-CDD)

The MABAC-CDD was developed to address a requirement of an updated, standardized, comprehensive assessment tool in the area of maladaptive behaviors or problem behaviors for use with the Indian population. This study aimed to assess the validity of the MABAC-CDD checklist in order to standardize the tool, which is a 107-item frequency-based checklist with 14 areas or sub-domains that assess maladaptive behavior or problem behaviors for children with developmental disabilities below the age of 18 years. The study found the MABAC-CDD tool to have statistically significant criterion validity established through Pearson coefficient correlation at r=0.43 (p=<.001). The results of the validity of the 14 areas or sub-domains of MABAC-CDD are also discussed. This study helps in standardizing the tool and in establishing the validity of the MABAC-CDD for assessment of maladaptive behaviors among children with developmental disabilities in India.

BISAP Beyond Pancreatitis: A New Horizon in Acute Kidney Injury Prediction

Background: Acute kidney injury (AKI) is a common complication in acute pancreatitis (AP), with a significant impact on mortality. The Bedside Index for Severity in Acute Pancreatitis (BISAP) score is well-established for assessing mortality risk in AP, but its utility in predicting AKI is less explored. Methods: We conducted a retrospective chart review of 779 AP patients across two hospitals in New York, USA, from 2016 to 2022. Data on patient demographics, laboratory values, and vital signs were collected. BISAP scores were calculated. The primary outcome was AKI, defined by the KDIGO criteria. Multivariate logistic regression was done to assess the association between the BISAP score and AKI, adjusting for confounders. Secondary outcomes include the association of the BISAP score to hospital length of stay and mortality. Results: There was a significant association between the BISAP score and AKI, with an odds ratio of 2.36 [95% C.I 1.42-4.41, p =0.001], indicating a more than twofold increase in AKI risk for each point increase in BISAP score. The BISAP score was also significantly correlated with longer hospital stays and increased mortality risk. Conclusion: The BISAP score is a strong predictor of AKI in AP patients. This association and relation to hospital stay and mortality highlights the potential of the BISAP score as a comprehensive risk assessment tool in AP, especially for early identification of patients at high risk for AKI. This study paves the way for future research into risk scoring systems for AKI in AP based on significant BISAP components.

Assessing Executive Functions: Confirmatory Factor Analysis of the Yellow-Red Test in Bosnian Elementary School Students.

Executive functions (EF) have been significantly correlated with many important participant characteristics, including education, behavior, and overall health. Assessing EF in children is particularly important, as doing so can help clinicians develop programs for EF remediation. However, there is a limited understanding of comprehensive performance-based EF assessment tools for children. Our goal in the present paper was to conduct a Confirmatory Factor Analysis (CFA) of the Yellow-Red test, a performance-based EF measure, in a Bosnian sample of early elementary school students. Specifically, our participants were 180 children aged 8-11years (M age = 9.6years, SD = 1), including 83 girls and 97 boys. The CFA showed that the data fit well with both a unidimensional model (global EF) and a two-dimensional EF model, comprised of (i) working memory and (ii) inhibition plus cognitive flexibility. A comparison of these two models showed that the two-factor model was a statistically better fit to this sample's performance than the unidimensional model. These results suggest that EF in this age group can be viewed as both a single construct and a multi-factor construct (with at least two-factors). The Yellow-Red Test, with its engaging and cross-cultural research base, is a useful instrument for detecting EF dysfunction, and it can provide valuable insights for informing tailored interventions.

Towards a rational framework for economic and risk assessment of energy efficiency projects

Shifting towards a low-carbon and sustainable economy requires both a shift to Renewable Energy Sources (RES) and a significant increase in Energy Efficiency (EE) targets. This paper introduces a novel, user-friendly, and step-by-step framework for the techno-economic and risk-based assessment of EE Projects (FEEP). The four-stage methodology represents a step beyond traditional methods by systematically identifying intervention areas, conducting technical evaluations, and providing a comprehensive tool for economic and risk assessment. The proposed tool may empower decision-makers to select the most suitable approaches for the economic viability analysis of future projects. The framework incorporates environmental assessment, quantifying anticipated CO2 reductions from EE measures. A real-world case study demonstrates how the new framework allows structuring the decision-making process under a reliable and straightforward approach, providing additional confidence to the investors through visual risk assessment indicators. The paper concludes with how managers and EE analysts of private and public institutions can take advantage of the proposed methodology to evaluate and benchmark a broader range of EE initiatives.

Deep learning-enabled nanophotonic test leveraging poly-L lysine-tethered carbon quantum dots to assess the risk of cardiovascular disease

The circulating cell-free mitochondrial DNA (ccf-mtDNA), in conjunction with circulating exosomes and NT-proBNP, represents a collective set of biomarkers crucial for the early identification and assessment of cardiovascular diseases (CVDs). In this context, our study explores an innovative quadruple-hybrid nano-photonic assay system engineered to identify all three distinct biomarkers. This cutting-edge assay comprises four sensing components: aminopyrene tethered carbon nanodots (CNDs) to efficiently detect circulating nucleic acids (ccf-NAs), followed by identification of ccf-mtDNA through PLL functionalized CNDs, and finally, targeting of NT-proBNP and circulating exosomes by graphene nanodots (GNDs-PLL) tethered with specific antibodies. The quadruple assay system demonstrated strong feasibility, high selectivity, and adaptability across various analytical platforms, with a detection limit of 0.369 fg and a quantification limit of 1.232 fg for ccf-mtDNA. The developed test overcomes the need for amplification and minimizes the detection time and assay-related complexities without disturbing the stability. The long short-term memory (LSTM) deep learning model accurately identified CVD and non-CVD samples with an overall accuracy rate of 99.86 % and validation loss of 0.25 % utilizing the sensor data and preliminary diagnostic data. The ability of the deep learning models to accurately discern CVD status suggests that integration of deep learning-based AI with biosensors further improves the precise diagnosis of CVD. Altogether, our observations highlight the promising potential of the developed AI-integrated biosensing system as a practical tool for comprehensive CVD risk assessment.

QOL-21. PSYCHOMETRIC VALIDATION OF THE FEAR OF CANCER RECURRENCE INVENTORY FOR PRIMARY BRAIN TUMOR PATIENTS

Abstract BACKGROUND Fear of cancer recurrence and progression (FCR) is a significant concern among those living with primary brain tumor and may be distinct compared to FCR in other cancer populations due to poorer prognosis, neurologic symptoms, and often lifelong treatment. The gold-standard comprehensive assessment tool for FCR–the FCR Inventory (FCRI)–includes 42 items with seven subscales. Validation of the FCRI scale excluded those with primary brain tumors. The present study is the first examination of the psychometric properties of the full FCRI in a heterogeneous sample of patients with primary brain tumors. METHODS Adult patients with primary brain tumors (n=334) completed the FCRI, with six additional brain tumor-specific items, and psychological, medical, and demographic questionnaires. In accordance with best practices of measure development, exploratory factor analysis (EFA) was conducted on the FCRI at the subscale level. Correlations investigated construct validity. RESULTS EFA largely supported the overall psychometric properties of the original FCRI. Several subscales were unchanged: Psychological Distress, Functioning Impairments, Insight, and Reassurance. One brain tumor-specific item (researching treatments) exhibited good fit on the Coping Skills subscale. On the Severity subscale, one item (belief that the tumor will not return) did not fit with an otherwise strong one-factor model. Additionally, five new brain tumor-specific items demonstrated good fit with the Triggers subscale. The resultant FCRI-Brain includes 41 original FCRI items plus six new brain tumor-specific items. FCRI-Brain demonstrated good convergent validity with measures of depression (r=.72), anxiety (r=.75), and death anxiety (r=.80; ps<.05). CONCLUSIONS This is the first validation of the comprehensive FCRI in patients with primary brain tumors. Factor analysis identified a theoretically similar and brain-tumor specific seven-factor model for the FCRI-Brain. Item-level and subscale statistics will be presented, including factor iteration and construction. Future work will use the FCRI to investigate FCR intervention efficacy in neuro-oncology.

Validation of the European French Version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-Vf)

ObjectiveThis study aimed to validate the French adaptation of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-Vf) for assessing voice disorders in France. The CAPE-Vf addresses limitations of the GRBAS by providing a more sensitive, standardized approach to evaluating six vocal parameters (overall severity, roughness, breathiness, strain, pitch, and loudness) on three tasks (sustained vowels, sentence reading, and spontaneous speech). The study focused on investigating the intra- and inter-rater reliability, as well as the convergent and discriminant validity of the CAPE-Vf. MethodsThirty-four dysphonic and seven euphonic native French speakers participated in the study. Thirteen speech-language pathologists from France evaluated the voice samples using both the CAPE-Vf and GRBAS tools at a one-week interval. Intra- and inter-rater reliability were calculated using intraclass correlation coefficients (ICC), while convergent and discriminant validity were measured by correlating CAPE-Vf with GRBAS and Voice Handicap Index (VHI) scores, respectively. ResultsThe CAPE-Vf showed good intra-rater reliability for overall severity (mean ICC: 0.89), strain (ICC: 0.83), and pitch (ICC: 0.88), while roughness, breathiness, and loudness exhibited moderate reliability. Inter-rater reliability was low for most parameters, except overall severity, which demonstrated good reliability (mean ICC: 0.77). Strong correlations were observed between CAPE-Vf and GRBAS Grade (mean r: 0.84), supporting its convergent validity. Moderate correlations were found for roughness, breathiness, and strain. The CAPE-Vf’s correlation with the VHI was moderate (mean r: 0.53), reflecting its discriminant validity. ConclusionThe CAPE-Vf is a valid and reliable tool for perceptual assessment of voice disorders in French-speaking populations, with stronger psychometric properties than the GRBAS, particularly for intra-rater reliability and overall severity. While inter-rater reliability was lower, qualitative feedback suggested that improvements to the protocol, particularly for pitch and loudness ratings, could enhance its clinical applicability. The findings support the CAPE-Vf as a comprehensive tool for standardized clinical voice assessment.

HPLC Based Metabolomic Fingerprint Profiling as A Comprehensive Quality Assessment Tool, Why Not for Standardization of Ayurvedic Herbs and Formulations?

HPLC Based Metabolomic Fingerprint Profiling as A Comprehensive Quality Assessment Tool, Why Not for Standardization of Ayurvedic Herbs and Formulations?

Assessing the impact of systemic conditions on periodontal health in Malaysian population: a retrospective study

BackgroundPeriodontal diseases, including gingivitis and periodontitis, are among the most prevalent oral health issues globally. They compromise the supportive structures of teeth and are influenced by both local and systemic factors. This study aimed to systematically assess the impact of systemic conditions on periodontal health in Malaysian population, addressing the gap in understanding these factors as potential risk factors.MethodsA retrospective, non-interventional study was conducted using medical records from Hospital Universiti Sains Malaysia, Kelantan, from September 2019 to December 2022. The study included patients with periodontitis and systemic conditions. Data were analyzed using descriptive statistics, chi-squared tests, Fisher’s exact tests, Mann-Whitney U tests, Kruskal-Wallis tests, Spearman’s correlation, and logistic regression.ResultsOut of 600 records, 274 patients were included. The cohort was 51.8% male, with a median age of 51 years. Malays accounted for 92.3% of the sample. Hypertension and diabetes mellitus were the most common comorbid conditions. Severe periodontitis was significantly associated with age (45–64 years, p = 0.018) and Malay ethnicity (p = 0.011). Logistic regression revealed that age and ethnicity were significant predictors of periodontitis severity, with Malays being 12.5 times more likely to develop severe periodontitis.ConclusionSystemic conditions significantly influence periodontitis development and progression. Age and ethnicity are crucial predictors of periodontitis severity in the Malaysian population. Comprehensive risk assessment tools are necessary to incorporate a broader spectrum of risk factors for better management and prevention.

Exploring influential components and indicators in hospital resilience assessment: a scoping review protocol

IntroductionHospitals are vital infrastructures that provide health services during emergencies and disasters. However, in recent years, disasters have led to hospital losses and interruptions in medical services. Consequently, the concept of resilience has garnered significant attention. Despite extensive research, the lack of clarity in explaining hospital resilience poses challenges in effective assessment and identifying key priorities for enhancing disaster risk management. Recently, the WHO’s Eastern Mediterranean Regional Office (EMRO) introduced a conceptual framework for the conceptualisation of hospital resilience, defining it through six interconnected components and four resilience capacities. Identifying specific indicators and characteristics for hospital resilience components based on the EMRO framework. This protocol outlines the method for conducting a scoping review to identify such indicators and characteristics to develop a comprehensive hospital resilience assessment tool.Methods and analysisThis scoping review will adhere to the six-step protocol proposed by Arksey and O’Malley. It aims to comprehensively understand current knowledge about resilient hospital characteristics and identify effective components and indicators for assessing hospital resilience. The review will encompass available articles indexed in PubMed, Scopus and Web of Science. Additionally, searches will explore the grey literature on Google Scholar, the WHO’s website and regional offices. There will be no publication date restrictions applied to the search. Quantitative and qualitative content analyses will assess and categorise the study results. Our protocol was drafted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols extension for scoping reviews.Ethics and disseminationThis protocol describes a scoping review within a doctoral thesis focused on health in emergencies and disasters, specifically hospital resilience. The study, associated with ethics code number (IR.USWR.REC.1402.120), aims to develop a comprehensive assessment tool for hospital resilience. Once peer-reviewed and published, the findings will inform experts, policymakers and relevant organisations in emergency and disaster management.

The identification, referral and management of patients with cardiac-related distress: a new model to support psychological recovery after a cardiac event

Abstract Background Identification, referral and management of patients with psychological distress is an important component of cardiac rehabilitation (CR). We developed a protocol to identify patients in hospital, CR and primary care settings, and refer them to a specialist psychocardiology clinic. Using the newly developed Cardiac Distress Inventory (CDI), we demonstrated that counselling resulted in reduced rates of cardiac-related distress. This study demonstrates the importance of having a clear pathway from screening to referral to intervention to support cardiac patients in their recovery. Purpose The team identified a dearth of high-quality research on distress in cardiac patients, including a lack of data on the resolution of cardiac-related distress after psychotherapeutic intervention. This was due to the lack of appropriate measurement of cardiac distress, and the absence of clear pathways for identification, referral and management of cardiac distress. Methods The Cardiac Emotions Study is a multi-site, multi-component study of cardiac-related distress. The team first developed the 55-item Cardiac Distress Inventory (CDI), a comprehensive clinical assessment tool. A brief screening version, the 12-item Cardiac Distress Inventory Short Form (CDI-SF), was then developed. Patients referred to the specialist psychocardiology clinic over a 6-month period (N=113) were administered the CDI-SF, together with the Generalised Anxiety Disorder 7 (GAD7) and the Patient Health Questionnaire (PHQ9), with all measures re-administered at discharge. Results More than half the clients presented to the Clinic within the first 3 months post-event (58%), while 84% presented within the first year. At presentation, over half the clients were anxious (GAD7>10; 53%), depressed (PHQ9>10; 57%), or distressed (CDI-SF>13; 56.4%). Levels of particular aspects of cardiac distress are shown in the Figure. On completion of counselling, distress had resolved for the majority of clients, with the distress rate of 18.6% at discharge equivalent to that seen in a normative sample of cardiac patients. Rates of anxiety and depression also significantly decreased after counselling. Conclusion This study demonstrated that distressed cardiac patients could be appropriately identified in settings such as hospital, CR and primary care and referred for counselling, and that counselling resulted in significant reductions in rates of cardiac distress, anxiety and depression. Undergoing counselling through a specialist psychocardiology clinic assisted clients in obtaining normative rates of post-cardiac event distress. The analysis showed the necessity of having a clear clinical pathway from screening to psychological treatment, and the utility of having a validated measure of cardiac distress that is sensitive to change after intervention.

Development and Validation of a "Stress and Coping Assessment Tool Associated with Maintaining Oral Health among Children with Special Health-care Needs".

In our routine pediatric dental practice, many of us encounter parents and caretakers of Children with Special Health Care Needs (CSHCN) who complain about the difficulties they face in daily tooth brushing of their children. Some parents may have to accept defeat as their children face overwhelming medical conditions to cater to; ultimately leading to paradigm shift of oral hygiene leading to increase of dental caries and gingival problems. To develop and validate a comprehensive tool that can help us in assessing parent related stressors and coping factors with regard to maintenance of oral hygiene of their children. Data related to stress and coping factors encountered during maintenance of oral hygiene of their children and their experiences during the child's dental treatment (if any) were collected from parents of CSHCN. Validation and feedback from content evaluation panel experts were done. A comprehensive assessment tool with 45 items (29 stresses related items and 16 coping related items) was developed after validation. We could develop and validate a 'Stress and Coping Assessment Tool associated with maintaining Oral health among Children with Special health care needs' - abbreviated as "SCATOCS" with a hope to benefit and manage oral health care to the referred population.

Changing the paradigm in heart failure: shifting from treatment to prevention.

Heart failure (HF) poses a major global health challenge with rising prevalence, significant morbidity and mortality, and substantial associated healthcare costs. With aging of the population and an increasing burden of comorbidities, the complex interplay between cardiovascular, kidney, and metabolic risk factors have been thrust into the spotlight and have broadened the traditional focus from HF treatment to an increased emphasis on prevention. In recognition of the evolving HF landscape, the American Heart Association released the PREVENT models which are comprehensive risk assessment tools that estimate 10- and 30-year risk of incident cardiovascular disease and its subtypes, including atherosclerotic cardiovascular disease (ASCVD) and, for the first time, HF. While it is an accurate risk estimation tool and represents a step forward in improving risk stratification for primary prevention of HF, there remain several limitations and unknowns like model performance across disaggregated racial and ethnic groups, the role of traditional ASCVD vs. HF-specific risk factors, HF prediction among those with known ASCVD, and the use of traditional regression techniques in lieu of potentially more powerful machine learning-based modeling approaches. Furthermore, it remains unclear how to optimize risk estimation in clinical care. The emergence of multiple novel pharmacological therapies that prevent incident HF, including sodium-glucose co-transporter 2 (SGLT2) inhibitors, glucagon-like peptide 1 (GLP1) receptor agonists, and nonsteroidal mineralocorticoid receptor antagonists (MRAs), highlights the importance of accurate HF risk prediction. To provide HF prevention with these effective but costly therapies, we must understand the optimal strategy in sequencing and combining these therapies and prioritize patients at highest risk. Such implementation requires both accurate risk stratification and a better understanding of how to communicate risk to patients and providers. This state-of-the-art review aims to provide a comprehensive overview of recent trends in HF prevention, including risk assessment, care management strategies, and emerging and novel treatments.

Development of a Cognitive Assessment Checklist for First-Grade Mathematics: Utilizing Hierarchical Cognitive Diagnostic Modeling in Elementary Education

This study aimed to address the need for a comprehensive assessment tool to evaluate the mathematical abilities of first-grade students through cognitive diagnostic assessment (CDA). The primary challenge involved in this endeavor was to delineate the specific cognitive skills and sub-skills pertinent to first-grade mathematics (FG-M) and to determine the most suitable model for assessment. Employing a mixed-methods approach, the research identified nine cognitive attributes essential for FG-M and developed a Q-matrix delineating the relationship between these attributes. A preliminary version of the FG-M checklist comprising 74 items was formulated. Subsequently, the assessment tool was administered to 1018 first-grade students, with their teachers utilizing the FG-M checklist for evaluation. Results indicated a commendable accuracy in classifying the nine cognitive attributes, ranging from 0.68 to 0.92, with an average accuracy of 0.76. Furthermore, the validity of the scores was corroborated by a substantial correlation (r = 0.78) between scores from the FG-M checklist and the arithmetic subtest of the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). Overall, the study concluded that the scores from the FG-M checklist are reliable for assessing the mathematical skills of first-grade students. The findings underscored the students’ proficiency in fundamental mathematical concepts such as cardinality, addition, subtraction, weight, and statistics. However, areas of weakness were identified in concepts related to multiplication, time, symmetry, and geometry. This research contributes significantly to the advancement of CDA in educational contexts, providing educators with a valuable tool for identifying students’ strengths and weaknesses in mathematical cognition.

Advancing Digital Education Technologies by Empowering Nurses With Point-of-Care Ultrasound: Protocol for a Mixed Methods Study.

Bedside ultrasonography, also known as point-of-care ultrasound (PoCUS), is a promising technological tool that enhances clinical assessment, enriching diagnostic capabilities and clinical reasoning. Its use in nursing spans various patient populations and health care settings, providing nurses with a valuable health assessment tool to improve care quality and patient safety. Despite its growing integration into clinical practice, PoCUS training has mainly focused on physicians, leaving a gap for trained nurses who demonstrate similar proficiency in conducting scans and interpreting images. Previous research highlights the value of digital tools in PoCUS training, showing their role in improving professionals' and students' knowledge, image interpretation skills, and clinical acumen. This study aimed to (1) establish an assessment instrument gauging nurses' competency milestones in PoCUS and evaluate its content and appearance validity, (2) develop a series of 5 educational videos focused on PoCUS and assess their content and appearance validity, and (3) construct an online learning environment tailored to nurses' PoCUS training needs and evaluate its content and appearance validity. We will conduct a methodological study of technological production guided by Rogers' diffusion of innovations theory. Subproject 1 will design and validate a comprehensive assessment tool for evaluating nurses' competency milestones in PoCUS use. For this purpose, a scoping review will be conducted. The review will be based on JBI Collaboration guidelines and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extended for Scoping Reviews (PRISMA-ScR) checklist. Subproject 2 involves an evaluation of content and appearance validity for a series of 5 educational videos on PoCUS, designed specifically for nurses about applying peripherally inserted central catheter lines, inserting nasogastric feeding tubes, assessing gastric residual volume, assessing pressure injuries and soft tissue conditions, and assessing muscle mass to monitor patient nutritional status. In subproject 3, a comprehensive online learning environment dedicated to PoCUS training for nurses will be developed and validated. The launch of an online learning environment represents a cornerstone of our dissemination strategy, scheduled to coincide with the inaugural Brazilian PoCUS symposium for nurses, an event organized by the project members. This platform will serve as a pivotal resource for continuous learning and professional development. Subproject 1 will start in the second half of 2024 and is expected to be completed by mid-2025. Subproject 2 is currently ongoing and is expected to be completed in early 2026. Subproject 3 is set to begin in early 2025 and is planned to be completed by 2026. Through these concerted efforts, the project aims to bridge the existing gap in PoCUS training for nurses, thereby fostering their proficiency and enhancing patient care outcomes. PRR1-10.2196/58030.

Novel Multi-Criteria Decision Analysis Based on Performance Indicators for Urban Energy System Planning

Urban energy systems planning presents significant challenges, requiring the integration of multiple objectives such as economic feasibility, technical reliability, and environmental sustainability. Although previous studies have focused on optimizing renewable energy systems, many lack comprehensive decision frameworks that address the complex trade-offs between these objectives in urban settings. Addressing these challenges, this study introduces a novel Multi-Criteria Decision Analysis (MCDA) framework tailored for the evaluation and prioritization of energy scenarios in urban contexts, with a specific application to the city of Bozen-Bolzano. The proposed framework integrates various performance indicators to provide a comprehensive assessment tool, enabling urban planners to make informed decisions that balance different strategic priorities. At the core of this framework is the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), which is employed to systematically rank energy scenarios based on their proximity to an ideal solution. This method allows for a clear, quantifiable comparison of diverse energy strategies, facilitating the identification of scenarios that best align with the city’s overall objectives. The flexibility of the MCDA framework, particularly through the adjustable criteria weights in TOPSIS, allows it to accommodate the shifting priorities of urban planners, whether they emphasize economic, environmental, or technical outcomes. The study’s findings underscore the importance of a holistic approach to energy planning, where trade-offs are inevitable but can be managed effectively through a structured decision-making process. Finally, the study addresses key gaps in the literature by providing a flexible and adaptable tool that can be replicated in different urban contexts to support the transition toward 100% renewable energy systems.

Effect of endoscopic ultrasound guided celiac plexus block on the palliation of pain in chronic pancreatitis (EPOCH Trial): study protocol for a randomized multicenter sham-controlled trial {1}

BackgroundCeliac plexus block has been commonly utilized for the treatment of chronic pancreatitis-associated abdominal pain. Prospective studies suggest efficacy in 30 to 50% of patients, although no randomized sham-controlled trials have been performed. The objective of this study is to assess the effect of endoscopic ultrasound (EUS)-guided celiac plexus block on abdominal pain in patients with documented chronic pancreatitis. MethodsThis is a two-arm randomized sham-controlled trial with blinded evaluators. The study will be conducted at multiple academic sites in the United States who are members of the United States Pancreatic Disease Study Group (USPG). Patients referred for EUS to exclude chronic pancreatitis as a cause of abdominal pain as well as those with established painful chronic pancreatitis undergoing EUS for another indication will be eligible. At the time of EUS with confirmation of chronic pancreatitis by standard EUS diagnostic criteria, patients will be randomized to either celiac plexus block or sham whereby an anesthetic and steroid combination will be injected into the celiac plexus or saline will be injected into the gastric lumen with the same type of needle as used for celiac plexus block, respectively. The main outcome measure will be a 50% reduction in abdominal pain using the Brief Pain Inventory Short Form (BPI-SF) at 1 month post-intervention. A number of secondary outcomes will be measured including visual analog scale (VAS), Comprehensive Pain Assessment Tool Short Form (COMPAT-SF) pain scores, and quality of life using a pancreas-specific validated measure (PANQOLI).DiscussionIn this study, the effect of celiac plexus block on abdominal pain in patients with chronic pancreatitis will be compared to a sham intervention. This randomized trial will offer a definitive assessment of the role of celiac plexus block for the treatment of abdominal pain in this setting.Trial registration {2}ClinicalTrials.gov NCT 06178315. Registered on December 21, 2023

Case Report: Delayed Diagnosis of Leprosy-Related Neuropathic Ulcer, Insights from a Case of Delay to Diagnose across Four Clinical Settings

Background Neuropathy is common in both Diabetes Mellitus (DM) and Leprosy, often resulting in neuropathic ulcers. Leprosy-related neuropathic ulcers are frequently misdiagnosed as DM-related, causing delays in appropriate care. This case report underscores the importance of timely recognition and a better understanding of Leprosy-related neuropathic ulcers to prevent misdiagnosis and improve patient outcomes. Methods The case report adopt the CARE Guidelines and was conducted at the Wound Care Specialist Clinic, Griya Afiat, Makassar, East Indonesia. Data were collected using a Minimum Data Sheet (MDS) to capture demographics, health history, and history of treatments. A head-to-toe assessment focused on the eyes, hands, and feet, with neuropathy, confirmed using the Semmes Weinstein Monofilament test, and angiopathy was assessed by palpating the dorsal pedis and posterior tibialis pulse. Wound care interventions consisted of cleansing, debridement, and dressing. Given the similarities between Leprosy-related neuropathic ulcers and DM-related neuropathic ulcers, the DMIST (depth, maceration, inflammation/infection, size, tissue type of the wound bed, type of wound edge, and tunnelling/undermining) tool was used to evaluate wound healing progress. Results Anamnesis indicated patient has no DM, with normal blood glucose; however, the patient had neuropathic wounds on her feet, asymmetrical eyebrow distribution, and rashes on her hands and calves, with neuropathy confirmed by a monofilament test—initial treatment involved Cadexomer Iodine powder to control bacterial growth and Honey-based gel to promote granulation. Over 62 days, 11 treatments were administered, with an average dressing change every 5.6 days, which improved the DMIST score from 12 to 4 by the end of observation day. Conclusions This case report highlights the significance of distinguishing leprosy-related neuropathic ulcers from those associated with DM to ensure accurate diagnosis and timely treatment. By employing comprehensive assessment tools and targeted wound care interventions, significant improvements in wound healing were achieved, emphasizing the need for greater awareness and clinical vigilance in managing Leprosy-related neuropathic ulcers.

Mapping coastal resilience: a Gis-based Bayesian network approach to coastal hazard identification for Queensland’s dynamic shorelines

Coastal regions worldwide face increasing threats from climate change-induced hazards, necessitating more accurate and comprehensive vulnerability assessment tools. This study introduces an innovative approach to coastal vulnerability assessment by integrating Bayesian Networks (BN) with the modern coastal vulnerability (CV) framework. The resulting BN-CV model was applied to Queensland's coastal regions, with a particular focus on tide-modified and tide-dominated beaches, which constitute over 85% of the studied area. The research methodology involved beach classification based on morphodynamic characteristics, spatial subdivision of Queensland's coast into 78 sections, and the application of the BN-CV model to analyze interactions between geomorphological features and oceanic dynamics. This approach achieved over 90% accuracy in correlating beach types with vulnerability factors, significantly outperforming traditional CVI applications. Key findings include the identification of vulnerability hotspots and the creation of detailed exposure and sensitivity maps for Gold Coast City, Redland City, Brisbane City, and the Sunshine Coast Regional area. The study revealed spatial variability in coastal vulnerability, providing crucial insights for targeted management strategies. The BN-CV model demonstrates superior precision and customization capabilities, offering a more nuanced understanding of coastal vulnerability in regions with diverse beach typologies. This research advocates for the adoption of the BN-CV approach to inform tailored coastal planning and management strategies, emphasizing the need for regular reassessments and sustained stakeholder engagement to build resilience against climate change impacts.Recommendations include prioritizing adaptive infrastructure in high-exposure areas like the Gold Coast, enhancing flood management in Brisbane, improving socio-economic adaptive capacity in Redland, and maintaining natural defences in Moreton Bay. This study contributes significantly to the field of coastal risk management, providing a robust tool for policymakers and coastal managers to develop more effective strategies for building coastal resilience in the face of climate change.

Methodology for assessing health risk behaviours among undergraduates in Sri Lanka: a literature review

It is imperative to learn more about the distinctive Health-Risk-Behaviours (HRB) that are culturally acceptable in the lower-resource settings. Therefore, the objective of this review is to identify tools measuring HRBs among undergraduates in Sri Lankan context. A literature review was conducted both manually and electronically through Google Scholar and Hinari and PubMed databases. Self-administered Questionnaires were used in National Surveys and individual studies. Youth-Risk Behaviour-Surveillance-System was the most commonly used comprehensive HRB assessment tool. The National College Health Risk Behaviour Survey, National College Health Assessment were other widely used instruments. There are few validated tools and multiple short scales or items combined like Health-Promotion-Lifestyle[1]Profile, Health-Behaviour-Questionnaire or Inventory, DOSPERT scale, Adolescent-Health-Attitude and Behaviour[1]Survey, Healthy-Lifestyle-Scale, Health-Behaviour-Scale and Health-Behaviour-Checklist. Objective methods for assessing high-risk behaviors (HRBs) include measures of personality and aggression, which have been used to critically quantify violence and accidental injury, as well as biochemical tests for alcohol, nicotine, and other drug use, mechanical or computer sensors, and biological tests such as urinary cultures for sexual risk behaviours. These tools had focused only on specific aspects of HRBs among undergraduates in Western countries and were not comprehensive assessments of HRBs of undergraduates in lower-resource settings. It was evident that there has been a deficit of choices for the adaptation of an HRB tool for undergraduates in lower-resource-settings and a new tool to be developed for Sri Lankan context.