Development and initial validation of a video-based peroral endoscopic myotomy assessment tool.

BACKGROUND AND AIMS: Video analysis has emerged as a potential strategy for performance assessment and improvement. We aimed to develop a video-based skill assessment tool for peroral endoscopic myotomy (POEM). METHODS: POEM was deconstructed into basic procedural components through video analysis by an expert panel. A modified Delphi approach and 2 validation exercises were conducted to refine the POEM assessment tool (POEMAT). Twelve assessors used the final POEMAT version to grade 10 videos. Fully crossed generalizability (G) studies investigated the contributions of assessors, endoscopists' performance, and technical elements to reliability. G coefficients below .5 were considered unreliable, between .5 and .7 as modestly reliable, and above .7 as indicative of satisfactory reliability. RESULTS: After task deconstruction, discussions, and the modified Delphi process, the final POEMAT comprised 9 technical elements. G analysis showed low variance for endoscopist performance (.8%-24.9%) and high interrater variability (range, 63.2%-90.1%). The G score was moderately reliable (≥.60) for "submucosal tunneling" and "myotomy" and satisfactorily reliable (≥.70) for "active hemostasis" and "mucosal closure." CONCLUSIONS: We developed and established initial content and response process validity evidence for the POEMAT. Future steps include appraisal of the tool using a wider range of POEM videos to establish and improve the discriminative validity of this tool.

Reliability and reproducibility of CBCT assessment of mandibular changes before and after treatment for Class III growing patients - an easy and quick way for evaluation.

The objective of this study was to evaluate intraobserver reliability and inter-observer reproducibility of a 3-dimensional (3D) assessment method for mandibular changes of growing patients after orthodontic treatment for Class III malocclusion.Methods Cone-beam computed tomography (CBCT) scans were performed before and after orthodontic treatment for 27 patients. During the scan, the patient was positioned such that his/her mandibular plane was parallel to floor. Three observers independently worked on the DICOM data, reconstructed the pre- and post-treatment 3D models in software, selected the stable anatomical structures (basal bone area from the lingual surface of the symphysis to the distal aspect of the first molars) to guide the automated superimposition process. Then, each observer registered 14 anatomical landmarks on the virtual models, for three times after suitable interval, to generate 3 sets of coordinates; the mean was taken as the coordinates for that particular landmark. The intraobserver reliability and inter-observer reproducibility of the method were analyzed.Results The ICCs was > 0.90 for 25 (92.6%) of the intraobserver assessments. The precision of the measurement method was < 0.3 mm in 24 (88.9%) cases. The interobserver reproducibility errors were < 0.3 mm in 21 of the 27 cases.Conclusions The intraobserver reliability and inter-observer reproducibility of 3D assessment of mandibular changes using the virtual models were excellent.

Leveraging Social Media to Increase Access to an Evidence-Based Diabetes Intervention Among Low-Income Chinese Immigrants: Protocol for a Pilot Randomized Controlled Trial.

BACKGROUND: Type 2 diabetes (T2D) in Chinese Americans is a rising public health concern for the US health care system. The majority of Chinese Americans with T2D are foreign-born older immigrants and report limited English proficiency and health literacy. Multiple social determinants of health limit access to evidence-based diabetes interventions for underserved Chinese immigrants. A social media-based diabetes intervention may be feasible to reach this community. OBJECTIVE: The purpose of the Chinese American Research and Education (CARE) study was to examine the potential efficacy of a social media-based intervention on glycemic control in Chinese Americans with T2D. Additionally, the study aimed to explore the potential effects of the intervention on psychosocial and behavioral factors involved in successful T2D management. In this report, we describe the design and protocol of the CARE trial. METHODS: CARE was a pilot randomized controlled trial (RCT; n=60) of a 3-month intervention. Participants were randomized to one of two arms (n=30 each): wait-list control or CARE intervention. Each week, CARE intervention participants received two culturally and linguistically tailored diabetes self-management videos for a total of 12 weeks. Video links were delivered to participants via WeChat, a free and popular social media app among Chinese immigrants. In addition, CARE intervention participants received biweekly phone calls from the study's community health workers to set goals related to T2D self-management and work on addressing goal-achievement barriers. Hemoglobin A1c (HbA1c), self-efficacy, diabetes self-management behaviors, dietary intake, and physical activity were measured at baseline, 3 months, and 6 months. Piecewise linear mixed-effects modeling will be performed to examine intergroup differences in HbA1c and psychosocial and behavioral outcomes. RESULTS: This pilot RCT study was approved by the Institutional Review Board at NYU Grossman School of Medicine in March 2021. The first participant was enrolled in March 2021, and the recruitment goal (n=60) was met in March 2022. All data collection is expected to conclude by November 2022, with data analysis and study results ready for reporting by December 2023. Findings from this pilot RCT will further guide the team in planning a future large-scale study. CONCLUSIONS: This study will serve as an important first step in exploring scalable interventions to increase access to evidence-based diabetes interventions among underserved, low-income, immigrant populations. This has significant implications for chronic care in other high-risk immigrant groups, such as low-income Hispanic immigrants, who also bear a high T2D burden, face similar barriers to accessing diabetes programs, and report frequent social media use (eg, WhatsApp). TRIAL REGISTRATION: ClinicalTrials.gov NCT03557697; https://clinicaltrials.gov/ct2/show/NCT03557697. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42554.

BIOS-Based Server Intelligent Optimization.

Servers are the infrastructure of enterprise applications, and improving server performance under fixed hardware resources is an important issue. Conducting performance tuning at the application layer is common, but it is not systematic and requires prior knowledge of the running application. Some works performed tuning by dynamically adjusting the hardware prefetching configuration with a predictive model. Similarly, we design a BIOS (Basic Input/Output System)-based dynamic tuning framework for a Taishan 2280 server, including dynamic identification and static optimization. We simulate five workload scenarios (CPU-instance, etc.) with benchmark tools and perform scenario recognition dynamically with performance monitor counters (PMCs). The adjustable configurations provided by Kunpeng processing reach 2N(N>100). Therefore, we propose a joint BIOS optimization algorithm using a deep Q-network. Configuration optimization is modeled as a Markov decision process starting from a feasible solution and optimizing gradually. To improve the continuous optimization capabilities, the neighborhood search method of state machine control is added. To assess its performance, we compare our algorithm with the genetic algorithm and particle swarm optimization. Our algorithm shows that it can also improve performance up to 1.10× compared to experience configuration and perform better in reducing the probability of server downtime. The dynamic tuning framework in this paper is extensible, can be trained to adapt to different scenarios, and is more suitable for servers with many adjustable configurations. Compared with the heuristic intelligent search algorithm, the proposed joint BIOS optimization algorithm can generate fewer infeasible solutions and is not easily disturbed by initialization.

Simple and sensitive detection method for Cobalt(II) in water using CePO4:Tb3+ nanocrystals as fluorescent probes.

A simple and sensitive method for detecting cobalt by synchronous fluorescence spectrometry technique with a novel fluorescence probe CePO4:Tb(3+) has been developed. CePO4:Tb(3+) nanocrystals were synthesized in aqueous solutions and characterized by transmission electron microscopy, electron diffraction pattern spectroscopy and spectrofluorometry. When Δλ=210 nm, the selected synchronous fluorescence is produced at 284 nm. CePO4:Tb(3+) nanocrystals were negatively charged under weakly basic conditions (pH=8.2), which can interact with Co(2+) via electrostatic interaction. Moreover, there is the spectrum overlap between the emission wavelength of CePO4:Tb(3+) NCs and the absorbance of Co(2+). So the energy transfer would occur, leading to the quenching phenomenon. The quenching equation of the system was agreed with the Stern-Volmer equation. The linear range and detection limit of Co(2+) were 5-1.8 µM and 3.5 nM, respectively. The method is successfully applied to the quantification of Co(2+) in water samples.