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1.
Nutr Clin Pract ; 2024 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-39010727

RESUMEN

BACKGROUND: Postoperative pancreatic fistula (POPF) remains one of the most severe complications after pancreatic surgery. The methods for predicting pancreatic fistula are limited. We aimed to investigate the predictive value of body composition parameters measured by preoperative bioelectrical impedance analysis (BIA) on the development of POPF. METHODS: A total of 168 consecutive patients undergoing pancreatic surgery from March 2022 to December 2022 at our institution were included in the study and randomly assigned at a 3:2 ratio to the training group and the validation group. All data, including previously reported risk factors for POPF and parameters measured by BIA, were collected. Risk factors were analyzed by univariable and multivariable logistic regression analysis. A prediction model was established to predict the development of POPF based on these parameters. RESULTS: POPF occurred in 41 of 168 (24.4%) patients. In the training group of 101 enrolled patients, visceral fat area (VFA) (odds ratio [OR] = 1.077, P = 0.001) and fat mass index (FMI) (OR = 0.628, P = 0.027) were found to be independently associated with POPF according to multivariable analysis. A prediction model including VFA and FMI was established to predict the development of POPF with an area under the receiver operating characteristic curve (AUC) of 0.753. The efficacy of the prediction model was also confirmed in the internal validation group (AUC 0.785, 95% CI 0.659-0.911). CONCLUSIONS: Preoperative assessment of body fat distribution by BIA can predict the risk of POPF after pancreatic surgery.

2.
Artículo en Inglés | MEDLINE | ID: mdl-39010832

RESUMEN

Irritable bowel syndrome with diarrhea (IBS-D) is a common intestinal condition that significantly impacts work efficiency and quality of life. The use of animal models is crucial for delving into the pathophysiology of IBS-D and exploring therapeutic options. However, a wide variety of animal models for IBS-D has been employed in previous studies, posing a considerable challenge for researchers in selecting a suitable model. In this review, conducted using the Web of Science database, we searched IBS-D-related research spanning from 2014 to 2023, described the differences in animal strains and modeling methods among various IBS-D features recapitulating models, summarized the frequency of model usage, pathogenesis, and pathological characteristics of these models, and discussed their current applications, limitations, and future perspectives. The objective is to offer theoretical guidance for future researchers, aiding them in choosing suitable animal models based on their experimental designs.

3.
BMC Public Health ; 24(1): 1767, 2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-38956480

RESUMEN

BACKGROUND: Women at middle age are puzzled by a series of menopausal disturbances, can be distressing and considerably affect the personal, social and work lives. We aim to estimate the global prevalence of nineteen menopausal symptoms among middle-aged women by performing a systematic review and meta-analysis. METHODS: Comprehensive search was performed in multiple databases from January, 2000 to March, 2023 for relevant studies. Random-effect model with double-arcsine transformation was used for data analysis. RESULTS: A total of 321 studies comprised of 482,067 middle-aged women were included for further analysis. We found varied prevalence of menopausal symptoms, with the highest prevalence of joint and muscular discomfort (65.43%, 95% CI 62.51-68.29) and lowest of formication (20.5%, 95% CI 13.44-28.60). Notably, South America shared dramatically high prevalence in a sort of menopausal symptoms including depression and urogenital symptoms. Besides, countries with high incomes (49.72%) had a significantly lower prevalence of hot flashes than those with low (65.93%), lower-middle (54.17%), and upper-middle (54.72%, p < 0.01), while personal factors, such as menopausal stage, had an influence on most menopausal symptoms, particularly in vaginal dryness. Prevalence of vagina dryness in postmenopausal women (44.81%) was 2-fold higher than in premenopausal women (21.16%, p < 0.01). Furthermore, a remarkable distinction was observed between body mass index (BMI) and prevalence of sleep problems, depression, anxiety and urinary problems. CONCLUSION: The prevalence of menopausal symptoms affected by both social and personal factors which calls for attention from general public.


Asunto(s)
Sofocos , Menopausia , Humanos , Femenino , Menopausia/fisiología , Prevalencia , Persona de Mediana Edad , Sofocos/epidemiología , Salud Global/estadística & datos numéricos
4.
Langmuir ; 40(28): 14738-14747, 2024 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-38957955

RESUMEN

The antifouling properties of conductive polymers have received extensive attention for biosensor and bioelectronic applications. Polyethylene glycol (PEG) is a well-known antifouling material, but the controlled regulation of the surface topography of PEG without a template remains a challenge. Here, we show a columnar structure antifouling conductive polymer brush with enhanced antifouling properties and considerable conductivity. The method involves synthesizing the 3,4-ethylenedioxythiophene monomer modified with azide (EDOT-N3), the electropolymerization of PEDOT-N3, and the in situ growth of PEG polymer brushes on PEDOT through double-click reactions. The resultant columnar structure polymer brush exhibits high electrical conductivity (3.5 Ω·cm2), ultrahigh antifouling property, electrochemical stability (capacitance retention was 93.8% after 2000 cycles of CV scans in serum), and biocompatibility.

5.
Int J Mol Sci ; 25(13)2024 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-39000475

RESUMEN

Metallothioneins (MTs) are non-enzymatic metal-binding proteins widely found in animals, plants, and microorganisms and are regulated by metal-responsive transcription factor 1 (MTF1). MT and MTF1 play crucial roles in detoxification, antioxidation, and anti-apoptosis. Therefore, they are key factors allowing organisms to endure the toxicity of heavy metal pollution. Phascolosoma esculenta is a marine invertebrate that inhabits intertidal zones and has a high tolerance to heavy metal stress. In this study, we cloned and identified MT and MTF1 genes from P. esculenta (designated as PeMT and PeMTF1). PeMT and PeMTF1 were widely expressed in all tissues and highly expressed in the intestine. When exposed to 16.8, 33.6, and 84 mg/L of zinc ions, the expression levels of PeMT and PeMTF1 in the intestine increased first and then decreased, peaking at 12 and 6 h, respectively, indicating that both PeMT and PeMTF1 rapidly responded to Zn stress. The recombinant pGEX-6p-1-MT protein enhanced the Zn tolerance of Escherichia coli and showed a dose-dependent ABTS free radical scavenging ability. After RNA interference (RNAi) with PeMT and 24 h of Zn stress, the oxidative stress indices (MDA content, SOD activity, and GSH content) and the apoptosis indices (Caspase 3, Caspase 8, and Caspase 9 activities) were significantly increased, implying that PeMT plays an important role in Zn detoxification, antioxidation, and anti-apoptosis. Moreover, the expression level of PeMT in the intestine was significantly decreased after RNAi with PeMTF1 and 24 h of Zn stress, which preliminarily proved that PeMTF1 has a regulatory effect on PeMT. Our data suggest that PeMT and PeMTF1 play important roles in the resistance of P. esculenta to Zn stress and are the key factors allowing P. esculenta to endure the toxicity of Zn.


Asunto(s)
Metalotioneína , Factores de Transcripción , Zinc , Metalotioneína/genética , Metalotioneína/metabolismo , Animales , Zinc/metabolismo , Factores de Transcripción/metabolismo , Factores de Transcripción/genética , Estrés Fisiológico/efectos de los fármacos , Estrés Fisiológico/genética , Factor de Transcripción MTF-1 , Proteínas de Unión al ADN/genética , Proteínas de Unión al ADN/metabolismo , Apoptosis/efectos de los fármacos , Filogenia , Secuencia de Aminoácidos , Regulación de la Expresión Génica/efectos de los fármacos , Clonación Molecular
7.
Sensors (Basel) ; 24(13)2024 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-39001160

RESUMEN

As the weak link in electro-optical imaging systems, photodetectors have always faced the threat of laser damage. In this paper, we experimentally investigated the damage mechanism of the photodetector induced by the out-of-band laser. The damage thresholds of the mid-infrared pulsed laser for Charge Coupled Device (CCD) and HgCdTe detectors were determined through damage experiments. The analysis of the damage phenomena and data for both CCD and HgCdTe detectors clearly demonstrated that out-of-band mid-infrared pulsed lasers could entirely incapacitate CCD and HgCdTe detectors. Our analysis of the damage process and data revealed that the primary mechanism of damage to CCD and HgCdTe detectors by mid-infrared pulsed lasers was primarily thermal. This study serves as a reference for further research on the mid-infrared pulsed laser damage mechanisms of CCD and HgCdTe detectors, as well as for laser protection and performance optimization in imaging systems.

8.
Environ Microbiome ; 19(1): 47, 2024 Jul 13.
Artículo en Inglés | MEDLINE | ID: mdl-39003484

RESUMEN

BACKGROUND: Myxococcota, characterized by their distinct social lifestyles, are widely distributed micro-predators in global sediments. They can feed on a wide range of bacterial, archaeal, and fungal prey. Myxococcota are capable of producing diverse secondary metabolites, playing key roles in microbial food webs, and regulating the microbial community structures in different ecosystems. However, Myxococcota are rarely pure cultured due to the challenging and stringent culturing conditions. Their natural distribution, niche differentiation, and predator-prey relationships in a specific habitat are poorly understood. RESULTS: In this study, we conducted a comprehensive analysis of the 16S rRNA gene sequence data from public databases and our collection. We compared the abundance, diversity, and distribution patterns of Myxococcota in various habitats, with a specific focus on mangroves. We found that Myxococcota accounted for 1.45% of the total prokaryotes in global sediments based on the abundance of 16S rRNA genes. Myxococcota are abundant and diverse in mangrove sediments. They tend to be more generalistic in mangroves than in other habitats due to their wide niche breadth. Besides, the deterministic processes (variable selection) influenced the assembly of mangrove Myxococcota communities significantly more than stochastic processes. Further, we determined that environmental factors explained a greater amount of total community variation in mangrove Myxococcota than geographical variables (latitude and sediment depth). In the end, through the analysis of microbial co-occurrence networks, Myxococcota emerges as a key component and functions as a connector in the mangrove microbial community. CONCLUSIONS: Our study enhances comprehension of mangrove Myxococcota's biogeography, assembly patterns, driving factors, and co-occurrence relationships, as well as highlights their unique niche and ecological importance in mangrove sediments.

9.
Food Chem ; 459: 140434, 2024 Jul 13.
Artículo en Inglés | MEDLINE | ID: mdl-39003854

RESUMEN

Tricyclazole is commonly used to prevent rice blast to meet the carbohydrate intake needs of half of the global population, and a large number of toxicological reports indicate that monitoring of tricyclazole is necessary. Here, we analyzed the structure of tricyclazole and designed different hapten derivatization strategies to prepare a high-performance monoclonal antibody (half inhibition concentration of 1.61 ng/mL), and then a lateral flow immunochromatographic sensor based on gold nanoparticles for the detection of tricyclazole in rice, with a limit of detection of 6.74 µg/kg and 13.58 µg/kg in polished and brown rice, respectively. The recoveries in rice were in the range of 84.6-107.4%, no complex pretreatment was required for comparison with LC-MS/MS, and the comparative analysis demonstrated that our method had good accuracy and precision. Therefore, the developed lateral flow immunochromatographic analysis was a reliable and rapid means for the on-site analysis of tricyclazole in rice.

10.
bioRxiv ; 2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-39005334

RESUMEN

Age is the greatest risk factor for Alzheimer's disease (AD) as well as for other disorders that increase the risk of AD such as diabetes and obesity. There is growing interest in determining if interventions that promote metabolic health can prevent or delay AD. Acarbose is an anti-diabetic drug that not only improves glucose homeostasis, but also extends the lifespan of wild-type mice. Here, we test the hypothesis that acarbose will not only preserve metabolic health, but also slow or prevent AD pathology and cognitive deficits in 3xTg mice, a model of AD, fed either a Control diet or a high-fat, high-sucrose Western diet (WD). We find that acarbose decreases the body weight and adiposity of WD-fed 3xTg mice, increasing energy expenditure while also stimulating food consumption, and improves glycemic control. Both male and female WD-fed 3xTg mice have worsened cognitive deficits than Control-fed mice, and these deficits are ameliorated by acarbose treatment. Molecular and histological analysis of tau and amyloid pathology identified sex-specific effects of acarbose which are uncoupled from the dramatic improvements in cognition, suggesting that the benefits of acarbose on AD are largely driven by improved metabolic health. In conclusion, our results suggest that acarbose may be a promising intervention to prevent, delay, or even treat AD, especially in individuals consuming a Western diet.

11.
Orthop Surg ; 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38946660

RESUMEN

BACKGROUND: Mobile bearing fracture is a rare long-term complication of unicompartmental knee arthroplasty (UKA), and relevant reports are sparse. Hence, its treatment options need further exploration. CASE PRESENTATION: This study presents the case of fracture of a polyethylene insert that occurred 12 years after mobile bearing medial UKA in a 75-year-old overweight woman who then underwent surgical intervention at our institution. However, we encountered significant challenges in removing the fragments from the broken bearing, resulting in retention of the remaining one-third of the fragment. We solved this problem by replacing the fractured insert with thicker mobile bearing. During the 1-month postoperative follow-up, the patient achieved good range of motion and excellent satisfaction, with no reported complications and a Knee Society Score of 90. Additionally, we reviewed the literature on the treatment for mobile bearing fractures after UKA. CONCLUSIONS: Bearing fracture is a rare cause of failure of mobile bearing UKA. This case highlights the challenges of UKA fracture bearing retrieval and underscores that mobile bearing replacement can be an effective intervention. The case we report shows that when removal of a residual meniscal bearing in a posterior dislocation is difficult to achieve, compromise may be an appropriate option because it does not cause additional complaints to the patient. This case emphasizes the importance of the surgeon having a thorough preoperative understanding of the location and potential pitfalls of fracture fragments in such situations.

12.
Phys Rev Lett ; 132(24): 247101, 2024 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-38949337

RESUMEN

We consider the effect of perturbing a single bond on ground states of nearest-neighbor Ising spin glasses, with a Gaussian distribution of the coupling constants, across various two- and three-dimensional lattices and regular random graphs. Our results reveal that the ground states are strikingly fragile with respect to such changes. Altering the strength of only a single bond beyond a critical threshold value leads to a new ground state that differs from the original one by a droplet of flipped spins whose boundary and volume diverge with the system size-an effect that is reminiscent of the more familiar phenomenon of disorder chaos. These elementary fractal-boundary zero-energy droplets and their composites feature robust characteristics and provide the lowest-energy macroscopic spin-glass excitations. Remarkably, within numerical accuracy, the size of such droplets conforms to a universal power-law distribution with exponents that depend on the spatial dimension of the system. Furthermore, the critical coupling strengths adhere to a stretched exponential distribution that is predominantly determined by the local coordination number.

13.
Phys Rev Lett ; 132(24): 246501, 2024 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-38949356

RESUMEN

Electrons residing in a flat-band system can play a vital role in triggering spectacular phenomenology due to relatively large interactions and spontaneous breaking of different degeneracies. In this work, we demonstrate chirally twisted triple bilayer graphene, a new moiré structure formed by three pieces of helically stacked Bernal bilayer graphene, as a highly tunable flat-band system. In addition to the correlated insulators showing at integer moiré fillings, commonly attributed to interaction induced symmetry broken isospin flavors in graphene, we observe abundant insulating states at half-integer moiré fillings, suggesting a longer-range interaction and the formation of charge density wave insulators which spontaneously break the moiré translation symmetry. With weak out-of-plane magnetic field applied, as observed half-integer filling states are enhanced and more quarter-integer filling states appear, pointing toward further quadrupling moiré unit cells. The insulating states at fractional fillings combined with Hartree-Fock calculations demonstrate the observation of a new type of correlated charge density wave insulators in graphene and points to a new accessible twist manner engineering correlated moiré electronics.

14.
Front Endocrinol (Lausanne) ; 15: 1385167, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38948526

RESUMEN

Background: Thyroid nodules, increasingly prevalent globally, pose a risk of malignant transformation. Early screening is crucial for management, yet current models focus mainly on ultrasound features. This study explores machine learning for screening using demographic and biochemical indicators. Methods: Analyzing data from 6,102 individuals and 61 variables, we identified 17 key variables to construct models using six machine learning classifiers: Logistic Regression, SVM, Multilayer Perceptron, Random Forest, XGBoost, and LightGBM. Performance was evaluated by accuracy, precision, recall, F1 score, specificity, kappa statistic, and AUC, with internal and external validations assessing generalizability. Shapley values determined feature importance, and Decision Curve Analysis evaluated clinical benefits. Results: Random Forest showed the highest internal validation accuracy (78.3%) and AUC (89.1%). LightGBM demonstrated robust external validation performance. Key factors included age, gender, and urinary iodine levels, with significant clinical benefits at various thresholds. Clinical benefits were observed across various risk thresholds, particularly in ensemble models. Conclusion: Machine learning, particularly ensemble methods, accurately predicts thyroid nodule presence using demographic and biochemical data. This cost-effective strategy offers valuable insights for thyroid health management, aiding in early detection and potentially improving clinical outcomes. These findings enhance our understanding of the key predictors of thyroid nodules and underscore the potential of machine learning in public health applications for early disease screening and prevention.


Asunto(s)
Aprendizaje Automático , Nódulo Tiroideo , Nódulo Tiroideo/diagnóstico , Nódulo Tiroideo/epidemiología , Nódulo Tiroideo/diagnóstico por imagen , Humanos , Femenino , Masculino , China/epidemiología , Estudios Transversales , Persona de Mediana Edad , Adulto , Detección Precoz del Cáncer/métodos , Anciano , Tamizaje Masivo/métodos , Ultrasonografía/métodos
15.
Opt Lett ; 49(13): 3818-3821, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38950275

RESUMEN

Photonic stepped-frequency radars based on optical frequency-shifting modulation have shown attractive properties such as wide bandwidth, centimeter range resolution, inherent frequency-time linearity with low spectrum spurs, and reduced system complexity. However, existing approaches typically exhibit meter- or centimeter-level radar range ambiguity, inversely proportional to the frequency step, due to the large frequency shift determined by acousto-optic or electro-optic (EO) modulators. Here, we overcome this limitation by injecting a narrowband, stepped-frequency signal into an optical frequency-shifting fiber cavity to achieve, for the first time, to our knowledge, a broadband photonic stepped-frequency radar with 150-m unambiguous detection and centimeter range resolution, surpassing the reported photonic- and electronic-based counterparts. The demonstrated approach effectively resolves the trade-off between ambiguity range and shifting frequency while maintaining the signal quality and bandwidth, bringing its practicality into reach for outdoor applications.

16.
World J Gastroenterol ; 30(22): 2829-2833, 2024 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-38947294

RESUMEN

In this editorial, we commented on a recently released manuscript by Zeng et al in the World Journal of Gastroenterology. We focused specifically on lifestyle changes in patients with non-alcoholic fatty liver disease (NAFLD). NAFLD is a hepatic manifestation of the metabolic syndrome, which ultimately leads to advanced hepatic fibrosis, cirrhosis, and hepatocellular carcinoma and affects more than 25% of the population globally. Existing therapeutic strategies against NAFLD such as pharmacologic therapies focus on liver protection, anti-inflammation, and regulating disease-related metabolic disorder symptoms. Although several drugs are in late-stage development, potent drugs against the diseases are lacking. Additionally, existing surgical approaches such as bariatric surgery are not routinely used to treat NAFLD. Intervening in patients' unhealthy lifestyles, such as weight loss through dietary changes and exercises to ameliorate patient-associated metabolic disorders and metabolic syndrome, is the first-line treatment for patients with NAFLD. With sufficient intrinsic motivation and adherence, the management of unhealthy lifestyles can reduce the severity of the disease, improve the quality of life, and increase the survival expectancy of patients with NAFLD.


Asunto(s)
Síndrome Metabólico , Enfermedad del Hígado Graso no Alcohólico , Calidad de Vida , Humanos , Enfermedad del Hígado Graso no Alcohólico/terapia , Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Síndrome Metabólico/terapia , Síndrome Metabólico/complicaciones , Estilo de Vida , Pérdida de Peso , Ejercicio Físico , Cirugía Bariátrica , Conducta de Reducción del Riesgo , Estilo de Vida Saludable , Factores de Riesgo
17.
Cancer Innov ; 3(3): e112, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38947760

RESUMEN

Background: Pulmonary sarcomatoid carcinoma (PSC) is a rare and aggressive subtype of non-small cell lung cancer (NSCLC), characterized by the presence of epithelial and sarcoma-like components. The molecular and immune landscape of PSC has not been well defined. Methods: Multiomics profiling of 21 pairs of PSCs with matched normal lung tissues was performed through targeted high-depth DNA panel, whole-exome, and RNA sequencing. We describe molecular and immune features that define subgroups of PSC with disparate genomic and immunogenic features as well as distinct clinical outcomes. Results: In total, 27 canonical cancer gene mutations were identified, with TP53 the most frequently mutated gene, followed by KRAS. Interestingly, most TP53 and KRAS mutations were earlier genomic events mapped to the trunks of the tumors, suggesting branching evolution in most PSC tumors. We identified two distinct molecular subtypes of PSC, driven primarily by immune infiltration and signaling. The Immune High (IM-H) subtype was associated with superior survival, highlighting the impact of immune infiltration on the biological and clinical features of localized PSCs. Conclusions: We provided detailed insight into the mutational landscape of PSC and identified two molecular subtypes associated with prognosis. IM-H tumors were associated with favorable recurrence-free survival and overall survival, highlighting the importance of tumor immune infiltration in the biological and clinical features of PSCs.

18.
Open Life Sci ; 19(1): 20220876, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38947770

RESUMEN

The common squid, Todarodes pacificus, is an important commercial species that inhabits the northwest Pacific Ocean, particularly the East Japan Sea, the Pacific coast of Japan, and the East China Sea. In this study, we chose 29 individuals from three areas: one type from the Sea of Japan and two types from the East China Sea. A total of 43,529 SNPs were obtained using genotyping-by-sequencing (GBS). Our analyses revealed low genetic diversity and genetic differentiation in each type. Heterozygote deficiency and inbreeding have caused this low level of genetic diversity. Population structure analysis indicated that the three types were genetically similar, which may be attributed to strong gene flow combined with the demographic history events during the last 2 million years. This new GBS application technique provides valuable information for the conservation of marine species genetics and could be useful for the effective management of this resource.

19.
Exp Gerontol ; : 112508, 2024 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-38986855

RESUMEN

hTERT gene therapies hold significant promise for treating age-related diseases. However, further research is required to address the challenges of delivery and ethical considerations. We hypothesized that exosomes derived from hTERT-immortalized cells could function similarly to hTERT gene therapies by maintaining telomere length and attenuating cellular senescence biomarkers. In this study, we overexpressed the hTERT gene in Human Foreskin Fibroblast-1 cells (HFF cells) to produce hTERT-immortalized HFF cells (hT-HFF cells). We then used exosomes derived from these hT-HFF cells to treat human fibroblasts, HFF cells. Our results demonstrated that these exosomes effectively attenuated biomarkers of cellular senescence in HFF cells. Furthermore, analysis revealed that hTERT mRNA was indeed packaged into the exosomes from hT-HFF cells. This mRNA was capable of elongating telomeres and delaying cellular senescence in HFF cells. Therefore, exosomes from hT-HFF cells show potential as a treatment for age-related diseases.

20.
J Voice ; 2024 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-38987039

RESUMEN

PURPOSE: This study aimed to evaluate the reliability and validity of GRBASzero in a real clinical setting. METHODS: The reliability and validity of GRBASzero were assessed using two independent datasets. Dataset 1 included 283 outpatients who underwent both GRBASzero assessment and human expert evaluation. Dataset 2 from the Perceptual Voice Qualities Database comprised 287 voice samples that underwent evaluation by GRBASzero and were subsequently compared with GRBAS (Grade, Roughness, Breathiness, Asthenicity, Strain) ratings provided by human experts. The reliability of GRBASzero was assessed using Fleiss Kappa, while the validity of GRBASzero was examined using the intraclass correlation coefficient. RESULTS: In dataset 1, the test-retest reliability of GRBASzero was poor, with the consistency of features A and S approaching random allocation. Consistency analysis with human experts showed a poor agreement for all features except for B. In dataset 2, there was also a poor agreement between GRBASzero and human experts. CONCLUSION: The reliability and validity of GRBASzero in a real clinical environment are poor and do not meet the requirements for clinical testing, indicating the need for further optimization and improvement.

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