Reliability and validity of belt-stabilized and tension dynamometry for assessing hip strength and power in uninjured adults.

OBJECTIVES: To investigate the intra-rater reliability and validity of belt-stabilized and tension dynamometry to assess hip muscle strength and power. DESIGN: Repeated measures. SETTING: Biomechanics laboratory. PARTICIPANTS: Seventeen uninjured adults (age = 22.0 ± 2.3y; 13 females). MAIN OUTCOMES MEASURES: Peak torque (strength) and rate of torque development (RTD; power) were measured for hip abduction, internal rotation, external rotation and extension using an isokinetic dynamometer, and belt-stabilized and tension dynamometry. RESULTS: For peak torque assessment, belt-stabilized and tension dynamometry showed good (Intraclass Correlation Coefficient [ICC] = 0.848-0.899) and good-to-excellent (ICC = 0.848-0.942) reliability, respectively. For RTD, belt-stabilized dynamometry showed fair reliability for abduction (ICC = 0.524) and good reliability for hip internal rotation, external rotation, and extension (ICC = 0.702-0.899). Tension dynamometry showed good reliability for all motions when measuring RTD (ICC = 0.737-0.897). Compared to isokinetic dynamometry, belt-stabilized and tension dynamometry showed good-to-excellent correlations for peak torque assessment (r = 0.503-0.870), and fair-to-good correlations for RTD (r = 0.438-0.674). Bland-Altman analysis showed that measures from belt-stabilized and tension dynamometry had clinically meaningful disagreement with isokinetic dynamometry. CONCLUSION: Tension dynamometry is reliable for assessing hip strength and power in all assessed motions. Belt-stabilized dynamometry is reliable for assessing internal rotation, external rotation, and extension. Validity of both methods is questionable, considering the lack of agreement with isokinetic dynamometry.

Parental perspectives regarding the return of genomic research results in neurodevelopmental disorders in South Africa: anticipated impact and preferences.

Few policies and little research exist regarding the disclosure of genomic results to research participants in Africa. As understanding participant preferences would be pivotal to the success of the feedback process, this study set out to address this issue by engaging with enrolled participants from an ongoing genomics research project on neurodevelopmental disorders with the aim to assess the anticipated impact of receiving pertinent results and explore the preferences for feedback in a South African context. Twelve semi-structured interviews were conducted with 17 parents of children participating in the research study. Transcribed interview data and observational notes were analysed using thematic analysis and framework matrices. Participants linked their own meaning to the impact of receiving a pertinent result and perceived the information as useful for reasons other than only clinical utility. These included closure, improved management of their child's condition and information regarding recurrence risks. In terms of preferences for feedback, an in-person result delivery session, conducted by a member of the study team or medical professional familiar with their child was preferred. In addition, participants felt a sense of ownership over their blood or their contribution to the research study, finding meaning even in non-pertinent results. These findings provide insight into the type of discussions that may be valuable in enabling the development of best practices and guidelines for the return of individual genetic research results, in a culturally appropriate manner, within South African communities.

The Answer ALS return of results study: Answering the duty to disclose.

Objective: The Return of Answer ALS Results (RoAR) Study was designed to provide a mechanism for participants in Answer ALS, a large, prospectively designed natural history and biorepository study to receive select clinical genetic testing results and study participants' experience with the results disclosure. Methods: Participants consented to receive results of five ALS genes (C9orf72, SOD1, FUS, TARDP, TBK1) and/or 59 medically actionable genes as designated by the American College of Medical Genetics. Patient-reported genetic testing outcomes were measured via a post-disclosure survey. Results: Of 645 eligible Answer ALS enrollees, 143 (22%) enrolled and completed participation in RoAR. Pathogenic variants were identified in 22/143 (15.4%) participants, including 13/143 (9.0%) in ALS genes and 9/143 (6.3%) in ACMG genes. Participant-reported measures of result utility indicated the research result disclosure was as or more successful than published patient-reported outcomes of result disclosure the clinical setting. Conclusions: This study serves as a model of a "disclosure study" to share results from genomic research with participants who were not initially offered the option to receive results, and our findings can inform the design of future, large scale genomic projects to empower research participants to access their genetic information.

Survival Outcomes and Prognostic Factors in Therapy-Related Acute Myeloid Leukemia: A SEER Database Study, 2000-2020.

INTRODUCTION: With advances in therapeutics and longer survival across different cancer spectrums, the incidence of therapy-related acute myeloid leukemia (tAML) has continued to rise. This study aims to evaluate the trend of survival outcomes and their association with sociodemographic factors in tAML over the last 20 years. METHODS: We identified tAML patients between 2000 and 2020 from the Surveillance, Epidemiology, and End Results database. Patients were divided into 4 age groups: 18-39, 40-59, 60-69, and >= 70 years, and 4 diagnostic periods: 2000-2005, 2006-2010, 2011-2015, and 2016-2020. Overall survival (OS) was compared using Kaplan Meier and log-rank methods. RESULTS: The 1-year (and 5-year) OS in patients with tAML was 59.3% (33.7%), 48.2% (24.8%), 37.2% (11.1%), and 32.9% (5.5%) in age groups 18-39, 40-59, 60-69, and >=70 years, respectively. The 1-year (and 5-year) OS based on the year of diagnosis was 20.9% (13.2%), 36.8% (15.2%), 41.9% (13.88%), and 40.4% (not reached) for 2000-2005, 2006-2010, 2011-2015, and 2016-2020 respectively. Among the youngest cohort aged 18-39 years, 1-year OS was 35.7%, 57.7%, 66.7%, and 59.6%, respectively, in 4 diagnostic periods, whereas 1-year OS was 10.5%, 23.9%, 32.2%, and 36.9%, respectively, in the oldest cohort aged >=70 years. Age, year of diagnosis, and geographic location were independent prognostic markers of OS. CONCLUSION: Our study demonstrates a significant improvement in the 1-year OS of tAML patients over the last decade, but the long-term prognosis remains dismal. Older patients continue to show improved survival in recent years with the addition of newer intensive and nonintensive options.

Growth performance, carcass composition, and qualitative meat features of broiler chickens after galactooligosaccharides and sodium butyrate in ovo administration.

The study aimed to analyze the growth performance, feed indicators, and quantitative and qualitative physicochemical features of carcass and meat from broiler chickens after rearing, stimulated in ovo on d 12 of incubation with various substances. In the experiment, 1,200 hatching eggs from meat-type hen Ross 308 parental flock were incubated. On d 12, the injection was performed. Group CON-0 was noninjected. Group CON-S was injected with saline. In the GOS group, the procedure was performed in ovo with galactooligosaccharides (dissolved 3.5 mg of GOS in 0.2 mL of NaCl). In the SB group, butyric acid sodium salt was administered in a 0.3% SB dissolved in 0.2 mL NaCl. After hatching, 336, 1-day-old chicks per group were transferred to the broiler house and kept in 7 pens with 12 chickens per group for 42 d. The body weight and feed intake indicators were calculated. Next, 40 birds were selected (n = 10 per group) and taken to analyze carcass composition and meat quality (pH, color, WHC, drip loss, chemical composition). Compared to the experimental groups, the highest body weight indicators were found in groups CON-0 and CON-S. The feed conversion ratio was the lowest in the SB group on d 36 to 42 (P < 0.05). The European Efficiency Production Factor in groups GOS and SB was lower than in group CON-S (P = 0.005). The GOS group showed higher pH24hours in the pectoral muscles than the CON-S group (P = 0.011). The leg muscles showed better WHC in the CON-S, GOS, and SB groups than in the CON-0 group (P < 0.001). A lower intramuscular fat of the pectoral and leg muscle content was demonstrated, especially in the SB group. Injection of galactooligosaccharides and sodium butyrate in ovo adversely affected broiler production but did not alter carcass composition. It varied pectoral muscles' pH and chemical composition and improved water holding capacity and chemical composition in leg muscles.

Robustness of radiomics among photon-counting detector CT and dual-energy CT systems: a texture phantom study.

OBJECTIVES: To evaluate the robustness of radiomics features among photon-counting detector CT (PCD-CT) and dual-energy CT (DECT) systems. METHODS: A texture phantom consisting of twenty-eight materials was scanned with one PCD-CT and four DECT systems (dual-source, rapid kV-switching, dual-layer, and sequential scanning) at three dose levels twice. Thirty sets of virtual monochromatic images at 70 keV were reconstructed. Regions of interest were delineated for each material with a rigid registration. Ninety-three radiomics were extracted per PyRadiomics. The test-retest repeatability between repeated scans was assessed by Bland-Altman analysis. The intra-system reproducibility between dose levels, and inter-system reproducibility within the same dose level, were evaluated by intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC). Inter-system variability among five scanners was assessed by coefficient of variation (CV) and quartile coefficient of dispersion (QCD). RESULTS: The test-retest repeatability analysis presented that 97.1% of features were repeatable between scan-rescans. The mean ± standard deviation ICC and CCC were 0.945 ± 0.079 and 0.945 ± 0.079 for intra-system reproducibility, respectively, and 86.0% and 85.7% of features were with ICC > 0.90 and CCC > 0.90, respectively, between different dose levels. The mean ± standard deviation ICC and CCC were 0.157 ± 0.174 and 0.157 ± 0.174 for inter-system reproducibility, respectively, and none of the features were with ICC > 0.90 or CCC > 0.90 within the same dose level. The inter-system variability suggested that 6.5% and 12.8% of features were with CV < 10% and QCD < 10%, respectively, among five CT systems. CONCLUSION: The radiomics features were non-reproducible with significant variability in values among different CT techniques. CLINICAL RELEVANCE STATEMENT: Radiomics features are non-reproducible with significant variability in values among photon-counting detector CT and dual-energy CT systems, necessitating careful attention to improve the cross-system generalizability of radiomic features before implementation of radiomics analysis in clinical routine. KEY POINTS: CT radiomics stability should be guaranteed before the implementation in the clinical routine. Radiomics robustness was on a low level among photon-counting detectors and dual-energy CT techniques. Limited inter-system robustness of radiomic features may impact the generalizability of models.

Relevance of a Customized Version of ChatGPT Explaining Laboratory Test Results in Patient Education.

ChatGPT is an artificial intelligence (AI) chatbot application. In this study, we explore the creation and use of a customized version of ChatGPT designed specifically for patient education, called "Lab Explainer." Lab Explainer aims to simplify and clarify the results of complex laboratory tests for patients, using the sophisticated capabilities of AI in natural language processing; it analyses various laboratory test data and provides clear explanations and contextual information. The approach involved adapting OpenAI's ChatGPT model specifically to analyze laboratory test data. The results suggest that Lab Explainer has the potential to improve understanding by providing an interpretation of laboratory tests to the patient. In conclusion, the Lab Explainer can assist patient education by providing intelligible interpretations of laboratory tests.

Kaiser score diagnosis of breast MRI lesions: Factors associated with false-negative and false-positive results.

PURPOSE: We sought factors associated with false-negative and false-positive results in the diagnosis of breast lesions using the Kaiser score (KS) on breast magnetic resonance imaging (MRI). METHODS: We retrospectively analyzed 1058 patients with 1058 breast lesions who underwent preoperative breast MRI with successful histopathologic results. Two radiologists assessed each lesion according to KS criteria, and clinicopathologic features and MRI findings were analyzed. Multivariate regression analysis was conducted to identify factors associated with false-negative and false-positive KS results. RESULTS: Of the 1058 lesions, 859 were malignant and 199 were benign. Particularly high misdiagnosis rates were observed for intraductal papilloma, inflammatory lesion, and mucinous carcinoma. For breast cancer, KS yielded 821 (95.6 %) true-positive and 38 (4.4 %) false-negative results. Multivariate analysis showed that smaller lesion size (≤1 cm) (OR, 3.698; 95 %CI, 1.430-9.567; p = 0.007), absence of ipsilateral breast hypervascularity (OR, 3.029; 95 %CI, 1.370-6.693; p = 0.006), and presence of hyperintensity on T2WI (OR, 2.405; 95 %CI, 1.121-5.162; p = 0.024) were significantly associated with false-negative breast cancer results. For benign lesions, KS yielded 141 (70.9 %) true-negative and 58 (29.1 %) false-positive results. Multivariate regression analysis revealed that non-mass enhancement lesions (OR, 4.660; 95 %CI, 2.018-10.762; p＜0.001), moderate/high background parenchymal enhancement (OR, 2.402; 95 %CI, 1.180-4.892; p = 0.016), and the presence of hyperintensity on T2WI (OR, 2.986; 95 %CI, 1.386-6.433; p = 0.005) were significantly associated with false-positive KS results. CONCLUSION: Several clinicopathologic and MRI features influence the accuracy of KS diagnosis. Understanding these factors may facilitate appropriate use of KS and guide alternative diagnostic approaches, ultimately improving diagnostic accuracy in the evaluation of breast lesions.

Validity and Reliability Assessment of the Complete Persian Version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto-Questionnaire in an Iranian Population.

Objective: The Temperament Evaluation of Memphis, Pisa, Paris, and San Diego - Auto-questionnaire (TEMPS-A) assesses five affective temperaments and has been translated into 32 languages. A 35-item short version is available in Persian, but the complete version is not yet translated. This study aimed to assess the validity and reliability of the complete Persian version of the TEMPS-A in an Iranian population. Method : This descriptive study translated the TEMPS-A questionnaire from English to Persian using a standard forward-backward method. The translation was evaluated for face and content validity by 10 psychiatry specialists, with quantitative content validity assessed through content validity ratio (CVR) and content validity index (CVI) calculations. The Persian TEMPS-A was completed twice, with a two-week interval, by 30 individuals out of the 319 medical staff of Imam Hossein Hospital in Tehran, Iran, who participated in the study, and its reliability was evaluated using Cronbach's alpha. The questionnaire was then distributed to the entire sample (n = 319) for the analysis of temperament frequencies and statistical indices by a statistician. Results: The Persian version of the TEMPS-A, consisting of 110 items across five factors (depressive, cyclothymic, hyperthymic, irritable, and anxious), demonstrated excellent reliability with Cronbach's alpha values of 0.910, 0.909, 0.911, 0.910, and 0.909, respectively. The questions related to cyclothymic and hyperthymic temperaments exhibited the highest and lowest correlation coefficients with the general scale, respectively. Most subscales in the Persian TEMPS-A version showed correlation coefficients ranging from 0.28 to 0.68. An ANOVA with Cochrane's test revealed a significant difference in the mean scores of the questionnaire items (P < 0.001), with a grand mean score of 1.73 across all questions. Conclusion: The Persian version of the TEMPS-A, consisting of 110 items, showed good internal consistency and a strong correlation with the original version. This suggests that it is suitable for use in temperament studies among the Iranian population.

Psychometric Properties of a Persian Version of the Columbia Suicide Severity Rating Scale (C-SSRS) in Iranian Soldiers.

Objective: Suicide is an important health issue nearly all over the world. The Columbia Suicide Severity Rating Scale (C-SSRS) is a well-known instrument for suicide risk assessment. Our purpose in this study is to provide a Persian version of the C-SSRS and evaluate its psychometric properties in the Iranian military population, particularly suicide risk leveling characteristic of the C-SSRS. Method : For linguistic adaptation, we gathered opinions of an expert panel consisting of 23 professionals in mental health sciences. Furthermore, this version was administered to two groups of soldiers, one representing a sample of normal population (N = 338), while the other group comprised a sample of clinical population from a referral psychiatric hospital (N = 348) in Tehran, capital of Iran, from July 2021 until one year later. Besides the C-SSRS, the Beck Scale for Suicidal Ideation (BSSI), Beck Hopelessness Scale (BSS), and General Health Questionnaire 28 (GHQ28) were obtained from the participants. Correlation coefficients, internal consistency, and factor analysis were evaluated using the Statistical Package for the Social Sciences (version 23) software. Results: All items of the Persian version of the C-SSRS had acceptable content validity and face validity. This tool demonstrated high correlation coefficients with the BSSI (r = 0.73, P < 0.001) and BHS (r = 0.64, P < 0.001), but a low correlation coefficient with the GHQ28 (r = 0.22, P < 0.001). Specifically, the suicide risk level based on the C-SSRS had a high correlation with both the BSSI and BHS. Also, its internal consistency was satisfactory (Cronbach's alpha = 0.89). Furthermore, factor analysis revealed two factors that is consistent with suicidal ideation and suicidal behavior factors. Conclusion: Our results indicated acceptable validity and reliability for the Persian version of the C-SSRS, demonstrating its capability to classify suicide risk. It can be concluded that the ordinal suicide risk level (as red, orange, yellow and green) is a valid index for the application of the C-SSRS.

Value of Knowing: Health-Related Behavior Changes following Amyloid PET Results Disclosure in Mild Cognitive Impairment.

BACKGROUND: Growing evidence supports the clinical utility of amyloid PET, however, whether patients at risk for dementia use knowledge of their brain amyloid status to alter their health behaviors remains unclear. OBJECTIVES: To explore the effect of amyloid PET results disclosure on self-reported health behaviors in patients with mild cognitive impairment. DESIGN: Self-reported health behaviors were a secondary outcome of the Return of Amyloid Imaging Scan Results (RAISR) randomized clinical trial of amyloid PET results disclosure for individuals with mild cognitive impairment. SETTING: Academic medical center. PARTICIPANTS: RAISR study participants included 82 patients with mild cognitive impairment who were 92% non-Hispanic white, 59% male, and, on average, 73 ± 8.61 years old with 16.25 ± 2.49 years of education. INTERVENTION: Participants were assigned to a scan group with the opportunity to have an amyloid PET scan and learn their results or to a control group consisting only of a mild cognitive impairment education session and no opportunity for an amyloid PET scan. MEASUREMENTS: A 14-item health behavior questionnaire supplemented with qualitative data from the open-ended text entries to describe "other" health behaviors and follow-up semi-structured interviews. Baseline assessments were conducted prior to group assignment. For the present analysis, 71 participants had available data and scan group participants were divided by amyloid status, creating three groups for comparison: amyloid positive, amyloid negative, and control (no scan). RESULTS: Over 12 months of follow-up, no significant differences were observed in lifestyle, vitamin/supplement use, stress reduction activities, cognitive stimulation, or advance directive completion. Amyloid-negative participants were less likely than controls to consider long-term care insurance (63.6% vs. 89.2%; P = .025), and to endorse behaviors classified as "other" (36.4% vs. 64.9%; P = 0.037). After adjusting for education level, gender, and Mini-Mental State Exam score, logistic regression showed that amyloid-negative patients were 74% less likely than controls to report "other" behaviors (OR = 0.26, 95% CI [0.08, 0.85], P = 0.025), and 78% less likely to consider long-term care insurance (OR= 0.22, 95% CI [0.06, 0.86], P = 0.03). Qualitative analysis of open-ended questionnaire data and supplemental interviews with scan group participants revealed "other" activities to include changes in areas like employment, driving, and residential status, and engagement in other non-medical activities (e.g., pursuing bucket lists). CONCLUSIONS: This exploratory analysis of health-related behavior changes following amyloid PET disclosure suggests that the value of knowing one's brain amyloid status may differ by scan result and encompass actions that focus more on maximizing quality of life than promoting cognitive health.

Self-Controlled Feedback in Motor Learning: The Effects Depend on the Frequency of Request.

The benefits of allowing learners to control when to receive knowledge of results (KR) compared to a yoked group has been recently challenged and postulated to be mild at best. A potential explanation for such dissident findings is that individuals differentially utilize the autonomy provided by the self-controlled condition, which, in its turn, affects the outcomes. Therefore, the present study investigated the effects of self-controlled KR on motor learning focusing on the frequency of KR requests when performing an anticipatory timing task. Self-controlled groups were created based on participants' KR frequency of request (High, Medium, and Low referring to fifth, third, and first quintile) and, then, Yoked groups were created self-control condition pairing the KR request of the Self-controlled groups. We also measured self-efficacy and processing time as means to verify potential correlates. The results supported the expected interaction. While no difference between self-controlled and yoked groups were found for low frequencies of KR, a moderate amount of KR request was related to better results for the self-controlled group. Nonetheless, the opposite trend was observed for high frequencies of KR; the yoked group was superior to the self-controlled group. The results of this study allow us to conclude that the choices made, and not just the possibility of choosing, seem to define the benefits of KR self-control in motor learning.

Risk Factors and Predictive Nomogram for Survival in Elderly Patients with Brain Glioma.

OBJECTIVE: To determine the factors that contribute to the survival of elderly individuals diagnosed with brain glioma and develop a prognostic nomogram. METHODS: Data from elderly individuals (age ≥65 years) histologically diagnosed with brain glioma were sourced from the Surveillance, Epidemiology, and End Results (SEER) database. The dataset was randomly divided into a training cohort and an internal validation cohort at a 6:4 ratio. Additionally, data obtained from Tangdu Hospital constituted an external validation cohort for the study. The identification of independent prognostic factors was achieved through the least absolute shrinkage and selection operator (LASSO) and multivariate Cox regression analysis, enabling the construction of a nomogram. Model performance was evaluated using C-index, ROC curves, calibration plot and decision curve analysis (DCA). RESULTS: A cohort of 20 483 elderly glioma patients was selected from the SEER database. Five prognostic factors (age, marital status, histological type, stage, and treatment) were found to significantly impact overall survival (OS) and cancer-specific survival (CSS), with tumor location emerging as a sixth variable independently linked to CSS. Subsequently, nomogram models were developed to predict the probabilities of survival at 6, 12, and 24 months. The assessment findings from the validation queue indicate a that the model exhibited strong performance. CONCLUSION: Our nomograms serve as valuable prognostic tools for assessing the survival probability of elderly glioma patients. They can potentially assist in risk stratification and clinical decision-making.

Construction and validation of a nomogram for predicting the prognosis of breast cancer patients who received adjuvant therapy: an analysis based on the SEER database.

Background: Breast cancer is the most common malignant tumor in women globally. Despite advances in primary treatment, the role of adjuvant therapy in reducing recurrence and improving survival is critical; however, there is a notable lack of tailored prognostic models for patients receiving adjuvant therapy. This study used the Surveillance, Epidemiology, and End Results (SEER) database to develop a prognostic nomogram for breast cancer patients receiving adjuvant therapy. Methods: The data of breast cancer patients who received adjuvant therapy after surgery in 2014-2015 were extracted from the SEER database. Univariate Cox regression identified significant prognostic variables that were further refined by least absolute shrinkage and selection operator (LASSO) regression and cross-validation analyses. These variables were incorporated into a multivariate Cox regression analysis to establish the predictive model. This model was visualized and validated using various statistical measures. Results: A total of 54,960 patients were included in the study, with 38,472 in the training set and 16,488 in the validation set. Age, sex, race, marital status, grade, tumor (T) stage, lymph node (N) stage, subtype, and radiotherapy were found to be significant independent risk factors of 1-, 3-, and 5-year overall survival (OS). The receiver operating characteristic curve area for 1-, 3-, and 5-year OS was >0.76 in both sets. The consistency index values were 0.768 and 0.763 for the training and validation sets, respectively. The calibration curves showed good fit, and the nomogram exhibited substantial clinical utility. Conclusions: Incorporating various significant factors, the constructed nomogram was able to effectively predict the prognosis of breast cancer patients who received adjuvant therapy. This nomogram extends understandings of complex prognosis scenarios. In addition, it could enhance personalized treatment plans and assist in patient counseling.

Impact of surgical types on overall survival in patients with ductal carcinoma in situ: an analysis based on the SEER database.

Background: Breast cancer, as one of the most common malignancies among women globally, presents a concerning incidence rate, underscoring the importance of addressing the treatment of its precursor lesion, ductal carcinoma in situ (DCIS). Treatment decisions for DCIS, involving the balance between breast-conserving surgery (BCS) and mastectomy, remain an area requiring further investigation. This study aimed to compare influence of different surgical types on overall survival (OS) of patients with DCIS and identify specific subgroups with improved OS to develop an effective survival nomogram for patients. Methods: Patient data from the Surveillance, Epidemiology, and End Results (SEER) database for DCIS cohort from 2010 to 2020 were retrieved. Kaplan-Meier (K-M) survival curves were utilized to compare prognostic OS of patients with different surgical methods. Cox regression analysis was employed to determine prognostic factors and establish a nomogram to predict 3-, 5-, and 10-year survival rates. The model was confirmed by Concordance Index (C-index), calibration curves, and receiver operating characteristic (ROC) curves. Results: A total of 71,675 patients with DCIS were included. Patients who underwent subcutaneous mastectomy (SM) demonstrated the best OS compared to other surgical types. Additionally, adjuvant radiotherapy or chemotherapy in combination with surgery significantly improved OS compared to surgery alone. Among DCIS patients aged ≤74 years, those who underwent SM benefited the most in terms of OS, while in the age group of 63-74 years, patients who underwent BCS had significantly higher OS than those who underwent total (simple) mastectomy (TM)/modified radical mastectomy (MRM). Multiple factors were associated with improved OS in DCIS patients, and these factors were integrated into the nomogram to establish OS predictions. The C-index, calibration curves, and ROC curves indicated that the nomogram was suitable for assessing patient prognosis. Conclusions: This study demonstrated that SM treatment yielded the best survival rates for DCIS patients, providing important guidance for future surgical decision-making. Moreover, identifying multiple independent factors related to survival and establishing reliable survival nomograms can assist physicians in developing personalized treatment plans and prolonging patient survival.

The Impact of Laboratory Automation on the Time to Urine Microbiological Results: A Five-Year Retrospective Study.

Total laboratory automation (TLA) is a valuable component of microbiology laboratories and a growing number of publications suggest the potential impact of automation in terms of analysis standardization, streaking quality, and the turnaround time (TAT). The aim of this project was to perform a detailed investigation of the impact of TLA on the workflow of commonly treated specimens such as urine. This is a retrospective observational study comparing two time periods (pre TLA versus post TLA) for urine specimen culture processing. A total of 35,864 urine specimens were plated during the pre-TLA period and 47,283 were plated during the post-TLA period. The median time from streaking to identification decreased from 22.3 h pre TLA to 21.4 h post TLA (p < 0.001), and the median time from streaking to final validation of the report decreased from 24.3 h pre TLA to 23 h post TLA (p < 0.001). Further analysis revealed that the observed differences in TAT were mainly driven by the contaminated and positive samples. Our findings demonstrate that TLA has the potential to decrease turnaround times of samples in a laboratory. Nevertheless, changes in laboratory workflow (such as extended opening hours for plate reading and antibiotic susceptibility testing or decreased incubation times) might further maximize the efficiency of TLA and optimize TATs.

Alectinib vs. Lorlatinib in the Front-Line Setting for ALK-Rearranged Non-Small-Cell Lung Cancer (NSCLC): A Deep Dive into the Main Differences across ALEX and CROWN Phase 3 Trials.

Various next-generation ALK TKIs are available as first-line options for ALK-positive NSCLC, with alectinib and lorlatinib being commonly preferred. However, no direct comparison between them has been conducted, making it impossible to pick a winner. We performed an analytic, 'non-comparative' assessment of the two phase 3 pivotal clinical trials showing superiority of alectinib (ALEX) and lorlatinib (CROWN) in comparison to crizotinib. Overall, the two studies were very similar in the study design and patient characteristics, with the exception of the selection and evaluation of brain metastases. PFS hazard ratios numerically favored lorlatinib, both according to the investigator and to BICR. Notably, the 3-year PFS rate was numerically higher with lorlatinib (64%) than with alectinib (46.4%). Despite similar response rates and overall intracranial response, the rate of complete intracranial response was higher with lorlatinib, with a cumulative incidence risk of CNS disease progression at 12 months of 9.4% with alectinib and 2.8% with lorlatinib. The peculiar toxicities of lorlatinib were related to lipidic profile alterations, peripheral oedema and cognitive effects, with no impact on cardiovascular risk nor impairment in quality of life versus crizotinib. Furthermore, the rate of permanent treatment discontinuation due to adverse events was numerically higher with alectinib (26%) than with lorlatinib (7%). In conclusion, despite the immature OS data for both drugs, the efficacy of lorlatinib appears higher than alectinib while maintaining a manageable toxicity profile.

Survival after thermal ablation versus wedge resection for stage I non-small cell lung cancer < 1 cm and 1 to 2 cm: evidence from the US SEER database.

BACKGROUND: This study compared the survival outcomes after thermal ablation versus wedge resection in patients with stage I non-small cell lung cancer (NSCLC) ≤ 2 cm. METHODS: Data from the United States (US) National Cancer Institute Surveillance Epidemiology and End Results (SEER) database from 2004 to 2019 were retrospectively analyzed. Patients with stage I NSCLC and lesions ≤ 2 cm who received thermal ablation or wedge resection were included. Patients who received chemotherapy or radiotherapy were excluded. Propensity-score matching (PSM) was applied to balance the baseline characteristics between patients who underwent the two procedures. RESULTS: Univariate and Cox regression analyses were performed to determine the associations between study variables, overall survival (OS), and cancer-specific survival (CSS). After PSM, 328 patients remained for analysis. Multivariable Cox regression analysis revealed, compared to wedge resection, thermal ablation was significantly associated with a greater risk of poor OS (adjusted HR [aHR]: 1.34, 95% CI: 1.09-1.63, p = 0.004) but not CSS (aHR: 1.28, 95% CI: 0.96-1.71, p = 0.094). In stratified analyses, no significant differences were observed with respect to OS and CSS between the two procedures regardless of histology and grade. In patients with tumor size 1 to 2 cm, compared to wedge resection, thermal ablation was significantly associated with a higher risk of poor OS (aHR: 1.35, 95% CI: 1.10-1.66, p = 0.004). In contrast, no significant difference was found on OS and CSS between thermal ablation and wedge resection among those with tumor size < 1 cm. CONCLUSIONS: In patients with stage I NSCLC and tumor size < 1 cm, thermal ablation has similar OS and CSS with wedge resection.

Leveraging artificial intelligence to summarize abstracts in lay language for increasing research accessibility and transparency.

OBJECTIVE: Returning aggregate study results is an important ethical responsibility to promote trust and inform decision making, but the practice of providing results to a lay audience is not widely adopted. Barriers include significant cost and time required to develop lay summaries and scarce infrastructure necessary for returning them to the public. Our study aims to generate, evaluate, and implement ChatGPT 4 lay summaries of scientific abstracts on a national clinical study recruitment platform, ResearchMatch, to facilitate timely and cost-effective return of study results at scale. MATERIALS AND METHODS: We engineered prompts to summarize abstracts at a literacy level accessible to the public, prioritizing succinctness, clarity, and practical relevance. Researchers and volunteers assessed ChatGPT-generated lay summaries across five dimensions: accuracy, relevance, accessibility, transparency, and harmfulness. We used precision analysis and adaptive random sampling to determine the optimal number of summaries for evaluation, ensuring high statistical precision. RESULTS: ChatGPT achieved 95.9% (95% CI, 92.1-97.9) accuracy and 96.2% (92.4-98.1) relevance across 192 summary sentences from 33 abstracts based on researcher review. 85.3% (69.9-93.6) of 34 volunteers perceived ChatGPT-generated summaries as more accessible and 73.5% (56.9-85.4) more transparent than the original abstract. None of the summaries were deemed harmful. We expanded ResearchMatch's technical infrastructure to automatically generate and display lay summaries for over 750 published studies that resulted from the platform's recruitment mechanism. DISCUSSION AND CONCLUSION: Implementing AI-generated lay summaries on ResearchMatch demonstrates the potential of a scalable framework generalizable to broader platforms for enhancing research accessibility and transparency.

Commentary: Core Descriptor Sets Using Consensus Methods Support 'Table One' Consistency.

Inconsistent reporting of patient characteristics in clinical research hampers reproducibility and limits analysis opportunities. This paper proposes condition-specific 'Core Descriptor Sets'(CDSs) comprising key factors like demographics, disease severity, comorbidities, and prognosis to standardise Table 1 reporting. Development entails stakeholder involvement, systematic identification of descriptors, value rating, and consensus-building using multiple Delphi rounds. Final agreement comes at an expert meeting. Benefits include easier cross-study comparison for example through individual patient meta-analysis, facilitated by comparison of consistently reported individual data rather than group level analysis. This may also support routine data analyses, subgroup and risk identification, and reduced research waste. CDSs describe cohorts thoroughly while minimising research burden. They are intended to enable improved clinical characterisation, personalisation, reproducibility, data sharing and knowledge building.