The OHStat Guidelines for Reporting Observational Studies and Clinical Trials in Oral Health Research: Manuscript Checklist.

Adequate and transparent reporting is necessary for critically appraising published research. Yet, ample evidence suggests that the design, conduct, analysis, interpretation, and reporting of oral health research could be greatly improved. Accordingly, the Task Force on Design and Analysis in Oral Health Research-statisticians and trialists from academia and industry-identified the minimum information needed to report and evaluate observational studies and clinical trials in oral health: the OHStat Guidelines. Drafts were circulated to the editors of 85 oral health journals and to Task Force members and sponsors and discussed at a December 2020 workshop attended by 49 researchers. The guidelines were subsequently revised by the Task Force's writing group. The guidelines draw heavily from the Consolidated Standards for Reporting Trials (CONSORT), Strengthening the Reporting of Observational Studies in Epidemiology (STROBE), and CONSORT harms guidelines and incorporate the SAMPL guidelines for reporting statistics, the CLIP principles for documenting images, and the GRADE indicating the quality of evidence. The guidelines also recommend reporting estimates in clinically meaningful units using confidence intervals, rather than relying on P values. In addition, OHStat introduces 7 new guidelines that concern the text itself, such as checking the congruence between abstract and text, structuring the discussion, and listing conclusions to make them more specific. OHStat does not replace other reporting guidelines; it incorporates those most relevant to dental research into a single document. Manuscripts using the OHStat guidelines will provide more information specific to oral health research.

The OHStat Guidelines for Reporting Observational Studies and Clinical Trials in Oral Health Research: Explanation and Elaboration.

Adequate and transparent reporting is necessary for critically appraising research. Yet, evidence suggests that the design, conduct, analysis, interpretation, and reporting of oral health research could be greatly improved. Accordingly, the Task Force on Design and Analysis in Oral Health Research-statisticians and trialists from academia and industry-empaneled a group of authors to develop methodological and statistical reporting guidelines identifying the minimum information needed to document and evaluate observational studies and clinical trials in oral health: the OHstat Guidelines. Drafts were circulated to the editors of 85 oral health journals and to Task Force members and sponsors and discussed at a December 2020 workshop attended by 49 researchers. The final version was subsequently approved by the Task Force in September 2021, submitted for journal review in 2022, and revised in 2023. The checklist consists of 48 guidelines: 5 for introductory information, 17 for methods, 13 for statistical analysis, 6 for results, and 7 for interpretation; 7 are specific to clinical trials. Each of these guidelines identifies relevant information, explains its importance, and often describes best practices. The checklist was published in multiple journals. The article was published simultaneously in JDR Clinical and Translational Research, the Journal of the American Dental Association, and the Journal of Oral and Maxillofacial Surgery. Completed checklists should accompany manuscripts submitted for publication to these and other oral health journals to help authors, journal editors, and reviewers verify that the manuscript provides the information necessary to adequately document and evaluate the research.

Autonomous or controlled interpreters? Model of Werktreue internalization for classical musicians.

Self-regulated learning-a cyclical process in which a learner sets a goal, monitors, and self-reflects on one's learning to set the next goal-is vital in instrumental learning. However, many conservatory students fail to initiate self-regulated learning; they take lessons passively, practice ineffectively, and fail to give satisfactory performance. These learning experiences could harm students' well-being, and physical and mental health problems are widespread among students. Nevertheless, factors contributing to self-regulated learning remain unknown. We hypothesized that musicians' autonomy in musical interpretation, which we refer to as interpretive autonomy, plays a pivotal role in self-regulated learning. Without developing interpretation, musicians fail to set personal goals, monitor, and self-evaluate their performances in terms of musicality. Although previous studies imply that interpretation plays a significant role in self-regulated learning, this has not been clearly demonstrated. Studies on interpretive autonomy are scarce due to a complicated discourse surrounding performers' freedom in interpretation. The ideology of Werktreue underpins the classical music field, and classical music performances are evaluated based on how faithfully a performer interpreted the composer's intention. Yet musicians hold various beliefs regarding the meaning of faithful interpretation, thus the degree of interpretive autonomy cannot be assessed unless its clear definition is provided. In addition, the mechanisms that promote or hinder interpretive autonomy in learning remain unexplained. To address these issues, we proposed a model of Werktreue internalization by applying self-determination theory. The model defines interpretive autonomy based on internalization types, identifies its effects on musicians' learning behavior and well-being, and reveals the mechanisms that promote or hinder interpretive autonomy in learning experiences. This model allows researchers and educators to assess the degree of interpretive autonomy, attribute impaired learning behavior and well-being to a lack of interpretive autonomy, and promote interpretive autonomy by supporting students' psychological needs in interpretation.

The role of pain and interpretation bias in fear of disease progression in people with diabetes.

Research indicates that fear of progression (FoP) may be a transdiagnostic construct underlying anxiety in people with chronic health conditions. Theories propose that interpretation of illness-related symptoms (such as pain) might be an important mechanism driving the development of FoP. However, FoP has rarely been studied in diabetes. In this study, we assessed FoP, pain, health threat-related interpretation bias, emotional states, and treatment-adherence in 198 participants with Type 1 or Type 2 diabetes and an age and gender-matched control group. We hypothesised that 1) people with diabetes will be more likely to interpret ambiguous stimuli as health threat-related than people without diabetes, 2) amongst those with diabetes, pain severity and interpretation bias will be associated with more severe levels of FoP, and 3) interpretation bias will moderate the relationship between pain severity and FoP in people with diabetes, such that the positive association between pain and FoP will become stronger when people have greater interpretation bias. Our results confirmed that people with diabetes were more likely to interpret ambiguous information as health threat-related compared to people without diabetes, with a large effect (d=0.84). Moreover, people with diabetes who reported persistent pain were more likely to interpret ambiguous stimuli as health threat-related (d=0.49). Amongst people with diabetes, pain severity and interpretation bias were significantly associated with FoP. However, we did not find evidence that interpretation bias moderated the relationship between pain and FoP and these relationships could not be accounted for by general psychopathology. PERSPECTIVE: People with diabetes had greater health threat-related interpretation bias than people without diabetes, especially for those with persistent pain and more severe fear of progression (FoP). Both pain severity and interpretation bias were associated with greater FoP, but interpretation bias did not moderate the relationship between pain and FoP.

pECGreview: Assessment of a Novel Tool to Evaluate the Accuracy of Pediatric ECG Interpretation Skills.

The skill of interpretation of the electrocardiogram (ECG) remains poor despite existing educational initiatives. We sought to evaluate the validity of using a subjective scoring system to assess the accuracy of ECG interpretations submitted by pediatric cardiology fellows, trainees, and faculty to the Pediatric ECG Review (pECGreview), a web-based ECG interpretation training program. We conducted a retrospective, cross-sectional study of responses submitted to pECGreview. ECG interpretations were assessed independently by four individuals with a range of experience. Accuracy was assessed using a 3-point scale: 100% for generally correct interpretations, 50% for over- or underdiagnosis of minor ECG abnormalities, and 0% for over- or underdiagnosis of major ECG abnormalities. Inter-rater agreement was assessed using expanded Bland-Altman plots, Pearson correlation coefficients, and Intraclass Correlation Coefficients (ICC). 1460 ECG interpretations by 192 participants were analyzed. 107 participants interpreted at least five ECGs. The mean accuracy score was 76.6 ± 13.7%. Participants were correct in 66.1 ± 5.1%, had minor over- or underdiagnosis in 21.5 ± 4.6% and major over- or underdiagnosis in 12.3 ± 3.9% of interpretations. Validation of agreement between evaluators demonstrated limits of agreement of 11.3%. Inter-rater agreement exhibited consistent patterns (all correlations ≥ 0.75). Absolute agreement was 0.74 (95% CI 0.69-0.80), and average measures agreement was 0.92 (95% CI 0.89-0.94). Accuracy score analysis of as few as five ECG interpretations submitted to pECGreview yielded good inter-rater reliability for assessing and ranking ECG interpretation skills in pediatric cardiology fellows in training.

DNA profiling in India: Addressing issues of sample preservation, databasing, marker selection, & statistical approaches.

DNA technology is the gold standard with respect to the identification of individuals from biological evidence. The technology offers the convenience of a universally similar approach and methodology for analysis across the globe. However, the technology has not realised its full potential in India due to the lack of a DNA database and lacunae in sample collection and preservation from the scene of crime and victims (especially those of sexual assault). Further, statistical interpretation of DNA results is non-existent in the majority of cases. Though the latest technologies and developments in the field of DNA analysis are being adopted and implemented,very little has been enacted practically to improve optimise sample collection and preservation. This article discusses current casework scenarios that highlight the pitfalls and ambiguous areas in the field of DNA analysis, especially with respect DNA databases, sampling, andstatistical approaches to genetic data analysis. Possible solutions and mitigation measures are suggested.

Assessment of the evidence yield for the calibrated PP3/BP4 computational recommendations.

PURPOSE: To investigate the number of rare missense variants observed in human genome sequences by ACMG/AMP PP3/BP4 evidence strength, following the calibrated PP3/BP4 computational recommendations. METHODS: Missense variants from the genome sequences of 300 probands from the Rare Genomes Project with suspected rare disease were analyzed using computational prediction tools able to reach PP3_Strong and BP4_Moderate evidence strengths (BayesDel, MutPred2, REVEL, and VEST4). The numbers of variants at each evidence strength were analyzed across disease-associated genes and genome-wide. RESULTS: From a median of 75.5 rare (≤1% allele frequency) missense variants in disease-associated genes per proband, a median of one reached PP3_Strong, 3-5 PP3_Moderate, and 3-5 PP3_Supporting. Most were allocated BP4 evidence (median 41-49 per proband) or were indeterminate (median 17.5-19 per proband). Extending the analysis to all protein-coding genes genome-wide, the number of PP3_Strong variants increased approximately 2.6-fold compared to disease-associated genes, with a median per proband of 1-3 PP3_Strong, 8-16 PP3_Moderate, and 10-17 PP3_Supporting. CONCLUSION: A small number of variants per proband reached PP3_Strong and PP3_Moderate in 3,424 disease-associated genes, and though not the intended use of the recommendations, also genome-wide. Use of PP3/BP4 evidence as recommended from calibrated computational prediction tools in the clinical diagnostic laboratory is unlikely to inappropriately contribute to the classification of an excessive number of variants as Pathogenic or Likely Pathogenic by ACMG/AMP rules.

Ventricular Fibrillation Arrest Triggered by Antiemetics Revealing an Underlying Long QT Syndrome in a Young Woman.

Undiagnosed phenomena such as long QT syndrome can have devastating effects on patients. Our case, involving a woman in her 30s, highlights the serious effects of undiagnosed long QT and how antiemetic medications can precipitate cardiac events that can lead to fatalities. Various medications are known to prolong QT intervals, and clinicians must be aware of the side effects of some of these commonly used medications. While survival was achieved in this case, education and reflection can act as a tool to help improve global standards of care in this subgroup of the population.

Revisiting the Electrochemical Impedance Spectroscopy of Porous Electrodes in Li-ion Batteries by Employing Reference Electrode.

Electrochemical impedance spectroscopy (EIS), characterized by its non-destructive and in-situ nature, plays a crucial role in comprehending the thermodynamic and kinetic processes occurring with Li-ion batteries. However, there is a lack of consistent and coherent physical interpretations for the EIS of porous electrodes. Therefore, it is imperative to conduct thorough investigations into the underlying physical mechanisms of EIS. Herein, by employing reference electrode in batteries, we revisit the associated physical interpretation of EIS at different frequency. Combining different battery configurations, temperature-dependent experiments, and elaborated distribution of relaxation time analysis, we find that the ion transport in porous electrode channels and pseudo-capacitance behavior dominate the high-frequency and mid-frequency impedance arcs, respectively. This work offers a perspective for the physical interpretation of EIS and also sheds light on the understanding of EIS characteristics in other advanced energy storage systems.

The physical basis of analog-to-digital signal processing in the EGFR system-Delving into the role of the endoplasmic reticulum.

Receptor tyrosine kinases exhibit ligand-induced activity and uptake into cells via endocytosis. In the case of epidermal growth factor (EGF) receptor (EGFR), the resulting endosomes are trafficked to the perinuclear region, where dephosphorylation of receptors occurs, which are subsequently directed to degradation. Traveling endosomes bearing phosphorylated EGFRs are subjected to the activity of cytoplasmic phosphatases as well as interactions with the endoplasmic reticulum (ER). The peri-nuclear region harbors ER-embedded phosphatases, a component of the EGFR-bearing endosome-ER contact site. The ER is also emerging as a central player in spatiotemporal control of endosomal motility, positioning, tubulation, and fission. Past studies strongly suggest that the physical interaction between the ER and endosomes forms a reaction "unit" for EGFR dephosphorylation. Independently, endosomes have been implicated to enable quantization of EGFR signals by modulation of the phosphorylation levels. Here, we review the distinct mechanisms by which endosomes form the logistical means for signal quantization and speculate on the role of the ER.

MFS-DBF: A trustworthy multichannel feature sieve and decision boundary formulation system for Obstructive Sleep Apnea detection.

The fine identification of sleep apnea events is instrumental in Obstructive Sleep Apnea (OSA) diagnosis. The development of sleep apnea event detection algorithms based on polysomnography is becoming a research hotspot in medical signal processing. In this paper, we propose an Inverse-Projection based Visualization System (IPVS) for sleep apnea event detection algorithms. The IPVS consists of a feature dimensionality reduction module and a feature reconstruction module. First, features of blood oxygen saturation and nasal airflow are extracted and used as input data for event analysis. Then, visual analysis is conducted on the feature distribution for apnea events. Next, dimensionality reduction and reconstruction methods are combined to achieve the dynamic visualization of sleep apnea event feature sets and the visual analysis of classifier decision boundaries. Moreover, the decision-making consistency is explored for various sleep apnea event detection classifiers, which provides researchers and users with an intuitive understanding of the detection algorithm. We applied the IPVS to an OSA detection algorithm with an accuracy of 84% and a diagnostic accuracy of 92% on a publicly available dataset. The experimental results show that the consistency between our visualization results and prior medical knowledge provides strong evidence for the practicality of the proposed system. For clinical practice, the IPVS can guide users to focus on samples with higher uncertainty presented by the OSA detection algorithm, reducing the workload and improving the efficiency of clinical diagnosis, which in turn increases the value of trust.

A novel way to prospectively evaluate of AI-enhanced ECG algorithms.

Significant strides will be made in the field of computerized electrocardiology through the development of artificial intelligence (AI)-enhanced ECG (AI-ECG) algorithms. Yet, the scientific discourse has primarily relied upon on retrospective analyses for deriving and externally validating AI-ECG classification algorithms, an approach that fails to fully judge their real-world effectiveness or reveal potential unintended consequences. Prospective trials and analyses of AI-ECG algorithms will be crucial for assessing real-world diagnostic scenarios and understanding their practical utility and degree influence they confer onto clinicians. However, conducting such studies is challenging due to their resource-intensive nature and associated technical and logistical hurdles. To overcome these challenges, we propose an innovative approach to assess AI-ECG algorithms using a virtual testing environment. This strategy can yield critical insights into the practical utility and clinical implications of novel AI-ECG algorithms. Moreover, such an approach can enable an assessment of the influence of AI-ECG algorithms have their users. Herein, we outline a proposed randomized control trial for evaluating the diagnostic efficacy of new AI-ECG algorithm(s) specifically designed to differentiate between wide complex tachycardias into ventricular tachycardia and supraventricular wide complex tachycardia.

Evidence on sulfadoxine-pyrimethamine resistance molecular markers from India: interpret with caution.

BACKGROUND: Sulfadoxine-pyrimethamine (SP), as a partner to artesunate as ACT is the treatment of choice for uncomplicated P. falciparum infections in the majority of India and SP-resistance has a potential to lead to ACT failure. In the lack of robust surveillance of therapeutic efficacy of SP, validate molecular markers of SP-resistance offer a hint of failing SP. However, studies reporting these validated markers often suffer from certain pitfalls that warrant a careful interpretation. MAIN BODY: Critical analyses of the results and their reported interpretations from a recent study and other studies conducted on the WHO-validated molecular markers of SP-resistance in India were analysed and the main problems with studying and reporting of these markers are presented here. It was noted that almost all studies analysed flawed either on the usage, estimation and/or interpretation of the standardized classification of the studies SP mutations. These flaws not only impart spatiotemporal incomparability of the published data but also have the potential of being misunderstood and wrongly translated. CONCLUSION: Based on this universal problem in studying, reporting and interpreting the data from the studies on molecular markers of SP-resistance, it is stressed that the future studies should be conducted with utmost caution so that robust evidence may be generated and correctly translated to policy.

GIHP: Graph convolutional neural network based interpretable pan-specific HLA-peptide binding affinity prediction.

Accurately predicting the binding affinities between Human Leukocyte Antigen (HLA) molecules and peptides is a crucial step in understanding the adaptive immune response. This knowledge can have important implications for the development of effective vaccines and the design of targeted immunotherapies. Existing sequence-based methods are insufficient to capture the structure information. Besides, the current methods lack model interpretability, which hinder revealing the key binding amino acids between the two molecules. To address these limitations, we proposed an interpretable graph convolutional neural network (GCNN) based prediction method named GIHP. Considering the size differences between HLA and short peptides, GIHP represent HLA structure as amino acid-level graph while represent peptide SMILE string as atom-level graph. For interpretation, we design a novel visual explanation method, gradient weighted activation mapping (Grad-WAM), for identifying key binding residues. GIHP achieved better prediction accuracy than state-of-the-art methods across various datasets. According to current research findings, key HLA-peptide binding residues mutations directly impact immunotherapy efficacy. Therefore, we verified those highlighted key residues to see whether they can significantly distinguish immunotherapy patient groups. We have verified that the identified functional residues can successfully separate patient survival groups across breast, bladder, and pan-cancer datasets. Results demonstrate that GIHP improves the accuracy and interpretation capabilities of HLA-peptide prediction, and the findings of this study can be used to guide personalized cancer immunotherapy treatment. Codes and datasets are publicly accessible at: https://github.com/sdustSu/GIHP.

Top Ten Tips Palliative Care Clinicians Should Know About Interpreting a Clinical Trial.

Evidence-based practice is foundational to high-quality palliative care delivery. However, the clinical trials that compose the evidence base are often methodologically imperfect. Applying their conclusions without critical application to the clinical practice context can harm patients. The tips provided can help clinicians infer judiciously from clinical trial results and avoid credulously accepting findings without critique. We suggest that statistical and mathematical expertise is unnecessary, but rather a keen curiosity about investigators' rationale for certain design choices and how these choices can affect results is key. For a more comprehensive understanding of clinical trials, this article can be used with the authors' corresponding ten tips article that focuses on designing a clinical trial.

Giving Back What the Patient Brings: On Winnicott's "Mirror-Role of Mother and Family in Child Development".

The author offers a creative reading of Winnicott's (1967) "Mirror-role of mother and family in child development." Winnicott presents the idea that a pivotal experience in the process of the infant's coming into being as himself is the mother's communicating to the infant, by the look in her eyes, what she sees there when she looks at him. In the absence of the experience of being seen, the infant's capacity to feel real and alive atrophies. The author fleshes out Winnicott's thinking by suggesting that just as the infant comes more fully into being as he sees himself in his mother's eyes, so too, the mother comes more fully into being as a mother as she sees herself in the infant's eyes. The paradigm shift that Winnicott has contributed to psychoanalysis is reflected in the clinical work he presents: (1) the goal of psychoanalysis is no longer the enrichment of the patient's self-understanding; rather, the analytic goal is the patient's coming more fully alive to himself; and (2) the analyst helps the patient achieve this end not by making astute interpretations but by allowing the patient to experience the pleasure of making discoveries of his or her own.

Interpretability and Clinical Utility of the Pediatric Evaluation of Disability Inventory - Patient Reported Outcome (PEDI-PRO) Score Report.

AIMS: Well-designed score reports can support therapists to accurately interpret assessments. We piloted a score report for the Pediatric Evaluation Disability Inventory-Patient Reported Outcome (PEDI-PRO) and evaluated: 1) To what extent can occupational and physical therapists (OT, PT) accurately interpret item-response theory (IRT)-based PEDI-PRO assessment results? 2) What is the perceived clinical utility of the pilot score report? METHODS: Exploratory, sequential mixed methods design. Focus groups with OT and PTs (n = 20) informed the development of the final score report; revisions were made in response to feedback. Next, OTs and PTs (n = 33) reviewed score reports from two fictional clients and answered survey questions about the interpretation of the PEDI-PRO results. Additional questions evaluated clinical utility. RESULTS: Focus groups: Visual cues supported score interpretation, but therapists requested additional explanations for advanced IRT measurement concepts. Survey: Therapists accurately interpreted foundational IRT concepts (e.g. identifying most/least difficult items, highest scores), but were less accurate when interpreting advanced concepts (e.g. fit, unexpected responses). Therapists anticipated sharing different components of the score report with family members, clinicians, and payers to support their clinical practice. CONCLUSIONS: The pilot PEDI-PRO score report was highly endorsed by therapists, but therapists may need additional training to interpret advanced IRT concepts.

Patient-authored medical record II: A not-knowing approach to psychiatric nursing.

A patient-authored medical record (PAMR) is a narrative-based prescription that is written by a psychiatric patient with help from a nurse. It is a tool specifically designed and developed for psychiatric nursing. We have reported its notable therapeutic effects for Japanese patients and found that the patients had accurate views of how to improve their illness. The present paper, which broadens the scope of this examination, includes the entire process of using this tool, including both patient-authored medical records and follow-up dialogue. We aim to demonstrate how a patient's potentials are leveraged and expanded through the interpretation of such texts through dialogue, in which interpretation takes the form of a conversational question based on not-knowing. Follow-up meetings facilitate the therapeutic process and team collaboration for patients, medical staff, and families. We also reaffirm the soundness and legitimacy of psychiatric patients writing their own prescription with help from a nurse.