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In Sweden, there has been a development of continuously more and earlier mandatory assessments in schools in the last decades. One of the latest is mandatory assessment in preschool classes from 2019, with one of the purposes to identify students in need of Special Education in Mathematics (SEM students). Preschool class is a compulsory school year for 6-year-olds which precedes compulsory school. The study at hand explores how teachers create knowledge of mathematics and the SEM student during their work with this mandatory assessment. Results show that mandatory assessment might affect how teachers assess knowledge, develop their teaching, and (re)produce knowledge of the six-year-olds as knowers and of knowledge in mathematics. We join the vast amount of research that has shown that mandatory assessment is a potentially sensitive situation for students who are already unprivileged, who face obstacles in their learning or who struggle with mathematics. Awareness of processes of inclusion, exclusion and (in)equity during assessment and in the following education is central to not count (SEM) students out as competent learners with valuable knowledge.

Alzheimer’s disease (AD) is a prevalent form of dementia that affects an estimated 32 million individuals globally. Identifying early indicators is vital for screening at-risk populations and implementing timely interventions. At present, there is an urgent need for early and sensitive biomarkers to screen individuals at risk of AD. Among all sensory biomarkers, olfaction is currently one of the most promising indicators for AD. Olfactory dysfunction signifies a decline in the ability to detect, identify, or remember odors. Within the spectrum of AD, impairment in olfactory identification precedes detectable cognitive impairments, including mild cognitive impairment (MCI) and even the stage of subjective cognitive decline (SCD), by several years. Olfactory impairment is closely linked to the clinical symptoms and neuropathological biomarkers of AD, accompanied by significant structural and functional abnormalities in the brain. Olfactory behavior examination can subjectively evaluate the abilities of olfactory identification, threshold, and discrimination. Olfactory functional magnetic resonance imaging (fMRI) can provide a relatively objective assessment of olfactory capabilities, with the potential to become a promising tool for exploring the neural mechanisms of olfactory damage in AD. Here, we provide a timely review of recent literature on the characteristics, neuropathology, and examination of olfactory dysfunction in the AD continuum. We focus on the early changes in olfactory indicators detected by behavioral and fMRI assessments and discuss the potential of these techniques in MCI and preclinical AD. Despite the challenges and limitations of existing research, olfactory dysfunction has demonstrated its value in assessing neurodegenerative diseases and may serve as an early indicator of AD in the future. [ABSTRACT FROM AUTHOR]

Final grades are the primary assessment tool used to measure students' acquired knowledge in higher education. However, some colleges and universities employ midterm grades as an early feedback tool for students and their advisors. In the economically fragile climate many institutions of higher learning face, an important question is whether early assessments can serve as a student retention tool. Our university's faculty post midterm grades and early assessment grades (pre-midterm). This study aimed to examine students' semester-long progress in Spanish classes by looking at the relationship between early assessment, midterm, and final grades. We found that early assessment and midterm grades strongly predict final grades, suggesting that early assessments may be an essential tool for colleges and universities to intervene with struggling students. [ABSTRACT FROM AUTHOR]

There is a small window of opportunity at the beginning of semester for a university to provide commencing students with timely and targeted support. However, there is limited information available on interventions that identify and support disengaged students from equity groups without using equity group status as the basis for the contact. The aim of this study was to use learning analytics that were explainable to the end users to identify and support commencing undergraduate students at an Australian regional university. Non-submission of an early assessment item accurately identified disengaged students and those students with successful dialogue with the Outreach Team were less likely to receive a failing grade. Analysis of intersectionality revealed that student progress rate decreased with additional equity factors. A holistic conversation with the Outreach Team increased retention for equity students the following semester, indicating that explainable learning analytics can be used to support equity students. [ABSTRACT FROM AUTHOR]

Abstract Background Cataracts are the world’s leading cause of avoidable blindness. In low-income countries, there are high rates of poor follow-up, which makes it very difficult to monitor surgical outcomes. To address this issue, the Better Operative Outcome Software Tool (BOOST Cataract app) predicts outcome on the first postoperative day and provides specific advice to improve outcomes. The aim of the study is to evaluate the ability of the BOOST Cataract app to categorise surgical outcomes and to analyse the possible factors that contribute to its performance. This was a prospective observational study performed at the General Hospital of Hospitalet of Llobregat. Results A total of 126 cataracts were included. Patients had a mean [SD] age of 75.8 [12.19] years, and 52% were females. Manual small-incision cataract surgery was involved in 57% and phacoemulsification in 43%. Thirty-eight percent of eyes presented significant corneal oedema on day 1. The BOOST Cataract app succeeded in categorising the final outcome in 65.6% of the eyes and in 93,4% of the eyes with good outcome.The agreement between the BOOST and UDVA outcomes was 0.353 (p

Cardiovascular disease(CVD) has become a major disease burden affecting people's health in China. Blood vessels are very important for human health and are the "sentinel" for the development of many cardiovascular and cerebrovascular diseases. The key to effectively preventing fatal, disabling heart, brain and peripheral vascular events lies in controlling traditional and non-traditional risk factors for vascular health from the source, and early assessment and intervention of early vascular lesions. Since 2004, China government promoted the early detection technology of vascular lesions and vascular medicine, and proposed the Beijing Vascular Health Stratification (BVHS) to provide suggestions for the examination, evaluation and management of risk factors, and to provide new ideas for lifelong maintenance of vascular health. This review mainly introduces the establishment and development of the clinical discipline of "vascular medicine" in the past 20 years in China, introduces the indicators for detecting vascular function and structure and the predictive value of vascular events, and carries out intelligent and digital management of vascular health throughout the life cycle of individualized prevention, treatment and rehabilitation for people with different parts or degrees of lesions, effectively reducing the occurrence and development of cardiovascular and cerebrovascular diseases, and the prospect of new technology in maintaining vascular health. [ABSTRACT FROM AUTHOR]

Abstract Background Aging and an increased fall risk have been demonstrated in hemodialysis patients at home and in a facility. However, studies investigating the cause of falls to prevent fractures in dialysis rooms are scarce. This study aimed to explore the related factors for accidental falls statistically in dialysis facilities for future fall prevention. Methods This study included 629 hemodialysis patients with end-stage renal disease. The patients were divided into two groups: the fall and non-fall groups. The main outcome was the presence or absence of falls in the dialysis room. Univariate and multivariate logistic analyses were performed; multivariate analysis was conducted using covariates significantly correlated in the univariate analysis. Results A total of 133 patients experienced falling accidents during the study period. The multivariate analysis indicated that the use of walking aid (p

Background: Cataracts are the world's leading cause of avoidable blindness. In low-income countries, there are high rates of poor follow-up, which makes it very difficult to monitor surgical outcomes. To address this issue, the Better Operative Outcome Software Tool (BOOST Cataract app) predicts outcome on the first postoperative day and provides specific advice to improve outcomes. The aim of the study is to evaluate the ability of the BOOST Cataract app to categorise surgical outcomes and to analyse the possible factors that contribute to its performance. This was a prospective observational study performed at the General Hospital of Hospitalet of Llobregat. Results: A total of 126 cataracts were included. Patients had a mean [SD] age of 75.8 [12.19] years, and 52% were females. Manual small-incision cataract surgery was involved in 57% and phacoemulsification in 43%. Thirty-eight percent of eyes presented significant corneal oedema on day 1. The BOOST Cataract app succeeded in categorising the final outcome in 65.6% of the eyes and in 93,4% of the eyes with good outcome.The agreement between the BOOST and UDVA outcomes was 0.353 (p<.000). The level of agreement improved to 0.619 (p<.000) in eyes with clear corneas. Success obtained by BOOST for both types of surgery was not statistically different. Eyes that obtained a good outcome on day one after surgery and eyes with clear cornea had 37 times higher odds (95% CI 6.66, 212.83) and 12 times higher odds (95% CI 3.13, 47.66) of being correctly categorised by the BOOST Cataract app than eyes that obtained a suboptimal (moderate and poor) outcome and eyes with corneal oedema on day 1. Conclusions: The BOOST Cataract app is an e-Health tool designed to address issues of measuring quality in low- and middle-income settings. Although its reliability is limited to eyes that obtain a good outcome and with clear corneas on day 1, the use of the tool on a regular basis facilitates monitoring and reporting outcomes when clinical data collection is challenging due to low postoperative follow-up rates. [ABSTRACT FROM AUTHOR]

Modern burn care is centralised, and studies show that early, prompt referral to dedicated burn services improve clinical outcomes. We describe the use of a novel clinical instrument, the burn injury Transfer Feedback Form, to support and educate referring clinicians about the early assessment and management of burn injuries. Since 2005, Transfer Feedback Forms have been completed for all burn-injured patients with inter-hospital transfer to a specialised burn unit in the state of New South Wales (NSW), Australia. The aim of this study was to review physiological, procedural, and system or process issues in the care of both adult and paediatric burn-injured patients needing retrieval and transfer in NSW as identified by the Transfer Feedback Form. Secondary objectives were to determine any significant differences in these parameters between metropolitan and regional or remote referring institutions, and if any improvements occurred in these parameters over time. This was a retrospective analysis of all patients who were transferred to a burn unit in NSW between July 2005 and July 2021 using their prospectively completed Transfer Feedback Forms. Patients were divided into metropolitan and non-metropolitan referral sources based on geographic location. Clinical issues or deficiencies identified during each patient transfer were then classified into various groups. To determine if transfer-related clinical concerns had changed with time, two distinct periods before and after 2015, when the NSW Trauma App was introduced, were analysed. We compared trends in frequency of transfer-related concerns before and after App introduction by using interrupted time series analysis. A total of 3233 patients had Feedback Forms submitted during the 16-year period. We included 929 children (28.7%) and 2304 adults (71.3%). Transfer-related clinical issues were identified in 904 adults (39.0%) and 484 children (52.0%). In both adult and paediatric patients, the most common transfer-related clinical deficiency was in relation to burn size estimation with 525 patients (43.7%) and 207 patients (30.6%), respectively. Between the time periods analysed, the number of issues arising during inter-hospital transfer fell significantly for both adults (from 46.1% to 26.1%; p < 0.05) and children (from 55.3% to 40.7%; p < 0.05). Segmented regression analysis demonstrated a significant break in the rate of transfer-related clinical issues in 2014 (p < 0.05) and 2015 (p < 0.01) for adults. Accurate body surface area estimations also increased significantly by 53% and 50% for adults and children (p < 0.05 for both), respectively, after 2015. Our analysis indicates that the early care of burn-injured patients undergoing inter-hospital transfer is associated with clinical, technical, and logistical challenges. However, introduction of the burn injury Transfer Feedback Form has been associated with improvements in early burn care by referring centres both temporally and geographically. Smartphone-based applications such as the NSW Trauma App have also probably contributed to these findings. Adopting these simple, inexpensive strategies into burn care systems will augment inter-hospital transfer of burn-injured patients, and improve clinical outcomes. • There are clinical and logistical challenges with burn patients undergoing hospital transfer. • We describe a novel instrument for providing feedback to referring clinicians. • Improvements have been seen in early burn care both temporally and geographically. • Smartphone-based applications (e.g. NSW Trauma App) have also contributed. [ABSTRACT FROM AUTHOR]

Background: Aging and an increased fall risk have been demonstrated in hemodialysis patients at home and in a facility. However, studies investigating the cause of falls to prevent fractures in dialysis rooms are scarce. This study aimed to explore the related factors for accidental falls statistically in dialysis facilities for future fall prevention. Methods: This study included 629 hemodialysis patients with end-stage renal disease. The patients were divided into two groups: the fall and non-fall groups. The main outcome was the presence or absence of falls in the dialysis room. Univariate and multivariate logistic analyses were performed; multivariate analysis was conducted using covariates significantly correlated in the univariate analysis. Results: A total of 133 patients experienced falling accidents during the study period. The multivariate analysis indicated that the use of walking aid (p < 0.001), orthopedic diseases (p < 0.05), cerebrovascular disease, and age were significantly correlated with falls. Conclusions: In the dialysis clinic, patients who use walking aids and have complicated orthopedic or cerebrovascular conditions are at a high risk of falling in the dialysis room. Therefore, establishing a safe environment may help prevent falls, not only for these patients but also among other patients with similar conditions. [ABSTRACT FROM AUTHOR]

BackgroundDespite growing evidence that early life experiences and exposures can impact child development, there is limited research on how prenatal and early life nutrition and early life parenting practices predict specific domains of child development in resource-limited settings. This study examines the association between prenatal factors, birth outcomes, and early life characteristics with motor, cognitive/language, and socioemotional development in Tanzania.MethodsWe assessed motor, cognitive/language, and socioemotional development among a cohort of 198 children aged 20-39 months in Dar es Salaam, Tanzania, whose mothers were previously enrolled in a randomized, placebo-controlled trial of prenatal vitamin A and zinc supplementation. Linear regression models were used to assess standardized mean differences in child development scores for randomized prenatal regimen and pregnancy, delivery, and early childhood factors.ResultsChildren born to mothers randomized to prenatal vitamin A had significantly lower reported motor scores in minimally adjusted and multivariate analyses, -0.29 SD, 95% CI [-0.54, -0.04], p = 0.03, as compared with children whose mothers did not receive vitamin A. There was no significant effect of randomized prenatal zinc on any development domain. Greater caregiver-child stimulation was associated with 0.38 SD, 95% CI [0.14, 0.63], p

The balance of people with multiple sclerosis (PwMS) is commonly assessed during neurological examinations through clinical Romberg and tandem gait tests that are often not sensitive enough to unravel subtle deficits in early-stage PwMS. Inertial sensors (IMUs) could overcome this drawback. Nevertheless, IMUs are not yet fully integrated into clinical practice due to issues including the difficulty to understand/interpret the big number of parameters provided and the lack of cut-off values to identify possible abnormalities. In an attempt to overcome these limitations, an instrumented modified Romberg test (ImRomberg: standing on foam with eyes closed while wearing an IMU on the trunk) was administered to 81 early-stage PwMS and 38 healthy subjects (HS). To facilitate clinical interpretation, 21 IMU-based parameters were computed and reduced through principal component analysis into two components, sway complexity and sway intensity, descriptive of independent aspects of balance, presenting a clear clinical meaning and significant correlations with at least one clinical scale. Compared to HS, early-stage PwMS showed a 228% reduction in sway complexity and a 63% increase in sway intensity, indicating, respectively, a less automatic (more conscious) balance control and larger and faster trunk movements during upright posture. Cut-off values were derived to identify the presence of balance abnormalities and if these abnormalities are clinically meaningful. By applying these thresholds and integrating the ImRomberg test with the clinical tandem gait test, balance impairments were identified in 58% of PwMS versus the 17% detected by traditional Romberg and tandem gait tests. The higher sensitivity of the proposed approach would allow for the direct identification of early-stage PwMS who could benefit from preventive rehabilitation interventions aimed at slowing MS-related functional decline during neurological examinations and with minimal modifications to the tests commonly performed. [ABSTRACT FROM AUTHOR]

BackgroundPatients with gastrointestinal or lung cancer often suffer from a loss of appetite (anorexia), resulting in reduced food intake (hypophagia) and body weight loss. This study evaluated the prevalence of anorexia, hypophagia, pre-cachexia and cachexia in patients with cancer at time of diagnosis.Patients and methodsPatients with newly diagnosed gastrointestinal or lung cancers were included. Body mass index (BMI) and weight loss over the prior 6 months were recorded. Patients were assessed for (pre-)cachexia and for anorexia using the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) and a specific anorexia questionnaire (AQ). Energy and protein intake were calculated through food diaries. Patients were considered hypophagic if intake was ≤70% of guideline-recommended levels.ResultsOverall, 102 patients [53 male; median age: 67 (range, 21–88) years] were enrolled. Mean BMI (± standard deviation) was 23.1 ± 3.4 kg/m2; average percentage of weight loss was 10.1 ± 7.8%. At diagnosis, 68% (69/102) of patients had cachexia, and 11% (11/102) pre-cachexia. Prevalence of anorexia was 57% (58/102) and 75% (76/102) according to FAACT and AQ, respectively. Forty-eight percent (49/102) of patients had hypophagia. Patients with anorexia had lower daily energy (p = 0.002) and protein intake (p = 0.0257), and greater percentage of weight loss (p = 0.0005). In patients with hypophagia, negative correlations were observed between percentage of weight loss and total daily calorie (r = –0.40; p = 0.01) and protein intake (r = –0.340; p = 0.018).ConclusionAnorexia, inadequate nutritional intake and cachexia are highly prevalent in patients with gastrointestinal or lung cancer at diagnosis. Negative protein and energy balance may play an important role in the pathogenesis of cachexia. Early multimodal strategies to improve food intake are urgently needed.

Acute pancreatitis is an acute inflammatory disorder of the pancreas, and severe acute pancreatitis is associated with high mortality. Early assessment the severity of AP has an important significance for improving clinical outcomes. Our object aimed to develop a nomogram with high simplicity and rapidity for predicting the severity of acute pancreatitis. Patients admitted to the Hunan Provincial People's Hospital within 72 h from onset of AP from January 2010 and December 2020 were enrolled to establish a nomogram. Independent predictors were determined using univariate and multivariate analysis and then assembled to construct a predicting nomogram. The performance of proposed nomogram was evaluated by Brier score and Harrell's concordance index (C-index). Meanwhile, clinical data of AP patients from January 2021 to January 2022 were collected for external validation. Album (OR 0.891, 95%CI 0.867–0.917), calcium (OR 0.151, 95%CI 0.084–0.273), neutrophil to lymphocyte ratio (OR 1.055, 95%CI 1.023–1.088) and systemic inflammatory response syndrome (OR 6.292, 95%CI 4.459–8.879) were identified as independent factors of SAP after univariate and multivariate analysis (p <.05). A predictive nomogram was accordingly established using these four independent variables. The internally verified C-index was 0.796 (95% CI 0.773–0.818), Brier score was 0.138. The externally verified C index was 0.820 (95% CI 0.754–0.887). A nomogram for predicting the severity of AP was well developed, it may be of great significance for clinicians to quickly assess the progress of AP and choose more-targeted strategies. [ABSTRACT FROM AUTHOR]

Objectives: Early assessments of health technologies help to better align and integrate their development and assessment. Such assessments can take many forms and serve different purposes, hampering users in their selection of the most appropriate method for a specific goal. The aim of this scoping review was to structure the large set of methods according to their specific goal.Methods: A scoping review was conducted using PubMed and reference lists of retrieved articles, to identify review studies with a methodological focus. From the included reviews, all individual methods were listed. Based on additional literature and examples, we extracted the specific goal of each method. All goals were clustered to derive a set of subclasses and methods were grouped into these subclasses.Results: Of the 404 screened, 5 reviews were included, and 1 was added when searching reference lists. The reviews described 56 methods, of which 43 (77%) were included and classified as methods to (1) explore the nature and magnitude of the problem, (2) estimate the nature and magnitude of the expected (societal) value, (3) identify conditions for the potential value to materialize, and (4) help develop and design the type of research that is needed.Conclusions: The wide range of methods for exploring the societal value of health technologies at an early stage of development can be subdivided into a limited number of classes, distinguishing methods according to their specific objective. This facilitates selection of appropriate methods, depending on the specific needs and aims. [ABSTRACT FROM AUTHOR]

Keywords: early assessment; flow cytometry; measurable residual disease; multiple myeloma; outcome EN early assessment flow cytometry measurable residual disease multiple myeloma outcome e82 e85 4 06/14/22 20220615 NES 220615 Multiple myeloma (MM) treatment has evolved remarkably with the introduction of new agents such as proteasome inhibitors, immunomodulatory drugs (IMIDS) and therapeutic antibodies. The level of minimal residual disease in the bone marrow of patients with multiple myeloma before high-dose therapy and autologous blood stem cell transplantation is an independent predictive parameter. The 26 patients with persistent positive MRD had worse PFS compared to the negative MRD post- and pre-ASCT cases (24 months vs 45 months vs 68 months, I p i < 0.0001). [Extracted from the article]

Grutters et al recently investigated the role of early health economic modelling of health technologies by undertaking a secondary analysis of health economic modelling assessments performed by their group. Our commentary offers a broad perspective on the potential utility of early health economic modelling to inform health technology assessment (HTA) and decision-making around reimbursement of new health technologies. Further we provide several examples to compliment Grutters and colleagues’ observations.

Background: Early identification of patients with acute severe pancreatitis is important for prompt and adequate treatment. Existing scores for pancreatitis are often laborious or require serial patient evaluation, whereas the qSOFA score, that was established to predict outcome in patients with suspected infection, is simple to perform. Aims and Methods: In this cohort study, we analyse the potential of the qSOFA score to predict outcome of patients with acute pancreatitis and refine the qSOFA score by rapid available laboratory parameters to the emergency room assessment of acute pancreatitis (ERAP) score. Validation was performed in a separate patient cohort. Results: In total 203 patients with acute pancreatitis were recruited. The qSOFA score has the potential to predict ICU admission (AUC = 0.730, p = 0.002) and organ failure (AUC = 0.799, p = 0.013) in acute pancreatitis. Respiratory rate, mental status, blood urea nitrogen and C-reactive protein are the rapid available parameters with the highest individual impact in binary logistic regression analyses. Their combination to the ERAP score can predict severity of acute pancreatitis according to the revised Atlanta classification (AUC = 0.689 ± 0.041, p < 0.001), ICU admission (AUC = 0.789 ± 0.067, p < 0.001), multi-organ dysfunction syndrome (AUC = 0.963 ± 0.024, p < 0.001) and mortality (AUC = 0.952 ± 0.028, p = 0.001). The performance and prognostic validity for organ failure and mortality were validated in an independent patient cohort. Conclusion: The qSOFA is a rapidly available prognostic score in acute pancreatitis with limited prognostic validity. A combination with the laboratory parameters BUN and CRP results in the new ERAP score with outstanding prognostic validity for multi-organ dysfunction syndrome and mortality. [ABSTRACT FROM AUTHOR]

The Charles Sturt University Retention Team has developed, tested, evaluated, and refined a retention model through 14 action-research cycles from 2017-2021. The project has expanded from a small pilot in one faculty to monitoring the engagement and submission of an early assessment item for over 70% of all commencing undergraduate students across the University. The Retention Model synergistically overlays curriculum design and student support and ensures academics embed best practice transition pedagogy and learning engagement activities into key first-year subjects. By monitoring the submission of early assessment items, the team can accurately identify and proactively contact students who are not engaged in their studies prior to their first census date. Every aspect of this program supports equity student groups that are over-represented at our regional university. This work has significantly improved commencing progress rates across the institution. [ABSTRACT FROM AUTHOR]

In a review recently published in this journal, Grutters et al outline the scope and impact of their early health economic modelling of healthcare innovations. Their reflections shed light on ways that health economists can shift-away from traditional reimbursement decision-support, towards a broader role of facilitating the exploration of existing care pathways, and the design of options to implement or discontinue healthcare services. This is a crucial role in organisations that face constant pressure to react and adapt with changes to their existing service configurations, but where there may exist significant disagreement and uncertainty on the extent to which change is warranted. Such dynamics are known to create complex implementation environments, where changes risk being poorly implemented or fail to be sustained. In this commentary, we extend the discussion by Grutters et al on early health economic modelling, to the evaluation of complex interventions and systems. We highlight how early health economic modelling can contribute to a participatory approach for ongoing learning and development within healthcare organisations.

A recent paper by Grutters et al makes the case for early health economic modeling in the development of health technologies. A number of examples of the value of early modeling are given, with analyses being performed at different stages in the development of several non-drug health technologies. This commentary acknowledges the contribution of the paper by Grutters et al and argues for an iterative and integrated approach to early modeling, assessing the cost-effectiveness of the technology, the value of future research and the interaction with the manufacturer’s pricing and revenue expectations.

Background To assess whether early health economic modeling helps to distinguish those healthcare innovations that are potentially cost-effective from those that are not potentially cost-effective. We will also study what information is retrieved from the health economic models to inform further development, research and implementation decisions. Methods We performed secondary analyses on an existing database of 32 health economic modeling assessments of 30 innovations, performed by our group. First, we explored whether the assessments could distinguish innovations with potential cost-effectiveness from innovations without potential cost-effectiveness. Second, we explored which recommendations were made regarding development, implementation and further research of the innovation. Results Of the 30 innovations, 1 (3%) was an idea that was not yet being developed and 14 (47%) were under development. Eight (27%) innovations had finished development, and another 7 (23%) innovations were on the market. Although all assessments showed that the innovation had the potential to become cost-effective, due to improved patient outcomes, cost savings or both, differences were found in the magnitude of the potential benefits, and the likelihood of reaching this potential. The assessments informed how the innovation could be further developed or positioned to maximize its cost-effectiveness, and informed further research. Conclusion The early health economic assessments provided insight in the potential cost-effectiveness of an innovation in its intended context, and the associated uncertainty. None of the assessments resulted in a firm ‘no-go’ recommendation, but recommendations could be provided on further research and development in order to maximize value for money.

Abstract Background A great body of evidence suggests that there are retinal functional and structural changes that occur in Alzheimer’s disease (AD). However, whether such changes are primary or secondary remains to be elucidated. We studied a range of retinal functional and structural parameters in association with AD- specific pathophysiological markers in the double transgenic APP/PS1 and control mice across age. Methods Electroretinogram (ERG) and optical coherence tomography (OCT) was performed in APP/PS1 and wild type (WT) control mice every 3 months from 3 to 12 months of age. For functional assessment, the a- and b-wave of the ERG, amplitude of oscillatory potentials (OP) and the positive scotopic threshold response (pSTR) were quantified at each time point. For structural assessment, the inner and outer retinal thickness was segmented and measured from OCT scans. Episodic memory was evaluated at 6, 9 and 12 months of age using the novel object recognition test. Amyloid beta (Aβ) distribution in the hippocampus and the retina were visualised at 3, 6 and 12 months of age. Inter- and intra- group analysis was performed to study rate of change for each parameter between the two groups. Results Inter-group analysis revealed a significant difference in b-wave and OPs of APP/PS1 compared to WT controls starting from 3 months (p

• FDG PET scans were acquired weekly to evaluate response to chemoradiotherapy in NSCLC patients and all evaluated PET metrics demonstrated a strong linear decrease over time. • Considerable differences were observed between diagnostic and first day of treatment PET scans. • Relative change in SUVmax was not associated to patient outcome. • Faster responding patients tended to have worse outcome. • The imaging time point maximizing the association of PET response with outcome varied per PET metric and outcome parameter. To test if the relative change in FDG-PET SUV max over the course of treatment was associated with disease progression and overall survival. Additionally, the prognostic values of other first-order PET-metric changes were investigated. The study included 38 patients with stage II–III NSCLC, who underwent concurrent chemoradiotherapy. Patients received two pre-treatment FDG-PET scans and four during-treatment scans at weekly intervals. SUV max was normalized to the start of treatment and analyzed using linear regression. Linear regression coefficients of other first order PET-metrics were grouped according to dissimilarity. Associations to patient outcome were analyzed using Cox hazard ratio. Twenty-eight patients satisfied the criteria for analysis. All PET-metrics demonstrated a strong linear correlation with time during treatment [median R-range: −0.87: −0.97]. No strong associations (p > 0.10) were found for the relative slope of SUV max to patient outcomes. Other first-order metrics did correlate with outcome but the single imaging time-point maximizing the association of PET response with outcome varied per PET metric and outcome parameter. All investigated FDG PET metrics linearly decreased during treatment. Relative change in SUV max was not associated to patient outcome while several other first order PET-metrics were related to patient outcome. A single optimal imaging time-point could not be identified. [ABSTRACT FROM AUTHOR]

Background: The American Academy of Pediatrics (AAP) has called for a universal system of developmental screening and surveillance to enhance early detection and intervention for children. While the need and potential impact of universal screening is well documented, recent reports show that screening rates have not reached expected goals and gaps remain in terms of effective follow‐up and referral to early intervention (EI) services. Few studies have explored parent and child experiences of developmental screening, which would aid researchers, practitioners and policymakers in improving early detection and referral to EI. The purpose of this qualitative study was to understand the experiences of caregivers and children who received developmental screening across different service sectors, including the type of screening received, location of screening, experiences during the screening process and the follow‐up interventions received following screening. Methods: Individual interviews were conducted with 31 caregivers. A descriptive qualitative design allowed for the exploration of caregiver experiences with developmental screening. Thematic analysis was utilized to categorize caregiver reflections prior to, during and following developmental screening events. Results: Analysis revealed five themes that described caregivers' experiences with screening and assessment for their child: (1) parent's goals of screening; (2) screening preparation and support; (3) parent/child response to screening; (4) result reporting and follow‐up; (5) overall satisfaction with screening process. Each theme was composed of several subthemes. Conclusions: Caregivers see the importance of developmental screening, caregivers and children respond well to screening delivered by various providers in multiple settings and caregivers find the information gleaned from screening events important in planning for their child's developmental trajectory. Key places where improvements can be made to further bolster parental engagement and satisfaction include screening preparation and follow‐up. [ABSTRACT FROM AUTHOR]

Background: The purpose of our study was to assess the predictive and prognostic role of 2-18F-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET)/MRI during high-dose methotrexate-based chemotherapy (HD-MBC) in de novo primary central nervous system lymphoma (PCNSL) patients aged 60 and above., Methods: This prospective multicentric ancillary study included 65 immunocompetent patients who received induction HD-MBC as part of the BLOCAGE01 phase III trial. FDG-PET/MRI were acquired at baseline, post 2 cycles (PET/MRI2), and posttreatment (PET/MRI3). FDG-PET response was dichotomized with "positive" indicating persistent tumor uptake higher than the contralateral mirroring brain region. Performances of FDG-PET and International PCNSL Collaborative Group criteria in predicting induction response, progression-free survival (PFS), and overall survival (OS) were compared., Results: Of the 48 PET2 scans performed, 9 were positive and aligned with a partial response (PR) on MRI2. Among these, 8 (89%) progressed by the end of the induction phase. In contrast, 35/39 (90%) of PET2-negative patients achieved complete response (CR). Among the 18 discordant responses at interim (PETCR/MRIPR), 83% ultimately achieved CR. Eighty-seven percent of the PET2-negative patients were disease free at 6 months versus 11% of the PET2-positive patients (P < .001). The MRI2 response did not significantly differentiate patients based on their PFS, regardless of whether they were in CR or PR. Both PET2 and MRI2 independently predicted OS in multivariate analysis, with PET2 showing a stronger association., Conclusions: Our study highlights the potential of interim FDG-PET for early management of PCNSL patients. Response-driven treatment based on PET2 may guide future clinical trials., Trial: LOCALYZE, NCT03582254, ancillary of phase III clinical trial BLOCAGE01, NCT02313389 (Registered July 10, 2018-retrospectively registered) https://clinicaltrials.gov/ct2/show/NCT03582254?term=LOCALYZE&draw=2&rank=1., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: the follow-up of the high-risk newborn determines the early diagnosis of sequelae that, when treated early, can have a better prognosis in many cases.Objective: to characterize the neurological development in high-risk children up to two years of age, before and after applying the rehabilitation treatment, at the "Gustavo Aldereguía Lima" University Polyclinic of Las Tunas.Methods: a prospective longitudinal study was carried out in the health district belonging to the polyclinic previously declared. The study population consisted of the 27 infants at the age of two, qualified as children at risk, treated in 2017 and 2018. They were characterized before and after the rehabilitation treatment.Results: the male sex prevailed (19 children, 70,4 %). A third of the sample did not show neurodevelopmental disorders. Of the risk factors associated with neurodevelopment, in 14 children prenatal factors were documented (51,9 %), 12 with perinatal factors (44,4 %) and 3 showed postnatal factors (11,1 %). In the health district consultation, 21 children were assessed (77,8 %) and 6 in the provincial neurodevelopment consultation (22,2 %). In the first assessment, the cases with impaired motor development (77,8 %), followed by language (55,6 %) and sensory (27,7 %) disorders prevailed. After rehabilitation impaired motor development was significantly reduced (being in 44,4 %).Conclusions: with rehabilitation a total or partial recovery was obtained in the studied children.

Abstract Background Hospitals increasingly make decisions about early development of and investment in innovative medical technologies (IMTs), but at present often without an early assessment of their potential to ensure selection of the most promising candidates for further development. This paper explores how early assessment is carried out in different health organisations and then discusses relevant learning points for hospitals. Methods A qualitative study design with a structured interview guide covering four themes was used. Content analyses of interview notes were performed covering four predetermined themes: context, basis for decision-making, process and structure, and perceptions. A fifth theme, handling cognitive bias, was identified during data analysis. Results A total of 11 organisations participated; eight from the private health industry and three public hospitals. The interviews identified four areas in which early assessment is performed in similar manner across the studied organisations and four areas where differences exist between public hospitals and private organisations. Public hospitals indicate a lower degree of formalised early assessment and less satisfaction with how early assessment is performed, compared to private organisations. Based on the above findings, two learning points may carry promise for hospitals. First, having dedicated prioritising committees for IMTs making stop/go decisions. This committee is separate from the IMT development processes and involved staff. Secondly, the committee should base decisions on a transparent early assessment decision-support tool, which include a broad set of domains, is iterative, describes uncertainty, and minimise cognitive biases. Conclusions Similarities and differences in the way early assessment is done in different health organisations were identified. These findings suggest promising learning points for the development of an early assessment model for hospitals.

Despite the early onset of challenging behaviors, there is a lack of research investigating the function of challenging behavior in toddlers with autism spectrum disorder (ASD) and developmental disabilities (DDs). The current study evaluated group differences in the frequency and severity of five functions of challenging behavior (i.e., Attention, Escape, Nonsocial, Physical, Tangible). A total sample of 98 toddlers, aged 19–40 months, were classified into the ASD group or the atypical development group. No group differences were found in regard to the reported frequency of the function of behavior. Group differences in the severity of the function of behavior were found in the Attention function only. Significant differences across ASD symptom severity groups were also found in the Attention and Nonsocial functions. Clinical implications of the current findings are discussed. [ABSTRACT FROM AUTHOR]

Grutters et al recently investigated the role of early health economic modelling of health technologies by undertaking a secondary analysis of health economic modelling assessments performed by their group. Our commentary offers a broad perspective on the potential utility of early health economic modelling to inform health technology assessment (HTA) and decision-making around reimbursement of new health technologies. Further we provide several examples to compliment Grutters and colleagues' observations. [ABSTRACT FROM AUTHOR]

Introduction: The input from practitioners in developmental assessment test revision is a crucial and leading component of the project. This paper highlights six key phases of the Griffiths III revision process and the value of having a guiding plan that includes test practitioner input. Methods: The revision of the Griffiths III consisted of six separate phases that were supported by practitioner and user input and feedback. These six phases and practitioner views ensured that the necessary core constructs and new areas for item development were included in the revised version. These processes also underscored the construct development and task review, item design, piloting and standardization of the revised version, as well as its production, release and subsequent training methods. Results: The six guiding phases provided a methodologically robust frame to the revision process. Practitioners valued an overall developmental measure with discrete data about and within the 'avenues of learning' allowing them to analyse a child's strengths and weaknesses. Communication with practitioners across the world demonstrated the wide disparity of culture and environments that the Griffiths Scales are deployed in. It is not possible to design a revised scale that is appropriate for all areas of use, so in this revision process, it was decided to design the scales as culturally fair as possible and support practitioners in other countries to translate and validate the scales for use. Conclusions: The revision of the Griffiths III found test users to be valuable sources of information on the basis of their experiences with the test and professional knowledge. Creating a continuous feedback mechanism within a phased process provided opportunities for the revision team to engage meaningfully with the data being obtained as well as test users to advance the scope and quality of the test. Revision teams are encouraged to consider the process and engagement methods explored in this study during their projects. [ABSTRACT FROM AUTHOR]

Early health technology assessment (HTA), which includes all methods used to inform industry and other stakeholders about the potential value of new medical products in development, including methods to quantify and manage uncertainty, has seen many applications in recent years. However, it is still unclear how such early value assessments can be integrated into the technology innovation process. This commentary contributes to the discussion on the purposes early HTA can serve. Similarities and differences in the perspectives of five stakeholders (i.e., the hospital, the patient, the assessor, the medical device industry, and the policy maker) on the purpose, value, and potential challenges of early HTA are described. All five stakeholders agreed that integrating early HTA in the innovation process has the possibility to shape and refine an innovation, and inform research and development decisions. The early assessment, using a variety of methodologies, can provide insights that are relevant for all stakeholders but several challenges, for example, feasibility and responsibility, need to be addressed before early HTA can become standard practice. For early evaluations to be successful, all relevant stakeholders including patients need to be involved. Also, nimble, flexible assessment methods are needed that fit the dynamics of medical technology. Best practices should be shared to optimize both the innovation process and the methods to perform an early value assessment. [ABSTRACT FROM AUTHOR]

Current emphasis on students' academic adaptation in higher education necessitates the evaluation of predictors of successful preparation of first-year students. This study evaluated the implementation of early assessment (EA) in two first-year financial accounting courses at a South African university, namely an introductory financial accounting course, aimed at students without prior exposure to accounting, and a professional body accredited accounting course, aimed at students with prior exposure to accounting. This module-specific benchmark assessment, early in the academic year is often used as a predictor of preparation, adaptation and potential future academic performance. Given the discontinuation of a university, wide EA protocol within a faculty the academic contribution of the EA has been questioned. The study's focus comprised two research questions, namely whether the EA can be used as a predictor of future academic performance of two different academic performance groups and whether students in a lower academic performance group are able to achieve success despite a low result in the EA. The research methodology included an analysis of variances to determine the correlation between the early assessment and either mid-year or final marks, as well as significance evaluation of the measured variance analysis using the Bonferroni test. The findings suggest that whilst the EA could potentially be used as an early warning sign for at-risk academically low performing students, the EA could also result in a misleading representation to students in the high academic performance category. Principally, the EA was found not to be a reliable predictor of future academic performance. In addition, the mixed results obtained from the evaluation of the effect of the nature and format of the assessment suggested that it had a low and non-meaningful effect on the predictive value of the early assessment. The fact that students in the academically low performance group were largely able to pass the module, however, suggests the success of intervention utilising the EA as an early warning. Higher education module developers could therefore consider the implementation of an appropriate EA in various undergraduate modules, based on the findings. [ABSTRACT FROM AUTHOR]

Background: A growing literature base supports the use of tests developed in high‐income countries to assess children in low resource settings when carefully translated, adapted, and applied. Evaluation of psychometric properties of adapted and translated measures within populations is necessary. The current project sought to evaluate the reliability and validity of an adapted and translated version of the Mullen Scales of Early Learning (AT‐MSEL) in rural Guatelama. Methods: The reliability and validity of the AT‐MSEL in rural Guatemala were analyzed for children ages 0–5 years. Results: Interrater reliability coefficients (ICC = 0.99–1.0) and internal consistency (Cronbach's alpha = 0.91–0.93) were excellent for all subscales. General linear models utilizing paired data showed consistency between standard scores (p < 0.0001). Mean raw scores increased with chronological age, as expected. Across age groups, subscales were significantly, positively correlated with one another (p < 0.05 ‐ < 0.001) with one exception, visual reception and expressive language at the 0–10 month age range (p = 0.43). Conclusions: The AT‐ MSEL showed strong psychometric properties in a sample of young children in rural Guatemala. Findings demonstrate that the AT‐MSEL can be used validly and reliably within this specific population of children. This work supports the concept that tests developed in high‐income countries can be used to assess children in low resource settings when carefully translated, adapted and applied. [ABSTRACT FROM AUTHOR]

Background: Little is known on symptom burden, psychosocial needs, and perception of prognosis in advanced lung cancer patients at the time of diagnosis, although early assessment is strongly recommended within the setting of daily routine care. Methods: Twelve study sites cross-sectionally assessed symptoms and psychosocial needs of patients suffering from newly diagnosed incurable lung cancer. Assessment comprised NCCN distress thermometer, FACT-L, SEIQoL-Q, PHQ-4, and shortened and modified SCNS-SF-34 questionnaires. Additional prognostic information from both patients and physicians were collected. Results: A total of 208 patients were evaluated. Mean age was 63.6 years, 58% were male, 84% suffered from stage IV lung cancer, and 71% had an ECOG performance status of 0–1. Mean distress level was 5.4 (SD 2.5), FACT-L total score was 86 (21.5), and TOI 50.5 (14.9). PHQ-4 was 4.6 (3.3), and shortened and modified SCNS-SF-34 showed 9 (8.7) unmet needs per patient. According to their physicians' perspective, 98.1% of patients were reflecting on and 85.2% were accepting incurability, while 26.5% of patients considered the treatment to be of curative intent. Conclusion: Our findings emphasize substantial domains of symptom burden seen in newly diagnosed, incurable lung cancer patients. Oncologists should be aware of these features and address prognostic issues early in the disease trajectory to facilitate opportunities to improve coping, advance care planning, and appropriate integration of palliative care, thus improving quality of life. [ABSTRACT FROM AUTHOR]

Background: Mother–infant dyads are not meeting recommended breastfeeding goals. There is lack of consensus regarding any program's ability to increase breastfeeding duration to meet the recommended guidelines, and effective strategies are needed moving forward to help families meet those goals. Primary prevention utilizing consistent visits with lactation professionals with a group of new mothers may efficiently address this care gap. Methods: Mother–infant dyads attending a newborn care clinic for 6 weeks received feeding assessment and standard-of-care guidance from an Internationally Board-Certified Lactation Consultant (IBCLC). Regression analysis was completed with outcome variables "exclusive direct breastfeeding" (EDB) and "any breastfeeding" (AB) at 6 weeks postpartum (PP) and odds ratios were calculated. Results: The number and timing of IBCLC visits was correlated with EDB at 6 weeks PP. Maternal/infant dyads seen at day 3 had 2.5 times higher odds of EDB at 6 weeks than those not receiving IBCLC standard-of-care feeding assessment. Dyads seen at days 3 and 14 had 3.4 times higher odds of EDB than those with less follow-up. Bottle use correlated with decreased odds of AB at 6 weeks PP; similarly, dyads seen only at day 14 PP had decreased odds of EDB. When looking at timing of the first involvement, dyads seen at 3 days had higher odds of EDB than dyads first seen at day 14 PP. Conclusions: This primary prevention strategy of early minimal intervention using an IBCLC increased the odds of EDB and AB at 6 weeks PP. These data support the conclusion that early feeding assessment the first 2 weeks PP with an IBCLC may increase breastfeeding at 6 weeks PP. [ABSTRACT FROM AUTHOR]

Background: To assess whether early health economic modeling helps to distinguish those healthcare innovations that are potentially cost-effective from those that are not potentially cost-effective. We will also study what information is retrieved from the health economic models to inform further development, research and implementation decisions. Methods: We performed secondary analyses on an existing database of 32 health economic modeling assessments of 30 innovations, performed by our group. First, we explored whether the assessments could distinguish innovations with potential cost-effectiveness from innovations without potential cost-effectiveness. Second, we explored which recommendations were made regarding development, implementation and further research of the innovation. Results: Of the 30 innovations, 1 (3%) was an idea that was not yet being developed and 14 (47%) were under development. Eight (27%) innovations had finished development, and another 7 (23%) innovations were on the market. Although all assessments showed that the innovation had the potential to become cost-effective, due to improved patient outcomes, cost savings or both, differences were found in the magnitude of the potential benefits, and the likelihood of reaching this potential. The assessments informed how the innovation could be further developed or positioned to maximize its cost-effectiveness, and informed further research. Conclusion: The early health economic assessments provided insight in the potential cost-effectiveness of an innovation in its intended context, and the associated uncertainty. None of the assessments resulted in a firm ‘no-go’ recommendation, but recommendations could be provided on further research and development in order to maximize value for money. [ABSTRACT FROM AUTHOR]

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Manufacturing companies are moving toward new business models based on Product-Service System (PSS). Academic and scientific literature reveal that there is a lack of suitable methods, tools and methodologies to support early PSS design activities and, in particular, early PSS concepts assessment. This paper focuses on identification and selection of PSS concepts in an Italian product-oriented company working in the automation sector willing to move toward the provision of product-service solutions. The Engineering Value Assessment (EVA) method has been selected and implemented to assess and select PSS concepts able, from one side, to fulfill customer needs and, from the other side, to ensure company profitability and alignment with its long-term strategy. [ABSTRACT FROM AUTHOR]

Background: Emotional maltreatment (EM) has profound effects on the developing brain but is hardest to identify in infancy. Early observations of parent–infant interactions may provide opportunities to identify babies at risk of neglect and EM. This prospective study tests, in the first fortnight of life, the feasibility of using an observation tool previously validated for use at 2 to 7 months of age. Methods: Women awaiting induction of labour were recruited in South Wales in July 2016. Women consented to being contacted postnatally and video recordings of mother‐infant interaction at two home visits between 7 and 10 days (T1) and 8–12 weeks old (T2). Demographic details, information on the pregnancy, delivery, and infant condition were obtained at T1. A questionnaire was completed at T2 to capture any significant events affecting the parent–infant relationship. The Parent‐Infant Interaction Observation Scale (PIIOS) was used to score the videos. Exclusion criteria included admission to neonatal unit. Results: Recruitment of suitable participants and full research data completion were feasible. Of 60 women who consented to be contacted post‐delivery, 30 women (31 infants) participated at T1 and T2. Three babies were excluded. Women accepted being observed in their homes with their babies, with no attrition between T1 and T2. Using the PIIOS 10 of the 13 items could be scored with an awake infant under 2 weeks. Conclusion: These encouraging findings can inform exploration of an observation tool to identify high‐risk dyads for targeted support. A trial and test of a modified scoring system (based on the PIIOS) should be developed for a future study using a larger sample size. Further research should assess if this approach reliably produces a consistent valid screening tool to assess parental sensitive responsiveness and resilience promoting behaviours at this early stage of life. [ABSTRACT FROM AUTHOR]