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AIM: This paper aims to report on two modifications made to improve the measurement precision of the Ms. Olsen test. Specifically, three items were added to the Ms. Olsen test and an extended scoring was applied to some items. DESIGN: The competence assessment had a quantitative cross-sectional design comprising of test results from 111 Registered Nurses in four municipalities in South-Eastern Norway. METHODS: The Rasch model was applied to evaluate the measurement properties in four versions: the Ms. Olsen test with 19 items and the same with three added items, and the Ms. Olsen test with 19 items with an expanded scoring for the original and expanded version, respectively. RESULTS: The person separation indexes were improved from 0.50 to 0.62. Other measurement properties were not alternating between the four versions; all had shortcomings in terms of targeting (person measure means 3.02-3.87) and unidimensionality (% t-test >5% 9.01%-13.51%). CONCLUSION: The clinical relevance and relatively short time spent on testing makes the Ms. Olsen test a reasonable choice and a step in the right direction for assessing competence as a means of targeting continuous professional development of nurses throughout their career. Nevertheless, depending on what kind of decisions are to be made, reliability might still be too low and further development is suggested. PUBLIC CONTRIBUTION: The initiative for the competence assessment came from nursing leaders in the four municipalities involved. The municipalities were represented in all stages of the research process through co-author LS, that is, design, data collection, data analysis, writing of the manuscript as well as dissemination of the results to the four municipalities. IMPLICATIONS FOR PRACTICE: The Ms. Olsen test exemplifies a move towards objective assessments in nursing. Precise and reliable measurements are essential to support the ongoing professional development of nurses.

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BACKGROUND: The first year after surgery is a period of significant change, during which patients are highly concerned and sensitive about the outcomes. OBJECTIVE: This study aimed to measure objectively the improvements and changes in the lower face and neck over the course of 1 year after rhytidectomy in Asian. MATERIALS AND METHODS: This study included a total of 50 patients, comprising 100 hemifaces, who underwent extended deep-plane rhytidectomy using a composite flap from January 2017 to December 2022. The patients' antero-posterior and lateral photographs at pre-surgery, between 2 weeks and 1 month, 3 months, 6 months, and 12 months after surgery were analyzed retrospectively. RESULTS: Measurements for each period and site are revealed a general trend where the most significant decrease occurred between 2 weeks and 1 month after surgery. This was followed by a slight increase at 3 months, with a subsequent decrease observed at 6 and 12 months after surgery. CONCLUSION: Objective assessment of lower face and neck at each period is considered to be potentially valuable as an evaluation resource for both patients and surgeons. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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(1) Background: The Modified Ashworth Scale (MAS) is commonly used clinically to evaluate spasticity, but its qualitative nature introduces subjectivity. We propose a novel metric scale to quantitatively measure spasticity using mechanomyography (MMG) to mitigate these subjective effects. (2) Methods: The flexor and extensor muscles of knee and elbow joints were assessed with the Modified Ashworth Scale (MAS) during the acquisition of mechanomyography (MMG) data. The median absolute amplitude of the MMG signals was utilized as a key descriptor. An algorithm was developed to normalize the MMG signals to a universal gravitational (G) acceleration scale, aligning them with the limits and range of MAS. (3) Results: We evaluated 34 lower and upper limbs from 22 volunteers (average age 39.91 ± 13.77 years) of both genders. Polynomial regression provided the best fit (R2 = 0.987), with negligible differences (mean of 0.001 G) between the MAS and MMG. We established three numerical sets for the median, minimum, and maximum MMG(G) values corresponding to each MAS range, ensuring consistent alignment of the Modified Ashworth levels with our proposed scale. (4) Conclusions: Muscle spasticity can now be quantitatively and semi-automatically evaluated using our algorithm and instrumentation, enhancing the objectivity and reliability of spasticity assessments.

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PRIMARY OBJECTIVE: To evaluate the accuracy of an innovative machine-learning-powered near-infrared spectroscopy (mNIRS)-based bio-optical sensitivity parameters, namely specific tissue optical index (STOI) and intracranial tissue optical index (ITOI) for effective triaging of patients with suspected traumatic brain injury (TBI) across different age-groups to facilitate timely intervention and curtail the silent epidemic. RESEARCH DESIGN: Prospective, observational, double-blinded, cross-sectional single-center. METHODS: A total of 240 subjects suspected with TBI and recommended for head CT scan were enrolled. Findings of CT were compared with the bio-optical sensitivity parameters (STOI+ITOI) generated by the mNIRS system to detect intracranial hemorrhages (ICHs). STATISTICAL SOFTWARE USED: SPSS (IBM VERSION 21.0) RESULTS: Bio-optical sensitivity parameters (STOI+ITOI) analysis of 1288 scanned lobes showed high specificity of 97% (CI 95-98%), sensitivity of 96% (CI 92-99%), and accuracy of 97% (CI 96-98%) across all ages, maintaining robust performance for detecting subdural, epidural, subarachnoid hemorrhages, and contusions. Also, the reliability in the diagnosis of ICH was evidenced by Youden's index of 0.93 and positive and negative likelihood ratios of 29.13 and 0.04, respectively. CONCLUSION: The mNIRS-based STOI+ITOI proves to be an effective triage tool for TBI, exhibiting superior diagnostic performance across all age-groups.

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INTRODUCTION: The variety of robotic surgery systems, training modalities, and assessment tools within robotic surgery training is extensive. This systematic review aimed to comprehensively overview different training modalities and assessment methods for teaching and assessing surgical skills in robotic surgery, with a specific focus on comparing objective and subjective assessment methods. METHODS: A systematic review was conducted following the PRISMA guidelines. The electronic databases Pubmed, EMBASE, and Cochrane were searched from inception until February 1, 2022. Included studies consisted of robotic-assisted surgery training (e.g., box training, virtual reality training, cadaver training and animal tissue training) with an assessment method (objective or subjective), such as assessment forms, virtual reality scores, peer-to-peer feedback or time recording. RESULTS: The search identified 1591 studies. After abstract screening and full-texts examination, 209 studies were identified that focused on robotic surgery training and included an assessment tool. The majority of the studies utilized the da Vinci Surgical System, with dry lab training being the most common approach, followed by the da Vinci Surgical Skills Simulator. The most frequently used assessment methods included simulator scoring system (e.g., dVSS score), and assessment forms (e.g., GEARS and OSATS). CONCLUSION: This systematic review provides an overview of training modalities and assessment methods in robotic-assisted surgery. Dry lab training on the da Vinci Surgical System and training on the da Vinci Skills Simulator are the predominant approaches. However, focused training on tissue handling, manipulation, and force interaction is lacking, despite the absence of haptic feedback. Future research should focus on developing universal objective assessment and feedback methods to address these limitations as the field continues to evolve.

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OBJECTIVE: The aim of this study was to evaluate the effect of three training methodologies on the acquisition of psychomotor skills for laparoendoscopic single-site surgery (LESS), using straight and articulating instruments. METHODS: A prospective study was conducted with subjects randomly divided into three groups, who performed a specific training for 12 days using three laparoscopic tasks in a laparoscopic simulator. Group-A trained in conventional laparoscopy setting using straight instruments and in LESS setting using both straight and articulating instruments. Group-B trained in LESS setting using straight and articulating instruments, whereas Group-C trained in LESS setting using articulating instruments. Participants' performance was recorded with a video-tracking system and evaluated with 12 motion analysis parameters (MAPs). RESULTS: All groups obtained significant differences in their performance in most of the MAPs. Group-C showed an improvement in nine MAPs, with a high level of technical competence. Group-A presented a marked improvement in bimanual dexterity skills. CONCLUSIONS: Training in LESS surgery using articulating laparoscopic instruments improves the quality of skills and allows smoother learning curves.

OBJETIVO: Evaluar el efecto de tres métodos de entrenamiento en la adquisición de habilidades psicomotrices para la cirugía laparoendoscópica por puerto único (LESS, laparoendoscopic single-site surgery) utilizando instrumental recto y articulado. MÉTODO: Se realizó un estudio prospectivo con sujetos divididos aleatoriamente en tres grupos, quienes realizaron un entrenamiento específico durante 12 días utilizando tres tareas laparoscópicas en un simulador laparoscópico. El grupo A entrenó en el entorno laparoscópico convencional con instrumentos rectos, y en el entorno LESS con instrumentos rectos y articulados. El grupo B entrenó en el entorno LESS con instrumentos rectos y articulados. El Grupo C entrenó en el entorno LESS con instrumentos articulados. El desempeño de los participantes se registró con un sistema de seguimiento en video y fue evaluado con 12 parámetros de análisis de movimiento (MAP, motion analysis parameters). RESULTADOS: Todos los grupos obtuvieron diferencias significativas en su desempeño para la mayoría de los MAP. El grupo C mostró una mejora en nueve MAP, con un alto nivel de competencia técnica. El grupo A mostró una marcada mejora en la habilidad de destreza bimanual. CONCLUSIONES: El entrenamiento en cirugía LESS con instrumentos articulados mejora la calidad de las habilidades adquiridas y permite curvas de aprendizaje más suaves.

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In low- and middle-income countries (LMICs) including India, cancer patients have a poor prognosis because of late diagnosis and cases already grown to advanced stages, low cancer awareness and skewed cancer care facilities. In India, the incidence of colorectal cancer (CRC) is ranked the 4th most common (6.4%) in males and the 5th most common (3.4%) in females. The improvement in the cure rate of rectal cancer has increased life expectancy, and assessment of the quality of life (QoL) in these patients has become a fundamental requirement. Little is known about how the patients perceive these adverse effects during curatively intended radiotherapy. Although studies have investigated the various adverse effects that can occur with radiotherapy and chemotherapy in carcinoma rectum patients, these have not yet been critically appraised and synopsized to form a comprehensive review of their prevalence and effects on QoL. The study was designed to explore the QoL issues in locally advanced carcinoma rectum patients during various phases of neoadjuvant concurrent chemo-radiotherapy (NACCRT). The study was performed over a period of 2 years at a single super speciality cancer hospital in North India. Patients were selected as per the inclusion criteria and followed up with a standard questionnaire incorporating various aspects depicting QoL. The interview technique was used for collecting QoL data at four points, at baseline, midway during treatment, at the end of treatment and 4 weeks after completion of NACCRT, using EORTC QLQ C30, for QLQ CR29. Special care was taken to avoid observer bias in cases of language issues, and interpreters' services were utilised, and compared with the baseline pre-treatment scores, patients reported a statistically significant and large clinically meaningful change in the global health status, social functioning, fatigue (FACIT-F), appetite loss, anxiety, sore skin and male and female sexual function at the post-treatment time point. Statistically significant changes with moderate clinically meaningful changes were reported for the functional scales-physical, role and emotional functioning of the QLQ C30 questionnaire and body image and weight of the CR29 questionnaire. Similar moderate clinical changes were found in the symptom scales-fatigue, nausea and vomiting, insomnia, constipation and diarrhoea of QLQ C30 and stool frequency, embarrassment with bowel function, impotence and dyspareunia. These parameters returned to almost the pre-treatment values after 4 weeks of completion of NACRT. Since QoL is a relatively subjective variable, differences in human race, culture, education and social environment will have impacts on the results. International cooperation is needed to study the QoL in patients with multiple cultural backgrounds. The existing QoL questionnaire tools have been designed with Western countries in mind, and we did face multiple social issues. We suggest that many similar multicentre studies shall be required to essentially tap the accurate QoL-related issues keeping in mind the diverse social, economic, racial and educational backgrounds. As we deal with the ever-increasing cancer menace and better life expectancy, QoL issues shall be a major determinant of treatment success besides primary treatment. These factors should form an integral part of treatment modality, and adequate counselling must be performed prior to initiation of care.

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Psoriasis is a chronic inflammatory skin disease, characterized by thick scaly plaques. It imposes a notable disease burden with varying levels of severity affecting the quality of life significantly. Current disease severity assessment relies on semi-objective visual inspection based on the Psoriasis Area and Severity index (PASI) score that might not be sensitive to sub-clinical changes. Histology of psoriasis skin lesions necessitate invasive skin biopsies. This indicates an unmet need for a non-invasive, objective and quantitative approach to assess disease severity serially. Herein, we employ multispectral Raster-Scanning Optoacoustic Mesoscopy (ms-RSOM) derived structural and microvascular functional imaging metrics to examine the lesional and non-lesional skin in psoriasis subjects across different severities and also evaluate the treatment outcome in a subject with topical steroids and biologics, such as adalimumab. ms-RSOM derived structural metrics like epidermal thickness and total blood volume (TBV) and microvascular functional information such as oxygen saturation (sO2) are evaluated by spectrally resolving the endogenous chromophores like melanin, oxy-, and deoxy-hemoglobin. Initial findings reveal an elevated sO2 and TBV with severity in lesional and non-lesional psoriasis skin, thus representing increasing inflammation. An increase in epidermal thickness is also noted with the degree of severity, corresponding to the inflammation and increased abnormal cell growth. As a marker to evaluate the treatment response, we observed a decrease in epidermal thickness, sO2, and TBV in a psoriasis patient post-treatment, which is consistent with the decrease in the PASI score from 4.1 to 1.9. We envision that ms-RSOM has a huge potential to be translated into routine clinical setting for the diagnosis of severity and assessment of treatment monitoring in psoriasis subjects.

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Isokinetics is a proven method to train and objectively assess the capability of muscle groups, particularly at the knee. The current re-injury rates and less than optimal return to sport percentages seen following anterior cruciate ligament surgery highlights the need for greater focus on what tests and methods are used to make these critical decisions. Isokinetics remains the best single method to objectively determine dynamic muscle strength, power, rate of force development and endurance. These factors make it well-suited to play a crucial role in influencing the appropriate patient progression through a rehabilitation program and assisting in determining return to play readiness following injury or surgery. In this article we will discuss why we believe isokinetics is a useful and necessary testing method, and elucidate testing parameters and goals used during knee extension/flexion assessment.

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INTRODUCTION: There is a growing emphasis on proficiency-based progression within surgical training. To enable this, clearly defined metrics for those newly acquired surgical skills are needed. These can be formulated in objective assessment tools. The aim of the present study was to systematically review the literature reporting on available tools for objective assessment of minimally invasive gynecological surgery (simulated) performance and evaluate their reliability and validity. MATERIAL AND METHODS: A systematic search (1989-2022) was conducted in MEDLINE, Embase, PubMed, Web of Science in accordance with PRISMA. The trial was registered with the Prospective Register of Systematic Reviews (PROSPERO) ID: CRD42022376552. Randomized controlled trials, prospective comparative studies, prospective single-group (with pre- and post-training assessment) or consensus studies that reported on the development, validation or usage of assessment tools of surgical performance in minimally invasive gynecological surgery, were included. Three independent assessors assessed study setting and validity evidence according to a contemporary framework of validity, which was adapted from Messick's validity framework. Methodological quality of included studies was assessed using the modified medical education research study quality instrument (MERSQI) checklist. Heterogeneity in data reporting on types of tools, data collection, study design, definition of expertise (novice vs. experts) and statistical values prevented a meaningful meta-analysis. RESULTS: A total of 19 746 titles and abstracts were screened of which 72 articles met the inclusion criteria. A total of 37 different assessment tools were identified of which 13 represented manual global assessment tools, 13 manual procedure-specific assessment tools and 11 automated performance metrices. Only two tools showed substantive evidence of validity. Reliability and validity per tool were provided. No assessment tools showed direct correlation between tool scores and patient related outcomes. CONCLUSIONS: Existing objective assessment tools lack evidence on predicting patient outcomes and suffer from limitations in transferability outside of the research environment, particularly for automated performance metrics. Future research should prioritize filling these gaps while integrating advanced technologies like kinematic data and AI for robust, objective surgical skill assessment within gynecological advanced surgical training programs.

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Background: The acquisition and refinement of technical skills by the surgical residents are central to surgical teaching; hence, there is increasing interest in the objective assessment of surgical competence. In the field of otology, as of now, there are limited studies for the assessment of surgical competence, also, various subjective methods are being used to assess this vital aspect of training. This study aimed to validate and use an objective assessment tool for the valuation of surgical skills in a tertiary care teaching institute in the Indian subcontinent. Methods: Surgical competence of the residents in temporal bone dissection was assessed on a Likert scale by using a grading scale developed by Wan et al., after obtaining necessary permissions. Results: Junior residents in ENT who had completed one year of residency in otolaryngology were asked to perform temporal bone surgery (cortical mastoidectomy) and were marked according to the proforma by two senior experienced otologists. The Cronbach's alpha value was .86 which is an indicator of good technical validity. Conclusions: In our study, we have validated a grading scoring scale used by Wan et al. to objectively assess the ability of an otology resident to perform temporal bone surgery. It is recommended for use in Indian scenario due to its good technical validity. The use of a Likert scale to individually rate each competency makes the evaluation precise and simple.

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Background and aims: Game genres, availability on smartphones, in-game purchases, and playing duration, have been thought to influence Gaming Disorder (GD). However, little research has comprehensively examined their relationships with GD. Therefore, we examined the relationship between GD, in-game purchases, gaming duration via consoles and smartphones, and genres of smartphone games. Study 1 was based on self-reports, and Study 2 included objective data to clarify these associations. Methods: We conducted two independent online surveys that collected sociodemographic data, game use patterns, and psychopathological assessment data, including GD severity (Study 1: N = 32,690; Study 2: N = 3,163). General mental illness scores and objective gaming time were also collected in Study 2. Results: In Study 1, in-game purchases, several gaming genres, and subjective gaming duration were positively associated with probable GD. On the other hand, interactions between card games and loot box charges were negatively related to probable GD. In Study 2, objective gaming times of most game genres were not associated with GD. Although the correlation between subjective and objective gaming duration was moderate, their correlations with GD differed. Discussion and conclusion: These results suggest the complexity of relationships between GD and in-game purchases, genres, and gaming duration. Results of this study suggest the importance of proper assessment of GD reflecting actual functional impairment in social life. Future studies should improve and update evaluation of assessments for gaming.

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BACKGROUND: Nasal septal perforations (NSP) can have a heterogeneous appearance on endoscopic examination with varying degrees of crusting, inflammatory change, and associated septal deviation. The clinical applicability of these findings as contributors to patient symptoms may be enhanced by use of a standardized assessment. METHODS: Video nasal endoscopy recordings were obtained from 40 patients with NSP. Five raters with varied levels of training ranging from a senior resident to an experienced septal perforation surgeon independently reviewed the videos for the following exam findings: crusting, scarring, granulation tissue, septal deviation, and edema. Scoring for each item was reported on a 3-point (0-2) scale, and each reviewer repeated scoring at a 14-day interval. Interrater and intrarater agreement were calculated using Fleiss kappa for each item and the total scores. Additionally, endoscopy scores were correlated with patient-reported NOSE-Perf symptom scores. RESULTS: Interrater agreement for the overall instrument was in the "fair-to-moderate" range with the following interrater agreement for each item: crusting (0.458-0.575), scarring (0.286-0.308), granulation (0.403-0.406), deviation (0.487-0.494), and edema (0.253-0.406). Intrarater agreement was generally "substantial" for individual items as well as the overall instrument (0.688). The NSP endoscopy scores were moderately correlated with NOSE-Perf scores (r = 0.44, p = 0.008). CONCLUSIONS: An endoscopic evaluation of NSP comprising five exam findings has acceptable interrater and intrarater reliability and correlates with patient-reported outcomes. NSP endoscopy may be applied to future clinical studies for characterization of NSP and assessment of treatment outcomes. LEVEL OF EVIDENCE: 3 Laryngoscope, 134:3049-3053, 2024.

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INTRODUCTION: The acute levodopa challenge test (ALCT) is an important and valuable examination but there are still some shortcomings with it. We aimed to objectively assess ALCT based on a depth camera and filter out the best indicators. METHODS: Fifty-nine individuals with parkinsonism completed ALCT and the improvement rate (IR, which indicates the change in value before and after levodopa administration) of the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III) was calculated. The kinematic features of the patients' movements in both the OFF and ON states were collected with an Azure Kinect depth camera. RESULTS: The IR of MDS-UPDRS III was significantly correlated with the IRs of many kinematic features for arising from a chair, pronation-supination movements of the hand, finger tapping, toe tapping, leg agility, and gait (rs = - 0.277 ~ - 0.672, P < 0.05). Moderate to high discriminative values were found in the selected features in identifying a clinically significant response to levodopa with sensitivity, specificity, and area under the curve (AUC) in the range of 50-100%, 47.22%-97.22%, and 0.673-0.915, respectively. The resulting classifier combining kinematic features of toe tapping showed an excellent performance with an AUC of 0.966 (95% CI = 0.922-1.000, P < 0.001). The optimal cut-off value was 21.24% with sensitivity and specificity of 94.44% and 87.18%, respectively. CONCLUSION: This study demonstrated the feasibility of measuring the effect of levodopa and objectively assessing ALCT based on kinematic data derived from an Azure Kinect-based system.

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PURPOSE: Attaining sufficient microsurgical skills is paramount for neurosurgical trainees. Kinematic analysis of surgical instruments using video offers the potential for an objective assessment of microsurgical proficiency, thereby enhancing surgical training and patient safety. The purposes of this study were to develop a deep-learning-based automated instrument tip-detection algorithm, and to validate its performance in microvascular anastomosis training. METHODS: An automated instrument tip-tracking algorithm was developed and trained using YOLOv2, based on clinical microsurgical videos and microvascular anastomosis practice videos. With this model, we measured motion economy (procedural time and path distance) and motion smoothness (normalized jerk index) during the task of suturing artificial blood vessels for end-to-side anastomosis. These parameters were validated using traditional criteria-based rating scales and were compared across surgeons with varying microsurgical experience (novice, intermediate, and expert). The suturing task was deconstructed into four distinct phases, and parameters within each phase were compared between novice and expert surgeons. RESULTS: The high accuracy of the developed model was indicated by a mean Dice similarity coefficient of 0.87. Deep learning-based parameters (procedural time, path distance, and normalized jerk index) exhibited correlations with traditional criteria-based rating scales and surgeons' years of experience. Experts completed the suturing task faster than novices. The total path distance for the right (dominant) side instrument movement was shorter for experts compared to novices. However, for the left (non-dominant) side, differences between the two groups were observed only in specific phases. The normalized jerk index for both the right and left sides was significantly lower in the expert than in the novice groups, and receiver operating characteristic analysis showed strong discriminative ability. CONCLUSION: The deep learning-based kinematic analytic approach for surgical instruments proves beneficial in assessing performance in microvascular anastomosis. Moreover, this methodology can be adapted for use in clinical settings.

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In this study, we sought to objectively and quantitatively characterize the prosodic features of autism spectrum disorder (ASD) via the characteristics of prosody in a newly developed structured speech experiment. Male adults with high-functioning ASD and age/intelligence-matched men with typical development (TD) were asked to read 29 brief scripts aloud in response to preceding auditory stimuli. To investigate whether (1) highly structured acting-out tasks can uncover the prosodic of difference between those with ASD and TD, and (2) the prosodic stableness and flexibleness can be used for objective automatic assessment of ASD, we compared prosodic features such as fundamental frequency, intensity, and mora duration. The results indicate that individuals with ASD exhibit stable pitch registers or volume levels in some affective vocal-expression scenarios, such as those involving anger or sadness, compared with TD and those with TD. However, unstable prosody was observed in some timing control or emphasis tasks in the participants with ASD. Automatic classification of the ASD and TD groups using a support vector machine (SVM) with speech features exhibited an accuracy of 90.4%. A machine learning-based assessment of the degree of ASD core symptoms using support vector regression (SVR) also had good performance. These results may inform the development of a new easy-to-use assessment tool for ASD core symptoms using recorded audio signals.

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Background Achilles tendinopathy is a common ankle disorder in both the general population and athletes. This condition can alter the mechanical characteristics of the Achilles tendon (AT) by decreasing tendon stiffness. Achilles tendinopathy is primarily treated conservatively; however, few monitoring tools exist for evaluating the condition of the AT. The Myoton PRO (Myoton AS, Tallinn, Estonia) device is a handheld tool used to evaluate tissue stiffness. However, no basic studies have examined the validity of Myoton PRO for assessing the AT. This study aimed to assess the validity of Myoton PRO using animal ATs and to examine its clinical applicability. Methods We used 28 fresh porcine ankles and evaluated AT stiffness at the calcaneus insertion site (AT0) and 2.0 cm above the calcaneus (AT2) using Myoton PRO. We also measured changes in the AT length using a tensile testing machine during the cyclic loading test. We investigated the correlation between dynamic stiffness and length change. Furthermore, we assessed the difference in stiffness between AT0 and AT2. Results The dynamic stiffness was 717.6 ± 183.1 N/m at AT0 and 467.4 ± 152.3 N/m at AT2. The change in length during the cyclic loading test was 1.8 ± 0.7 mm. The correlation between dynamic stiffness and length change was as follows: AT0, r=-0.61; AT2, r=-0.64 (P<0.001). The dynamic stiffness at AT0 was significantly greater than that at AT2 (P<0.001). Conclusions AT assessment using Myoton PRO has potential clinical utility as an indicator of tissue stiffness.

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Purpose: Hydrofilm, a polyurethane-based barrier film, can be used to prevent acute radiation dermatitis (RD) in adjuvant whole-breast irradiation (WBI) for breast cancer. This cost-effective prophylactic measure is currently being recommended to a growing number of patients, yet long-term safety data and its impact on late radiation-induced skin toxicity such as pigmentation changes and fibrosis have not been investigated. Methods: We objectively evaluated patients who were previously enrolled in either of two intrapatient-randomised (lateral versus medial breast halve) controlled trials on the use of Hydrofilm for RD prevention (DRKS00029665; registered on 19 July 2022). Results: Sixty-two patients (47.7% of the initial combined sample size) provided consent for this post-hoc examination, with a median follow-up time (range) of 58 (37-73) months. Following WBI, there was a significant increase in yellow skin tones of the entire breast when compared to baseline measurements before WBI (p < 0.001) and a significant increase of cutis, subcutis, and oedema thickness (p < 0.001, p < 0.001, and p = 0.004, respectively). At follow-up, there were no significant differences in either pigmentation changes or skin fibrosis between the Hydrofilm and standard of care breast halves. Conclusion: These data suggest that Hydrofilm can be safely used in the context of acute RD prevention, without affecting late side effects, supporting its widespread use.

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Previous studies have established the utility of facial expressions as an objective assessment approach for determining the hedonics (overall pleasure) of food and beverages. This study endeavors to validate the conclusions drawn from preceding research, illustrating that facial expressions prompted by tastants possess the capacity to forecast the perceived hedonic ratings of these tastants. Facial expressions of 29 female participants, aged 18-55 years, were captured using a digital camera during their consumption of diverse concentrations of solutions representative of five basic tastes. Employing the widely employed facial expression analysis application FaceReader, the facial expressions were meticulously assessed, identifying seven emotions (surprise, happiness, scare, neutral, disgust, sadness, and anger) characterized by scores ranging from 0 to 1-a numerical manifestation of emotional intensity. Simultaneously, participants rated the hedonics of each solution, utilizing a scale spanning from -5 (extremely unpleasant) to +5 (extremely pleasant). Employing a multiple linear regression analysis, a predictive model for perceived hedonic ratings was devised. The model's efficacy was scrutinized by assessing emotion scores from 11 additional taste solutions, sampled from 20 other participants. The anticipated hedonic ratings demonstrated robust alignment and agreement with the observed ratings, underpinning the validity of earlier findings even when incorporating diverse software and taste stimuli across a varied participant base. We discuss some limitations and practical implications of our technique in predicting food and beverage hedonics using facial expressions.