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Background Hand rehabilitation needs valid evaluation tools; the 400-point Hand Assessment (HA) is an exhaustive but not standardised tool. The aim of this study was to validate a standardised version of this test. Methods A modified version and a standardised prototype was made for this prospective validation study (four centres, three countries). Psychometric properties studied: reliability (intra-rater and inter-rater, standard error of measurement [SEM], minimum detectable change [MDC],internal consistency); content validity, construct validity with Jebsen Taylor hand function test, Q uick DASH, MOS-SF 36 and pain; responsiveness, using an anchor-based approach (ROC curve with area under curve, mean response change) with calculation of MCID. For SEM, MDC and responsiveness, Quick DASH was used for comparison. Results One hundred and seventy-six patients with hand/wrist injuries were included between May 2013 and February 2015. One hundred and seventy were available for final analysis: 67% men; mean age 43.4 ± 13.2 years; both manual and office workers (46, 5% of each); 37% had a hand or wrist fracture. Reliability: ICC intra-rater = 0.967 [0.938–0.982]; inter-rater = 0.868 [0.754–0.932]. Distribution-based approach: for 400-point HA/Q uick DASH: SEM = 3.48/4.52, MDC = 9.065/12.53, internal consistency of 400-point HA: Cronbach α = 0.886. Validity: Content validity was good according to COSMIN guidelines. Construct validity: correlation coefficient: Jebsen-Taylor hand function test = − 0.573 [− 0.666–0.464], Q uick DASH = − 0.432 at T0 [− 0.545–0.303], − 0.551 at T3 [− 0.648–0.436]; MOS-SF 36 physical component = 0.395 [0.263–0.513]; no correlation with MOS-SF 36 mental component = 0.142 [− 0.009 + 0.286] and pain = − 0.166 [− 0.306 + 0.018]. Responsiveness: Anchor-based approach: AUC Δ400-point HA = 0.666 [0.583–0.749], AUC ΔQ uick DASH = 0.556 [0.466–0.646]. MCID (optimal ROC curve cut-off): 6.07 for 400-point HA, − 2.27 for Q uick DASH. MCID with mean response change + 12.034 ± 9.067 for 400-point HA and − 8.03 ± –9.7 for Q uick DASH. The patient’s global impression of change was only correlated with the Δ400-point HA. Conclusions The 400-point HA standardised version has good psychometric properties. For responsiveness, we propose an MCID of at least 12.3/100. However, these results must be confirmed in other populations and pathologies. Trial registration This study was retrospectively registered into ISCTRN registry (Number ISRCTN25874481 ) the 07/02/2019.

Endothelial cells (ECs), lining blood vessels’ lumen, play an essential role in regulating vascular functions. As multifunctional components of vascular structures, pluripotent stem cells (PSCs) are the promising source for potential therapeutic applications in various vascular diseases. Our laboratory has previously established an approach for differentiating porcine epiblast stem cells (pEpiSCs) into ECs, representing an alternative and potentially superior cell source. However, the condition of pEpiSCs-derived ECs growth has yet to be determined, and whether pEpiSCs differentiate into functional ECs remained unclear. Changes in morphology, proliferation and functional endothelial marker were assessed in pEpiSCs-derived ECs in vitro. pEpiSCs-derived ECs were subjected to magnetic-activated cell sorting (MACS) to collect CD-31+ of ECs. We found that sorted ECs showed the highest proliferation rate in differentiation media in primary culture and M199 media in the subculture. Next, sorted ECs were examined for their ability to act as typical vascular ECs through capillary-like structure formation assay, Dil-acetylated low-density lipoprotein (Dil-Ac-LDL) uptake, and three-dimensional spheroid sprouting. Consequently, pEpiSCs-derived ECs function as typical vascular ECs, indicating that pEpiSC-derived ECs might be used to develop cell therapeutics for vascular disease.

Ultrasound is one of the most important examinations for clinical diagnosis of cardiovascular diseases. The speed of image movements driven by the frequency of the beating heart is faster than that of other organs. This particularity of echocardiography poses a challenge for sonographers to diagnose accurately. However, artificial intelligence for detection, functional evaluation, and disease diagnosis has gradually become an alternative for accurate diagnosis and treatment using echocardiography. This work discusses the current application of artificial intelligence in echocardiography technology, its limitations, and future development directions. Highlights 1. Application of artificial intelligence (AI) in echocardiography is now widely studied, and AI technique has the potential to optimize the diagnostic potential of echocardiography. 2. Application of artificial intelligence in echocardiography is important in the following aspects: recognizing the standard section, cardiac cavity automatic segmentation, functional left ventricle assessment, and cardiac disease diagnosis. 3. Standardized data collection and image annotation are essential for artificial intelligence in echocardiography.

Keyphrase prediction models are among the natural language processing (NLP) tasks that have improved their performance with transformers and large language models (LLMs). Instead of extracting present keyphrases in the text, these models also generate absent keyphrases. This improvement has led to significant challenges in the evaluation process of these models, which rely on metrics that compare the predicted keyphrases with the reference keyphrases. To measure the performance of these models, several evaluation metrics such as F1-score, ROUGE-L, and BertScore have been used. However, they often prioritize lexical similarity over semantic usefulness. Consequently, the functional usefulness of keyphrases in document representation is not evaluated during the evaluation process, which leads to inconsistencies in the evaluation results. Therefore, in this paper we propose a functional evaluation metric for Keyphrase prediction models (FEM-KP), a new evaluation metric that uses a two-track approach where track (A) evaluates the performance of the model to generate keyphrases capable of constructing a document summary, while track (B) measures the ability of these phrases to retrieve the document. We evaluated the performance of four keyphrase prediction models using current evaluation metrics and FEM-KP across the Inspec, KP20k, and Krapivin datasets. The experimental results showed that FEM-KP is the only evaluation system that maintained a consistent performance ranking regardless of document length or dataset complexity. In contrast, other metrics showed inversions in ranking. These results confirm that FEM-KP is a robust, reliable, and domain-independent evaluation metric for evaluating the performance of keyphrase prediction systems.

ObjectiveThis study examines the test–retest reliability, the minimal clinically important difference (MCID), and its correlation with the Rolland Morris Disability Questionnaire (RMDQ) of the Dubousset Functional Test (DFT) in evaluating the functional capacity and dynamic balance of patients with chronic non-specific low back pain (cnsLBP).MethodsSeventy-five patients with cnsLBP aged 18 years and over were included. The Five-Repetition Sit-To-Stand Test (5R-STS), the subcomponents of the DFT (the Up and Walk Test, the Steps Test, the Down and Sitting Test, and the Dual-Tasking Test) were administered to the patients. Patients were rested for 1 h, and the DFT was applied again. Pain level was evaluated with the Visual Analogue Scale before the tests started and after the tests were completed. Self-report function assessment was made using the RMDQ. ResultsThe test–retest reliability of the subcomponents of the DFT was excellent. The ICCs were: 0.91, 0.86, 0.89, and 0.89, respectively. The standard measurement errors of the subcomponents of the DFT were 0.32, 0.12, 0.14, and 0.25, respectively. The subcomponents of the DFT were highly correlated with the RMDQ and 5R-STS with the correlation coefficients of 0,83, 0,83, 0,79, 0,83 and 0,81, 0,75, 0,73, and 0,82, respectively (p < 0.01). The MCIDs of the subcomponents were 0,60, 0,23, 0,27, and 0,48, respectively. ConclusionThe DFT is reliable in evaluating patients’ functional capacity and dynamic balance with cnsLBP without causing discomfort. It is simple, quick, and simultaneously assesses multiple areas contributing to spinal alignment, muscle integrity, and balance.

Optoelectronic devices are the gold standard for 3D evaluation in clinics, but due to the complexity of this kind of hardware and the lack of access for patients, affordable, transportable, and easy-to-use systems must be developed to be largely used in daily clinics. The KinectTM sensor has various advantages compared to optoelectronic devices, such as its price and transportability. However, it also has some limitations: (in)accuracy of the skeleton detection and tracking as well as the limited amount of available points, which makes 3D evaluation impossible. To overcome these limitations, a novel method has been developed to perform 3D evaluation of the upper limbs. This system is coupled to rehabilitation exercises, allowing functional evaluation while performing physical rehabilitation. To validate this new approach, a two-step method was used. The first step was a laboratory validation where the results obtained with the KinectTM were compared with the results obtained with an optoelectronic device; 40 healthy young adults participated in this first part. The second step was to determine the clinical relevance of this kind of measurement. Results of the healthy subjects were compared with a group of 22 elderly adults and a group of 10 chronic stroke patients to determine if different patterns could be observed. The new methodology and the different steps of the validations are presented in this paper.

Background: The Achilles tendon is prone to rupture, particularly in middle-aged men, and chronic injuries are often due to missed diagnoses or inadequate treatment. While acute ruptures can be managed with primary repair, chronic cases with tendon gaps >3 cm require reconstruction. A minimally invasive technique using autologous semitendinosus and gracilis tendon grafts has previously shown favorable short-term outcomes. This study evaluates longer-term outcomes with a minimum 5-year follow-up. Methods This study analyzed 21 patients undergoing minimally invasive Achilles tendon reconstruction with autologous hamstring grafts, compared with 21 healthy controls. magnetic resonance imaging confirmed diagnoses, and surgeries (2016–2019) used the EndoButton system for graft stabilization. Assessments included Achilles tendon Total Rupture Score (ATRS) for patient-reported outcomes, EuroQoL–5 Dimensions, 5 Levels (EQ-5D-5L) for overall health, and visual analog scale (VAS) for pain and satisfaction. Functional tests measured dorsiflexion (lunge test), calf endurance (heel rise test), and muscle strength (single-leg hop test), comparing operated vs unoperated legs. Results ATRS and EQ-5D-5L Index improved from 2 to 5 years (P = .0136, P = .0396), although significance was lost after Bonferroni correction. Functional test results remained stable. The operated limb achieved >90% of the nonoperated side across tests. Compared with controls, patients reported lower EQ-5D-5L scores and greater pain (P < .05), but satisfaction remained high (VAS score 9/10). One retear occurred due to infection. Conclusion Minimally invasive Achilles tendon reconstruction using hamstring autografts results in sustained functional and subjective improvements at a minimum of 5 years postoperatively. Despite modest residual deficits compared with uninjured controls, high satisfaction and strong limb symmetry support the long-term efficacy of this approach. This study demonstrates that the functional and subjective results of patients after Achilles tendon reconstruction with hamstring graft remain stable and satisfactory at a minimum of 5 years postoperatively. Level of Evidence: Level III, retrospective cohort study.

To improve methods for predicting the impact of missense variants of uncertain significance (VUS) in BRCA1 and BRCA2 on protein function. Functional data for 248 BRCA1 and 207 BRCA2 variants from assays with established high sensitivity and specificity for damaging variants were used to recalibrate 40 in silico algorithms predicting the impact of variants on protein activity. Additional random forest (RF) and naïve voting method (NVM) metapredictors for both BRCA1 and BRCA2 were developed to increase predictive accuracy. Optimized thresholds for in silico prediction models significantly improved the accuracy of predicted functional effects for BRCA1 and BRCA2 variants. In addition, new BRCA1-RF and BRCA2-RF metapredictors showed area under the curve (AUC) values of 0.92 (95% confidence interval [CI]: 0.88–0.96) and 0.90 (95% CI: 0.84–0.95), respectively. Similarly, the BRCA1-NVM and BRCA2-NVM models had AUCs of 0.93 and 0.90. The RF and NVM models were used to predict the pathogenicity of all possible missense variants in BRCA1 and BRCA2. The recalibrated algorithms and new metapredictors significantly improved upon current models for predicting the impact of variants in cancer risk–associated domains of BRCA1 and BRCA2. Prediction of the functional impact of all possible variants in BRCA1 and BRCA2 provides important information about the clinical relevance of variants in these genes.

Smartwatch-based functional assessments for upper extremity movement are a promising tool for a detailed and serial assessment during stroke rehabilitation, but their clinical application remains challenging. In this study, nine patients with hemiparesis due to a stroke participated in occupational therapy sessions using virtual reality-based rehabilitation devices. An Action Research Arm Test (ARAT) was performed at baseline and after intervention, with wrist smartwatch sensors recording motion data. We extracted acceleration and gyro sensor data from smartwatches and calculated the average motion segment size (MSS) as a measure of motion smoothness. Among the included patients, four participants completed all 10 therapy sessions and the follow-up evaluation. The average MSSs of acceleration for all x, y, and z directions were significantly correlated with the ARAT scores across all task domains. For angular motion, the average MSS in the gross movement task (domain 4) showed strong correlations with the ARAT scores: roll (rs = 0.735, p = 0.004), pitch (rs = 0.715, p = 0.009), and yaw (rs = 0.704, p = 0.007). At the serial follow-ups, most participants showed a considerable increase in the average MSSs of the roll, pitch, and yaw angles measured during domain 4, alongside improvements in their clinical ARAT scores. Our findings support the feasibility of using commercial smartwatch-based parameters for upper extremity functional evaluations during stroke rehabilitation and highlight their potential for serial follow-up assessments.