A new mathematical approach to improve the original dietary inflammatory index (DII) calculation

Accumulating evidence links dietary intake to inflammatory processes involved in non-communicable disease (NCD) development. The dietary inflammatory index (DII) designed by Shivappa et al. has been shown to capture the inflammatory potential of dietary behavior in a large number of epidemiological studies. Thus, the DII may serve as future tool to assess someone’s nutritional inflammatory capacities and hence, the individual risks for NCD development later in life. The calculation method of the DII, however, can benefit from alternative mathematical steps, particularly regarding the transformation from standardized daily food consumption to percentile scores. Here, we provide novel approaches, the scaling-formula (SF) and scaling-formula with outlier detection (SFOD) methods, with the aim to optimize the DII calculation method proposed by Shivappa and colleagues. We illustrate on simulated data specific limitations of the original DII calculation and show the benefits of the SF/SFOD by using simulated data and data from the prospective TEENDIAB study cohort, which supports the application of SF/SFOD in future epidemiological and clinical studies.

An Intervention-Related Comparison of Preschoolers’ Scores on the TGMD-2 and TGMD-3

This study compared preschoolers’ fundamental motor skills (FMS) on the Test of Gross Motor Development 2nd and 3rd editions (TGMD-2 and TGMD-3) before (pretest) and after (posttest) a motor skill intervention. This study also compared FMS changes (TGMD raw and percentile scores for total score, and locomotor and object control/ball subscales) across the intervention when FMS were measured using the two editions. Sixty-four preschoolers ( Mage = 4.4, SD = 0.44 years) completed the TGMD-2 and TGMD-3 before and after a motor skill intervention. We determined the level of agreement between assessments using intra-class correlations (ICC), Lin’s Concordance Correlation Coefficient, and Bland-Altman plots. Overall, our results support an acceptable relative agreement between the TGMD-2 and TGMD-3 for raw scores, but there were variable strengths of agreement (by subscales) for percentile scores. Both assessments supported the efficacy of the intervention. This consistent demonstration of efficacy but varied strength of agreement suggests that the TGMD-2 and TGMD-3 are similar but not interchangeable.

Agreement Between the KTK3+ Test and the Athletic Skills Track for Classifying the Fundamental Movement Skills Proficiency of 6- to 12-Year-Old Children

The main aim of this study was to determine the agreement in classification between the modified KörperKoordinations Test für Kinder (KTK3+) and the Athletic Skills Track (AST) for measuring fundamental movement skill levels (FMS) in 6- to 12-year old children. 3,107 Dutch children (of which 1,625 are girls) between 6 and 12 years of age (9.1 ± 1.8 years) were tested with the KTK3+ and the AST. The KTK3+ consists of three items from the KTK and the Faber hand-eye coordination test. Raw scores from each subtest were transformed into percentile scores based on all the data of each grade. The AST is an obstacle course consisting of 5 (grades 3 till 5, 6–9 years) or 7 (grades 6 till 8, 9–12 years) concatenated FMS that should be performed as quickly as possible. The outcome measure is the time needed to complete the track. A significant bivariate Pearson correlation coefficient of 0.51 was found between the percentile sum score of the KTK3+ and the time to complete the AST, indicating that both tests measure a similar construct to some extent. Based on their scores, children were classified into one of five categories: <5, 5–15, 16–85, 86–95 or >95%. Cross tabs revealed an agreement of 58.8% with a Kappa value of 0.15 between both tests. Less than 1% of the children were classified more than two categories higher or lower. The moderate correlation between the KTK3+ and the AST and the low classification agreement into five categories of FMS stress the importance to further investigate the test choice and the measurement properties (i.e., validity and reliability) of both tools. PE teachers needs to be aware of the context in which the test will be conducted, know which construct of motor competence they want to measure and know what the purpose of testing is (e.g., screening or monitoring). Based on these considerations, the most appropriate assessment tool can be chosen.

Medical knowledge and clinical productivity: independently correlated metrics during radiology residency

Objective To determine the association between medical knowledge relevant to radiology practice (as measured by the Dutch radiology progress test [DRPT]) and clinical productivity during radiology residency. Methods This study analyzed the results of 6 DRPTs and time period–matched clinical production points of radiology residents affiliated to a tertiary care academic medical center between 2013 and 2016. The Spearman correlation analysis was performed to determine the association between DRPT percentile scores and average daily clinical production points. Linear regression analyses were performed to determine the association of DRPT percentile scores with average daily clinical production points, adjusted for age and gender of the radiology resident, and postgraduate year. Results Eighty-four DRPTs with time period–matched clinical production points were included. These 84 DRPTs were made by 29 radiology residents (18 males and 11 females) with a median age of 31 years (range: 26–38 years). The Spearman correlation coefficient between DRPT percentile scores and average daily clinical production points was 0.550 (95% confidence interval: 0.381–0.694) (p < 0.001), indicating a significant moderate positive association. On multivariate analysis, average daily clinical production points (β coefficient of 0.035, p = 0.003), female gender of the radiology resident (β coefficient of 12.690, p = 0.001), and postgraduate year (β coefficient of 10.179, p < 0.001) were significantly associated with DRPT percentile scores. These three independent variables achieved an adjusted R2 of 0.527. Conclusion Clinical productivity is independently associated with medical knowledge relevant to radiology practice during radiology residency. These findings indicate that clinical productivity of a resident could be a potentially relevant metric in a radiology training program. Key Points • There is a significant moderate correlation between medical knowledge relevant to radiology practice and clinical productivity during radiology residency. • Medical knowledge relevant to radiology practice remains independently associated with clinical productivity during radiology residency after adjustment for postgraduate year and gender. • Clinical productivity of a resident may be regarded as a potentially relevant metric in a radiology training program.

Objective Resident Characteristics Associated with Performance on the Ophthalmic Knowledge Assessment Program Examination

Background To determine objective resident characteristics that correlate with Ophthalmic Knowledge Assessment Program (OKAP) performance, as well as to correlate OKAP performance with Accreditation Council for Graduate Medical Education (ACGME) milestone assessments, written qualifying examination (WQE) scores, and oral board pass rates. Methods Review of administrative records at an ACGME-accredited ophthalmology residency training program at an urban, tertiary academic medical center. Results The study included data from a total of 50 resident physicians who completed training from 2012 to 2018. Mean (standard deviation) OKAP percentile performance was 60.90 (27.51), 60.46 (28.12), and 60.55 (27.43) for Years 1, 2, and 3 examinations, respectively. There were no statistically significant differences based on sex, marital status, having children, MD/PhD degree, other additional degree, number of publications, number of first author publications, or grades on medical school medicine and surgery rotations. OKAP percentile scores were significantly associated with United States Medical Licensing Examination (USMLE) Step 1 scores (linear regression coefficient 0.88 [0.54–1.18], p = 0.008). Finally, continuous OKAP scores were significantly correlated with WQE (r s = 0.292, p = 0.049) and oral board (r s = 0.49, p = 0.001) scores. Conclusion Higher OKAP performance is correlated with passage of both WQE and oral board examinations during the first attempt. USMLE Step 1 score is the preresidency academic factor with the strongest association with success on the OKAP examination. Programs can utilize this information to identify those who may benefit from additional OKAP, WQE, and oral board preparation assistance.

Sensitivity to interventions and the relationship with numeracy

The main goal of this research was to investigate whether people exhibit algorithm aversion—a tendency to avoid using an imperfect algorithm even if it outperforms human judgments—in the case of estimating students’ percentile scores on a standardized math test. We also explored the relationships between numeracy and algorithm aversion and tested two interventions aimed at reducing algorithm aversion. In two studies, we asked participants to estimate the percentiles of 46 real 15-year-old Polish students on a standardized math test. Participants were offered the opportunity to compare their estimates with the forecasts of an algorithm—a statistical model that predicted real percentile scores based on fi ve explanatory variables (i.e., gender, repeating a class, the number of pages read before the exam, the frequency of playing online games, socioeconomic status). Across two studies, we demonstrated that even though the predictions of the statistical model were closer to students’ percentile scores, participants were less likely to rely on the statistical model predictions in making forecasts. We also found that higher statistical numeracy was related to a higher reluctance to use the algorithm. In Study 2, we introduced two interventions to reduce algorithm aversion. Depending on the experimental condition, participants either received feedback on statistical model predictions or were provided with a detailed description of the statistical model. We found that people, especially those with higher statistical numeracy, avoided using the imperfect algorithm even though it outperformed human judgments. Interestingly, a simple intervention that explained how the statistical model works led to better performance in an estimation task

Gross Motor Function in Children with Congenital Zika Syndrome

Background Little information on gross motor function of congenital Zika syndrome (CZS) children is available. Objectives To evaluate gross motor function in CZS children aged up to 3 years, and its associated factors and changes in a minimum interval of 6 months. Methods One hundred children with CZS and cerebral palsy (36 with confirmed and 64 with presumed CZS) were evaluated with the Gross Motor Function Classification System (GMFCS) and Gross Motor Function Measure (GMFM-88/GMFM-66). Forty-six were reevaluated. Wilcoxon tests, Wilcoxon tests for paired samples, percentile scores, and score changes were performed. Results Clinical and socioeconomic characteristics (except maternal age), GMFM scores and GMFCS classification of confirmed and probable cases, which were analyzed together, were similar. The mean age was 25.6 months ( ± 5.5); the median GMFM-88 score was 8.0 (5.4–10.8); and the median GMFM-66 score was 20.5 (14.8–23.1); 89% were classified as GMFCS level V. Low economic class, microcephaly at birth, epilepsy, and brain parenchymal volume loss were associated with low GMFM-66 scores. The median GMFM-66 percentile score was 40 (20–55). On the second assessment, the GMFM-66 scores in two GMFCS level I children and one GMFCS level IV child improved significantly. In one GMFCS level III child, one GMFCS level IV child, and the group of GMFCS level V children, no significant changes were observed. Conclusions Almost all CZS children had severe cerebral palsy; in the third year of life, most presented no improvement in gross motor function and were likely approaching their maximal gross motor function potential.

A-28 Updated Baselines Show Improvement, Even When Athletes Sustain A Concussion Between Assessments

Objective To explore change across repeated baseline assessments using raw scores and percentile scores, for athletes sustaining and not sustaining a concussion between baselines. Method Athletes (12–23 years) completed two valid, baseline neurocognitive test sessions using ImPACT. Participants were divided into independent groups based on having sustained a concussion between annual baselines (CONCUSSION; N = 269) or no concussion (NO CONCUSSION; N = 270) between baselines. Raw change scores were calculated between the first and follow-up baseline for both groups by subtracting the first baseline score from the updated baseline score on the four ImPACT composite scores. Age- and gender-based percentile scores were then applied for all participants, and percentile change scores were calculated in the same manner. Raw change scores and percentile change scores between groups were compared using 4 ANOVAs with a Bonferroni-corrected p-value of (p &lt; .0125). Results Using raw scores ANOVAs revealed that athletes in the CONCUSSION group showed significantly greater improvement on follow-up testing than athletes in the NO CONCUSSION group on Verbal Memory (p &lt; .001) and Visual Motor Speed (p = .001), but not on Visual Memory (p = .41) and Reaction Time (p = .04). Using percentile ranks, ANOVAs revealed significantly greater improvement in CONCUSSION group on Verbal Memory (p &lt; .001), but not on Visual Memory (p = .34), Visual Motor Speed (p = .03), or Reaction Time (p = .014). Conclusions Athletes sustaining a concussion between annual baseline assessments show increases on Verbal Memory and Visual Motor Speed follow-up testing when using raw composite scores, but only on Verbal Memory when using age- and gender-based percentile ranks.

Protective Factors in Resilient Volunteers Facing Compassion Fatigue

Volunteers may be exposed to the negative consequences of dealing with human suffering, such as compassion fatigue. However, very little is known about the protective factors that contribute to their resilience. The aim of this study was to analyze the extent to which different strengths (psychological endurance, purpose, and social support), orientations to happiness, and compassion satisfaction predict volunteers’ resilient outcomes (subjective well-being and post-traumatic growth) and compassion fatigue. Participants were 116 Spanish Red Cross volunteers (77.8% women). They were separately classified into three groups (low, medium, and high) according to the 33rd and 66th percentile scores on each resilient outcome. Univariate analyses of variance and post-hoc comparisons computed separately showed significant differences in most factors analyzed, except compassion fatigue. Logistic regressions revealed that endurance, organization support, and eudaimonia allowed for the correct classification of 83.3% of those high in post-traumatic growth (82.2% of the true-positives and 84.4% of the true-negatives). In addition to endurance and organization support, purpose was the strongest predictor of well-being (85.7% were correctly classified, 82.8% of the true-negatives and 88.2% of the true-positives). Finally, lower endurance predicted compassion fatigue (65.7% and 61.3% of the true-negatives and 69.4% of the true-positives). Findings indicate ways to promote resilience among volunteers.