搜索结果：Interpretation

Exome sequencing (ES) has become a primary tool for diagnosing neurodevelopmental disorders (NDDs), yet the interpretation of genetic variants in large, heterogeneous cohorts presents significant challenges that automated pipelines often fail to resolve. This study showcases the complexities and novel findings derived from a decade-long analysis of 419 Italian NDD patient-parent trios. While ES established a molecular diagnosis in 36.5% of cases (53.8% in syndromic presentations), our investigation moves beyond diagnostic yield to highlight the critical value of manual curation integrated with deep phenotyping. We demonstrate how this rigorous approach uncovers complex disease mechanisms, revealing that variants initially misclassified as missense or stop-gain are, in fact, pathogenic splicing defects confirmed by functional analysis. Furthermore, we resolve the paradox of pathogenic truncating PPM1D variants in control databases by demonstrating their somatic mosaic nature, a crucial insight for population data interpretation. Our work also refines gene-disease correlations by challenging the established role of MID2 in NDDs, providing further evidence for DSCAM as a high-confidence risk gene, and expanding the known phenotypic spectrum of disorders, such as a novel GNAI2-related syndrome lacking expected immune dysfunction. This study underscores that navigating the complexities of large NDD cohorts requires a detailed, expert-driven approach to not only enhance diagnostic yield but also to advance our fundamental understanding of rare disease genetics.

Population-based reference intervals (popRIs) used in laboratory medicine may obscure important information related to individual biological variation. This study aims to further explore this issue by deriving personalized reference intervals (prRIs) based on biological variation estimates and comparing them with popRIs for selected clinical chemistry, hormone, and coagulation measurands. Forty-five healthy adults (28 females, 17 males) were sampled weekly for six weeks. Analytical variation, within-subject and between-subject components were estimated according to the EFLM Biological Variation committee recommendations. prRIs were calculated from both calculated CVI, CVP, and EFLM biological variation data. The index of individuality (II) and reference interval index (RII) were used to assess the adequacy of popRIs. PrRIs were generally narrower than popRIs, with 94.7% of RII values <1. Coagulation tests also displayed narrower prRIs than popRIs, suggesting the potential for more individualized interpretation of serial results. High individuality (II <0.6) was demonstrated for liver enzymes (ALT, AST, LDH, GGT, ALP), albumin, creatinine, ferritin, thyroid hormones (TSH, FT4) and lipids suggesting limited applicability of popRIs. Zinc and prolactin exhibited broader prRIs in some individuals, reflecting interindividual heterogeneity, while creatine kinase showed high intraindividual variability consistent with physical activity. In contrast, iron (II&#x202f;>&#x202f;1.4) supported the validity of population-based intervals. prRIs were generally narrower than popRIs across most measurands, particularly for analytes with high individuality. These findings suggest that prRIs may provide additional information for individualized interpretation of serial laboratory results. However, their clinical utility requires further validation in diseased populations and outcome-based studies before routine implementation.

Supraspinatus tendon pathologies are common causes of shoulder pain. Magnetic resonance imaging (MRI) is the reference imaging method but requires expert interpretation. Automated classification may improve diagnostic consistency and support musculoskeletal imaging workflows. This study aimed to develop and evaluate a hierarchical deep learning model to classify supraspinatus tendon status as intact tendons, tendinopathy/partial-thickness tears, or full-thickness tears. A total of 1192 shoulder MRI scans were analyzed. The hierarchical system consisted of a left-right orientation classifier, a full-thickness tear detector (model F), and a classifier for distinguishing intact tendons from tendinopathy/partial-thickness tears (model ITP). A flat 3-class model served as a baseline comparator. Performance was evaluated on both an internal test set and an independent external cohort. On the internal test set, the hierarchical system achieved a system-level sensitivity of 68.1% for tendinopathy/partial-thickness tears, outperforming the flat baseline (57.4%) while maintaining comparable sensitivity for full-thickness tears (hierarchical vs flat: 94.1% vs 95.1%). On the independent external cohort, the sensitivity for tendinopathy/partial-thickness tears was 45.5% for the hierarchical model and 18.2% for the flat baseline. The hierarchical model also showed a numerically higher balanced accuracy (hierarchical vs flat: 68.1% vs 64.5%), macro F1-score, and macro area under the curve, although its overall accuracy was lower (76.4% vs 79.8%). A hierarchical deep learning approach that mirrors clinical diagnostic reasoning may improve the recognition of tendinopathy and partial-thickness tears, a challenging category for nonspecialist readers. Given the overlapping CIs, these findings should be interpreted as indicative of a trend rather than definitive improvement. External validation supports feasibility across different MRI sources, though the predominance of data from a single institution limits generalizability and warrants further prospective evaluation.

Blood culture remains gold standard for diagnosing bloodstream infections; however, distinguishing true pathogens from contaminants remains a critical challenge. Misclassification can lead to inappropriate antimicrobial use, prolonged hospitalization, and increased healthcare burden. This study proposes a structured, stepwise clinical- microbiological model to differentiate pathogenic from non-pathogenic organisms in blood cultures. The study aimed to determine proportions of pathogens and non-pathogens in automated blood culture isolates. In this prospective cohort study at a tertiary hospital in northern India, blood culture-positive adults were evaluated in 2024. Organisms were classified as pathogenic or non-pathogenic using SOFA score, time to positivity (TTP), and site concordance, through a seven-step algorithm, with a 28-day follow-up. Among 1600 blood culture samples received, 205 isolates were positive for an organism, 160 (78%) were identified as pathogenic and 45 (22%) as non-pathogenic. The most common pathogens were Klebsiella (20.0%), Acinetobacter (9.3%), and Pseudomonas (6.3%), while non-pathogens were mainly coagulase-negative staphylococci (CONS, 18.5%) and Stenotrophomonas (8.3%). Mean TTP was significantly shorter in pathogens (16.3 &#xb1; 8.0 hours; bacterial pathogens with 15.01 hours, while fungal pathogens with 26.33 hours) compared to non-pathogens (21.5 &#xb1; 10.1 hours; p < 0.001). Discordance was observed in 7 cases (3.4%) where clinicians labelled isolates as non-pathogens but microbiologists disagreed, and in 26 cases (12.7%) with the opposite interpretation. Overall agreement was 65.4%, with a Cohen's kappa of 0.28. This model offers effective framework for distinguishing pathogens from non-pathogens in BSIs. Incorporating SOFA score, TTP, and culture concordance enhances diagnostic stewardship, informs antimicrobial decisions, and supports prognostication, especially in resource-limited healthcare settings.

Quadratic attention enhances interaction capacity in Transformer models but leads to rapid growth in computational demands as attention rank increases. This paper presents a bounded-rank quadratic attention mechanism where fixed-dimensional feature encodings determine the interaction space and enforce a strict upper bound on attention rank. A Fourier-domain formulation offers a spectral interpretation of the quadratic kernel via unitary transformation while maintaining exact attention computation. The proposed approach achieves bounded-rank attention with computational complexity that scales linearly with sequence length when the encoding dimension remains constant. Experimental validation on a real-world Tea pest image dataset yields 84.5% classification accuracy, surpassing the 82.1% achieved by a standard Vision Transformer under equivalent experimental conditions. Attention processing time per image declines from 14.8 ms to 5.6 ms. Peak memory usage declines from 820 MB to 430 MB. Although memory bandwidth and kernel launch overhead restrict the measured speedup to [Formula: see text], the accuracy loss under additive noise reaches 2.9% compared to 3.1% for the baseline, demonstrating comparable robustness. These findings indicate that explicit rank control in attention mechanisms can be realized through representational design, offering an efficient bounded-rank alternative to conventional full-rank attention.

Salivary gland dysfunction in Sj&#xf6;gren's disease (SjD) is clinically heterogeneous. Unstimulated whole salivary flow (UWSF) reflects basal secretion, while stimulated tests such as the Saxon test assess secretory reserve. Whether integrating these complementary domains defines clinically meaningful glandular functional states remains unclear. We conducted a retrospective cohort study of 193 anti-Sj&#xf6;gren's syndrome antigen A (anti-SSA)-positive patients with SjD. Using established clinical thresholds for UWSF and the Saxon test, we defined three functional phenotypes: preserved basal and reserve (PP), partial impairment (PL/LP) and combined low function (LL). Clinical features, patient-reported outcomes, submandibular gland (SMG) gland ratio and longitudinal salivary changes were evaluated. Dryness and swallowing difficulty differed significantly across phenotypes. Compared with PP, the LL phenotype exhibited higher European Alliance of Associations for Rheumatology (EULAR) Sj&#xf6;gren's Syndrome Patient-Reported Index dryness (&#x3b2;=1.67, 95% CI 0.64 to 2.70)&#x2009;and increased odds of swallowing difficulty (OR 6.19, 95% CI 2.71 to 14.9) after multivariable adjustment. Histological analyses showed markedly reduced SMG preservation in LL. Longitudinally, PP showed measurable declines in UWSF and Saxon test, whereas PL/LP remained relatively stable. LL had minimal longitudinal change in UWSF and a directionally positive Saxon slope, best interpreted in the context of floor-constrained end point behaviour rather than biological recovery. Baseline-to-last transition analyses showed substantial same-phenotype retention, and most longitudinally evaluable LL patients remained below the impaired Saxon threshold throughout follow-up. Integrated basal-reserve functional phenotyping defines clinically and structurally anchored salivary gland functional states in SjD. This framework may support clinical stratification and state-dependent interpretation of longitudinal salivary end points in studies targeting glandular outcomes.

The objective of this study was to evaluate the impact of centralised clinical and imaging case evaluation on the diagnostic assessment of patients with suspected axial spondyloarthritis (axSpA). We established a central telemedicine platform that allowed the collection of clinical and imaging information from patients who presented to rheumatologists and orthopaedists with suspicion of axSpA. Collected information included the suspected diagnosis, demographic, clinical, laboratory, and imaging data relevant for the diagnosis. Remote central expert evaluation comprised a detailed review of the submitted clinical and imaging data, followed by an expert diagnostic conclusion on the presence or absence of axSpA. A total 969 cases of suspected axSpA were evaluated. Based on the local assessment, 264 of 969 patients (27.2%) were diagnosed with axSpA. After central review, axSpA was considered present in 238 (24.6%) cases overall. Among patients with a local diagnosis of axSpA, 142 (53.8%) were considered axSpA also by central evaluation; however, in 89 (33.7%), an alternative cause of back pain-most commonly degenerative or mechanical disorders-was considered more likely. In comparison, among 319 patients locally assessed as not having axSpA, 265 (83.1%) were considered as no axSpA by central reviewers. One of the main drivers of the discrepancy between local and central diagnostic assessment was the interpretation of imaging findings as indicative of axSpA or not. Remote evaluation of clinical and imaging information by assessors with expertise in axSpA may support the diagnostic process in patients with suspected axSpA and help reduce the risk of misdiagnosis.

Rheumatic heart disease (RHD) remains a major cause of morbidity and mortality in low-resource settings, underscoring the need for accurate and scalable screening approaches. The 2023 World Heart Federation (WHF) screening criteria were designed to facilitate task-shifting but real-world performance data are limited. We evaluated the diagnostic accuracy and operational performance of the 2023 WHF criteria in a large school-based screening programme in Uganda. We conducted a cross-sectional diagnostic accuracy study among 11&#x2009;198 children aged 5-17 years screened between September and November 2024 in Lira District, Northern Uganda. All screen-positive children (n=522) and a stratified random sample of screen-negative children (n=3301) underwent confirmatory echocardiography. The index test was nurse-performed handheld echocardiography using a standardised three-view protocol. The reference standard was comprehensive echocardiography interpreted by a blinded expert adjudication panel using full WHF criteria. Diagnostic accuracy metrics included sensitivity, specificity, positive and negative predictive values and likelihood ratios. Partial verification bias was addressed using multiple imputation. Among 3802 participants who had the reference standard test and no alternative cardiac diagnosis, 122&#x2009;cases of RHD were identified. After accounting for partial verification bias, sensitivity was 60.0% (95% CI 46.6 to 73.5%)&#x2009;and specificity 96.3% (95% CI 96.0 to 96.7%). Positive and negative predictive values were 19.5% and 99.4%, respectively. Complete-case analysis overestimated sensitivity (80.3%) and underestimated specificity (89.0%). Missed cases were predominantly early-stage or aortic valve disease, with no advanced cases missed. Exploratory analysis using single-expert interpretation yielded comparable performance. In this large real-world evaluation, nurse-performed handheld echocardiographic screening using the 2023 WHF criteria demonstrated high specificity and negative predictive value, supporting its role as a scalable frontline triage strategy for RHD. After accounting for partial verification bias, sensitivity was moderate, with missed cases representing early-stage disease, highlighting opportunities to improve case detection through optimisation of screening workflows, training and technology.

This scoping review analyzed research trends and the effectiveness of sexual media literacy educational interventions for adolescents and provided foundational evidence for developing effective programs. Guided by Arksey and O'Malley's scoping review framework, ten databases were systematically searched for studies published between 2015 and 2025. Studies involving adolescents and individuals who educate or mediate adolescents' media use were included. Two independent reviewers screened titles, abstracts, and full texts, yielding a final sample of 11 studies. The included studies predominantly targeted middle school students, and the theory of planned behavior was the most commonly applied theoretical framework. Most programs (81.8%) emphasized strengthening adolescents' ability to interpret sexual content in media. Program duration ranged from 1 to 10 sessions, with total instructional time ranging from 90 minutes to 18 hours. Reported outcomes included improvements in sexual media literacy (72.7%), knowledge (36.4%), attitude (54.5%), behavior (45.5%), belief (18.2%), and interpersonal process (36.4%). The main teaching methods were lecture-based delivery (63.6%), offline interactive activities (63.6%), and web-based programs (36.4%). Overall, the programs improved adolescents' sexual media literacy, sexual health outcomes, and sexual health-related communication skills. This review provides evidence that sexual media literacy programs can improve adolescents' media interpretation skills and sexual health-related outcomes. Integrating learner-centered approaches with media-based instruction may be particularly useful and has meaningful implications for developing tailored sexual media literacy programs for adolescents.

The microbial safety of food additives is regulated under Japan's Specifications and Standards for Food Additives (JSFA), which includes detection tests for Salmonella. The current standard procedure in JSFA requires selective enrichment of Salmonella using tetrathionate (TT) and Rappaport-Vassiliadis (RV) broths with differing incubation temperatures: 43 &#xb1; 0.2&#x2103; for TT broth under high microbial load conditions, 35 &#xb1; 2&#x2103; for TT broth under low bacterial load conditions, and 42 &#xb1; 0.2&#x2103; for RV broth. These distinct incubation requirements necessitate separate temperature control, thereby increasing the complexity of laboratory procedures. In this study, we evaluated the temperature-dependent enrichment behavior of Salmonella under a limited set of conditions relevant to the JSFA method. Salmonella enterica subsp. enterica serovars Abony and Typhimurium were inoculated into food additive products in lactose broth with or without Escherichia coli at 102, 1.3&#xd7;105, and 1.3&#xd7;106 CFU/sample as a competing bacterium. The inoculated mixtures were incubated at 35 &#xb1; 1&#x2103; for 22 hr, after which aliquots (TT: 1 mL/RV: 0.1 mL) were inoculated into TT and RV broths and incubated at 42 &#xb1; 0.2&#x2103; and 43 &#xb1; 0.2&#x2103; for RV broth under none/low-level E. coli co-inoculation, whereas RV broth was incubated at 42 &#xb1; 0.2&#x2103; under high-level E. coli co-inoculation, and at 35 &#xb1; 2&#x2103;, 42 &#xb1; 0.2&#x2103;, and 43 &#xb1; 0.2&#x2103; for TT broth. The cultures were plated on selective agar to evaluate Salmonella recovery. For TT broth, no clear differences in recovery scores were observed among 35 &#xb1; 2&#x2103;, 42 &#xb1; 0.2&#x2103;, and 43 &#xb1; 0.2&#x2103;, regardless of E. coli co-inoculation. Under none/low-level E. coli co-inoculation, recovery after RV enrichment at 42 &#xb1; 0.2&#x2103; and 43 &#xb1; 0.2&#x2103; was comparable. In some food additive products, colonies were not recovered on one or more selective media in some replicate experiments; however, when three selective agars were used in parallel, the incubation temperature for TT broth did not markedly affect the overall test interpretation. The recovery of S. Typhimurium on some selective agars was reduced following incubation in RV broth containing food additives, protease and isoamylase co-inoculated with E. coli at high microbial loads. This suggests that high levels of bacterial contamination in certain food additive enzyme products, including protease and isoamylase, may suppress Salmonella recovery in RV broth. Further investigation using a broader range of contaminating microorganisms and food additive types is required to validate these findings.

The endothelial glycocalyx is a complex fibrous network of molecules that extends from the endothelial cell membrane for distances that range from less than 0.3 micron to several microns. The mechanisms determining the overall organization of the glycocalyx are still poorly understood, but our understanding is informed by high-resolution methods to analyze periodicity in electron micrographs of the glycocalyx revealed by chemical stains, and super-resolution optical imaging of specific moieties such as heparan sulfate and hyaluronic acid. The interpretation of these images in terms of the permeability properties of the vascular wall requires additional modeling of water and macromolecule flows through ordered molecular structures. While hydrodynamic approaches have been the primary focus of these efforts, extension of the fiber matrix theories that account for the space available to water and solutes within the matrix provides new ways to interpret images where detailed hydrodynamic models are not yet available. A combination of both approaches suggests ways to evaluate the primary molecular filter formed by the spaces between fibers in the glycocalyx in two possible arrangements: Thicker 10-12&#xa0;nm diameter fibers formed by the core proteins of syndecans and glypicans and their side chains with adsorbed plasma components or thinner (<2&#xa0;nm diameter) fibers of glycoprotein sidechains that extend above the core protein. This chapter is dedicated to Charles Michel, whose novel experimental methods to investigate the glycocalyx in microvessels, where permeability was measured, and associated theoretical analyses are starting points for the material described in this chapter.

Non-adherence to medication represents an important global challenge that compromises patient outcomes and increases healthcare costs, particularly in Spain due to the high prevalence of chronic conditions. Therefore, identifying the key factors influencing adherence is a valuable approach for developing targeted interventions. This study analysed two large real-world primary care databases from Madrid and Catalonia using four feature selection methods and three machine learning classifiers, together with threshold optimisation, calibration analysis, bootstrap confidence intervals, and importance analyses. Recursive Feature Elimination with Cross-Validation (RFECV), a cross-validated procedure that iteratively removes less informative variables) combined with Extreme Gradient Boosting (XGBoost), a tree-based algorithm that combines multiple decision trees, achieved the best performance in both cohorts. Overall, 48 structural factors were identified, 19 in Madrid and 29 in Catalonia, with consistent validation and test performance (AUROC 0.6953/0.6952 and 0.7775/0.7788, respectively). In Madrid, the number of medications and chronic disease burden were the most relevant factors, whereas in Catalonia smoking-related factors, rural or urban context, and prescription-timing factors were important. These findings support the value of using artificial intelligence to identify patterns and develop patient-centred adherence strategies in clinical practice. Although such data-driven AI models can reveal useful patterns, their interpretation should remain grounded in comprehensive adherence frameworks and and the results should be interpreted considering the heterogeneity between the databases, indirect adherence measures, and the absence of richer social determinants or external validation. Future research should therefore address these limitations to strengthen the generalisability of the findings.

To assess and summarize the outcomes of major pharmacologic, device-based, and surgical interventions reported in systematic reviews and meta-analyses for the treatment of Meniere's disease. CINAHL, Cochrane, PubMed, Scopus. Twenty-two systematic reviews with meta-analyses of randomized and nonrandomized studies were identified, assessing interventions including gentamicin, corticosteroids, betahistine, positive pressure therapy, adjunctive acupuncture, endolymphatic sac decompression, and cochlear implantation. The review was reported in accordance with PRISMA 2020 and PRISMA-S, and methods followed Cochrane Handbook guidance. Four investigators extracted data. When possible, data were pooled using a random-effects model. Outcomes included vertigo control, tinnitus improvement, and adverse events. Intratympanic gentamicin showed the highest vertigo control rate (89%) but carried a mild hearing loss risk and a 23% subjective hearing reduction rate. Intratympanic steroids offered modest benefit with fewer auditory risks. Positive pressure therapy showed mixed results, while acupuncture demonstrated symptomatic benefit when combined with other therapies. Endolymphatic sac decompression achieved 75%-82% control of vertigo initially but declined over time. Cochlear implants improved speech perception and tinnitus in profound hearing loss. No eligible meta-analyses evaluated antivirals, ventilation tubes, vestibular nerve section, or labyrinthectomy. Intratympanic gentamicin provides the strongest vertigo control but is backed by low-quality evidence and risks hearing loss. Conservative treatments like intratympanic steroids and betahistine show modest benefit with mixed evidence. Adjunctive options like acupuncture require cautious interpretation due to low-quality evidence. Surgical and device-based options demonstrate variable effectiveness, highlighting the need for individualized, symptom-driven care and further high-quality trials.

The efficacy of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) in the treatment of nonalcoholic fatty liver disease (NAFLD) has not been fully elucidated. The purpose of this systematic review and meta-analysis is to provide reliable evidence for clinical interpretation of the advantages and disadvantages of RYGB and SG in the treatment of NAFLD by directly comparing the efficacy of RYGB and SG in the treatment of NAFLD. All over the world. PubMed, Embase, Web of Science, and ClinicalTrials.gov were searched for relevant articles up to December 2025. Mean difference (MD) and 95% confidence interval (CI) were used for quantitative synthesis of continuous variables, and risk ratio and 95% CI were used for quantitative analysis of categorical variables. The primary outcomes of the study were changes in NAFLD activity score (NAS), fibrosis stage, and changes in liver enzymes (including alanine aminotransferase and aspartate aminotransferase) from initial to follow-up. Secondary outcomes included changes in body weight, body mass index, percentage total weight loss, and percentage excess weight loss. A total of 16 original studies were included in our final meta-analysis. Our primary analysis showed no significant overall difference between SG and RYGB in improving NAS (MD = .23, 95% CI: .69-1.16). Exploratory subgroup analyses suggested potential time-dependent patterns, although these varied by outcome: longer-term follow-up (> 1 year) was associated with a point estimate favoring RYGB for NAS (MD = .75, 95% CI: .03-1.47), but favoring SG for alanine aminotransferase reduction (MD = -5.92, 95% CI: -8.24 to 3.60). No significant between-group difference was observed for aspartate aminotransferase changes (P = .18), and RYGB was associated with greater weight loss. Given the exploratory nature of these subgroup analyses, these findings should be interpreted cautiously and considered hypothesis-generating. Metaregression analysis revealed that the difference in weight loss between procedures was significantly associated with the effect size for NAS improvement (&#x3b2; = -.11, 95% CI: -.21 to .01, P = .032) and accounted for 100% of the between-study heterogeneity (R2 = 100%). Although our primary analysis showed no significant overall difference between SG and RYGB in improving NAS, RYGB was associated with greater weight loss. Metaregression findings suggested that any potential histological advantage of RYGB may be largely attributable to its superior weight loss efficacy rather than to weight-independent mechanisms. Exploratory subgroup analyses suggested potential differences in long-term histological outcomes that varied across measures and should be considered hypothesis-generating. These findings warrant confirmation in future prospective studies.

This paper presents a comprehensive investigation of emerging wave structures associated with the regularized long-wave equation formulated in a nonlinear (2+1)-dimensional framework. By employing advanced analytical techniques, namely the modified Khater method and the Sardar subequation technique, a diverse class of exact solutions is constructed. These solutions encompass bright, dark, singular, and periodic soliton profiles, each demonstrating distinct propagation characteristics. The physical nature of these wave forms is illustrated through detailed two-dimensional plots, three-dimensional surfaces, and projected visual representations to enhance interpretability. To further understand the intrinsic dynamics of the model, qualitative analysis of the corresponding unperturbed planar system is conducted through phase-portrait investigation. When an external periodic forcing term is incorporated, the system exhibits complex nonlinear phenomena, including the onset of chaotic motion. This transition is rigorously examined using phase projections, temporal evolution plots, Poincar&#xe9; sections, and the computation of Lyapunov exponents to confirm the presence of sensitive dependence on initial conditions. Moreover, an extensive multistability analysis is performed by varying initial states, revealing that slight modifications in system parameters can induce significant transitions between stable and unstable dynamical regimes. Numerical simulations implemented via the fourth-order Runge-Kutta algorithm provide strong computational support for the analytical findings. Overall, the integration of symbolic techniques with high-precision numerical simulations establishes a robust framework for exploring intricate behaviors in higher-dimensional nonlinear dynamical systems.

To evaluate whether participation in the Health Equity Morning Report (HEMR), a novel case-based curriculum, was associated with increased pediatric residents' observable mentions or plans related to social/structural determinants of health (SSDOH) during inpatient rounds. In academic year 2024-2025, the authors developed a direct-observational checklist informed by national health-related social needs screening tools and generated validity evidence through expert review and calibration. Pediatric interns were observed twice before and twice after curriculum exposure. Each encounter received an ordinal score (0 = no SSDOH content, 1 = SSDOH mention, 2 = SSDOH plan). Mann-Whitney U tests compared ordinal scores; Fisher's exact tests compared proportions. A brief post-session survey assessed perceived educational value. We analyzed 132 patient encounters, including 52 pre-curriculum encounters and 80 post-curriculum encounters. No SSDOH-related mention or plan occurred during the pre-curriculum period, whereas 9 of 80 post-curriculum encounters (11.3%) included engagement (six plans, three mentions). Differences were statistically significant (U = 1846.0, P =.01; Fisher's exact test P =.01). Among survey respondents (n = 65), 41 (79%) rated the session Very or Extremely educational. Participation in HEMR was associated with increased SSDOH-related engagement during rounds and was rated highly by learners.

Quantitative susceptibility mapping (QSM) quantifies tissue magnetic susceptibility from gradient-echo phase data and is increasingly used to assess brain iron content. Although QSM has been validated from 1.5 T to 9.4 T, its multicenter performance at 5 T has not been evaluated. Six healthy volunteers (3 men, 3 women; mean age 29 &#xb1; 4 years) underwent brain QSM as a traveling-subject cohort across six 5 T MRI systems at different institutions, with a 3 T system as the clinical reference. Three-dimensional multi-echo gradient-echo data were acquired using standardized protocols, and QSM maps were reconstructed with a uniform pipeline. Nine bilateral regions of interest were measured using combined automated and manual segmentation. The 5 T scan-rescan assessment showed high repeatability, with ICCs ranged from 0.93 to 0.99. Inter-scanner reproducibility at 5 T was high for large deep gray matter structures (within-subject standard deviation < 5 ppb for pallidum, putamen, and caudate), comparable to multicenter data at 3 T and 7 T. Cross-field agreement between 3 T and 5 T was good/excellent agreement for putamen, thalamus, pallidum, substantia nigra, and white matter, but moderate cross-field ICC or wide LoA for brainstem, caudate, dentate nucleus, and red nucleus. The established susceptibility hierarchy was preserved at 5 T, and values were consistent with normative data across field strengths. An apparent trend of decreasing QSM values at higher field was observed across pooled studies, which should be interpreted as protocol/literature dependent rather than intrinsic field effects. These findings provide the first multicenter benchmark for brain QSM at 5 T.