Global assessment of the severity of epilepsy (GASE) Scale in children: Validity, reliability, responsiveness

Summary Objective The Global Assessment of Severity of Epilepsy (GASE) Scale is a single-item, 7-point global rating scale designed for neurologist-report of overall severity of epilepsy in children. Building on previous preliminary evidence of its validity and reliability for research and clinical use, this study evaluated the GASE Scale\u27s construct validity, reliability, and responsiveness to changes in severity of epilepsy. Methods Data used for the study arose from the Health-Related Quality of Life in Children with Epilepsy Study (HERQULES), a 2-year multicenter prospective cohort study (n = 374) with observations taken at baseline, and 6, 12, and 24 months after diagnosis. Construct validity and reliability were quantified using Spearman\u27s correlation and intraclass correlation coefficient (ICC). Responsiveness was assessed using both distribution-based and anchor-based indices. Results The GASE Scale was at least moderately correlated (r ≥ 0.30) with several key clinical aspects and most strongly correlated with frequency and intensity of seizures and interference of epilepsy or drugs with daily activities (r \u3e 0.30). Total variation in GASE Scale scores explained by seven core clinical aspects of epilepsy increased over time (R2 = 28% at baseline to R2 = 70% at 24 months). The GASE Scale had modest test-retest reliability (ICC range: 0.52-0.64) and was responsive to changes in clinical criteria (standardized response mean range: 0.49-0.68; probability of change range: 0.69-0.75; Guyatt\u27s responsiveness statistic range: 0.56-0.84). The GASE Scale showed potential to discriminate stable and changed patients according to select criteria and to a composite score (area under the receiver operating characteristic [ROC] curve range: 0.50-0.67). Significance Results offer additional evidence in support of the GASE Scale\u27s validity, reliability, as well as responsiveness to changes in severity of epilepsy in children. We conclude that the GASE Scale is a potentially useful tool for assessing the severity of epilepsy in both clinical and research settings

WorldGPT: A Sora-Inspired Video AI Agent as Rich World Models from Text and Image Inputs

Several text-to-video diffusion models have demonstrated commendable capabilities in synthesizing high-quality video content. However, it remains a formidable challenge pertaining to maintaining temporal consistency and ensuring action smoothness throughout the generated sequences. In this paper, we present an innovative video generation AI agent that harnesses the power of Sora-inspired multimodal learning to build skilled world models framework based on textual prompts and accompanying images. The framework includes two parts: prompt enhancer and full video translation. The first part employs the capabilities of ChatGPT to meticulously distill and proactively construct precise prompts for each subsequent step, thereby guaranteeing the utmost accuracy in prompt communication and accurate execution in following model operations. The second part employ compatible with existing advanced diffusion techniques to expansively generate and refine the key frame at the conclusion of a video. Then we can expertly harness the power of leading and trailing key frames to craft videos with enhanced temporal consistency and action smoothness. The experimental results confirm that our method has strong effectiveness and novelty in constructing world models from text and image inputs over the other methods.Comment: 11 pages, 2 figures, 2 table

UnifiedVisionGPT: Streamlining Vision-Oriented AI through Generalized Multimodal Framework

In the current landscape of artificial intelligence, foundation models serve as the bedrock for advancements in both language and vision domains. OpenAI GPT-4 has emerged as the pinnacle in large language models (LLMs), while the computer vision (CV) domain boasts a plethora of state-of-the-art (SOTA) models such as Meta's SAM and DINO, and YOLOS. However, the financial and computational burdens of training new models from scratch remain a significant barrier to progress. In response to this challenge, we introduce UnifiedVisionGPT, a novel framework designed to consolidate and automate the integration of SOTA vision models, thereby facilitating the development of vision-oriented AI. UnifiedVisionGPT distinguishes itself through four key features: (1) provides a versatile multimodal framework adaptable to a wide range of applications, building upon the strengths of multimodal foundation models; (2) seamlessly integrates various SOTA vision models to create a comprehensive multimodal platform, capitalizing on the best components of each model; (3) prioritizes vision-oriented AI, ensuring a more rapid progression in the CV domain compared to the current trajectory of LLMs; and (4) introduces automation in the selection of SOTA vision models, generating optimal results based on diverse multimodal inputs such as text prompts and images. This paper outlines the architecture and capabilities of UnifiedVisionGPT, demonstrating its potential to revolutionize the field of computer vision through enhanced efficiency, versatility, generalization, and performance. Our implementation, along with the unified multimodal framework and comprehensive dataset, is made publicly available at https://github.com/LHBuilder/SA-Segment-Anything.Comment: 9 pages, 29 figure

VisionGPT: Vision-Language Understanding Agent Using Generalized Multimodal Framework

With the emergence of large language models (LLMs) and vision foundation models, how to combine the intelligence and capacity of these open-sourced or API-available models to achieve open-world visual perception remains an open question. In this paper, we introduce VisionGPT to consolidate and automate the integration of state-of-the-art foundation models, thereby facilitating vision-language understanding and the development of vision-oriented AI. VisionGPT builds upon a generalized multimodal framework that distinguishes itself through three key features: (1) utilizing LLMs (e.g., LLaMA-2) as the pivot to break down users' requests into detailed action proposals to call suitable foundation models; (2) integrating multi-source outputs from foundation models automatically and generating comprehensive responses for users; (3) adaptable to a wide range of applications such as text-conditioned image understanding/generation/editing and visual question answering. This paper outlines the architecture and capabilities of VisionGPT, demonstrating its potential to revolutionize the field of computer vision through enhanced efficiency, versatility, and generalization, and performance. Our code and models will be made publicly available. Keywords: VisionGPT, Open-world visual perception, Vision-language understanding, Large language model, and Foundation modelComment: 17 pages, 5 figures, and 1 table. arXiv admin note: substantial text overlap with arXiv:2311.1012

Hockey Fans in Training: A Pilot Pragmatic Randomized Controlled Trial

Introduction  Hockey Fans in Training (Hockey FIT) is a gender-sensitized weight loss and healthy lifestyle program. We investigated 1) feasibility of recruiting and retaining overweight and obese men into a pilot pragmatic randomized controlled trial and 2) potential for Hockey FIT to lead to weight loss and improvements in other outcomes at 12 wk and 12 months.  Methods  Male fans of two ice hockey teams (35-65 yr; body mass index ≥28 kg·m-2) located in Ontario (Canada) were randomized to intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT includes a 12-wk active phase (weekly, coach-led group meetings including provision of dietary information, practice of behavior change techniques, and safe exercise sessions plus incremental pedometer walking) and a 40-wk minimally supported phase (smartphone app for sustaining physical activity, private online social network, standardized e-mails, booster session/reunion). Measurement at baseline and 12 wk (both groups) and 12 months (intervention group only) included clinical outcomes (e.g., weight) and self-reported physical activity, diet, and self-rated health.  Results  Eighty men were recruited in 4 wk; trial retention was >80% at 12 wk and >75% at 12 months. At 12 wk, the intervention group lost 3.6 kg (95% confidence interval, -5.26 to -1.90 kg) more than the comparator group (P < 0.001) and maintained this weight loss to 12 months. The intervention group also demonstrated greater improvements in other clinical measures, physical activity, diet, and self-rated health at 12 wk; most sustained to 12 months.  Conclusions  Results suggest feasible recruitment/retention of overweight and obese men in the Hockey FIT program. Results provide evidence for the potential effectiveness of Hockey FIT for weight loss and improved health in at-risk men and, thus, evidence to proceed with a definitive trial

Hockey Fans in Training: A Pilot Pragmatic 1 Randomized Controlled Trial

Introduction Hockey Fans in Training (Hockey FIT) is a gender-sensitized weight loss and healthy lifestyle program. We investigated 1) feasibility of recruiting and retaining overweight and obese men into a pilot pragmatic randomized controlled trial and 2) potential for Hockey FIT to lead to weight loss and improvements in other outcomes at 12 wk and 12 months. Methods Male fans of two ice hockey teams (35–65 yr; body mass index ≥28 kg·m−2) located in Ontario (Canada) were randomized to intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT includes a 12-wk active phase (weekly, coach-led group meetings including provision of dietary information, practice of behavior change techniques, and safe exercise sessions plus incremental pedometer walking) and a 40-wk minimally supported phase (smartphone app for sustaining physical activity, private online social network, standardized e-mails, booster session/reunion). Measurement at baseline and 12 wk (both groups) and 12 months (intervention group only) included clinical outcomes (e.g., weight) and self-reported physical activity, diet, and self-rated health. Results Eighty men were recruited in 4 wk; trial retention was \u3e80% at 12 wk and \u3e75% at 12 months. At 12 wk, the intervention group lost 3.6 kg (95% confidence interval, −5.26 to −1.90 kg) more than the comparator group (P \u3c 0.001) and maintained this weight loss to 12 months. The intervention group also demonstrated greater improvements in other clinical measures, physical activity, diet, and self-rated health at 12 wk; most sustained to 12 months. Conclusions Results suggest feasible recruitment/retention of overweight and obese men in the Hockey FIT program. Results provide evidence for the potential effectiveness of Hockey FIT for weight loss and improved health in at-risk men and, thus, evidence to proceed with a definitive trial

Hockey Fans in Training (Hockey FIT) Pilot Study Protocol: A Gender-Sensitized Weight Loss and Healthy Lifestyle Program for Overweight and Obese Male Hockey Fans

Background: Effective approaches that engage men in weight loss and lifestyle change are important because of worldwide increases, including in Canada, in obesity and chronic diseases. Football Fans in Training (FFIT), developed in Scotland, successfully tackled these problems by engaging overweight/obese male football fans in sustained weight loss and positive health behaviours, through program deliveries at professional football stadia. Methods: Aims: 1) Adapt FFIT to hockey within the Canadian context and integrate with HealtheSteps™ (evidence-based lifestyle program) to develop Hockey Fans in Training (Hockey FIT); 2) Explore potential for Hockey FIT to help overweight/obese men lose weight and improve other outcomes by 12 weeks, and retain these improvements to 12 months; 3) Evaluate feasibility of recruiting and retaining overweight/obese men; 4) Evaluate acceptability of Hockey FIT; and 5) Conduct program optimization via a process evaluation. We conducted a two-arm pilot pragmatic randomized controlled trial (pRCT) whereby 80 overweight/obese male hockey fans (35–65 years; body-mass index ≥28 kg/m2 ) were recruited through their connection to two junior A hockey teams (London and Sarnia, ON) and randomized to Intervention (Hockey FIT) or Comparator (Wait-List Control). Hockey FIT includes a 12-week Active Phase (classroom instruction and exercise sessions delivered weekly by trained coaches) and a 40-week Maintenance Phase. Data collected at baseline and 12 weeks (both groups), and 12 months (Intervention only), will inform evaluation of the potential of Hockey FIT to help men lose weight and improve other health outcomes. Feasibility and acceptability will be assessed using data from self-reports at screening and baseline, program fidelity (program observations and coach reflections), participant focus group discussions, coach interviews, as well as program questionnaires and interviews with participants. This information will be analyzed to inform program optimization. Discussion: Hockey FIT is a gender-sensitive program designed to engage overweight/obese male hockey fans to improve physical activity and healthy eating choices, thereby leading to weight loss and other positive changes in health outcomes. We expect this study to provide evidence for a full-scale confirmatory pRCT. Trial registration: NCT02396524 (Clinicaltrials.gov). Date of registration: Feb 26, 2015

MDM2 Integrates Cellular Respiration and Apoptotic Signaling through NDUFS1 and the Mitochondrial Network

Signaling diversity and subsequent complexity in higher eukaryotes is partially explained by one gene encoding a polypeptide with multiple biochemical functions in different cellular contexts. For example, mouse double minute 2 (MDM2) is functionally characterized as both an oncogene and a tumor suppressor, yet this dual classification confounds the cell biology and clinical literatures. Identified via complementary biochemical, organellar, and cellular approaches, we report that MDM2 negatively regulates NADH:ubiquinone oxidoreductase 75 kDa Fe-S protein 1 (NDUFS1), leading to decreased mitochondrial respiration, marked oxidative stress, and commitment to the mitochondrial pathway of apoptosis. MDM2 directly binds and sequesters NDUFS1, preventing its mitochondrial localization and ultimately causing complex I and supercomplex destabilization and inefficiency of oxidative phosphorylation. The MDM2 amino-terminal region is sufficient to bind NDUFS1, alter supercomplex assembly, and induce apoptosis. Finally, this pathway is independent of p53, and several mitochondrial phenotypes are observed in Drosophila and murine models expressing transgenic Mdm2

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Assessing function in patients undergoing joint replacement: a study protocol for a cohort study

BACKGROUND: Joint replacement is an effective intervention for people with advanced arthritis, although there is an important minority of patients who do not improve post-operatively. There is a need for robust evidence on outcomes after surgery, but there are a number of measures that assess function after joint replacement, many of which lack any clear theoretical basis. The World Health Organisation has introduced the International Classification of Functioning, Disability and Health (ICF), which divides function into three separate domains: Impairment, activity limitations and participation restrictions. The aim of this study is to compare the properties and responsiveness of a selection of commonly used outcome tools that assess function, examine how well they relate to the ICF concepts, and to explore the changes in the measures over time. METHODS/DESIGN: Two hundred and sixty three patients listed for lower limb joint replacement at an elective orthopaedic centre have been recruited into this study. Participants attend the hospital for a research appointment prior to surgery and then at 3-months and 1-year after surgery. At each assessment time, function is assessed using a range of measures. Self-report function is assessed using the WOMAC, Aberdeen Impairment, Activity Limitation and Participation Restriction Measure, SF-12 and Measure Yourself Medical Outcome Profile 2. Clinician-administered measures of function include the American Knee Society Score for knee patients and the Harris Hip Score for hip patients. Performance tests include the timed 20-metre walk, timed get up and go, sit-to-stand-to-sit, step tests and single stance balance test. During the performance tests, participants wear an inertial sensor and data from motion analysis are collected. Statistical analysis will include exploring the relationship between measures describing the same ICF concepts, assessing responsiveness, and studying changes in measures over time. DISCUSSION: There are a range of tools that can be used to assess function before and after joint replacement, with little information about how these various measures compare in their properties and responsiveness. This study aims to provide this data on a selection of commonly used assessments of function, and explore how they relate to the ICF domains