The adoption of standardized metrics and indicators of antimicrobial use (AMU) in the food animal industry is essential for the success of programs aimed at promoting the responsible and judicious use of antimicrobials in this activity. The objective of this study was to introduce the use of standardized AMU metrics and indicators to quantify the use of florfenicol and oxytetracycline in the Chilean salmon industry, and in this way evaluate the feasibility of their use given the type of health and production information currently managed by the National Fisheries and Aquaculture Service (SERNAPESCA), the Chilean agency responsible for regulating aquaculture in Chile. The data available from SERNAPESCA allowed the construction and evaluation of the most data-demanding AMU metrics and indicators. Consequently, the use of florfenicol and oxytetracycline administered by oral and parenteral routes was quantified using the treatment incidence based on both animal defined daily dose (TIDDDvet) and animal used daily dose (TIUDDA). To that end, the study included information from 1320 closed production cycles from farms rearing Atlantic salmon, coho salmon and rainbow trout that were active between January 2017 and December 2021. By applying standardized AMU metrics and indicators, we were able to determine that the median of TIDDDvet for florfenicol was 75.1 (80 % range, 20.0-158.0) DDDvet per ton-year at risk for oral procedures and 0.36 (80 % range, 0.07-1.19) DDDvet per ton-year at risk for parenteral procedures. For oxytetracycline, the median TIDDDvet was 3.09 (80 % range, 0.74-42.8) and 0.47 (80 % range, 0.09-1.68) DDDvet per ton-year at risk for oral and parenteral procedures, respectively. The median TIUDDA for treatments with florfenicol was 45.6 (80 % range, 10.9-96.5) UDDA per ton-year at risk for oral treatments and 0.28 (80 % range, 0.05-0.80) UDDA per ton-year at risk for parenteral treatments. For oxytetracycline, the median TIUDDA was 2.63 (80 % range, 0.61-28.2) UDDA per ton-year at risk for oral treatments and 0.41 (80 % range, 0.08-1.29) UDDA per ton-year at risk for parenteral treatments. This study demonstrates that it is feasible to move from traditional AMU metrics and indicators to standardized ones in the Chilean salmon industry. This is possible because the competent authority requires salmon farms to report detailed health and production information at a high frequency. The use of standardized AMU metrics and indicators can help the authority to have a more comprehensive view of the antimicrobial use in the Chilean salmon industry.

Artificial intelligence (AI) has numerous applications in radiology. Clinical research studies to evaluate the AI models are also diverse. Consequently, diverse outcome metrics and measures are employed in the clinical evaluation of AI, presenting a challenge for clinical radiologists. This review aims to provide conceptually intuitive explanations of the outcome metrics and measures that are most frequently used in clinical research, specifically tailored for clinicians. While we briefly discuss performance metrics for AI models in binary classification, detection, or segmentation tasks, our primary focus is on less frequently addressed topics in published literature. These include metrics and measures for evaluating multiclass classification; those for evaluating generative AI models, such as models used in image generation or modification and large language models; and outcome measures beyond performance metrics, including patient-centered outcome measures. Our explanations aim to guide clinicians in the appropriate use of these metrics and measures.

BACKGROUND: According to the World Health Organization (WHO), mental health is \'a state of wellbeing in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community\'. Any population metric of mental health and wellbeing should therefore not only reflect the presence or absence of mental challenges but also a person\'s broad mental capacity and functioning across a range of cognitive, social, emotional and physical dimensions. However, while existing metrics of mental health typically emphasize ill health, existing metrics of wellbeing typically focus on happiness or life satisfaction, indirectly infer wellbeing from a selection of social and economic factors, or do not reflect a read out of the full spectrum of mental functioning that impacts people\'s everyday life and that spans the continuum from distress and the inability to function, through to the ability to function to one\'s full potential.
METHODS: We present the Mental Health Quotient, or MHQ, a population metric of mental wellbeing that comprehensively captures mental functioning, and examine how it relates to functional productivity. We describe the 47-item assessment and the life impact rating scale on which the MHQ metric is based, as well as the rationale behind each step of the nonlinear algorithm used to construct the MHQ metric.
RESULTS: We demonstrate a linear relationship between the MHQ metric and productive life function where movement on the scale from any point or in any direction relates to an equivalent shift in productive ability at the population level, a relationship that is not borne out using simple sum scores. We further show that this relationship is the same across all age groups. Finally, we demonstrate the potential for the types of insights arising from the MHQ metric, offering examples from the Global Mind Project, an initiative that aims to track and understand our evolving mental wellbeing, and since 2020 has collected responses from over 1 million individuals across 140 + countries.
CONCLUSIONS: The MHQ is a metric of mental wellbeing that aligns with the WHO definition and is amenable to large scale population monitoring.

The coronavirus disease (COVID-19) pandemic affects the healthcare system worldwide and challenges many governments and institutions. Antimicrobial stewardship program advocating the wise use of antimicrobial agents. Its metrics include antimicrobial use measures, process, and outcome performance indications. We will conduct a retrospective observational study with the main hypothesis that the COVID-19 pandemic does not affect the antimicrobial stewardship program and its metrics. We will compare antimicrobial stewardship metrics (process, outcome, utilization) and antibiotic resistance two years before (2018-2019) (Group A) & two years with the COVID-19 pandemic (2020-2021) (Group B). The study will be conducted in Saqr Hospital, a secondary care hospital in the emirate of Ras Al Khaimah in the United Arab Emirates. Data will be analyzed using SPSS version 22. Numerical data will be presented as mean (SD) or median (IQR). Chi-square or Fisher\'s exact test will be used to analyze categorical data. The t-test or Mann-Whitney U test will be used to compare the difference of numerical variables. p < 0.05 will be considered statistically significant. Multivariate logistic regression will be used to investigate the relation between different variables with (1) cost and (2) antibiotic resistance.

BACKGROUND: Quality and accuracy of online scientific data are crucial, given that the internet and social media serve nowadays as primary sources of medical knowledge.
OBJECTIVE: This study aims to analyze the relationship between scientific relevance and online visibility of strabismus research to answer the following questions: (1) Are the most popular strabismus papers scientifically relevant? (2) Are the most high-impact strabismus studies shared enough online?
METHODS: The Altmetric Attention Score (AAS) was used as a proxy for online visibility, whereas citations and the journal\'s impact factor (IF) served as a metric for scientific relevance. Using \"strabismus\" as a keyword, 100 papers with the highest AAS and 100 papers with the highest number of citations were identified. Statistical analyses, including the Spearman rank test, linear regression, and factor analysis, were performed to assess the relationship between AAS, citations, a journal\'s IF, and mentions across 18 individual Web 2.0 platforms.
RESULTS: A weak, positive, statistically significant correlation was observed between normalized AAS and normalized citations (P<.001; r=0.27) for papers with high visibility. Only Twitter mentions and Mendeley readers correlated significantly with normalized citations (P=.02 and P<.001, respectively) and IF (P=.04 and P=.009, respectively), with Twitter being the strongest significant predictor of citation numbers (r=0.53). For high-impact papers, no correlation was found between normalized citations and normalized AAS (P=.12) or the IF of the journal (P=.55).
CONCLUSIONS: While clinical relevance influences online attention, most high-impact research related to strabismus is not sufficiently shared on the web. Therefore, researchers should make a greater effort to share high-impact papers related to strabismus on online media platforms to improve accessibility and quality of evidence-based knowledge for patients.

UNASSIGNED: Venous thromboembolism (VTE) risk reduction strategies include early initiation of chemoprophylaxis, reducing missed doses, weight-based dosing and dose adjustment using anti-Xa levels. We hypothesized that time to initiation of chemoprophylaxis would be the strongest modifiable risk for VTE, even after adjusting for competing risk factors.
UNASSIGNED: A prospectively maintained trauma registry was queried for patients admitted July 2017-October 2021 who were 18 years and older and received emergency release blood products. Patients with deep vein thrombosis or pulmonary embolism (VTE) were compared to those without (no VTE). Door-to-prophylaxis was defined as time from hospital arrival to first dose of VTE chemoprophylaxis (hours). Univariate and multivariate analyses were then performed between the two groups.
UNASSIGNED: 2047 patients met inclusion (106 VTE, 1941 no VTE). There were no differences in baseline or demographic data. VTE patients had higher injury severity score (29 vs 24), more evidence of shock by arrival lactate (4.6 vs 3.9) and received more post-ED transfusions (8 vs 2 units); all p<0.05. While there was no difference in need for enoxaparin dose adjustment or missed doses, door-to-prophylaxis time was longer in the VTE group (35 vs 25 hours; p=0.009). On multivariate logistic regression analysis, every hour delay from time of arrival increased likelihood of VTE by 1.5% (OR 1.015, 95% CI 1.004 to 1.023, p=0.004).
UNASSIGNED: The current retrospective study of severely injured patients with trauma who required emergency release blood products found that increased door-to-prophylaxis time was significantly associated with an increased likelihood for VTE. Chemoprophylaxis initiation is one of the few modifiable risk factors available to combat VTE, therefore early initiation is paramount. Similar to door-to-balloon time in treating myocardial infarction and door-to-tPA time in stroke, \"door-to-prophylaxis time\" should be considered as a hospital metric for prevention of VTE in trauma.
UNASSIGNED: Level III, retrospective study with up to two negative criteria.

The perceived value of athlete monitoring systems (AMS) has recently been questioned. Poor perceptions of AMS are important, because where practitioners lack confidence in monitoring their ability to influence programming, and performance is likely diminished. To address this, researchers have primarily sought to improve factors related to monitoring metrics, e.g., validity rather than socio-environmental factors, e.g., buy-in. Seventy-five practitioners (response rate: n = 30) working with Olympic and Paralympic athletes were invited to take part in a survey about their perceptions of AMS value. Fifty-two per cent (n = 13) was confident in the sensitivity of their athlete self-report measures, but only 64% (n = 16), indicated their monitoring was underpinned by scientific evidence. A scientific base was associated with improved athlete feedback (rS (23) = 0.487, p =0.014*) and feedback correlated with athlete monitoring adherence (rS (22) = 0.675, p =  <0.001**). If athletes did not complete their monitoring, 52% (n = 13) of respondents felt performance might be compromised. However, most respondents 56% (n = 14), had worked with internationally successful athlete(s) who did not complete their monitoring. While AMS can be a useful tool to aid performance optimisation, its potential value is not always realised. Addressing socio-environmental factors alongside metric-factors may improve AMS efficacy.

Crawfurd Hospital (CFH) set up a Transitional Care Facility (TCF) in November 2022 as an interim holding facility for medically stable patients awaiting a long-term discharge disposition. The team invented the SAFE score, to monitor 4 main domains commonly impacted in long-term stays - namely Skin, Action (Behaviour), Function and Emotion. A sample size of 50 patients met the inclusion criteria and were scored by the nurses on day 7, day 14, and monthly thereafter during their TCF stay, and once more within 72 h prior to their discharge. There was no significant improvement or worsening noted across all 4 domains in this pilot study, suggesting that the TCF has achieved its goal of maintaining its patients in all these domains. The scores at the various time points were also useful for the team to immediately identify changes in individual patient scores and act on these findings to ensure optimal patient care. Through this pilot study, we identified further minor improvements which can be made to the and the score, and such a scoring system may further be applicable to various intermediate to long-term care homes to oversee these domains of care.

RNA is a complex macromolecule that plays central roles in the cell. While it is well known that its structure is directly related to its functions, understanding and predicting RNA structures is challenging. Assessing the real or predictive quality of a structure is also at stake with the complex 3D possible conformations of RNAs. Metrics have been developed to measure model quality while scoring functions aim at assigning quality to guide the discrimination of structures without a known and solved reference. Throughout the years, many metrics and scoring functions have been developed, and no unique assessment is used nowadays. Each developed assessment method has its specificity and might be complementary to understanding structure quality. Therefore, to evaluate RNA 3D structure predictions, it would be important to calculate different metrics and/or scoring functions. For this purpose, we developed RNAdvisor, a comprehensive automated software that integrates and enhances the accessibility of existing metrics and scoring functions. In this paper, we present our RNAdvisor tool, as well as state-of-the-art existing metrics, scoring functions and a set of benchmarks we conducted for evaluating them. Source code is freely available on the EvryRNA platform: https://evryrna.ibisc.univ-evry.fr.

UNASSIGNED: At the end of life, individuals may experience physical symptoms such as pain, and guidelines recommend medications to manage these symptoms. Yet, little is known about the symptom management long-term care (LTC) residents receive at the end of life. Our research team developed a metric-whether residents receive one or more prescriptions for an end-of-life symptom management medication in their last two weeks-to explore end-of-life care for LTC residents. This qualitative study aimed to inform the refinement of the end-of-life prescribing metric, including the acceptability and applicability to assess the quality of a resident\'s symptom management at end-of-life.
UNASSIGNED: We conducted 14 semi-structured interviews with Ontario health-care providers (physicians and nurses) who work in LTC homes and family caregivers of residents who died in LTC. Interviews were conducted virtually between February 2021 and December 2022, and were analyzed using thematic analysis.
UNASSIGNED: We identified three major themes relating to perceptions of the metric: 1) appropriateness, 2) health-care provider applicability, and 3) caregiver applicability. Participants noted that the metric may be appropriate to assess end-of-life care, but noted important nuances. Regarding applicability, health-care providers found value in the metric and that it could inform their practice. Conversely, caregivers found limited value in the metric.
UNASSIGNED: The proposed metric captures a very specific aspect of end-of-life care-whether end-of-life medications were prescribed or not. Participants deemed that the metric may reflect whether LTC homes have processes to manage a resident\'s end-of-life symptoms with medication. However, participants thought the metric could not provide a complete picture of end-of-life care and its quality.