Perspectives Charter School

Abstract Background Histological scoring is central to assessing disease activity and remission in ulcerative colitis (UC) clinical trials. However, there are two key challenges in the histological assessment of UC: high inter-rater variability and the lack of a standardised scoring system. The low agreement between pathologists increases the sample size required to power the endpoint effectively and increases costs and timelines to accommodate adjudication or consensus. The absence of standardised scoring across trials means sponsors must commit to a scoring system that may be suboptimal and limits comparability between studies. Our objective was to evaluate the impact of adopting a universal scoring template that can translate to any of the most common scoring systems and the introduction of a reading plan to increase pathologist alignment for active and remission ulcerative colitis. Methods Two expert pathologists with 14-40+ years of individual experience independently scored 51 whole-slide images (WSIs) from 10 UC patients using a universal scoring template derived from Simplified Geboes Score (SGS), Nancy Index (NI), and Robarts Histopathology Index (RHI) across 2 scoring rounds (R1, R2). Remission cut-offs were defined as SGS≤2A.1, NI ≤ 0, and RHI≤3. After R1 and a washout period, the pathologists were guided through a reading alignment and documentation process. Inter-rater reliability was calculated with pairwise overall percentage agreement and weighted Cohen’s kappa. The effect of including a reading plan and scoring template on future trial cost and timelines was modelled using these data and published literature from the VIVID-1 trial1 as an example of a large IBD phase 3 clinical trial. Results Targeted reader-alignment sessions using a standardised reading plan improved SGS inter-rater reliability from 49% to 73% agreement (Cohen’s k = 0.56 to 0.61). Agreement in R1 for SGS groupings (i.e., 0, 1, 2A, 2B, 3) improved by 23.5% in R2 (Fig.1). Agreement for remission (≤2A.1) and active (≥2B.1) groupings for SGS increased by 4% from R1 to R2 (Fig.2). For a clinical trial of 1056 IBD participants (5 biopsies at two time points), the estimated number of biopsy slides requiring adjudication by approximately 3000 WSIs without a reading plan. The inclusion of such an approach would reduce the number of adjudications by ∼745, equivalent to ∼75 patients. Conclusion The universal scoring system did not worsen inter-rater variability compared with typical clinical trial performance, and the structured reading plan markedly improved alignment between readers. The impact of these tools on trials will result in significant time, cost, and risk savings through reduced scoring burden and patient enrolment requirements. Reference: 1.Magro F, Jairath V, De Hertogh G, et al. DOP054 Early Histologic Response and Remission are Associated With Objective Control of Inflammation After One Year of Treatment With Mirikizumab in Moderately-to-Severely Active Crohn’s Disease. Journal of Crohn’s and Colitis. 2025;19(Supplement_1):i188-i189. Conflict of interest: Dr. Windell, Dylan: I disclose the following financial relationship(s) with a commercial interest: Perspectum Ltd. Magness, Alastair: I am an employee of Perspectum Ltd. Li, Rongxue: I disclose the following financial relationship(s) with a commercial interest: Perspectum Ltd Davis, Tom: I disclose the following financial relationship(s) with a commercial interest: Perspectum Ltd Beyer, Cayden: Employee of Perspectum Thomaides Brears, Helena: I disclose the following financial relationship(s) with a commercial interest: Perspectum Ltd Larkin, Sarah: I disclose the following financial relationship(s) with a commercial interest: Perspectum Ltd Aljabar, Paul: Employee of Perspectum Ltd. Kainth, Reema: I disclose the following financial relationship(s) with a commercial interest: Perspectum Ltd Wakefield, Phil: I disclose the following financial relationship(s) with a commercial interest: Perspectum Ltd Langford, Caitlin: I disclose the following financial relationship(s) with a commercial interest: Perspectum Ltd Fryer, Eve: No conflict of interest Goldin, Rob: None Landy, Jonathan: No conflict of interest

Abstract Introduction: More than a decade since the 2010 landmark Lancet Commission called for systems-based reforms, aligning health professions education (HPE) with health system needs remains a global imperative. This review systematically examined the literature on adult learning among Singapore’s healthcare professionals within a system characterized by mixed-financing and low gatekeeping, with implications for national improvement and global adaptation. Methods We conducted a comprehensive search of PubMed, ERIC, SCOPUS, and CINAHL from February to July 2025. Publications and abstracts describing, examining, referencing, or commenting on adult learning in Singapore were included without time restriction. Two reviewers independently screened titles and abstracts, with full-text review confirming relevance. Screening was managed using Covidence systematic review software. Results The search identified 762 unique articles, with 58 studies meeting the final inclusion criteria. Singapore’s HPE research is concentrated in nursing and medicine, predominantly uses survey-based methods, and focuses on lower-level Kirkpatrick outcomes. While simulation and online learning are increasingly being studied, gaps exist in postgraduate assessment, educational scholarship, multi-institutional studies, and higher-level outcome evaluations. Discussion This profile is a probable consequence of systemic features in many similar health systems. Our study offers a transferable methodology for other system to map their own HPE landscapes, identify structural influences on scholarship, and strategically align educational research with national priorities. This system-level analysis helps advance the global agenda for contextually relevant and impactful HPE.

Abstract The design and implementation of a training experience with future Peruvian mathematics teachers is described, aimed at developing the competence of analyzing the didactic suitability of curricular materials on probability. From a qualitative approach and with the support of the guidelines of didactic engineering based on the Ontosemiotic Approach, the protocols of written responses of 38 participants are available. The results show limitations in the assessment of suitability indicators and difficulties to elaborate a reasoned judgment on it. It is concluded that there is a need to promote reflective practice on the use of curricular materials and proposals for improvement changes in all facets of didactic suitability in a joint manner.

The relationship between mental health and human rights is integral and interdependent. There are clinical, social and economic reasons, as well as moral and legal obligations to advance mental health care as fundamental to human rights. Significant considerations for this matter are especially crucial when addressing the COVID-19 pandemic across the world. The aim of this research study was to analyse the responses to the ongoing pandemic, concerning the human rights of persons with psychosocial disabilities and the right to the mental health of the general population, in Lithuania. Methods included online surveys, semi-structured interviews, and a focus group. This article presents the results as a complex picture containing lived experiences of mental health difficulties of the general population, barriers to accessing the needed support and services, as well as analysis of violations of human rights. It also highlights the need for more research on the long-term consequences of the pandemic and lockdowns on the mental health of the population; also, on how human rights of persons with mental health conditions, and especially those with psychosocial disabilities, can be better ensured and protected in Lithuania.

AfricArXiv, Eider Africa, TCC Africa, and PREreview have joined forces to bring together scientists from across Africa and scientists engaged in African-related research for a series of 3 virtual discussions and collaborative peer review.

What are the new technologies for research quality assessment in academic publishing in the light of Open Science? A webinar contribution to Peer Review Week 2020 organised by TCC Africa and AfricArXiv