Cohen's Coefficient Research Articles

A novel gradient echo data based vein segmentation algorithm and its application for the detection of regional cerebral differences in venous susceptibility

Accurate segmentation of cerebral venous vasculature from gradient echo data is of central importance in several areas of neuroimaging such as for the susceptibility-based assessment of brain oxygenation or planning of electrode placement in deep brain stimulation. In this study, a vein segmentation algorithm for single- and multi-echo gradient echo data is proposed. First, susceptibility maps, true susceptibility-weighted images, and, in the multi-echo case, R2* maps were generated from the gradient echo data. These maps were filtered with an inverted Hamming filter to suppress background contrast as well as artifacts from field inhomogeneities at the brain boundaries. A shearlet-based scale-wise representation was generated to calculate a vesselness function and to generate segmentations based on local thresholding. The accuracy of the proposed algorithm was evaluated for different echo times and image resolutions using a manually generated reference segmentation and two vein segmentation algorithms (Frangi vesselness-based, recursive vesselness filter) as a reference with the Dice and Cohen's coefficients as well as the modified Hausdorff distance. The Frangi-based and recursive vesselness filter methods were significantly outperformed with regard to all error metrics. Applying the algorithm, susceptibility differences likely related to differences in blood oxygenation between superficial and deep venous territories could be demonstrated.

Surgical validation of functional magnetic resonance urography in the study of ureteral anomalies distal to the uretero-pelvic junction in a pediatric cohort.

Ureteral anomalies distal to the Uretero-Pelvic Junction (UPJ) belong to the wide spectrum of congenital anomalies of the kidney and urinary tract (CAKUT). They can cause severe obstruction requiring a detailed anatomical depiction to define the surgical approach. Up to date, ultrasonography, voiding cystourethrography and scintigraphy are considered the gold-standard diagnostic tools to study obstructive anomalies of the urinary tract, however, they do not provide accurate ureteral anatomical details. The aim of our study was to evaluate the concordance between functional magnetic resonance urography (fMRU) and intraoperative findings to define ureteral anomalies distal to UPJ. Pediatric patients with ureteral anomalies distal to the UPJ who underwent surgery after performing fMRU were retrospectively collected. Surgical data were compared with radiological results. The concordance was assessed considering both pathological and non-pathological urinary tracts and was calculated by means of the Cohen's kappa coefficient. fMRU diagnostic accuracy was defined by sensitivity, specificity, and binomial exact confidence intervals. We included 46 patients. The sensitivity and specificity of fMRU were 98.0% and 83,3%; positive predictive value 90,4%, negative predictive value 96.2%. The concordance between surgical findings and fMRU was 92,3%, with a k Cohen's coefficient of 0.83 (excellent). Our study demonstrates the excellent agreement between fMRU and surgical findings in the definition of ureteral anomalies distal to the UPJ in children. Thus, it could be considered a valid imaging technique in the preoperative planning as it provides the surgeon with important information regarding the etiology and site of the obstruction.

The effect of the chemical composition on the sensory characterization of Ecuadorian coffee

The study aims to test if Ecuadorean coffee's symbolic and material contents agree with the instrumental analysis and grading protocols. We studied the relationship between the chemical composition and the organoleptic characteristics of eight non-specialty and six specialty coffee samples. Firstly, the study addresses the grading following the Specialty Coffee American Association (SCAA) method. The second stage focuses on the qualitative composition of the coffee brews employing GC-MS and caffeine concentrations using HPLC. Then, we employed statistical tools such as Cohen's concordance coefficients, dissimilarity dendrograms, and linear correlations between the chemical compounds in the beverage and the attributes' scores. The grading panel consisted of 6 semi-trained-testers who would assess if the primary cultural capital can provide a criterion to identify specialty coffee. The variety of compounds allowed the evaluators to distinguish between commercial and specialty coffees. However, the composition analysis identified molecules that would imply greater gradation in the tasting, a prevision that was not reflected in the results. Finally, we confirmed that basic training could create cultural capital to distinguish non-specialties from specialty coffees through their chemistry and organoleptic attributes.

Concordance of pharmacist versus patient responses regarding counselling in community pharmacy.

Patient counselling on medication is one of the activities that can and should be performed in community pharmacy. Patient counselling was proved to have a positive effect on clinical outcomes, quality of life, drug/disease knowledge, satisfaction and reduced health-service utilization. Our objective was to assess the degree of concordance between the responses of patient and pharmacist on the same questions regarding provided counselling. Data from two questionnaires containing a common block of 14 questions regarding the counselling provided on the medications use, safety concerns, storage, validity term, disposal and disease monitoring was paired and analysed. Questionnaires were paired based on a code and Kappa Cohen coefficient (KCc) and the prevalence adjusted biased adjusted kappa (PABAK) were calculated to evaluate the degree of concordance between pharmacist versus patient responses. The values of the KCc and PABAK were interpreted as per Altman. For the 14 questions, data from 2047 to 2378 questionnaires collected from 520 community pharmacies in 10 of Romania's counties were analysed. The highest level of concordance ('very good') was achieved on the items regarding the counselling on the medicines' route of administration (PABAK=0.88), time of administration (PABAK=0.80) and dosage (PABAK=0.82). The highest disagreement (week concordance) was found on the question regarding the counselling on the medicines adverse effects (PABAK=0.01), where 44.8% of patients responded that they received counselling as compared to 93.1% of the pharmacists who responded that they offered counselling. For the rest of the questions, moderate concordance was found. Overall a moderate level of concordance between patient and pharmacist responses was found on the majority of the questions, with the highest level found for drug use (dosage, route and time of administration). The highest discrepancy was found for the counselling on the medicines adverse effects.

تحلیل محتوای ظرفیتسازی در بخش آموزش عالی جهت پاسخگویی به انتظارات جامعه

Capacity-building policies have been proposed in order to promote further flexibility, improve the performance of the organization's programs, and to meet the needs and expectations of the forever-changing population. The main purpose of this study is to identify higher education capacities and so the Thematic Analysis Method was employed to analyze the content. Fourteen key experts and academic chairpersons, who have managerial and research experience in this field, formed the research sample. Qualitative data was obtained by focusing on words, the close inspection, accuracy, description and interpretation of texts, and detailed interviews. Data analysis was performed by analogy, using the Thematic Analysis Method, and according to existing theories. In order to evaluate the adequacy of the thematic analysis, its theoretical validity was tested by receiving the opinions of experts and using them as a specialized committee, and using the Kappa Cohen coefficient. By reviewing and approving the members participating in the accreditation process and estimating the coefficient to be 0.768, it can be said that the research findings have the required credibility and can be trusted. According to the findings of this study, the twelve main factors which outline the capacity of higher education to meet society's expectations in individual, organizational and environmental areas are factors such as, knowledge, skills, competence, strategy, structure, system and process, culture, resources and infrastructure, judicial-political environment, socio-cultural environment, industry, and stakeholders. These factors are plotted by a network of themes.

Lung ultrasonography for long-term follow-up of COVID-19 survivors compared to chest CT scan

BackgroundWhile lung ultrasonography (LUS) has utility for the evaluation of the acute phase of COVID-19 related lung disease, its role in long-term follow-up of this condition has not been well described. The objective of this study is to compare LUS and chest computed tomography (CT) results in COVID-19 survivors with the intent of defining the utility of LUS for long-term follow-up of COVID-19 respiratory disease. MethodsProspective observational study that enrolled consecutive survivors of COVID-19 with acute hypoxemic respiratory failure (HARF) admitted to the Respiratory Intensive Care Unit. Three months following hospital discharge, patients underwent LUS, chest CT, body plethysmography and laboratory testing, the comparison of which forms the basis of this report. Results38 patients were enrolled, with a total of 190 lobes analysed: men 27/38 (71.1%), mean age 60.6 y (SD 10.4). LUS findings and pulmonary function tests outcomes were compared between patients with and without ILD, showing a statistically significant difference in terms of LUS score (p: 0.0002), FEV1 (p: 0.0039) and FVC (p: 0.012). ROC curve both in lobe by lobe and in patient's overall analysis revealed an outstanding ILD discrimination ability of LUS (AUC: 0.94 and 0.95 respectively) with a substantial Cohen's coefficient (K: 0.74 and 0.69). ConclusionsLUS has an outstanding discrimination ability compared to CT in identifying an ILD of at least mild grade in the post COVID-19 follow-up. LUS should be considered as the first-line tool in follow-up programs, while chest CT could be performed based on LUS findings.

Self-collected saliva for SARS-CoV-2 detection: A prospective study in the emergency room.

Current diagnostic standards involve severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) detection in nasopharyngeal swabs (NPS), but saliva is an attractive and noninvasive option for diagnosis. The objectives were to determine the performance of saliva in comparison with NPS for detecting SARS‐CoV‐2 and to compare the optimized home brew reverse‐transcription polymerase chain reaction (RT‐PCR) with a commercial RT‐PCR. Paired NPS and saliva specimens were prospectively collected and tested by RT‐PCR from patients presenting at an emergency room with signs and symptoms compatible with coronavirus disease‐2019. A total of 348 samples from 174 patients were tested by RT‐PCR assays. Among 174 patients with symptoms, 63 (36%) were SARS‐CoV‐2 positive in NPS using the optimized home‐brew PCR. Of these 63 patients, 61 (98%) were also positive in saliva. An additional positive SARS‐CoV‐2 saliva was detected in a patient with pneumonia. Kappa Cohen's coefficient agreement between NPS and saliva was 0.96 (95% confidence interval [CI], 0.90–0.99). Median Ct values in NPS versus saliva were 18.88 (interquartile range [IQR], 15.60–23.58; range, 11.97–38.10) versus 26.10 (IQR, 22.75–30.06; range, 13.78–39.22), respectively (p < .0001). The optimized home‐brew RT‐PCR demonstrated higher analytical and clinical sensitivity compared with the commercial RT‐PCR assay. A high sensitivity (98%) and agreement (kappa 0.96) in saliva samples compared to NPS was demonstrated when using an optimized home‐brew PCR even when the viral load in saliva was lower than in NPS. This noninvasive sample is easy to collect, requires less consumable and avoids discomfort to patients. Importantly, self‐collection of saliva can diminish exposure to healthcare personnel.

The concordance of endoscopic and histologic findings of 530 pediatric patients suspicious for celiac disease in a referral center, Isfahan, Iran

Introduction: The purpose of this study is evaluation of concordance of histologic and endoscopic findings in pediatrics referred to Imam Hossein children’s hospital, in Isfahan for evaluation of celiac disease. An accurate prediction of the likelihood of a histologic finding in the setting of a visually normal endoscopy can help prepare families for unanticipated results. Patients and Methods: This is a retrospective study conducted from 2015-2017. The sampling method is census and all eligible patients are included in the study. At the beginning of the work, obtaining consent for entering the project has been done through interviews. After that, patients information such as file number, age and gender according to the file were entered into the data gathering sheet. Data were analyzed using SPSS software version 22. Pvalue&lt; 0.05 was considered significant. Results: Around 530 patients suspected of having celiac disease participated in the present study. The mean age of the subjects was 6.88 ± 4.31 years. Among them, 57.6% (305 patients) were girls and 42.4% (225 patients) were boys. According to the results, the kappa agreement coefficient is equal to 0.42. There was moderate agreement between endoscopy and pathology findings (kappa = 0.42). Conclusion: The results of the study and the kappa Cohen coefficient indicate the appropriateness of using endoscopy in patients with suspected celiac disease.

Modified J-CAPRA scoring system in predicting treatment outcomes of metastatic prostate cancer patients undergoing androgen deprivation therapy.

The J‐CAPRA score is an assessment tool which stratifies risk and predicts outcome of primary androgen deprivation therapy (ADT) using prostate‐specific antigen, Gleason score, and clinical TNM staging. Here, we aimed to assess the generalisability of this tool in multi‐ethnic Asians. Performance of J‐CAPRA was evaluated in 782 Malaysian and 16,946 Japanese patients undergoing ADT from the Malaysian Study Group of Prostate Cancer (M‐CaP) and Japan Study Group of Prostate Cancer (J‐CaP) databases, respectively. Using the original J‐CAPRA, 69.6% metastatic (M1) cases without T and/or N staging were stratified as intermediate‐risk disease in the M‐CaP database. To address this, we first omitted clinical T and N stage variables, and calculated the score on a 0–8 scale in the modified J‐CAPRA scoring system for M1 patients. Notably, treatment decisions of M1 cases were not directly affected by both T and N staging. The J‐CAPRA score threshold was adjusted for intermediate (modified J‐CAPRA score 3–5) and high‐risk (modified J‐CAPRA score ≥6) groups in M1 patients. Using J‐CaP database, validation analysis showed that overall survival, prostate cancer‐specific survival, and progression‐free survival of modified intermediate and high‐risk groups were comparable to those of original J‐CAPRA (p > 0.05) with Cohen's coefficient of 0.65. Around 88% M1 cases from M‐CaP database were reclassified into high‐risk category. Modified J‐CAPRA scoring system is instrumental in risk assessment and treatment outcome prediction for M1 patients without T and/or N staging.

Use of electronic patient data storage for evaluating and setting the risk category of late effects in childhood cancer survivors.

Many of the late effects of cancer treatment in childhood may occur even decades after the treatment, and only a minority of the survivors remain as healthy as their peers. Providing appropriate long-term care for childhood cancer survivors after transition to primary health care is a challenge. Both survivors and primary care providers need information on potential late effects. The lack of a systematic late effect follow-up plan may lead to excessive use of health care services or delayed intervention. While manual compilation of individual follow-up plans is time consuming for experienced clinicians, electronic algorithms may be feasible. In Finland, international guidelines for determining the risk of late effects have been implemented. Nationally, Turku University Hospital was asked with developing an automatized system for calculating the risk of late effects, based on electronic patient records saved in the hospital data lake. An electronic algorithm that uses details from exposure-based health screening guidelines published by the Children's Oncology Group was created. The results were compared with those manually extracted by an experienced clinician. Significant concordance between the manual and algorithm-based risk classification was found. A total of 355 patients received a classification using the algorithm, and 325 of those matched with the manual categorization, producing a Cohen's coefficient of 0.91 (95% confidence interval 0.88-0.95). Automated algorithms can be used to categorize childhood cancer survivors efficiently and reliably into late effect risk groups. This further enables automatized compilation of appropriate individual late effect follow-up plan for all survivors.

Closed Rhinoplasty: A Single Surgeon Experience of 238 Cases over 2 Years.

Closed rhinoplasty is currently losing favour as a method of rhinoplasty reshaping procedure. Open rhinoplasties are usually performed by surgeons because of the greater degree of visualisation of the cartilages and bones within the nose that need to be reshaped. Because of the criticisms of closed rhinoplasty the senior author performed an audit of his outcomes to determine whether closed rhinoplasty still has a role to play in the armamentarium of the plastic surgeon. We conducted this study as a retrospective review of all closed rhinoplasty operations performed by a single surgeon over a two-year period (from 1st January 2016 to 31st December 2017). The operative technique is provided. An independent panel of 3 assessors (2 board certified consultant plastic surgeons and one lay member of the public) rated outcomes of the closed technique based on photographic series. Statistical analysis was performed using Cohen's Kappa and Friedman test. Additionally, the length of follow up period, revision rates, and post-operative complications (general and aesthetic) were examined. A total of 242 cases of rhinoplasty were performed (8 open and 234 closed rhinoplasty; 225 primary and 17 revision operations). The first consultant surgeon gave a score in a range from 4.2/5 to 4.9/5 with a mode of 4.8 and a mean score of 4.7/5. The second consultant surgeon gave a range of 4.1/5 to 4.9/5 with a mode of 4.4 and mean score of 4.3/5. The lay panel member scored the cases in a range from 4.4/5 to 5/5 with a mode of 4.8 and a mean score of 4.9/5. Cohen's coefficient was 0.72 showing substantial agreement across the panel. The complication rate for the recorded data was 0.8% with two cases of soft tissue infection treated with oral antibiotics. The results of this paper advocates the benefits of the closed approach in aesthetic rhinoplasty. Surgeons should appreciate that both open and closed approaches are complimentary. The favouring of a single approach is indicated in the scenarios discussed. The remaining cases seem to produce equivocal results and the choice of procedure should be based on patient anatomy, outcome aims, and the ability of a surgeon to perform their preferred technique.

Flatfoot or not: subjective perception of the height of the feet arch among orthopedists

Background. The visual assessment of flatfoot is the most commonly used method by pediatric orthopedists. It is necessary to confirm good consistency among specialists to justify its use as a standard.&#x0D; Aim. The aim of this study was to determine the consistency of visual assessment of flatfoot among orthopedists.&#x0D; Materials and methods. The first stage of this study included 187 primary school-aged children. The main methods used were clinical examination and computer plantography. Then, 130 images of the right foot were randomly selected in standard projections medial and posterior, which were provided to 32 orthopedists (ten of whom were experts). Specialists needed to note whether the foot presented for analysis was flat. We used the w-Kendall concordance coefficient and -Kendall correlation coefficient to determine the inter-rater reliability. After five months, the intra-rater reliability was determined, and the Cohen coefficient was calculated.&#x0D; Results. Our study demonstrated that the inter-rater reliability varied significantly depending on whether the orthopedist specialized in foot pathology. When calculating the concordance coefficient, an increase in the consistency among experts was noted after five months (0.58 and 0.76, respectively), compared with orthopedists who do not specialize in foot pathology. Although some heterogeneity was noted according to experts on the same foot, the overall correlation coefficient corresponded to a good and excellent level of consistency (0.650.84). Cohens coefficient among specialists corresponded to a good level of confidence (0.72), whereas among orthopedists who do not specialize in foot pathology, there was a low level of confidence (0.31). According to experts, the frequency of flatfoot was 24.6%, whereas according to orthopedists who do not specialize in foot pathology, it was 40.9% when they evaluated images of the same feet.&#x0D; Conclusion. Experts answers regarding which foot should be considered flat demonstrated a good and excellent level of consistency. Therefore, they can be used to determine reference values of anthropometric parameters of the medial foot arch.

X-ray Dark-Field Radiography: Potential for Visualization of Monosodium Urate Deposition.

The aim of this study was to evaluate the potential of x-ray dark-field radiography for the noninvasive detection of monosodium urate (MSU) crystals as a novel diagnostic tool for gout. Contrast-to-noise ratios of MSU crystals in conventional radiography and dark-field radiography have been compared in a proof of principle measurement. Monosodium urate crystals have been injected into mouse legs in an ex vivo experimental gout setup. Three radiologists independently evaluated the images for the occurrence of crystal deposits in a blinded study for attenuation images only, dark-field images only, and with both images available for a comprehensive diagnosis. All imaging experiments have been performed at an experimental x-ray dark-field setup with a 3-grating interferometer, a rotating anode tube (50 kVp), and a photon-counting detector (effective pixel size, 166 μm). X-ray dark-field radiography provided a strong signal increase for MSU crystals in a physiological buffer solution compared with conventional attenuation radiography with a contrast-to-noise ratio increase from 0.8 to 19.3. Based on conventional attenuation images only, the reader study revealed insufficient diagnostic performance (sensitivity, 11%; specificity, 92%) with poor interrater agreement (Cohen's coefficient κ = 0.031). Based on dark-field images, the sensitivity increased to 100%, specificity remained at 92%, and the interrater agreement increased to κ = 0.904. Combined diagnosis based on both image modalities maximized both sensitivity and specificity to 100% with absolute interrater agreement (κ = 1.000). X-ray dark-field radiography enables the detection of MSU crystals in a mouse-based gout model. The simultaneous avaliability of a conventional attenuation image together with the dark-field image provides excellent detection rates of gout deposits with high specificity.

Local staging of prostate cancer with multiparametric-MRI: accuracy and inter-reader agreement.

BackgroundThe accuracy of prostate cancer local staging at the time of diagnosis directly influences patient prognosis and treatment.AimTo evaluate the diagnostic performance and interobserver variability of mp-MRI in local staging of prostate cancer, using the histopathologic findings at prostatectomy as the reference standard.MethodsFifty patients (mean age 64.4±7.2) with biopsy confirmed prostate cancer were included in this prospective study. All patients were examined with mp-MRI before radical prostatectomy and images were read by three independent radiologists. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and accuracy rate were calculated and compared for all three readers. Interobserver agreement was evaluated using Kappa Cohen coefficient of agreement.ResultsThe overall Se, Sp, PPV, NPV and accuracy rates for detecting extraprostatic tumor extension (EPE) ranged between 76.5–94.1%, 45.5–84.9%, 43.8–76.2%, 83.3–96.6% and 58–88%. For evaluation of seminal vesicle invasion (SVI), the overall Se, Sp, PPV, NPV and accuracy rates ranged between 57.1–85.7%, 86.1–97.7%, 40.0–85.7%, 92.5–97.7% and 82–96%, respectively. The overall Kappa Cohen coefficient of agreement varied between 0.349–0.638 for EPE and between 0.507–0.668 for SVI.ConclusionsOur results showed that 1.5T mp-MRI is a reliable method for local staging of prostate cancer, with good diagnostic performance in detecting EPE and SVI. The overall interobserver agreement rates between readers with the same level of experience in prostate MRI ranged from fair to good in the evaluation of EPE and from moderate to good for the assessment of SVI.

Normative health-related fitness values for French children: The Diagnoform Programme.

The primary objective of this study was to establish sex- and age-specific physical fitness percentiles for French children. The secondary aim was to assess sex, weight status, and age differences for physical fitness levels in French children. A sample of 31484 children (16023 boys, 15461 girls) aged 6-11years participated in the Diagnoform programme. Cardiorespiratory fitness, muscular endurance, speed, flexibility, and agility were assessed in this national programme. Percentile values were estimated as a function of age stratified by sex using a parametric method providing smooth centile curves and explicit formulae for the centile estimates. Values from the 10th to the 90th percentile are reported. The influence of body weight according to sex on the physical fitness level was also examined using an analysis of covariance adjusted for age. Physical fitness levels were slightly better in boys, except for agility and flexibility, in which girls performed better (Cohen's coefficient, 0.20-0.45; P<.001). All physical fitness tests were significantly associated with age (P<.0001). In general, overweight and obese children had a significantly poorer physical fitness level compared with their normal-weight counterparts (P<.05). No difference was found between thin and normal-weight boys and girls, except for agility (P<.05). Reference values provide normative data for French children, and these data should be useful for identifying special needs for appropriate intervention programmes.

The nature of a nurse’s workplace and their attitude towards learning communicative competence — a representative study of Polish nurses’ population

Background: In the education of nurses and midwives, the greatest emphasis is put on practical skills as the most important element of vocational competences. Education in the sphere of widely understood interpersonal communication and effective team interdisciplinary cooperation is getting equally important. It also accounts for important complementation of practical skills. Exploration of factors influencing the attitude towards learning communicative competence in a group of nurses undertaking specialization training. Methods: In the cross-sectional survey study 969 professionally active nurses from various regions of Poland took part. The respondents were divided into two groups, depending on the specialization training completed (“anaesthesiological, intensive care medicine and emergency medicine nursing” vs. “geriatrics, long-term and palliative care nursing”). The voluntary, anonymous survey was conducted with the use of CSAS questionnaire. A comparative analysis of the results for the two examined groups of nurses was performed with the use of the t-Student test. The scale of the effect for the observed mean variation was estimated with the use of d Cohen coefficient. Results: The examined nurses manifested a positive attitude towards learning communicative competence, however, a statistically significant difference in the context of the specificity of the ward was observed. The age of nurses had a negative influence on the analysed variables. Also, a correlation between high self-esteem of the possessed communicative skills and a high CSAS result was noted. Conclusions: The nature of the ward, time of hospitalization, as well as age and education of the personnel influence shaping the attitudes of the nursing personnel in the applicability of communicative competence in their professional practice.

P4593Effectiveness of using the Syntax Score II calculator for the patients with multi-vessel coronary arteries lesion

Abstract Introduction The most significant disadvantage of the SYNTAX score is the lack of an individualized approach due to the absence of the clinical parameters. The Syntax Score II calculator which includes 6 clinical indicators is more accurate decision-making tool that should help the “heart team” to choose a strategy for myocardial revascularization. The purpose of the study was to examine the effectiveness of using Syntax Score II for patients with multi-vessel coronary artery lesions who was dedicated to PCI. Material and methods From 01/2018 to 12/2018, 760 patients were included in the research, who was dedicated to PCI by the decision of the local “heart team”. In present analysis were included 116 (15%) of these patients with the multi-vessel coronary lesion and with a left main coronary artery lesion of different complexity. Patients who had previously undergone myocardial revascularization were excluded from analysis. The age of patients ranged from 41 to 86 years (mean age 67 + 9 years). There were males - 67.2%. Diabetes mellitus was present in 34.5% of the patients. 42.2% of the patients had angina pectoris (NYHA 3–4), and 60.3% had II class chronic heart failure. Results The average Syntax Score of the 116 patients was 23.1 + 7.8 (from 11 to 59). Syntax Score of the 52 (44.8%) patients was more than 23, and less than 23 in 64 (55.2%) of the cases. The Syntax Score II for the same patients recommended only CABG in 13 (11.2%), only PCI - in 6 (5.2%) and equality between methods - in 97 (83.6%) cases. Only in 6 (5.2%) patients, there was complete agreement between the risk scales, and for 53 (45.7%) of them, the methods were equal. For 44 (37.9%) patients, the Syntax score recommended CABG (Syntax score more than 23), and Syntax Score II indicated equality of methods. In 2 (1.7%) patients with a SYNTAX score of more than 23 the Syntax Score II nevertheless recommended PCI. The “heart team” decision and the Syntax Score II recommendation were in agreement in 103 (88.8%) of the cases, while the “heart team” decision and the SYNTAX recommendation were in agreement only in 64 (55.2%) of the cases. At the hospital stage, there were 2 (1.7%) cases of stent thrombosis with a fatal outcome, both in patients with SYNTAX score 42 and 28. To determine the degree of consistency between the risk scales, the Kappa Cohen coefficient was calculated, which was 0.06 (p=0.93), which indicates lack of consistency between SYNTAX and Syntax Score II in recommendations. Conclusion The Syntax Score II risk scale is an effective tool for making “heart team” decisions about myocardial revascularization method and expands indications for performing PCI, and in 88.8% of cases with multi-vessel coronary arteries lesion, it is possible to get equal predictions between the methods of revascularization. In 40% of cases in patients with a SYNTAX of more than 23 Syntax Score II determines an equiprobable prognosis for performing PCI and CABG.

The effect of the intervention dance program on the level of functional fitness and postural stability in elderly

Objective: The major objective of this study was to investigate the influence of six months dance intervention program on the level of functional fitness and postural stability in the elderly.Methods: The exercise program was carried out three times a week and included 60 dance exercise sessions. 60 elderly participated in the study (67.5±5.69 years), 30 in a dance intervention group (weight: 70.32±13.59kg; BMI 25.95±3.79 kg/m2), 30 in a control group (weight: 76. 93±15.45kg; BMI 27.06±3.88 kg/m2). Three subtests were used to determine the level of functional fitness from the Senior fitness test battery; the static posturography method assessed the level of balance abilities in one position.Results: The most meaningful results to emerge from the data are that the intervention dance program led to a post-exercise increase in the level of agility, dynamic balance and reaction speed measured by 8 Foot up Go test in the dance group. The results indicate a statistically significant difference value in the dance group compared to the control group between post-test results (p=0.01). Values of the other monitored parameters were not statistically significant. The Cohen coefficient d reflects the low or medium value of the intervention program's effectiveness.Conclusions: Even if the dance intervention program did not have a more significant effect on the level of the tested parameters, we must state that only a slight improvement or a steady level of functional fitness and postural stability is a positive result in this age. Keywords: aging, dance, Senior fitness test, motor abilities, balance ability

Electrocardiogram Changes with Neuroleptic Cardiomyopathy: The influence of age factor

By calculating the Cohen coefficient, the force of the influence of an age factor on the dynamics of electrocardiographic parameters at development of a neuroleptic cardiomyopathy is determined. It is established that in patients of different age crucial importance plays not the age factor, but side cardiotoxic effect of antipsychotics leading finally to development of the cardiac pathology. Keywords: Antipsychotics; Cardiotoxicity; Neuroleptic cardiomyopathy; Electrocardiogram changes; Age effect As a result of active therapy of both the main mental and concomitant somatic pathology, the life expectancy of mental patients, in particular those suffering from schizophrenia, has increased significantly [1-5]. This process is accompanied by a significant increase in the duration of antipsychotic therapy (APT), thereby significantly lengthening the time of damaging cardiotoxic effects of antipsychotics (AP) on the heart, which is fraught with the development of severe life-threatening iatrogenic pathology-neuroleptic cardiomyopathy (NCMP) [6].

Upper Extremity Angiographic Patterns in Systemic Sclerosis: Implications for Surgical Treatment

Conventional angiography is often used in the preoperative work-up of hand surgery patients with systemic sclerosis. The goal of this study was to propose a classification system based on the pattern of arterial involvement in a series of upper extremity angiograms. The authors hypothesized that this classification system would demonstrate high inter- and intrarater reliability. A retrospective review of 110 upper extremity angiograms in patients with systemic sclerosis (obtained between 1996 and 2017) was performed. Images were classified into 4 types based on the patency of the radial and ulnar arteries at the wrist, and into 3 subtypes based on the patency of the superficial and deep palmar arches. Classification reliability was compared with Fleiss' Kappa (for inter-rater) and Cohen's (for intrarater) coefficient between 4 fellowship-trained hand surgeons and a hand fellow. The inter-rater reliability between all 5 observers using types alone was 0.83 (0.80-0.85), whereas the inter-rater reliability using subtypes was 0.64 (confidence interval [CI] 95%, 0.62-0.65). The intrarater reliability using types alone ranged from 0.80 to 0.95, whereas intrarater reliabilities using subtypes were 0.81 (CI 95%, 0.72-0.90), 0.78 (CI 95%, 0.69-0.87), 0.87 (CI 95%, 0.80-0.95), 0.64 (CI 95%, 0.53-0.75), and 0.92 (CI 95%, 0.86-0.98) for the 4 attendings and a hand fellow, respectively. Fifty-seven percent of angiograms were interpreted as having loss of ulnar artery patency at the wrist (type 2) with 77% having additional loss of superficial palmar arch patency (type 2A). This large series of angiograms in patients with systemic sclerosis demonstrates a classification system for conventional angiography that shows high inter-rater and intrarater reliability using type alone. When subtypes were used, the inter-rater and intrarater reliabilities decreased to moderate and moderate-to-high, respectively. This study represents the first step in establishing a classification system that, by grouping patients with similar angiogram findings, may allow for targeted research into risk stratification, monitoring, and treatment in systemic sclerosis.