Confidence In Interpretation Research Articles

MR-Guided PET Reconstruction: A Potential Advancement for Patients With Epilepsy.

We report a case of a 33-year-old man with epilepsy and equivocal EEG, MRI signs of mesiotemporal sclerosis, and nondiagnostic standard FDG-PET imaging. The patient underwent repeat FDG-PET/MRI to clarify the sidedness of the epileptogenic focus and to confirm the suspected MTS. The standard PET reconstruction using block sequential regularized expectation maximization failed to provide evidence of a clear epileptogenic focus. However, using MR-guided PET reconstruction, circumscribed hypometabolism was observed in the right-sided entorhinal cortex, compatible with the epileptogenic focus. The MR-guided PET reconstruction provided significantly improved gray/white matter differentiation, enhancing confidence in imaging interpretation.

Sainsc: A Computational Tool for Segmentation-Free Analysis of In Situ Capture Data.

Spatially resolved transcriptomics (SRT) has become the method of choice for characterising the complexity of biomedical tissue samples. Until recently, scientists were restricted to SRT methods that can profile a limited set of target genes at high spatial resolution or transcriptome-wide but at a low spatial resolution. Through recent developments, there are now methods that offer both subcellular spatial resolution and full transcriptome coverage. However, utilising these new methods' high spatial resolution and gene resolution remains elusive due to several factors, including low detection efficiency and high computational costs. Here, we present Sainsc (Segmentation-free analysis of in situ capture data), which combines a cell-segmentation-free approach with efficient data processing of transcriptome-wide nanometre-resolution spatial data. Sainsc can generate cell-type maps with accurate cell-type assignment at the nanometre scale, together with corresponding maps of the assignment scores that facilitate interpretation of the local confidence of cell-type assignment. We demonstrate its utility and accuracy for different tissues and technologies. Compared to other methods, Sainsc requires lower computational resources and has scalable performance, enabling interactive data exploration. Sainsc is compatible with common data analysis frameworks and is available as open-source software in multiple programming languages.

Validity of wearable sensors for total knee arthroplasty (TKA) rehabilitation: A study in younger and older healthy participants

BackgroundWith 100,000 total knee arthroplasty (TKA) procedures taking place in the United Kingdom annually, the demand on rehabilitation services is high. Most regimes are home-based. Without clinician-patient interaction, detection of rehabilitation concerns can be delayed, reducing the chance of successful early intervention. Wearable technologies, such as MotionSenseTM (Stryker, US), may offer a solution to this problem by remotely supporting post-operative TKA rehabilitation through the provision of personalised rehabilitation and tracking of home exercises, enabling healthcare professionals to continuously monitor rehabilitation progress remotely. Validation of such devices against a known kinematic model in activities of daily living is important for confident interpretation of resulting clinical data. The aim of this study therefore was to validate the accuracy of MotionSenseTM against a clinical motion capture standard. MethodsTwenty younger and 14 older healthy, able-bodied adults attended one testing session (Younger: 24 ± 4 years old; Older: 71 ± 5 years old). Movement was tracked using Vicon motion analysis and a Plug-In-Gait lower body model was applied to all participants. Three activities were performed – walking, stair ascent, stair descent. The knee flexion angle root mean square error (RMSE) between the technologies was determined. ResultsFor both groups the knee flexion RMSE remained below 3° for all activities. The combined RMSE for all adults was 2.4° for walking, 2.7° for stair ascent, and 2.6° for stair descent. The signed error increased during the swing phase of gait. ConclusionMotionSenseTM was found to accurately estimate knee flexion angles during several common activities compared to Vicon motion capture.

A-343 Novel In-Line Hemolysis Detection on a Blood Gas Analyzer for Capillary Samples

Abstract Background Point-of-care (POC) blood gas and electrolyte analyzers utilizing whole blood as the predominant sample type are blinded by the presence of hemolysis until today. Moreover, capillary samples are particularly vulnerable to in-vitro hemolysis due to excessive force applied during sample collection. Here, we introduce the GEM Premier 7000 with iQM3 (GEM 7000) which incorporates automatic, in-line hemolysis detection in capillary blood gas samples without a need for additional sample volume or reagents. Methods The hemolysis detection module which is integrated into the disposable GEM cartridge uses acoustophoretic technology and photometric measurements to detect hemolysis in whole blood. In GEM 7000, hemolysis of ≥ 116 mg/dL was found to have significant interference with potassium results. A hemolysis flag is presented as the degree of hemolysis: none (0 - 50 and 51 - 115), mild (116 - 200 and 201 - 300), moderate (301 - 400), and gross (≥401). Due to volume limitations with native capillary samples and challenges in assessing hemolysis levels with a comparator assay, venous blood spiked volumetrically with hemolysate and transferred to capillary devices was used to verify the hemolysis flag performance. An agreement analysis was performed using the Roche cobas hemolysis value. The device's (GEM 7000) ability to flag hemolyzed capillary samples is demonstrated in a simulated clinical setting using native and contrived fingerstick capillary samples. Results Hemolysis verification with transferred capillary samples demonstrated that 98.2% (274/279) of samples were correctly flagged based on the cobas hemolysis value of spiked hemoglobin. Hemolysis in the native capillary samples (N = 235) was primarily distributed in the 0-50 mg/dL range. Additionally, native capillary samples altered using vigorous flea mixing (> 1 minute) showed hemolysis distribution over a wide hemolysis degree (none to gross), and their potassium results were flagged accordingly. Conclusions By providing integrated hemolysis detection in capillary blood sample measurements, the GEM Premier 7000 with iQM3 system can provide quality and confidence in the clinical interpretation of critical results such as potassium.

Usefulness of a Pluralistic Approach in Sentinel Surveillance: Seasonal Influenza Activity Based on Case Counts per Sentinel Site in the National Epidemiological Surveillance of Infectious Diseases Program and Test Counts, Case Counts, and Test Positivity from the National Hospital Organization.

In Japan, based on the National Epidemiological Surveillance of Infectious Diseases (NESID) Program, influenza cases from approximately 5,000 sentinel sites are monitored weekly as part of influenza surveillance (as the number of influenza cases per sentinel site). One limitation is that the number of influenza tests conducted is not reported. However, the National Hospital Organization (NHO), with approximately 140 hospitals, routinely publishes three indicators: the number of influenza tests, the number of influenza-positive cases, and test positivity. We used the NESID and NHO data from April 2011 to June 2022 to assess the usefulness of multiple indicators for monitoring influenza activity. The temporal trends of the NHO and NESID indicator were similar, and the NHO indicator levels correlated well with those of the NESID indicators. However, influenza positivity in the NHO data showed an earlier rise and peak time than that in the NESID indicator. Importantly, during the non-epidemic summer periods and the coronavirus disease 2019 pandemic, a sizable number of influenza tests were still performed at NHO hospitals, with results showing considerably low case counts and test positivity. These data show that a relatively small number of sentinel sites is sufficient to monitor influenza activity nationally and that utilizing multiple indicators can increase our confidence in situational awareness and data interpretations.

Effectiveness of electrocardiogram interpretation education program using mixed learning methods and webpage

AimThis study was conducted to develop an electrocardiogram education program that incorporates an HTML webpage and blended learning methods to enhance electrocardiogram interpretation skills. Through continual and efficient education, the program aims to assist nurses in providing appropriate care and treatment to patients.DesignPre-post design study.MethodsWe developed an electrocardiogram interpretation HTML webpage based on an electrocardiogram interpretation algorithm and implemented an 18-week (2023.5.15 ~ 2023.9.22) electrocardiogram education program, which included daily 5-minute training sessions. Twenty-seven ward nurses were provided with the URL (https://ecgweb.github.io/ECGwebEN) to the electrocardiogram interpretation HTML webpage and shared one electrocardiogram case daily for self-interpretation. Electrocardiogram interpretation performance and confidence were evaluated through questionnaires at three phases: before the program, after 6 weeks of basic electrocardiogram and arrhythmia education, and after 12 weeks of application of the electrocardiogram interpretation HTML webpage and case-based lecture education. The statistical tests used were repeated-measures ANOVA or the Wilcoxon signed-rank test.ResultsThe average score for electrocardiogram interpretation performance before the electrocardiogram education program was 11.89(SD = 3.50), after 6 weeks of basic electrocardiogram and arrhythmia education it was 14.15(SD = 3.68), and after 12 weeks of application of the electrocardiogram interpretation HTML webpage and case-based lecture education, it was 15.56(SD = 3.04). This shows that electrocardiogram interpretation performance significantly improved over time (p < .001). Additionally, post-hoc analysis revealed significant differences in electrocardiogram interpretation performance at each stage, i.e., before, during, and after the application of an electrocardiogram education program. Furthermore, the electrocardiogram interpretation confidence questionnaire score (pre-Median 18, IQR = 5; post-Median 23, IQR = 3) was improved significantly after the completion of the 18-week education program (p < .001).ConclusionsBased on the results of this study, we believe that an electrocardiogram education program using HTML webpage, and a blended teaching method would be very beneficial for maintaining and improving electrocardiogram interpretation skills of clinical nurses. Such a program can help nurses interpret electrocardiograms more effectively and assist them in making important decisions in patient care.

How to interpret consumer confidence shocks? State-level evidence

Using novel quarterly data of 29 U.S. states from 2005:I to 2015:IV, we revisit the link between consumer confidence and economic activity. We find that an innovation in consumer confidence is followed by a significant and persistent increase in consumption and output but a temporary decline in inflation. These findings suggest that the supply-side (news) interpretation of consumer confidence receives more empirical support than the demand-side (animal spirit) interpretation in our sample.

Practice and confidence in electrocardiogram interpretation among ICU nurses: A cross-sectional study

ObjectivesThis study aimed to determine practice and confidence in electrocardiogram (ECG) interpretation among intensive care unit (ICU) nurses in Fujian Province, China, and identify predictors of ECG interpretation practice. Research methodology/designA quantitative cross-sectional study was conducted between October 2021 and December 2021 among 357 respondents. SettingConducted online at twenty-one hospitals in all nine cities of Fujian Province. Main outcome measuresPurposive and convenient sampling techniques were employed in selecting hospitals and respondents, respectively. A validated and pre-tested Chinese version of the questionnaire was used in data collection. We conducted binary logistic regression to identify the predictors of ICU nurses’ ECG interpretation practice, and linear regression to analyze the relationship between ECG interpretation practice and confidence. We considered statistically significant a p-value < 0.05. ResultsThe practice mean score of the respondents was 5.54 (SD = 2.26) out of 10 points, and only 2.2 % of nurses correctly interpreted all the patient ECG strips. Few ICU nurses (25.5 %) had good ECG interpretation practice, with a confidence mean score of 2.02 (SD = 0.99) out of 4 points in their overall ability to interpret patient ECG strips. Currently working unit in comparison to cardiac ICU (emergency ICU: AOR = 5.71, 95 % CI: 1.84–17.75); previous ECG training (AOR = 2.02, 95 % CI: 1.10–3.70); source of ECG training (university/school) (AOR = 2.02, 95 % CI: 1.12–3.65); and ECG knowledge (AOR = 16.18, 95 % CI: 7.43–35.25) were significantly associated with the ECG interpretation practice. ConclusionsICU nurses’ ECG interpretation practice in the current study was relatively poor. An ECG education program is recommended to impart ICU nurses with basic ECG knowledge for enhancing good ECG interpretation practice and confidence in nursing care provision. Implications for clinical practiceGood ECG interpretation skills are paramount among ICU nurses for better patient outcomes. ECG knowledge among ICU nurses is an important predictor of effective ECG monitoring for cardiac arrhythmias. Therefore, frequent, continuouszgood practice and boost confidence in the provision of quality nursing care.

How to improve medical students’ ECG interpretation skills ? Multicenter survey and results of a comparative study evaluating a new educational approach

BackgroundLearning to interpret electrocardiograms (ECGs) is a crucial objective in medical education. Despite its importance, errors in ECGs interpretation are common, and the optimal teaching methods have not yet been clearly established.ObjectivesTo evaluate students’ confidence in ECGs analysis and their opinion on current teaching methods, and to assess the effectiveness of a new ECG educational approach.MethodsFirst, we conducted a survey on ECG learning among fourth to sixth-year medical students. Second, a 5-week multicenter comparative study was conducted with fourth-year medical students during their cardiology internship. Two different teaching methods were used, assigned by center. The first group participated in 5-minutes workshops 4 times a week using a “reversed classroom” method, supervised by a cardiologist, where students took turns selecting, presenting and discussing ECGs. The control group attended a single 2-hour face-to-face ECG course. All participants completed a 30-minute ECGs analysis test at baseline and after 5 weeks.ResultsOut of 401 survey respondents, the confidence levels in ECG interpretation were 3/5 (IQR 2–3) for routine situations and 2/5 (IQR 1–3) for emergency situations. Satisfaction with ECG teaching was low (2/5, IQR 1–3) and 96.3% of respondents favored more extensive ECG training. In the comparative study, 52 students from 3 medical schools were enrolled (control group: n = 27; workshop group: n = 25). Both groups showed significant improvement in exam scores from baseline to 5-week (33/100 ± 12/100 to 44/100 ± 12/100, p < 0.0001 for the control group and 36/100 ± 13/100 to 62/100 ± 12/100, p < 0.0001 for the workshop group). The improvement was significantly greater in the workshop group compared to the control group (+ 26 ± 11 vs. + 11 ± 6, p < 0.001).ConclusionsAmong French medical students who initially reported low confidence and insufficient skills in ECG interpretation, the workshop approach using a “reversed classroom” method was found to be more effective than conventional lecture-based teaching during cardiology internship.Graphical abstract

Innovative solutions to frontier exploration in Eastern Mediterranean salt basins

The Eastern Mediterranean region is expected to hold large undiscovered natural gas resources that could address critical energy supply needs of the surrounding countries. However, exploration is challenged due to regional geologic complexities. The combination of Messinian salt structures and diapiric shales in offshore Cyprus and Egypt often causes strong attenuation of seismic energy and severe seismic imaging illumination shadows, which lead to large uncertainty regarding subsalt reservoir presence and the underlying petroleum system assessment. As part of the efforts to solve these imaging challenges, we present innovative seismic acquisition solutions to address key exploration risks such as reservoir presence. A one-sided wide-azimuth configuration consisting of one streamer vessel and one dedicated source vessel operating under the simultaneous-source mode was used to acquire data in a cost-effective way. An 8000 in3 low-frequency source was used on both vessels to provide higher energy output in the low-frequency bands of less than approximately 4 Hz. Our preliminary results show evidence of seismic image uplift due to enhanced acquisition and processing, leading to greater confidence in interpretation, which is critical for positioning wells in future drilling campaigns. This paper highlights seismic testing results undertaken to design a large exploration-scale seismic survey in the Eastern Mediterranean and early results from the execution of that program. This will help better refine optimal design criteria for future acquisition, signal processing, and imaging in order to unlock additional resources beneath complex salt provinces and identify where additional imaging needs still exist.

Use of Cognitive Interviews in the Development of a Survey Assessing American Indian and Alaska Native Adult Perspectives on Genetics and Biological Specimens.

The cognitive interview process is a method to validate a survey instrument's face validity and enhance confidence in item interpretation, as well as a method to engage communities in the research process. Trained American Indian and Alaska Native (AIAN) interviewers conducted retrospective cognitive interviews at three AIAN communities to assess the item quality of a 131-item survey item that measures AIAN knowledge and attitudes on genetics and biological specimens. A cognitive interview process was used to assess cultural consonance, thought processes used when considering survey instructions, items and responses, and language preference of survey items in the development of a survey to assess public knowledge and attitudes on genetics. Content analysis was used to analyze interview data. Survey instructions, items and scales generated no cognitive difficulties. The participants noted being unfamiliar with terminology used to describe genetic and biological specimens. In several cases, the participants' written response in the survey and verbal response in the interview did not align. A resultant 52-item survey for use in AIAN communities was finalized. Cognitive interviewing is resource-intensive; however, ignoring community engagement during survey development results in inappropriate interpretations about culturally diverse populations such as AIAN peoples.

Diabetes self-care activities and its correlates in patients with diabetic neuropathy.

Diabetic neuropathy is the most common chronic complication observed in patients with diabetes and has significant clinical implications, such as decreased quality of life and increased morbidity and mortality rates. Studies on the factors affecting diabetes self-care activities pertaining to patients with diabetic neuropathy are limited. Therefore, a more in-depth study targeting individuals with diabetic neuropathy is required to develop patient-centred nursing interventions. This study aimed to identify diabetes self-care activities among patients with diabetic neuropathy and determine their correlates. This study employed a descriptive correlational design and the study subjects consisted of 99 patients with diabetic neuropathy. Descriptive statistics and hierarchical regression analyses were used to analyse the factors affecting diabetes self-care activities. This study follows the STROBE guidelines to ensure rigorous reporting of cross-sectional studies. Our findings revealed positive correlations between diabetes self-care activities and factors including knowledge of diabetes foot care, diabetes foot care practices, interpretation of diabetic neuropathy and foot care confidence. Foot care confidence positively correlated with diabetes foot care knowledge, practices and interpretation of neuropathy, but negatively related to diabetic stress. In determining the impact of these factors on diabetes self-care activities, hierarchical regression analysis revealed that patients with higher diabetes foot care practices and foot care confidence demonstrated higher levels of diabetes self-care activities. The study findings confirmed that diabetic foot care practices and foot care confidence significantly influenced self-care activities in patients with diabetic neuropathy. Considering these results, customizing the intervention content to match diabetic foot care practices and diabetic foot care confidence can enhance self-care activities in patients with diabetic neuropathy. Survey questionnaires were completed by patients with diabetic neuropathy in this study.

Comparing early and delayed [99mTc]Tc-MIBI SPECT/CT parathyroid scans: agreement, confidence levels, and clinical predictive factors

BackgroundParathyroid scan is an important imaging modality for localizing hyperfunctioning parathyroid tissue in patients with hyperparathyroidism. Unfortunately, whether early or delayed timing is the optimal protocol for [99mTc]Tc-MIBI SPECT/CT parathyroid remains under debate. This study aimed to evaluate the agreement and compare the confidence levels of physicians when interpreting early and delayed [99mTc]Tc-MIBI SPECT/CT parathyroid scans. Additionally, it sought to identify clinical factors that related to positive scan result. We conducted a prospective study where the early and delayed [99mTc]Tc-MIBI SPECT/CT was separately interpreted as either positive or negative. Furthermore, these interpretations were categorized based on whether they fell within more or less confidence levels of the readers and were correlated with clinical information.ResultsWe enrolled 39 patients with hyperparathyroidism with 158 possible locations of parathyroid glands. The per-location agreement between the early and delayed scans was moderate (concordant rate: 80.3%, Kappa = 0.558), and the per-patient agreement was slight (concordant rate: 71.8%, Kappa = 0.093). The confidence of interpretation was significantly higher for the delayed scans. Calcium supplementation, low serum parathyroid hormone levels, and low serum phosphate levels were associated with positive early scans. High calcium level and high parathyroid hormone levels were associated with positive delayed scans.ConclusionsOur study highlights the impact of the timing of SPECT/CT in [99mTc]Tc-MIBI parathyroid scans. The different confidence levels between early and delayed scans, along with clinical factors, imply that various factors affect parathyroid scan interpretation, and individualized scanning protocols adjusted for specific settings may be needed to optimize the successful localization of hyperfunctioning parathyroid tissue.

The Echo Report Understood: Improving Education in Echocardiography for Junior Doctors.

With echocardiography standing as the most widely used cardiac imaging modality, echocardiography report interpretation is a core responsibility of junior doctors. The literature, however, reveals a deficit in echocardiography education. The implications of this for patient care should not be ignored. To address this need, a hybrid teaching session was developed for junior (intern and resident grade) doctors, with the aim to increase understanding of echocardiography and increase confidence in report interpretation. Pre- and post-session data were analysed. Results revealed that the vast majority of respondents received less than an hour of echocardiography teaching at medical school, with over two-thirds receiving less than an hour in the postgraduate setting. A total of 80% of doctors interpreted echocardiography reports weekly, with almost all doctors perceiving this skill as important. Despite this, an overwhelming majority of doctors did not feel confident interpreting reports.The educational intervention achieved significant increases in perceived understanding of echocardiography and confidence with report interpretation. Participants were better able to identify cardiac pathology and understand report terminology. This intervention has the scope to improve patient safety through better management of cardiac patients and recognition of pathology from echocardiography. This work also identifies a need for more echocardiography education, having uncovered a concerning lack of confidence amongst junior doctors and an appetite for further teaching on this important topic.

Machine-learning-assisted seismic prediction of massive (up to 500 m) sands and their geologic meaning: Lower wilcox intraslope basins, south-central Texas, USA

We studied deep (up to 6000 m) Lower Wilcox strata (Guadalupe A) immediately above the Midway shale using a 1000-km2 3D seismic volume and sparse six deep-well, wireline-log data in south-central Texas. Although some of the wells encounter sandstones collectively as thick as 500 m, traditional seismic attributes and seismic inversion are unable to reveal the sign and extent of the massive sand distribution in the intraslope minibasins. A new workflow that incorporates machine learning into seismic lithology and geomorphology was tested for quantitative mapping of sand-content sandstone thickness. The procedure significantly updates current workflows for better geologic and reservoir prediction with higher resolution and accuracy. In addition to good fit to impedance in training wells, results tied gamma-ray and sand-content curves at a blind-test well, ensuring high confidence in stratigraphic and depositional interpretation. The study recognized multiple thick, sandy intraslope minibasins in a 30-km-wide upper slope. Clinoforms on the shelf, erosional channels at the shelf edge, sandy channels, and fans in intraslope minibasins were found to support the interpretation of a unique sediment-disposal system triggered by hyperpycnal flows. Existence of massive sand accumulations in the upper slope zone in the Gulf Coast suggest the existence of another major mechanism of large sand transport during the early Wilcox in a high sea-level stand and possibly a future deep gas play in the area.

Drug Testing Interpretation in the Peripartum Setting: Results of Clinician Survey.

The objectives of this study were to (1) survey obstetrical and pediatric clinicians' experience, confidence, and training in maternal and neonatal drug testing interpretation; (2) determine their proficiency in drug test interpretation; and (3) assess predictors of correct interpretation. We conducted a cross-sectional survey of clinicians caring for pregnant people or newborns at an urban academic center. We assessed clinicians' demographic characteristics, experience, confidence, and prior training in interpretation of maternal and newborn drug tests. We assessed proficiency in interpreting drug tests using 11 clinical vignettes and categorized scores as poor (0-2), fair (3-5), and good (≥6) performance to facilitate data interpretation. We used descriptive statistics to summarize responses. Multinomial logistic regression was used to determine associations of clinician characteristics and score category (reference category: poor performance). In total, 103 respondents completed the survey including 60 obstetrical clinicians (58.3%), 19 family medicine physicians (18.5%), 21 pediatric clinicians (20.4%), and 3 social workers (2.9%) (response rate, ~40%). The mean correct response was 4.1 (SD, 2.17; range, 0-11). Most respondent scores were fair (n = 47.6%), followed by good (n = 28.2%) and poor (n = 24.3%). Increased frequency, confidence, and training in interpreting maternal screening and confirmatory tests were associated with higher proficiency. Increased confidence and training in interpreting neonatal screening and confirmatory tests, but not frequency, were associated with higher proficiency. Most clinicians demonstrated fair proficiency in interpreting drug tests. Predictors of proficiency were confidence and prior training for drug test interpretation, suggesting that educational interventions could improve proficiency.

Comparing performance of primary care clinicians in the interpretation of SPIROmetry with or without Artificial Intelligence Decision support software (SPIRO-AID): a protocol for a randomised controlled trial

IntroductionSpirometry is a point-of-care lung function test that helps support the diagnosis and monitoring of chronic lung disease. The quality and interpretation accuracy of spirometry is variable in primary care....

Detrital zircon REE and tectonic settings

Earth's long-term history is preserved in the rock archive, yet this record is incomplete, hindering our understanding of how tectonic processes have evolved and shaped our planet's evolution. The physio-chemical resilience of zircon and its ability to be rapidly analyzed for age, isotopic, and elemental data has made it a key phase in unraveling Earth's long-term evolution. The europium anomaly (Eu/Eu*) and the differentiation degree between light and heavy rare earth elements (LREEN¯/HREEN¯) of zircons positively correlate with the pressure of magma crystallization because high pressure inhibits plagioclase crystallization and promotes garnet growth. However, this correlation can be influenced by fluctuations in redox conditions, protolith composition, and water content of magma, whose stability varies in different tectonic settings. Therefore, the correlation coefficient between Eu/Eu* and LREEN¯/HREEN¯ of detrital zircons (rDz) provides a new proxy to help distinguish tectonic settings. We evaluate this new proxy using available global detrital zircon REE data from different tectonic settings in modern and deep times. The data from well-constrained simple tectonic settings suggest that rDz is higher in convergent settings (0.53–0.85) than in collisional settings (0.12–0.51). Convergent settings can also yield relatively low rDz (0.28–0.55) when there is a contribution of a mantle plume lying below the overriding plate of a subduction zone.When studying a detrital zircon archive derived from a large distributive province that includes sources from a variety of settings, known provenance information should be used to disentangle mixed source signals. Also, only considering detrital zircon grains that formed a short time (e.g., 50 or 100 Myr) prior to deposition can reduce the likelihood of multi-cycle distal mixing of contemporaneous but tectonically distinct zircons in a sample. Additionally, greater confidence in interpretations of changes in tectonic settings may be derived from evolution patterns of rDz instead of isolated values. A decreasing trend can likely be interpreted as a transition from convergent to collisional or mantle plume settings, whereas an increasing trend implies an opposite tectonic transition.

Arterial Spin-Labeling and DSC Perfusion Metrics Improve Agreement in Neuroradiologists' Clinical Interpretations of Posttreatment High-Grade Glioma Surveillance MR Imaging-An Institutional Experience.

MR perfusion has shown value in the evaluation of posttreatment high-grade gliomas, but few studies have shown its impact on the consistency and confidence of neuroradiologists' interpretation in routine clinical practice. We evaluated the impact of adding MR perfusion metrics to conventional contrast-enhanced MR imaging in posttreatment high-grade glioma surveillance imaging. This retrospective study included 45 adults with high-grade gliomas who had posttreatment perfusion MR imaging. Four neuroradiologists assigned Brain Tumor Reporting and Data System scores for each examination on the basis of the interpretation of contrast-enhanced MR imaging and then after the addition of arterial spin-labeling-CBF, DSC-relative CBV, and DSC-fractional tumor burden. Interrater agreement and rater agreement with a multidisciplinary consensus group were assessed with κ statistics. Raters used a 5-point Likert scale to report confidence scores. The frequency of clinically meaningful score changes resulting from the addition of each perfusion metric was determined. Interrater agreement was moderate for contrast-enhanced MR imaging alone (κ = 0.63) and higher with perfusion metrics (arterial spin-labeling-CBF, κ = 0.67; DSC-relative CBV, κ = 0.66; DSC-fractional tumor burden, κ = 0.70). Agreement between raters and consensus was highest with DSC-fractional tumor burden (κ = 0.66-0.80). Confidence scores were highest with DSC-fractional tumor burden. Across all raters, the addition of perfusion resulted in clinically meaningful interpretation changes in 2%-20% of patients compared with contrast-enhanced MR imaging alone. Adding perfusion to contrast-enhanced MR imaging improved interrater agreement, rater agreement with consensus, and rater confidence in the interpretation of posttreatment high-grade glioma MR imaging, with the highest agreement and confidence scores seen with DSC-fractional tumor burden. Perfusion MR imaging also resulted in interpretation changes that could change therapeutic management in up to 20% of patients.

The bacterial and archaeal communities of flies, manure, lagoons, and troughs at a working dairy.

Fundamental investigations into the location, load, and persistence of microbes, whether beneficial or detrimental, are scarce. Many questions about the retention and survival of microbes on various surfaces, as well as the load necessary for spread, exist. To answer these questions, we must know more about where to find various microbes and in what concentrations, the composition of the microbial communities, and the extent of dissemination between various elements. This study investigated the diversity, composition, and relative abundance of the communities associated with manure, lagoons, troughs, house flies, and stable flies present at a dairy, implementing two different free-stall management systems: flow-through and cross-vent. Shotgun metagenomics at the community level was used to compare the microbiomes within the dairy, allowing confident interpretation at the species level. The results showed that there were significant difference in microbial composition between not only each of the dairy elements but also management styles. The primary exceptions were the microbiomes of the house fly and the stable fly. Their compositions heavily overlapped with one another, but interestingly, not with the other components sampled. Additionally, both species of flies carried more pathogens than the other elements of the dairy, indicating that they may not share these organisms with the other components, or that the environments offered by the other components are unsatisfactory for the survival of some pathogens.. The lack of overlapping pathogen profiles suggests a lack of transfer from flies to other dairy elements. Dairy health data, showing a low incidence of disease, suggests minimal sharing of bacteria by the flies at a level required for infection, given the health program of this dairy. While flies did carry a multitude of pathogenic bacteria, the mere presence of the bacteria associated with the flies did not necessarily translate into high risk leading to morbidity and mortality at this dairy. Thus, using flies as the sole sentinel of dairy health may not be appropriate for all bacterial pathogens or dairies.