Estimates Of Accuracy Research Articles

On a Stability of Non-Stationary Discrete Schemes with Respect to Interpolation Errors

The aim of this article is to analyze the efficiency and accuracy of finite-difference and finite-element Galerkin schemes for non-stationary hyperbolic and parabolic problems. The main problem solved in this article deals with the construction of accurate and efficient discrete schemes on nonuniform and dynamic grids in time and space. The presented stability and convergence analysis enables improving the existing accuracy estimates. The obtained stability results show explicitly the rate of accumulation of interpolation and projection errors that arise due to the movement of grid points. It is shown that the cases when the time grid steps are doubled or halved have different stability properties. As an additional technique to improve the accuracy of discretizations on non-stationary space grids, it is recommended to use projection operators instead of interpolation operators. This technique is used to solve a test parabolic problem. The results of specially selected computational experiments are also presented, and they confirm the accuracy of all theoretical error estimates obtained in this article.

Application of machine learning to predict unbound drug bioavailability in the brain

Purpose: Optimizing brain bioavailability is highly relevant for the development of drugs targeting the central nervous system. Several pharmacokinetic parameters have been used for measuring drug bioavailability in the brain. The most biorelevant among them is possibly the unbound brain-to-plasma partition coefficient, Kpuu,brain,ss, which relates unbound brain and plasma drug concentrations under steady-state conditions. In this study, we developed new in silico models to predict Kpuu,brain,ss.Methods: A manually curated 157-compound dataset was compiled from literature and split into training and test sets using a clustering approach. Additional models were trained with a refined dataset generated by removing known P-gp and/or Breast Cancer Resistance Protein substrates from the original dataset. Different supervised machine learning algorithms have been tested, including Support Vector Machine, Gradient Boosting Machine, k-nearest neighbors, classificatory Partial Least Squares, Random Forest, Extreme Gradient Boosting, Deep Learning and Linear Discriminant Analysis. Good practices of predictive Quantitative Structure-Activity Relationships modeling were followed for the development of the models.Results: The best performance in the complete dataset was achieved by extreme gradient boosting, with an accuracy in the test set of 85.1%. A similar estimation of accuracy was observed in a prospective validation experiment, using a small sample of compounds and comparing predicted unbound brain bioavailability with observed experimental data.Conclusion: New in silico models were developed to predict the Kpuu,brain,ss of drug candidates. The dataset used in this study is publicly disclosed, so that the models may be reproduced, refined, or expanded, as a useful tool to assist drug discovery processes.

An examination of point-particle Lagrangian simulations for assessing time-resolved hydroacoustic particle flux measurements in sediment-laden flows.

Accurate modelling and prediction of sediment transport in aquatic environments is essential for sustainable coastal and riverine management. Current capabilities rely on physical process-based numerical models and fine-scale sediment flux measurements. High-resolution hydroacoustic instrumentation has emerged as a promising tool for such measurements. However, challenges arise due to the inherent complexity of ultrasound scattering processes. This study introduces a numerical modelling using a point-particle approach to simulate the echoes backscattered by such instrumentation in sediment-laden flow conditions. The model considers geometric, statistical, particle cloud, and flow-induced effects on sediment velocity, concentration, and flux estimates using an acoustic concentration and velocity profiler as a reference. The model performance is assessed here under unidirectional constant flow conditions in terms of velocity, concentration, and time-resolved sediment flux estimates for a large range of the particles' advection speed and sampled volume sizes. Application to the estimation of the measurement accuracy of sediment flux in these flows is also considered, with a final error on the flux seen to be partially controlled by the residence time of particles within the sampled volumes. The proposed model provides insights into scattering processes and offers a tool for investigating robust sediment flux estimation techniques in various flow conditions.

Построение краткосрочного прогноза количества вагонов на станции и путях необщего пользования

Objective: collect raw data for building predictive models. Analyze the initial data, identify data outliers and outliers, divide the data into time intervals, calculate correlation coefficients, partial autocorrelation, cross-correlation, analyze the trend and seasonality of the obtained time series. Using autoregressive models, machine learning models, neuro-fuzzy models to build forecasts of time series and determine the quality of the obtained forecasts. Methods: point density, autocorrelation, partial autocorrelation, cross-correlation, Foster-Stewart test, Dickey-Fuller test, ARMA, MLP, Encoder-Decoder LTSM, TSK, Fuzzy-Partitions, SCRG, Transformers. Results: we obtained estimates of the prediction accuracy of the selected models, compared the results of the predictive models trained on different samples of initial data. Conclusions are made about the efficiency and methods of building predictive models. Practical significance: the 
 significance of building accurate predictive models for the key quantitative indicators of stations and nonpublic routes operation is shown. The factors influencing the accuracy of the obtained forecasts are analyzed.

The psychometric properties of the Arabic version of the dieting beliefs scale (DBS)

BackgroundThere are relatively few data about the association between locus of control and weight loss in Arabic populations. A tool does exist, the Dieting Belief Scale (DBS), that was designed to measure individuals’ beliefs regarding their ability to control their body weight. The aim of this study was to translate this tool into Arabic and to evaluate its psychometric properties. MethodsThe forward translation of the DBS from English to Arabic was completed by two professional bilingual translators, while the back translation from Arabic to English was independently performed by another two different professional bilingual translators. An online survey using the tool was then completed by 245 participants, fully aware of the study's purpose. Psychometric analyses were subsequently conducted to assess the reliability and validity of the Arabic DBS.Internal consistency was examined using Cronbach's α and McDonald's ω coefficients. Test-retest reliability was also assessed. Confirmatory factor analysis was employed to evaluate the fit of a three-factor model, with indices including Comparative Fit Index (CFI), Tucker Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA), and Standardized Root Mean Square Residual (SRMR). Convergent validity was assessed by examining the correlation between the Arabic DBS and the Eating Attitude Test (EAT-26) previously translated into Arabic, the latter identifying attitudes, feelings and behaviors related to eating. ResultsThe Arabic translated DBS scale demonstrated high translation accuracy and content validity estimates. Cronbach's α and McDonald's ω reliability coefficients for the translated scale were approximately 0.91. Test-retest reliability was 0.96. The three-factor model showed an acceptable fit (CFI = 0.93, TLI = 0.92, RMSE = 0.08, SRMR = 0.06). The Arabic version of the DBS was found to have good convergent validity, as evidenced by the significant correlation between the EAT-26 and DBS questionnaires (r = 0.53, p < 0.01). ConclusionThe Arabic version of the DBS is highly reliable and has sufficient content validity to measure belief about personal ability to control one's weight.

Examining the effects of pleasantness ratings on correct and false recognition in the DRM paradigm: accuracy, recollection and familiarity estimates.

Distinctive encoding usually increases correct recognition while also producing a reduction in false recognition. In the Deese-Roediger-McDermott (DRM) illusion this phenomenon, called the mirror effect, occurs when participants focus on unique features of each of the words in the study list. In previous studies, the pleasantness rating task, used to foster distinctive encoding, generated different patterns of results. The main aim of our research is to examine under what circumstances this task can produce the mirror effect in the DRM paradigm, based on evidence from recognition accuracy and subjective retrieval experience. In Experiment 1, a standard version (word pleasantness rating on a 5-point Likert-type scale) was used for comparison with two other encoding conditions: shallow processing (vowel identification) and a read-only control. The standard task, compared to the other conditions, increased correct recognition, but did not reduce false recognition, and this result may be affected by the number of lists presented for study. Therefore, in experiment 2, to minimize the possible effect of the so-called retention size, the number of studied lists was reduced. In addition, the standard version was compared with a supposedly more item-specific version (participants rated the pleasantness of words while thinking of a single reason for this), also including the read-only control condition. In both versions of the pleasantness rating task, more correct recognition is achieved compared to the control condition, with no differences between the two versions. In the false recognition observed here, only the specific pleasantness rating task achieved a reduction relative to the control condition. On the other hand, the subjective retrieval experience accompanied correct and false recognition in the various study conditions. Although the standard pleasantness rating task has been considered to perform item-specific processing, our results challenge that claim. Furthermore, we propose a possible boundary condition of the standard task for the reduction of false recognition in the DRM paradigm.

Probabilistic state estimation in district heating grids using deep neural network

Probabilistic state estimation is critical for operating and controlling district heating grids efficiently. However, computational bottlenecks of traditional solvers limit the feasibility of uncertainty-aware Bayesian estimation. This paper proposes using deep neural networks (DNNs) to enable fast and accurate posterior estimation. Fully-connected neural networks (FCNNs), convolutional neural networks (CNNs), and recurrent neural networks (RNNs) are evaluated as candidate approximators of the physical model. Markov chain Monte Carlo sampling in the heat exchange space is leveraged to generate posterior samples. Experiments on a benchmark heating grid demonstrate FCNNs can efficiently learn the mapping from heat exchanges to network states. A FCNN trained on 20 training epochs after hyperparameter optimization provides the best approximation accuracy and uncertainty estimates, outperforming prior methods based on Deep Neural Networks. The results highlight the potential of data-driven deep learning models for probabilistic state estimation. The proposed framework could enable real-time uncertainty-aware control and decision-making for future intelligent district heating grids.

Reliability, validity and acceptability of an online clinical reasoning simulator for medical students: An international pilot

Introduction Clinical reasoning skills are essential for decision-making. Current assessment methods are limited when testing clinical reasoning and management of uncertainty. This study evaluates the reliability, validity and acceptability of Practicum Script, an online simulation-based programme, for developing medical students’ clinical reasoning skills using real-life cases. Methods In 2020, we conducted an international, multicentre pilot study using 20 clinical cases with 2457 final-year medical students from 21 schools worldwide. Psychometric analysis was performed (n = 1502 students completing at least 80% of cases). Classical estimates of reliability for three test domains (hypothesis generation, hypothesis argumentation and knowledge application) were calculated using Cronbach’s alpha and McDonald’s omega coefficients. Validity evidence was obtained by confirmatory factor analysis (CFA) and measurement alignment (MA). Items from the knowledge application domain were analysed using cognitive diagnostic modelling (CDM). Acceptability was evaluated by an anonymous student survey. Results Reliability estimates were high with narrow confidence intervals. CFA revealed acceptable goodness-of-fit indices for the proposed three-factor model. CDM analysis demonstrated good absolute test fit and high classification accuracy estimates. Student survey responses showed high levels of acceptability. Conclusion Our findings suggest that Practicum Script is a useful resource for strengthening students’ clinical reasoning skills and ability to manage uncertainty.

The CT revolution: the role of PIOPED II in establishing CT pulmonary angiography as the reference standard for pulmonary embolism diagnosis.

The PIOPED II study provided a robust estimate of the diagnostic accuracy of multidetector CTPA in suspected pulmonary embolism and played a pivotal role in establishing CTPA as the current diagnostic gold standard https://bit.ly/3HEyVxy.

Validated, Quantitative, Machine Learning-Generated Neurologic Assessment of Multiple Sclerosis Using a Mobile Application.

The BeCare MS Link mobile app collects data as users complete different in-app assessments. It was specifically developed to evaluate the symptomatology and neurologic function of patients with multiple sclerosis (MS) and to become a digital equivalent of the Expanded Disability Status Scale (EDSS) and other standard clinical metrics of MS progression. Our research compared EDSS scores derived from the BeCare MS link app to EDSS scores derived from neurologist assessment for the same cohort of 35 patients diagnosed with MS. App-derived data were supplied to 4 different machine learning algorithms (MLAs) with an independent EDSS score prediction generated from each. These scores were compared with the clinically derived EDSS score to assess the similarity of the scores and to determine an accuracy estimate for each. Of the 4 MLAs employed, the most accurate MLA produced 19 EDSS score predictions that exactly matched the clinically derived scores, 21 score predictions within 0.5 EDSS points, and 32 score predictions within 1 EDSS point. The remaining MLAs also provided a relatively high level of accuracy in predicting EDSS scores when compared with clinically derived EDSS, with over 80% of scores predicted within 1 point and a mean squared error with a range of 1.05 to 1.37. The BeCare MS Link app can replicate the clinically derived EDSS assessment of a patient with MS. The app may also offer a more complete evaluation of disability in patients with MS.

Estimating and Assessing Monthly Water Level Changes of Reservoirs and Lakes in Jiangsu Province Using Sentinel-3 Radar Altimetry Data

Generating accurate monthly estimations of water level fluctuations in reservoirs and lakes is crucial for supporting effective water resource management and protection. The dual-satellite configuration of Sentinel-3 makes it possible to monitor water level changes with great coverage and short time intervals. However, the potential of Sentinel-3’s Synthetic Aperture Radar Altimetry (SRAL) data to enable operational monitoring of water levels across Jiangsu Province on a monthly basis has not yet been fully explored. This study demonstrated and validated the use of Sentinel-3’s SRAL to generate accurate monthly water level estimations needed to inform water management strategies. The monthly water levels of lakes and reservoirs from 2017 to 2021 were produced using Sentinel-3 level-2 land products. Results showed that, compared with in situ data across eight studied lakes, all lakes presented R (Pearson correlation coefficient) values greater than 0.5 and Root Mean Square Error (RMSE) values less than 1 m. Notably, water level estimates for Tai Lake, Gaoyou Lake, and Luoma Lake were particularly accurate, with R above 0.9 and RMSE below 0.5 m. Furthermore, the monthly water level estimates derived from the Sentinel-3 data showed consistent seasonal trends over the multi-year study period. The annual water level of all lakes did not change significantly, except for Shijiu Lake, of which the difference between the highest and lowest water level was up to about 5 m. Our findings confirmed the water level observation ability of Sentinel-3. The accuracy of water level monitoring could be influenced by internal water level differences, terrain features, as well as the area and shape of the lake. Larger lakes with more altimetry sampling points tended to yield higher accuracy estimates of water level fluctuations. These results demonstrate that the frequent, wide-area coverage offered by this satellite platform provides valuable hydrological information, especially across remote regions lacking in situ data. Sentinel-3 has immense potential to support improved water security in data-scarce regions.

Toward Generalizable Machine Learning Models in Speech, Language, and Hearing Sciences: Estimating Sample Size and Reducing Overfitting.

Many studies using machine learning (ML) in speech, language, and hearing sciences rely upon cross-validations with single data splitting. This study's first purpose is to provide quantitative evidence that would incentivize researchers to instead use the more robust data splitting method of nested k-fold cross-validation. The second purpose is to present methods and MATLAB code to perform power analysis for ML-based analysis during the design of a study. First, the significant impact of different cross-validations on ML outcomes was demonstrated using real-world clinical data. Then, Monte Carlo simulations were used to quantify the interactions among the employed cross-validation method, the discriminative power of features, the dimensionality of the feature space, the dimensionality of the model, and the sample size. Four different cross-validation methods (single holdout, 10-fold, train-validation-test, and nested 10-fold) were compared based on the statistical power and confidence of the resulting ML models. Distributions of the null and alternative hypotheses were used to determine the minimum required sample size for obtaining a statistically significant outcome (5% significance) with 80% power. Statistical confidence of the model was defined as the probability of correct features being selected for inclusion in the final model. ML models generated based on the single holdout method had very low statistical power and confidence, leading to overestimation of classification accuracy. Conversely, the nested 10-fold cross-validation method resulted in the highest statistical confidence and power while also providing an unbiased estimate of accuracy. The required sample size using the single holdout method could be 50% higher than what would be needed if nested k-fold cross-validation were used. Statistical confidence in the model based on nested k-fold cross-validation was as much as four times higher than the confidence obtained with the single holdout-based model. A computational model, MATLAB code, and lookup tables are provided to assist researchers with estimating the minimum sample size needed during study design. The adoption of nested k-fold cross-validation is critical for unbiased and robust ML studies in the speech, language, and hearing sciences. https://doi.org/10.23641/asha.25237045.

Protein structure accuracy estimation using geometry-complete perceptron networks.

Estimating the accuracy of protein structural models is a critical task in protein bioinformatics. The need for robust methods in the estimation of protein model accuracy (EMA) is prevalent in the field of protein structure prediction, where computationally-predicted structures need to be screened rapidly for the reliability of the positions predicted for each of their amino acid residues and their overall quality. Current methods proposed for EMA are either coupled tightly to existing protein structure prediction methods or evaluate protein structures without sufficiently leveraging the rich, geometric information available in such structures to guide accuracy estimation. In this work, we propose a geometric message passing neural network referred to as the geometry-complete perceptron network for protein structure EMA (GCPNet-EMA), where we demonstrate through rigorous computational benchmarks that GCPNet-EMA's accuracy estimations are 47% faster and more than 10% (6%) more correlated with ground-truth measures of per-residue (per-target) structural accuracy compared to baseline state-of-the-art methods for tertiary (multimer) structure EMA including AlphaFold 2. The source code and data for GCPNet-EMA are available on GitHub, and a public web server implementation is freely available.

Systematic review and meta-analysis of diagnostic test accuracy of ST-segment elevation for acute coronary occlusion

ObjectiveTo evaluate the diagnostic sensitivity and specificity of ST-segment elevation on a 12‑lead ECG in detecting ACO across any coronary artery, challenging the current STEMI-NSTEMI paradigm. MethodsStudies from MEDLINE and Scopus (2012−2023) comparing ECG findings with coronary angiograms were systematically reviewed and analyzed following PRISMA-DTA guidelines. QUADAS-2 assessed the risk of bias. Study selectionStudies included focused on AMI patients and provided data enabling the construction of contingency tables for sensitivity and specificity calculation, excluding those with non-ACS conditions, outdated STEMI criteria, or a specific focus on bundle branch blocks or other complex diagnoses. Data were extracted systematically and pooled test accuracy estimates were computed using MetaDTA software, employing bivariate analyses for within- and between-study variation. The primary outcomes measured were the sensitivity and specificity of ST-segment elevation in detecting ACO. ResultsThree studies with 23,704 participants were included. The pooled sensitivity of ST-segment elevation for detecting ACO was 43.6% (95% CI: 34.7%–52.9%), indicating that over half of ACO cases may not exhibit ST-segment elevation. The specificity was 96.5% (95% CI: 91.2%–98.7%). Additional analysis using the OMI-NOMI strategy showed improved sensitivity (78.1%, 95% CI: 62.7%–88.3%) while maintaining similar specificity (94.4%, 95% CI: 88.6%–97.3%). ConclusionThe findings reveal a significant diagnostic gap in the current STEMI-NSTEMI paradigm, with over half of ACO cases potentially lacking ST-segment elevation. The OMI-NOMI strategy could offer an improved diagnostic approach. The high heterogeneity and limited number of studies necessitate cautious interpretation and further research in diverse settings.

Ground Truth in Classification Accuracy Assessment: Myth and Reality

The ground reference dataset used in the assessment of classification accuracy is typically assumed implicitly to be perfect (i.e., 100% correct and representing ground truth). Rarely is this assumption valid, and errors in the ground dataset can cause the apparent accuracy of a classification to differ greatly from reality. The effect of variations in the quality in the ground dataset and of class abundance on accuracy assessment is explored. Using simulations of realistic scenarios encountered in remote sensing, it is shown that substantial bias can be introduced into a study through the use of an imperfect ground dataset. Specifically, estimates of accuracy on a per-class and overall basis, as well as of a derived variable, class areal extent, can be biased as a result of ground data error. The specific impacts of ground data error vary with the magnitude and nature of the errors, as well as the relative abundance of the classes. The community is urged to be wary of direct interpretation of accuracy assessments and to seek to address the problems that arise from the use of imperfect ground data.

Genomic selection accelerates genetic improvement of resistance to Vibriosis in the Pacific oyster, Crassostrea gigas

Due to lack of acquired immune system, the oysters cultured along coasts are subject to frequent pathogen threats, which leads to severe disease outbreaks around the world. It's well recognized that the selection breeding of aquatic animals can be accelerated via the harnessing of genomic tools to increase genetic gain and shorten the breeding time. In this work, we carried out genomic selection breeding in the Pacific oysters (Crassostrea gigas) for genetic improvement of resistance to Vibriosis. The genome-wide variations were genotyped by ddRAD-seq from 295 oysters with contrasted resistance to Vibrio infection. Based on genome-wide SNPs, we performed an estimation of genomic heritability and prediction accuracy for resistance to Vibrio alginolyticus in C. gigas. The genomic heritability of resistance to V. alginolyticus was low to moderate, ranging from 0.1405 to 0.2730. Four genomic selection models including rrBLUP, Bayes A, Bayes B and Bayesian Lasso were evaluated, of which Bayes A showed superior prediction accuracy and computational speed. The genomic estimated breeding value (GEBV) calculated by genomic selection model can effectively distinguish the resistance or susceptibility of oysters to Vibriosis. Selection of individuals with high GEBV as broodstock greatly improved the resistance to Vibriosis of their progeny, resulting in 18.42% increase in relative survival rate and 12.73% increase in relative survival time compared to the control population. For the first time, this work reported the efficiency of genomic selection breeding for genetic improvement for resistance trait to Vibriosis in the C. gigas, which would greatly accelerate the cultivation of Vibriosis resistant oyster strains to support the healthy and sustainable development of aquaculture.

The Spatially Adaptable Filter for Error Reduction (SAFER) Process: Remote Sensing-Based LANDFIRE Disturbance Mapping Updates

LANDFIRE (LF) has been producing periodic spatially explicit vegetation change maps (i.e., LF disturbance products) across the entire United States since 1999 at a 30 m spatial resolution. These disturbance products include data products produced by various fire programs, field-mapped vegetation and fuel treatment activity (i.e., events) submissions from various agencies, and disturbances detected by the U.S. Geological Survey Earth Resources Observation and Science (EROS)-based Remote Sensing of Landscape Change (RSLC) process. The RSLC process applies a bi-temporal change detection algorithm to Landsat satellite-based seasonal composites to generate the interim disturbances that are subsequently reviewed by analysts to reduce omission and commission errors before ingestion them into LF’s disturbance products. The latency of the disturbance product is contingent on timely data availability and analyst review. This work describes the development and integration of the Spatially Adaptable Filter for Error Reduction (SAFER) process and other error and latency reduction improvements to the RSLC process. SAFER is a random forest-based supervised classifier and uses predictor variables that are derived from multiple years of pre- and post-disturbance Landsat band observations. Predictor variables include reflectance, indices, and spatial contextual information. Spatial contextual information that is unique to each contiguous disturbance region is parameterized as Z scores using differential observations of the disturbed regions with its undisturbed neighbors. The SAFER process was prototyped for inclusion in the RSLC process over five regions within the conterminous United States (CONUS) and regional model performance, evaluated using 2016 data. Results show that the inclusion of the SAFER process increased the accuracies of the interim disturbance detections and thus has potential to reduce the time needed for analyst review. LF does not track the time taken by each analyst for each tile, and hence, the relative effort saved was parameterized as the percentage of 30 m pixels that are correctly classified in the SAFER outputs to the total number of pixels that are incorrectly classified in the interim disturbance and are presented. The SAFER prototype outputs showed that the relative analysts’ effort saved could be over 95%. The regional model performance evaluation showed that SAFER’s performance depended on the nature of disturbances and availability of cloud-free images relative to the time of disturbances. The accuracy estimates for CONUS were inferred by comparing the 2017 SAFER outputs to the 2017 analyst-reviewed data. As expected, the SAFER outputs had higher accuracies compared to the interim disturbances, and CONUS-wide relative effort saved was over 92%. The regional variation in the accuracies and effort saved are discussed in relation to the vegetation and disturbance type in each region. SAFER is now operationally integrated into the RSLC process, and LANDFIRE is well poised for annual updates, contingent on the availability of data.

Procalcitonin for the diagnosis of postoperative bacterial infection after adult cardiac surgery: a systematic review and meta-analysis

Background and aimsPatients undergoing cardiac surgery are subject to infectious complications that adversely affect outcomes. Rapid identification is essential for adequate treatment. Procalcitonin (PCT) is a noninvasive blood test that could serve this purpose, however its validity in the cardiac surgery population is still debated. We therefore performed a systematic review and meta-analysis to estimate the accuracy of PCT for the diagnosis of postoperative bacterial infection after cardiac surgery.MethodsWe included studies on adult cardiac surgery patients, providing estimates of test accuracy. Search was performed on PubMed, EmBase and WebOfScience on April 12th, 2023 and rerun on September 15th, 2023, limited to the last 10 years. Study quality was assessed with the QUADAS-2 tool. The pooled measures of performance and diagnostic accuracy, and corresponding 95% Confidence Intervals (CI), were calculated using a bivariate regression model. Due to the variation in reported thresholds, we used a multiple-thresholds within a study random effects model for meta-analysis (diagmeta R-package).ResultsEleven studies were included in the systematic review, and 10 (2984 patients) in the meta-analysis. All studies were single-center with observational design, five of which with retrospective data collection. Quality assessment highlighted various issues, mainly concerning lack of prespecified thresholds for the index test in all studies. Results of bivariate model analysis using multiple thresholds within a study identified the optimal threshold at 3 ng/mL, with a mean sensitivity of 0.67 (0.47–0.82), mean specificity of 0.73 (95% CI 0.65–0.79), and AUC of 0.75 (IC95% 0.29–0.95). Given its importance for practice, we also evaluated PCT’s predictive capability. We found that positive predictive value is at most close to 50%, also with a high prevalence (30%), and the negative predictive value was always > 90% when prevalence was < 20%.ConclusionsThese results suggest that PCT may be used to help rule out infection after cardiac surgery. The optimal threshold of 3 ng/mL identified in this work should be confirmed with large, well-designed randomized trials that evaluate the test’s impact on health outcomes and on the use of antibiotic therapy.PROSPERO Registration number CRD42023415773. Registered 22 April 2023.Graphical abstract

Diagnosis of human leptospirosis: systematic review and meta-analysis of the diagnostic accuracy of the Leptospira microscopic agglutination test, PCR targeting Lfb1, and IgM ELISA to Leptospira fainei serovar Hurstbridge

BackgroundLeptospirosis is an underdiagnosed infectious disease with non-specific clinical presentation that requires laboratory confirmation for diagnosis. The serologic reference standard remains the microscopic agglutination test (MAT) on paired serum samples. However, reported estimates of MAT’s sensitivity vary. We evaluated the accuracy of four index tests, MAT on paired samples as well as alternative standards for leptospirosis diagnosis: MAT on single acute-phase samples, polymerase chain reaction (PCR) with the target gene Lfb1, and ELISA IgM with Leptospira fainei serovar Hurstbridge as an antigen.MethodsWe performed a systematic review of studies reporting results of leptospirosis diagnostic tests. We searched eight electronic databases and selected studies that tested human blood samples and compared index tests with blood culture and/or PCR and/or MAT (comparator tests). For MAT selection criteria we defined a threshold for single acute-phase samples according to a national classification of leptospirosis endemicity. We used a Bayesian random-effect meta-analysis to estimate the sensitivity and specificity of MAT in single acute-phase and paired samples separately, and assessed risk of bias using the Quality Assessment of Studies of Diagnostic Accuracy Approach- 2 (QUADAS-2) tool.ResultsFor the MAT accuracy evaluation, 15 studies were included, 11 with single acute-phase serum, and 12 with paired sera. Two included studies used PCR targeting the Lfb1 gene, and one included study used IgM ELISA with Leptospira fainei serovar Hurstbridge as antigen. For MAT in single acute-phase samples, the pooled sensitivity and specificity were 14% (95% credible interval [CrI] 3–38%) and 86% (95% CrI 59–96%), respectively, and the predicted sensitivity and specificity were 14% (95% CrI 0–90%) and 86% (95% CrI 9–100%). Among paired MAT samples, the pooled sensitivity and specificity were 68% (95% CrI 32–92%) and 75% (95% CrI 45–93%) respectively, and the predicted sensitivity and specificity were 69% (95% CrI 2–100%) and 75% (2–100%).ConclusionsBased on our analysis, the accuracy of MAT in paired samples was not high, but it remains the reference standard until a more accurate diagnostic test is developed. Future studies that include larger numbers of participants with paired samples will improve the certainty of accuracy estimates.

Exploring the Ability of Educators to Identify Behaviors Indicative of Emerging Psychopathologies in Elementary School Students: Assessing the Use of a Novel Vignette Measure.

The present study sought to assess the ability of teachers to identify emerging mental health disorders through a novel vignette measure. Canadian certified primary grade teachers (N = 101) completed a survey that included a novel vignette measure. Participants rated the severity of fictitious student behaviors depicted in several vignettes and their accuracy was calculated based on how closely their ratings matched the severity of symptoms depicted. Accuracy estimates derived through this measure differed considerably from previous vignette measure paradigms, producing much lower estimates of identification accuracy. A binomial logistics regression indicated that neither the gender nor pathology depicted in the vignettes significantly influenced rating accuracy. This novel vignette measure may represent a quick and effective means of assessing the accuracy of teachers in identifying emerging mental health disorders in their students.