Interclass Correlation Research Articles

Comparison of dimensions and functional features of mitral and tricuspid annuli in the same healthy adults: insights from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study.

Evaluation of mitral (MA) and tricuspid annuli (TA) in the same healthy subject in a non-invasive way in real-life clinical settings makes an opportunity to compare their dimensions and derived functional properties. The purpose of the present cohort study was to investigate whether there are any differences in the three-dimensional speckle-tracking echocardiography- (3DSTE-) measured size and derived functional characteristics of the MA and TA in the same healthy adults. The study comprised 248 healthy adults, in which 3DSTE was performed to determine MA and TA dimensions and functional properties. Due to insufficient image quality, 89 cases were excluded, therefore the remaining population consisted of 159 subjects (age: 35.6±12.9 years, 76 males). Subjects were enrolled on a voluntary basis consecutively between January 2011 and November 2017 in the outpatient clinic of the tertiary cardiology center at the Department of Medicine, University of Szeged, Hungary. Data were analyzed by Student's t-test, analysis of variance (ANOVA) test, Fischer's exact test, Pearsons' correlations, interclass correlations and Bland-Altman tests. Same-side MA/TA end-diastolic annular dilation is associated with simultaneous MA/TA end-systolic dilation and vice versa. MA dilation in end-diastole and end-systole results in MA functional improvement/deterioration. Dilation of end-diastolic TA dimensions does not obviously entail differences in TA function. However, similar to MA, more dilated TA in end-systole is associated with impaired TA function. Dilated MA dimensions (end-diastolic MA area: 4.31±0.62 vs. 10.89±1.18 cm2, P<0.05) are not obviously associated with dilated end-diastolic TA dimensions (area: 7.05±1.42 vs. 7.81±1.48 cm2, P=ns) and functional improvement/impairment (fractional area change: 27.5%±10.8% vs. 25.2%±10.6%, P=ns). Dilation of MA and TA is associated with different contralateral responses in morphology and function.

The bone trauma and soft-tissue injury classification system in total hip arthroplasty (BOSTI Hip).

The primary objective of this study was to develop a validated classification system for assessing iatrogenic bone trauma and soft-tissue injury during total hip arthroplasty (THA). The secondary objective was to compare macroscopic bone trauma and soft-tissues injury in conventional THA (CO THA) versus robotic arm-assisted THA (RO THA) using this classification system. This study included 30 CO THAs versus 30 RO THAs performed by a single surgeon. Intraoperative photographs of the osseous acetabulum and periacetabular soft-tissues were obtained prior to implantation of the acetabular component, which were used to develop the proposed classification system. Interobserver and intraobserver variabilities of the proposed classification system were assessed. The BOne trauma and Soft-Tissue Injury classification system in total Hip arthroplasty (BOSTI Hip) grades osseous acetabular trauma and periarticular muscle damage during THA. The classification system has an interclass correlation coefficient of 0.90 (95% CI 0.86 to 0.93) for interobserver agreement and 0.89 (95% CI 0.84 to 0.93) for intraobserver agreement. RO THA was associated with improved BOSTI Hip scores (p = 0.002) and more pristine osseous surfaces in the anterior superior (p = 0.001) and posterior superior (p < 0.001) acetabular quadrants compared with CO THA. There were no differences between the groups in relation to injury to the gluteus medius (p = 0.084), obturator internus (p = 0.241), piriformis (p = 0.081), superior gamellus (p = 0.116), inferior gamellus (p = 0.132), quadratus femoris (p = 0.208), and vastus lateralis (p = 0.135), but overall combined muscle injury was reduced in RO THA compared with CO THA (p = 0.023). The proposed BOSTI Hip classification provides a reproducible grading system for stratifying iatrogenic bone trauma and soft-tissue injury during THA. RO THA was associated with improved BOSTI Hip scores, more pristine osseous acetabular surfaces, and reduced combined periarticular muscle injury compared with CO THA. Further research is required to understand if these intraoperative findings translate to differences in clinical outcomes between the treatment groups.

Eliminating quantization errors in classification-based sound source localization

Sound Source Localization (SSL) involves estimating the Direction of Arrival (DOA) of sound sources. Since the DOA estimation output space is continuous, regression might be more suitable for DOA, offering higher precision. However, in practice, classification often outperforms regression, exhibiting greater robustness. Conversely, classification’s drawback is inherent quantization error. Within the classification paradigm, the DOA output space is discretized into several intervals, each treated as a class. These classes show strong inter-class correlations, being inherently ordered, with higher similarity as intervals grow closer. Nevertheless, this characteristic has not been fully exploited. To address this, we propose Unbiased Label Distribution (ULD) to eliminate quantization error in training targets. Furthermore, we introduce Weighted Adjacent Decoding (WAD) to overcome quantization error during the decoding stage. Finally, we tailor two loss functions for the soft labels: Negative Log Absolute Error (NLAE) and Mean Squared Error without activation (MSE(wo)). Experimental results show our approach surpasses classification quantization limits, achieving state-of-the-art performance. Our code and supplementary material are available at https://github.com/linfeng-feng/ULD.

Validity and reliability of the cigarette purchase task when participant cigarette consumption is unconstrained.

Hypothetical purchase tasks offer effective and efficient methods to assess the reinforcing value of various substances, including cigarettes. The purpose of the present study is to examine the validity and reliability of the Cigarette Purchase Task (CPT) in an experimental arrangement in which participants were receiving free cigarettes. Critical to the validity of the CPT is that those who smoke can accurately estimate how much they would smoke under varying economic constraints. Participants (N = 9) were provided free study cigarettes for 8 weeks. Participants completed the CPT once weekly. To examine the validity of the five CPT demand indices (i.e., demand intensity, Pmax, Omax, breakpoint, and α), we used a simple linear regression stratified by session number to model which of the five CPT demand indices were associated with the number of cigarettes smoked per day during Week 1 of the experiment. Significant associations in the hypothesized direction were noted across the five CPT indices, with the evidence for validity greatest for intensity, followed by Omax, Pmax, breakpoint, and α. To examine CPT test-retest reliability, we estimated interclass correlation coefficients between Sessions 1 and 4 and Sessions 5 and 8. All but one interclass correlation coefficient supported "good" or "excellent" reliability, with the only exception seen with the α index between Sessions 1 and 4, which was moderate reliability. Collectively, these results provide evidence supporting the construct validity and temporal stability/reliability of the CPT demand indices under conditions of limited economic constraint. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Discrepancies in ASPECTS obtained by artificial intelligence and experts: Associated factors and prognostic implications

PurposeThe differences between the Alberta Stroke Program Early CT Score (ASPECTS) obtained by experts and artificial intelligence (AI) software require elucidation. We aimed to characterize the discrepancies between the ASPECTS obtained by AI and experts and determine the associated factors and prognostic implications. MethodsThis multicenter, retrospective, observational cohort study included patients showing acute ischemic stroke caused by large-vessel occlusion in the anterior circulation. ASPECTS was determined by AI software (RAPID ASPECTS) and experts from the core laboratory. Interclass correlation coefficients (ICCs) and Bland–Altman plots were used to illustrate the consistency and discrepancies; logistic regression analyses were used to assess the correlates of inconsistency; and receiver operating characteristic analyses were performed to assess the diagnostic performance for predicting unfavorable clinical outcomes. ResultsThe study population included 491 patients. The ICC for the expert and AI ASPECTS was 0.63 (95 % confidence interval [CI]: 0.25–0.79).The mean difference between expert and AI ASPECTS was 2.24. Chronic infarcts (odds ratio [OR], 1.9; 95 % CI, 1.1–3.4; P=0.021) and expert scores in the internal capsule (OR, 2.9; 95 % CI, 1.1–7.7; P=0.034) and lentiform (OR, 2.4; 95 % CI, 1.3–4.7; P=0.008) were significant correlates of inconsistency. The ASPECTS obtained by AI showed a significantly higher area under the curve for unfavorable outcomes (0.68 vs. 0.63, P=0.04). ConclusionsIn comparison with expert ASPECTS, AI ASPECTS overestimated the infarct extent. Future studies should aim to determine whether AI ASPECTS assessments should use a lower threshold to screen patients for endovascular therapy.

More negative sagittal tibial tuberosity-trochlear groove distances are correlated with larger patellofemoral chondral lesion size.

The purpose of this study is to assess the association between sagittal tibial tuberosity-trochlear groove (sTT-TG) distance and patellofemoral chondral lesion size in patients undergoing cartilage restoration procedures. A retrospective cohort analysis of patients who underwent an osteochondral allograft transplantation or matrix-induced autologous chondrocyte implantation in the patellofemoral compartment, from 2010 to 2020, were included if they had patellofemoral high-grade lesions, magnetic resonance imaging (MRI) and minimum 2-year follow-up. The preoperative sTT-TG distance was measured independently on axial T2-weighted MRI sequences by two authors, each at least two weeks apart. Intraoperative lesion size was reported according to operative report measurements by the attending surgeon. An interclass correlation coefficient (ICC) was calculated to assess intra- and inter-rater reliability, and categorical data analysis and linear regression models were used to assess the relationship between sTT-TG and lesion size. A total of 80 patients (50 females) with a mean age of 31.5 ± 10.4 years, body mass index of 27.0 ± 5.9 kg/m2 and follow-up of 61.5 ± 21.4 months were included. A total of 107 lesions were present: 63 patients with unipolar (patella = 41, trochlea = 22) and 22 with bipolar lesions. The mean MRI defect size was 1.6 ± 1.0 cm2 and the mean intraoperative defect size was 3.8 ± 2.4cm2. Intra- (ICC: 0.99,0.98) and inter-rater reliability (ICC: 0.96) were excellent for both MRI defect size and sTT-TG measurements. The mean sTT-TG was -4.8 ± 4.9 mm and was significantly inversely related to MRI defect size (-0.45, p < 0.01), intraoperative patellar lesion size (-0.32, p = 0.01), total lesion area (-0.22, p = 0.04), but not trochlear lesion size (-0.09, p = 0.56). Multivariable regression demonstrated a more negative sTT-TG remained an independent variable correlated with larger MRI-measured patellofemoral defect sizes and intraoperative patellar lesions. A more negative sTT-TG was an independent variable correlated with larger patellofemoral lesions in patients undergoing patellofemoral cartilage restoration. Level III, Diagnostic.

Braille Smart Book with Audio Connection QR Code to Improve the Teeth-Brushing Skills of Blind Children

Background: Since one of the things that prevents blind people from learning about dental and oral health is poor eyesight, the dental and oral health of blind children is typically worse than that of persons with normal vision. The average score is 35% of children who can brush their teeth properly and correctly. Blind children have difficulty interpreting what they should do. To overcome this, the media "Braille Smart Book With Audio Connection QR Code" was created to improve the teeth brushing skills of blind children. Research Objective: To produce "Braille Smart Book With Audio Connection QR Code" media that is effective and feasible to implement to improve the teeth brushing skills of blind children. Method: Using the Research and Development (R&amp;D) method with a pre-experiment research design (One Group pre-test and post-test design). With a sample size of 20 blind children, they were given intervention with "Braille Smart Book With Audio Connection QR Code" for 10 days. Results: The media expert validated the "Braille Smart Book With Audio Connection QR Code" using the interclass correlation coefficient test and obtained a value of 0.935. "Braille Smart Book With Audio Connection QR Code" has been proven effective in improving the teeth brushing skills of blind children. Conclusion: The media "Braille Smart Book With Audio Connection QR Code" is effective in improving the teeth brushing skills of blind children.

Improving deep representation learning via auxiliary learnable target coding

Deep representation learning is a subfield of machine learning that focuses on learning meaningful and useful representations of data through deep neural networks. However, existing methods for semantic classification typically employ pre-defined target codes such as the one-hot and the Hadamard codes, which can either fail or be less flexible to model inter-class correlation. In light of this, this paper introduces a novel learnable target coding as an auxiliary regularization of deep representation learning, which can not only incorporate latent dependency across classes but also impose geometric properties of target codes into representation space. Specifically, a margin-based triplet loss and a correlation consistency loss on the proposed target codes are designed to encourage more discriminative representations owing to enlarging between-class margins in representation space and favoring equal semantic correlation of learnable target codes respectively. Experimental results on several popular visual classification and retrieval benchmarks can demonstrate the effectiveness of our method on improving representation learning, especially for imbalanced data.

Development and validation of a novel angiography-derived index of absolute coronary blood flow and resistance.

Intracoronary continuous thermodilution has been recently proposed as an invasive method to quantify absolute coronary flow (Qabs) and resistance (Rabs) in vivo. The aim of the present study is to develop and validate of a novel pressure-wire- and microcatheter-free surrogate of coronary flow and resistance derived from a standard coronary angiogram. Angiography derived coronary flow (Qangio) and resistance (Rangio) was prospectively validated in a two-center cohort of patients from Oxford Heart Centre and the Essex Cardiothoracic Centre. Qabs and Rabs were measured during resting and hyperemic conditions with continuous thermodilution using the Rayflow microcatheter. Qangio and Rangio were computed from the diagnostic coronary angiogram in a blinded fashion in resting and hyperemic conditions. A total of 62 patients and 115 vessels were included in the present analysis. The median Qabs at rest was 75ml/min (53-95) and 151ml/min (105-203) during hyperemia; Qangio at rest was 84ml/min (66-108) and 154ml/min (115-195) during hyperemia. There was a strong correlation between Qabs and Qangio (R = 0,72; p < 0.001, R = 0,86; p < 0.001 respectively) with satisfactory interclass correlation (0.841, 95% CI 0.509-0.957; p = 0.0003). The median Rabs was 1111 mmHg/(L/min) (830-1581.4) at rest and 454 mmHg/(L/min) (348-610) during hyperemia; angiographic resistance (Rangio) was 937.4 mmHg/(L/min) (695.4-1261.9) at rest and 492.4 mmHg/(L/min) (406-697) during hyperemia. There was a strong correlation between Rabs and Rangio in both conditions (R = 0,81; p < 0.001 and R = 0,78; p < 0.001 respectively). The was a good correlation between absolute coronary flow reserve (CFR) and angiography-derived CFR (R = 0,61; p < 0.001) and between absolute microvascular resistance reserve (MRR) and angiography-derived MRR (R = 0,49; p < 0.001).

An exploration of the agreement, inter- and intra-rater reliability, and reproducibility of three common methods used to measure minimum toe clearance with optical motion capture systems under three shoe conditions

BackgroundThe gait variable minimum toe clearance (MTC) has been investigated concerning trip-related fall research in older adults. However, comparing studies is difficult due to the different methods used to measure MTC and shoe conditions, which may affect agreement. Measurement methods can include using a single virtual point (SVP), multiple virtual points (MVPS), or metatarsal head markers (marker-based). The shoe types used in MTC studies include standard shoes (SS), personal shoes (PS), and barefoot (BF) conditions. Research questionWhat is the agreement, inter and intra-rater reliability, and repeatability for the 3 commonly used methods of measuring MTC (SVP, MVPS, marker-based) under the 3 shoe conditions for optical motion capture systems (SS, PS, BF)? MethodsTwelve healthy young adults (mean [SD] 23.8 [1.9] years,7 males) participated in this observational study. In a randomized order, participants completed 25 walking trials at self-selected normal and slow speeds in SS, PS, and BF conditions while infrared cameras recorded the maker trajectories. Each participant performed a familiarization trial for at least 1 minute before collecting data on each shoe condition. Statistical analyses included Bland-Altman 95 % limits of agreement (LOA) analyses, interclass correlation coefficient (ICC) analyses for inter- and intra-rater reliability, and the repeatability coefficient (RC). ResultsThe SVP and MVPS had a tighter 95 % LOA than the marker-based method, particularly under SS and BF conditions. The inter-rater reliability was good to excellent under these shoe conditions. Intra-reliability for all methods under all shoe conditions was excellent (ICC >.90). The RC was very similar for each method, with none exceeding 1.02 cm. SignificanceThe study provides estimates of the agreement between MTC methods and suggests that only SVP or MVPS produced similar results in SS/BF conditions. Additionally, a "true" change in MTC requires a difference greater than 1.02 cm.

Automated immunohistochemistry of intra-epidermal nerve fibres in skin biopsies: A proof-of-concept study.

To develop a standardised, automated protocol for detecting protein gene product 9.5 (PGP9.5) positive intra-epidermal nerve fibres (IENFs) in skin biopsies, transitioning from the established manual technique to an automated platform. This automated method, although currently intended for research applications, may improve the accessibility of this diagnostic test for small fibre neuropathy in clinical settings. Skin biopsies (n = 274) from 100 participants (fibromyalgia syndrome n = 62; idiopathic small fibre neuropathy: n = 16; healthy volunteers: n = 22) were processed using an automated immunohistochemistry platform. IENF quantification was performed by blinded examiners, with reliability assessed via a two-way mixed-effects model to evaluate inter- and intra-observer variability. The automated staining system reproduced intra-epidermal nerve fibre density (IENFD) counts consistent with free-floating sections (mean ± standard deviation: free-floating: 5.6 ± 3.4 fibres/mm; automated: 5.9 ± 3.2 fibres/mm). A median difference of 0.3 with a lower bound 95% Confidence Interval (CI) at -0.00005 established non-inferiority against a margin of -0.4 (p = .08). Specifically, the inter-class correlation coefficient (class denotes consistency in measured observations) was 99% (95% CI: 0.9-1), indicating excellent agreement between free-floating and automated methods. The inter- and intra-class coefficient between examiners were both 99% (95% CI: 0.9-0.1) for IENFD, demonstrating high reliability using sections stained using the automated method. Automated immunohistochemistry provides high-throughput reliable and reproducible intra-epidermal nerve fibre quantification. This method, although currently proof-of-concept, for research use only, may be more widely deployed in histopathology laboratories to increase the adoption of IENFD assessment for the diagnosis of peripheral neuropathies.

Detection of synovial inflammation in the sacroiliac joint space through intravoxel incoherent motion imaging: an alternative to contrast agents.

We investigated the diagnostic accuracy of simplified intravoxel incoherent motion (IVIM) imaging for detecting synovial inflammation in the sacroiliac joint (SIJ) in a population with active sacroiliitis. In accordance with the Assessment of Spondyloarthritis International Society criteria, 86 SIJs of 46 patients with active sacroiliitis were included in this retrospective study conducted between November 2020 and January 2022. Based on T1-weighted post-gadolinium images, the SIJs were divided into two groups: synovial inflammation positive (SIP) (n = 28) and synovial inflammation negative (SIN) (n = 58). Synovial areas in the SIJ space were independently and blindly reviewed for the presence of inflammation by two radiologists with differing levels of expertise in radiology. Using four b values, apparent diffusion coefficient (ADC)= ADC (0, 800) and the simplified 3T IVIM method parameters true diffusion coefficient (D1)= ADC (50, 800), D= ADC (400, 800), f1= f (0, 50, 800), f2= f (0, 400, 800), pseudodiffusion coefficient (D*)= D* (0, 50, 400, 800), ADClow = ADC (0, 50), and ADCdiff= ADClow - D were generated voxel by voxel for each patient. The IVIM and ADC parameters at the SIN and SIP joints were compared. The D parameter was significantly increased in SIP areas (1.23 ± 0.34 × 10-3 mm2/s) compared with SIN areas (1.02 ± 0.16 × 10-3 mm2/s) (P = 0.004). Conversely, the D* parameter was significantly decreased in SIP areas (21.78 ± 3.77 × 10-3 mm2/s) compared with SIN areas (16.19 ± 4.58 × 10-3 mm2/s) (P < 0.001). When the optimal cut-off value of 1.11 × 10-3 mm2/s was selected, the sensitivity for the D value was 71% and the specificity was 72% [area under the curve (AUC): 0.716)]. When the optimal cut-off value of 21.06 × 10-3 mm2/s was selected, the sensitivity for the D* value was 78.6%, and the specificity was 79.3% (AUC: 0.829). The interclass correlation coefficient was excellent for f1, f2 D*, D, and ADCdiff, good for ADClow and D1, but reasonable for ADC. The presence of synovial inflammation in the SIJ can be evaluated with high sensitivity and specificity using only four b values through the simplified IVIM method without the need for a contrast agent. IVIM imaging is a technique that allows us to gain insights into tissue perfusion without the administration of contrast agents, utilizing diffusion-weighted images. In this study, for the first time, we demonstrated the potential of detecting synovial inflammation in the SIJ using IVIM, specifically through the pseudodiffusion (D*) parameter, without the need for contrast agents.

Brazilian Portuguese Translation and Validation of the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-IUGA revised.

Condition-specific sexual questionnaires are important patient-reported outcome measures. The aim of this study was to translate and validate the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-International Urogynecology Association Revised (PISQ-IR) into Brazilian Portuguese and to clinically validate it in a Brazilian Portuguese-speaking population. Translation and validation of the PISQ-IR was performed according to the International Urogynecological Association-recommended process and guidelines. For external validity, PISQ-IR subscales were compared with the clinical measures, Pelvic Organ Prolapse Quantification system (POP-Q) stage, pelvic floor muscle tone, and Oxford Grading Scale (Pearson correlations). Descriptive statistics, internal consistency (Cronbach's alpha coefficient), and test-retest reliability (interclass correlation coefficient) were calculated for all PISQ-IR subscales. A total of 120 sexually active and 106 not sexually active women were enrolled in the study between March 2015 and July 2019. Internal consistency was acceptable, with Cronbach's alpha values 0.60-0.80, except for the sexual arousal and orgasm, sexual arousal and partner-related issues, sexual arousal and condition-specific issues, global rating of sexual quality and condition impact subscales. PISQ-IR demonstrated good reliability (α > 0.6, CIC = 0.996). The agreement for each individual questionnaire item also individually presented substantial agreement between the assessments (κ 0.61-0.8). There was a correlation between PISQ-IR and POP, mixed, stress and fecal incontinence diagnosis and a positive correlation with pelvic floor muscle function according to the Oxford Scale in sexually active women. For sexually inactive women there was a correlation between PISQ-IR and mixed urinary symptoms. The Brazilian Portuguese version of PISQ-IR is a reliable and valid tool that can be easily used for the identification and assessment of sexual function in Brazilian Portuguese-speaking women with pelvic floor disorders.

Hounsfield units in assessing bone mineral density in ankylosing spondylitis patients with cervical fracture-dislocation.

Cervical spine fracture-dislocations in patients with ankylosing spondylitis (AS) are mostly unstable and require surgery. However, osteoporosis, one of the comorbidities for AS, could lead to detrimental prognoses. There are few accurate assessments of bone mineral density in AS patients. To analyze Hounsfield units (HUs) for assessing bone mineral density in AS patients with cervical fracture-dislocation. The HUs from C2 to C7 of 51 patients obtained from computed tomography (CT) scans and three-dimensional reconstruction of the cervical spine were independently assessed by two trained spinal surgeons and statistically analyzed. Inter-reader reliability and agreement were assessed by interclass correlation coefficient. The HUs decreased gradually from C2 to C7. The mean values of the left and right levels were significantly higher than those in the middle. Among the 51 patients, 25 patients (49.02%) may be diagnosed with osteoporosis, and 16 patients (31.37%) may be diagnosed with osteopenia. The HUs obtained by cervical spine CT are feasible for assessing bone mineral density with excellent agreement in AS patients with cervical fracture-dislocation.

The Child Oral Health Impact Profile-Short Form 19 Cross-Cultural Adaptation and Validity for the Portuguese Pediatric Population.

Background/Objectives: To better understand the impact of different oral conditions on children, several instruments are available to measure oral health-related quality of life (OHRQoL). To adapt and validate cross-culturally the Child Oral Health Impact Profile-Short Form 19 (COHIP-SF19) questionnaire to the Portuguese language. Methods: The COHIP SF-19 was translated and back-translated, and tested for its reliability and for psychometric properties in children who were aged between 8 and 17 years old. The COHIP-19-PT was tested for its internal consistency, construct validity, content validity, and test-retest reliability. Results: The COHIP-19-PT revealed good internal consistency (Cronbach's alpha = 0.88) and test-retest reliability (interclass correlation = 0.78). The CFA analysis confirmed the structure of COHIP-19-PT. The first-order model showed an adequate fit: GFI = 0.878; CFI = 0.812; RMSEA = 0.083 (90% CI: 0.077-0.090). No invariance was found for the gender-based groups. The correlation between the sub-scales was also assessed, confirming significant correlations between all subdomains. Conclusions: The COHIP-19-PT is a valid and reliable scale for measuring children's oral health-related quality of life.

Approbation and validation of Russian version of the interstitial cystitis symptoms and problem index

BACKGROUND: Improving the effectiveness of diagnosing and treating patients with primary bladder pain syndrome is crucial in current urology owing to the high prevalence of the condition, its significant impact on the quality of life, and the similarity of its clinical manifestations to other diseases. The clinical manifestations of primary bladder pain syndrome is typically evaluated using specialized questionnaires, with one of the most commonly utilized being the Interstitial Cystitis Symptoms and Problem Index. AIM: This study aimed to validate the Russian version of the Interstitial Cystitis Symptoms and Problem Index and thus assess its reliability and validity in accurately measuring the symptoms and problems associated with interstitial cystitis. MATERIALS AND METHODS: The study included 62 participants and divided them into two groups. Group A included 32 patients diagnosed with primary bladder pain syndrome, comprising 26 women and 6 men, with an average age of 55 years. Group B consisted of 30 conditionally healthy volunteers, comprising 20 men and 10 women, with an average age of 46 years. All participants were required to complete the Russian version of the Interstitial Cystitis Symptoms and Problem Index, Pelvic Pain and Urgency/Frequency (PUF) scale, and International Prostate Symptom Score (IPSS) and maintain a voiding diary. Additionally, patients with PBPS underwent cystoscopy with bladder hydrodistention. Data collected from the participants were utilized to determine the internal consistency, external validity, and test–retest reliability of the questionnaires using the interclass correlation coefficient. RESULTS: The mean of the Interstitial Cystitis Symptoms and Problem Index total in group A was 31.55 ± 7.07, which significantly (p 0.001) exceeded the score of group B (2.90 ± 1.47). The Cronbach’s alpha of the total and “ICSI” and “ICPI” domains was 0.990, 0.834, and 0.854 respectively, confirming the high internal consistency of the Russian version of the Interstitial Cystitis Symptoms and Problem Index. External validity was verified by the relevant correlations with other questionnaires. Moreover, the total score of the questionnaire correlated with the clinical manifestations of primary bladder pain syndrome, the presence of Hunner’s lesions, and bladder capacity. CONCLUSIONS: The study findings indicate that the Russian version of the Interstitial Cystitis Symptoms and Problem Index exhibits good validity and reliability. Therefore, it can be recommended for use in clinical practice as an effective tool for assessing symptoms and problems associated with interstitial cystitis.

A comparison of phage susceptibility testing with two liquid high-throughput methods.

Phage therapy is a promising antibacterial strategy, especially given that drug-resistant bacterial infections are escalating worldwide. Because phages are not active against all strains of a given species, phages being considered for therapeutic use would ideally be tested against bacterial isolates from individual patients prior to administration. Standardized, clinically validated phage susceptibility testing (PST) methods are needed for assessing in vitro phage activity. This study compared two high-throughput liquid-based PST assays. The first, using the Biolog Omnilog™, assessed changes in microbial respiration leading to color changes based on a tetrazolium dye. The second, Agilent BioTek Cytation 7, assessed changes in optical density. Both used 96-well microtiter plate formats. A total of 55 diverse phages with activity against Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, or Enterococcus faecalis were studied against their respective susceptible bacterial hosts and non-susceptible controls, with susceptibility defined based on plaque assay. PST was performed by both assays in replicates, with results compared in terms of hold times (time through which bacterial growth is inhibited by phage compared to controls). Coefficients of variance and interclass correlation coefficients were used to assess inter- and intra-assay reproducibility. Based on a ≤50% coefficient of variance cutpoint, 87% of Biolog and 84% of Agilent assays were considered valid for susceptible bacteria, with 100% considered valid for non-susceptible bacteria by both systems. Using a 8 h hold time cutpoint, 100% of the results matched between the two assays. The interclass correlation coefficient showed 26% excellent agreement, 35% good agreement, and 17% moderate agreement between the two assays for susceptible isolates and 100% excellent agreement for non-susceptible isolates. Overall, the assays compared provided good/fair statistical reproducibility for the assessment of phage susceptibility.

The Knee injury and Osteoarthritis Outcome Score (KOOS) for lateral tibial plateau fractures- relevance, reliability and responsiveness.

This study aimed to evaluate the patient-reported relevance, test-retest reliability, and responsiveness for each of the five KOOS subscales in patients with lateral tibial plateau fractures. Adult patients with surgically treated lateral tibial plateau fractures (AO 41B) were included. The primary outcome measure was the KOOS subscales: Pain, Symptoms, Activity of Daily Living (ADL), Sport and Recreational Activities (Sport/rec), and kne-related Quality of Life (QOL). The KOOS was repeated at 14 and 15 days, six weeks, and 6 and 12 months. Content validity was partly evaluated by patients ranking the relevance of all the items in the KOOS, test-retest reliability by an interclass correlation coefficient, and responsiveness by effect size and based on 3 pre-defined hypotheses related the the global rating of change. Forty-one patients with a mean age of 54.8 years (ranging from 21 to 81 years) were included. The results showed an acceptable relevance of all the KOOS subscales. The test-retest reliability was moderate to high for all five subscales, with an interclass-correlation coefficient ranging from 0.6 to 0.9. At the 6- and 12-month follow-ups, the responsiveness showed large effect sizes for all the KOOS subscales, ranging from 0.9 to 2.1. Moderate to high correlations (r ≥ 0.4)was observed for the predefine hypotheses. The KOOS questionnaire showed acceptable relevance, high test-retest reliability and acceptable responsivness within one year following a lateral tibial plateau fracture. More research is needed for further validation of psychometric properties of KOOS for patients with lateral tibial plateau fractures.

Assessing the interplay of presentation and competency in online video examinations: a focus on health system science education

BackgroundThe integration of Health System Science (HSS) in medical education emphasizes mastery of competencies beyond mere knowledge acquisition. With the shift to online platforms during the COVID-19 pandemic, there is an increased emphasis on Technology Enhanced Assessment (TEA) methods, such as video assessments, to evaluate these competencies. This study investigates the efficacy of online video assessments in evaluating medical students’ competency in HSS.MethodsA comprehensive assessment was conducted on first-year medical students (n = 10) enrolled in a newly developed curriculum integrating Health System Science (HSS) into the Bachelor of Medicine program in 2021. Students undertook three exams focusing on HSS competency. Their video responses were evaluated by a panel of seven expert assessors using a detailed rubric. Spearman rank correlation and the Interclass Correlation Coefficient (ICC) were utilized to determine correlations and reliability among assessor scores, while a mixed-effects model was employed to assess the relationship between foundational HSS competencies (C) and presentation skills (P).ResultsPositive correlations were observed in inter-rater reliability, with ICC values suggesting a range of reliability from poor to moderate. A positive correlation between C and P scores was identified in the mixed-effects model. The study also highlighted variations in reliability and correlation, which might be attributed to differences in content, grading criteria, and the nature of individual exams.ConclusionOur findings indicate that effective presentation enhances the perceived competency of medical students, emphasizing the need for standardized assessment criteria and consistent assessor training in online environments. This study highlights the critical roles of comprehensive competency assessments and refined presentation skills in online medical education, ensuring accurate and reliable evaluations.

A radiomics model utilizing CT for the early detection and diagnosis of severe community-acquired pneumonia

BackgroundCommunity-Acquired Pneumonia (CAP) remains a significant global health concern, with a subset of cases progressing to Severe Community-Acquired Pneumonia (SCAP). This study aims to develop and validate a CT-based radiomics model for the early detection of SCAP to enable timely intervention and improve patient outcomes.MethodsA retrospective study was conducted on 115 CAP and SCAP patients at Southern Medical University Shunde Hospital from January to December 2021. Using the Pyradiomics package, 107 radiomic features were extracted from CT scans, refined via intra-class and inter-class correlation coefficients, and narrowed down using the Least Absolute Shrinkage and Selection Operator (LASSO) regression model. The predictive performance of the radiomics-based model was assessed through receiver operating characteristic (ROC) analysis, employing machine learning classifiers such as k-Nearest Neighbors (KNN), Support Vector Machine (SVM), Logistic Regression (LR), and Random Forest (RF), trained and validated on datasets split 7:3, with a training set (n = 80) and a validation set (n = 35).ResultsThe radiomics model exhibited robust predictive performance, with the RF classifier achieving superior precision and accuracy compared to LR, SVM, and KNN classifiers. Specifically, the RF classifier demonstrated a precision of 0.977 (training set) and 0.833 (validation set), as well as an accuracy of 0.925 (training set) and 0.857 (validation set), suggesting its superior performance in both metrics. Decision Curve Analysis (DCA) was utilized to evaluate the clinical efficacy of the RF classifier, demonstrating a favorable net benefit within the threshold ranges of 0.1 to 0.8 for the training set and 0.2 to 0.7 for the validation set.ConclusionsThe radiomics model developed in this study shows promise for early SCAP detection and can improve clinical decision-making.