Intercorrelation Coefficient Research Articles

Microvascular flow imaging of fibroids: A prospective pilot study.

Imaging fibroid vascularity may predict fibroid growth and aid to determine most appropriate therapy. Microvascular (MV) flow imaging is relatively new and is able to detect slow flow in small vessels. Data on feasibility, reproducibility, and reliability of MV-flow imaging in fibroids is lacking. The purpose of our study was to determine the reproducibility of MV-flow imaging and to explore this technique for clinical practice for assessing blood flow in fibroids. Thirty patients with one or multiple fibroids (diameter 1.5-12.0 cm) were prospectively included. Transvaginal ultrasound scanning was performed in B-mode, 2D MV-Flow™, 2D and 3D power Doppler mode (HERA W10, Samsung) by two experienced gynecologists at a tertiary care clinic from February to December 2021. The primary outcome was intra- and interobserver agreement of the vascular index (VI) and color score (CS). The following parameters: '2D MV-flow VI', '3DPD VI', '2D MV-flow CS' and '2DPD CS' were measured offline in the center, pseudocapsule, and entire fibroid. Secondary offline outcomes for exploring 2D MV-flow for clinical practice, included (1) ability to discern vascular structures, (2) assessing the degree of vascularity via CS and calculating a VI, and (3) determining penetration depth of the ultrasound signal in both power Doppler and MV-flow imaging. All scans of the 30 included patients were of sufficient quality to analyze. Inter- and intra-observer correlations of all studied parameters were good to excellent, both for 2D MV-flow and 2D power Doppler (intercorrelation coefficient 0.992-0.996). Using 2D MV-flow different vascular structures were visible in detail, in contrary to using 2D and 3D power Doppler. In significantly more fibroids central flow could be visualized using 2D MV-flow (63%) than with 2D power Doppler (13%,p = 0.001). Finally, penetration of the ultrasound signal was deeper using 2D MV-flow (3.92 cm) than with 2D power Doppler (2.95 cm, p = 0.001). Using 2D MV-flow imaging for determining vascularity is highly reproducible. It has potential added value for clinical practice as it depicts detailed vascular structures and the degree of vascularity, especially in the center of the fibroid.

Validity and reliability study of the Mediterranean Lifestyle Index: Turkish adaptation

ObjectiveThe Mediterranean Lifestyle Index (MEDLIFE) differs from similar scales in that it concurrently includes diet and lifestyle. The current study translated MEDLIFE into Turkish, and assessed its reliability and validity. MethodsA questionnaire was administered to 300 individuals 19–65 years of age. The questionnaire was subsequently re-administered to 87 research participants. The questionnaire, asking for general information, MEDLIFE, and information regarding anthropometric measurements, was sent to the users of an online platform. The scale was converted into the applicable Turkish form by an expert group. Test-retest reliability was evaluated with the intraclass correlation coefficient (ICC). In addition, kappa coefficients (k) and Bland–Altman graphs were determined for each item to assess reliability. ResultsThe mean scores before and after were 14.5 ± 3.68 and 14.3 ± 3.81, respectively, and the intercorrelation coefficient r was 0.817 for test-re-test reliability. ConclusionThe validity and reliability of the scale in the Turkish language was confirmed. This study is the first to translate MEDLIFE into another language and may aid in assessing the scale's adaptability to other languages. Food consumption record and physical activity record studies must be performed to ensure validity.

The repeatability of periodontal imaging with intraoral ultrasound scanning.

Ultrasound is a non-invasive and low-cost diagnostic tool widely used in medicine. Recent studies have demonstrated that ultrasound imaging might have the potential to be used intraorally to assess the periodontium by comparing it to current imaging methods. This study aims to characterize the repeatability of intraoral periodontal ultrasound imaging. Two hundred and twenty-three teeth were scanned from fourteen volunteers participating in this study. One operator conducted all the scans in each tooth thrice with a 20MHz intraoral ultrasound. The repeatability of three measurements, alveolar bone crest to the cementoenamel junction (ABC-CEJ), gingival thickness (GT), and alveolar bone thickness (ABT), was calculated with intercorrelation coefficient (ICC). Measurements were also compared with mean absolute deviation (MAD), repeatability coefficient (RC), and descriptive statistics. ICC scores for intra-rater repeatability were 0.917(0.897,0.933), 0.849(0.816,0.878), and 0.790(0.746,0.898), MAD results were 0.610mm (± 0.508), 0.224 (± 0.200), and 0.067 (± 0.060), and RC results were 0.648, 0.327, and 0.121 for ABC-CEJ, GT, and ABT measurements, respectively. Results of the present study pointed towards good or excellent repeatability of ultrasound as a measurement tool for periodontal structures. Clinicians could benefit from the introduction of a novel chairside diagnostic tool. Ultrasound is a non-invasive imaging assessment tool for the periodontium with promising results in the literature. Further validation, establishment of scanning protocols, and commercialization are still needed before ultrasound imaging is available for clinicians.

Pre-operative prediction of post-operative urinary retention in lumbar surgery: a prospective validation of machine learning model.

Predicting urinary retention is difficult. The aim of this study is to prospectively validate a previously developed model using machine learning techniques. Patients were recruited from pre-operative clinic. Prediction of urinary retention was completed pre-operatively by 4 individuals and compared to ground truth POUR outcomes. Inter-rater reliability was calculated with intercorrelation coefficient (2,1). 171 patients were included with age 63 ± 14years, 58.5% (100/171) male, BMI 30.4 ± 5.9kg/m2, American Society of Anesthesiologists class 2.6 ± 0.5, 1.7 ± 1.0 levels, 56% (96/171) fusions. The observed rate of POUR was 25.7%. The model's performance was found to be 0.663 (0.567-0.759). With a regression model probability cutoff of 0.24 and a neural network cutoff of 0.23, the following predictive power was achieved: specificity 90.6%, sensitivity 22.7%, negative predictive value 77.2%, positive predictive value 45.5%, and accuracy 73.1%. Intercorrelation coefficient for the regression aspect of the model was found to be 0.889 and intercorrelation coefficient for the neural network aspect of the model was found to be 0.874. This prospective study confirms performance of the prediction model for POUR developed with retrospective data, showing great correlation. This supports the use of machine learning techniques in the prediction of postoperative complications such as urinary retention.

The Validity and Applicability of the Revised Delirium Rating Scale (DRS-R98) for Delirium Severity Assessment in a Critical Care Setting.

Delirium is a neuropsychiatric syndrome common in critical illness. Worsening delirium severity is associated with poorer clinical outcomes, yet its assessment remains under-reported with most severity assessment tools not validated for critical care. The DRS-R98 is a widely applied and validated tool. The aim of this project is to report the validation and utility of the DRS-R98 in critical illness. This prospective, cohort study was conducted in adults with delirium admitted to a critical care unit and predicted to stay for ≥ 24 h. We excluded patients with severe neurological or communication barriers that would have interfered with the DRS-R98 assessment. Patients were screened using a delirium detection algorithm and the Confusion Assessment Method for the Intensive Care Unit. Eligible patient informations were collected and reported to qualified assessor/s before visiting clinical areas, confirming delirium presence and undertaking DRS- R98 assessments. To assess the tool's construct validity, an intensivist completed the Clinical Global Impression-Scale (CGI-S). To calculate the inter-rater reliability (IRR) a subset of patients were simultaneously evaluated by two assessors. We assessed 22 patients, 73% were male, with a median age of 65 years (IQR14). The DRS -R98 mean (SD) severity score was 24 (+/-7.7), total scale was 29 (+/18.0), and CGI-S 3.5 (+/11.5). Assessment duration was 90 min (+/-55) and 15 min (+/-5) for record data extraction and clinical assessment respectively. The CGI-S significantly correlated with DRS-R98 severity (r = 0.626) and total (r = 0.628) scales. The DRS-R98 Cronbach's alpha was 0.896 for severity scale and 0.886 for total scale. The inter-rater reliability (IRR) was assessed in six patients and reported an inter-correlation coefficient of 0.505 (p = 0.124) and 0.565 (p = 0.93) for the severity and total scale respectively. In critical care, the Delirium Rating Scale R98 had good construct validity, excellent internal consistency, and moderate inter-rater reliability.

Development and Validation of the Observation Checklist Assessing the Hygiene and Sanitation of the Food Preparation Areas in Kota Bharu Kelantan Preschool.

The current inspection checklist for the assessment of food preparation areas in preschools in Malaysia has not been revised since 2012. The checklist's content needs to be improved to ensure relevant parameters are covered during preschool inspections. The objective of this study was to develop and validate an observation checklist for assessing the hygiene and sanitation of food preparation areas in preschools. The study was conducted in Kota Bharu Kelantan from March 2021 to February 2022. The development of the observation checklist was conducted in four stages: (1) the construction of domains and items from the existing literature, (2) content validation by six experts (using the item-level content validity index (I-CVI) and the scale-level content validity index (S-CVI), (3) face validation by 10 experts (using the item-level face validity index (I-FVI) and the scale-level face validity index (S-FVI)), and (4) reliability analysis (using the intercorrelation coefficient (ICC)). Four assessors performed the reliability analysis at two preschools. The initial draft of the checklist contained three domains and 57 items: building and facility (10 subdomains and 38 items), process control (four subdomains and 12 items), and food handlers (one subdomain and seven items). The I-CVI scores for building and facility, process control, and food handlers were 0.97, 1.00, and 1.00, respectively, indicating good relevancy of items. The S-CVI value was 1.0 for all domains, showing good relevance of the items. The I-FVIabove 0.8 and S-FVI values above 0.9 for all domains imply that the participants easily understood the checklist. The ICC for each domain was 0.847 (95% CI 0.716-0.902) for the building facility and 1.0 for process control and food handler, and the ICC for the three domains combined was 0.848 (95% CI 0.772-0.904). The final validated checklist consists of three domains with 57 items. The newly developed observation checklist is a valid and reliable tool for assessing the hygiene and sanitation of preschool food preparation areas.

Assessment of Self-Care Activities Using Diabetes Self-Management Questionnaire in Diabetes Patients

One of the non-communicable diseases found in all regions of the world, including rural areas, is Diabetes Mellitus, caused by a chronic metabolic disorder characterized by increased glucose levels in the blood due to impaired insulin secretion. Diabetic neuropathy is damage to peripheral nerves or peripheral nerves commonly experienced by people with type 2 diabetes mellitus, characterized by excessive pain and decreased sensitivity to touch. The purpose of this study was to determine the self-management carried out by diabetic patients in the city of Surakarta. This study is cross-sectional with a sample of 99 respondents using a purposive sampling technique with inclusion criteria of 40-60 years of age and type 2 DM patients. The tests carried out were the inter-class intercorrelation coefficient test and the Kruskal–Wallis test using SPSS. The results of this study mean the highest interclass correlation coefficient was the diabetic foot care subclass with a value of 0.773 representing the homogeneity of the DMSQ questions and a confidence interval of 0.687-0.839 at 95% with a significance of p 0.05 in each subclass.

Dosiomics and radiomics to predict pneumonitis after thoracic stereotactic body radiotherapy and immune checkpoint inhibition.

Pneumonitis is a relevant side effect after radiotherapy (RT) and immunotherapy with checkpoint inhibitors (ICIs). Since the effect is radiation dose dependent, the risk increases for high fractional doses as applied for stereotactic body radiation therapy (SBRT) and might even be enhanced for the combination of SBRT with ICI therapy. Hence, patient individual pre-treatment prediction of post-treatment pneumonitis (PTP) might be able to support clinical decision making. Dosimetric factors, however, use limited information and, thus, cannot exploit the full potential of pneumonitis prediction. We investigated dosiomics and radiomics model based approaches for PTP prediction after thoracic SBRT with and without ICI therapy. To overcome potential influences of different fractionation schemes, we converted physical doses to 2 Gy equivalent doses (EQD2) and compared both results. In total, four single feature models (dosiomics, radiomics, dosimetric, clinical factors) were tested and five combinations of those (dosimetric+clinical factors, dosiomics+radiomics, dosiomics+dosimetric+clinical factors, radiomics+dosimetric+clinical factors, radiomics+dosiomics+dosimetric+clinical factors). After feature extraction, a feature reduction was performed using pearson intercorrelation coefficient and the Boruta algorithm within 1000-fold bootstrapping runs. Four different machine learning models and the combination of those were trained and tested within 100 iterations of 5-fold nested cross validation. Results were analysed using the area under the receiver operating characteristic curve (AUC). We found the combination of dosiomics and radiomics features to outperform all other models with AUCradiomics+dosiomics, D = 0.79 (95% confidence interval 0.78-0.80) and AUCradiomics+dosiomics, EQD2 = 0.77 (0.76-0.78) for physical dose and EQD2, respectively. ICI therapy did not impact the prediction result (AUC ≤ 0.5). Clinical and dosimetric features for the total lung did not improve the prediction outcome. Our results suggest that combined dosiomics and radiomics analysis can improve PTP prediction in patients treated with lung SBRT. We conclude that pre-treatment prediction could support clinical decision making on an individual patient basis with or without ICI therapy.

Ultrasound Imaging of the Periodontium Complex: A Reliability Study.

Ultrasonography is a noninvasive, low-cost diagnostic tool widely used in medicine. Recent studies have demonstrated that ultrasound imaging might have the potential to be used intraorally to assess periodontal biomarkers. To evaluate the reliability of interlandmark distance measurements on intraoral ultrasound images of the periodontal tissues. Sixty-four patients from the graduate periodontics (n = 33) and orthodontics (n = 31) clinics were recruited. A 20 MHz handheld intraoral ultrasound transducer was used to scan maxillary and mandibular incisors, canines, and premolars. Distances between the alveolar bone crest and cementoenamel junction (ABC-CEJ), gingival thickness (GT), and alveolar bone thickness (ABT) were measured by 3 raters. The intercorrelation coefficient (ICC) and mean absolute deviation (MAD) were calculated among and between the raters. Raters also scored images according to quality. The ICC scores for intrarater reliability were 0.940 (0.932-0.947), 0.953 (0.945-0.961), and 0.859 (0.841-0.876) for ABC-CEJ, GT, and ABT, respectively. The intrarater MAD values were 0.023 (±0.019) mm, 0.014 (±0.005) mm, and 0.005 (±0.003) mm, respectively. The ICC scores for interrater reliability were 0.872 (95% CI: 0.836-0.901), 0.958 (95% CI: 0.946-0.968), and 0.836 (95% CI: 0.789-0.873) for ABC-CEJ, GT, and ABT, respectively. The interrater MAD values were 0.063 (±0.029) mm, 0.023 (±0.018) mm, and 0.027 (±0.012) mm, respectively. The present study showed the high reliability of ultrasound in both intrarater and interrater assessments. Results suggest there might be a potential use of intraoral ultrasound to assess periodontium.

THE CULTURAL ADAPTATION, RELIABILITY AND VALIDITY OF THE TURKISH VERSION OF THE SIMPLE PHYSICAL ACTIVITY QUESTIONNAIRE IN COMMON MENTAL DISORDERS

Purpose: This study aims to evaluate the validity and reliability of the Turkish version of the Simple Physical Activity Questionnaire (SIMPAQ-T) in patients with common mental disorders.
 Methods: A total of eighty-one patients (mean age: 40.14±13.05 years) were included in this study. The SIMPAQ-T was used to evaluate the participants' physical activity levels and sedentary behaviors. To be used as descriptive data, DSM-5 Level 1 Cross-Cutting Symptom Measure-Adult was used to evaluate mental health symptomatology. International Physical Activity QuestionnaireShort Form (IPAQ-SF) and Brief Psychiatric Rating Scale (BPRS) were used to test the validity of the questionnaire.
 Results: The items of the SIMPAQ-T exhibited excellent intercorrelation coefficient (ICC) values (time spent in bed (0.93 (95% CI: 0.90-0.96)), sedentary time 0.87 (95% CI: 0.80-0.92), walking time 0.98 (95% CI: 0.98-0.99), exercise time 0.99 (95% CI: 0.99-0.99), and incidental activity time 0.95 (95% CI: 0.92-0.97)). The SIMPAQ-T was moderately correlated with IPAQ-SF in terms of sedentary (rho=0.641, p=0.001) and walking time (rho=0.564, p=0.001), indicating good construct validity. However, the BPRS had a significant correlation with only the sedentary time of the SIMPAQ (rho=0.246, p=0.022), indicating convergent validity was poor.
 Conclusion: The SIMPAQ-T is semantically and linguistically adequate to quickly assess physical activity level and sedentary behavior in patients with common mental disorders.

Development and Validation of the Observation Checklist Assessing the Hygiene and Sanitation of the Food Preparation Areas in Preschools

A validated checklist for assessing the hygiene and sanitation of food preparation areas in the preschools is needed to ensure food safety for the preschool children. The objective of this study aimed to validate a newly developed observation checklist assessing the hygiene and sanitation of food preparation areas in preschools.
 The study was carried out in Kota Bharu Kelantan and was conducted in four stages: preparation of observation checklist from the existing literature; validation of checklist content by six expert panels (measuring the item-level content validity index (I-CVI), and scale-level content validity index (S-CVI)); face validation of checklist by ten expert panels (measuring the item-level face validity index (I-FVI) and scale-level face validity index (S-FVI)); and reliability analysis in assessing the inter correlation-coefficient (ICC). The reliability analysis was performed on two preschools by four assessors.
 The initial draft of the checklist contained three domains and 57 items: building and facility (10 subdomains and 40 items); process control (4 subdomains and 13 items); and food handlers (one subdomain and 7 items). The I-CVI were 0.97, 1.00 and 1.00, and S-CVI were 1.0, 1.0 and 1.0 for building and facility, process control, and food handler, respectively. The I-FVI showed 0.99 for building and facility, 1.00 for process control, and 1.00 for food handler. The intraclass correlation coefficients (ICC) of these 3 domains were 0.848 (95%CI 0.772, 0.904) as shown in Table 1, indicating a good reliability (values between 0.75 and 0.9) [1]. The final validated checklist consisted of 3 domains and 57 items.
 The newly developed observation checklist is a valid and reliable tool to assess the hygiene and sanitation of food preparation areas in preschools.

Control of electric power quality indicators in distribution networks comprising a high share of solar photovoltaic and wind power stations

Mass-scale integration of renewable power stations into distribution power networks is a main trend of power industry development aimed at its decarbonation. All solar photovoltaic (SPVS) and wind power (WPS) stations are connected to the existing medium- and high-voltage distribution networks, excluding large capacity wind power and photoelectric fields. Modern SPVS and WPS are integrated into energy systems with the use of inverters/converters into which control algorithms for output power and protection have to be included. Critical deviations of electric power quality indicator (EPQI) from their normal operation values may occur, in networks, in these inverters/converters low-load conditions. Such deviation appears in low irradiance conditions in SPVS and low wind speed in WPS. It has to be noted that various electric loads of industrial consumers can be connected to the distribution networks for which such EPQI deviations are critical. This article deals with the newly developed method and device for EPQI sampling control enabling to automatically detect EPQI deviations including short-term ones. Results of preliminary simulation modeling, in various operation conditions, of distribution network including SPVS and WPS are used in the newly developed device. Besides, the device implements automatic Wald’s sequential analysis procedure on the basis of a multiple-choice indicator distributed in accordance with the binomial law. The effectiveness of EPQI sampling control based on the mathematical statistics methods has been demonstrated. It has been proposed to apply an integrated indicator, i.e. the absolute value of intercorrelation coefficient, for current and voltage signals, in order to take account of the complex effect of EPQI on the electric loads. Implementing the developed method and device for sample-based EPQI control makes it possible to prevent considerable and long-term EPQI deviations, in order to ensure reliable operation of consumers’ electric receivers, in distribution networks comprising a high share of SPVS and WPS.

Real-time assessment of anteroposterior stability of spinal segments

PurposeWhile anteroposterior instability of spinal segments is regarded as an important biomechanical aspect in the clinical evaluation of lumbar pathologies, the reliability of the available diagnostic tools is limited and an intraoperative method to quantify stability is lacking. The aim of this study was to develop and validate an instrument to measure the anteroposterior stability of a spinal segments in real-time.MethodsTorsi of five fresh-frozen human cadavers were used for this study. After pedicle screw insertion, a specifically modified reposition tool composed with load and linear sensors was used to measure the segmental anteroposterior motion caused by 100 N anterior and posterior force during 5 loading cycles on either side of the instrumentation by two different operators. The spinal segments were then resected from the torsi and anteroposterior loading with ± 100 N was repeated in an advanced biomechanical spine testing setup as a reference measurement. The Inter-correlation coefficient (ICC) was used for validation of the “intraoperative” device.ResultsInter-operator repeatability of the measurements showed an ICC of 0.93 (p < 0.0001) and the bilateral (left–right) comparison had an ICC of 0.73 (p < 0.0001). The ICC resulting from the comparison to the reference measurement was 0.82 (p < 0.0001) without offset correction, and 0.9 (p < 0.0001) with offset correction. The ICC converged at this value already after two of the five performed loading cycles.ConclusionAn accurate and reliable measurement tool is developed and validated for real-time quantification of anteroposterior stability of spinal segments and serves as a basis for future intraoperative use.

Body composition in students physical education and sport: cross-sectional pilot study

Purpose: Young people who study physical education and sport are a priori regarded as having proper body structure and body composition. It is widely presumed that young who study physical education at one of several national universities of physical education (East Sarajevo) could be characterized with proper physique and body composition. Aim of the current study was to assess and analyze the body composition of a male students Physical Education and Sport, University East Sarajevo, by bioelectric impedance analysis and determine the significance of inter correlation coefficients.&#x0D; Material and methods: In study the participants consist 30 male students of Faculty of Physical Education and Sport, University of East Sarajevo, the III year of study (Body Height = 182.20 ± 6.89cm; Body Weight = 80.06 ± 8.80kg; Body Mass Index= 24.03 ± 2.58kg/m²).&#x0D; Results: of the study showed that the body composition is within the healthy (allowed) values recommended for this population of students (Body Fat=10.90kg or 13.62%; Body Muscle= 65.74kg or 82.40%; Body Water = 61.54%; Basal metabolic rate = 2045.07kCal; Daily calorie intake = 8436.56 kCal, etc.). Inter correlation coefficients showed inverse and significantly high correlation (p=0.000) between (inter correlation coefficient Fat-Muscle = -0.945), (inter correlation coefficients Fat-Water = -0.963) while direct correlation was achieved between (inter correlation coefficient Muscle-Water = 0.986).&#x0D; Conclusion: The obtained results of the study defined the appropriate body composition of the students, which is a consequence of their adequate physical activity and well-designed curricula at the home faculty. In the parameters of body composition, students of physical education and sports in East Sarajevo had a higher muscle component and lower values ​​of fat component than other students as a result of their somatotype, way of studying, teaching and extracurricular physical activities.

MUM-1 immunohistochemistry has high accuracy and reliability in the diagnosis of chronic endometritis: a multi-centre comparative study with CD-138 immunostaining.

The current gold standard for chronic endometritis (CE) diagnosis is immunohistochemistry (IHC) for CD-138. However, IHC for CD-138 is not exempt from diagnostic limitations. The aim of our study was to evaluate the reliability and accuracy of MUM-1 IHC, as compared with CD-138. This is a multi-centre, retrospective, observational study, which included three tertiary hysteroscopic centres in university teaching hospitals. One hundred ninety-three consecutive women of reproductive age were referred to our hysteroscopy services due to infertility, recurrent miscarriage, abnormal uterine bleeding, endometrial polyps or myomas. All women underwent hysteroscopy plus endometrial biopsy. Endometrial samples were analysed through histology, CD138 and MUM-1 IHC. The primary outcome was to evaluate the diagnostic accuracy of MUM-1 IHC for CE, as compared with CD-138 IHC. Sensitivity and specificity of CD-138 and MUM-1 IHC were respectively 89.13%, 79.59% versus 93.48% and 85.03%. The overall diagnostic accuracy of MUM-1 and CD-138 IHC were similar (AUC = 0.893 vs AUC = 0.844). The intercorrelation coefficient for single measurements was high between the two techniques (ICC = 0.831, 0.761-0.881 95%CI). However, among CE positive women, MUM-1 allowed the identification of higher number of plasma cells/hpf than CD-138 (6.50 [SD 4.80] vs 5.05 [SD 3.37]; p = 0.017). Additionally, MUM-1 showed a higher inter-observer agreement as compared to CD-138. IHC for MUM-1 and CD-138 showed a similar accuracy for detecting endometrial stromal plasma cells. Notably, MUM-1 showed higher reliability in the paired comparison of the individual samples than CD-138. Thus, MUM-1 may represent a novel, promising add-on technique for the diagnosis of CE.

Multicentric Atrial Strain COmparison between Two Different Modalities: MASCOT HIT Study.

Two methods are currently available for left atrial (LA) strain measurement by speckle tracking echocardiography, with two different reference timings for starting the analysis: QRS (QRS-LASr) and P wave (P-LASr). The aim of MASCOT HIT study was to define which of the two was more reproducible, more feasible, and less time consuming. In 26 expert centers, LA strain was analyzed by two different echocardiographers (young vs senior) in a blinded fashion. The study population included: healthy subjects, patients with arterial hypertension or aortic stenosis (LA pressure overload, group 2) and patients with mitral regurgitation or heart failure (LA volume–pressure overload, group 3). Difference between the inter-correlation coefficient (ICC) by the two echocardiographers using the two techniques, feasibility and analysis time of both methods were analyzed. A total of 938 subjects were included: 309 controls, 333 patients in group 2, and 296 patients in group 3. The ICC was comparable between QRS-LASr (0.93) and P-LASr (0.90). The young echocardiographers calculated QRS-LASr in 90% of cases, the expert ones in 95%. The feasibility of P-LASr was 85% by young echocardiographers and 88% by senior ones. QRS-LASr young median time was 110 s (interquartile range, IR, 78-149) vs senior 110 s (IR 78-155); for P-LASr, 120 s (IR 80-165) and 120 s (IR 90-161), respectively. LA strain was feasible in the majority of patients with similar reproducibility for both methods. QRS complex guaranteed a slightly higher feasibility and a lower time wasting compared to the use of P wave as the reference.

Self-assessment of Polish pharmacy staff\u2019s readiness to promote health

Background Nowadays, pharmacists are expected to focus not only on dispensing medicines but also on the wellness of the patient. In some developed countries a pharmacist is clearly defined as a health care professional that can make a contribution to improving the general health of the population. Objective To assess the readiness of Polish pharmacy staff to engage in health promotion and educational activities. Setting Community pharmacies in Poland. Method The study group consisted of 308 pharmacy staff (248 pharmacists and 60 pharmacy technicians) employed in Polish pharmacies. The survey questionnaire referred to three domains: systemic solutions for health promotion, readiness of pharmacy staff as a professional group to promote health, personal readiness to promote health. Responses about pharmacy staff’s readiness to promote health were scored using a 10-point scale. Scale reliability for all items (overall readiness), and for items within the three domains separately, were tested using Cronbach’s α and average inter-correlation coefficient among the items. Main outcome measure Pharmacy staff’s readiness to promote health (the questionnaire containing 32 items). Results The overall readiness of pharmacy staff to promote health was rather low (average of 4.6 ± 1.5 in 1–10 scale). The highest scores were obtained for pharmacy staff’s personal readiness to promote health (average of 5.5 ± 1.8) which was neutral on the scale. The lowest scores were obtained for systemic solutions for health promotion (average of 3.6 ± 1.4). Readiness of pharmacy staff as a professional group was ranked in the middle (average 4.8 ± 1.8). Surveyed pharmacy staff rated their readiness to promote health in the work environment significantly higher than promoting health in the local community. Female and younger pharmacy staff as well as those with job seniority of less than 5 years, or pharmacy technicians assessed their readiness to promote health significantly higher than others. Readiness to promote health was higher among pharmacy staff working in pharmacies employing up to 3 staff members and at pharmacies with over 200 customers daily. Conclusions The overall readiness of pharmacy staff to promote health was low, especially in the domain of systemic solutions in health promotion.

Comparative Evaluation of ICDAS, WHO and Histological Examination in Detection of Occlusal Carious Lesions

Detection of occlusal carious lesions with visual scoring systems is in a continuous validation with the histological depth of carious demineralization. Objective: The present study aimed to compare the International Caries Detection and Assessment System (ICDAS), the World Health Organization (WHO) system and histological examination in detecting occlusal carious lesions. Material and Methods: 20 premolars were evaluated by visual examination using ICDAS, WHO and histological examination using stereomicroscope (SM) for occlusal caries detection. Occlusal surfaces were evaluated by two examiners then all teeth were visually and histologically assessed. Results: For each of three systems the inter class correlation coefficient was examined, the differences between the three systems of occlusal caries detection were minimal. The visual examination through WHO recorded the higher intercorrelation coefficient followed by ICDAS system then histological examination respectively. Conclusion: WHO and ICDAS have demonstrated reproducibility and diagnostic accuracy when compared with histological examination for detecting occlusal caries.KeywordsInternational caries detection and assessment system; World health organization; Histological examination; Occlusal caries.

Bangla language modeling algorithm for automatic recognition of hand-sign-spelled Bangla sign language

Because of using traditional hand-sign segmentation and classification algorithm, many diversities of Bangla language including joint-letters, dependent vowels etc. and representing 51 Bangla written characters by using only 36 hand-signs, continuous hand-sign-spelled Bangla sign language (BdSL) recognition is challenging. This paper presents a Bangla language modeling algorithm for automatic recognition of hand-sign-spelled Bangla sign language which consists of two phases. First phase is designed for hand-sign classification and the second phase is designed for Bangla language modeling algorithm (BLMA) for automatic recognition of hand-sign-spelled Bangla sign language. In first phase, we have proposed two step classifiers for hand-sign classification using normalized outer boundary vector (NOBV) and window-grid vector (WGV) by calculating maximum inter correlation coefficient (ICC) between test feature vector and pre-trained feature vectors. At first, the system classifies hand-signs using NOBV. If classification score does not satisfy specific threshold then another classifier based on WGV is used. The system is trained using 5,200 images and tested using another (5, 200 × 6) images of 52 hand-signs from 10 signers in 6 different challenging environments achieving mean accuracy of 95.83% for classification with the computational cost of 39.972 milliseconds per frame. In the Second Phase, we have proposed Bangla language modeling algorithm (BLMA) which discovers all “hidden characters” based on “recognized characters” from 52 hand-signs of BdSL to make any Bangla words, composite numerals and sentences in BdSL with no training, only based on the result of first phase. To the best of our knowledge, the proposed system is the first system in BdSL designed on automatic recognition of hand-sign-spelled BdSL for large lexicon. The system is tested for BLMA using hand-sign-spelled 500 words, 100 composite numerals and 80 sentences in BdSL achieving mean accuracy of 93.50%, 95.50% and 90.50% respectively.

Image Quality and Reliability of a Novel Dark-Blood Late Gadolinium Enhancement Sequence in Ischemic Cardiomyopathy.

The aim of this study was to assess the reliability of a 2D dark-blood phase-sensitive late gadolinium enhancement sequence (2D-DBPSLGE) compared with 2D phase-sensitive inversion recovery late gadolinium enhancement sequence (2D-BBPSLGE) in patients with ischemic cardiomyopathy (ICM). A total of 73 patients with a clinical history of ICM were prospectively enrolled. The following endpoints were evaluated: (a) comparison of image quality between 2D-BBPSLGE and 2D-DBPSLGE for differentiation between blood pool-late gadolinium enhancement (LGE), remote myocardium-LGE, and blood pool-remote myocardium; (b) diagnostic accuracy of 2D-DBPSLGE compared with gold standard 2D-BBPSLGE for the evaluation of infarcted segments; (c) diagnostic accuracy of 2D-DBPSLGE for the evaluation of microvascular obstruction (MVO); (d) comparison of transmurality index between 2D-BBPSLGE and 2D-DBPSLGE; (e) comparison of papillary muscle hyperenhancement between 2D-BBPSLGE and 2D-DBPSLGE; inter-reader agreement for depiction of hyperenhanced segments in both LGE sequences. Data were analyzed using paired t test, Wilcoxon test, and McNemar test, and η coefficient and intercorrelation coefficient (ICC). Image quality was superior for 2D-DBPSLGE for differentiation of blood pool-LGE (P<0.001). 2D-DBPSLGE, compared with 2D-BBPSLGE, showed a sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 96.93%, 99.89%, 99.71%, 98.78, and 99.04%, respectively. Concerning MVO detection, 2D-DBPSLGE showed a sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 66.67%, 100.00%, 100.00%, 80.95%, and 86.21%, respectively. 2D-DBPSLGE underestimated the transmurality (P=0.007) and identified papillary muscle hyperenhancement (P<0.001). Both LGE sequences showed comparable interobserver agreement for the evaluation of infarcted areas (2D-BBPSLGE: ICC 0.99;2D-DBPSLGE: ICC 0.99). Compared with 2D-BBPSLGE, 2D-DBPSLGE sequences provide better differentiation between LGE and blood-pool, while underestimating LGE trasmurality and the presence of MVO.