Kappa Coefficient Analysis Research Articles

Antimicrobial Susceptibility of Escherichia coli Isolates Causing Community-Acquired Urinary Tract Infections: Comparison of Methods

Due to bacterial resistance to antimicrobials, antibiotic therapy for urinary tract infections (UTIs) has become a major challenge for clinicians. The present work aimed to compare the antimicrobial susceptibility profiles of 53 uropathogenic Escherichia coli (UPEC) isolates, assessed using the disk diffusion method and two automated systems (PHOENIX BD™ and VITEK2), with interpretations based on CLSI and BrCAST guidelines. Twenty-five antibiotics were tested to assess differences in susceptibility profiles. Statistical tools, including Kappa coefficient analysis and chi-square tests, were applied to assess concordance and significance between methods. Among the main discrepancies found, BrCAST has classified a greater number of UPEC isolates as resistant to more than half of the antibiotics tested by the disk diffusion method, when compared to CLSI. Although faster, the PHOENIX BD and VITEK2 automated systems exhibited significant discrepancies, with divergences observed for half of the antimicrobials tested. Both automated methods showed discrepancies compared to the disk diffusion method under CLSI and BrCAST guidelines. PHOENIX BD classified some isolates resistant by DD/CLSI as susceptible, while VITEK2 misclassified 25% to 50% of the antimicrobials tested. Conversely, VITEK2 also classified some isolates susceptible to DD/CLSI as resistant to 25% of the antimicrobials tested. Regarding DD/BrCAST, PHOENIX BD classified resistant isolates as susceptible (to 50% of the antimicrobials tested). In comparison, VITEK2 classified resistant isolates as susceptible and susceptible isolates as resistant (25% of the antimicrobials for both). These findings highlight the need for careful selection of susceptibility testing methods, as variations in interpretive criteria between CLSI and BrCAST could impact clinical decision-making. This study underscores the importance of methodological consistency in accurately informing antibiotic therapy in UTI management, especially in the face of rising resistance.

FEV1/FEV6 Cutoff Points to Avoid False Negatives When Using Portable Devices, PICO-6® and COPD-6®, in COPD Detection in Primary Healthcare Services.

Background: Chronic obstructive pulmonary disease (COPD) is a frequent but underdiagnosed disease, primarily due to the lack of access to forced spirometry (FS) in primary care. Portable, easy-to-use expiratory flow meters like Piko-6® and COPD-6® that measure FEV1, FEV6, and FEV1/FEV6 ratio provide an alternative. Given that Piko-6® and COPD-6® devices measure FEV6 but not FVC, the aim of the study is to determine the optimal cutoff value for the FEV1/FEV6 ratio of each device to avoid false negatives when these devices are used for COPD screening in primary care (PC). Methods: A total of 664 patients of 35 years of age or older with a cumulative tobacco consumption of 10 or more packs/year were recruited at two university hospitals. FS (gold standard) was performed and FEV1, FVC, and FEV1/FVC measurements were compared with FEV1, FEV6, and FEV1/FEV6 measurements acquired using Piko-6® and COPD-6® devices. The devices were compared using statistical methods including Pearson correlation coefficients, the Youden index (YI), kappa coefficient, Bland-Altman plots, and ROC curves analysis. Results: Correlations between FEV1/FEV6 using Piko-6® and COPD-6® and FEV1/FVC with FS were 0.79 and 0.73, respectively. Piko-6® achieved the best YI in FEV1/FEV6 (0.73), whereas for COPD-6®, it was 0.80. Concordance between Piko-6® and FS was 83.9% (kappa 0.67 ± 0.028) and for COPD-6®, it was 68.7% (kappa 0.42 ± 0.02). Conclusions: This is the first study that compares two hand-held expiratory flow meters with FS. Piko-6® and COPD-6® devices are effective tools for COPD detection, as their measurements provide a good correlation with FS. In order to avoid false negative results, the FEV1/FEV6 cutoff point needs to be increased to 0.73 and 0.80 with Piko-6® and COPD-6®, respectively.

Practical application of has recommendations (2007 and 2021), concerning the diagnosis of malnutrition in persons aged 70 and over, to patients hospitalized in geriatric follow-up and rehabilitation care

The 2007 French Haute Autorité de santé recommendation on the diagnosis of malnutrition in the elderly was revised in 2021. The main objective was to compare the prevalence of malnutrition according to the recommendations. The secondary objectives were to compare 3-month mortality and assess the prevalence of sarcopenia and sarcopenic obesity. The 2021 criteria were applied retrospectively to a cohort. Concordance analysis was carried out using Cohen's kappa coefficient and statistical analysis of mortality using Fisher's exact test. There were 135 patients, 60% malnourished with 35% severely malnourished according to HAS 2007, 49% malnourished with 62% severely malnourished according to HAS 2021 with moderate agreement. There were 25 cases of confirmed sarcopenia and one case of sarcopenic obesity. Moderately to severely malnourished people had an increased risk of death at 3 months (HAS 2021).

Wearable smart glasses for first‐person video analysis to evaluate nursing skills: A pilot study with a mixed method design

AbstractBackgroundComprehensive assessment of skills and performance are necessary to improve the quality of care in nursing education. Various factors pose challenges to accurate assessments, including high student–teacher ratio and observer bias.ObjectivesTo establish an assessment system based on first‐person video of smart glasses and validate its usability and feasibility.MethodsWe used two cameras (smart glasses for first‐person perspective and a web cam) to perform video analysis for skill and performance assessments. Usability tests were conducted using quantitative and qualitative questionnaires for the usefulness and acceptability of the current assessment system. Data from standardised checklists for three clinical nursing skills (intramuscular injection, endotracheal suction, and Levin tube feeding) were used to analyse the inter‐rater reliability in addition to Fleiss' Kappa coefficient analysis. A total of 22 participants (18 students and 4 reviewers) were recruited. They completed the study. Apart from physical discomfort component, the proposed smart glasses‐based first‐person video assessment system achieved good usability scores from both students and reviewers.Results and ConclusionsFleiss' Kappa values for individual items ranged from 0.450 to 0.808, with an overall average value of 0.592. Results of this study validated the potential of smart glasses‐based assessment system where a set of beneficial mechanisms may meaningfully support the formative learning process. However, issues regarding upgrading the device and need for guidelines for roles of raters and students still remain.

Assessment of autostereoscopic perception using artificial intelligence-enhanced face tracking technology.

Stereopsis, the ability of humans to perceive depth through distinct visual stimuli in each eye, is foundational to autostereoscopic technology in computing. However, ensuring stable head position during assessments has been challenging. This study evaluated the utility of artificial intelligence (AI)-enhanced face tracking technology in overcoming this challenge by ensuring that each eye consistently receives its intended image. The Lume Pad 2, an autostereoscopic tablet with AI-enhanced face tracking, was utilized to simulate quantitative parts of the Stereo Fly test and TNO Stereotests for contour and random dot stereopsis. The study recruited 30 children (14 males and 16 females, mean age of 9.2 ± 0.3 years, age range of 6-12 years) and 30 adults (10 males and 20 females, mean age of 29.4 ± 1.0 years, age range of 21-42 years) to assess the tablet's inter-session reliability. Agreement between conventional and the autostereoscopic tablet-simulated stereotests was tested in a larger group of 181 children (91 males and 90 females, mean age of 9.1 ± 0.4 years, age range of 6-12 years) and 160 adults (69 males and 91 females, mean age of 38.6 ± 2.1 years, age range of 21-65 years). Inter-session reliability and agreement were analyzed using weighted Kappa coefficient and non-parametric Bland-Altman analysis. The autostereoscopic tablet demonstrated high inter-session reliability (κ all > 0.80), except for the simulated TNO Stereotest in adults, which demonstrated moderate inter-session reliability (κ = 0.571). Non-parametric Bland-Altman analysis revealed zero median differences, confirming consistent inter-session reliability. Similar patterns were observed in comparing AI-based and conventional methods, with both the weighted Kappa coefficient (κ all > 0.80) and non-parametric Bland-Altman analysis indicating significant agreement. The agreement between methodologies was confirmed by permissible differences, which were smaller than the minimum step range. The integration of AI-based autostereoscopic technology with sub-pixel precision demonstrates significant potential for clinical stereopsis measurements.

Comparison of computer-aided quantitative measurement and physician visual assessment in the evaluation of intracranial atherosclerotic stenosis: a vessel wall magnetic resonance imaging study.

Intracranial atherosclerotic stenosis is a leading cause of ischemic stroke in China. Accurate assessment of intracranial atherosclerotic stenosis through imaging techniques is crucial for guiding therapeutic interventions and prognostic stratification. Vessel wall magnetic resonance imaging (VWMRI) has emerged as a reliable method for evaluating intracranial arterial vessels. With the advancement of technology, computer-aided quantitative measurement (CAQM) is increasingly used in imaging assessment. This study aimed to compare physician visual assessment (PVA) with CAQM in the VWMRI evaluation of intracranial atherosclerotic stenosis. This retrospective cross-sectional study consecutively enrolled patients diagnosed with intracranial atherosclerotic stenosis through imaging examinations at the Fourth Affiliated Hospital of China Medical University from December 2018 to December 2023. Clinical data were collected for analysis. Two radiologists independently and separately conducted CAQM and PVA on the VWMRI images of intracranial atherosclerotic stenosis patients. The imaging features evaluated encompassed stenosis severity, vessel wall remodeling, vessel wall thickening patterns, fibrous cap characteristics, lipid core ratio, and plaque enhancement degree. The study further assessed the discrepancies and concordance between the assessment results obtained from the two methods using paired sample t-tests, Wilcoxon signed-rank tests, and Cohen's kappa coefficient analysis. This study enrolled a total of 589 patients. The PVA time was shorter than CAQM (12.02±3.63 vs. 20.48±6.50 min). However, compared with digital subtraction angiography, the CAQM had a better area under the curve (0.88) than the PVA (0.80) in assessing luminal stenosis degree. The proportions of vessel wall remodeling (227/38.5%) and plaque surface irregularity (127/21.6%) evaluated by PVA were both lower than those by CAQM (438/74.4%, 171/29.0%). Meanwhile, no statistically significant differences were found in the patterns of wall thickening (P=0.12/0.39) and the proportion of plaque lipid core (P=0.65 and P=0.27), with good agreement between the two methods (K=0.67/0.85, K=0.97/0.94). While there were no statistical differences in the assessment of plaque enhancement degree in specific arteries (middle cerebral artery and basilar artery) (n=77/36, P=0.08/0.21), an overall statistical difference was observed (n=113, P=0.03). Additionally, there was poor agreement in assessing plaque enhancement degree, with Cohen's kappa values of 0.13 (-0.05 to 0.32) and 0.16 (-0.06 to 0.39). This study revealed disparities between PVA and CAQM in the evaluation of intracranial atherosclerotic stenosis of VWMRI. CAQM is recommended for assessing stenosis degree, vessel wall remodeling, and fibrous cap characteristics. However, PVA is suggested to assess wall thickening patterns and lipid core ratio to expedite diagnosis. Further research is needed to validate CAQM's superiority in evaluating plaque enhancement degrees.

Classification of coal bursting liability of some chinese coals using machine learning methods

The classification of coal bursting liability (CBL) is essential for the mitigation and management of coal bursts in mining operations. This study establishes an index system for CBL classification, incorporating dynamic fracture duration (DT), elastic strain energy index (WET), bursting energy index (KE), and uniaxial compressive strength (RC). Utilizing a dataset comprising 127 CBL measurement groups, the impacts of various optimization algorithms were assessed, and two prominent machine learning techniques, namely the back propagation neural network (BPNN) and the support vector machine (SVM), were employed to develop twelve distinct models. The models’ efficacy was evaluated based on accuracy, F1-score, Kappa coefficient, and sensitivity analysis. Among these, the Levenberg–Marquardt back propagation neural network (LM-BPNN) model was identified as superior, achieving an accuracy of 96.85%, F1-score of 0.9113, and Kappa coefficient of 0.9417. Further validation in Wudong Coal Mine and Yvwu Coal Industry confirmed the model, achieving 100% accuracy. These findings underscore the LM-BPNN model’s potential as a viable tool for enhancing coal burst prevention strategies in coal mining sectors.

Serological Surveillance and Risk Factor Analysis for Parrot Bornavirus in Taiwan

Parrots are traded globally and pose a substantial risk for disease transmission involving parrot-specific pathogens. Parrot bornavirus (PaBV) belongs to the Bornaviridae family and encompasses two clades: alphapsittaciforme (PaBV-1 to -4, PaBV-7, and -8) and betapsittaciforme (PaBV-5 and PaBV-6). These clades cause proventricular dilatation disease, a chronic disease affecting all parrot species. PaBV infections can persist for varying durations in parrots, but the transmission routes are still not well understood. Therefore, surveillance of PaBV-infected parrots is necessary for disease control and improving psittacine aviculture. This study used isolated PaBV-4 NTUCL7 and PaBV-5 NTUCL54 strains to establish and validate two serological diagnostic methods: immunoblotting (IB) and immunocytochemical staining (ICC). To determine the prevalence of PaBV in parrots in Taiwan, 370 clinical serum samples were collected from 13 collaborative veterinary hospitals during a 1-year surveillance period. Serological surveillance revealed a seropositivity rate of 25.68%. Among the seropositive samples, 91.58% were infected with alphapsittaciforme PaBV, demonstrating the predominance of this viral clade in parrots. An analysis of risk factors also demonstrated an association between seropositivity and parrot genera, age, and clinical signs. Cohen’s kappa coefficient analysis showed a high degree of similarity (kappa value = 0.975) between the IB and ICC results, which shows that these serological diagnostic measures are robust. This study established two reliable serological diagnostic measures that are instrumental in serological surveillance, particularly in one of the major parrot-exporting regions. The surveillance results increase the understanding of PaBV infection and associated risk factors and allow methods to be devised for the conservation and protection of parrot populations.

Region-specific interobserver agreement of the Alberta Stroke Program Early Computed Tomography Score: A meta-analysis.

The Alberta Stroke Program Early CT Score (ASPECTS) is a widely used scoring system for evaluating ischemic stroke to determine therapeutic strategy. However, there is variation in the interobserver agreement of ASPECTS. This systematic review and meta-analysis aimed to investigate the interobserver agreement of total and regional ASPECTS. A comprehensive search was conducted in the Web of Sciences, PubMed, and Scopus databases to identify relevant studies. Inclusion criteria were studies of noncontrast CT performed within 24hours of ischemic stroke in the middle cerebral artery territory. A total of 20 studies, with 3482 patients, reporting interobserver agreement of total and regional ASPECTS were included in the meta-analysis. The interobserver agreement for total ASPECTS in studies using Kappa coefficient (κ) analysis was substantial (κ=.67, 95% confidence interval [CI]: .57-.78). In studies using intraclass correlation coefficient (ICC) analysis, agreement was excellent (ICC=.84, 95% CI: .77-.90). Interobserver agreement was higher in studies in which the observer was unblinded to clinical scenario in both groups (κ=.74, 95% CI: .59-.89, and ICC=.82, 95% CI: .79-.85). Per-region analysis showed that the caudate nucleus had the highest agreement (κ=.68, 95% CI: .60-.76, and ICC=.84, 95% CI: .74-.93), while M2 and internal capsule in Kappa studies (κ=.45, 95% CI: .34-.55 and κ=.47, 95% CI: .28-.66), and M4 and internal capsule in ICC studies (ICC=.54, 95% CI: .43-.64 and ICC=.55, 95% CI: .18-.91) had the lowest agreement. This meta-analysis demonstrates substantial to excellent interobserver agreement for total ASPECTS, which supports using this method for stroke treatment. However, findings emphasize the need to consider interobserver agreement in specific regions of ASPECTS for treatment decisions.

Development of a robust TaqMan probe-based one-step multiplex RT-qPCR for simultaneous detection of SARS-CoV-2 and Influenza A/B viruses

BackgroundDuring the coronavirus disease 2019 (COVID-19) pandemic, the simultaneous detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Influenza A, and Influenza B viruses is essential for rapid differential diagnosis in patients with similar symptoms, especially during “flu season” in the post-pandemic era. So far, several multiplex methods have been approved for the simultaneous detection of SARS-CoV-2, Influenza A, and Influenza B. However, due to the rapid mutation rate of the SARS-CoV-2 genome and the emergence of new variants, existing methods must be improved and updated.MethodsTo identify a highly conserved region in the SARS-CoV-2 N-gene, a genomic survey was performed to increase the sensitivity and specificity of primer and probe sets targeting the SARS-CoV-2 genome. The 95% LLOD (95% lower limits of detection) were calculated by probit analysis. A total of 70 predetermined clinical samples using singleplex RT-qPCR assays, were included. The clinical performance of the multiplex RT-qPCR assay was determined and compared with a commercial multiplex kit. The Cohen’s kappa coefficient, P-value (McNemar’s test), Passing-Bablok regression, and Bland Altman agreement analysis were determined to monitor the agreement of the assays.ResultsThe novel SARS-CoV-2 primer and probe set designed in this assay was able to detect all variants of concern (VOCs) and variants of interest (VOIs) with high analytical and clinical performance. The 95% LLOD for the multiplex RT-qPCR was 20 copies per reaction for the N gene of SARS-CoV-2, 2 copies per reaction for M1 gene of Influenza A and NS1 gene of Influenza B. The diagnostic sensitivity of the multiplex RT-qPCR was 94.4%, 93.7%, and 100% for the detection of SARS-CoV-2, Influenza A, and Influenza B genomes, respectively. Moreover, the specificity was identical (100%) in both assays. According to the agreement analysis results, there was no statistical difference between our multiplex assay and the commercial kit.ConclusionsIn this study, we developed a novel in-house made multiplex RT-qPCR assay, with high sensitivity, specificity, and reliability for the diagnosis of SARS-CoV-2 infection in clinical samples. This is valuable during Influenza seasons when influenza co-circulates with SARS-CoV-2, as it saves costs, time, and thus specific and timely treatment of patients.

Parent-child concordance and treatment outcome of trauma-focused cognitive behavioral therapy in a child advocacy center

Child maltreatment has been associated with the development of Post-Traumatic Stress (PTS) symptoms. Research suggests that parent-child concordance on ratings of child PTS symptoms after maltreatment may pose clinical implications that can guide treatment. The current study examines parent-child concordance of child PTS symptoms and changes in symptoms from pre- to post-treatment with Trauma-Focused Cognitive Behavioral Therapy using archival clinical records of 29 children seen in a Child Advocacy Center. Cohen’s Kappa and Intraclass Correlation Coefficient analyses indicated that child and parent ratings were only concurrent post-treatment. PTS symptoms as rated by parents and children decreased significantly from pre- to post-treatment. Findings highlight the importance of comparing cross-informant ratings and support using evidence-based treatment to reduce PTS symptoms in children.

Adverse events in gastrointestinal endoscopy: Validation of the AGREE classification in a real-life 5-year setting.

The novel AGREE classification for adverse events (AEs) in gastrointestinal (GI) endoscopy has not yet been validated in a real-world setting. Our study aims to evaluate the correlation between the grades of AEs in the ASGE and AGREE classifications and to assess the interobserver agreement of the two classification systems. The correlation and association between the AE grades of the ASGE and AGREE classifications were analyzed using the Spearman rank correlation test and the chi-squared analysis, respectively. A weighted Cohen's kappa coefficient analysis was performed to determine the interobserver agreement of both classification systems. We prospectively collected the AEs that occurred in our endoscopy unit over the past five years. A total of 226 AEs (226/84,863, 0.3%) occurred. There was a correlation between the ASGE and AGREE classifications (ρ=0.61) and a moderately significant association (p<0.01, Cramer's V=0.7). The interobserver agreement for the ASGE classification was fair (kappa 0.60, 95% confidence interval [CI]: 0.54, 0.67), whereas it was good for the AGREE classification (kappa 0.80, 95% CI: 0.62, 0.87). The AGREE classification was validated for the first time in a real-world setting and showed a positive correlation and higher interobserver agreement than the ASGE classification.

Reflectance Spectroscopy for the Classification and Prediction of Pigments in Agronomic Crops.

Reflectance spectroscopy, in combination with machine learning and artificial intelligence algorithms, is an effective method for classifying and predicting pigments and phenotyping in agronomic crops. This study aims to use hyperspectral data to develop a robust and precise method for the simultaneous evaluation of pigments, such as chlorophylls, carotenoids, anthocyanins, and flavonoids, in six agronomic crops: corn, sugarcane, coffee, canola, wheat, and tobacco. Our results demonstrate high classification accuracy and precision, with principal component analyses (PCAs)-linked clustering and a kappa coefficient analysis yielding results ranging from 92 to 100% in the ultraviolet-visible (UV-VIS) to near-infrared (NIR) to shortwave infrared (SWIR) bands. Predictive models based on partial least squares regression (PLSR) achieved R2 values ranging from 0.77 to 0.89 and ratio of performance to deviation (RPD) values over 2.1 for each pigment in C3 and C4 plants. The integration of pigment phenotyping methods with fifteen vegetation indices further improved accuracy, achieving values ranging from 60 to 100% across different full or range wavelength bands. The most responsive wavelengths were selected based on a cluster heatmap, β-loadings, weighted coefficients, and hyperspectral vegetation index (HVI) algorithms, thereby reinforcing the effectiveness of the generated models. Consequently, hyperspectral reflectance can serve as a rapid, precise, and accurate tool for evaluating agronomic crops, offering a promising alternative for monitoring and classification in integrated farming systems and traditional field production. It provides a non-destructive technique for the simultaneous evaluation of pigments in the most important agronomic plants.

Event-free survival (EFS) in patients with high-risk neuroblastoma (HRNB) receiving eflornithine (DFMO) maintenance treatment based on a retrospective, blinded independent central review (BICR) of imaging during long-term follow-up.

e22007 Background: BICR methodology can evaluate investigator bias in open label studies. Here (BICR W2218), we address potential investigator bias in the open-label evaluation of EFS in a subset of NMTRC003B patients selected for comparison to patients from ANBL0032 (COG trial; NCT00026312) using imaging and clinical assessments. BICR results were then compared to the propensity-score (PS)-matched external control (NO DFMO) patients from ANBL0032. Methods: NMTRC003B DFMO-treated patients (≤2 years, 750 ±250 mg/m2 BID) on (n = 87) or per (n = 5) ANBL0032 and in remission post-dinutuximab completion were selected for inclusion in the BICR. Imaging evaluations (incl. anatomical [CT/MRI] and nuclear [MIBG and/or PET]) were determined at end of immunotherapy (baseline; to confirm remission); at 3, 6, 9, 12, 18, and 24 months; and, per Standard of Care after 24 months. While only required for the 2-year on-therapy period, imaging data were collected during follow up and also evaluated by BICR. All available imaging data (per patient at each visit; baseline via long-term follow up) from NMTRC003B patients were evaluated by two independent radiologists (IR) with adjudication by a third independent radiologist. BICR data from DFMO patients (N = 92) were used to evaluate BICR-EFS vs. EFS in DFMO-treated patients (N = 92) meeting selection criteria (demographic and risk characteristics) for PS-matched comparison (1:3 ratio for DFMO:NO-DFMO) to ANBL0032 (N = 270). ANBL0032 had enrolled N = 1328 HNRB patients assigned to dinutuximab and follow up (≤10 years)1 and required similar imaging evaluations that were unavailable for the BICR. Concordance was evaluated with Cohen’s Kappa coefficient analysis, and EFS using Kaplan-Meier and Cox regression analyses. Results: All 92 patients had adequate imaging at baseline and were included in the BICR. N = 21/92 (22.8%) cases were adjudicated with a final outcome of unequivocal EFS event in N = 15. Despite discordance in n = 2 patients, concordance was very high during the on-treatment (2 years) and full follow-up (≤7) periods with near perfect agreement. In line with previously reported data1, DFMO treatment was associated with significant improvement in relapse events in BICR-DFMO cases vs. PS-matched, external NO DFMO patients over the full BICR period [hazard ratio, HR 0.54 (95% CI: 0.31, 0.95), p = 0.0337] with 2- and 4-year BICR-EFS for DFMO vs. NO DFMO of 88% vs. 80%, and 84% vs. 73%, respectively. Conclusions: This BICR indicates minimal, if any, bias in imaging evaluations in the original NMTRC003B study, providing confidence in the finding that DFMO treatment in HNRB patients in remission post upfront dinutuximab approximately halves the risk of relapse compared to matched control patients.

Clinical, Dermoscopic and Histopathological Evaluation of Basal Cell Carcinoma.

Dermoscopy aids in identifying histopathological subtypes and the presence of clinically undetectable pigmentation in basal cell carcinoma (BCC). To investigate the dermoscopic features of BCC subtypes and better understand non-classical dermoscopic patterns. Clinical and histopathological findings were recorded by a dermatologist who was blinded to the dermoscopic images. Dermoscopic images were interpreted by two independent dermatologists blinded to the patients' clinical and histopathologic diagnosis. Agreement between the two evaluators and with histopathological findings was evaluated using Cohen's kappa coefficient analysis. The study included a total of 96 BBC patients with 6 histopathologic variants: nodular (n=48, 50%), infiltrative (n=14, 14.6%), mixed (n=11, 11.5%), superficial (n=10, 10.4%), basosquamous (n=10, 10.4%), and micronodular (n=3, 3.1%). Clinical and dermoscopic diagnosis of pigmented BCC showed high agreement with histopathological diagnosis. The most common dermoscopic findings according to subtype were as follows: nodular BCC: shiny white-red structureless background (85.4%), white structureless areas (75%), and arborizing vessels (70.7%); infiltrative BCC: shiny white-red structureless background (92.9%), white structureless areas (78.6%), arborizing vessels (71.4%); mixed BCC: shiny white-red structureless background (72.7%), white structureless areas (54.4%), and short fine telangiectasias (54.4%); superficial BCC: shiny white-red structureless background (100%), short fine telangiectasias (70%); basosquamous BCC: shiny white-red structureless background (100%), white structureless areas (80%), keratin masses (80%); micronodular BCC: short fine telangiectasias (100%). In this study, arborizing vessels were the most common classical dermoscopic feature of BCC, while shiny white-red structureless background and white structureless areas were the most frequent non-classical dermoscopic features.

P225 The accuracy of different intestinal ultrasound parameters in detecting endoscopic activity in patients with inflammatory bowel disease

Abstract Background Intestinal ultrasound (IUS) is considered an accurate tool for assessment of disease activity in inflammatory bowel disease (IBD) patients. We investigated the accuracy of IUS to detect active disease as compared to ileocolonoscopy. Methods We performed a two-center international cross-sectional study that included formally diagnosed IBD patients who underwent IUS and ileocolonoscopy, within a 4 weeks interval. Active disease on IUS was defined as bowel wall thickness (BWT) &amp;gt;3 mm in the most affected bowel segment. Additional IUS parameters evaluated included increase in Doppler color flow in the bowel wall (modified Limberg score &amp;gt; 0), presence of inflammatory fat (FW) and loss of bowel wall stratification (BWS). Active disease at endoscopy was defined as Simple Endoscopic Score for Crohn’s Disease (SES-CD) &amp;gt;2 and Mayo endoscopic score &amp;gt;0. The accuracy of IUS compared to ileocolonoscopy was estimated using sensitivity, specificity, and Cohen’s kappa coefficient analyses. Results We included 85 patients (table 1) performing IUS for disease monitoring (69.4%) and symptoms suggestive of IBD flare (30.6%). Disease was active in IUS in 38/42 (90.5%) of clinically active [Harvey Bradshaw index (HBI) ≥5, Simple Clinical Colitis activity index (SCCAI) &amp;gt;2] and 22/43 (51.2%) of clinically inactive patients (kappa coefficient 0.391, p&amp;lt;0.001). C-reactive protein (CRP) level was 6.95 mg/dl [IQR 2.19-17.75] vs 1.8 mg/dl [IQR 0.85-3.75] in active vs inactive disease on IUS respectively (p&amp;lt;0.001). All patients underwent both endoscopy and IUS, with 63/85 (74.1%) exhibited endoscopic activity. IUS demonstrated 92.1% sensitivity, 90.9% specificity, 96.7% PPV, 80% NPV and kappa coefficient 0.79 in detecting endoscopically active disease (p&amp;lt;0.001). IUS detected 58/63 (92.1%) of endoscopically active cases, and identified the most affected bowel segment in 50/63 (79%) of them. Inability of IUS to identify the most affected bowel segment at endoscopy included rectal involvement (53.8%), complex surgical history (15.38%), stenosis of ileocecal valve (7.69%) and limitations due to obesity (23.07%). Mean BWT of the most affected segment was 4.49 (±1.16) vs 2.33 mm (± 0.63) in endoscopically active vs inactive patients respectively (p&amp;lt;0.001). We furthermore evaluated the accuracy of additional IUS parameters (increased color Doppler flow, FW and loss of BWS) in predicting endoscopic activity (table 2). Conclusion IUS represents a non-invasive tool that can accurately identify disease activity both in Crohn’s disease and ulcerative colitis, when compared to ileocolonoscopy. The most sensitive parameter to detect endoscopic activity was an increased BWT.

Evaluation of diagnostic efficacy of digital liquid chip method for detection of specific antineutrophil cytoplasmic antibodies

To explore the clinical diagnostic efficacy of antineutrophil cytoplasmic antibody associated vasculitis (AAV) by comparing the consistency and coincidence rate of serum anti-myeloperoxidase (MPO) antibody and anti-protease 3 (PR3) antibody detected by digital liquid chip method (DLCM) and enzyme-linked immunosorbent assay (ELISA). To provide reference for the selection of detection methods of anti-MPO antibody and anti-PR3 antibody in clinical laboratory. This study is a cross-sectional study, a total of 307 cases of antineutrophil cytoplasmic antibodies were detected in the Department of Clinical Immunology, West China Hospital of Sichuan University from January to March 2021. The serum samples and related clinical information were collected. At the same time, the levels of anti-MPO antibody and anti-PR3 antibody in serum samples were detected by ELISA and DLCM, indirect immunofluorescence (IIF) was used to re-test the differential samples between the two methods. SPSS 26.0 was used to analyze the test results, Cohen's kappa coefficient analysis was used to compare the consistency of the two methods, and paired chi-square test was used to compare the sensitivity and specificity of the two methods to AAV. The results showed that the positive cases of anti-MPO antibody detected by ELISA and DLCM were 63 and 44, and the negative cases were 244 and 263; the positive cases of anti-PR3 antibody detected by ELISA and DLCM were 34 and 28, and the negative cases were 273 and 279. The results of anti-MPO antibody and anti-PR3 antibody detected by the two methods had good consistency and coincidence rate, in which the total coincidence rate of anti-MPO antibody was 92.51%, the positive coincidence rate was 66.67%, and the negative coincidence rate was 99.18%. The results of consistency analysis showed that kappa=0.741 had well consistency. The total coincidence rate of anti-PR3 antibody is 96.74%, the positive coincidence rate is 76.47%, and the negative coincidence rate is 99.27%. The consistency analysis results show that kappa=0.821 had strong consistency. The results of IIF re-test of differential samples showed that the coincidence rate between DLCM and IIF was higher. The results of comparative analysis of anti-MPO antibody and anti-PR3 antibody showed that the specificity of DLCM was better than that of ELISA, and its sensitivity was lower than that of ELISA. In conclusion, the results of anti-MPO antibody and anti-PR3 antibody detected by DLCM were consistent with those of ELISA. In the combined detection of anti-MPO antibody and anti-PR3 antibody, the specificity of DLCM is better than that of ELISA.

Reliability of Bigliani's Classification using Magnetic Resonance Imaging for Determination of Acromial Morphology.

Bigliani classification is used for determination of acromial morphology, but poor inter-observer reliability has been reported on conventional radiographs. This study aims to assess inter- and intra-observer reliability using magnetic resonance imaging (MRI). Forty consecutive patients diagnosed with subacromial impingement syndrome were included to study. All subjects underwent standard shoulder MRI scan and acromial shape was evaluated by nine observers of different level of expertise (three attending surgeons, three senior orthopaedic residents and three radiologists). A second set of evaluation was performed in order to assess intra-observer reproducibility. Kappa (κ) coefficient analyses both for interobserver reliability and intra-observer reproducibility were then performed. Overall inter-observer agreement among nine observers was fair (κ=0.323). κ values for all 4 individual types ranged from 0.234 to 0.720 with highest agreement for type 4 and lowest agreement for type 3. Second evaluation did not result with an increase of inter-observer agreement (κ=0.338, fair). The κ coefficients for intra-observer reproducibility of nine observers ranged from 0.496 to 0.867. Overall intra-observer reproducibility was substantial. Comparison of inter- and intra-observer reliability among three groups showed no significant difference (p=0.92 and 0.22, respectively). Results showed that MRI did not show superior reliability compared to conventional radiographs. Moreover, inter- and intra-observer agreement did not differ between observers of different level of expertise. Findings of present study suggest that despite a sophisticated imaging modality like MRI, Bigliani's classification apparently lacks accuracy and additional criteria, or different assessment methods are required to assess acromial morphology for clinical guidance.

Concordance of Peripheral Blood and Bone Marrow Next-Generation Sequencing in Hematologic Neoplasms.

Objective Mutational analysis by next-generation sequencing (NGS) obtained by peripheral blood NGS has been of clinical interest to use as a minimally invasive screening tool. Our study evaluates the correlation between NGS results on peripheral blood and bone marrow in hematolymphoid disease. Method We evaluated patients who had NGS for presumed hematologic malignancy performed on peripheral blood and bone marrow within a 1-year interval of each other. We excluded cases in which chemotherapy or bone marrow transplant occurred in the interval between the two tests. The concordance across peripheral blood and bone marrow NGS results was assessed by kappa coefficient analysis. Results A total of 163 patients were studied. Concordance of peripheral blood and bone marrow NGS found in 150 patients (92.0%) with a kappa coefficient of 0.794 (kappa standard error 0.054) and P value for testing kappa <0.0001. Myeloid neoplasms showed concordant results in 77/78 cases (98.7%) with a kappa coefficient of 0.916. Lymphoid neoplasms showed concordant results in 26/31 cases (83.9%) with a kappa coefficient of 0.599. Nonneoplastic cases showed concordant results in 47/54 cases (87.0%) with a kappa coefficient of 0.743. Conclusion Peripheral blood NGS is a reliable tool for mutational analysis and provides a less invasive method for screening and monitoring of the molecular profile.

Land use classification of open-pit mine based on multi-scale segmentation and random forest model.

The mining industry production is an important pillar industry in China, while its extensive production activities have led to several ecological and environmental problems. Earth observation technology using high-resolution satellite imagery can help us efficiently obtain information on surface elements, surveying and monitoring various land occupation issues arising from open-pit mining production activities. Conventional pixel-based interpretation methods for high-resolution remote sensing images are restricted by “salt and pepper” noise caused by environmental factors, making it difficult to meet increasing requirements for monitoring accuracy. With the Jingxiang phosphorus mining area in Jingmen Hubei Province as the studied area, this paper uses a multi-scale segmentation algorithm to extract large-scale main characteristic information using a layered mask method based on the hierarchical structure of the image object. The remaining characteristic elements were classified and extracted in combination with the random forest model and characteristic factors to obtain land occupation information related mining industry production, which was compared with the results of the Classification and Regression Tree model. 23 characteristic factors in three aspects were selected, including spectral, geometric and texture characteristics. The methods employed in this study achieved 86% and 0.78 respectively in overall extraction accuracy analysis and the Kappa coefficient analysis, compared to 79% and 0.68 using the conventional method.