Kendall's Coefficient Of Concordance Research Articles

Expert Evaluation of the Expression of Personal Competencies in Professional Activities

Abstract The analysis of scientific literature provides basis for the relevance of personal competence, focusing on the development of individual's opportunities in professional activities. A new modern approach to personal development is associated with learning and development; health, wellness and safe workplaces; human resources measurement, reporting and financial management and empowering competencies/individual skills, comprising critical thinking and analysis; technology knowledge; research capabilities; quantitative and critical legal thinking capabilities. For the purpose of identifying the relevance of personal competencies in professional activities, an expert evaluation of the energy and environmental sectors was conducted. Summary results of the research of personal competencies in professional activities is presented in an expert evaluation model, distinguishing between the most significant and the least significant components. Non-parametric tests and calculation of the concordance of expert opinions by means of the Kendall concordance coefficient W and H0 hypothesis tests determine good and very good concordance of expert opinions in all cases.

Immunohistochemical HER2 Status Evaluation in Breast Cancer Pathology Samples: A Multicenter, Parallel-Design Concordance Study.

As patients with increased human epidermal growth factor receptor (HER2) overexpression are more likely to benefit from trastuzumab treatment, the accuracy of HER2 receptor status in breast cancer patients is significant for appropriate disease management. However, this assessment is not harmonized and results may be highly variable between centers. The aim of this study was to investigate the degree of interlaboratory variability in the results of HER2 expression reported by 5 participating centers and to assess the concordance between these centers and a reference laboratory.Materials and Methods: A total of 30 breast cancer samples were tested and scored for HER2 expression using immunohistochemical method in 5 centers from Turkey and in a reference laboratory from Netherlands (Academic Medical Center, Amsterdam). All the participating centers had an experience of more than 10 years regarding the HER2 testing. The results were compared both among the centers and with the reference laboratory. When the concordance of participating centers and the reference laboratory was evaluated regarding negative (0-1+), equivocal 2(+) and positive 3(+) classification of HER2 immunostaining, the highest concordance was found in Center-A, and the lowest in Center-C (Kendall's tau-b concordance coefficient 0.911 and 0.724, respectively). The concordance of the centers with reference laboratory was 80.0% both in equivocal and positive samples, while it increased up to 91.8% in negative samples. This study showed that in general there is sufficiently good agreement between the reference laboratory and the participating centers for immunohistochemical HER2 assessment.

Construction of training evaluation system for nurses specialized in cardiovascular disease based on the Kirkpatrick model

Objective To construct the training evaluation system for nurses specialized in cardiovascular disease based on the Kirkpatrick model. Methods From January to October 2017, a total of 30 domestic experts of clinical medicine and nursing specialized in cardiovascular disease from several ClassⅢ Grade A hospitals, in accordance with Kirkpatrick model, were consulted by Delphi method. According to the expert opinion, the weight of the indexes at all levels was determined by the analytic hierarchy process. Results The study conducted a total of 2 rounds of correspondence. The positive coefficient of the first round of consultation was 90.00%, and the positive coefficient of second rounds of consultation was 92.59%; The authority coefficient (Cr) of the experts was 0.76, and the Kendall coefficient of concordance (W) was 0.6~0.8, which was statistically significant by χ2 test (P<0.05) . The evaluation index system included 4 first level indicators, 14 second level indexes and 45 third level indexes. Conclusions The training effect evaluation model of nurses specialized in cardiovascular can reflect the standard of training quality, make the training management scientific and fair, and have wide application value, which is beneficial to promote the construction of specialized nursing team for cardiovascular diseases. Key words: Cardiovascular diseases; Specialized nurse; Kirkpatrick model; Training effect

Characterization of Severe Arterial Phase Respiratory Motion Artifact on Gadoxetate Disodium-Enhanced MRI – Assessment of Interrater Agreement and Reliability

To assess the interrater agreement and reliability of experienced abdominal radiologists in the characterization and grading of arterial phase gadoxetate disodium-related respiratory motion artifact on liver MRI. This prospective multicenter study was initiated by the working group for abdominal imaging within the German Roentgen Society (DRG), and approved by the local IRB of each participating center. 11 board-certified radiologists independently reviewed 40 gadoxetate disodium-enhanced liver MRI datasets. Motion artifacts in the arterial phase were assessed on a 5-point scale. Interrater agreement and reliability were calculated using the intraclass correlation coefficient (ICC) and Kendall coefficient of concordance (W), with p < 0.05 deemed significant. The ICC for interrater agreement and reliability were 0.983 (CI 0.973 - 0.990) and 0.985 (CI 0.978 - 0.991), respectively (both p < 0.0001), indicating excellent agreement and reliability. Kendall's W for interrater agreement was 0.865. A severe motion artifact, defined as a mean motion score ≥ 4 in the arterial phase was observed in 12 patients. In these specific cases, a motion score ≥ 4 was assigned by all readers in 75 % (n = 9/12 cases). Differentiation and grading of arterial phase respiratory motion artifact is possible with a high level of inter-/intrarater agreement and interrater reliability, which is crucial for assessing the incidence of this phenomenon in larger multicenter studies. · Inter- and intrarater agreement for motion artifact scoring is excellent among experienced readers.. · Interrater reliability for motion artifact scoring is excellent among experienced readers.. · Characterization of severe motion artifacts proved feasible in this multicenter study.. · Ringe KI, Luetkens JA, Fimmers R et al. Characterization ofSevere Arterial Phase Respiratory Motion Artifact on Gadoxetate Disodium-Enhanced MRI - Assessment of Interrater Agreement and Reliability. Fortschr Röntgenstr 2017; 190: 341 - 347.

Creation and Initial Validation of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale

ObjectiveTo assess consensual validity, interrater reliability, and criterion validity of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale, a new functional outcome scale intended to capture the severity of oropharyngeal dysphagia, as represented by the degree of diet texture restriction recommended for the patient. DesignParticipants assigned International Dysphagia Diet Standardisation Initiative Functional Diet Scale scores to 16 clinical cases. Consensual validity was measured against reference scores determined by an author reference panel. Interrater reliability was measured overall and across quartile subsets of the dataset. Criterion validity was evaluated versus Functional Oral Intake Scale (FOIS) scores assigned by survey respondents to the same case scenarios. Feedback was requested regarding ease and likelihood of use. SettingWeb-based survey. ParticipantsRespondents (N=170) from 29 countries. InterventionsNot applicable. Main Outcome MeasuresConsensual validity (percent agreement and Kendall τ), criterion validity (Spearman rank correlation), and interrater reliability (Kendall concordance and intraclass coefficients). ResultsThe International Dysphagia Diet Standardisation Initiative Functional Diet Scale showed strong consensual validity, criterion validity, and interrater reliability. Scenarios involving liquid-only diets, transition from nonoral feeding, or trial diet advances in therapy showed the poorest consensus, indicating a need for clear instructions on how to score these situations. The International Dysphagia Diet Standardisation Initiative Functional Diet Scale showed greater sensitivity than the FOIS to specific changes in diet. Most (>70%) respondents indicated enthusiasm for implementing the International Dysphagia Diet Standardisation Initiative Functional Diet Scale. ConclusionsThis initial validation study suggests that the International Dysphagia Diet Standardisation Initiative Functional Diet Scale has strong consensual and criterion validity and can be used reliably by clinicians to capture diet texture restriction and progression in people with dysphagia.

Comparative Analysis of Savers and Non-Savers among Tomato Farmers in Ghana

Abstract The study sought to examine the differences between savers and non-savers among a cross-section of 562 farmers randomly selected from six districts in three regions (Ashanti, Brong Ahafo and Upper East) of Ghana. By means of descriptive statistics in the form of frequencies and percentages, the study segregated the respondents into savers and non-savers and Kendall coefficient of concordance was employed to identify the motives of saving among savers and non-saving among non-savers. In order to test whether savers and non-savers differ in relationship to some key socio-economic demographic characteristics, a series of Pearson’s Chi-tests for independence were employed. Finally, by the application of economic-psychology theory on financial savings through binary logistic regression, the study examined empirical differences between savers and non-savers. The study found out that in terms of a key economic variable, that is, income generated from tomato production, savers tend not to differ from non-savers. The issue then is since savers are faced with similar economic challenges relating to their income generating activities, but still manages to save, then the differences between savers and non-saver go beyond economic reasons. Thus, the distinction between saving and non-saving which is underlined by psychological traits have been found to be mainly behavioural and demographic in nature conveying the idea that rural households themselves have a significant part to play with regards to forming, improving and maintaining their savings habits.

The Concordance of Perception about Dog Bite Impacts and Practices after Dog Bite in Victims, Chiang Mai, Thailand: The Participatory One-Health Disease Detection (PODD) Project Setting Area

Dog bite injury is the one important public health concern especially in rabies endemic areas such as Asia. The negative impacts of dog bite include rabies virus inoculation, wound infection, psychological problems or other somatic disabilities. Thailand is one of rabies endemic country and canine population which is rabid mammals still circulate in the community. The perception of rabies prevention program is necessary and reflect the success of the prevention campaign in communities. The objective of this study was to access the perception of victim practices after the dog bite and their perception of negative impacts to victims. The cross-sectional study was conducted during January 2015 to December 2016. Twenty-one participants who Participatory One Health Disease Detection (PODD) volunteers were invited into the study. We created the perception’s ranking table and keyword cards for the participation. The victims ordered the keyword card and discussed with their ordering. The ranking and discussing data were collected and analyzed by Kendall coefficient of concordance. Only nine participants (42.86%) knew or accustomed the details of dog bite prevention campaign. We significantly found of concordance in both topics; the effect of the bite that victims mostly concerned was rabies virus infection (mean rank = 1.64, Kendall’s W = 0.63, p

Predictors of Success in Bariatric Surgery: the Role of BMI and Pre-operative Comorbidities.

This is a retrospective review of 204 patients who underwent bariatric surgery. The impact of weight regain (WR), pre-operative comorbidities and BMI values on the recurrence of comorbidities was evaluated, and an equation was elaborated to estimate BMI at 5years of bariatric surgery. Pre-operative data, after 1year and after 5years, was collected from the medical records. Descriptive analyses and bivariate hypothesis tests were performed first, and then, a generalised linear regression model with Tweedie distribution was adjusted. The hit rate and the Kendall coefficient of concordance (Kendall's W) of the equation were calculated. At the end, the Mann-Whitney test was performed between the BMI, WR and the presence of comorbidities, after a post-operative period of 5years. The adjustment of the model resulted in an equation that estimates the mean value of BMI 5years after surgery. The hit rate was 82.35% and the value of Kendall's W was 0.85 for the equation. It was found that patients with comorbidities presented a higher median WR (10.13%) and a higher mean BMI (30.09kg/m2) 5years after the surgery. It is concluded that the equation is useful for estimating the mean BMI at 5years of surgery and that patients with low pre-operative HDL and folic acid levels, with depression and/or anxiety and a higher BMI, have a higher BMI at 5years of surgery and higher incidence of comorbid return and dissatisfaction with post-operative results.

P.1.i.034 - Assessment of the myelination of brain structures in patients with schizophrenia using the MRI method

Although previous studies have consistently demonstrated that neurocognitive and social cognitive impairments are commonly observed in schizophrenia, the neural substrates of deficits of cognitive function remain unclear, especially for the chronic schizophrenia. There has been little resting-state functional magnetic resonance imaging (rs-fMRI) study of cognitive function in chronic schizophrenia. In this study we aimed to investigate the changes of rs-fMRI signals with regional homogeneity (ReHo), and explore the correlations between abnormal regional activity and cognitive function in chronic schizophrenia.Altogether 76 subjects, 37 patients with chronic schizophrenia and 39 normal controls matched approximately for age, gender and education level were enrolled. All subjects were evaluated psychotic symptoms by Positive and Negative Syndrome Scale (PANSS) and cognitive function by Wisconsin Card Sorting Test (WCST). Conventional MRI and rs-fMRI were performed in all subjects. ReHo was calculated to measure the temporal synchronization of a given voxel and its neighboring voxels based on Kendall coefficient of concordance (KCC) in the rs-fMRI.For the numbers of achieved categories, percentage of conceptual level response in the scores of WCST, the patient group was significantly lower than the control group (p<0.05). For the total errors, perseverative errors, non-perseverative errors, the patient group was significantly higher than the control group (p<0.05). Significant differences in ReHo were found in 11 regions (included five activated and five with decreased activity in the cerebrum and one with decreased activity in the cerebellum) in the chronic schizophrenia patients when compared with the normal controls. The ReHo map clusters that were significantly different between the two groups showed no significant correlation with clinical symptoms. Correlation of the whole brain with subscores of PANSS-T, PANSS-P, PANSS-N and WCST were significantly found in some regions.The study identified five increased and six decreased spontaneous synchrony in the cerebrum and cerebellum in chronic schizophrenia patients compared to the normal matched controls, which were associated with positive, negative symptoms, and deficits of executive functioning.

A Critical Quality Appraisal Of Studies Estimating The Cost Of Radiotherapy

To critically appraise the quality of radiotherapy cost studies published between 2004 and 2015. Building upon a recent systematic literature review looking at the provider cost in PubMed Medline, Embase (Defourny, 2016), selected studies were examined in-depth focusing on the study quality. The review was performed by three independent reviewers and restricted to studies using cost data published after the QHES grid became available. Selected studies were critically assessed based on 3 existing instruments: CHEERS, CHEC, and QHES. To compare the instruments (inter-instrument agreement) and the agreement between rater, the Kendall coefficient of concordance was calculated. A further refined examination of the references was conducted, focusing on the guidelines’ items relevant for costing. The selection restricted our analysis to 15 articles to be studied in-depth, out of the 52 studies previously selected. The mean score across all articles were respectively 70%, 81%, 72%, mirroring variation in scope of the articles. Over time, instruments’ scores rise with a higher tendency for QHES. Comparison of the instruments per assessor yielded a significant coefficient of 94%, 84% and 87% while the coefficient per rater was significant at 69%, 81% and 77% for each instruments. The inter-rater analysis yielded 10 percent point variation, meaning that they agreed most in rating articles against CHEC, QHES and lastly CHEERS. While the overall mean score was fairly good (74% [31%-93%]), in-depth examination highlights the omission (in the instruments) of criteria covering the type of cost analysis (mean, incremental or full costing) as well as whether the analysis features were modelled or reality-based; these define methodology transparency. Cost studies’ quality was fairly good while influenced by the instrument more than by the assessor. Existing cost guidance establishes an outline framework while leaving a high degree of freedom in the reporting by the researchers which jeopardize comparability across studies.

Reliability of Evaluating Achilles Tendon Vascularization Assessed With Doppler Ultrasound Advanced Dynamic Flow

The reliability of quantifying intratendinous vascularization by high-sensitivity Doppler ultrasound advanced dynamic flow has not been examined yet. Therefore, this study aimed to investigate the intraobserver and interobserver reliability of evaluating Achilles tendon vascularization by advanced dynamic flow using established scoring systems. Three investigators evaluated vascularization in 67 recordings in a test-retest design, applying the Ohberg score, a modified Ohberg score, and a counting score. Intraobserver and interobserver agreement for the Ohberg score and modified Ohberg score was analyzed by the Cohen κ and Fleiss κ coefficients (absolute), Kendall τ b coefficient, and Kendall coefficient of concordance (W; relative). The reliability of the counting score was analyzed by intraclass correlation coefficients (ICC) 2.1 and 3.1, the standard error of measurement (SEM), and Bland-Altman analysis (bias and limits of agreement [LoA]). Intraobserver and interobserver agreement (absolute/relative) ranged from 0.61 to 0.87/0.87 to 0.95 and 0.11 to 0.66/0.76 to 0.89 for the Ohberg score and from 0.81 to 0.87/0.92 to 0.95 and 0.64 to 0.80/0.88 to 0.93 for the modified Ohberg score, respectively. The counting score revealed an intraobserver ICC of 0.94 to 0.97 (SEM, 1.0-1.5; bias, -1; and LoA, 3-4 vessels). The interobserver ICC for the counting score ranged from 0.91 to 0.98 (SEM, 1.0-1.9; bias, 0; and LoA, 3-5 vessels). The modified Ohberg score and counting score showed excellent reliability and seem convenient for research and clinical practice. The Ohberg score revealed decent intraobserver but unexpected low interobserver reliability and therefore cannot be recommended.

Diagnostic Accuracy of Split-Bolus Single-Phase Contrast-Enhanced Cone-Beam CT for the Detection of Liver Tumors before Transarterial Chemoembolization

PurposeTo evaluate detectability of hepatocellular carcinoma (HCC) using split-bolus cone-beam CT in intraindividual comparison between cone-beam CT and contrast-enhanced MR imaging. Materials and MethodsIn a retrospective, single-center study, 28 patients with 85 HCC tumors were treated with transarterial chemoembolization between May 2015 and June 2016. All patients underwent arterial and hepatobiliary phase (HBP) MR imaging within 1 month before transarterial chemoembolization. Cone-beam CT images were acquired using a split-bolus contrast injection with 2 contrast injections and 1 cone-beam CT acquisition. Statistical analyses included Friedman 2-way analysis, Kendall coefficient of concordance, and Wilcoxon test. Tumor detectability was scored using a 5-point system (1 = best; 5 = worst) by 2 independent readers resulting in 170 evaluated tumors. Quantitative analysis included signal-to-noise and contrast-to-noise ratio and contrast measurements. P values < .05 were considered significant. ResultsBetter tumor detection was provided with split-bolus cone-beam CT (2.91/2.73) and HBP MR imaging (2.93/2.21) compared with arterial MR imaging (3.72/3.05; P < .001) without statistical difference between cone-beam CT and HBP MR imaging in terms of detectability (P = .154) and sensitivity for hypervascularized tumors. More tumors were identified on cone-beam CT (n = 121/170) than on arterial MR imaging (n = 94/170). Average contrast-to-noise ratio values of arterial and HBP MR imaging were higher than for cone-beam CT (7.79, 8.58, 4.43), whereas contrast values were higher for cone-beam CT than for MR imaging (0.11, 0.13, 0.97). ConclusionsSplit-bolus cone-beam CT showed excellent detectability of HCC. Sensitivity is comparable to HBP MR imaging and better than arterial phase MR imaging.

Accounts Receivables Management

This paper studied how Zoomlion Company Limited manages its accounts receivables. Based on multiple linear regression analysis, Kendall coefficient of concordance and One sample t-test, the result shows effective credit control systems by the company. However, poor monitoring and lack of effective follow up measures were the key challenges to debt management. The paper recommend stricter adherence to the credit policy and vigorously pursued effective recovery strategies and further prescribed best practices in accounts receivables management.

PERSEPSI PETANI TERHADAP PENGGUNAAN PUPUK ORGANIK PADA USAHATANI MENDONG

Changing a habit is not an easy job, let alone that has great risks as they relate to social and cultural issues. In understanding of technological innovation requires mental readiness to take the decision to adopt it through a process of perception, because the rate of adoption of an innovation depends on the perceptual characteristics of the adopter of innovation that includes the company telnologi relative advantage, the level of conformance level of complexity, can be tried and can be observed. The purpose of this study to examine the relationship between the characteristics of the farmers, the communication behavior and support efforts by the perception of farmers to use organic fertilizer on crops mendong. Partially, the data were analyzed using Spearman Rank analysis, while simultaneously using Kendall concordance coefficient W. Analysis Research was conducted in February-November 2016 using the method of survey. Sampling using simple random sampling against rushes farmers in Sub Manonjaya with a total sample of 30 farmers. The results showed the internal characteristics of the farmers, support the business climate as well as the perception of farmers on organic farming fertilization mendong included in the medium category and communication behavior are included in the low category. Simultaneously there is a relationship between the internal characteristics of the farmers, the communication behavior and support the business climate by perception of farmers on the use of organic fertilizer to the level of the relationship is very close. Partially that have a relationship with the perception of the use of organic fertilizers is the communication behavior and the support of the business climate. Guidance to the farmers both individually and institutionally still needs to be done to encourage farmers to use organic fertilizer on farm mendong.

Headmaster’s Competencies in Management Area: Evaluating the Significance Level of Managerial Competencies in Lithuanian Comprehensive Schools

The aim of the article is to present the insights of carried survey on evaluating the level of significance of managerial competencies in comprehensive schools in Lithuania. The approach that head teachers’ managerial competency highly influences the process of education and is one of the most important factors ensuring efficiency of school activities such as educational policy and strategic planning, educational process, management of human, material and financial resources has been followed. Researcher self-made questionnaire for expert evaluation was used to measure competency components. In the paper the author presents main results of one part of the research related to school leader’s competencies in management area, which was divided into five spheres: strategic institution management, teaching and learning process administration, managing human resource development, ensuring and managing structure, processes and resources of institution, strategic partnership and collaboration. Each of the spheres comprises different items – competences a successful headmaster should dispose. The significance, specified as the most important, was assessed by ranking procedure. The Kendall coefficient of concordance has been used to assess the agreement among raters for every ranked question. The results revealed that the most significant head teachers’ competencies which highly influence the results of school activity areas are the abilities to form the strategic direction and implement effective staff policy, strengthen the attitude of school community that each student can reach a success in the learning process, organize conducive conditions for professional staff development, administer property and allocations, collaborate with parents, foster-parents or guardians.

Problems of Rural Entrepreneurs:A Case Study of District Jalandhar

The present study is an effort to examine the problems of rural entrepreneurs in Jalandhar. The results of the study found that 'inadequate finance', 'inadequate marketing', 'restricted mobility', 'lack of managerial skills', 'technical experience', 'lack of modernization', 'work-family imbalance, 'lack of awareness', 'lack of skilled manpower', 'inadequate supply of power', 'insufficient supply of inputs', 'cut throat competition', 'inflation' and 'reducing subsidies' are the fourteen problems that have an adverse impact over the growth of rural entrepreneurship in Jalandhar. The significant value of Kendall Coefficient of Concordance signifies that there is a close concordance among the perceptions of the respondents pertaining to the statements designed for the study. The findings of the present study will be useful for the various stakeholders' viz., centre and state governments especially dealing with the micro and small scale industry, non-governmental organizations etc. to formulate effective policy for the promotion of rural entrepreneurship in our economy.

Evaluation of facial attractiveness in black people according to the subjective facial analysis criteria.

ABSTRACTObjective: The objective of this study was to evaluate the facial attractiveness in 30 black individuals, according to the Subjective Facial Analysis criteria. Methods: Frontal and profile view photographs of 30 black individuals were evaluated for facial attractiveness and classified as esthetically unpleasant, acceptable, or pleasant by 50 evaluators: the 30 individuals from the sample, 10 orthodontists, and 10 laymen. Besides assessing the facial attractiveness, the evaluators had to identify the structures responsible for the classification as unpleasant and pleasant. Intraexaminer agreement was assessed by using Spearman's correlation, correlation within each category using Kendall concordance coefficient, and correlation between the 3 categories using chi-square test and proportions.Results: Most of the frontal (53. 5%) and profile view (54. 9%) photographs were classified as esthetically acceptable. The structures most identified as esthetically unpleasant were the mouth, lips, and face, in the frontal view; and nose and chin in the profile view. The structures most identified as esthetically pleasant were harmony, face, and mouth, in the frontal view; and harmony and nose in the profile view. The ratings by the examiners in the sample and laymen groups showed statistically significant correlation in both views. The orthodontists agreed with the laymen on the evaluation of the frontal view and disagreed on profile view, especially regarding whether the images were esthetically unpleasant or acceptable.Conclusions: Based on these results, the evaluation of facial attractiveness according to the Subjective Facial Analysis criteria proved to be applicable and to have a subjective influence; therefore, it is suggested that the patient's opinion regarding the facial esthetics should be considered in orthodontic treatmentplanning.

Evaluation of Lactobacillus coryniformis CECT5711 strain as a coadjuvant in a vaccination process: a randomised clinical trial in healthy adults

BackgroundAlthough the effects of probiotics on the immune system have been extensively evaluated under disease states, their role in healthy situations remains unclear, since changes are hardly expected under immunological homeostasis. EFSA indicates that vaccination protocols could be used to evaluate the potential role of probiotics to improve the immune response against antigen challenges. The aim of the study was to evaluate the effect of Lactobacillus coryniformis CECT5711 (Lc) on the specific immunity of healthy volunteers undergoing vaccination with Hepatitis A virus (HAV).MethodsOne hundred twenty-three healthy adults were randomised into three groups to follow a 6-week (wk) intervention and all received an intramuscular HAV vaccine 2 weeks after starting the intervention: 1) PRO1 received Lc for 2weeks (1 capsule/day; 3 × 109 CFU/capsule) and placebo capsules after vaccination; 2) PRO2 received a daily capsule of Lc (3 × 109 cfu/day) before and after the challenge; 3) Control group (C) received a daily placebo capsule before and after the vaccine. Blood samples were collected at the beginning (visit 1; V1) and after 2 (V2) and 6 weeks (V3) of the intervention. At each visit, lymphocyte subset counts and cytokine levels were analysed. Specific HAV antibodies were analysed at V1 and V3. To evaluate differences between groups, one-way ANOVA with Bonferroni post-hoc test were used regarding lymphocyte subset counts and specific HAV antibodies production, and Friedman test of related samples and Kendall concordance coefficient for cytokines production. Chi square test was used to analyse seroconversion rates.ResultsSpecific HAV antibodies were significantly higher in PRO1 (50.54 ± 29.57) compared to C (36.23 ± 16.45) (P = 0.017) and showed an intermediate value in PRO2 (41.61 ± 15.74). Seroconversion rates were similar in the three groups (97.3, 92.3 and 97.4% in C, PRO1 and PRO2 respectively). Memory T-helper lymphocytes increased in V3 vs. V1 (P = 0.032) in PRO2. No differences were found in cytokine concentrations.ConclusionMixed results have been found regarding the usefulness of Lc supplementation to increase the antigen-specific antibody response to an immune challenge. Clinical trial registration number: EudraCT Number 2016-000183-42. Registered 19 January 2016. Retrospectively registered.

Introducing a Novel Applicant Ranking Tool to Predict Future Resident Performance: A Pilot Study.

The purposes of this study are to (1) introduce our novel Applicant Ranking Tool that aligns with the Accreditation Council for Graduate Medical Education competencies and (2) share our preliminary results comparing applicant rank to current performance. After a thorough literature review and multiple roundtable discussions, an Applicant Ranking Tool was created. Feasibility, satisfaction, and critiques were discussed via open feedback session. Inter-rater reliability was assessed using weighted kappa statistic (κ) and Kendall coefficient of concordance (W). Fisher's exact tests evaluated the ability of the tool to stratify performance into the top or bottom half of their class. Internal medicine and anesthesiology residents served as the pilot cohorts. The tool was considered user-friendly for both data input and analysis. Inter-rater reliability was strongest with intradisciplinary evaluation (W = 0.8-0.975). Resident performance was successfully stratified into those functioning in the upper vs. lower half of their class within the Clinical Anesthesia-3 grouping (p = 0.008). This novel Applicant Ranking Tool lends support for the use of both cognitive and noncognitive traits in predicting resident performance. While the ability of this instrument to accurately predict future resident performance will take years to answer, this pilot study suggests the instrument is worthy of ongoing investigation.

Evaluating the Constraints to Development of Agricultural Insurance for Cashew Crop Farmers in Brong-Ahafo Region of Ghana

Research evidence from the International Institute of Tropical Agriculture (CIAT) in 2011 gives credence to the notion that cashew development would mitigate the impact of climate change on cocoa in 2012. This makes cashew development imperative, however to do so requires access to credit from financial institutions, which ration credits when it comes to lending to the agricultural sector. Research evidence has shown a correlation between agricultural insurance and loan uptake in Malawi and Ghana. However an evaluation of the cashew subsector in the Brong-Ahafo Region of Ghana with an aim of developing agricultural insurance schemes for cashew crop farmers has not been without constraints. This study sought to investigate the key constraints that would impede the development of agricultural insurance for cashew crop farmers in the Brong-Ahafo Region of Ghana. Based on a positivist research philosophy, the study employed quantitative techniques. A multistage sampling technique was employed, which involved purposively selecting stakeholders of Ghana Agricultural Insurance Pool (GAIP). A simple random sampling technique was also employed to select 30 pool stakeholders from GAIP. Data were collected by means of structured questionnaires. Data were analyzed by employing descriptive statistics, and the Kendall coefficient of concordance was used in identifying and analyzing the perceived constraints to developing agricultural insurance for the cashew crop farmers in the study area. The result from the survey indicated that high marketing cost; high premiums (making the product unaffordable); lack of agricultural insurance legislation; low availability of data; lack of knowledge about product development; and lack of qualified personnel in the area of agricultural insurance were some of the perceived constraints that would impede the development of agricultural insurance in the study area. Thus a Public Private Partnership approach, as well as research and development, is imperative to overcome the financial, marketing, institutional, technical data, human resources and legal constraints to agricultural insurance and cashew development in the study area.