Perfect Agreement Research Articles

Local in Time Conservative Binary Dynamics at Fourth Post-Minkowskian Order

Leveraging scattering information to describe binary systems in generic orbits requires identifying local and nonlocal in time tail effects. We report here the derivation of the universal (nonspinning) local in time conservative dynamics at fourth post-Minkowskian order, i.e., O(G4). This is achtieved by computing the nonlocal-in-time contribution to the deflection angle, and removing it from the full conservative value in [C. Dlapa , .; C. Dlapa , .]. Unlike the total result, the integration problem involves two scales—velocity and mass ratio—and features multiple polylogarithms, complete elliptic and iterated elliptic integrals, notably in the mass ratio. We reconstruct the local radial action, center-of-mass momentum and Hamiltonian, as well as the exact logarithmic-dependent part(s), all valid for generic orbits. We incorporate the remaining nonlocal terms for ellipticlike motion to sixth post-Newtonian order. The combined Hamiltonian is in perfect agreement in the overlap with the post-Newtonian state of the art. The results presented here provide the most accurate description of gravitationally bound binaries harnessing scattering data to date, readily applicable to waveform modeling. Published by the American Physical Society 2024

Current and secular accretion rates of EX Hydrae

We report an observed accretion rate of\ $ M_1\!=\! pm0.60) for the white dwarf in the short-period, intermediate polar This result is based upon the accretion-induced $4 energy flux from $2.45 to 100\,keV and the corresponding luminosity at the Gaia distance of 56.77\,pc. Our result is in perfect agreement with the theoretical mass transfer rate from the secondary star induced by gravitational radiation (GR) and the spin-up of the white dwarf, $- M_2\!=\! pm0.35) 24<!PCT!> of it is caused by the spin-up. The agreement indicates that mass transfer is conservative. The measured $ M_1$ obviates the need for angular momentum loss (AML) by any process other than GR. We complemented this result with an estimate of the mean secular mass transfer rate over $ by interpreting the non-equilibrium radius of the secondary star in based on published evolutionary calculations. This suggests a time-averaged mass transfer rate enhanced over GR by a factor GR Combined with the present-day lack of such an excess, we suggest that an enhanced secular AML is due to an intermittently active process, such as the proposed frictional motion of the binary in the remnants of nova outbursts. We argue that despite its weakly magnetic nature, has evolved in a very similar way to non-magnetic CVs. We speculate that the discontinuous nature of an enhanced secular AML may similarly apply to the latter.

Verifying a novel bile cytology scoring system.

The scoring system for bile cytology (SSBC) aims to improve bile cytology diagnostic accuracy. Here, the practicality of SSBC was verified by multiple cytotechnologists. Bile cytological specimens were evaluated by 24 cytotechnologists using SSBC. The samples were assessed before using the SSBC (first-time assessment) according to three categories: benign, indeterminate, and malignant. A first scoring evaluation (FSE) was then performed using SSBC; each item in the scoring system was classified as present or absent. After distributing an instruction sheet with diagnostic criteria, a second scoring evaluation (SSE) was performed using SSBC. Each method was evaluated using diagnostic accuracy and interobserver and intraobserver agreement. Several samples were assessed as indeterminate in the first-time assessment. Although the specificity of the SSE improved, the sensitivity and accuracy decreased compared with those of the FSE. The overall interobserver agreement was fair for all parameters, including abnormal chromatin, irregular internuclear distances, irregularly overlapped nuclei, irregular cluster margins, and final evaluation in the FSE and SSE. The final evaluation by histological type exhibited slight agreement for well-differentiated tubular adenocarcinoma and almost perfect agreement for poorly differentiated tubular adenocarcinoma in the FSE and SSE. For moderately differentiated tubular adenocarcinoma, agreement was moderate in the FSE and fair in the SSE. For cholangitis, a slight agreement was observed in the FSE, which improved to fair in the SSE. Although the SSBC is expected to improve specificity, there exists ambiguity regarding SSBC criteria and interindividual assessment differences. Therefore, the objective assessment method should be revised.

#2646 Precision verification and method comparison of anti-MPO anti-hsPR3 immunoassay on Alegria2 instrument

Abstract Background and Aims Antibodies to myeloperoxidase (anti-MPO) and proteinase 3 (anti-PR3) are recognized as the only clinically relevant antineutrophil cytoplasmic antibodies (ANCA) specificities so far. ANCA testing can be used in different clinical settings, especially in situations that require rapid diagnosis like renal-pulmonary syndrome that require result within 24 hours. The aim of this study was to perform analytical verification of the new automated single test ELISA based method on Alegria2 instrument to test if the reagents and analyser were acceptable for the routine use. Method For precision assessment we tested two concentration levels of commercial control material in triplicate for five days in a row. We used EASI acceptable criteria for precision for anti-MPO as well as for anti-hsPR3. For method comparison we included 50 patients with history or suspicion of vasculitis. Anti-MPO and anti-PR3 were measured using 5 different reagents: Anti-Myeloperoxidase ELISA (IgG) and anti-PR3-hn-hr ELISA (IgG) on Euroimmun Analyzer I-2P (EUROIMMUN AG, Lubeck, Germany), MPO and PR3 II chemiluminiscent immunoassay (CLIA) on IDS iSYS (IDS ISYS, Pouilly en Auxois, France), QUANTA Flash® MPO and QUANTA Flash® PR3 CLIA on BIO-FLASH® (Inova Diagnostics Inc, San Diego, USA), Anti-MPO and anti-PR3 hs on Alegria2 ELISA based method (Orgentec, Mainz, Germany), and Anti-MPO and anti-PR3 ELISA (Orgentec, Mainz, Germany). Results were categorized as positive or negative and we calculated kappa statistics as well as intraclass correlation coefficient. Complete statistical analysis was done using MedCalc statistical software (MedCalc version 14.8.1, Ostend, Belgium). Results Within-laboratory precision (CV%) for anti-MPO for normal and pathological controls were 5.73% and 15.14% respectively. For anti-PR3 hs within-laboratory precision (CV%) for normal and pathological controls were 5.46% and 18.89% respectively. Intraclass correlation coefficient showed excellent degree of consistency in average measures (0.9778 (95% CI: 0.9665-0.9862)) for anti-MPO and good reliability on single ratings (0.8981 (95% CI: 0.8522-0.9344). For anti PR3 intraclass correlation coefficient showed excellent degree of consistency in average measures (0.9257 (95% CI: 0.8873-0.9539)) but only moderate consistency in single ratings (0.7136 (95% CI: 0.6115-0.8053)). Separate Cohen`s kappa testing revealed almost perfect agreement for most reagent combination for anti- MPO (kappa from 0.825 to 0.958). For anti-PR3 we found moderate agreement between QUANTA Flash® PR3 and PR3 II IDS iSYS (kappa 0.520) but mostly substantial agreement (kappa from 0.629 to 0.865). We also found almost perfect agreement between anti-PR3 hs on Alegria2 and QUANTA Flash® PR3 (kappa = 0.901). Conclusion Our results showed a rather small relative variability and met the precision criteria defined by EASI initiative. Satisfactory agreement between methods is very reassuring but due to the lack of standardisation in autoimmune diagnostics imposes that information about methodological differences must be clearly stated on laboratory report. According to our results the new method for anti-MPO and anti-PR3 proved to be suitable for the routine use.

Development and Validation of a Composite Skin Quality Scale

Abstract Background The increasing demand for skin quality interventions in aesthetic medicine underscores the necessity for objective, evidence-based assessment tools that may be used to evaluate novel interventions or devices. Objectives To develop and validate a 5-point photo-numeric rating scale for assessing overall skin quality, including radiance, color evenness, and smoothness. Methods The IBSA (Institut Biochimique SA) Composite Skin Quality Scale was developed and underwent live validation with 88 real-world patients, chosen to encompass a broad spectrum of skin qualities and Fitzpatrick skin types. Scale validation was performed by board-certified plastic surgeons and dermatologists over 2 rounds, 2 weeks apart. Reliability was assessed via intrarater and interrater agreements, utilizing weighted kappa statistics and intraclass correlation coefficient (ICC). The scale's ability to discern a clinically relevant 1-grade difference was evaluated with 72 photo pairs. Results Combined intrarater reliability results showed weighted kappa values of 0.812 (right side) and 0.815 (left side), and an ICC of 0.903 for both sides, indicating almost perfect agreement. Interrater reliability ranged from substantial to almost perfect, with kappa coefficients between 0.654 and 0.853, and ICCs from 0.657 to 0.855 across all rater pairs in both rounds. The ability to detect a clinically relevant 1-point difference using the scale was established. Conclusions Integrating various key aspects of skin quality, the IBSA Composite Skin Quality Scale is a clinically relevant and highly reliable tool, suitable for skin assessment in clinical studies of new aesthetic technologies and products.

Post-Newtonian multipoles from the next-to-leading post-Minkowskian gravitational waveform

We consider the frequency-domain leading order and next-to-leading order post-Minkowskian waveforms obtained from the tree-level and one-loop amplitudes describing the scattering of two massive scalar objects and the emission of one graviton. We explicitly calculate their post-Newtonian (PN) limit obtaining an expansion up to the third subleading PN order in all ingredients: the tree-level amplitude, the odd and even parts of the real one-loop kernel, and the Compton or “rescattering” cuts, thus reaching 3PN precision for the latter. We provide explicit expressions for the multipole decomposition of these results in the center-of-mass frame and compare them with the results obtained from the classical multipolar post-Minkowskian method. We find perfect agreement between the two, once the Bondi-Metzner-Sachs supertranslation frame is properly adjusted and the infrared divergences due to rescattering are suitably subtracted in dimensional regularization. This shows that the approach proposed in Georgoudis [An eikonal-inspired approach to the gravitational scattering waveform, 089] can be applied beyond the soft-regime ensuring the agreement between amplitude-based and multipolar post-Minkowskian results for generic frequencies. Published by the American Physical Society 2024

Adequacy of sigmoidoscopy as compared to colonoscopy for assessment of disease activity in patients of ulcerative colitis: a prospective study.

Patients of ulcerative colitis (UC) on follow-up are routinely evaluated by sigmoidoscopy. There is no prospective literature to support this practice. We assessed agreement between sigmoidoscopy and colonoscopy prospectively in patients with disease extent beyond the sigmoid colon. We conducted a prospective observational study at a tertiary care institute for agreement between sigmoidoscopy and colonoscopy. We assessed endoscopic activity using the Mayo Endoscopic Score (MES) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and histological activity using the Nancy Index (NI), Robarts Histopathology Index (RHI), and Simplified Geboes Score (SGS). Sigmoidoscopy showed a strong agreement with colonoscopy for MES and UCEIS with a kappa (K) of 0.96 and 0.94 respectively. The misclassification rate for MES and UCEIS was 3% and 5% respectively. Sigmoidoscopy showed perfect agreement (K = 1.00) with colonoscopy for assessment of the presence of endoscopic activity in the colon using MES ??1 as activity criteria and strong agreement (K = 0.93) using MES > 1 as activity criteria. Sigmoidoscopy showed strong agreement with colonoscopy for assessment of the presence of endoscopic activity using UCEIS (K = 0.92). Strong agreement was observed between sigmoidoscopy and colonoscopy using NI (K = 0.86), RHI (K = 1.00), and SGS (K = 0.92) for the detection of histological activity. The misclassification rate for the detection of histological activity was 2%, 0%, and 1% for NI, RHI, and SGS respectively. Sigmoidoscopy showed strong agreement with colonoscopy for endoscopic and histologic disease activity. Sigmoidoscopy is adequate for assessment of disease activity in patients with UC during follow-up evaluation.

Statistics of Extreme Events in Integrable Turbulence

We use the spectral kinetic theory of soliton gas to investigate the likelihood of extreme events in integrable turbulence described by the one-dimensional focusing nonlinear Schrödinger equation (fNLSE). This is done by invoking a stochastic interpretation of the inverse scattering transform for fNLSE and analytically evaluating the kurtosis of the emerging random nonlinear wave field in terms of the spectral density of states of the corresponding soliton gas. We then apply the general result to two fundamental scenarios of the generation of integrable turbulence: (i) the asymptotic development of the spontaneous modulational instability of a plane wave, and (ii) the long-time evolution of strongly nonlinear, partially coherent waves. In both cases, involving the bound state soliton gas dynamics, the analytically obtained values of the kurtosis are in perfect agreement with those inferred from direct numerical simulations of the fNLSE, providing the long-awaited theoretical explanation of the respective rogue wave statistics. Additionally, the evolution of a particular nonbound state gas is considered, providing important insights related to the validity of the so-called virial theorem. Published by the American Physical Society 2024

On the intermediate Jacobian of M5-branes

We study Euclidean M5-branes wrapping vertical divisors in elliptic Calabi-Yau fourfold compactifications of M/F-theory that admit a Sen limit. We construct these Calabi-Yau fourfolds as elliptic fibrations over coordinate flip O3/O7 orientifolds of toric hypersurface Calabi-Yau threefolds. We devise a method to analyze the Hodge structure (and hence the dimension of the intermediate Jacobian) of vertical divisors in these fourfolds, using only the data available from a type IIB compactification on the O3/O7 Calabi-Yau orientifold. Our method utilizes simple combinatorial formulae (that we prove) for the equivariant Hodge numbers of the Calabi-Yau orientifolds and their prime toric divisors, along with a formula for the Euler characteristic of vertical divisors in the corresponding elliptic Calabi-Yau fourfold. Our formula for the Euler characteristic includes a conjectured correction term that accounts for the contributions of pointlike terminal ℤ2 singularities corresponding to perturbative O3-planes. We check our conjecture in a number of explicit examples and find perfect agreement with the results of direct computations.

Investigation of Bandgap Properties of a Piezoelectric Phononic Crystal Plate Based on the PDE Module in COMSOL.

Aiming to address the vibration noise problems on ships, we constructed a piezoelectric phononic crystal (PC) plate structure model, solved the governing equations of the structure using the partial differential equations module (PDE) in the finite element softwareCOMSOL6.1, and obtained the corresponding energy band structure, transmission curves, and vibration modal diagrams. The application of this method to probe the structural properties of two-dimensional piezoelectric PCs is described in detail. The calculation results obtained using this method were compared with the structures obtained using the traditional plane wave expansion method (PWE) and the finite element method (FE). The results were found to be in perfect agreement, which verified the feasibility of this method. To safely and effectively adjust the bandgap within a reasonable voltage range, this paper explored the order of magnitude of the plate thickness, the influence of the voltage on the bandgap, and the dependence between them. It was found that the smaller the order of magnitude of the plate thickness, the smaller the order of magnitude of the band in which the bandgap was located. The magnitude of the driving voltage that made the bandgap change became smaller accordingly. The new idea of attaching the PC plate to the conventional plate structure to achieve a vibration damping effect is also briefly introduced. Finally, the effects of lattice constant, plate width, and thickness on the bandgap were investigated.

True lateral imaging during lumbar medial branch radiofrequency neurotomy: Interobserver reliability

BackgroundTrue lateral imaging (TLI), obtained by superimposing bilateral lumbar spine structures and aligning superior endplate cortical bone, requires deliberate rotational adjustments of the laterally positioned fluoroscope in both the axial and longitudinal planes. True lateral segmental imaging is necessary to depict true and accurate radiofrequency (RF) cannula positioning relative to bony anatomy during lumbar medial branch radiofrequency neurotomy (LMBRFN). ObjectiveTo determine the interobserver reliability of TLI during LMBRFN. MethodsThis was a retrospective review of a prospectively generated collection of lateral fluoroscopic images to determine the interobserver reliability of TLI during LMBRFN. Lateral fluoroscopic images were prospectively collected from 34 consecutive L4-5 and L5-S1 LMBRFN procedures during routine clinical practice. Employing International Pain and Spine Intervention Society (IPSIS) LMBRFN and TLI techniques, an RF cannula was positioned parallel to the L3 and L4 medial branches and the L5 dorsal rami. During the normal course of TLI, untrue and final true lateral segmental images were obtained and saved. An original data set of 100 pairs of true and untrue lateral images was reviewed to verify true laterality using established criteria; disagreement was resolved by consensus or discarding ambiguous cases. To measure interobserver reliability (Cohen's Kappa), two blinded expert reviewers independently reviewed the image set, identifying the true lateral image and the plane requiring correction. ResultsThe observers agreed upon 98/98 true lateral RF-segment images (Kappa score 1.0 [1.00,1.00]). The observers agreed upon 86/98 maneuvers to correct the untrue RF-segment image. The Kappa score for determining the most appropriate corrective maneuver was 0.76 (0.63,0.89), showing substantial interobserver agreement. ConclusionsThe true lateral image of the targeted RF segment during LMBRFN was reliably determined with perfect interobserver agreement. Interobserver agreement was substantial regarding the maneuver to achieve TLI.

3D endoanal ultrasound versus external phased array MRI in detection and evaluation of anal sphincteric lesions

BackgroundThe anal sphincteric complex is formed by internal and external sphincters making two partially overlapping tubes around the anal canal. Anal sphincteric lesions represent a spectrum of entities with different patients’ presentations and surgical managements. Endoanal ultrasound has an increasing role in detection and evaluation of anal sphincteric lesions as compared to MRI of the anal canal. The aim of this work was to compare between the 3D EAUA and external phased array MRI in detection and evaluation of anal sphincteric lesions.ResultsThere is almost perfect agreement of 97.92% (Κw = 0.972) between 3D EAUS and external phased array MRI in the detection of the internal anal sphincter lesions and fair agreement of 66.67% (Κw = 0.37) in the detection of the external anal sphincteric lesions.Conclusions3D EAUS and external phased array MRI are comparable imaging techniques in the detection of the internal anal sphincter lesions, while the MRI could detect more external sphincteric lesions than EAUS.

Chaos near to the critical point: butterfly effect and pole-skipping

We study the butterfly effect and pole-skipping phenomenon for the 1RCBH model which enjoys a critical point in its phase diagram. Using the holographic idea, we compute the butterfly velocity and interestingly find that this velocity can probe the critical behavior of this model. We calculate the dynamical exponent of this quantity near the critical point and find a perfect agreement with the value of the other quantity’s dynamical exponent near this critical point. We also find that at special points, namely the (ω⋆=iλL,k⋆=iλL/vB),\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$(\\omega _\\star = i \\lambda _L, \\, k_\\star = i\\lambda _L/v_B),$$\\end{document} where λL\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\lambda _L$$\\end{document} and vB\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$v_B$$\\end{document} are Lyapunov exponent and butterfly velocity respectively, the phenomenon of pole-skipping appears which is a sign of a multivalued retarded Green’s function. Furthermore, we observe that vB2≥cs2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$v_B^2 \\ge c_s^2$$\\end{document} at each point of parameter space of the 1RCBH model where cs\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$c_s$$\\end{document} is the speed of sound wave propagation.

Evaluation of the reliability and validity of the upright head roll test for lateral semicircular canal benign paroxysmal positional vertigo.

The upright head roll test (UHRT) is a recently introduced diagnostic maneuver for lateral semicircular canal benign paroxysmal positional vertigo (LSC-BPPV). This study aimed to evaluate the reliability and validity of the UHRT. Two separate studies were conducted. Study 1 analyzed 827 results of videonystagmography (VNG) to assess UHRT reliability, and Study 2 analyzed 130 LSC-BPPV cases to evaluate UHRT validity. The inter-test reliability between UHRT and the supine head roll test (SHRT) showed substantial agreement (Cohen's kappa = 0.753) in direction-changing positional nystagmus (DCPN) and almost perfect agreement (Cohen's kappa = 0.836) in distinguishing the direction of DCPN. The validity assessment of UHRT showed high accuracy in diagnosing LSC-BPPV (80.0%) and in differentiating the variant types (74.6%). UHRT was highly accurate in diagnosing the canalolithiasis type in LSC-BPPV patients (Cohen's kappa = 0.835); however, it showed only moderate accuracy in diagnosing the cupulolithiasis type (Cohen's kappa = 0.415). The intensity of nystagmus in UHRT was relatively weaker than that in SHRT (P < 0.05). UHRT is a reliable test for diagnosing LSC-BPPV and distinguishing subtypes. However, UHRT has a limitation in discriminating the affected side owing to a weaker intensity of nystagmus than SHRT.

Counting \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\mathcal{N}$$\\end{document} = 8 black holes as algebraic varieties

We calculate the helicity trace index B14 for \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\mathcal{N}$$\\end{document} = 8 pure D-brane black holes using various techniques of computational algebraic geometry and find perfect agreement with the existing results in the literature. For these black holes, microstate counting is equivalent to finding the number of supersymmetric vacua of a multi-variable supersymmetric quantum mechanics which in turn is equivalent to solving a set of multi-variable polynomial equations modulo gauge symmetries. We explore four different techniques to solve a set of polynomial equations, namely Newton Polytopes, Homotopy continuation, Monodromy and Hilbert series. The first three methods rely on a mixture of symbolic and high precision numerics whereas the Hilbert series is symbolic and admit a gauge invariant analysis. Furthermore, exploiting various exchange symmetries, we show that quartic and higher order terms are absent in the potential, which if present would have spoiled the counting. Incorporating recent developments in algebraic geometry focusing on computational algorithms, we have extended the scope of one of the authors previous works [1, 2] and presented a new perspective for the black hole microstate counting problem. This further establishes the pure D-brane system as a consistent model, bringing us a step closer to \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\mathcal{N}$$\\end{document} = 2 black hole microstate counting.

Assessment of inter- and intraobserver agreement for META score in distinguishing osteoporotic from multiple myeloma vertebral fractures.

To conduct an independent assessment of inter- and intraobserver agreement for the META score as a tool for differentiating osteoporotic vertebral fractures and multiple myeloma vertebral fractures. This is a retrospective observational study. The magnetic resonance imaging analysis was made by two independent spinal surgeons. We designated a Subjective assessment, in which the surgeon should establish a diagnostic classification for each vertebral fracture based on personal experience: secondary to osteoporosis, categorized as a benign vertebral fracture (BVF), or attributed to multiple myeloma, categorized a malign vertebral fracture (MVF). After a 90-day interval, both surgeons repeated the evaluations. For the next step, the observers should establish a diagnosis between BVF and MVF according to the META score system, and both observers repeated the evaluations after a 90-day interval. The intra and interobserver reliability of the Subjective evaluation was studied using the kappa (κ) test. Then, the META evaluations were paralleled using the intraclass correlation coefficient (ICC). A total of 220 patients who had the potential to participate in the study were initially enrolled, but after applying the exclusion criteria, 44 patients were included. Thirty-three patients had BVF, and 12 patients presented MVF. Interobserver agreement for both Subjective evaluations moments (initial and 90-days interval) found a slight agreement for both moments (0.35 and 0.40 respectively). Kappa test for both META evaluations moments (initial and 90-days interval) found a moderate interobserver agreement for both moments (0.54 and 0.48 respectively). It was observed that the ICC calculated for the Initial evaluation using META score was 0.680 and that in the 90-days interval was 0.726, indicating regular to good agreement. Kappa test for intraobserver agreements for the Subjective evaluation presented moderate agreement for both Surgeons. On the other side, Kappa test for intraobserver agreements for the META evaluation presented substantial agreement for both Surgeons. The Intraclass Correlation Coefficient of the META score found presented an almost perfect agreement for both Surgeons. Intra and interobserver agreement for both surgeons were unsatisfactory. The lack of consistent reproducibility by the same observer discourages and disfavors the routine use of the META score in clinical decision making, when potentially cases of multiple myeloma may be present.

Simulation-Based Cardiopulmonary Examination Skills Checklist: Assessment of Inter-rater Reliability

Purpose: Experiential learning using high-fidelity simulation is a valuable tool for teaching Doctor of Physical Therapy (DPT) students the cardiopulmonary examination. There are currently no standardized assessment tools to evaluate student performance and provide feedback on these skills. The cardiovascular and pulmonary section of the American Physical Therapy Association recently published recommended competency levels for entry-level physical therapists including examination skills. The primary aim of this study was to create and assess inter-rater reliability of a cardiopulmonary examination skills checklist that aligns with these recommendations and can be used in the simulation environment. Methods: A skills checklist with 6 sections was developed to assess student performance on the cardiopulmonary examination within a high-fidelity simulation experience. Training videos on the cardiopulmonary examination and checklist use were created and given to 3 graders. Seventy-three DPT students performed the cardiopulmonary examination within simulation while being recorded. Three graders then assessed the same 25 randomly selected videos using the checklist. Inter-rater reliability, item % agreement and student performance were analyzed. Results: The overall interclass correlation coefficient (ICC) of the checklist was calculated to be 0.858, demonstrating strong agreement between graders. The ICC for individualized checklist sections ranged from 0.659 to 0.960, demonstrating good to near perfect agreement. The average percent correct achieved by students was 80.48 (6.91%), R = 65% to 93.33%. There were &gt;80% agreement for 55/60 items and &gt;90% agreement for 44/60 items. Conclusion: The checklist provided an effective tool to assess student performance on the cardiopulmonary examination and demonstrated consistent scoring between graders.

Intercomparison of eddy-covariance software for urban tall-tower sites

Abstract. Long-term tall-tower eddy-covariance (EC) measurements have been recently established in three European pilot cities as part of the ICOS-Cities project. We conducted a comparison of EC software to ensure a reliable generation of interoperable flux estimates, which is the prerequisite for avoiding methodological biases and improving the comparability of the results. We analyzed datasets covering 5 months collected from EC tall-tower installations located in urbanized areas of Munich, Zurich, and Paris. Fluxes of sensible heat, latent heat, and CO2 were calculated using three software packages (i.e., TK3, EddyPro, and eddy4R) to assess the uncertainty of flux estimations attributed to differences in implemented postprocessing schemes. A very good agreement on the mean values and standard deviations was found across all three sites, which can probably be attributed to a uniform instrumentation, data acquisition, and preprocessing. The overall comparison of final flux time series products showed a good but not yet perfect agreement among the three software packages. TK3 and EddyPro both calculated fluxes with low-frequency spectral correction, resulting in better agreement than between TK3 and the eddy4R workflow with disabled low-frequency spectral treatment. These observed flux discrepancies indicate the crucial role of treating low-frequency spectral loss in flux estimation for tall-tower EC systems.

Comparative evaluation of the diagnostic accuracies of four different malaria rapid diagnostic test kits available in Ghana.

Malaria rapid diagnostic test (mRDT) kit is one of the techniques for diagnosing malaria. Due to its inherent advantages over the microscopy technique, several brands of the kit have flooded malaria endemic countries, without prior in-country evaluation. Two of such mRDT kits are Oscar (India) and Standard Q (Korea Republic). In this study, the performance of Oscar and Standard Q mRDT kits were compared to First Response (India) and CareStart (USA) mRDTs, which have been evaluated and deployed for use approved by the Ministry of Health (MOH). In this comparative study, whole blood samples were collected from patients suspected of malaria. Plasmodium falciparum was detected in each sample using nested polymerase chain reaction (nPCR), microscopy and the four mRDTs. The sensitivities, specificities, accuracies, positive and negative predictive values and accuracies of the mRDTs were determined using nPCR as a reference technique. Kappa statistic was used to determine the level of agreement among the techniques. Two hundred (200) blood samples were analyzed in this study. The overall detection rates of P. falciparum by microscopy, First Response, CareStart, Oscar-PfHRP2, Standard Q mRDT kits and nPCR were 31.5%, 34.5%, 33.5%, 32%, 31% and 43% (x2 = 6.1, p = 0.046), respectively. The accuracies of CareStart and First Response were comparable (90.5% vs. 89.5%). Further, comparing their sensitivities, Oscar-PfHRP2 was 74.4% (95% confidence interval (CI): 63.9-83.2) while that of Standard Q was 72.1% (95% CI: 61.4-81.2), with comparable accuracies (Oscar-PfHRP2-89% and Standard Q -88%). Apart from First Response that was 98.3% specific, the others were 100% specific. Kappa test revealed perfect diagnostic agreement (κ = 0.90-0.98) among the four mRDTs. That notwithstanding, Oscar-PfHRP2 agreed better with CareStart (κ = 0.94) and First Response (κ = 0.92) compared to the agreement between Standard Q and, CareStart (κ = 0.92) and First Response (κ = 0.90). Taken together, the diagnostic performance of the four mRDT kits were statistically similar. That notwithstanding, new mRDT kits should be evaluated prior to deployment for use.

Revisiting logarithmic correction to five dimensional BPS black hole entropy

We compute logarithmic correction to the entropy of BPS black holes in asymptotically flat five dimensional space-time using finite temperature black hole geometry and find perfect agreement with the microscopic results and macroscopic computations based on zero temperature near horizon geometry. We also reproduce the Bekenstein-Hawking term for zero temperature black hole entropy from the corresponding term for finite temperature black hole.