Subjective Grading Research Articles

MR Defecating Proctography with Emphasis on Posterior Compartment Disorders.

MR defecating proctography (MRDP) is a noninvasive examination that can be used for evaluating posterior compartment disorders. MRDP has several advantages over conventional fluoroscopic defecography. These benefits include high-contrast resolution evaluation of the deep pelvic organs, simultaneous multicompartmental assessment that is performed statically and dynamically during defecation, and lack of ionizing radiation. MRDP also provides a highly detailed anatomic evaluation of the pelvic floor supportive structures, including direct assessment of the pelvic floor musculature and indirect assessment of the endopelvic fascia. As the breadth of knowledge regarding anatomic and functional posterior compartment disorders expands, so too does the advancement of noninvasive and surgical treatment options for these conditions. High-quality MRDP examinations, with key anatomic and functional features reported, guide treatment planning. Reporting of MRDP examination findings with use of standardized terminology that emphasizes objective measurements rather than subjective grading aids consistent communication among radiologists, clinicians, and surgeons. Familiarity with commonly encountered posterior compartment pelvic floor pathologic entities that contribute to posterior compartment disorders and awareness of the essential information needed by surgeons are key to providing an optimal multidisciplinary discussion for planning pelvic floor dysfunction treatment. The authors provide an overview of the basic concepts of the MRDP acquisition technique, the anatomic abnormalities of posterior compartment pelvic floor pathologic entities associated with defecatory disorders, and recently developed interdisciplinary MRDP reporting templates and lexicons. In addition, the associated imaging findings that are key for surgical treatment guidance are highlighted. © RSNA, 2022 Online supplemental material is available for this article.

Lid wiper epitheliopathy: Current knowledge and future directions

Abstract Lid wiper epitheliopathy (LWE) is a recently recognized clinical entity that involves the epithelial cells lining the lid wiper region of the upper and lower eyelids. LWE has gained attention in the field of ophthalmology due to its association with ocular discomfort, especially in contact lens wearers and individuals with dry eye symptoms. This review article aims to provide an overview of the current understanding of LWE, including its etiology, clinical implications, diagnosis, and potential treatment approaches. The etiology of LWE is believed to be multifactorial, with mechanical factors, contact lens wear, dry eye disease, and inflammation among the contributing factors. Clinically, LWE is diagnosed through the observation of the lid wiper region after staining with vital dyes. LWE is now recognized as a potential diagnostic sign of dry eyes, even in non-contact lens users. The condition has been linked to ocular surface discomfort and may explain a subset of dry eye cases where signs and symptoms do not correlate. Various grading scales have been used to assess the severity of LWE, with some studies exploring the potential of objective methods to complement subjective grading. While much progress has been made in understanding LWE, future research should focus on refining diagnostic criteria, exploring innovative treatment modalities, and investigating its association with other ocular surface conditions. A better understanding of LWE will contribute to improved management strategies and patient outcomes, particularly in individuals experiencing ocular discomfort and dry eye symptoms.

The Impact of Project-Based Learning Models on Improving Students' Value and Understanding on Natural Sciences Lessons

In the era of independent learning, there was a low interest in and understanding of Natural Sciences (IPA) subjects among students. The project-based learning model emerged as an alternative to overcoming these constraints. So researchers want to know the impact of project-based learning in primary schools. The method used is pre-experimental quantitative, with the design as follows: taking samples, pretest, providing guidance, post-test after guidance, looking for the average value of the pretest and post-test, and T test results. The research was conducted at Surakarta Basic School with a 30th grade student. Types of bound variables are the values and understanding of students in the V class of Natural Sciences (IPA) and project-based free learning variables. Collecting techniques with post-test and post-test as well as data analysis with pairs of T tests. Research finds that project-based learning models have an influence on elementary school students in the fifth grade in natural science subjects (IPA). Based on the analysis, results show that t hitung > t table (2.977 > 1.6991) means there are significant differences, so the project-based learning model has an influence on value and understanding.
 Keywords: Impact of Project-Based Learning, Project-Based Learning Models, Improving Students' Value

Integrated radiomics, dose-volume histogram criteria and clinical features for early prediction of saliva amount reduction after radiotherapy in nasopharyngeal cancer patients

PurposePreviously, the evaluation of xerostomia depended on subjective grading systems, rather than the accurate saliva amount reduction. Our aim was to quantify acute xerostomia with reduced saliva amount, and apply radiomics, dose-volume histogram (DVH) criteria and clinical features to predict saliva amount reduction by machine learning techniques.Material and methodsComputed tomography (CT) of parotid glands, DVH, and clinical data of 52 patients were collected to extract radiomics, DVH criteria and clinical features, respectively. Firstly, radiomics, DVH criteria and clinical features were divided into 3 groups for feature selection, in order to alleviate the masking effect of the number of features in different groups. Secondly, the top features in the 3 groups composed integrated features, and features selection was performed again for integrated features. In this study, feature selection was used as a combination of eXtreme Gradient Boosting (XGBoost) and SHapley Additive exPlanations (SHAP) to alleviate multicollinearity. Finally, 6 machine learning techniques were used for predicting saliva amount reduction. Meanwhile, top radiomics features were modeled using the same machine learning techniques for comparison.Result17 integrated features (10 radiomics, 4 clinical, 3 DVH criteria) were selected to predict saliva amount reduction, with a mean square error (MSE) of 0.6994 and a R2 score of 0.9815. Top 17 and 10 selected radiomics features predicted saliva amount reduction, with MSE of 0.7376, 0.7519, and R2 score of 0.9805, 0.9801, respectively.ConclusionWith the same number of features, integrated features (radiomics + DVH criteria + clinical) performed better than radiomics features alone. The important DVH criteria and clinical features mainly included, white blood cells (WBC), parotid_glands_Dmax, Age, parotid_glands_V15, hemoglobin (Hb), BMI and parotid_glands_V45.

Interaction Of Inflammatory Parameters And Thiol/Disulfide System Of Antioxidant Protection In Chronic Obstructive Pulmonary Disease

Introduction — Increased incidence and prevalence of chronic obstructive pulmonary disease (COPD) provides rationale for describing the disease progression mechanism, considering the interaction of key participants of this process. The objective of our study was to establish the dysfunction parameters of thiol/disulfide system components and adaptive immunity unit in patients with stable chronic obstructive pulmonary disease (COPD). Material and Methods — We examined patients with stable COPD of moderate (62 subjects) or severe (50 subjects) grades. The control group included 32 subjects. Prooxidant and antioxidant markers of oxidative stress were investigated with ELISA. We determined cytokine levels in blood plasma and the number of T helper cells expressing IL-6R with flow cytometry (BD FACSCanto II, USA). Correlation pleiads sensu Terentiev were employed to visualize the data. Results — Changes in both antioxidant and cytokine status of subjects with COPD of varying severity grades implied the progression of systemic inflammation in conditions of uncontrolled activation of adaptive immunity unit rather than just a shift in the peroxide balance and an increase in oxygen metabolites. Conclusion — Accumulation of biomolecule peroxidation products, imbalance in the prooxidant-antioxidant system, and a change in pathogenetic mechanism of inflammation could lead to an aggravated course of bronchopulmonary pathology.

Long-term examinations of the lumbal disc and facet joint changes in 5 German Shepard dogs

The purpose of this first-time long-term observational study was to evaluate the changes of the caudal lumbar spine at the locations L5/6, L6/7, and L7/S1 in 5 German shepherd dogs over a 6-year time period using computed tomography (CT) and magnetic resonance imaging (MRI). The dogs had a mean age of 26 months at the time of the first examination. In addition, it was evaluated whether a breeding examination, with regard to disc degeneration, is justified in young dog. The locations L7/S1, L6/7, and L5/6 were examined in more detail with regard to their signal intensity changes, the facet joint angle changes in dorsal (dors) and transverse (trans) planes, and disc surface changes in sagittal (sag) and transverse (trans) reconstruction planes with CT and MRT in 2015 and 2021. All data were collected computer-based and analyzed statistically. Subsequently, the results were compared to the measured signal intensity and to the subjective disc degeneration grading according to Seiler used in practice. Over the period of 6 years a significant loss of the measured signal intensity of the intervertebral discs in the transverse plane and an overall facet joint widening in the transverse plane of 0.54° as well as in the dorsal plane of 1.8° was evident. In addition, there was no evidence of a relationship between the size of the facet joint angle and the degree of disc degeneration. Furthermore, regardless of the initial degree of degeneration, the discs showed low signal intensity and higher Seiler grade during follow-up. The results of the present study group indicate that an inconspicuous condition of the lumbar intervertebral discs at the time of the initial breeding examination in the young dog does not allow an accurate prediction of the subsequent degree of degeneration and that there are ongoing remodeling processes at the facet joints even in healthy German shepherd dogs.

Analisis Keterampilan Berpikir Tingkat Tinggi Siswa SMA pada Pembelajaran Fisika

Higher-order thinking skills are the ability of students to work on and complete knowledge or ideas in the form of new solutions and relate them to what they find themselves. Higher-order thinking skills need to be possessed by all students so that they can solve problems in everyday life. This study aims to describe the high-level thinking skills of high school students in learning physics. This research is qualitative research with a literature study method, and the data analysis technique used is content analysis. The secondary data sources used are articles or journals from research on higher-order thinking skills, totaling ten articles or journals published in 2016 - 2021. The analysis that has been carried out has classified higher-order thinking skills based on physics subject materials, regional distribution, and grade levels which are reviewed according to the following indicators C4 (analyze), C5 (evaluate), and C6 (create or create). The data categorization results show that the average percentage of higher-order thinking skills is still in the low category in each indicator. The conclusions of this study are expected to provide information related to the description of students' higher-order thinking skills in learning physics in high school grades.

Objectively quantifying facial erythema in rosacea aided by the ImageJ analysis of VISIA red images.

Facial erythema, a prominent characteristic of rosacea, causes concern to both the patient and doctor. In clinical practice, commonly used erythema severity subjective assessment tools lack objectivity and are less comprehensive. Even with images taken by the VISIA® system, diffused erythema is difficult to segment and evaluate fully due to the automatic threshold segmentation method. This study aimed to explore a more objective and scientificerythema quantification tool with the aid of the ImageJ software analysis of the red area images taken by the VISIA® system. Patients with rosacea were enrolled and assessed for the clinical severity of their illness using various stools-the standard grading systems (SGS) for rosacea, investigator's global assessment (IGA), and clinician's erythema assessment (CEA). Facial images in the red area mode of the VISIA® system were further analyzed by the ImageJ for the relative intensity of redness and percentage of erythema area; the correlation with the scores of the subjective grading systems was evaluated. This study included 201 patients (195 females and 6 males). The relative intensity of redness was positively correlated to the SGS, IGA, and CEA scores (0.688, 0.725, and 0.718, respectively) (p < 0.001). The percentage of erythema area was positively correlated to the SGS, IGA, and CEA scores (0.615, 0.666, and 0.656, respectively) (p < 0.001). We demonstrated a more objective and precise method of assessing the severity of facial erythema rosacea, which could comprehensively assess the severity by both the area and intensity of facial erythema.

Deep Learning–Assisted Detection of Glaucoma Progression in Spectral-Domain OCT

To develop and validate a deep learning (DL) model for detection of glaucoma progression using spectral-domain (SD)-OCT measurements of retinal nerve fiber layer (RNFL) thickness. Retrospective cohort study. A total of 14034 SD-OCT scans from 816 eyes from 462 individuals. A DL convolutional neural network was trained to assess SD-OCT RNFL thickness measurements of 2 visits (a baseline and a follow-up visit) along with time between visits to predict the probability of glaucoma progression. The ground truth was defined by consensus from subjective grading by glaucoma specialists. Diagnostic performance was summarized by the area under the receiver operator characteristic curve (AUC), sensitivity, and specificity, and was compared with conventional trend-based analyses of change. Interval likelihood ratios were calculated to determine the impact of DL model results in changing the post-test probability of progression. The AUC, sensitivity, and specificity of the DL model. The DL model had an AUC of 0.938 (95% confidence interval [CI], 0.921-0.955), with sensitivity of 87.3% (95% CI, 83.6%-91.6%) and specificity of 86.4% (95% CI, 79.9%-89.6%). When matched for the same specificity, the DL model significantly outperformed trend-based analyses. Likelihood ratios for the DL model were associated with large changes in the probability of progression in the vast majority of SD-OCT tests. A DL model was able to assess the probability of glaucomatous structural progression from SD-OCT RNFL thickness measurements. The model agreed well with expert judgments and outperformed conventional trend-based analyses of change, while also providing indication of the likely locations of change. Proprietary or commercial disclosure may be found after the references.

Academic performance of first-year university students: modelling the role of reading competence

ABSTRACT Implementation of the European Higher Education Area changed the assessment model in higher education towards a competence-based system, so that students are assessed by what they demonstrate they can do (competences). However, assessment of certain key competences, such as reading, ceases at higher education. The question remains whether reading competence continues to influence academic achievement at this level. We designed a reading comprehension test based on PISA questions and administered it to new-intake university students. The results were linked to students’ grades in each first-year subject and their sociodemographic administrative data. The influence of reading competence and socioeconomic status on grades in all first-year subjects was analysed through structural equation models. The results show that reading competence at the start of university education has a direct influence on grades in all first-year subjects and an indirect influence through the admission grade. In conclusion, reading competence needs to be further developed and promoted even in the university context.

Assessment of Keratitis Severity Using Quantitative Image Analysis in an In Vivo Murine Model of Staphylococcus aureus Bacterial Keratitis.

Bacterial keratitis (BK) severity in murine models has traditionally been measured by subjective clinical grading or quantification of ocular bacterial burden. This investigation explores an objective and repeatable quantification of slit lamp photography (SLP) images to measure BK severity. BALB/c strain mice underwent three parallel scratches of the right cornea with subsequent inoculation of 107Staphylococcus aureus cells. SLP imaging and clinical severity grading were performed at 48 hours post-infection. Stromal infiltrate (SI) area on SLP images were quantified. Bacterial burden was determined after enucleation and homogenization. Spearman rank correlations (rs) were used to estimate associations between SI area, clinical severity grades, and bacterial burden. BALB/c strain mice (n = 14) were evaluated with an average SI area of 0.92 mm2 (standard deviation, SD = 0.65) and average bacterial burden of 3.16 × 105 colony forming units per milliliter (CFU/mL) (SD = 8.3 × 105). Clinical severity grade positively correlated with SI area (rs = 0.59, p = 0.0276) and bacterial burden (rs = 0.66, p = 0.0106). There was a trend towards positive association between SI area and bacterial burden (rs = 0.51, p = 0.0543). SLP annotation of SI area is correlated with clinical severity and may provide an objective, quantitative, and repeatable assessment of BK disease severity. SLP annotation of SI area is a novel quantitative method to evaluate bacterial keratitis severity longitudinally in mouse models which may be a powerful tool to better understand BK pathogenesis and response to treatments.

Can advanced edge enhancement software improve image quality to visualise tubes, catheters and wires in digital chest radiographs?

IntroductionThis study aimed to test whether Advanced Edge Enhancement (AEE) software could improve the localisation of tubes, catheters or wires, while also affecting the overall image quality in chest x-rays (CXR). MethodsIn total, 50 retrospective CXRs were included. All images were obtained utilising the Canon X-ray system (CANON/Arcoma Precision T3 DR System, Canon Europe, Amsterdam, NL) with a CXDI-810C wireless detector. A clinical image, plus three additional AEE algorithms were applied using post processing (two intensity variations 1 and 4) on all CXRs totalling 350 different images. Three radiologists evaluated the images using a subjective Absolute Visual Grading Analysis (VGA). The clinical images used in post processing were not applied as reference in the analysis. Each radiologist graded the images separately in a randomized order, with a score of three indicating suitability for diagnostic assessment. ResultsThe three AEE algorithms contributed to an overall improvement (average 16–49%) in visualisation of tube, catheter or wire on CXR images. The Mann–Whitney U tests showed a statistically significant (p < 0.05) improvement in contrast resolution and sharpness, indicating an increased ability to differentiate tubes, wires or catheters tips from surrounding tissues. For the noise criterion, not applying any AEE algorithm showed a significantly higher homogeneity in soft tissue (p < 0.001), reducing the ability to visualise soft tissue. The high-intensity catheter algorithm was the only algorithm to achieve a statistically significant (p = 0.017) increase in the ability to differentiate pulmonary tissues of similar density. ConclusionAn overall improvement in the visualisation of tube, catheter and wire placement was obtained using the three AEE-algorithms. The bone and catheter algorithms showed the highest consistency, with the small structure algorithm underperforming in resolution and low contrast resolution. In general, image noise increased regardless of algorithm type or applied intensity. The AEE-algorithms should therefore be seen as a supplementary tool to the clinical image protocol, while having the potential to improve image quality to specific clinical situations. Implications for practiceAEE filtered images appear to be a supplement to the current practice of using CXRs in the diagnosis in placement of catheters, tubes and wires in the chest region. The use of AEE-algorithms has the potential to improve the daily work in clinical practice, which serves the basis for further investigation of its effect on radiographic practices.

Self-efficacy and Academic Performance of Mathematics Students in a South African University during the COVID-19 Pandemic

Students’ learning contexts are capable of having a significant impact on their learning beliefs and academic performance. As a result, students studying during the COVID-19 pandemic outbreak may be at risk of lower academic self-efficacy and subject grades. These students may also hold specific ideas regarding the impact of COVID-19-related changes on their ability to succeed, which could have a direct impact on their self-efficacy and academic performance. Thus, this study seeks to examine how the COVID-19 pandemic has affected the self-efficacy and academic performance of mathematics students in a South African university. The paper also sought to examine how teaching and learning in a mathematics education classroom can be sustained post-COVID-19 pandemic. As such, the study was underpinned by an interpretivist paradigm. The study employed a qualitative research approach and a case study design in which the participant of the study were mathematics education lecturers, heads of departments, and pre-service mathematics student-teachers registered for the 2019/20 academic session at the faculty of education in the selected university. Data for the study was collected through the use of a semi-structured interview. The findings of the study revealed that although students’ self-efficacy is adversely impacted by negative emotions like tension, the psychological strain of confinement, academic workload demands, online assessment, and the loss of relatives brought on by the COVID-19 pandemic, these factors have no impact on students’ academic performance. Furthermore, findings revealed that for the teaching and learning of mathematics education to be sustained post-COVID-19 pandemic, there is a dire need for a change in curriculum as well as the pedagogical approaches. Based on the findings of the study, it was concluded that even though the original goal of the sudden transition in the education system was to salvage the academic year, it is now evident that maintaining teaching and learning in higher education institutions will require more than just changing instructional delivery but mathematics education lecturers should adopt the lessons learned from online instruction and develop opportunities for a hybrid approach to teaching-learning. Keywords: COVID-19 pandemic, Mathematics education, Performance, Self-efficacy, Sustainable

Remplissage in Addition to Arthroscopic Bankart Repair for Shoulder Instability With On-Track Hill–Sachs Lesions Reduces Residual Apprehension Without External Rotation Limitation

<h3>Purpose</h3> To evaluate the role of remplissage as an adjunct to Bankart repair in patients with recurrent anterior shoulder dislocation combined with on-track Hill–Sachs lesion. <h3>Methods</h3> Arthroscopic Bankart repair with remplissage data (December 2018-2020) were collected (BR group). Inclusion criteria were (1) recurrent anterior shoulder dislocation, (2) on-track Hill–Sachs lesion, (3) minimal/subcritical glenoid bone loss (<17%), and (4) postoperative follow-up >1 year. Exclusion criteria were (1) revision surgery, (2) first dislocation with acute glenoid rim fracture, and (3) combined with other surgery. The control group was identified in Bankart repair–only cohort (B group). All patients were evaluated preoperatively, and at 3 weeks, 6 weeks, 3 months, 6 months, and then annually postoperatively. Visual analogue scale for pain, Self-Assessment Numerical Evaluation, American Shoulder and Elbow Surgeons Shoulder score, ROWE, and Western Ontario Shoulder Instability were evaluated at preoperative and final follow-up. Residual apprehension experience and external rotation deficit were evaluated. Patients, who were followed-up for more than 1 year, were asked how often they experienced any subjective apprehension in 4 grades (1: always, 2: frequently, 3: occasionally, 4: never). Patients who had a history of recurrent dislocation or revision surgery were investigated. <h3>Results</h3> In total, 53 patients (B, 28; BR, 25) were included. At final follow-up, both groups showed improvement in 5 clinical scores postsurgery (<i>P</i> < .001). The BR group showed greater ROWE scores than the B group (B: 75.2 ± 13.6, BR: 84.4 ± 10.8; <i>P</i> = .009). Residual apprehension patient ratio (B: 71.4% [20/28], BR: 32% [8/25]; <i>P</i> = .004) and the mean subjective apprehension grade (B: 3.1 ± 0.6, BR: 3.6 ± 0.6; <i>P</i> = .005) showed statistically significant difference, whereas no patients in either group experienced external rotation deficit (B: 14.8 ± 12.9°, BR: 18.0 ± 15.2°, <i>P</i> = .420). Only 1 patient in the B group had not responded to surgery, with dislocation recurrence (<i>P</i> = .340). <b>Conclusions</b>: Remplissage with arthroscopic Bankart repair in on-track Hill–Sachs lesion has a role in reducing residual apprehension without external rotation limitation. <h3>Level of Evidence</h3> Level III, retrospective comparative therapeutic trial.

Development and validation of a new photographic scale to grade lid wiper epitheliopathy

PurposeLid wiper epitheliopathy (LWE) is a clinical sign that has been associated with dry eye disease (DED) and contact lens discomfort (CLD). This study describes the development, validation and graders’ preference of a new photographic scale for LWE, the Photographic Lid Wiper Epitheliopathy (PLWE) scale. MethodsThe PLWE grading scale was developed using LWE images selected from 57 screened patients (≥18 years of age) with confirmed LWE in both eyes. To validate the PLWE scale, a set including 20 images showing varying degrees of LWE from none to severe was chosen. To assess grading validity and grading reliability, observers were asked to grade the selected images using the PLWE and another commonly used subjective LWE grading protocol (Korb) on two separate sessions. ResultsThe mean grade (±SD) of all images was not statistically significant different between the PLWE scale (1.55 ± 0.44) and the alternative grading scale (Korb, 1.47 ± 0.54) (ANOVA F1, p > 0.05). The average difference from the mean of all graders was 0.03 ± 0.53 using the PLWE scale and 0.06 ± 0.57 when using the Korb protocol (ANOVA F1, p > 0.05). The Coefficient of Repeatability was 1.04 and 1.12 for the PLWE and Korb scales (p > 0.05). Ninety-five percent of the graders found PLWE easier to use than Korb and the same percentage would consider using the PLWE scale in clinical practice. ConclusionThe format of the PLWE is similar to other anterior segment visual grading scales and this study revealed an ease of use preference for employing the PLWE by the graders. The presence of LWE has been associated with DED and CLD, and the addition of this new photographic scale could facilitate clinical judgement and record keeping of LWE in clinical practice.

Effect of using learning video media towards students’ study achievement of fiqh subject grade VII (research at state Islamic junior high school model Pasirsukarayat)

This research aims to determine whether studying video media affects students' study accomplishment of Fiqh in grade 7 at State Islamic Junior High School Model Pasirsukarayat. The research is based on the assumption that students' study success is tied to the educational medium employed. Using learning material that engages and motivates students will impact their learning accomplishment. This study used a pretest-posttest two-group design. Observation, documentation, interview, and test are data collection methods. Based on the hypothesis significance test result, employing learning video media (t-count 2,58 t-table = 1,71) at the real level = 0.05 and the degree of freedom (df) = 78 has the lowest score = 7 and the maximum score = 10. The group that does not utilize learning video media scores (t-count 2,45 t-table = 1,71) at the actual level = 0,05 the degree of freedom (df) = 78 with the lowest score = 5 and the maximum score = 7. Ho is rejected, hence it may be concluded that utilizing learning video medium affects pupils' Fiqh grade 7 study success.

Developing Objective Computational Methods for Quantifying Ankle Osteoarthritis using Low-Dose Weight Bearing CT

Category: Ankle Arthritis; Ankle; Other Introduction/Purpose: Decision regarding ankle osteoarthritis (OA) management varies depending on the severity and distribution of the associated joint degeneration. Disease staging is typically based on subjective grading of appearance on conventional plain radiographs, with reported sub-par reproducibility and reliability. Weight-bearing computed tomography (WBCT) offers clinical advantages in the setting of OA, where thinning of the ankle cartilage, softening of the cartilage, and other deformities become more apparent under load. WBCT also provides a better geometric representation of the ankle and allows for more accurate measurements when compared to a conventional radiograph. The purpose of this study was to develop and describe computational methods to objectively quantify radiographic changes associated with ankle OA apparent on low-dose WBCT images. Methods: We analyzed two patients with ankle OA and one healthy control that had all undergone WBCT of the foot and ankle. The severity of OA in the ankle of each patient was scored using the Kellgren-Lawrence (KL) classification by plain weight-bearing radiographs. For each ankle, the subsequent analysis focused on a volume of interest (VOI) centered on the tibiotalar joint. Within the VOI, the initial computational analysis focused on measuring the 3D joint space width (JSW). Subsequent analyses utilized WBCT image intensity (Hounsfield Unit, or HU) profiles along lines perpendicular to the subchondral bone/cartilage interface of the distal tibia extending across the entire VOI. The HU intensity profiles were recorded, and graphical plots of the HU distributions were generated for each line. These plots were then used to calculate the HU contrast, a novel measure of the regional variation in bone density. Results: The average JSW was 3.89 mm for the healthy control ankle, 2.69 mm for the mildly arthritic ankle (KL 2), and 1.57 mm for the severely arthritic ankle (KL 4). The average HU contrast was 72.31 for the healthy control ankle, 62.69 for the mildly arthritic ankle, and 33.98 for the severely arthritic ankle. The use of four projections at different locations throughout the joint allowed us to visualize specifically which quadrants have reduced joint space width and contrast. One projection in the severely arthritic ankle had JSW and contrast values of 0 due to complete joint space loss along with projection 4, which corresponds in this case to the posterolateral part of the joint (Figure). Conclusion: We presented a novel computational assessment of ankle osteoarthritis using low-dose WBCT imaging. We were able to demonstrate differences between normal ankles and ankles with mild and severe OA using JSW and HU contrast measurements. This methodology represents an important step towards a more reliable OA assessment when compared to the current standard qualitative evaluations, potentially serving as a starting point for the development of a more robust osteoarthritis staging system. Additional studies are needed to assess the algorithm more rigorously over a variety of radiographic presentations.

Relationship Between Adenotonsillar Size and Snoring Sound: Acoustic Analysis

Background and Objectives The most common cause of snoring in children is enlarged tonsils and adenoids. However, there is insufficient evidence to determine whether the subjective measurement of tonsil hypertrophy, the most common prevailing method, reflects the actual tonsil size and volume. Therefore, we tried to determine whether the subjective grading of tonsil size and actual tonsil volume is related, and whether tonsil volume, weight, and adenoid index are correlated with the acoustic analysis of snoring.Subjects and Method The study was conducted on 21 children between the ages of 4 and 15 who came for tonsillectomy and adenoidectomy due to snoring symptoms. The degree of adenotonsillar hypertrophy was measured using the Brodsky grading scale and adenoid index. After tonsillectomy, the volume and weight of resected tonsil were measured. For acoustic analysis, the Praat software was used to determine formant frequency and sound intensity. A linear regression model and a dummy variable were used to determine the correlation between the quantitative values of tonsil, adenoid and the result of acoustic analysis.Results The Brodsky tonsil grade tended to match the actual tonsil volume, but it was not statistically significant (&lt;i&gt;p&lt;/i&gt;=0.073). There was no correlation between snoring intensity and actual tonsil volume, weight, and adenoid index. Formant frequency 1 and 2 were statistically negatively correlated with the actual tonsil volume (&lt;i&gt;p&lt;/i&gt;=0.011, 0.002).Conclusion The study confirmed that the acoustic analysis of pediatric snoring could be a screening test to predict tonsil volume and changes in the vocal tract due to tonsil hypertrophy.

The Coronavirus Disease 2019 Pandemic and Mental Health-Related School-Nurse Visits in United States Schools.

ObjectivesNo studies have examined school-nurse visits related to mental health (MH) during the COVID-19 pandemic. We examined changes in the rate of MH-related school-nurse visits before and during the COVID-19 pandemic.MethodsWe analyzed school-nurse visit data (n=3,445,240) for subjects Grade K-12 in U.S. public schools using electronic health record software (SchoolCare, Ramsey, NJ). Data between January 1-December 31 in 2019 (pre-COVID-19 pandemic) vs. January 1-December 31 in 2020 (during COVID-19 pandemic) were compared. For each year, total visits to a school-nurse were calculated for general MH, anxiety, and self-harm. The exposure was number of school-nurse visits in each time period (2019 vs. 2020). The main outcome was change in the rate of general MH, anxiety, and self-harm visits in 2019 vs. 2020.ResultsThere were 2,302,239 total school-nurse visits in 2019 vs. 1,143,001 in 2020. During the COVID-19 pandemic, the rate of visits for general MH increased by 30% (4.7 to 6.1 per 10,000 visits, 95%CI [18%,43%]; p<0.001), and visits for anxiety increased by 25% (24.8 to 31 per 10,000 visits, 95%CI [20%,30%]; p<0.001). There was no significant difference in self-harm visits across all ages during the COVID-19 pandemic.ConclusionsOur study found a significant increase in the rate of school-nurse visits for MH and anxiety during the COVID-19 pandemic, suggesting the pediatric population is at-risk for increased negative MH-effects associated with the pandemic and highlights a critical role of school-nurses in identifying youth with potential MH-needs.

Nutrition value of dominant three fishes of Sudanese red sea coast

Based on the current demand on fish as food, marine fishes of the Sudan have been arbitrary divided into first, second and third grade fish. Examples of these are the red emperor (Plectroponus moculates) grade I, mullet fish (Plectroponus moculates) as grade II and unicorn fish (Naso unicornis) as grade III. This subjective grading, need to be evaluated on grounds of organo-leptic tests, gross chemical and body parts analysis and inclusion in experimentally designed feeding tests. The mean value and range of moisture, protein, fat and ash was determined and compared for the three species. The highest calorific value was (232.08) in C. crisbis and the lowest (144.2) in P. maculatus. The calorific value was expressed as a calories per percent of protein content plus calories per percent of fat content. The highest calorific value was (232.08) in C. crisbis and the lowest (144.2) in P. maculatus. The gross chemical composition was comparable between the three groups in ash content, but showed significant variability within moisture, within protein and in fat. The mean body weight in each cell in a column (feed 1, 2, 3 and the control) was based on a triplicate and they were compared using the least significant difference (LSD) test. Very highly significant growth correlation (p