Observers’ Agreement on Measurements in Fiberoptic Endoscopic Evaluation of Swallowing

Abstract

This study analyzed the effect that dysphagia etiology, different observers, and bolus consistency might have on the level of agreement for measurements in FEES images reached by independent versus consensus panel rating. Sixty patients were included and divided into two groups according to dysphagia etiology: neurological or head and neck oncological. All patients underwent standardized FEES examination using thin and thick liquid consistencies. Two observers scored the same exams, first independently and then in a consensus panel. Four ordinal FEES variables were analyzed. Statistical analysis was performed using a linear weighted kappa coefficient and Bayesian multilevel model. Intra- and interobserver agreement on FEES measurements ranged from 0.76 to 0.93 and from 0.61 to 0.88, respectively. Dysphagia etiology did not influence observers' agreement level. However, bolus consistency resulted in decreased interobserver agreement for all measured FEES variables during thin liquid swallows. When rating on the consensus panel, the observers deviated considerably from the scores they had previously given on the independent rating task. Observer agreement on measurements in FEES exams was influenced by bolus consistency, not by dysphagia etiology. Therefore, observer agreement on FEES measurements should be analyzed by taking bolus consistency into account, as it might affect the interpretation of the outcome. Identifying factors that might influence agreement levels could lead to better understanding of the rating process and assist in developing a more precise measurement scale that would ensure higher levels of observer agreement for measurements in FEES exams.

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Variability in solar irradiance observed at two contrasting Antarctic sites

Publication date: 15 May–1 June 2016
Source:Atmospheric Research, Volumes 172–173
Author(s): Boyan H. Petkov, Kamil Láska, Vito Vitale, Christian Lanconelli, Angelo Lupi, Mauro Mazzola, Marie Budíková
The features of erythemally weighted (EW) and short-wave downwelling (SWD) solar irradiances, observed during the spring–summer months of 2007–2011 at Johann Gregor Mendel (63°48′S, 57°53′W, 7m a.s.l.) and Dome Concordia (75°06′S, 123°21′E, 3233m a.s.l.) stations, placed at the Antarctic coastal region and on the interior plateau respectively, have been analysed and compared to each other. The EW and SWD spectral components have been presented by the corresponding daily integrated values and were examined taking into account the different geographic positions and different environmental conditions at both sites. The results indicate that at Mendel station the surface solar irradiance is strongly affected by the changes in the cloud cover, aerosols and albedo that cause a decrease in EW between 20% and 35%, and from 0% to 50% in SWD component, which contributions are slightly lower than the seasonal SWD variations evaluated to be about 71%. On the contrary, the changes in the cloud cover features at Concordia station produce only a 5% reduction of the solar irradiance, whilst the seasonal oscillations of 94% turn out to be the predominant mode. The present analysis leads to the conclusion that the variations in the ozone column cause an average decrease of about 46% in EW irradiance with respect to the value found in the case of minimum ozone content at each of the stations. In addition, the ratio between EW and SWD spectral components can be used to achieve a realistic assessment of the radiation amplification factor that quantifies the relationship between the atmospheric ozone and the surface UV irradiance.

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Observers’ Agreement on Measurements in Fiberoptic Endoscopic Evaluation of Swallowing

Abstract

This study analyzed the effect that dysphagia etiology, different observers, and bolus consistency might have on the level of agreement for measurements in FEES images reached by independent versus consensus panel rating. Sixty patients were included and divided into two groups according to dysphagia etiology: neurological or head and neck oncological. All patients underwent standardized FEES examination using thin and thick liquid consistencies. Two observers scored the same exams, first independently and then in a consensus panel. Four ordinal FEES variables were analyzed. Statistical analysis was performed using a linear weighted kappa coefficient and Bayesian multilevel model. Intra- and interobserver agreement on FEES measurements ranged from 0.76 to 0.93 and from 0.61 to 0.88, respectively. Dysphagia etiology did not influence observers' agreement level. However, bolus consistency resulted in decreased interobserver agreement for all measured FEES variables during thin liquid swallows. When rating on the consensus panel, the observers deviated considerably from the scores they had previously given on the independent rating task. Observer agreement on measurements in FEES exams was influenced by bolus consistency, not by dysphagia etiology. Therefore, observer agreement on FEES measurements should be analyzed by taking bolus consistency into account, as it might affect the interpretation of the outcome. Identifying factors that might influence agreement levels could lead to better understanding of the rating process and assist in developing a more precise measurement scale that would ensure higher levels of observer agreement for measurements in FEES exams.

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USE OF A SIMPLE THERMALISED NEUTRON FIELD FOR QUALITY ACCEPTANCE OF WHOLE BODY TLDS.

USE OF A SIMPLE THERMALISED NEUTRON FIELD FOR QUALITY ACCEPTANCE OF WHOLE BODY TLDS.

Radiat Prot Dosimetry. 2016 Jan 21;

Authors: Gilvin PJ, Baker ST, Eakins JS, Tanner RJ

Abstract
The individual monitoring service of Public Health England (PHE) uses Harshaw™ whole-body and extremity thermoluminescent dosemeters (TLDs) with high-sensitivity lithium fluoride LiF:Mg,Cu,P, together with Harshaw 8800™ automated readers. The neutron-insensitive, (6)Li-depleted variety of TLD material is used by PHE because the service provides separate neutron and photon dosemeters. The neutron dosemeters are not sensitive to photons and vice versa. Since insensitivity to neutrons is a supply requirement for TLDs, there is a need to test every new (annual) consignment for this. Because it is thermal neutrons that produce a response in (6)Li TLDs, a thermal field is needed. To this end, PHE has adopted the simple approach of sandwiching the TLDs between two ISO water-filled slab phantoms. In this arrangement, the fast neutrons from an Am-Be source are effectively thermalised. Details of the method are given, together with the results of supporting MCNP calculations and some typical results.

PMID: 26801052 [PubMed – as supplied by publisher]

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The Improved Overhearing Backup AODV Protocol in MANET

Mobile ad hoc network (MANET) is one of the most widely used networks, which has attracted attentions, having features such as limited energy resources, limited bandwidth, and security weaknesses due to lack of a central infrastructure. Safe and suitable routing is one of the research aspects of MANET. In this paper, a proposed method, called M-AODV, which is a type of overhearing backup protocol, based on AODV, is presented. The simulation results of this protocol, applied by NS2 simulator, showed the improvement of packet delivery rate and reduction of overhead and delay. Moreover, to assess the security of the proposed protocol, we simulated M-AODV and AODV protocols under black hole and wormhole attacks, using no security solution. The results showed that M-AODV had been improved in terms of packet delivery ratio, and the delay had been reduced as well, but the amount of overhead had been increased.

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Gute Prognose nach endoskopischer Resektion und Radiofrequenzablation

Frühneoplasien des Barrett-Oesophagus
Dysplasien und Frühkarzinome bei Barrett-Ösophagus können heute endoskopisch reseziert und mit Radiofrequenz behandelt werden. Die Ergebnisse einer aktuellen Registerstudie zeigen jedoch, dass eine subtile Diagnostik unabdingbar ist.

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Surgical Results and Oncologic Outcomes for Rectal Cancer with Tailored Mesorectal Excision over Two Decades.

Surgical Results and Oncologic Outcomes for Rectal Cancer with Tailored Mesorectal Excision over Two Decades.

World J Surg. 2016 Jan 22;

Authors: Law WL, Foo DC

Abstract
OBJECTIVE: This study aimed to compare the characteristics of the tumors, the management strategy, and oncologic outcomes of patients with rectal cancer surgery in these two periods: period 1 (1993-2001) and period 2 (2002-2011).
METHODS: All patients who underwent radical resection of rectal cancer from 1993 to 2011 were included. Comparisons of the patients' demographics, characteristics, operating results, and oncologic outcome between the two periods were undertaken.
RESULTS: Radical resection for rectal cancer was performed in 1611 patients (993 men). Patients were significantly older and more had comorbid medical diseases in period 2. More laparoscopic resections were performed and more patients had preoperative chemoradiation in period 2. The postoperative mortality was significantly lower and the hospital stay was significantly shorter in period 2. In those with non-metastatic cancer, the 5-year local recurrences of patients in period 1 and period 2 were 11.9 and 5.9 %, respectively. (p = 0.002) The patients in period 2 had significantly better 5-year overall (68.1 vs. 60.2 %, p = 0.003) and 5-year cancer-specific survival (76.1 vs. 69.4 %, p < 0.001) when compared with those treated in period 1. The improvement occurred mainly in patients with abdominoperineal resection and those with stage III diseases. In the multivariate analysis, among the other histological factors, operations performed in period 2 and laparoscopic surgery were independent factors associated with better overall survival.
CONCLUSIONS: Significant improvement in the surgical outcomes in terms of a lower recurrence rate and better survival was achieved in the recent years with the increase in neoadjuvant therapy and the application of laparoscopic surgery.

PMID: 26801507 [PubMed – as supplied by publisher]

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