Explore the vast range of titles available.

Background Although of great value in the management of lateral clavicle fractures, substantial variation in their classification exists. We performed a retrospective study to address the inter- and intraobserver reliability of three different classification systems for lateral clavicle fractures. Methods Radiographs of 20 lateral clavicle fractures that represented a full spectrum of adult fracture patterns were graded by five experienced radiologists and five experienced trauma surgeons according to the Orthopaedic Trauma Association (OTA), the Neer, and the Jäger/Breitner classification systems. This evaluation was performed at two different time points separated by 3 months. To measure the observer agreement, the Fleiss kappa coefficient (κ) was applied and assessed according to the grading of Landis and Koch. Results The overall interobserver reliability showed a fair agreement in all three classification systems. For the OTA classification system, the interobserver agreement showed a mean kappa value of 0.338 ranging from 0.350 (radiologists) to 0.374 (trauma surgeons). Kappa values of the interobserver agreement for the Neer classification system ranged from 0.238 (trauma surgeons) to 0.276 (radiologists) with a mean κ of 0.278. The Jäger/Breitner classification system demonstrated a mean kappa value of 0.330 ranging from 0.306 (trauma surgeons) to 0.382 (radiologists). The overall intraobserver reliability was moderate for the OTA and the Jäger/Breitner classification systems, while the overall intraobserver reliability for the Neer classification system was fair. The kappa values of the intraobserver agreements showed, in all classification systems, a wide range with the OTA classification system ranging from 0.086 to 0.634, the Neer classification system ranging from 0.137 to 0.448, and a range from 0.154 to 0.625 of the Jäger/Breitner classification system. Conclusions The low inter- and intraobserver agreement levels exhibited in all three classification systems by both specialist groups suggest that the tested lateral clavicle fracture classification systems are unreliable and, therefore, of limited value. We should recognize there is considerable inconsistency in how physicians classify lateral clavicle fractures and therefore any conclusions based on these classifications should be recognized as being somewhat subjective.

Previously, we developed a novel Coronary Artery Tree description and Lesion EvaluaTion (CatLet©) angiographic scoring system, which was capable of accounting for the variability in the coronary anatomy and assisting in the risk-stratification of patients with acute myocardial infarction (AMI). Our preliminary study revealed that the CatLet score better predicted clinical outcomes for AMI patients than the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery score. However, the reproducibility of the CatLet score in both inter- and intra-observer remains to be evaluated. A total of 30 consecutive AMI patients, admitted in September of 2015, were independently assessed by two experienced interventional cardiologists to evaluate the inter-observer reproducibility of the CatLet score. Another set of 49 consecutive AMI patients, admitted between September and October in 2014, were assessed by one of the two interventional cardiologists on two occasions 3 months apart to evaluate the intra-observer reproducibility of the CatLet score. The weighted kappa was used to express the degree of agreement. The weighted kappa values (95% confidence interval) for the intra- and inter-observer reproducibility of the CatLet Score were 0.82 (0.59-1.00, Z = 7.23, P < 0.001) and 0.86 (0.54-1.00, Z = 5.20, P < 0.001), respectively, according to the tertile analysis (≤14, 15-22, >22). Regarding the adverse characteristics pertinent to lesions and dominance parameters, the kappa values for the inter-observer variability were 0.80 (0.56-1.00, Z = 6.47, P < 0.001) for total number of lesions, 0.57 (0.28-0.85, Z = 3.03, P < 0.001) for bifurcation, 0.69 (0.43-0.96, Z = 5.06, P < 0.001) for heavy calcification, 1.00 (0.72-1.00, Z = 6.93, P < 0.001) for tortuosity, 0.54 (0.26-0.82, Z = 3.78, P < 0.001) for thrombus, 0.69 (0.48-0.91, Z = 6.29, P < 0.001) for right coronary artery dominance, 0.69 (0.41-0.96, Z = 4.91, P < 0.001) for left anterior descending artery length, and 0.22 (0.06-0.51, Z = 1.56, P = 0.06) for diagonal size. Equivalent values for the intra-observer variability were moderate to almost perfect (range 0.54-1.00). The reproducibility of the CatLet angiographic scoring system for evaluation of the coronary angiograms ranged from substantial to excellent. The high reproducibility of the CatLet angiographic scoring system will boost its clinical application to patients with AMI.

Background: Foot-and-mouth disease (FMD) is an infectious and highly contagious disease of cloven-hoofed domestic and wild animals, causing heavy economic losses to the livestock industry. Rapid and reliable diagnosis of the disease is essential for the implementation of effective control measures. This study compared sandwich enzyme-linked immunosorbent assay (S-ELISA) and conventional reverse transcription polymerase chain reaction (RT-PCR) for the diagnosis of FMD. Methods: A total of 60 epithelial samples from suspected cases of FMD were tested using both S-ELISA and RT-PCR assays. The level of agreement between the assays was assessed by calculating the Kappa value. Results: S-ELISA detected 38 (63%) samples positive for FMD virus (FMDV). Being predominant, serotype O was detected in 22 (57.9%) of the total samples tested positive, whereas 9 (23.7%) and 7 (18.4%) samples were found positive for serotypes A and Asia-1, respectively. RT-PCR detected viral genome in 51 (85%) of the samples using pan-FMDV primers set, 1F/1R. Thirty-six samples were found positive and 7 negative by both the tests. The level of agreement between the tests was assessed by calculating the Kappa value, which was found to be fair (Kappa value = 0.303 and 95% CI = 0.089; 0.517) and significant (p = 0.009). However, 2 samples, which were found positive on S-ELISA tested negative on RT-PCR. This may be attributed to the presence of nucleotide mismatch(es) in the primer-binding sites that may have resulted in failure of amplification of the viral genome. The serotype-specific RT-PCR assays not only confirmed serotyping results of S-ELISA but were also able to establish serotype in 9 S-ELISA-negative but pan-FMDV RT-PCR-positive samples. Conclusions: The RT-PCR assay contributes significantly to establishing a quick, sensitive, and definitive diagnosis of FMD in resource-constrained countries. Samples giving negative results in S-ELISA should be tested in RT-PCR for the disease detection and virus typing.

Objective This study investigated the consistency of the FIB-4, APRI, and GPR indices in assessing significant liver fibrosis and cirrhosis in patients with Coronavirus Disease 2019(COVID-19) who also suffer from various liver diseases, providing references for the clinical selection and application for non-invasive assessment methods. Methods The study evaluated 744 COVID-19 patients with coexisting liver diseases: 508 cases with non-alcoholic fatty liver disease (NAFLD), 158 cases with chronic hepatitis B (CHB), and 78 cases with a combination of both ailments. FIB-4, APRI, and GPR were employed to assess significant liver fibrosis and cirrhosis. Concordance among the methods was determined using Kappa analysis, and receiver operating characteristic (ROC) curves helped identify the optimal cutoff values for each index. Results For COVID-19 patients with NAFLD, Kappa values for significant liver fibrosis were 0.81, 0.90, 0.80, and 0.79, and for cirrhosis, they were 0.88, 0.97,0.88, and 0.88, respectively (all p  < 0.05). Among those with CHB, Kappa values were 0.81, 0.81, 0.83, and 0.75 for fibrosis, and0.87, 0.91, 0.88, and 0.92 for cirrhosis (all p  < 0.05). In patients with coexisting liver diseases, the values were 0.87, 0.86, 0.86, and 0.78 for fibrosis, and 0.67, 0.69, 0.54, and 0.81for cirrhosis (all p  < 0.05). Linear trend analysis revealed significant relationships between FIB-4 values, APRI values, GPR values, and the severity of COVID-19 (χ 2 trend: 15.205,35.114, and 13.973, respectively, all p  < 0.001), between FIB-4 values and APRI values and the coronavirus negative conversion time (all p  < 0.05) in COVID-19 with NAFLD, and between FIB-4 values and GPR values and the coronavirus negative conversion time in patients with COVID-19 with CHB(all p  < 0.05). Conclusion Using the current cutoff values, the non-invasive assessments demonstrated almost perfect consistency in evaluating significant liver fibrosis and cirrhosis in COVID-19 patients with liver diseases, though FIB-4 and GPR showed moderate consistency in cirrhosis evaluation in patients with coexisting liver conditions. Moreover, it also indicated that increased liver fibrosis correlates with more severe COVID-19 and prolonged coronavirus negative conversion time.

This paper discusses a study proposed to analyze technology affecting English Language Teaching (ELT). To begin with, English is an important language in a society where it acts as a bridge to connect different races in a society. However, in the circumstance of 21st-century education specifically for English Language Teaching (ELT) which has been affected by Industrial Revolution 4.0, technology plays an important part as it offers the potential to enhance teaching processes and facilitate the learning of English as Second Language (ESL). For this purpose, Technology Pedagogy Content Knowledge (TPACK) paves a way to determine the correlation between technology, pedagogy and content knowledge among the English teachers on how they incorporate these technology tools in their English teaching. Hence, because of this reason, English teachers will answer a TPACK questionnaire which was adapted from two different questionnaires to understand further how English teachers employ the technologies in ELT. Therefore, by holding on to this purpose, a questionnaire was adapted from two different major questionnaires that related to TPACK. As neighbour to the previous sentence, this research was about this adapted questionnaire that had gone through content validation by experts with more than 10 years of teaching experience in English subject. The methodology that had been used in this research was quantitative method. The data obtained was presented in the form of descriptive statistics and was analyzed by using Microsoft Excel to calculate the Content Value Index (CVI) and Kappa Values for validity. Also, the data was presented in the form of table as it can eliminate any incomprehensibility that arises in interpreting the data. Thus, as the result, the finding of this research had supported the face and content validity and this proved that the result had high reliability and validity. Hence, this adapted questionnaire will be further research in a pilot study to test the efficiency of this instrument.

Hydrologically sensitive areas (HSAs) are runoff-generating areas often targeted for effective water resources planning and management actions. Commonly, HSAs can be mapped as areas in a landscape with a topographic index (TI) greater than a threshold level. This study explored the impact of a gradient of different TI threshold values for delineating HSAs using two popular TIs: a topographic wetness index (TWI) and a soil topographic index (STI). The resultant HSAs for each TI were compared to the Federal Emergency Management Agency (FEMA) 100-year floodplain map in New Jersey and its five water regions. Spatial comparison indicators were used to assess the spatial similarity between the HSAs delineated and the FEMA floodplain map. Such comparisons identified the threshold that delineated HSAs whose spatial distributions were most consistent with the FEMA floodplain at each spatial scale for each TI. For example, the identified threshold for using a TWI to delineate HSAs was 10.5 at the state level; however, this threshold varied by the water region. The HSAs delineated approximate the spatial extent of runoff-contributing areas to the 100-year flood relevant for water resources planning and management actions for flood hazard mitigation.

The recorded strong motion data in the Delhi region provide an excellent opportunity to study high-frequency decay parameter, kappa (κ) for the National Capital (Delhi) region and to further understand its implications to study the site effects characterized by different stations within the vicinity of the study region. The kappa values are estimated at 30 locations from 99 accelerograms of 19 earthquakes recorded in the Delhi region and are found to vary from place to place depending upon the controlling parameters, primarily the site characterization. The estimated average values of ‘κ’ lie in the range 0.0118–0.0537 s for the various locations of the region depending upon the source, path, and site characteristics of earthquakes considered in the present study. The distance dependence is found insignificant, while there is a scatter in the variation of κ values with that of magnitude which indicates that κ is more related to the site characteristic for the entire Delhi region which in turn reveals the fact of the basic criterion of the κ parameter. To affirm the total attenuation on the instruments, the site effects demonstrate the behavior of amplification to the geological exposure. It has been found that the various sites under consideration for the study area amplify between 0.6 and 7.0 Hz predominant frequency ( fpeak ) and agree with the geological arrangements of the region. Based on the present study, the most vulnerable areas are the northeastern region of Delhi which lies in proximity to the flood plains of Yamuna river and alluvial deposits of younger origins of the foreland basin along with the southwestern part of Delhi capital which is comprised of the water-saturated alluvial deposits. The estimated ‘κ’ values are found to be correlated with those of the estimated site amplifications and are useful in strong ground motions simulation for the proper evaluation of seismic hazard to build a seismic risk resilient society.

The International Academy of Manual/Musculoskeletal Medicine (IAMMM) has completely revised the protocol for reproducibility studies of diagnostic procedures in Manual/Musculoskeletal Medicine (M/M Medicine). The protocol was and is aimed at the practitioners in the field of M/M Medicine. This IAMMM protocol can be used in a very practical way and makes it feasible to perform reproducibility studies equally well in private practices and clinics for M/M Medicine with two or more physicians and as by educational boards of the societies of M/M Medicine. This IAMMM protocol provides practical solutions for sample size calculations in reproducibility studies using kappa statistics. Step by step, many different statistical aspects of reproducibility studies are explained, resulting in a very structured protocol format of how to perform a reproducibility study using overall agreement and the kappa value as statistical outcome.

Due to the huge amount of data obtained from students’ academic results in most tertiary institutions such as the colleges, polytechnics and universities, data mining has become one of the most effective tools for discovering vital knowledge from students’ dataset. The discovered knowledge can be productive in understanding numerous challenges in the scope of education and providing possible solutions to these challenges. The main objective of this research is to utilize the J48 decision algorithm model to test, classify and predict the students’ dataset by identifying some important attributes and instances. The analysis was conducted on the final year students’ academic results in C# programming amongst five universities which was imported in csv excel file dataset in WEKA environment. These training datasets contained the scores obtained in the examinations, grade remarks, grades, gender, and department. The knowledge extracted for the prediction model will help both the tutors and students to determine the success grade performance in the future. Flow lines, J48 decision trees, confusion matrices and a program flowchart were generated from the students’ dataset. The KAPPA value obtained from the prediction in this research ranges from 0.9070–0.9582 which perfectly agrees with the standard for an ideal analysis on datasets.

Background & objectives: Various indices are available to record different grade of severity of dental fluorosis. These indices have chances of inter- and intra- examiner variability. Therefore, study was conducted to compare three different indices for recording dental fluorosis to find out the best and most practical index of recording dental fluorosis for field studies in children living in a fluoride endemic area. Methods: The severity grades were recorded in 300 schoolchildren aged 12-15 yr having dental fluorosis of low, medium and high fluoride areas using three different indices, viz. Dean's fluorosis index (1942), tooth surface index for fluorosis (TSIF, 1984) and ICMR index (2013). Dean's index was used as gold standard. Results: The occurrence of moderate and severe cases was higher as per the Dean's index and of mild and severe cases was higher as per the TSIF and the ICMR index. The mean time required for recording dental fluorosis as per Dean's index and TSIF was similar and almost double (1.25±0.05 min) of that required for ICMR index (0.68±0.20 min). The intra-examiner variability was found to be least in the ICMR index compared to Dean's index and TSIF. Interpretation & conclusions: The ICMR index is a simple index with objective scores and takes less time in recording the dental fluorosis as compared to Dean's index and TSIF in field studies.