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Early Barrett cancer can be curatively treated by endoscopic resection. The choice of the resection technique, however—endoscopic mucosal resection (EMR) or submucosal dissection (ESD)—largely depends on the assumed infiltration depth as judged by the endoscopist. However, the accuracy of endoscopic diagnosis of the degree of cancer infiltration is not known. Three to four high‐quality images (both in overview and close‐up) from 202 of early Barrett esophagus cancer cases (82% men, mean age 66.9 years) were selected from our endoscopy database (73.3% stage T1a and 26.7% in stage T1b). Images were shown to 9 Barrett esophagus experts, with patients' clinical data (age, sex, Barrett esophagus length) and biopsy results. The experts were asked to predict infiltration depth (T1b vs. T1a), and to suggest the appropriate endoscopic resection technique (EMR or ESD, or surgery). Interobserver variability (kappa values) was also determined for these parameters. Overall positive (PPV) and negative predictive values (NPV) to diagnose T1b versus T1a infiltration were 40.7% (95% CI: 36.7, 44.8) and 79.8% (95% CI: 77.5, 81.9), respectively; kappa value was 0.41. Paris classification (kappa 0.51) and suggested treatment also varied between experts. In a post hoc analysis, only the correlation between lesions classified as invisible or flat according to the Paris classification (IIB; 25% of all cases) and the suggested resection technique was better: In this subgroup, EMR was recommended in >80% of cases, with a high complete (basal R0) resection rate (mean of 88.1%). Precise endoscopic distinction between mucosal and submucosal involvement of Barrett esophagus cancer by experts as a basis for choosing the resection technique has limited predictive values and high interobserver variability. It seems that mainly invisible/flat lesions may result in good resection outcomes when treated by EMR, but this stratification strategy has to be assessed in further studies.

Although lying is ubiquitous and present in all fields, there are very few medical references dealing with this subject. The aim of this study is to quantify and qualify lying in medical expert assessment. It is a retrospective study of 32 medical expert assessment cases, separated into two groups. The first analyses 16 people who were the subject of a judicial expert assessment. The second concerns a mandated consultant for insurances or mediation. The results appear to be influenced, essentially, in both groups, by the presence of an initial false diagnosis which is itself the main reason for the medical expert assessment, and by psychiatric disorders requiring treatment with psychotropic drugs. Intentional fraud appeared to be in the minority.

2022 SEP 8 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- New research on shoulder pain is the subject of a new report. According to [...]

2022 JUL 21 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- Investigators publish new report on Information Technology. According to news reporting originating in Shanghai, [...]

2022 APR 30 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- A new study on Digestive System Diseases and Conditions - Barrett Esophagus [...]

This article examines the factors that affect the capacity of the road network and environmental safety. The expert questionnaire was carried out by ranking the factors affecting the traffic capacity of the road network and environmental safety. The ranking of the factors showed that the knowledge of the Traffic Rules has the greatest impact on the throughput of the road network, and the quality of driver training is also an important factor. The article presents the results of an expert assessment, from which it follows that in order to increase the throughput of the road network and environmental safety, it is necessary to strengthen control over the observance of the Traffic Rules and improve the quality of driver training, taking into account ethics and eco-driving.

Human activities are increasingly impacting our oceans and the focus tends to be on their environmental impacts, rather than consequences for animal welfare. Global shipping density has quadrupled since 1992. Unsurprisingly, increased levels of vessel collisions with cetaceans have followed this global expansion of shipping. This paper is the first to attempt to consider the severity of ship-strike on individual whale welfare. The methodology of the 'Welfare Assessment Tool for Wild Cetaceans' (WATWC) was used, which is itself based upon the Five Domains model. Expert opinion was sought on six hypothetical but realistic case studies involving humpback whales (Megaptera novaeangliae) struck by ships. Twenty-nine experts in the cetacean and welfare sector took part. They were split into two groups; Group 1 first assessed a case we judged to be the least severe and Group 2 first assessed the most severe. Both groups then additionally assessed the same four further cases. This was to investigate whether the severity of the first case influenced judgements regarding subsequent cases (i.e. expert judgements were relative) or not (i.e. judgements were absolute). No significant difference between the two groups of assessors was found; therefore, the hypothesis of relative scoring was rejected. Experts judged whales may suffer some level (>1) of overall (Domain 5) harm for the rest of their lives following a ship-strike incident. Health, closely followed by Behaviour were found to be the welfare aspects most affected by ship-strikes. Overall, the WATWC shows a robust potential to aid decision-making on wild cetacean welfare. [ABSTRACT FROM AUTHOR]

A deep learning model that used feature fusion to classify benign and malignant ovarian tumors on gray scale and color Doppler US images achieved a similar performance to clinical expert assessment.

2020 AUG 27 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- Investigators discuss new findings in Women's Health - Obstetrics and Gynecology. According to news [...]

2020 JUL 25 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- New research on Health and Medicine - Hematology is the subject of [...]

2020 JUL 16 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- Data detailed on Women's Health - Obstetrics and Gynecology have been presented. According to [...]

This paper provides a brief analysis of analytical models and models of fuzzy logical inference, which are used for solving various problems associated with the ecological state of environmental objects. The classification of models is given. The results of the analysis of the works showed that stochastic models are often used, in particular, regression models and models of fuzzy logical inference when verbally setting the parameters of objects. Analytical models of environmental objects are non-stationary, non-linear and are characterized by after effect, therefore, these models have significant limitations in application. The analysis of the using of models of fuzzy logical inference for solving environmental problems. The results of the analysis showed that for many tasks in different areas of human activity, decisions are being made regarding the ecological state of the environment. It is concluded that the development of decision-making models regarding the ecological state of environmental objects is a relevant aim.

The descriptive data pertaining to the remaining, largely intact, glass vessels produced in ancient Egypt between the reigns of Tuthmosis IV (1401–1391 BCE) and Pinudjem II (959–945 BCE) contained in Die Glasgefäße im Alten Ägypten [The Glass Vessels in Ancient Egypt], was extracted and standardized to create a dataset that could be analysed to determine the most typical and atypical features of vessels attributed to the New Kingdom in the corpus. Seven descriptive categories were assessed based on the percentage of incidence to determine if a vessel could be defined as statistically “atypical.” An expert’s evaluation was employed as a second assessment method. The two methods identified 76 vessels from a total number of 320 vessels and agreed on 16 vessels considered as atypical, all of which had little or no provenance information. The resulting 76 vessels identified as “atypical” by the combined methods were subsequently compared with the respective provenance information and current location to determine patterns of collection and distribution throughout the world. The data showed that the Americas held the largest number of vessels that had little or no provenance data, including those held in private collections. The combined atypical tests identified that the Americas hold the largest proportion of atypical vessels. It is not the intention of this research to undermine the authenticity of vessels but to determine if data methods can be used to identify atypical traits in archaeological collections and to encourage the application of archaeometric testing to provide supporting information on statistically rare objects.

The carbon balance of peatlands is predicted to shift from a sink to a source this century. However, peatland ecosystems are still omitted from the main Earth system models that are used for future climate change projections, and they are not considered in integrated assessment models that are used in impact and mitigation studies. By using evidence synthesized from the literature and an expert elicitation, we define and quantify the leading drivers of change that have impacted peatland carbon stocks during the Holocene and predict their effect during this century and in the far future. We also identify uncertainties and knowledge gaps in the scientific community and provide insight towards better integration of peatlands into modelling frameworks. Given the importance of the contribution by peatlands to the global carbon cycle, this study shows that peatland science is a critical research area and that we still have a long way to go to fully understand the peatland–carbon–climate nexus.

Risk assessment models (RAMs) for venous thromboembolism (VTE) and bleeding in hospitalized medical patients inform appropriate use of thromboprophylaxis. Our aim was to use a novel approach for selecting risk factors for VTE and bleeding to be included in RAMs. First, we used the results of a systematic review of all candidate factors. Second, we used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of the evidence for the identified factors. Third, we using a structured approach to select factors to develop the RAMs, by building on clinical and methodological expertise. The expert panel made judgments on whether to include, potentially include, or exclude risk factors, according to domains of the GRADE approach and the Delphi method. The VTE RAM included age >60 years, previous VTE, acute infections, immobility, acute paresis, active malignancy, critical illness, and known thrombophilia. The bleeding RAM included age ≥65 years, renal failure, thrombocytopenia, active gastroduodenal ulcers, hepatic disease, recent bleeding, and critical illness. We identified acute infection as a factor that was not considered in widely used RAMs. Also, we identified factors that require further research to confirm or refute their importance in a VTE RAM (eg, D-dimer). We excluded autoimmune disease which is included in the IMPROVE (International Medical Prevention Registry on Venous Thromboembolism) bleeding RAM. Our results also suggest that sex, malignancy, and use of central venous catheters (factors in the IMPROVE bleeding RAM) require further research. In conclusion, our study presents a novel approach to systematically identifying and assessing risk factors to be included or further explored during RAM development.

ABSTRACTIntroductionPlasma kallikrein is a  mediator of vascular leakage and inflammation. Activation of plasma kallikrein can induce features of diabetic macular edema (DME) in preclinical models. Human vitreous shows elevated plasma kallikrein levels in patients with DME. Because of the incomplete response of some patients to anti-VEGF agents, and the treatment burden associated with frequent dosing, there is still considerable need for VEGF-independent targeted pathways.Areas coveredThis review covers the role of plasma kallikrein in the pathogenesis of DME and the therapeutic potential of plasma kallikrein inhibitors. It discusses early clinical studies of plasma kallikrein pathway modulation for DME, which have been associated with some improvement in visual acuity but with limited improvement in macular edema. This review also highlights KVD001, which is furthest along the development pathway, THR-149, which has recently completed a phase 1 study, and oral agents under development.Expert opinionPlasma kallikrein inhibitors have a potential role in the treatment of DME, with mixed functional/anatomic results in early clinical trials. Given the large unmet need in DME treatment, further studies are warranted.

Background Intracranial atherosclerotic stenosis (ICAS) is associated with high risk of recurrent strokes despite best medical management (MM). We aimed to synthesize the evidence from randomized studies comparing intracranial stenting plus MM versus MM alone.Methods Comprehensive search of MEDLINE database was performed until May 2023. The data were extracted and pooled as risk ratio (RR) with 95% confidence interval (95% CI).Results We included three multicenter RCTs totaling 919 patients. As compared to MM alone, intracranial stenting was associated with statistically significant higher risks of any stroke or death (RR = 2.93, 95%CI [1.80–4.78], p < 0.0001), stroke in the same territory of qualifying artery (RR = 3.56, 95%CI [1.97–6.44], p < 0.0001), any ischemic stroke (RR = 2.22, 95%CI [1.27–3.87], p= 0.005), hemorrhagic stroke (RR = 13.49, 95%CI [2.59–70.15], p= 0.0002), and death (RR = 5.43, 95%CI [1.21–24.40], p= 0.003) within 30 days of randomization. There was a persistent lack of benefit and signals of harm at the last follow up within 1–3 years: any stroke or death (RR = 1.57, 95%CI [0.92–2.67], p= 0.1), stroke in the same territory of qualifying artery (RR = 1.84, 95%CI [0.97–3.50], p= 0.06), any ischemic stroke (RR = 1.56, 95%CI [1.11–2.20], p= 0.01), death (RR = 1.61, 95%CI [0.77–3.38], p= 0.2). The cumulative rate of stroke in the same territory of qualified artery with MM alone within the 1–3-year follow up was lower than expected, with only 47 out of the 450 (10.4%) MM alone patients suffering such events.Conclusion The findings from this meta-analysis do not recommend stenting as a routine care option for the broader symptomatic ICAS patient population. The rates of recurrent strokes in ICAS patients managed with aggressive MM do not seem to be as high as anticipated. Additional multicenter RCTs including safer devices, larger sample sizes, and patients at higher risk of recurrent events are warranted.

The quality management systems compliant with the ISO 9001:2009 have been thoroughly researched and described in detail in the world literature. The accredited management systems used in the testing laboratories and compliant with the ISO/IEC 17025:2005 have been mainly described in terms of the system design and implementation. They have also been investigated from the analytical point of view. Unfortunately, a low number of studies concerned the management system functioning in the accredited testing laboratories. The aim of following study was to assess the management system functioning in the accredited testing laboratories in Poland. On 8 October 2015, 1,213 accredited testing laboratories were present in Poland. They investigated various scientific areas and substances/objects. There are more and more such laboratories that have various problems and different long-term experience when it comes to the implementation, maintenance and improvement of the management systems. The article describes the results of the conducted expert assessment (survey) carried out to examine the conditions for the functioning of a management system in an accredited laboratory. It also focuses on the characteristics of the accredited research laboratories in Poland. The authors discuss the selection of the external and internal conditions that may affect the accredited management system. They show how the experts assessing the selected conditions were chosen. The survey results are also presented.

On the basis of the existing methods of creation process of innovation projects there were defined the basic directions by innovation project management in technology park. Also, scientific problems of subject area and option of the projects were chosen. Depending on the defined scientific problems in the paper, the process of innovative project management in the departments of the technology park in higher educational schools of Azerbaijan was considered. On the basis of the prior scientific directions and scientific profiles of scientific technology park in Sumgait State University (SSU) solutions of problem of innovative project management have been defined.

A report from Gadjah Mada University in Yogyakarta, Indonesia discusses the findings of a study on delirium in pediatric patients. The study aimed to determine the incidence of delirium, identify risk factors, and validate scoring systems for predicting delirium. The research found that the incidence of delirium in pediatric patients was relatively high at 22.8%. The study also concluded that the Watcha scoring system was the most reliable for predicting delirium. However, some demographic and perioperative factors were not found to be risk factors for delirium. [Extracted from the article]

XB Consulting, an executive coaching and business consulting firm and developers of the XC InSight assessment solution, announced the selection and development system is now available in Spanish, as well [...]

A methodical approach is given which is applied to prediction of the persistence of the natural isolation properties of the geological environment for a time period of 10⁴–10⁵ years, when disposing of radioactive waste in geological formations. It is based on modelling geodynamic and tectonic processes development with time and assessing their effects on the persistence of structural tectonic blocks. An algorithm to conduct the research is proposed.

Assessment by experts may be the best method available for retrospective occupational exposure measurement in community-based studies. This study was undertaken to examine the validity of occupational exposure assessment by comparing the ratings of experienced raters with previously recorded industrial hygiene measurements. We obtained 50 measurements from industrial hygiene records, covering a variety of jobs and substances and created 47 job descriptions around these measurements. Three raters were asked to assess exposure to a checklist of 19 substances (including those substances which had been measured). We estimated the sensitivity of the raters in correctly detecting those substances known to have been present. Using a liberal criterion for the ratings, the average sensitivity among the raters was 90%. Using a more stringent criterion, the average sensitivity was 73%. Among substances coded as present, the raters were quite accurate in rating the relative concentration and frequency of exposure. This trial demonstrated that a team of experienced raters could successfully characterize jobs in which important exposures occurred. Am. J. Ind. Med. 43:519–522, 2003. © 2003 Wiley-Liss, Inc.

Introduction:Convolutional neural networks (CNN) can determine markers of cardiac function and structure from echocardiographic imaging datasets. A comparison of measurement results between a CNN and conventional echocardiographic experts with regard to clinical outcome in chronic heart failure (HF) is not available.Methods:Data from the MyoVasc Cohort Study (n=3,289; NCT04064450) on chronic HF were analyzed. Comprehensive clinical phenotyping was performed during an investigation in a dedicated study center. Left ventricular ejection fraction (LVEF) and left ventricular mass (LVM) were measured by a CNN published by Zhang et al. Clinical outcome was assessed by a structured follow-up with subsequent validation and adjudication of endpoints.Results:Data from automatic and human measurements were available in 2,815 subjects with a median follow-up of 5.5 [4.2/6.6] years. The correlation of both measurements was dependent on image quality, ranging between 0.6 and 0.8. In multivariable Cox regression adjusted for age and sex, human and automated LVEF and LVM measures per changes in one standard deviation demonstrated comparable risks for all-cause mortality (LVEF: HRhuman 0.57 [0.52/0.63] vs. HRauto 0.60 [0.55/0.66]; LVM: HRhuman 1.56 [1.42/1.70] vs. HRauto 1.58 [1.43/1.76]) and for worsening HF (LVEF: HRhuman 0.55 [0.51/0.59] vs. HRauto 0.58 [0.53/0.63],; LVM: HRhuman 1.56 [1.45/1.69] vs. HRauto 1.59 [1.47/1.73]). C-indices of both prediction models did not differ significantly (P=0.19). Sensitivity analysis demonstrated no significant differences in model performance for both asymptomatic and symptomatic HF, as well as among HF phenotypes (all P>0.05).Conclusions:CNN-based assessment of LVEF and LVM was non-inferior to conventional expert measurement in predicting all-cause mortality and worsening of HF. This underlines the potential of an CNN-based pipeline for automated evaluation of echocardiography in high-throughput.

Cardiac arrhythmias and sudden death are likely among patients known to have cardiac lesions from sarcoidosis. Other clinical presentations include conduction defects, congestive heart failure, and a picture suggesting myocardial [...]

If a war erupted between nations of the North Atlantic Treaty Organization and the Warsaw Pact, would NATO be prepared to fight it? Leading U.S. military strategists are not sure that question can be answered in the affirmative today, though a flurry of programs are under way to ensure a positive response within several years.

Artificially intelligent (AI) computer programs are emerging in several disciplines including education. This paper provides an overview of one type of AI program called, "expert systems." The potential application of expert systems to the diagnosis and assessment of special-needs chlidren is examined and existing prototype systems are reviewed. The future of this technology is discussed in relation to emerging development tools designed for the creation of expert systems by the lay public.

In the light of current NHS strategy, assessment of needs, particularly among those with significant disability, has become highly topical. This article outlines the complexity and skill required for assessing and managing neurologically-related disability. The multifaceted nature of assessment in rehabilitation is indicated, along with an example of such an assessment service developed in practice. The benefits of an assessment strategy in neurorehabilitation is emphasized in terms of resources, patient outcomes and staff development.

This paper investigates the abilities of a group of experts to produce subjective probabilities on the likelihood of their students obtaining various grades in their final-year examinations. We examine the calibration of these experts, and how their ability to forecast depends on experience and assessment procedures. We find that these well-motivated and statistically literate assessors, working in their field of expertise, still suffer from the types of assessment problems noted in previous studies on more naive subjects.

A Correction to this paper has been published: https://doi.org/10.1038/s41558-021-00991-1.

In 2005, Britain's leading authority on best medical practice issued general guidelines on the most effective approaches to treating post-traumatic stress disorder. The guidelines were released in the wake of [...]

The paper presents the solution to the problem of numerical simulation of thermal comfort in domestic premises. Three thermal bridges have been selected as the key parameters for enclosure structures. They have been calculated on the basis of thermographic studies of a group of typical brick blocks of flats which are located in the city of Tyumen. The considered thermal bridges are as follows: the insulation connections in the outer wall openings; insulation in the outer wall corners; insulation in the outer wall-floor structure connections. The functional connections of the thermal comfort level versus the values of the thermal bridge parameters have been determined. The study has resulted in an express-method of the expert assessment of thermal comfort in domestic premises based on the total assessment of thermal bridges in enclosure structures. The method can be used for a complete structural survey of residential buildings, and in examination of building operation and heat-protective properties of enclosure structures.