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Using a person-centered approach, this study was conducted to identify (a) specific athlete profiles in terms of degree of discrepancy between their self-appraisals and the reflected appraisals of their coach and (b) the relations between these profiles and athlete burnout. Athletes (N = 369; Mage = 21.15 years) fulfilled measures of self-appraisals, reflected appraisals of their coach, and burnout. Latent profile analysis allowed the identification of three profiles: concordance (84%), positive discrepancy (11%), and negative discrepancy (5%). Analyses revealed relationships between athletes' profile membership and the three dimensions of burnout: emotional and physical exhaustion, sport devaluation, and reduced sense of accomplishment. More specifically, results indicated that athletes with a positive discrepancy profile (i.e., who rated themselves more positively than they think their coaches see them) were more at risk of burnout. This study contributes to existing research on psychosocial determinants of athlete burnout in the context of the coach–athlete relationship. [ABSTRACT FROM AUTHOR]

Problem definition: Professional sports leagues may be suspended because of various reasons, such as the recent coronavirus disease 2019 pandemic. A critical question that the league must address when reopening is how to appropriately select a subset of the remaining games to conclude the season in a shortened time frame. Despite the rich literature on scheduling an entire season starting from a blank slate, concluding an existing season is quite different. Our approach attempts to achieve team rankings similar to those that would have resulted had the season been played out in full. Methodology/results: We propose a data-driven model that exploits predictive and prescriptive analytics to produce a schedule for the remainder of the season composed of a subset of originally scheduled games. Our model introduces novel rankings-based objectives within a stochastic optimization model, whose parameters are first estimated using a predictive model. We introduce a deterministic equivalent reformulation along with a tailored Frank–Wolfe algorithm to efficiently solve our problem as well as a robust counterpart based on min-max regret. We present simulation-based numerical experiments from previous National Basketball Association seasons 2004–2019, and we show that our models are computationally efficient, outperform a greedy benchmark that approximates a nonrankings-based scheduling policy, and produce interpretable results. Managerial implications: Our data-driven decision-making framework may be used to produce a shortened season with 25%–50% fewer games while still producing an end-of-season ranking similar to that of the full season, had it been played. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2022.0558 .

A prominent theory in political psychology contends that individual differences in negativity bias explain political ideology: people who are more sensitive to negative stimuli find solace and comfort in conservative approaches to politics. Using self‐reported measures of negativity bias, the evidence is relatively consistent. Yet, using physiological indicators of the negativity bias, the results are, across the board, inconsistent with the negativity bias argument. Building on recent neuroscience work, we propose and test two innovations. First, unconscious and conscious processes are not necessarily aligned. Therefore, we propose that there are different – conscious and unconscious – paths that could link ideology with the negativity bias. Second, individuals vary in their ability and motivation to down‐regulate arousal and reflect on their emotions. As such, the ideology‐negativity bias may emerge in some individuals but not in others. In two preregistered laboratory studies (US and the Netherlands), we find limited evidence for these claims. In a subsequent registered report, we replicate some inconsistent patterns that emerged in study 1. We confirm that self‐reported social conservatism and implicit social conservatism (measured with an IAT) are positively correlated. We also establish that negativity bias is unrelated to social conservatism (both explicit and implicit). We conclude that negativity bias is most likely not the answer to why people on the left and right differ. [ABSTRACT FROM AUTHOR]

To examine the concordance rate of MRI findings with intraoperative and pathologic findings in patients with Placenta Accreta Spectrum (PAS), as well as the use of structured reporting, and their relationship to clinical outcomes. An IRB approved retrospective chart review was performed for patients with a history of cesarean delivery, a diagnosis of PAS on post-operative pathology report, and a placental MRI prior to delivery between 2008-2022. Concordance rates were calculated between final MRI, ultrasound, operative, and pathologic diagnoses, as well as impact on clinical outcomes. Quantitative variables were analyzed using a t-test. Categorical variables were analyzed using chi-squared and Fischer's exact tests. A total of 59 patients met initial inclusion criteria. Of these 59 patients, 8 (13.6%) were interpreted using structured reporting. Discordance between preoperative imaging, operative findings and final pathology diagnoses were associated with increased blood loss, blood transfusion, ICU admission, and postpartum length of stay. Structured reporting was found to significantly reduce the amount of diagnostic discordance (p=.017) and was associated with decreased ICU admissions when utilized (p=.045). Use of structured reporting in the interpretation of placental MRI may decrease the amount of discordance between imaging and intraoperative or pathologic diagnoses, which in our study is associated with improved patient outcomes including decreased blood loss and amount of blood transfused. Radiologists must be cognizant of key imaging features of PAS on MRI, as interpretation provides an opportunity to positively impact the quality and safety of patient care. [ABSTRACT FROM AUTHOR]

Background: Circulating tumor DNA (ctDNA) has emerged as a promising biomarker for noninvasive cancer diagnostics, particularly in the context of metastatic non‐small‐cell lung cancer (NSCLC). Detecting targetable variants through ctDNA analysis offers the potential to guide treatment decisions, especially in cases where tissue samples are insufficient or unavailable. Method: In this study, we developed and validated a next‐generation sequencing panel targeting 101 cancer‐related genes (101‐test) to detect somatic variants in ctDNA from a large cohort of Chinese patients with metastatic NSCLC. The performance of the 101‐test was assessed by evaluating its limit of detection (LOD), accuracy, and precision in identifying molecular variants. Additionally, the concordance between ctDNA and tissue samples for detecting targetable variants was analyzed in 904 patients. Results: The 101‐test demonstrated a LOD of 0.38% for single‐nucleotide variants (SNVs), 0.33% for insertions and deletions (InDels), and 0.33% for fusions. Sensitivity was 98.3% for SNVs, 100% for InDels, and 100% for fusions when compared to digital droplet PCR (ddPCR)/breakpoint PCR reference methods. The by‐variant sensitivity for somatic variants was 97.5%, with a specificity of 99.9% between tumor‐only and tumor‐normal analyses. In a real‐world cohort, the concordance between ctDNA and tissue samples for identifying targetable variants was 72.2% (457/633). Notably, the EGFR S768I variant, recently recommended by clinical guidelines, achieved an 80% concordance rate. Furthermore, 4.3% of patients (27/633) with targetable variants were identified exclusively through ctDNA testing. Conclusion: The ctDNA‐based 101‐test is a highly sensitive and specific tool for detecting targetable variants in metastatic NSCLC, particularly in cases with insufficient tissue samples. The findings support the use of ctDNA testing as a reliable and complementary method to traditional tissue‐based molecular analysis, enhancing the precision of treatment strategies for NSCLC patients. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the importance of education, reasonable adjustments and medication reviews in supporting optimal medicines adherence in people with learning disabilities • To enhance your awareness of factors that contribute to suboptimal medicines adherence in people with learning disabilities • To acknowledge the importance of involving family or carers in supporting medicines adherence. Rationale and key points: People with learning disabilities often have long-term conditions that require the regular use of medicines. Medicines adherence can be particularly challenging in this population and support with taking medicines is often not provided in a way that meets people’s needs. Suboptimal medicines adherence can negatively affect the health outcomes of people with learning disabilities, which are already poorer than those of the general population. • Achieving optimal medicines adherence among people with learning disabilities requires a multi-component strategy that includes education, reasonable adjustments and medication reviews. • Factors that cause and/or contribute to suboptimal medicines adherence among people with learning disabilities include burdensome medicine regimens, medicines prescribed in unsuitable forms, overmedication and overprescribing, lack of medication reviews, lack of reasonable adjustments, suboptimal communication from healthcare professionals and suboptimal care coordination. • Family and carers are often those who administer medicines, so it is crucial to involve, educate and support them about the person’s medicine regimen so that they can help ensure the medicines are taken as prescribed. Reflective activity: ‘How to’ articles can help you to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when supporting a person with a learning disability to take their medicines as prescribed. • How you could use this information to educate nursing students or colleagues on the appropriate actions to take to support a person with a learning disability to take their medicines as prescribed. [ABSTRACT FROM AUTHOR]

Background and Objective: There is insufficient evidence on whether the concordance of sociodemographic, behavioral, and nutritional characteristics between spouses correlates with the concordance of metabolic syndrome (MetS) between spouses, or if a spouse's characteristics are directly linked to their own MetS. This study seeks to evaluate the association between the concordance of characteristics and the concordance of MetS in couples and investigate whether a spouse's attributes are linked to their partner's MetS. Methods: Analyzing data from the Korea National Health and Nutrition Examination Survey 2019–2021, 1824 couples with complete data, including MetS parameters, sociodemographic details, health behaviors, and dietary information, were included. General linear model and logistic regression were employed. Results: Among couples, 10.7% exhibited concordant MetS, with spousal concordance ranging from 1.3% to 81.5% for nonoptimal characteristics. Multivariate analysis revealed that the odds of both partners having MetS increased by 1.04–1.61 times with a higher mean age of the couple and higher concordance in lower education, poor subjective health, insufficient strength exercise, and excessive carbohydrate consumption. When accounting for both individual and spousal factors, the odds of MetS rose with the higher mean age of the couple, having a spouse with MetS, their own characteristics (lower education, poor subjective health, insufficient strength exercise, and sedentary behavior for husbands and wives; alcohol consumption and insufficient walking for husbands; and excessive carbohydrate intake for wives), and spousal factors such as smoking (in husbands) and lower education, lower economic status, and excessive carbohydrate intake (in wives). In wives, spousal sedentary behavior and poor subjective health were linked to decreased odds. Conclusions: The findings suggest a connection between MetS concordance and shared characteristics in couples, as well as an association between both spousal MetS status and characteristics and their own MetS. [ABSTRACT FROM AUTHOR]

A nonparametric method proposed by DeLong et al in 1988 for comparing areas under correlated receiver operating characteristic curves is used widely in practice. However, the DeLong method as implemented in popular software quietly deletes individuals with any missing values, yielding potentially invalid and/or inefficient results. We simplify the DeLong algorithm using ranks and extend it to accommodate missing data by using a mixed model approach for multivariate data. Simulation results demonstrate the validity and efficiency of our procedure for data missing at random. We illustrate our proposed procedure in SAS, Stata, and R using the original DeLong data. [ABSTRACT FROM AUTHOR]

Background: Idiopathic intracranial hypertension (IIH) is a cause of chronic headaches that are probably driven by raised intracranial pressure (ICP). Cerebral venous sinus pressure is thought to play a role in the underlying pathology, but its relation with intracranial pressure requires further investigation. We aimed to evaluate the concordance between lumbar puncture opening pressure (LPOP) as indicator of the ICP and cerebral venous sinus pressure in patients investigated for IIH. Methods: In this case-series replication study, all patients with IIH suspicion and who underwent cerebral venous sinus pressure measurement followed immediately by LP opening pressure (LPOP) measurement were retrospectively included. Pearson's correlation and measurement agreement (Bland-Altman plots) between venous pressure and LPOP were analyzed. Results: 52 consecutive patients (46 women; median age, 31 years [IQR = 25–42]) were included. The mean pressure in the superior sagittal sinus (SSS) and in the torcular were 20.9mmHg (SD ± 7.3) and 20.8 mmHg (SD ± 6.8), respectively. The mean LPOP was 22mmHg (SD ± 6.4). Pressure measured in the transverse venous sinus, the torcular, and the SSS correlated with LPOP (p < 0.001). Bland-Altman plots showed that torcular pressure strongly agreed with LPOP (mean difference of 1.7mmHg). The limit of agreement (LOA) (mean difference ± 1.96SD) contained 98.1% of the differences between the two methods, confirming the concordance between the two measures. Torcular pressure and LPOP were consistent in patients with a trans-stenotic pressure gradient ≥ or < to 8 mmHg (mean difference: 1mmHg and 2.4mmHg, respectively), and for those with a LP OP ≥ or < to 18mmHg (mean difference: 1.8mmHg and 1.95mmHg, respectively). Conclusions: In patients investigated for IIH, the ICP measured at the LP is correlated and concordant with the torcular pressure. These results confirm previous findings and further corroborate the hypothesis that cerebral venous system plays a major role in CSF dynamics and ICP. [ABSTRACT FROM AUTHOR]

AbstractA job-exposure matrix (JEM) is a tool that can estimate diesel engine exhaust (DEE) exposures. JEMs based on expert judgment or measurement data are limited by the information available at the time of development. Over time, more information about hazardous exposures is understood through additional measurements and peer-reviewed publications. This study presents a systematic approach to updating an existing DEE JEM using published data to better reflect current scientific knowledge. The literature was searched for occupational exposure studies that measured DEE as elemental carbon (EC) between January 2010 and May 2022. Four-digit North American Industry Classification System (NAICS) 2002 and National Occupational Classification-Statistics (NOC-S) 2006 codes were assigned to each identified subgroup within the studies. EC exposures were categorized as low (0–10 µg/m3), moderate (10–20 µg/m3), or high (>20 µg/m3). Weighted arithmetic means were calculated for each industry-occupation intersection (IOI) identified in the literature. These means were used to adjust, or retain, the existing exposure level within the JEM cells using a decision tree based on the number of studies, workplace locations, and pooled sample size of the weighted mean. Concordance was measured between the updated JEM (Diesel Exhaust in Canada JEM (DEC-JEM)), the previous (existing) JEM, and the Canadian Job-Exposure Matrix (CANJEM). Thirty-seven studies were identified from the published literature reporting on 53 unique IOIs (20 NAICS and 34 NOC-S codes), including occupations in the mining, construction, and transportation industries. Exposure levels for 66% of identified IOIs increased, most in construction and mining. After the decision tree’s results were expanded to the full DEC-JEM, the exposure level of 486 IOIs (12.5% of DEC-JEM) and 286,710 workers (15.8% of DEE-exposed workers) increased. There was a significant correlation between qualitative exposure levels in the updated DEC-JEM and CANJEM (Kendall’s τ = 0.364, p < 0.001). This study describes a systematic approach to updating an existing JEM to incorporate new scientific knowledge. The updated DEC-JEM better reflects existing exposure knowledge in several industries, particularly construction. Future analyses include investigating its use as an exposure assessment tool in disease surveillance. [ABSTRACT FROM AUTHOR]

In forensic genetics, utilizing massively parallel sequencing (MPS) to analyze short tandem repeats (STRs) has demonstrated several advantages compared to conventional capillary electrophoresis (CE). Due to the current technical limitations, although flanking region polymorphisms had been mentioned in several previous studies, most studies focused on the core repeat regions of STRs or the variations in the adjacent flanking regions. In this study, we developed an MPS system consisting of two sets of multiplex PCR systems to detect not only the STR core repeat regions but also to observe variants located at relatively distant positions in the flanking regions. The system contained 42 commonly used forensic STRs, including 21 autosomal STRs (A-STRs) and 21 Y-chromosomal STRs (Y-STRs), and a total of 350 male individuals from a Chinese Han population were genotyped. The length and sequence variants per locus were tallied and categorized based on length (length-based, LB), sequence without flanking region (core repeat regions sequence-based, RSB), and sequence with flanking region (core repeat and flanking regions sequence-based, FSB), respectively. Allele frequencies, Y-haplotype frequencies, and forensic parameters were calculated based on LB, RSB, and FSB, respectively, to evaluate the improvement in discrimination power, heterozygosity, and effectiveness of forensic systems. The results suggested the sequence variations have more influence on A-STRs and could improve the identification ability of MPS-STR genotyping. Concordance between MPS and CE methods was confirmed by using commercial CE-based STR kits. The impact of flanking region variations on STR genotype analysis and potential factors contributing to discordances were discussed. A total of 58 variations in the flanking regions (53 SNPs/SNVs and 5 InDels) were observed and most variations (48/58) were distributed in A-STRs. In summary, this study delved deeper into the genetic information of forensic commonly used STR and advanced the application of massively parallel sequencing in forensic genetics. [ABSTRACT FROM AUTHOR]

Background: The European Thyroid Association Thyroid Imaging Data and Reporting Systems (EU-TIRADS) is widely used in the risk stratification of thyroid nodule malignancy. However, data on the subject in Sub-Saharan Africa are limited. The objective of this study is to evaluate the clinical, sonographic and histopathological concordance of thyroid nodules in the diagnosis of thyroid cancer. Methods: This was an analytical cross-sectional study that examined the clinical, ultrasound and pathological data of 61 patients from 4 hospitals in the city province of Kinshasa over a period of 24 months, from June 01, 2020 to May 31, 2022. Results: Of the 61 patients, their mean age was 47.38 ± 8.8 years. The mean clinical score of the patients was 3.4 ± 0.84 with the extremes ranging from 1 to 5. The majority of the patients were classified as having an intermediate risk, ie 85.2% of the cases. It was noted that 41% of the nodules had a high risk according to the EU-TIRADS score and 8.2% of the nodules were malignant after histopathological analysis. The ROC curves reported at the diagnosis of malignancy show an area under the curve of 0.709 with 95% CI (0.486–0.931), a Youden index of 0.769 for the clinical score, and an area under the curve of 0.830 with 95% CI (0.605–0.995), a Youden index of 0.772 for the EU-TIRADS score. Conclusion: In a low-income country, a well-performed thyroid ultrasound and the well-applied clinical score could be an important tool in the selection of thyroid nodules suspected of malignancy and requiring histopathological examination to avoid excessive acts in the patient. [ABSTRACT FROM AUTHOR]

Objectives: Recently, a joint group of the American College of Rheumatology (ACR) and the European Alliance of Associations for Rheumatology (EULAR) proposed new criteria for Takayasu arteritis (TAK) (the 2022 ACR/EULAR criteria). This study applied the 2022 ACR/EULAR criteria to patients with previously diagnosed TAK based on the 1990 ACR criteria and investigated the concordance rate between the two criteria according to the four imaging modalities. Methods: This study reviewed the medical records of 179 patients who met the 1990 ACR criteria for TAK. The imaging modalities included conventional angiography, computed tomography angiography, fluorodeoxyglucose-positron emission tomography, and magnetic resonance angiography. Results: Regardless of the imaging modalities, the concordance rate between the two criteria was 85.5% when including all patients, whereas it increased to 98.1% when only patients aged ≤60 years were included. Among the four imaging modalities, computed tomography angiography exhibited the highest concordance rate between the two criteria (85.6%). The concordance rate among patients aged >60 years was 95.7%. Only one patient aged 50–60 years was reclassified as having both TAK and giant cell arteritis. Conclusions: The concordance rate was 85.5% regardless of the imaging modalities and increased to 86.9% on simultaneous computed tomography angiography and fluorodeoxyglucose-positron emission tomography imaging. [ABSTRACT FROM AUTHOR]

The article considers the multivariate stochastic orders of upper orthants, lower orthants and positive quadrant dependence (PQD) among simple max-stable distributions and their exponent measures. It is shown for each order that it holds for the max-stable distribution if and only if it holds for the corresponding exponent measure. The finding is non-trivial for upper orthants (and hence PQD order). From dimension d ≥ 3 these three orders are not equivalent and a variety of phenomena can occur. However, every simple max-stable distribution PQD-dominates the corresponding independent model and is PQD-dominated by the fully dependent model. Among parametric models the asymmetric Dirichlet family and the Hüsler-Reiß family turn out to be PQD-ordered according to the natural order within their parameter spaces. For the Hüsler-Reiß family this holds true even for the supermodular order. [ABSTRACT FROM AUTHOR]

Yuqi Zhang,1,2 Keqian Du,1,2 Xiaoxue Feng,1,2 Jia Xu,1,2 Peijun Xu,1,2 Jianlin Huang1,2 1Department of Rheumatology, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 2Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of ChinaCorrespondence: Jianlin Huang; Peijun Xu, Department of Rheumatology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, People’s Republic of China, Email hjianl@mail.sysu.edu.cn; xupj@mail.sysu.edu.cnPurpose: This study aimed to compare the rates of disease remission evaluated using various remission criteria, including Boolean2.0, Boolean1.0, clinical disease activity index (CDAI), simplified disease activity index (SDAI), and disease activity score using 28 joints based on C-reactive protein (DAS28-CRP) in patients with rheumatoid arthritis (RA).Patients and Methods: A cross-sectional observational analysis was performed using data from patients with RA enrolled in a smart system of disease management group (SSDM). The clinical remission rates of RA patients estimated using the DAS28-CRP, CDAI, SDAI, Boolean1.0 and Boolean2.0 criteria were investigated. Variables were compared using the t-test, Mann–Whitney U-test, or chi-squared test. The agreement between Boolean remission and the DAS28-CRP, CDAI, or SDAI definitions of remission was assessed using McNemar’s test with k coefficient of agreement.Results: A total of 5619 patients were included in the analysis. The mean age of the patients was 56.33 (± 13.01) years, with the majority being female (4491, 79.9%). The rates of remission, as assessed by Boolean2.0, Boolean1.0, DAS28-CRP, CDAI, and SDAI, were 16.6%, 9.7%, 35.2%, 9.1%, and 9.4%, respectively. Comparison with Boolean1.0 criteria revealed higher concordance between Boolean2.0 and DAS28-CRP remission and lower concordance with CDAI and SDAI, regardless of whether the analysis was conducted on the entire population or subgroups based on gender, age or disease duration. Additionally, the administration of different medications may have influenced the rate of Boolean2.0 remission.Conclusion: This study demonstrated a higher concordance between Boolean2.0 criteria and DAS28-CRP remission and a lower concordance with CDAI and SDAI when compared with Boolean1.0 remission criteria.Keywords: Boolean, clinical disease activity index, concordance, disease activity score using 28 joints, remission, simplified disease activity index

Abstract Background Idiopathic intracranial hypertension (IIH) is a cause of chronic headaches that are probably driven by raised intracranial pressure (ICP). Cerebral venous sinus pressure is thought to play a role in the underlying pathology, but its relation with intracranial pressure requires further investigation. We aimed to evaluate the concordance between lumbar puncture opening pressure (LPOP) as indicator of the ICP and cerebral venous sinus pressure in patients investigated for IIH. Methods In this case-series replication study, all patients with IIH suspicion and who underwent cerebral venous sinus pressure measurement followed immediately by LP opening pressure (LPOP) measurement were retrospectively included. Pearson’s correlation and measurement agreement (Bland-Altman plots) between venous pressure and LPOP were analyzed. Results 52 consecutive patients (46 women; median age, 31 years [IQR = 25–42]) were included. The mean pressure in the superior sagittal sinus (SSS) and in the torcular were 20.9mmHg (SD ± 7.3) and 20.8 mmHg (SD ± 6.8), respectively. The mean LPOP was 22mmHg (SD ± 6.4). Pressure measured in the transverse venous sinus, the torcular, and the SSS correlated with LPOP (p

Abstract In forensic genetics, utilizing massively parallel sequencing (MPS) to analyze short tandem repeats (STRs) has demonstrated several advantages compared to conventional capillary electrophoresis (CE). Due to the current technical limitations, although flanking region polymorphisms had been mentioned in several previous studies, most studies focused on the core repeat regions of STRs or the variations in the adjacent flanking regions. In this study, we developed an MPS system consisting of two sets of multiplex PCR systems to detect not only the STR core repeat regions but also to observe variants located at relatively distant positions in the flanking regions. The system contained 42 commonly used forensic STRs, including 21 autosomal STRs (A-STRs) and 21 Y-chromosomal STRs (Y-STRs), and a total of 350 male individuals from a Chinese Han population were genotyped. The length and sequence variants per locus were tallied and categorized based on length (length-based, LB), sequence without flanking region (core repeat regions sequence-based, RSB), and sequence with flanking region (core repeat and flanking regions sequence-based, FSB), respectively. Allele frequencies, Y-haplotype frequencies, and forensic parameters were calculated based on LB, RSB, and FSB, respectively, to evaluate the improvement in discrimination power, heterozygosity, and effectiveness of forensic systems. The results suggested the sequence variations have more influence on A-STRs and could improve the identification ability of MPS-STR genotyping. Concordance between MPS and CE methods was confirmed by using commercial CE-based STR kits. The impact of flanking region variations on STR genotype analysis and potential factors contributing to discordances were discussed. A total of 58 variations in the flanking regions (53 SNPs/SNVs and 5 InDels) were observed and most variations (48/58) were distributed in A-STRs. In summary, this study delved deeper into the genetic information of forensic commonly used STR and advanced the application of massively parallel sequencing in forensic genetics.

Abstract Background The European Thyroid Association Thyroid Imaging Data and Reporting Systems (EU-TIRADS) is widely used in the risk stratification of thyroid nodule malignancy. However, data on the subject in Sub-Saharan Africa are limited. The objective of this study is to evaluate the clinical, sonographic and histopathological concordance of thyroid nodules in the diagnosis of thyroid cancer. Methods This was an analytical cross-sectional study that examined the clinical, ultrasound and pathological data of 61 patients from 4 hospitals in the city province of Kinshasa over a period of 24 months, from June 01, 2020 to May 31, 2022. Results Of the 61 patients, their mean age was 47.38 ± 8.8 years. The mean clinical score of the patients was 3.4 ± 0.84 with the extremes ranging from 1 to 5. The majority of the patients were classified as having an intermediate risk, ie 85.2% of the cases. It was noted that 41% of the nodules had a high risk according to the EU-TIRADS score and 8.2% of the nodules were malignant after histopathological analysis. The ROC curves reported at the diagnosis of malignancy show an area under the curve of 0.709 with 95% CI (0.486–0.931), a Youden index of 0.769 for the clinical score, and an area under the curve of 0.830 with 95% CI (0.605–0.995), a Youden index of 0.772 for the EU-TIRADS score. Conclusion In a low-income country, a well-performed thyroid ultrasound and the well-applied clinical score could be an important tool in the selection of thyroid nodules suspected of malignancy and requiring histopathological examination to avoid excessive acts in the patient.

Accurate identification of prostate cancer Gleason grade group remains an important component of the initial management of clinically localized disease. However, Gleason score upgrading (GSU) from biopsy to radical prostatectomy can occur in up to a third of patients treated with surgery. Concern for disease undergrading remains a source of diagnostic uncertainty, contributing to both over-treatment of low-risk disease as well as under-treatment of higher-risk prostate cancer. This review examines the published literature concerning risk factors for GSU from time of biopsy to prostatectomy final pathology. Risk factors identified for Gleason upgrading include patient demographic and clinical factors including age, body mass index, race, prostate volume, and biomarker based assays, including prostate-specific antigen (PSA) density, and testosterone values. In addition, prostate magnetic resonance imaging (MRI) findings have also been associated with GSU. Biopsy-specific characteristics associated with GSU include lower number of biopsy cores and lack of targeted methodology, and possibly increasing percent biopsy core positivity. Recognition of risk factors for disease undergrading may prompt confirmatory testing including repeat sampling or imaging. Continued refinements in imaging guided biopsy techniques may also reduce sampling error contributing to undergrading.

Motivated by recently investigated results on dependence measures and robust risk models, this article provides an overview of dependence properties of many well known bivariate copula families, where the focus is on the Schur order for conditional distributions, which has the fundamental property that minimal elements characterize independence and maximal elements characterize perfect directed dependence. We give conditions on copulas that imply the Schur ordering of the associated conditional distribution functions. For extreme-value copulas, we prove the equivalence of the lower orthant order, the Schur order for conditional distributions, and the pointwise order of the associated Pickands dependence functions. Furthermore, we provide several tables and figures that list and illustrate various positive dependence and monotonicity properties of copula families, in particular, from classes of Archimedean, extreme-value, and elliptical copulas. Finally, for Chatterjee’s rank correlation, which is consistent with the Schur order for conditional distributions, we give some new closed-form formulas in terms of the parameter of the underlying copula family.

The introduction justifies the topicality of studying and importance of conceptualization and operationalization of the social and psychological phenomenon of constructive behavior in conflict situations. The theoretical analysis involved three main stages. The first stage focused on identification of the subject matter and functional structure of constructive behavior in an interpersonal conflict situation. The conceptualized phenomenon is understood as a functional system of conscious, creative activity of an individual, the overall target and meaning focus of which is connected with searching for and formation ways and means of developing and implementing the program, integrated and arranged as a whole, of coordinated executive interactions with a partner to satisfy one’s own and the partner’s meaningful interests when contradictions arise within common, shared social and psychological space. The second stage dealt with consideration of the major characteristics of constructive behavior in an interpersonal conflict situation. The range of these characteristics includes subjectness, proactivity, purposefulness, creativity, eco-sensitivity, syntonicity, concordance, integrativeness, productivity, supra-situational supersubject non-opposition. The third stage of the scientific analysis sought to compare constructive behavior with other forms of reacting in an interpersonal conflict situation. The given qualitative comparative analysis yielded the indicators of constructive behavior in an interpersonal conflict situation that can be used as the basis of subsequent operationalization and development of appropriate psychodiagnostic tools. In conclusion, the author summarizes the scientific analysis undertaken and gives a complete definition of constructive behavior in an interpersonal conflict.

Background SARS-CoV-2 antigen-detection rapid diagnostic tests (Ag-RDTs) have become widely utilized but longitudinal characterization of their community-based performance remains incompletely understood. Methods This prospective longitudinal study at a large public university in Seattle, WA utilized remote enrollment, online surveys, and self-collected nasal swab specimens to evaluate Ag-RDT performance against real-time reverse transcription polymerase chain reaction (rRT-PCR) in the context of SARS-CoV-2 Omicron. Ag-RDT sensitivity and specificity within 1 day of rRT-PCR were evaluated by symptom status throughout the illness episode and Orf1b cycle threshold (Ct). Results From February to December 2022, 5757 participants reported 17 572 Ag-RDT results and completed 12 674 rRT-PCR tests, of which 995 (7.9%) were rRT-PCR positive. Overall sensitivity and specificity were 53.0% (95% confidence interval [CI], 49.6%–56.4%) and 98.8% (95% CI, 98.5%–99.0%), respectively. Sensitivity was comparatively higher for Ag-RDTs used 1 day after rRT-PCR (69.0%), 4–7 days after symptom onset (70.1%), and Orf1b Ct ≤20 (82.7%). Serial Ag-RDT sensitivity increased with repeat testing ≥ 2 (68.5%) and ≥ 4 (75.8%) days after an initial Ag-RDT-negative result. Conclusions Ag-RDT performance varied by clinical characteristics and temporal testing patterns. Our findings support recommendations for serial testing following an initial Ag-RDT-negative result, especially among recently symptomatic persons or those at high risk for SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

Histological diagnosis of sarcomas (malignant bone and soft tissue tumors) is challenging due to their rarity, morphological diversity, and constantly evolving diagnostic criteria. In this study, we aimed to assess the concordance in histological diagnosis of bone and soft tissue tumors between referring hospitals and a tertiary sarcoma center and analyzed the clinical impact of the diagnostic alteration. We analyzed 628 consecutively accessioned specimens from 624 patients who visited a specialized sarcoma center for treatment. The diagnoses at referring hospitals and those at the sarcoma center were compared and classified into four categories: agreed, disagreed, specified, and de‐specified. Of the 628 specimens, the diagnoses agreed in 403 (64.2%) specimens, whereas some changes were made in 225 (35.8%) specimens: disagreed in 153 (24.3%), specified in 52 (8.3%), and de‐specified in 20 (3.2%) cases. The benign/intermediate/malignant judgment changed for 92 cases (14.6%). The diagnostic change resulted in patient management modification in 91 cases (14.5%), including surgical and medical treatment changes. The main inferred reason for the diagnostic discrepancies was a different interpretation of morphological findings of the tumor, which accounted for 48.9% of the cases. This was followed by the unavailability of specialized immunohistochemical antibodies and the unavailability of genetic analysis. In summary, our study clarified the actual clinical impact of diagnostic discrepancy in bone and soft tissue tumors. This may underscore the value of pathology consultation, facilitating access to specialized diagnostic tools, and continued education. These measures are expected to improve diagnostic precision and ultimately benefit patients. [ABSTRACT FROM AUTHOR]

Objective: To validate the level of agreement between self‐report and clinical examination for oral conditions and evaluate the effect of sociodemographic conditions on the validity of self‐report among women aged 60 and older. Methods: A cross‐sectional study was conducted in a social community center for seniors in Southern Brazil. Sociodemographic data (age, level of education, and income) were measured. Participants were interviewed and clinically examined for the number of teeth (DMF‐T index) and the use of dental prostheses. The self‐reported number of teeth in each arch and the use of dental prostheses were gathered through interviews. The level of agreement was estimated using the observed agreement, Kappa statistics, sensitivity/specificity (edentulism/prostheses) and Lin's concordance correlation coefficient, and related tests (number of teeth). The validity of the oral conditions was estimated according to sociodemographic information. Results: Ninety‐nine women participated in the study. High levels of agreement were observed for edentulism (97.8%; 95%CI 92.8;99.7; Kappa 0.947) and the use of dental prostheses (97.0%; 95%CI 91.3;99.4; Kappa 0.922). In both conditions, despite achieving similar concordance correlation coefficients (ranging from weak to moderate), the mean number of upper teeth was lower in clinical examination (7.1 ± 5.2) compared with self‐reported (8.6 ± 3.6), while the opposite was observed for lower teeth (clinical examination: 9.1 ± 3.4; self‐reported: 6.6 ± 5.3). Larger differences were found among women of low income and educational levels. Conclusions: Our findings suggest that the participants' socio‐economic position might influence their self‐reported number of teeth. [ABSTRACT FROM AUTHOR]

Objectives: Familial Crohn's disease (CD) accounts for approximately 1.5%–22.5% of all CD cases worldwide. We aimed to assess the concordance in disease subtype and phenotypic features among patients with CD and their relatives based on data from a large, well‐characterized, referral center‐based cohort in China. Methods: A retrospective study was conducted on patients with familial CD who were admitted to the Sixth Affiliated Hospital of Sun Yat‐sen University between January 2012 and June 2022. We analyzed the disease characteristics and performed a concordance analysis within the same family among patients with familial CD. Results: Among 5150 patients, 70 (1.4%) had a family history of Crohn's disease. The median age of the patients at initial diagnosis did not differ significantly between the probands and successors of family members with CD (p = 0.25). At the initial diagnosis, 54 first‐degree relatives showed moderate concordance in age (κ = 0.50) and disease location (κ = 0.44). At the last follow‐up visit, all family members and first‐degree relatives showed good concordance in upper gastrointestinal involvement (κ = 0.67 and 0.62) and stricturing or penetrating behavior (κ = 0.69 and 0.77), respectively. Patients with familial CD within the same family showed moderate agreement regarding anti‐tumor necrosis factor α monoclonal antibody use and treatment efficacy (κ = 0.44 and 0.42) and mild agreement regarding the efficacy and adverse reactions of thiopurine (κ = 0.26 and 0.35). Conclusions: The proportion of patients with familial CD in China may be relatively low. The consistency of certain disease features in familial CD may be associated with the degree of kinship and convergence with longer follow‐up duration. [ABSTRACT FROM AUTHOR]

Digitalization of pathology workflows has undergone a rapid evolution and has been widely established in the diagnostic field but remains a challenge in the nonclinical safety context due to lack of regulatory guidance and validation experience for good laboratory practice (GLP) use. One means to demonstrate that digital slides are fit for purpose, that is, provide sufficient quality for pathologists to reach a diagnosis, is conduction of comparison studies, which have been published both, for veterinary and human diagnostic pathology, but not for toxicologic pathology. Here, we present an approach that uses study material from nonclinical safety studies and that allows for the statistical comparison of concordance rates for glass and digital slide evaluation while minimizing time and effort for the involved personnel. Using a benchmark study design, we demonstrate that evaluation of digital slides fits the purpose of nonclinical safety evaluation. These results add to reports of successful workflow validations and support the full adaptation of digital pathology in the regulatory field. [ABSTRACT FROM AUTHOR]

While several test concordance tables have been published, the research underpinning such tables has rarely been examined in detail. This study aimed to survey the publically available studies or documentation underpinning the test concordance tables of the providers of four major international language tests, all accepted by the Australian Department of Home Affairs for Australian visa purposes. To evaluate the concordance studies, we first identified the good practice principles in concordance research through a review of both the relevant literature and leading professional standards in the field of educational measurement and language assessment. Next, we reviewed the concordance studies against the identified good practice principles. Our findings revealed that the information supplied by test providers varied, with some making the full research papers available, whereas others providing little information about their underpinning research. None of the concordance studies fulfilled all the good practice principles. Based on the findings of this study, we offer recommendations for future concordance research in the field of language testing as well as suggestions for practice. [ABSTRACT FROM AUTHOR]

Background: Patch test is the gold standard for diagnosing allergic contact dermatitis. Conventionally, the patches are applied for 48 h, which in tropical weather conditions causes excessive sweating, leading to irritation, and sometimes the patches come off, making the test inconclusive. Objective: To compare the patch test positivity after 24 and 48 h of occlusion time in patients of allergic contact dermatitis, using standard allergen concentration. Materials and methods: Clinically suspected patients of allergic contact dermatitis were enrolled and patch tested using the Indian Standard Series, parthenium acetone extracts (1:50, 1:100 and 1:200 dilutions) and patient material. Patches were applied in duplicate on either side of the back, using a random number table. One set of patches was removed after 24‐h of occlusion, while the other set after 48‐h. Readings were performed at 48‐ and 96‐h by two independent dermatologists, blinded to the duration of occlusion. Results: The study had 97 adult patients (58 males and 39 females; mean age: 48.12 ± 13.07 years). A total of 133 and 142 positive reactions were observed after 48 h occlusion at 48 and 96 h reading, respectively. Of these 117 (87.9%) and 132 (92.9%) patches were positive and concordant and noted at 24 h occlusion time. The Cohen's kappa coefficient were 0.94 for 48 h and 0.97 for 96 h reading, hence showing an almost complete agreement (ⱪ > 0.81) between patches occluded for 24 and 48 h. Conclusion: Though there is no significant difference in patch test positivity among ISS allergens after either occlusion time, 48 h occlusion performs significantly better compared with 24 h, when reactions of all allergens (ISS, patient material and parthenium acetone extract) are analysed together. [ABSTRACT FROM AUTHOR]

Background: Reversible loss of consciousness is the primary therapeutic endpoint of general anesthesia; however, the drug‐invariant mechanisms underlying anesthetic‐induced unconsciousness are still unclear. This study aimed to investigate the static, dynamic, topological and organizational changes in functional brain network induced by five clinically‐used general anesthetics in the rat brain. Method: Male Sprague–Dawley rats (n = 57) were randomly allocated to received propofol, isoflurane, ketamine, dexmedetomidine, or combined isoflurane plus dexmedetomidine anesthesia. Resting‐state functional magnetic resonance images were acquired under general anesthesia and analyzed for changes in dynamic functional brain networks compared to the awake state. Results: Different general anesthetics induced distinct patterns of functional connectivity inhibition within brain‐wide networks, resulting in multi‐level network reorganization primarily by impairing the functional connectivity of cortico‐subcortical networks as well as by reducing information transmission capacity, intrinsic connectivity, and network architecture stability of subcortical regions. Conversely, functional connectivity and topological properties were preserved within cortico‐cortical networks, albeit with fewer dynamic fluctuations under general anesthesia. Conclusions: Our findings highlighted the effects of different general anesthetics on functional brain network reorganization, which might shed light on the drug‐invariant mechanism of anesthetic‐induced unconsciousness. [ABSTRACT FROM AUTHOR]

Persons with HIV (PWH) face an increased risk of cardiovascular events due to immune activation, comorbidities, and certain antiretrovirals (ARVs). However, the current cardiovascular risk (CVR) scores are not specifically directed toward PWH. This study aimed to assess the agreement between different predictive CVR scores and explore their relationship with clinical and demographic data in Mexican PWH. A descriptive cross-sectional analysis was conducted in 200 PWH with a mean age of 42 years who were treated at a Mexican urban center from 2017 to 2018. The majority (83%) was on ARV treatment and 79.5% had undetectable viral loads (VLs). Moderate- to high-risk scores were infrequent, with Framingham Risk Score for Hard Coronary Heart Disease scores showing higher values, with very low concordance among all scores. Logistic regression analysis revealed significant associations between the CVR scores and the initial recorded VL, CD4 cell count, and elevated triglyceride levels. However, no associations were found with measures such as body mass index or abdominal circumference. Treatment with integrase strand transfer inhibitors (INSTIs), particularly first-generation inhibitors, showed strong associations with all predictive scores, notably ASCVD (odds ratio = 7.03, 95% confidence interval 1.67–29.64). The poor concordance among the CVR scores in PWH highlights the need for a specific score that considers comorbidities and ARV drugs. Despite the relatively young age of the participants, significant correlations were observed between INSTI use, initial VL, CD4 cell count, and triglyceride levels, which are factors not considered in the existing risk scores. Regardless of the actual value of the scores, screening for CVR in PWH is recommended. [ABSTRACT FROM AUTHOR]

Quantifying the association between components of multivariate random curves is of general interest and is a ubiquitous and basic problem that can be addressed with functional data analysis. An important application is the problem of assessing functional connectivity based on functional magnetic resonance imaging (fMRI), where one aims to determine the similarity of fMRI time courses that are recorded on anatomically separated brain regions. In the functional brain connectivity literature, the static temporal Pearson correlation has been the prevailing measure for functional connectivity. However, recent research has revealed temporally changing patterns of functional connectivity, leading to the study of dynamic functional connectivity. This motivates new similarity measures for pairs of random curves that reflect the dynamic features of functional similarity. Specifically, we introduce gradient synchronization measures in a general setting. These similarity measures are based on the concordance and discordance of the gradients between paired smooth random functions. Asymptotic normality of the proposed estimates is obtained under regularity conditions. We illustrate the proposed synchronization measures via simulations and an application to resting-state fMRI signals from the Alzheimer's Disease Neuroimaging Initiative and they are found to improve discrimination between subjects with different disease status. [ABSTRACT FROM AUTHOR]

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Background: Human epidermal growth factor receptor 2 (HER2)-low status has recently gained attention because of the potential therapeutic benefits of antibody–drug conjugates (ADCs) in breast cancer patients. We aimed to investigate the concordance of HER2 status between core needle biopsy (CNB) and subsequent surgical resection specimens focusing on the HER2-low status. Methods: This retrospective study was conducted in 1,387 patients with invasive breast cancer whose HER2 status was evaluated in both CNB and surgical resection specimens. The discordance rates between CNB and surgical resection specimens and the clinicopathological features associated with HER2 status discordance were analyzed. Results: The overall concordance rates of HER2 status between CNB and surgical resection specimens were 99.0% (κ = 0.925) for two-group classification (negative vs. positive) and 78.5% (κ = 0.587) for three-group classification (zero vs. low vs. positive). The largest discordance occurred in CNB-HER2-zero cases with 42.8% of them reclassified as HER2-low in surgical resection. HER2 discordance was associated with lower histologic grade, tumor multiplicity, and luminal A subtype. In multivariate analysis, tumor multiplicity and estrogen receptor (ER) positivity were independent predictive factors for HER2-zero to low conversion. Conclusions: Incorporation of HER2-low category in HER2 status interpretation reduces the concordance rate between CNB and surgical resection specimens. Tumor multiplicity and ER positivity are predictive factors for conversion from HER2-zero to HER2-low status. Therefore, HER2 status should be re-evaluated in resection specimens when considering ADCs in tumors exhibiting multiplicity and ER positivity. [ABSTRACT FROM AUTHOR]

Aim: A multisociety consensus group proposed a new nomenclature for metabolic dysfunction‐associated steatotic liver disease (MASLD). Although patients with nonalcoholic fatty liver disease (NAFLD) are expected to be reclassified as patients with MASLD under the new nomenclature, the concordance between MASLD and NAFLD remains unclear. Moreover, waist circumference could be adjusted by ethnicity for diagnosing MASLD; however, there are limited data on the optimal waist circumference in the Japanese population. Methods: This cross‐sectional study was conducted on 3709 Japanese patients with NAFLD. The primary endpoint was the prevalence of MASLD in patients with NAFLD. The difference between the original waist circumference criteria (>94 cm for men and >80 cm for women) and the Japanese metabolic syndrome criteria (≥85 cm for men and ≥90 cm for women) for concordance between NAFLD and MASLD was also investigated. Results: According to the original criteria, the prevalence of MASLD in patients with NAFLD was 96.7%. Similarly, according to the Japanese waist circumference criteria, 96.2% of patients with NAFLD could be reclassified as those with MASLD. The concordance rate was significantly higher in the original criteria than in the Japanese criteria (p = 0.02). Conclusions: NAFLD could be considered MASLD using the original MASLD criteria in the Japanese population, and insights from NAFLD research could be applied to MASLD. [ABSTRACT FROM AUTHOR]

We develop a framework for creating distortion functions that are used to construct new bivariate copulas. It is achieved by transforming non-negative random variables with Lomax-related distributions. In this paper, we apply the distortions to the base copulas of independence, Clayton, Frank, and Gumbel copulas. The properties of the tail dependence coefficient, tail order, and concordance ordering are explored for the new families of distorted copulas. We conducted an empirical study using the daily net returns of Amazon and Google stocks from January 2014 to December 2023. We compared the popular Clayton, Gumbel, Frank, and Gaussian copula models to their corresponding distorted copula models induced by the unit-Lomax and unit-inverse Pareto distortions. The new families of distortion copulas are equipped with additional parameters inherent in the distortion function, providing more flexibility, and are demonstrated to perform better than the base copulas. After analyzing the data, we have found that the joint extremes of Amazon and Google stocks are more likely for high daily net returns than for low daily net returns. [ABSTRACT FROM AUTHOR]

Despite their global presence and ubiquity, members of the class Geoglossomycetes (Pezizomycotina, Ascomycota) are understudied systematically and ecologically. These fungi have long been presumed saprobic due to their occurrence in or near leaf litter and soils. Additionally, they lack an apparent association with other organisms, reinforcing this perception. However, observations of sporocarps near ericaceous shrubs have given rise to an alternative hypothesis that members of Geoglossomycetes may form ericoid mycorrhizae or ectomycorrhizae. This claim, however, has yet to be confirmed via microscopy or amplicon-based studies examining root communities. As a result, our current understanding of their ecology is based on cursory observations. This study presents a comparative analysis of genomic signatures related to ecological niche to investigate the hypothesis of an ericoid mycorrhizal or ectomycorrhizal ecology in the class. We compared the carbohydrate-active enzyme (CAZyme) and secondary metabolite contents of six newly sequenced Geoglossomycetes genomes with those of fungi representing specific ecologies across Pezizomycotina. Our analysis reveals CAZyme and secondary metabolite content patterns consistent with ectomycorrhizal (EcM) members of Pezizomycotina. Specifically, we found a reduction in CAZyme-encoding genes and secondary metabolite clusters that suggests a mutualistic ecology. Our work includes the broadest taxon sampling for a phylogenomic study of Pezizomycotina to date. It represents the first functional genomic and genome-scale phylogenetic study of the class Geoglossomycetes and improves the foundational knowledge of the ecology and evolution of these understudied fungi.

Ki-67 proliferative index (PI) scoring is measured by estimating the proportion of the number of active cell nuclei in hotspot regions within immunohistochemical (IHC) stained slides. It provides valuable information about the rate of proliferation in a tumour. Manual scoring of Ki-67 PI is laborious, time-consuming and often the victim of interobserver variability between pathologists. This motivated us to develop an AI-based method to automate Ki-67 PI scoring with the aim to improve the concordance of pathologists' inter-observability through aided diagnosis. We sourced 88 sequential cases of sarcomas for our study. We applied watershed algorithm to perform nuclear segmentation on 440 regions of interest (ROI). A study was conducted where three pathologists scored the Ki-67 PI on the ROIs with and without AI-assistance. Our study demonstrated great concordance between the pathologists scoring with AI-assistance. After AI assistance, inter-pathologist discordance was significantly reduced by 82.1 %

Abstract Background Circulating tumor DNA (ctDNA) has emerged as a promising biomarker for noninvasive cancer diagnostics, particularly in the context of metastatic non‐small‐cell lung cancer (NSCLC). Detecting targetable variants through ctDNA analysis offers the potential to guide treatment decisions, especially in cases where tissue samples are insufficient or unavailable. Method In this study, we developed and validated a next‐generation sequencing panel targeting 101 cancer‐related genes (101‐test) to detect somatic variants in ctDNA from a large cohort of Chinese patients with metastatic NSCLC. The performance of the 101‐test was assessed by evaluating its limit of detection (LOD), accuracy, and precision in identifying molecular variants. Additionally, the concordance between ctDNA and tissue samples for detecting targetable variants was analyzed in 904 patients. Results The 101‐test demonstrated a LOD of 0.38% for single‐nucleotide variants (SNVs), 0.33% for insertions and deletions (InDels), and 0.33% for fusions. Sensitivity was 98.3% for SNVs, 100% for InDels, and 100% for fusions when compared to digital droplet PCR (ddPCR)/breakpoint PCR reference methods. The by‐variant sensitivity for somatic variants was 97.5%, with a specificity of 99.9% between tumor‐only and tumor‐normal analyses. In a real‐world cohort, the concordance between ctDNA and tissue samples for identifying targetable variants was 72.2% (457/633). Notably, the EGFR S768I variant, recently recommended by clinical guidelines, achieved an 80% concordance rate. Furthermore, 4.3% of patients (27/633) with targetable variants were identified exclusively through ctDNA testing. Conclusion The ctDNA‐based 101‐test is a highly sensitive and specific tool for detecting targetable variants in metastatic NSCLC, particularly in cases with insufficient tissue samples. The findings support the use of ctDNA testing as a reliable and complementary method to traditional tissue‐based molecular analysis, enhancing the precision of treatment strategies for NSCLC patients.

OBJECTIVES The primary objective of this study is to assess the degree of concordance and discordance between the interpretations of computed tomography (CT) brain images by resident and consultant radiologists while emphasizing the critical significance of accurate image interpretation for informed clinical decision-making. METHODOLOGY The evaluation of radiology reports for CT Brain interpretation through a prospective analysis at the Radiology Department of Rehman Medical Institute over two years, from 1st October 2020 to 31st October 2022. A total of 198 patients who underwent cranial CT scans were interpreted by residents (R1, R2, R3, R4). Following this, the consultant radiologists reviewed the images and completed their reports. The reports of the residents and the consultant radiologists were then compared, and concordance was achieved when the residents’ reports were consistent with the final radiologist’s reports. The data collected were recorded in Microsoft Excel. The statistical analysis was performed using SPSS version 22 (IBM Corp., Armonk, NY), and the kappa coefficient was used to determine the level of agreement between residents and consultants. RESULTS Among the 198 CT Head reports evaluated, 186 of them were in agreement with the final report of the consultant radiologist. Of the correctly diagnosed cases, R1 correctly diagnosed 46 cases, R2 correctly diagnosed 80 cases, R3 correctly diagnosed 54 cases, and R4 correctly diagnosed 6 cases. Our study achieved a percentage agreement of 93.93, with a Cohen's kappa coefficient of 0.8. CONCLUSION The overall concordance rate between residents and consultant radiologists was 93.93%, with a kappa coefficient 0.8. This high kappa coefficient indicates strong agreement between the two groups.

Many sport horse studbooks worldwide use microsatellite markers for parentage verification. However, many have expressed a desire to introduce genomic selection using genome-wide dense single nucleotide polymorphism (SNP) genotypes to complement their current breeding programmes. Hence, it does not make sense to genotype the same animal for both microsatellite markers and SNP markers. Transitioning to SNP-based parentage verification is an obvious solution but one barrier to this transition is the lack of SNP data on parents from which to verify parentage against. Therefore, the objective of this study was to assess the ability to impute the SNP genotype of a stallion from the genotypes of its progeny, with or without the consideration of the genotype of the progeny’s dam. Genotype information from 55 935 SNPs was available on 13 327 horses. A total of 98 stallions had genotype data on 10 progeny and the genotypes of these stallions were used as a test population. Genome-wide genotype imputation was undertaken by combining a family- and population-based imputation approach. Several different scenarios were assessed to quantify the ability to accurately impute the genotype of a stallion based on genotype data of incrementally more half-sibling progeny. Using genomic information from four progeny the average genotype concordance of the imputed sire genotype compared to the actual sire’s genotype was 0.932. The average genotype concordance rate increased to 0.960 when the genotypes of 10 progeny were included in the imputation process. The inclusion of the genotypes of the dams of the progeny improved the concordance rate from 0.932 to 0.977 when based on the genotype of just four progeny and their dams and from 0.960 to 0.996 when based on the genotype of 10 progeny and their dams. These results suggest it is possible to impute the genotype of a non-genotyped horse from the genotypes of its progeny and that the inclusion of the genotypes of the dams of the progeny improves this imputation accuracy further.

The experiences associated with remembering, including metamemory feelings about the act of remembering and attempts at remembering, are not often integrated into general accounts of memory. For example, David Rubin (2022) proposes a unified, three-dimensional conceptual space for mapping memory states, a map that does not systematically specify metamemory feelings. Drawing on Rubin's model, we define a distinct role for metamemory in relation to first-order memory content. We propose a fourth dimension for the model and support the proposal with conceptual, neurocognitive, and clinical lines of reasoning. We use the modified model to illustrate several cases, and show how it helps to conceptualize a new category of memory state: autonoetic knowing, exemplified by déjà vu. We also caution not to assume that memory experience is directly correlated with or caused by memory content, an assumption Tulving (1989) labeled the doctrine of concordance.