Reliability assessment of ultrasound muscle echogenicity in patients with rheumatic diseases: Results of a multicenter international web-based study

ObjectivesTo investigate the inter/intra-reliability of ultrasound (US) muscle echogenicity in patients with rheumatic diseases.MethodsForty-two rheumatologists and 2 radiologists from 13 countries were asked to assess US muscle echogenicity of quadriceps muscle in 80 static images and 20 clips from 64 patients with different rheumatic diseases and 8 healthy subjects. Two visual scales were evaluated, a visual semi-quantitative scale (0–3) and a continuous quantitative measurement (“VAS echogenicity,” 0–100). The same assessment was repeated to calculate intra-observer reliability. US muscle echogenicity was also calculated by an independent research assistant using a software for the analysis of scientific images (ImageJ). Inter and intra reliabilities were assessed by means of prevalence-adjusted bias-adjusted Kappa (PABAK), intraclass correlation coefficient (ICC) and correlations through Kendall’s Tau and Pearson’s Rho coefficients.ResultsThe semi-quantitative scale showed a moderate inter-reliability [PABAK = 0.58 (0.57–0.59)] and a substantial intra-reliability [PABAK = 0.71 (0.68–0.73)]. The lowest inter and intra-reliability results were obtained for the intermediate grades (i.e., grade 1 and 2) of the semi-quantitative scale. “VAS echogenicity” showed a high reliability both in the inter-observer [ICC = 0.80 (0.75–0.85)] and intra-observer [ICC = 0.88 (0.88–0.89)] evaluations. A substantial association was found between the participants assessment of the semi-quantitative scale and “VAS echogenicity” [ICC = 0.52 (0.50–0.54)]. The correlation between these two visual scales and ImageJ analysis was high (tau = 0.76 and rho = 0.89, respectively).ConclusionThe results of this large, multicenter study highlighted the overall good inter and intra-reliability of the US assessment of muscle echogenicity in patients with different rheumatic diseases

Mental Preparation of Students Preceding the Course

In the preparation of”complete actors” only the technical aspects are not decisive, they will not only train them for the level of mastery. Aerobic exercises, forexample, can only play a part in recreation and muscular development, but when we talk about the scenic movement that uses actors’ preparation, the situation changes; the future actor has to work out physical exercises by passing through the mental as well as the spiritual filter. Each student should think about how the exercises indicated by the teacher feel in their bodies, the reception may be different from the way the teacher / college actors / dancers experience the movement. In this context, the student is the only expert in what he likes to do with the movements indicated by the one in front of him, or what emotions are evoked when he experiences a choreographic phrase. This makes the study of acting or dance a form of art, and the difference is given by their inner experiences. the uniqueness of the body on the move.

Les registres d'essais cliniques (vecteurs incontournables de transparence de la recherche biomédicale internationale)

PARIS-BIUP (751062107) / SudocSudocFranceF

Backscatter modelling and inversion from Cassini/SAR data: Implications for Titan’s sand seas properties and climatic conditions

Sand seas on Titan may reflect the present and past climatic conditions. Understanding the morphodynamics and physicochemical properties of Titan’s dunes is therefore essential for a better comprehension of the climatic and geological history of the largest Saturn’s moon. We derived quantitatively surface properties (texture, composition) from the modelling of microwave backscattered signal and Monte Carlo inversion of despeckled Cassini/SAR data over the equatorial sand seas. We show that dunes and inter-dunes have significantly different physical properties. Absorption is more efficient in the dunes compared to the inter-dunes. The inter-dunes are smoother with an higher dielectric constant than the dunes. Considering the composition, the inter-dunes are in between the dunes and the bright inselbergs, suggesting the presence of a shallow layer of sediment in between the dunes. Additionally potential secondary bedforms may have been detected. Implications for dune morphodynamics, sediment inventory and climatic conditions occurring on Titan will be discussed

Titan's Sand Seas properties from the modelling of microwave-backscattered signal of Cassini/SAR

Titan's sand seas may reflect the current and past surface conditions. Assessing the physicochemical properties and the morphodynamics of the equatorial linear dunes is a milestone in our comprehension of the climatic and geological history of the largest Saturn's moon. Based on enhanced SAR processing leading to despeckled Cassini RADAR data sets, we analyzed quantitatively the surface properties (e.g., slopes, texture, composition...) over the sand seas. First, using a large amount of overlaps and a wide range of incidence angle and azimuths, we show that the radar cross-section over the inter-dunes strongly differs from the one over the dunes. This strongly suggests significant difference in the physical properties between these two geomorphic units. Then, we derived quantitatively the surface properties from the modelling of microwave-backscattered signal using a Monte-Carlo inversion. Our results show that dunes are globally more microwaves absorbent than the inter-dunes. The inter-dunes are smoother with a higher dielectric constant than the dunes. Considering the composition, the inter-dunes are in between the dunes and the bright inselbergs mainly composed of water ice, suggesting the presence of a shallow layer of sediment in between the dunes. This may suggest that Titan dunes are developing over a coarser sediment bed similarly to what is observed in some terrestrial sand seas such as in Ténéré desert (Niger, see also contribution #EGU2016-13383). Additionally, potential secondary bedforms (such as ripples) as well as avalanche faces may have been detected

Texture and composition of Titan's equatorial sand seas inferred from Cassini SAR data: Implications for aeolian transport and dune morphodynamics

The texture, composition, and morphology of dunes observed in the equatorial regions of Titan may reflect present and/or past climatic conditions. Determining the physio‐chemical properties and the morphodynamics of Titan's dunes is therefore essential to understanding of the climatic and geological history of the largest moon of Saturn. We quantitatively derived average surface properties of dune and interdune areas (texture, composition) from modeling of the microwave backscattered signal and Monte‐Carlo inversion of the despeckled Cassini/SAR data over Titan's three largest sand seas: Belet, Shangri‐La and Fensal. We present the first analysis of the backscatter functions extracted from despeckled SAR images that cover such a large range in incidence angles, including data from the beginning of the Cassini mission up to its Grand Finale. We show that dunes and interdunes have significantly different physical properties. Dunes are found to be more microwave absorbent than interdunes. Additionally, potential secondary bedforms, such as ripples and avalanches, may have been detected, providing potential evidence for currently active dunes and sediment transport. Our modelling shows that the interdunes have multi‐scale roughnesses with higher dielectric constants than the dunes which have a low dielectric constant consistent with organic sand. The radar brightness of the interdunes can be explained by the presence of a shallow layer of significantly larger organic grains, possibly non‐mobilized by the winds. Together, our findings suggest that Titan's sand seas evolve under the current multi‐directional wind regimes with dunes that elongate with their crests aligned in the residual drift direction

Reliability assessment of ultrasound muscle echogenicity in patients with rheumatic diseases: Results of a multicenter international web-based study

Objectives: To investigate the inter/intra-reliability of ultrasound (US) muscle echogenicity in patients with rheumatic diseases. Methods: Forty-two rheumatologists and 2 radiologists from 13 countries were asked to assess US muscle echogenicity of quadriceps muscle in 80 static images and 20 clips from 64 patients with different rheumatic diseases and 8 healthy subjects. Two visual scales were evaluated, a visual semi-quantitative scale (0-3) and a continuous quantitative measurement ("VAS echogenicity," 0-100). The same assessment was repeated to calculate intra-observer reliability. US muscle echogenicity was also calculated by an independent research assistant using a software for the analysis of scientific images (ImageJ). Inter and intra reliabilities were assessed by means of prevalence-adjusted bias-adjusted Kappa (PABAK), intraclass correlation coefficient (ICC) and correlations through Kendall's Tau and Pearson's Rho coefficients. Results: The semi-quantitative scale showed a moderate inter-reliability [PABAK = 0.58 (0.57-0.59)] and a substantial intra-reliability [PABAK = 0.71 (0.68-0.73)]. The lowest inter and intra-reliability results were obtained for the intermediate grades (i.e., grade 1 and 2) of the semi-quantitative scale. "VAS echogenicity" showed a high reliability both in the inter-observer [ICC = 0.80 (0.75-0.85)] and intra-observer [ICC = 0.88 (0.88-0.89)] evaluations. A substantial association was found between the participants assessment of the semi-quantitative scale and "VAS echogenicity" [ICC = 0.52 (0.50-0.54)]. The correlation between these two visual scales and ImageJ analysis was high (tau = 0.76 and rho = 0.89, respectively). Conclusion: The results of this large, multicenter study highlighted the overall good inter and intra-reliability of the US assessment of muscle echogenicity in patients with different rheumatic diseases

Reliability assessment of the definition of ultrasound enthesitis in SpA: results of a large, multicentre, international web-based study

Objectives: To investigate the reliability of the OMERACT ultrasound (US) Task Force definition of US enthesitis in spondyloarthritis (SpA). Methods: In this web exercise, based on the evaluation of 101 images and 39 clips of the main entheses of the lower limbs, the elementary components included in the OMERACT definition of US enthesitis in SpA [hypoechoic areas, entheseal thickening, power Doppler signal (PD) at the enthesis, enthesophytes/calcifications, bone erosions] were assessed by 47 rheumatologists from 37 rheumatology centres in 15 countries.Inter and intra-observer reliability of the US components of enthesitis was calculated using Light's kappa, Cohen's kappa, Prevalence and Bias Adjusted Kappa (PABAK) and their 95% confidence intervals. Results: Bone erosions and PD showed the highest overall inter-reliability [Light's kappa: 0.77 (0.76-0.78), 0.72 (0.71-0.73), respectively; PABAK: 0.86 (0.86-0.87), 0.73 (0.73-0.74), respectively], followed by enthesophytes/calcifications [Light's kappa: 0.65 (0.64-0.65), PABAK: 0.67 (0.67-0.68)]. This was moderate for entheseal thickening [Light's kappa: 0.41 (0.41-0.42), PABAK: 0.41 (0.40-0.42)], and fair for hypoechoic areas [Light's kappa: 0.37 (0.36-0.38); PABAK: 0.37 (0.37-0.38)]. A similar trend was observed in the intra-reliability exercise, although this was characterized by an overall higher degree of reliability for all US elementary components compared with the inter-observer evaluation. Conclusions: The results of this multicentre, international, web-based study show a good reliability of the OMERACT US definition of bone erosions, PD, and enthesophytes/calcifications. The low reliability of entheseal thickening and hypoechoic areas raises questions about the opportunity to revise the definition of these two major components for the US diagnosis of enthesitis