Evaluation of magnetic resonance imaging guidelines for differentiation between thoracolumbar intervertebral disk extrusions and intervertebral disk protrusions in dogs

Four MRI variables have recently been suggested to be independently associated with a diagnosis of thoracolumbar intervertebral disk extrusion or protrusion. Midline intervertebral disk herniation, and partial intervertebral disk degeneration were associated with intervertebral disk protrusion, while presence of a single intervertebral disk herniation and disk material dispersed beyond the boundaries of the intervertebral disk space were associated with intervertebral disk extrusion. The aim of this retrospective, cross‐sectional study was to determine whether using these MRI variables improves differentiation between thoracolumbar intervertebral disk extrusions and protrusions. Eighty large breed dogs with surgically confirmed thoracolumbar intervertebral disk extrusions or protrusions were included. Randomized MRI studies were presented on two occasions to six blinded observers, which were divided into three experience categories. During the first assessment, observers made a presumptive diagnosis of thoracolumbar intervertebral disk extrusion or protrusion without guidelines. During the second assessment they were asked to make a presumptive diagnosis with the aid of guidelines. Agreement was evaluated by Kappa‐statistics. Diagnostic accuracy significantly improved from 70.8 to 79.6% and interobserver agreement for making a diagnosis of intervertebral disk extrusion or intervertebral disk protrusion improved from fair (κ = 0.27) to moderate (κ = 0.41) after using the proposed guidelines. Diagnostic accuracy was significantly influenced by degree of observer experience. Intraobserver agreement for the assessed variables ranged from fair to excellent and interobserver agreement ranged from fair to moderate. The results of this study suggest that the proposed imaging guidelines can aid in differentiating thoracolumbar intervertebral disk extrusions from protrusions

A universal soil classification system from the perspective of the General Theory of Classification: a review

The paper addresses issues of the application of the General Theory of Classification in the development of a universal soil classification system. Requirements for such a system, the comparison of different approaches to its development, and obstacles on the way to it are outlined. Besides, the problem of the definition of soils and importance of distinguishing between differentiating and diagnostic criteria are discussed. It is shown that, from the perspective of the General Theory of Classification, a universal soil classification system should be natural, genetic, “fundamental-and-specific”, and hierarchical. It is concluded that the World Reference Base for Soil Resources (WRB) does not meet these requirements and therefore cannot be considered as universal. The ways of addressing the problems of a universal soil classification system are suggested

The quality of communication about older patients between hospital physicians and general practitioners: a panel study assessment

<p>Abstract</p> <p>Background</p> <p>Optimal care of patients is dependent on good professional interaction between general practitioners and general hospital physicians. In Norway this is mainly based upon referral and discharge letters. The main objectives of this study were to assess the quality of the written communication between physicians and to estimate the number of patients that could have been treated at primary care level instead of at a general hospital.</p> <p>Methods</p> <p>This study comprised referral and discharge letters for 100 patients above 75 years of age admitted to orthopaedic, pulmonary and cardiological departments at the city general hospital in Trondheim, Norway. The assessments were done using a Delphi technique with two expert panels, each with one general hospital specialist, one general practitioner and one public health nurse using a standardised evaluation protocol with a visual analogue scale (VAS). The panels assessed the quality of the description of the patient's actual medical condition, former medical history, signs, medication, Activity of Daily Living (ADL), social network, need of home care and the benefit of general hospital care.</p> <p>Results</p> <p>While information in the referral letters on actual medical situation, medical history, symptoms, signs and medications was assessed to be of high quality in 84%, 39%, 56%, 56% and 39%, respectively, the corresponding information assessed to be of high quality in discharge letters was for actual medical situation 96%, medical history 92%, symptoms 60%, signs 55% and medications 82%. Only half of the discharge letters had satisfactory information on ADL. Some two-thirds of the patients were assessed to have had large health benefits from the general hospital care in question. One of six patients could have been treated without a general hospital admission. The specialists assessed that 77% of the patients had had a large benefit from the general hospital care; however, the general practitioners assessment was only 59%. One of four of the discharge letters did not describe who was responsible for follow-up care.</p> <p>Conclusion</p> <p>In this study from one general hospital both referral and discharge letters were missing vital medical information, and referral letters to such an extent that it might represent a health hazard for older patients. There was also low consensus between health professionals at primary and secondary level of what was high benefit of care for older patients at a general hospital.</p

Effect of changes over time in the performance of a customized SAPS-II model on the quality of care assessment

Purpose: The aim of our study was to explore, using an innovative method, the effect of temporal changes in the mortality prediction performance of an existing model on the quality of care assessment. The prognostic model (rSAPS-II) was a recalibrated Simplified Acute Physiology Score-II model developed for very elderly Intensive Care Unit (ICU) patients. Methods: The study population comprised all 12,143 consecutive patients aged 80 years and older admitted between January 2004 and July 2009 to one of the ICUs of 21 Dutch hospitals. The prospective dataset was split into 30 equally sized consecutive subsets. Per subset, we measured the model's discrimination [area under the curve (AUC)], accuracy (Brier score), and standardized mortality ratio (SMR), both without and after repeated recalibration. All performance measures were considered to be stable if 1 without and after repeated recalibration for the year 2009. Results: For all subsets, the AUCs were stable, but the Brier scores and SMRs were not. The SMR was downtrending, achieving levels significantly below 1. Repeated recalibration rendered it stable again. The proportions of hospitals with SMR>1 and SMR <1 changed from 15 versus 85% to 35 versus 65%. Conclusions: Variability over time may markedly vary among different performance measures, and infrequent model recalibration can result in improper assessment of the quality of care in many hospitals. We stress the importance of the timely recalibration and repeated validation of prognostic models over tim

Psychometric properties of two physical activity questionnaires, the AQuAA and the PASE, in cancer patients

Background: This study aimed to evaluate the reliability and validity of two self-report physical activity (PA) questionnaires - the AQuAA (Activity Questionnaire for Adults and Adolescents) and PASE (Physical Activity Scale for the Elderly) - in cancer patients. Methods: Test-retest reliability was determined by administering the questionnaires twice within 5 days. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and smallest detectable difference (SDD) were calculated. Construct validity was determined by comparing the questionnaire results with ActiGraph accelerometer scores using Spearman correlation coefficients (r(s)) and ICCs. Content validity was examined using the Three-Step Test-Interview (TSTI). Results: Reliability for the AQuAA scores were fair to excellent (ICC = 0.57 to 0.78). Reliability for the PASE scores ranged from good to excellent (ICC = 0.67 to 0.90). Correlations between the ActiGraph and the AQuAA and the PASE were low (r(s) = 0.05 and 0.16 respectively, and ICC = -0.001 to 0.44). The TSTI showed that participants experienced difficulties with the examples provided with the questions, the perceptions of intensity level of PA, and with recalling the time spent on PA. Conclusions: Both questionnaires showed good to excellent test-retest reliability for most scores. Construct validity of both questionnaires was low, as indicated by the low correlations with the ActiGraph. Except for a few difficulties that participants perceived when filling out the questionnaires, the content validity of both questionnaires was goo

Invasive alien phytoplankton of the Danube basin

Invazivni fitoplankton moţe značajno utjecati na bioraznolikost mijenjajući odnose izmeĎu vrsta kao i na pomicanje ekološke ravnoteţe. Invazivne fitoplanktonske vrste mogu proizvoditi toksine koji su štetni za ostali fitoplankton, zooplankton, razne vodene organizme i ljude. Dunav kao druga najveća rijeka Europe i dio kanala Rajna-Majna-Dunav vaţan je za riječni promet te samim time predstavlja koridor širenja invazivnih vrsta čime ugroţava autohtone vrste, zbog nepaţnje ili čak namjernog unošenja invazivnih vrsta. U ovom su radu obraĎene najznačajnije invazivne ili potencijalno invazivne vrste dunavskog bazena i to: Cuspidothrix issatschenkoi, Raphidiopsis raciborskii, Dolichospermum compactum, Gloetrichia echinulata, Rahidiopsis mediterranea, Monactinus simplex, Skeletonema potamos, Actinocyclus normanii.Invasive phytoplankton species can significantly affect the biodiversity changing species relationships and shifting of ecological balance. Invasive phytoplankton species can produce toxins which are harmful to other phytoplankton, zooplankton, different aquatic organisms and humans. The Danube is the second largest river in Europe, and as part of the Rhine-MainDanube channel is important for river traffic, and is therefore a corridor of invasive species endangering native species due to intentional or advisedly importing invasive species. In this paper, the most important invasive or potentially invasive species of the Danube basin are described: Cuspidothrix issatschenkoi, Raphidiopsis raciborskii, Dolichospermum compactum, Gloetrichia echinulata, Rahidiopsis mediterranea, Monactinus simplex, Skeletonema potamos, Actinocyclus normanii

Comparative Analysis of PHP Frameworks in Web Application Development

Svrha ovog rada je istražit definicije PHP razvojnih okvira, razloge iza njihove popularnosti te analizirati kako izgleda proces izrade mrežnih aplikacije prilikom njihove implementacije. Cilj je prikazati kako pravilno odabrani razvojni okvir može, na jednostavan način, postići visoke standarde kvalitete i efikasnosti. Kroz razumijevanje značajki svakog od razvojnih okvira i njihovih specifičnosti, programeri mogu procijeniti odgovara li okvir njihovim potrebama te koji od njih je najbolji izbor za određeni projekt. Kako bi se postavila teorijska podloga, rad najprije započinje sa poviješću mrežnih aplikacija, prateći njihov razvoj od ranih statičkih stranica do kompleksnih mrežnih aplikacija koje znamo danas. Zatim slijedi povijesni pregled PHP jezika, objašnjenje njegovih prednosti zajedno s razlozima njegove široke rasprostranjenosti i popularnosti. U narednim poglavljima objašnjavaju se brojne prednosti razvojnih okvira, gdje se poseban fokus stavlja na neke od glavnih značajki koje nude, kao što su: MVC arhitektura, objektno relacijsko mapiranje, sustavi za predloške i sustavi za usmjeravanje. Navedene i mnoge druge značajke, usporedno se i detaljno analiziraju unutar pet najpopularnijih razvojnih okvira: Laravel, Symfony, CodeIgniter, Yii i CakePHP kako bi se prezentirale njihove mane i prednosti. Na temelju popularnosti, odabrani su Laravel i Symofny razvojni okviri kako bi se provela usporedna analiza procesa izrade mrežnih aplikacije u svakom od njih. U nastavku je prikazan način postavljanja projekta, kreiranje modela, kontrolera i pogleda, zajedno s implementiranjem ruta, migracijama i postavljanjem autentifikacijskih paketa, sve kako bi se dao detaljan uvid u njihove alate i različite pristupe rješenjima za određeni problem

Libraries in Times of Crisis

Cilj rada je prikazati odgovor knjižnica diljem svijeta na krizna razdoblja i ukazati na važnost pravovremene pripreme, ali i prilagodbe u kriznim situacijama. U radu se opisuje uloga knjižnica u kriznim razdobljima s posebnim osvrtom na pandemiju bolesti COVID-19. Navode se krizne situacije s kojima se knjižnice mogu suočiti te se promatra kako one odgovaraju na njih. Ističe se važnost kriznog upravljanja koji ima ulogu smanjivanja učinka štete koju potencijalne krizne situacije mogu prouzročiti. Zatim se naglašava uloga prostora knjižnice koji može prisvojiti razne uloge u svojoj zajednici nakon određene katastrofe. Kvaliteta komuniciranja unutar same ustanove, ali i sa javnošću nikada nije bila izraženije zbog čega se analizira način komunikacije koje su knjižnice odabrala sa svojim korisnicima. Opisuje se uloga koju knjižničari predstavljaju u svojim zajednicama, ali i problemi s kojima se susreću, gdje se posebno ističe njihovo mentalno zdravlje. Rad donosi i pregled usluga i programa koje knjižnice u kriznom razdoblju nude svojim zajednicama, kao i reakciju korisnika na njih. Analiziraju se čitateljske navike korisnika, gdje se daje kratki osvrt na iznenađujuće utjecaje anksioznosti. Naposljetku, proučava se utjecaj pandemije i potresa na hrvatske knjižnice, te se detaljno opisuje poduzete mjere prilikom suočavanja s krizama