Reproducibility of the peritoneal regression grading score for assessment of response to therapy in peritoneal metastasis.

The four-tiered peritoneal regression grading score (PRGS) assesses the response to chemotherapy in peritoneal metastasis (PM). The PRGS is used, for example, to assess the response to pressurised intraperitoneal aerosol chemotherapy (PIPAC). However, the reproducibility of the PRGS is currently unknown. We aimed to evaluate the inter- and intraobserver variability of the PRGS. Thirty-three patients who underwent at least three PIPAC treatments as part of the PIPAC-OPC1 or PIPAC-OPC2 clinical trials at Odense University Hospital, Denmark, were included. Prior to each therapy cycle, peritoneal quadrant biopsies were obtained and three haematoxylin and eosin (H&E)-stained step sections were scanned and uploaded to a pseudonymised web library. For determining interobserver variability, eight pathologists assessed the PRGS for each quadrant biopsy, and Krippendorff's alpha and intraclass correlation coefficients (ICCs) were calculated. For determining intraobserver variability, three pathologists repeated their own assessments and Cohen's kappa and ICCs were calculated. A total of 331 peritoneal biopsies were analysed. Interobserver variability for PRGS of each biopsy and for the mean and maximum PRGS per biopsy set was moderate to good/substantial. The intraobserver variability for PRGS of each biopsy and for the mean and maximum PRGS per biopsy set was good to excellent/almost perfect. Our data support the PRGS as a reproducible and useful tool to assess response to intraperitoneal chemotherapy in PM. Future studies should evaluate the prognostic and predictive role of the PRGS

Role of immunohistochemistry for interobserver agreement of Peritoneal Regression Grading Score in peritoneal metastasis.

Pressurized intraperitoneal aerosol chemotherapy (PIPAC)-directed therapy is a new treatment option for peritoneal metastasis (PM). The 4-tiered Peritoneal Regression Grading Score (PRGS) has been proposed for assessment of histological treatment response. We aimed to evaluate the effect of immunohistochemistry (IHC) on interobserver agreement of the PRGS. Hematoxylin and eosin (H&E)-stained and IHC-stained slides (n = 662) from 331 peritoneal quadrant biopsies (QBs) taken prior to 99 PIPAC procedures performed on 33 patients were digitalized and uploaded to a web library. Eight raters (five consultants and three residents) assessed the PRGS, and Krippendorff's alpha coefficients (α) were calculated. Results (IHC-PRGS) were compared with data published in 2019, using H&E-stained slides only (H&E-PRGS). Overall, agreement for IHC-PRGS was substantial to almost perfect. Agreement (all raters) regarding single QBs after treatment was substantial for IHC-PRGS (α = 0.69, 95% confidence interval [CI] = 0.66-0.72) and moderate for H&E-PRGS (α = 0.60, 95% CI = 0.56-0.64). Agreement (all raters) regarding the mean PRGS per QB set after treatment was higher for IHC-PRGS (α = 0.78, 95% CI = 0.73-0.83) than for H&E-PRGS (α = 0.71, 95% CI = 0.64-0.78). Among residents, agreement was almost perfect for IHC-PRGS and substantial for H&E-PRGS. Agreement (all raters) regarding maximum PRGS per QB set after treatment was substantial for IHC-PRGS (α = 0.61, 95% CI = 0.54-0.68) and moderate for H&E-PRGS (α = 0.60, 95% CI = 0.53-0.66). Among residents, agreement was substantial for IHC-PRGS (α = 0.66, 95% CI = 0.57-0.75) and moderate for H&E-PRGS (α = 0.55, 95% CI = 0.45-0.64). Additional IHC seems to improve the interobserver agreement of PRGS, particularly between less experienced raters

Exploring Ecoacoustic Trajectories in a Giant Sequoia Forest After Wildfire

Forest management strategies that create spatially diverse fire-caused disturbance outcomes, consistent with historic fire regimes, are a desired condition for fire adapted western United States forests. In this context, the temporal dynamics of forest response to fire can inform the tempo and scale of forest management, including prescribed burning. Here, we investigated the use of ecoacoustic methods to assess ecological condition in a four-year period (2016–2019) after wildfire in a giant sequoia forest landscape within Kings Canyon National Park, California, United States. Audio recorders at nine sites were deployed soon after the 2015 Rough Fire subsided. The monitoring sites were located in regions with different fire histories, representing five fire history categories. We used the Acoustic Complexity Index (ACI) to document biotic chorus complexity. This previously tested ecoacoustic index provided a daily indicator of biotic sound activity in frequencies dominated by avian calls. Patterns in ACI were evaluated using generalized additive mixed models to understand the relationship with time-since-fire and covariates that accounted for season, fire history category, and weather conditions. We showed that time-since fire and fire-history influenced patterns in ACI after accounting for season and air temperature effects. Monitoring sites where prescribed fire preceded the Rough Fire showed the highest predicted ACI and evidence for a relatively consistent seasonal pattern in ecoacoustic activity across subsequent seasons. Sites without prescribed fire and burned by the Rough Fire exhibited the most pronounced successive decreases in ACI in the first and second years after the fire. The daily temporal resolution of the ecoacoustic index also revealed phenological shifts related to time-since-fire and fire history. Sites unburned by the Rough Fire offered some context for how fire changed ecoacoustic activity post-wildfire, however evidence suggested they were also impacted by the presence of the nearby Rough Fire. The patterns in the ecoacoustic index when combined with vegetation surveys offered complementary insights into ecological dynamics of regeneration after fire. Our exploratory analysis showed that using ecoacoustic methods in wildfire monitoring offers a scalable approach to remote sensing of ecological trends. Archived recordings from the monitoring effort afford future opportunities for new or more detailed insights

Three-dimensional beam pattern of regular sperm whale clicks confirms bent-horn hypothesis

Author Posting. © Acoustical Society of America, 2005. This article is posted here by permission of Acoustical Society of America for personal use, not for redistribution. The definitive version was published in Journal of the Acoustical Society of America 117 (2005): 1473-1485, doi:10.1121/1.1828501.The three-dimensional beam pattern of a sperm whale (Physeter macrocephalus) tagged in the Ligurian Sea was derived using data on regular clicks from the tag and from hydrophones towed behind a ship circling the tagged whale. The tag defined the orientation of the whale, while sightings and beamformer data were used to locate the whale with respect to the ship. The existence of a narrow, forward-directed P1 beam with source levels exceeding 210 dBpeak re: 1 µPa at 1 m is confirmed. A modeled forward-beam pattern, that matches clicks >20° off-axis, predicts a directivity index of 26.7 dB and source levels of up to 229 dBpeak re: 1 µPa at 1 m. A broader backward-directed beam is produced by the P0 pulse with source levels near 200 dBpeak re: 1 µPa at 1 m and a directivity index of 7.4 dB. A low-frequency component with source levels near 190 dBpeak re: 1 µPa at 1 m is generated at the onset of the P0 pulse by air resonance. The results support the bent-horn model of sound production in sperm whales. While the sperm whale nose appears primarily adapted to produce an intense forward-directed sonar signal, less-directional click components convey information to conspecifics, and give rise to echoes from the seafloor and the surface, which may be useful for orientation during dives.This work was funded by grants from the Office of Naval Research Grants N00014-99-1-0819 and N00014-01-1-0705, and the Packard Foundation