The reliability of the ankle brachial index : a systematic review

Background: The ankle brachial index (ABI) is widely used in clinical practice as a non-invasive method to detect the presence and severity of peripheral arterial disease (PAD). Current guidelines suggest that it should be used to monitor potential progression of PAD in affected individuals. As such, it is important that the test is reliable when used for repeated measurements, by the same or different health practitioners. This systematic review aims to examine the literature to evaluate the inter- and intra-rater reliability of the ABI. Methods: A systematic search of MEDLINE, EMBASE and CINAHL Complete was conducted to 20 January 2019. Two authors independently reviewed and selected relevant studies and extracted the data. Methodological quality was determined using the Quality Appraisal of Reliability (QAREL) Checklist. Results: Fifteen studies of ABI reliability in a range of patient populations were identified as suitable for inclusion in the review: seven considered inter-rater reliability, four intra-rater reliability, and four studies evaluated both inter- and intra-rater reliability. Inter-rater reliability was found to be highly variable, with intraclass correlation coefficients (ICC's) ranging from poor to excellent (ICC 0.42-1.00), while intra-rater also demonstrated considerable variation, with ICCs from 0.42-0.98. Meta-analysis was not possible due to the lack of statistical information reported. Conclusions: Results of included studies suggest the inter- and intra-tester reliability of the ABI is acceptable. However, inconsistencies in obtaining systolic pressure measurements, calculating ABI values, and incomplete reporting of methodologies and statistical analysis make it difficult to determine the validity of the results of included studies. Further research, with more consistent reliability methodology, statistical analysis and reporting conducted in populations at risk of PAD is needed to conclusively determine the ABI reliability

Cortical Tonotopic Map Changes in Humans Are Larger in Hearing Loss Than in Additional Tinnitus

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The Intra- and Interobserver Agreement on Diagnosis of Dupuytren Disease, Measurements of Severity of Contracture, and Disease Extent

This agreement study aimed to determine the intra- and interobserver agreement of four variables for diagnosing DD, determining severity of contracture, and disease extent. One of them is a new measurement on the area of nodules and cords, to be able to determine disease extent in early cases without flexion deformities. Intra-observer agreement was slightly higher on average than interobserver agreement. Overall, the intra- and interobserver agreement in diagnosing DD and determining the severity of flexion contracture is high. Also, the newly introduced variable area of nodules and cords has high intra- and interobserver agreement, indicating that it is suitable to measure disease extent

A systematic review and meta-analysis on the prevalence of Dupuytren disease in the general population of Western countries

Background: Dupuytren disease is a fibroproliferative disease of palmar fascia of the hand. Its prevalence has been the subject of several reviews; however, an accurate description of the prevalence range in the general population—and of the relation between age and disease—is lacking. Methods: Embase and PubMed were searched using database-specific Medical Subject Headings; titles and abstracts were searched for the words Dupuytren, incidence, and prevalence. Two reviewers independently assessed the articles using inclusion and exclusion criteria, and rated the included studies with a quality assessment instrument. In a meta-analysis, the median prevalence, as a function of age by sex, was estimated, accompanied by 95 percent prediction intervals. The observed heterogeneity in prevalence was investigated with respect to study quality and geographic location. Results: Twenty-three of 199 unique identified articles were included. The number of participants ranged from 37 to 97,537, and age ranged from 18 to 100 years. Prevalence varied from 0.6 to 31.6 percent. The quality of studies differed but could not explain the heterogeneity among studies. Mean prevalence was estimated as 12, 21, and 29 percent at ages 55, 65, and 75 years, respectively, based on the relation between age and prevalence determined from 10 studies. Conclusions: The authors describe a prevalence range of Dupuytren disease in the general population of Western countries. The relation between age and prevalence of Dupuytren disease is given according to sex, including 95 percent prediction intervals. It is possible to determine disease prevalence at a certain age for the total population, and for men and women separately

Forage Grasses and Legumes with Broad Adaptation for Southeast Asia

A wide range of forages is currently being evaluated by farmers and researchers in seven countries in Southeast Asia. Broadly-adapted species have been identified for fodder banks, grazed systems, tree cropping, erosion control and improved fallows. The most promising accessions to date are Stylosanthes guianensis CIAT 184, Brachiaria decumbens cv Basilisk, Brachiaria humidicola cv Tully and CIAT 6133, CIAT 6780, Centrosema pubescens CIAT 15160 and Andropogon gayanus cv Kent and CIAT 621. Other forages that show promise are Paspalum atratum, Arachis pintoi, and Macroptilium gracile cv. Maldonado. Local seed supply and distribution systems are needed to ensure that these species reach their potential on farms

Entanglement in a quantum annealing processor

Entanglement lies at the core of quantum algorithms designed to solve problems that are intractable by classical approaches. One such algorithm, quantum annealing (QA), provides a promising path to a practical quantum processor. We have built a series of scalable QA processors consisting of networks of manufactured interacting spins (qubits). Here, we use qubit tunneling spectroscopy to measure the energy eigenspectrum of two- and eight-qubit systems within one such processor, demonstrating quantum coherence in these systems. We present experimental evidence that, during a critical portion of QA, the qubits become entangled and that entanglement persists even as these systems reach equilibrium with a thermal environment. Our results provide an encouraging sign that QA is a viable technology for large-scale quantum computing.Comment: 13 pages, 8 figures, contact corresponding author for Supplementary Informatio