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Can Physicians Identify Inappropriate Nuclear Stress Tests? An Examination of Inter-Rater Reliability for the 2009 Appropriate Use Criteria for Radionuclide Imaging
BackgroundâWe sought to determine inter-rater reliability of the 2009 Appropriate Use Criteria for radionuclide imaging and whether physicians at various levels of training can effectively identify nuclear stress tests with inappropriate indications.
Methods and ResultsâFour hundred patients were randomly selected from a consecutive cohort of patients undergoing nuclear stress testing at an academic medical center. Raters with different levels of training (including cardiology attending physicians, cardiology fellows, internal medicine hospitalists, and internal medicine interns) classified individual nuclear stress tests using the 2009 Appropriate Use Criteria. Consensus classification by 2 cardiologists was considered the operational gold standard, and sensitivity and specificity of individual raters for identifying inappropriate tests were calculated. Inter-rater reliability of the Appropriate Use Criteria was assessed using Cohen Îș statistics for pairs of different raters. The mean age of patients was 61.5 years; 214 (54%) were female. The cardiologists rated 256 (64%) of 400 nuclear stress tests as appropriate, 68 (18%) as uncertain, 55 (14%) as inappropriate; 21 (5%) tests were unable to be classified. Inter-rater reliability for noncardiologist raters was modest (unweighted Cohen Îș, 0.51, 95% confidence interval, 0.45â0.55). Sensitivity of individual raters for identifying inappropriate tests ranged from 47% to 82%, while specificity ranged from 85% to 97%.
ConclusionsâInter-rater reliability for the 2009 Appropriate Use Criteria for radionuclide imaging is modest, and there is considerable variation in the ability of raters at different levels of training to identify inappropriate tests
Ecosystem mapping in the Central Arctic Ocean (CAO) during the SAS-Oden expedition
As a result of global warming, the marine ecosystem around the North Pole, the Central Arctic Ocean (CAO), is in fast transition from a permanently to a seasonally ice-covered ocean. The sea-ice loss is expected to enable summer access to the CAO for non-icebreaking ships, including fishery vessels, in the near future1. However, the lack of knowledge on the CAO ecosystem impedes any assessment of the sustainability of potential future fisheries in the CAO. Taking a precautionary approach, the EU and nine countries in October 2018 signed the Agreement to Prevent Unregulated High Seas Fisheries in the Central Arctic Ocean. This agreement entered into force in June 2021 and a.o. requires the establishment of a joint scientific program to improve the understanding of the CAO ecosystem, including mapping and monitoring. To reduce the existing lack of knowledge, 12 scientists from the EFICA Consortium participated, together with 26 other on-board scientists, in sampling and data collection of ecosystem data during the Swedish SAS-Oden expedition in summer 2021. This report describes the field work performed by the EFICA scientists using water-column acoustics, deep-sea optical observations, and fish, zooplankton, sediment otolith and eDNA sampling for targeting fish, zooplankton and mammals. Further ecosystem data (physical, chemical and biological) were collected by the EFICA scientists in collaboration with other scientists on-board. Together with this report, a metadata database containing lists of all collected samples and data that are relevant for future fish-stock modelling and assessment studies was delivered to the European Commission
Gravitational Waves From Known Pulsars: Results From The Initial Detector Era
We present the results of searches for gravitational waves from a large selection of pulsars using data from the most recent science runs (S6, VSR2 and VSR4) of the initial generation of interferometric gravitational wave detectors LIGO (Laser Interferometric Gravitational-wave Observatory) and Virgo. We do not see evidence for gravitational wave emission from any of the targeted sources but produce upper limits on the emission amplitude. We highlight the results from seven young pulsars with large spin-down luminosities. We reach within a factor of five of the canonical spin-down limit for all seven of these, whilst for the Crab and Vela pulsars we further surpass their spin-down limits. We present new or updated limits for 172 other pulsars (including both young and millisecond pulsars). Now that the detectors are undergoing major upgrades, and, for completeness, we bring together all of the most up-to-date results from all pulsars searched for during the operations of the first-generation LIGO, Virgo and GEO600 detectors. This gives a total of 195 pulsars including the most recent results described in this paper.United States National Science FoundationScience and Technology Facilities Council of the United KingdomMax-Planck-SocietyState of Niedersachsen/GermanyAustralian Research CouncilInternational Science Linkages program of the Commonwealth of AustraliaCouncil of Scientific and Industrial Research of IndiaIstituto Nazionale di Fisica Nucleare of ItalySpanish Ministerio de Economia y CompetitividadConselleria d'Economia Hisenda i Innovacio of the Govern de les Illes BalearsNetherlands Organisation for Scientific ResearchPolish Ministry of Science and Higher EducationFOCUS Programme of Foundation for Polish ScienceRoyal SocietyScottish Funding CouncilScottish Universities Physics AllianceNational Aeronautics and Space AdministrationOTKA of HungaryLyon Institute of Origins (LIO)National Research Foundation of KoreaIndustry CanadaProvince of Ontario through the Ministry of Economic Development and InnovationNational Science and Engineering Research Council CanadaCarnegie TrustLeverhulme TrustDavid and Lucile Packard FoundationResearch CorporationAlfred P. Sloan FoundationAstronom
Search for gravitational waves associated with the InterPlanetary Network short gamma ray bursts
We outline the scientific motivation behind a search for gravitational waves
associated with short gamma ray bursts detected by the InterPlanetary Network
(IPN) during LIGO's fifth science run and Virgo's first science run. The IPN
localisation of short gamma ray bursts is limited to extended error boxes of
different shapes and sizes and a search on these error boxes poses a series of
challenges for data analysis. We will discuss these challenges and outline the
methods to optimise the search over these error boxes.Comment: Methods paper; Proceedings for Eduardo Amaldi 9 Conference on
Gravitational Waves, July 2011, Cardiff, U
Search for Gravitational Wave Bursts from Six Magnetars
Soft gamma repeaters (SGRs) and anomalous X-ray pulsars (AXPs) are thought to be magnetars: neutron stars powered by extreme magnetic fields. These rare objects are characterized by repeated and sometimes spectacular gamma-ray bursts. The burst mechanism might involve crustal fractures and excitation of non-radial modes which would emit gravitational waves (GWs). We present the results of a search for GW bursts from six galactic magnetars that is sensitive to neutron star f-modes, thought to be the most efficient GW emitting oscillatory modes in compact stars. One of them, SGR 0501+4516, is likely similar to 1 kpc from Earth, an order of magnitude closer than magnetars targeted in previous GW searches. A second, AXP 1E 1547.0-5408, gave a burst with an estimated isotropic energy >10(44) erg which is comparable to the giant flares. We find no evidence of GWs associated with a sample of 1279 electromagnetic triggers from six magnetars occurring between 2006 November and 2009 June, in GW data from the LIGO, Virgo, and GEO600 detectors. Our lowest model-dependent GW emission energy upper limits for band-and time-limited white noise bursts in the detector sensitive band, and for f-mode ringdowns (at 1090 Hz), are 3.0 x 10(44)d(1)(2) erg and 1.4 x 10(47)d(1)(2) erg, respectively, where d(1) = d(0501)/1 kpc and d(0501) is the distance to SGR 0501+4516. These limits on GW emission from f-modes are an order of magnitude lower than any previous, and approach the range of electromagnetic energies seen in SGR giant flares for the first time.United States National Science FoundationScience and Technology Facilities Council of the United KingdomMax-Planck-SocietyState of Niedersachsen/GermanyItalian Istituto Nazionale di Fisica NucleareFrench Centre National de la Recherche ScientifiqueAustralian Research CouncilCouncil of Scientific and Industrial Research of IndiaIstituto Nazionale di Fisica Nucleare of ItalySpanish Ministerio de Educacion y CienciaConselleria d'Economia Hisenda i Innovacio of the Govern de les Illes BalearsFoundation for Fundamental Research on Matter supported by the Netherlands Organisation for Scientific ResearchPolish Ministry of Science and Higher EducationFoundation for Polish ScienceRoyal SocietyScottish Funding CouncilScottish Universities Physics AllianceNational Aeronautics and Space Administration NNH07ZDA001-GLASTCarnegie TrustLeverhulme TrustDavid and Lucile Packard FoundationResearch CorporationAlfred P. Sloan FoundationRussian Space AgencyRFBR 09-02-00166aIPN JPL Y503559 (Odyssey), NASA NNG06GH00G, NASA NNX07AM42G, NASA NNX08AC89G (INTEGRAL), NASA NNG06GI896, NASA NNX07AJ65G, NASA NNX08AN23G (Swift), NASA NNX07AR71G (MESSENGER), NASA NNX06AI36G, NASA NNX08AB84G, NASA NNX08AZ85G (Suzaku), NASA NNX09AU03G (Fermi)Astronom
Search for Gravitational Waves from Low Mass Compact Binary Coalescence in LIGO's Sixth Science Run and Virgo's Science Runs 2 and 3
We report on a search for gravitational waves from coalescing compact
binaries using LIGO and Virgo observations between July 7, 2009 and October 20,
2010. We searched for signals from binaries with total mass between 2 and 25
solar masses; this includes binary neutron stars, binary black holes, and
binaries consisting of a black hole and neutron star. The detectors were
sensitive to systems up to 40 Mpc distant for binary neutron stars, and further
for higher mass systems. No gravitational-wave signals were detected. We report
upper limits on the rate of compact binary coalescence as a function of total
mass, including the results from previous LIGO and Virgo observations. The
cumulative 90%-confidence rate upper limits of the binary coalescence of binary
neutron star, neutron star- black hole and binary black hole systems are 1.3 x
10^{-4}, 3.1 x 10^{-5} and 6.4 x 10^{-6} Mpc^{-3}yr^{-1}, respectively. These
upper limits are up to a factor 1.4 lower than previously derived limits. We
also report on results from a blind injection challenge.Comment: 11 pages, 5 figures. For a repository of data used in the
publication, go to:
. Also see the
announcement for this paper on ligo.org at:
<http://www.ligo.org/science/Publication-S6CBCLowMass/index.php
Swift follow-up observations of candidate gravitational-wave transient events
We present the first multi-wavelength follow-up observations of two candidate
gravitational-wave (GW) transient events recorded by LIGO and Virgo in their
2009-2010 science run. The events were selected with low latency by the network
of GW detectors and their candidate sky locations were observed by the Swift
observatory. Image transient detection was used to analyze the collected
electromagnetic data, which were found to be consistent with background.
Off-line analysis of the GW data alone has also established that the selected
GW events show no evidence of an astrophysical origin; one of them is
consistent with background and the other one was a test, part of a "blind
injection challenge". With this work we demonstrate the feasibility of rapid
follow-ups of GW transients and establish the sensitivity improvement joint
electromagnetic and GW observations could bring. This is a first step toward an
electromagnetic follow-up program in the regime of routine detections with the
advanced GW instruments expected within this decade. In that regime
multi-wavelength observations will play a significant role in completing the
astrophysical identification of GW sources. We present the methods and results
from this first combined analysis and discuss its implications in terms of
sensitivity for the present and future instruments.Comment: Submitted for publication 2012 May 25, accepted 2012 October 25,
published 2012 November 21, in ApJS, 203, 28 (
http://stacks.iop.org/0067-0049/203/28 ); 14 pages, 3 figures, 6 tables;
LIGO-P1100038; Science summary at
http://www.ligo.org/science/Publication-S6LVSwift/index.php ; Public access
area to figures, tables at
https://dcc.ligo.org/cgi-bin/DocDB/ShowDocument?docid=p110003
Implementation and testing of the first prompt search for gravitational wave transients with electromagnetic counterparts
Aims. A transient astrophysical event observed in both gravitational wave
(GW) and electromagnetic (EM) channels would yield rich scientific rewards. A
first program initiating EM follow-ups to possible transient GW events has been
developed and exercised by the LIGO and Virgo community in association with
several partners. In this paper, we describe and evaluate the methods used to
promptly identify and localize GW event candidates and to request images of
targeted sky locations.
Methods. During two observing periods (Dec 17 2009 to Jan 8 2010 and Sep 2 to
Oct 20 2010), a low-latency analysis pipeline was used to identify GW event
candidates and to reconstruct maps of possible sky locations. A catalog of
nearby galaxies and Milky Way globular clusters was used to select the most
promising sky positions to be imaged, and this directional information was
delivered to EM observatories with time lags of about thirty minutes. A Monte
Carlo simulation has been used to evaluate the low-latency GW pipeline's
ability to reconstruct source positions correctly.
Results. For signals near the detection threshold, our low-latency algorithms
often localized simulated GW burst signals to tens of square degrees, while
neutron star/neutron star inspirals and neutron star/black hole inspirals were
localized to a few hundred square degrees. Localization precision improves for
moderately stronger signals. The correct sky location of signals well above
threshold and originating from nearby galaxies may be observed with ~50% or
better probability with a few pointings of wide-field telescopes.Comment: 17 pages. This version (v2) includes two tables and 1 section not
included in v1. Accepted for publication in Astronomy & Astrophysic
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