Using qualitative descriptors of chronic liver disease on MRI: A practice prone to error.

PURPOSE: Assess accuracy of qualitative descriptors for chronic liver disease (CLD) in radiology reports compared to histopathological staging. METHODS: Database search for patients with hepatitis B/C (HBV/HCV) CLD, abdominal MRI during 2009-2016, and liver biopsy within 6 months of MRI or prior biopsy showing cirrhosis. Reports reviewed for mention of CLD and associated descriptors. Findings stratified into categories: normal/no mention of CLD; changes of CLD without qualitative descriptor; mild/early; moderate; severe/advanced and cirrhosis. Descriptive ranges categorized to the lesser degree. Percent concordance/discordance of descriptors and Scheuer stage (F0-F4), false positive (FP), false negative (FN) and sensitivity/specificity calculated. RESULTS: 309 patients, median age 54 (24-74). 91% had HCV (282/309), 7% HBV and 2% both HBV/HCV. Biopsy showed 19% without CLD/F0; 8% F1, 15% F2, 15% F3 and 43% F4. 188 MRI reports (61%) stated CLD was present; however, 16 had no fibrosis on histopathology (9% FP). 39% (121/309) did not mention or stated no CLD; however, 78 had CLD on histopathology (64% FN). 59% of FN were early fibrosis (F1 or F2), 27% F3 and 11% F4. Overall sensitivity and specificity was 69% and 73%, respectively. 77% (145/188) of MRI reports used a descriptive qualifier when describing CLD. 10% were concordant with exact histopathology staging. Of discordant reports, 90% identified CLD but under-called severity. CONCLUSION: Abdominal radiologists can detect CLD on MRI but degree of CLD is often under-called compared to histopathology suggesting radiologists should refrain from qualitative descriptors in assessing CLD on MRI and reaffirms the need for quantitative imaging.

American Academy of Clinical Neuropsychology consensus conference statement on uniform labeling of performance test scores.

Objectives: Descriptive labels of performance test scores are a critical component of communicating outcomes of neuropsychological and psychological evaluations. Yet, no universally accepted system exists for assigning qualitative descriptors to scores in specific ranges. In addition, the definition and use of the term "impairment" lacks specificity and consensus. Consequently, test score labels and the denotation of impairment are inconsistently applied by clinicians, creating confusion among consumers of neuropsychological services, including referral sources, trainees, colleagues, and the judicial system. To reduce this confusion, experts in clinical and forensic neuropsychological and psychological assessment convened in a consensus conference at the 2018 Annual Meeting of the American Academy of Clinical Neuropsychology (AACN). The goals of the consensus conference were to recommend (1) a system of qualitative labels to describe results from performance-based tests with normal and non-normal distributions and (2) a definition of impairment and its application in individual case determinations. Results: The goals of the consensus conference were met resulting in specific recommendations for the application of uniform labels for performance tests and for the definition of impairment, which are described in this paper. In addition, included in this consensus statement is a description of the conference process and the rationales for these recommendations. Conclusions/Importance: This consensus conference is the first formal attempt by the professional neuropsychological community to make recommendations for uniform performance test score labels and to advance a consistent definition of impairment. Using uniform descriptors and terms will reduce confusion and enhance report comprehensibility by the consumers of our reports as well as our trainees and colleagues.

Towards reporting standards for neuropsychological study results: A proposal to minimize communication errors with standardized qualitative descriptors for normalized test scores.

OBJECTIVE: Rapid, clear and efficient communication of neuropsychological results is essential to benefit patient care. Errors in communication are a lead cause of medical errors; nevertheless, there remains a lack of consistency in how neuropsychological scores are communicated. A major limitation in the communication of neuropsychological results is the inconsistent use of qualitative descriptors for standardized test scores and the use of vague terminology. PATIENTS AND METHODS: PubMed search from 1 Jan 2007 to 1 Aug 2016 to identify guidelines or consensus statements for the description and reporting of qualitative terms to communicate neuropsychological test scores was conducted. The review found the use of confusing and overlapping terms to describe various ranges of percentile standardized test scores. RESULTS: In response, we propose a simplified set of qualitative descriptors for normalized test scores (Q-Simple) as a means to reduce errors in communicating test results. The Q-Simple qualitative terms are: 'very superior', 'superior', 'high average', 'average', 'low average', 'borderline' and 'abnormal/impaired'. A case example illustrates the proposed Q-Simple qualitative classification system to communicate neuropsychological results for neurosurgical planning. CONCLUSIONS: The Q-Simple qualitative descriptor system is aimed as a means to improve and standardize communication of standardized neuropsychological test scores. Research are needed to further evaluate neuropsychological communication errors. Conveying the clinical implications of neuropsychological results in a manner that minimizes risk for communication errors is a quintessential component of evidence-based practice.

Evaluation of marine subareas of Europe using life history parameters and trophic levels of selected fish populations.

European marine waters include four regional seas that provide valuable ecosystem services to humans, including fish and other seafood. However, these marine environments are threatened by pressures from multiple anthropogenic activities and climate change. The European Marine Strategy Framework Directive (MSFD) was adopted in 2008 to achieve good environmental status (GEnS) in European Seas by year 2020, using an Ecosystem Approach. GEnS is to be assessed using 11 descriptors and up to 56 indicators. In the present analysis two descriptors namely "commercially exploited fish and shellfish populations" and "food webs" were used to evaluate the status of subareas of FAO 27 area. Data on life history parameters, trophic levels and fisheries related data of cod, haddock, saithe, herring, plaice, whiting, hake and sprat were obtained from the FishBase online database and advisory reports of International Council for the Exploration of the Sea (ICES). Subareas inhabited by r and K strategists were identified using interrelationships of life history parameters of commercially important fish stocks. Mean trophic level (MTL) of fish community each subarea was calculated and subareas with species of high and low trophic level were identified. The Fish in Balance (FiB) index was computed for each subarea and recent trends of FiB indices were analysed. The overall environmental status of each subarea was evaluated considering life history trends, MTL and FiB Index. The analysis showed that subareas I, II, V, VIII and IX were assessed as "good" whereas subareas III, IV, VI and VII were assessed as "poor". The subareas assessed as "good" were subject to lower environmental pressures, (less fishing pressure, less eutrophication and more water circulation), while the areas with "poor" environment experienced excessive fishing pressure, eutrophication and disturbed seabed. The evaluation was based on two qualitative descriptors ("commercially exploited fish and shellfish populations" and "food webs") is therefore more robust.

Estimativa da divergência entre ecótipos de braquiária baseada em descritores quantitativos e qualitativos / Estimation of genetic divergence between braquiária ecotypes based on quantitative and qualitative descriptors

O presente trabalho objetivou estimar a divergência genética entre ecótipos de Urochloa brizantha com base na análise de descritores quantitativos, qualitativos e sua análise conjunta a fim de selecionar os promissores para liberação como cultivares desta espécie. Oito ecótipos (B1, B2, B3, B4, B5, B6, B8) e a cultivar 'Marandu' de U. brizantha foram implantados em piquetes, com 1000m2 cada, em duas repetições. Foram avaliados cinco descritores quantitativos e dez qualitativos no período seco e das águas. Os descritores quantitativos foram: área foliar, comprimento e largura das lâminas foliares, massa seca (MS) e proporção de lâmina foliar na MS. Os descritores qualitativos mensurados foram: resistência ao cisalhamento, volume de gás acumulado na fração rápida e lenta, proteína bruta, fibra em detergente neutro, fibra em detergente ácido, celulose, lignina em ácido sulfúrico, sílica e digestibilidade in vitro da matéria orgânica. Houve divergência genética entre os ecótipos de U. brizantha, especialmente em relação aos descritores quantitativos. Com base nos agrupamentos dos descritores quantitativos, qualitativos e sua análise conjunta, o agrupamento contendo de B1, B3 e B5 com 'Marandu' podem resultar em ecótipos promissores de U. brizantha .

This study aimed to estimate the genetic divergence between Urochloa brizantha ecotypes based on quantitative, qualitative descriptors and their joint analysis to select the promising to release as cultivars of this species. Eight ecotypes (B1, B2, B3, B4, B5, B6, B8) and cultivar 'Marandu' of U. brizantha were implanted into pickets with 1000m2 each, with two repetitions. Five quantitative descriptors were evaluated [leaf area (ALF), length and width of leaf blades (CLF and LLF, respectively), dry mass (MS), mass of dry matter (MMS) and proportion of leaf blade in MS (PLF)] in two forage samples, being a representative of rainfall, in February 2000, and another in the dry period, in August 2000. It was measured the qualitative descriptors: shear strength (RC), volume of accumulated gas in fast and slow fraction (A and B, respectively), crude protein (CP), neutral detergent fiber (NDF), acid detergent fiber (ADF ), cellulose (CEL), lignin in sulfuric acid (LIG), silica (SIL) and in vitro digestibility of organic matter (IVOMD). There was considerable genetic divergence in U. brizantha ecotypes, especially regarding to quantitative descriptors. Based on the groupings of quantitative, qualitative descriptors and their joint analysis, the grouping containing of B1, B3 and B5 with 'Marandu' can result in promising U. brizantha ecotypes.

Marcadores RAPD e caracteres morfoagronômicos na determinação da diversidade genética entre acessos de pimentas e pimentões / RAPD markers and morphoagronomic traits in determining genetic diversity among chili peppers and sweet peppers

A diversidade genética existente em coleções e bancos de germoplasma pode ser estimada por meio de diversos métodos, sendo que a escolha destes depende da disponibilidade dos recursos e da precisão desejada pelo pesquisador. Neste trabalho, marcadores RAPD e caracteres morfoagronômicos foram usados para estimar a divergência genética entre 52 acessos de Capsicum spp. Um total de 57 variáveis binárias geradas pela caracterização morfoagronômica e 84 bandas polimórficas obtidas a partir da análise por RAPD foram analisadas separadamente e em conjunto, permitindo a construção de três dendrogramas. Observou-se a formação de dois grupos principais, tanto na análise morfoagronômica e molecular separadamente, quanto na análise conjunta dos dados. O agrupamento dos acessos pela análise conjunta seguiu o mesmo padrão verificado para a análise molecular, que se constituiu em um grupo formado por acessos de C. baccatum e outro grupo formado pelos acessos de C. chinense, C. frutescens e C. annuum. Esse agrupamento segue a proposta vigente para a classificação de Capsicum spp. em complexos gênicos. A associação dos métodos permitiu uma melhor distinção entre os acessos, o agrupamento desses em nível de espécie e a conclusão de que não há duplicatas na coleção, demonstrando a importância do uso de diferentes técnicas na caracterização de um banco de germoplasma.

The genetic diversity within collections and banks of germplasm can be estimated by different methods and their choice is dependent of the available resources and the desired precision from the researcher. In the present work, RAPD markers and morph-agronomic traits were used to estimate the genetic divergence among 52 Capsicum spp. accessions. Fifty-seven binary variables from morph-agronomic characterization and 84 polymorphic markers from RAPD analysis were both separately and jointly evaluated and three dendrograms were generated. Two major groups were formed in all analyses. The clusters from the joint analysis were similar to the ones from molecular analysis. One group was formed with only C. baccatum accessions and the other one with C. chinense, C. frutescens and C. annuum accessions. These results were in agreement with the gene pool complexes proposal. The association of these methods allowed a better distinction among the accessions, a cluster formation at species level and a conclusion that there is no duplicates in the collection, showing how important is the use of different methods to characterize a germplasm bank.