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Reliability of a clinical sensory test battery in patients with spine-related leg and arm pain
(2024)
Background: The current standard to evaluate the presence of somatosensory dysfunctions is quantitative sensory testing, but its clinical utility remains limited. Low-cost and time-efficient clinical sensory testing (CST) batteries have thus been developed. Recent studies show moderate to substantial reliability in populations with neuropathic pain. This study evaluates the inter- and intra-tester reliability of people with spine-related leg and arm pain, representing mixed pain mechanisms.
Methods: Fifty-three patients with spine-related leg (n = 41) and arm pain (n = 12) attended three CST sessions. The CST battery consisted of eleven tests, determining loss and gain of sensory nerve function. CST was performed by the same investigator twice and by an additional investigator to determine inter- and intra-tester reliability. Fleiss' (inter-tester) and Cohen's (intra-tester) kappa were calculated for dichotomized and intraclass correlation coefficients (ICC) for continuous outcomes.
Results: Fleiss' kappa varied among modalities from fair to substantial (κ = 0.23–0.66). Cold, warm, and vibration detection thresholds and cold and pressure pain thresholds reached kappa >0.4 (moderate to substantial reliability). Cohen's kappa ranged from moderate to substantial (κ = 0.45–0.66). The reliability of the windup ratio was poor (ICC <0.18).
Conclusion: CST modalities with moderate to substantial inter-tester reliability could be of benefit as a screening tool. The moderate to substantial intra-tester reliability for all sensory modalities (except windup ratio) supports their potential use in clinical practice and research to monitor somatosensory changes over time in patients with spine-related limb pain of mixed pain mechanisms.
Significance: We already know that most modalities of clinical sensory test (CST) batteries achieve moderate to substantial inter- and intra-tester reliability in populations with neuropathic pain.
This study evaluates the reliability of a CST battery in populations with mixed pain mechanisms. We found inter-tester reliability varied from poor to substantial for sensory modalities, questioning the value of some CST modalities. The CST battery showed moderate to substantial intra-tester reliability, suggesting its usefulness to monitor sensory changes over time in this cohort.
Evolution of stock market efficiency in Europe: Evidence from measuring periods of inefficiency
(2024)
This study introduces novel measures to quantify periods of market inefficiency, enabling precise analysis of their evolution over time and effective comparisons across markets or groups of markets. These measures are applied to an extensive dataset comprising stock indices from 25 European countries from 2007 to 2022. The empirical findings reveal a 20% increase in market inefficiency across Europe, primarily driven by heightened average inefficiencies in the stock markets of the group of developed European countries such as Germany and the Scandinavian countries.
Diadromous fish have exhibited a dramatic decline since the end of the 20th century. The allis shad (Alosa alosa) population in the Gironde-Garonne-Dordogne (GGD) system, once considered as a reference in Europe, remains low despite a fishing ban in 2008. One hypothesis to explain this decline is that the downstream migration and growth dynamics of young stages have changed due to environmental modifications in the rivers and estuary. We retrospectively analysed juvenile growth and migration patterns using otoliths from adults caught in the GGD system 30 years apart during their spawning migration, in 1987 and 2016. We coupled otolith daily growth increments and laser ablation inductively-coupled plasma mass spectrometry measurements of Sr:Ca, Ba:Ca, and Mn:Ca ratios along the longest growth axis from hatching to an age of 100 days (i.e., during the juvenile stage). A back-calculation allowed us to estimate the size of juveniles at the entrance into the brackish estuary. Based on the geochemistry data, we distinguished four different zones that juveniles encountered during their downstream migration: freshwater, fluvial estuary, brackish estuary, and lower estuary. We identified three migration patterns during the first 100 days of their life: (a) Individuals that reached the lower estuary zone, (b) individuals that reached the brackish estuary zone, and (c) individuals that reached the fluvial estuary zone. On average, juveniles from the 1987 subsample stayed slightly longer in freshwater than juveniles from the 2016 subsample. In addition, juveniles from the 2016 subsample entered the brackish estuary at a smaller size. This result suggests that juveniles from the 2016 subsample might have encountered more difficult conditions during their downstream migration, which we attribute to a longer exposure to the turbid maximum zone. This assumption is supported by the microchemical analyses of the otoliths, which suggests based on wider Mn:Ca peaks that juveniles in 2010s experienced a longer period of physiological stress during their downstream migration than juveniles in 1980s. Finally, juveniles from the 2016 subsample took longer than 100 days to exit the lower estuary than we would have expected from previous studies. Adding a new marker (i.e., Ba:Ca) helped us refine the interpretation of the downstream migration for each individual.
Additive manufacturing is an essential tool in innovative production processes. The extended degrees of freedom offer much potential in usage, construction, and product design. Rising raw material and energy costs, constantly increasing environmental requirements, and the increasing demand for resource-saving products represent a paradigm shift in classic production processes.
In addition to the purely energetic evaluation, developing energy models is a method to determine energy consumption and reduce it in the long term. The specific energy consumption model, also known as the SEC model, allows a quick estimation of energy consumption by multiplying the SEC with a unit like the mass of the workpiece, the manufacturing time, or the exposed area. Here, high dependence on the used machine, the considered peripheral devices, and the geometry are noticeable.
Previous studies, such as those by Kellens et al. and Baumers et al., have laid the basis for understanding the energy demands of PBF-LB/M processes. Various energy models have subsequently been proposed, including those by Paul and Anand, Yi et al., Lv et al., and Hui et al. These models are often limited by their specificity to sub-processes or subsystems. This results in limitations in their applicability to other manufacturing machines or inaccuracies in energy consumption predictions. The simulation accuracy ACC is mostly in the range of 90% with the limitation of small sample sizes. Moreover, nearly, all these models rely heavily on process time information, making the accuracy of their simulations largely dependent on the quality of the underlying time model.
In the following study, two manufacturing machines of the PBF-LB/M process are analyzed and compared with other studies. The aim is to analyze the power and resource consumption to use these data to build an improved energy model with a high accuracy, which can be used as an additional parameter in the adapted design methodology. Furthermore, potential savings are derived from the load curves.