Nevin Manimala

Eur Radiol. 2022 Sep 24. doi: 10.1007/s00330-022-09143-1. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate commercial deep learning-based software for fully automated coronary artery calcium (CAC) scoring on non-electrocardiogram (ECG)-gated low-dose CT (LDCT) with different slice thicknesses compared with manual ECG-gated calcium-scoring CT (CSCT).

METHODS: This retrospective study included 567 patients who underwent both LDCT and CSCT. All LDCT images were reconstructed with a 2.5-mm slice thickness (LDCT_2.5-mm), and 453 LDCT scans were reconstructed with a 1.0-mm slice thickness (LDCT_1.0-mm). Automated CAC scoring was performed on CSCT (CSCT_auto), LDCT_1.0-mm, and LDCT_2.5-mm images. The reliability of CSCT_auto, LDCT_1.0-mm, and LDCT_2.5-mm was compared with manual CSCT scoring (CSCT_manual) using intraclass correlation coefficients (ICCs) and Bland-Altman analysis. Agreement, in CAC severity category, was analyzed using weighted kappa statistics. Diagnostic performance at various Agatston score cutoffs was also calculated.

RESULTS: CSCT_auto, LDCT_1.0-mm, and LDCT_2.5-mm demonstrated excellent agreement with CSCT_manual (ICC [95% confidence interval, CI]: 1.000 [1.000, 1.000], 0.937 [0.917, 0.952], and 0.955 [0.946, 0.963], respectively). The mean difference with 95% limits of agreement was lower with LDCT_1.0-mm than with LDCT_2.5-mm (19.94 [95% CI, -244.0, 283.9] vs. 45.26 [-248.2, 338.7]). Regarding CAC severity, LDCT_1.0-mm achieved almost perfect agreement, and LDCT_2.5-mm achieved substantial agreement (kappa [95% CI]: 0.809 [0.776, 0.838], 0.776 [0.740, 0.809], respectively). Diagnostic performance for detecting Agatston score ≥ 400 was also higher with LDCT_1.0-mm than with LDCT_2.5-mm (F1 score, 0.929 vs. 0.855).

CONCLUSIONS: Fully automated CAC-scoring software with both CSCT and LDCT yielded excellent reliability and agreement with CSCT_manual. LDCT_1.0-mm yielded more accurate Agatston scoring than LDCT_2.5-mm using fully automated commercial software.

KEY POINTS: • Total Agatston scores and all vessels of CSCT_auto, LDCT_1.0-mm, and LDCT_2.5-mm demonstrated excellent agreement with CSCT_manual (all ICC > 0.85). • The diagnostic performance for detecting all Agatston score cutoffs was better with LDCT_1.0-mm than with LDCT_2.5-mm. • This automated software yielded a lower degree of underestimation compared with methods described in previous studies, and the degree of underestimation was lower with LDCT_1.0-mm than with LDCT_2.5-mm.

PMID:36152039 | DOI:10.1007/s00330-022-09143-1

Eur J Cancer Care (Engl). 2022 Sep 24:e13710. doi: 10.1111/ecc.13710. Online ahead of print.

ABSTRACT

OBJECTIVE: Physical and psychosocial effects of oral cancer result in long-term self-management needs. Little attention has been paid to survivors’ self-efficacy in managing their care. Study goals were to characterise self-care self-efficacy and evaluate socio-demographics, disease, attitudinal factors and psychological correlates of self-efficacy and engagement in head and neck self-exams.

METHODS: Two hundred thirty-two oral cancer survivors completed measures of socio-demographics, self-care self-efficacy, head and neck self-exams and attitudinal and psychological measures. Descriptive statistics characterised self-efficacy. Hierarchical regressions evaluated predictors of self-efficacy.

RESULTS: Survivors felt moderately confident in the ability to manage self-care (M = 4.04, SD = 0.75). Survivors with more comorbidities (β = -0.125), less preparedness (β = 0.241), greater information (β = -0.191), greater support needs (β = -0.224) and higher depression (β = -0.291) reported significantly lower self-efficacy. Head and neck self-exam engagement (44% past month) was relatively low. Higher preparedness (OR = 2.075) and self-exam self-efficacy (OR = 2.606) were associated with more engagement in self-exams.

CONCLUSION: Many survivors report low confidence in their ability to engage in important self-care practices. Addressing unmet information and support needs, reducing depressive symptoms and providing skill training and support may boost confidence in managing self-care and optimise regular self-exams.

PMID:36151904 | DOI:10.1111/ecc.13710

J Magn Reson Imaging. 2022 Sep 24. doi: 10.1002/jmri.28438. Online ahead of print.

ABSTRACT

BACKGROUND: Pancreatic cystic lesions (PCLs) are followed for years due to older and likely biased works demonstrating a strong association with pancreatic carcinoma; more recent data are needed clarifying this relationship.

PURPOSE: To determine the association between PCLs on MRI and a synchronous or future diagnosis of pancreatic carcinoma.

STUDY TYPE: Single-center retrospective cohort.

POPULATION: A total of 192 patients (111 female, 58%) with median age 66 years (range 26-87 years) with PCLs on abdominal MRI from 2011 to 2016.

FIELD STRENGTH/SEQUENCES: 1.5 T and 3 T, including T₂ WI, T₁ WI, diffusion weighted imaging and contrast-enhanced T₁ WI.

ASSESSMENT: Each PCL was reviewed independently by 2 of 10 fellowship-trained abdominal radiologists. Fukuoka guideline worrisome features and high-risk stigmata were evaluated. Follow-up imaging and clinical notes were reviewed within a system that captures pancreatic carcinoma for the region, for a median follow-up of 67 months (interquartile range: 43-88 months).

STATISTICAL TESTS: Pancreatic carcinoma prevalence and incidence rate for future carcinoma with 95% confidence intervals (95% CI). Fisher exact test, logistic regression with odds ratios (OR) and the Wilcoxon rank-sum test were used to assess PCL morphologic features with the Kolmogorov-Smirnov test used to assess for normality. P < 0.05 defined statistical significance.

RESULTS: The prevalence of pancreatic carcinoma on initial MRI showing a PCL was 2.4% (95% CI: 0.9%, 5.2%). Thickened/enhancing cyst wall was associated with pancreatic carcinoma, OR 52 (95% CI: 4.5, 1203). Of 189 patients with a PCL but without pancreatic carcinoma at the time of initial MRI, one developed high-grade dysplasia and none developed invasive carcinoma for an incidence rate of 0.97 (95% CI: 0.02, 5.43) and 0 (95% CI: 0, 3.59) cases per 1000 person-years, respectively.

DATA CONCLUSION: A low percentage of patients with a PCL on MRI had a pancreatic carcinoma at the time of initial evaluation and none developed carcinoma over a median 67 months of follow-up.

EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: 5.

PMID:36151888 | DOI:10.1002/jmri.28438

Pest Manag Sci. 2022 Sep 24. doi: 10.1002/ps.7199. Online ahead of print.

ABSTRACT

BACKGROUND: Rugose spiraling whitefly (RSW), Aleurodicus rugioperculatus Martin is a highly polyphagous invasive pests native to Central America. The occurrence of A. rugioperculatus in oriental region was reported for the first time from India, Pollachi, Tamil Nadu in 2017. It is widely distributed in India, causing severe economic damage to coconut and other horticultural crops. This pest is a recent invasion in India and the information on its potential distribution is lacking. Thus, in the present study we used the latest Coupled Model Intercomparison Project phase 6 (CMIP6) dataset through MaxEnt to determine the potential distribution of RSW in present and future climate change scenarios in 2050 and 2070 under Shared Socioeconomic Pathway (SSP) 126 and SSP585 emission scenario. Performance of the model was evaluated using Area Under the Curve (AUC), true skill statistic (TSS) and continuous Boyce index (CBI) RESULTS: The MaxEnt model performed well and predicted the potential distribution of A. rugioperculatus with high accuracy AUC values of 0.991 and 0.989, TSS of 0.891 and 0.842, CBI of 0.972 and 0.934 for training and testing, respectively. Jackknife analysis revealed that A. rugioperculatus distribution was mostly influenced by temperature based bioclimatic variables contributing 62.1% of the suitability with precipitation variables contributing the remainder. The most important bioclimatic variables for RSW distribution was annual mean temperature (Bio 1; 28.9%) followed by mean diurnal range (Bio 2: 19.5%) and annual precipitation (Bio 12: 19.1) Potential suitable areas for RSW establishment were mostly found in the entire coastal and southern states of India. A. rugioperculatus prefers warm and humid climate which indicates that tropics, subtropics and temperate regions are ideal for its spread and invasion. Our results highlighted that suitable habitat area for A. rugioperculatus is predicted to increase and highest probability of invasion and spread in 2050 and 2070 under future climate change scenarios of SSP126 and SSP585 compared to present climatic conditions.

CONCLUSIONS: This is the first study used latest CMIP6 models and predicted potential distribution of RSW in India under present and future climate change scenarios. Implementing strict domestic quarantine measures may prevent the spread and damage of RSW to non-coastal regions of India. Results of the current study would help in timely monitoring and surveillance of RSW and to formulate integrated pest management strategies at the national level to restrict its spread, invasion and damage to new areas. This article is protected by copyright. All rights reserved.

PMID:36151887 | DOI:10.1002/ps.7199

Int J Cancer. 2022 Sep 24. doi: 10.1002/ijc.34299. Online ahead of print.

ABSTRACT

Although pre-diagnostic circulating concentrations of the immune activation markers soluble CD27 (sCD27), sCD30 and chemokine ligand-13 (CXCL13) have been associated with non-Hodgkin lymphoma (NHL) risk, studies have been limited by sample size in associations with NHL subtypes. We pooled data from eight nested case-control studies to investigate subtype-specific relationships for these analytes. Using polytomous regression, we calculated odds ratios (ORs) with 95% confidence intervals (CIs) relating study-specific analyte tertiles to selected subtypes vs. controls (n=3,310): chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL; n=623), diffuse large B cell lymphoma (DLBCL; n=621), follicular lymphoma (FL; n=398), marginal zone lymphoma (MZL; n=138), mantle cell lymphoma (MCL; n=82) and T cell lymphoma (TCL; n=92). We observed associations with DLBCL for elevated sCD27 [OR for 3^rd vs. 1^st tertile (OR_T3 )=2.2, 95% CI=1.6-3.1], sCD30 (OR_T3 =2.0, 95% CI=1.6-2.5) and CXCL13 (OR_T3 =2.3, 95% CI=1.8-3.0). We also observed associations with sCD27 for CLL/SLL (OR_T3 =3.3, 95% CI=2.4-4.6), MZL (OR_T3 =7.7, 95% CI=3.0-20.1) and TCL (OR_T3 =3.4, 95% CI=1.5-7.7), and between sCD30 and FL (OR_T3 =2.7, 95% CI=2.0-3.5). In analyses stratified by time from phlebotomy to case diagnosis, the sCD27-TCL and all three DLBCL associations were equivalent across both follow-up periods (<7.5, ≥7.5 years). For other analyte-subtype comparisons, associations were stronger for the follow-up period closer to phlebotomy, particularly for indolent subtypes. In conclusion, we found robust evidence of an association between these immune markers and DLBCL, consistent with hypotheses that mechanisms related to immune activation are important in its pathogenesis. Our other findings, particularly for the rarer subtypes MZL and TCL, require further investigation.

PMID:36151863 | DOI:10.1002/ijc.34299

Scand J Clin Lab Invest. 2022 Sep 24:1-5. doi: 10.1080/00365513.2022.2123387. Online ahead of print.

ABSTRACT

Persisting inflammation has been discovered in lungs and other parenchymatous organs of some COVID-19 convalescents. Calprotectin, neutrophil extracellular traps (NETs), syndecan-1 and neopterin are general key inflammatory markers, and systemically enhanced levels of them may remain after the COVID-19 infection. These inflammatory markers were therefore measured in serum samples of 129 COVID-19 convalescent and 27 healthy blood donors or employees at Oslo Blood bank, Norway. Also antibodies against SARS-CoV-2 nucleocapsid antigen were measured, and timing of sampling and severity of infection noted. Whereas neopterin and NETs values remained low and those for syndecan-1 were not raised to statistically significant level, concentrations for calprotectin, as measured by a novel mixed monoclonal assay, were significantly increased in the convalescents. Antibodies against SARS-CoV-2 nucleocapsid antigen were elevated, but did not correlate with levels of inflammatory markers. Difference between the groups in only one biomarker makes evaluation of ongoing or residual inflammation in the convalescents difficult. If there is a low-grade inflammation, it would in that case involve neutrophils.

PMID:36151851 | DOI:10.1080/00365513.2022.2123387

Int Rev Psychiatry. 2022 May-Jun;34(3-4):413-422. doi: 10.1080/09540261.2022.2108313. Epub 2022 Aug 25.

ABSTRACT

BACKGROUND: To identify psychological interventions that improve outcomes for those who overdose, especially amongst Lesbian, Gay, Bisexual, Transgender, Intersex and Questioning populations.

OBJECTIVE: To recognize and assess the results from all studies including randomized control trials (RCTs) that have studied the efficiency of psychiatric and psychological assessment of people who have depression that undergo non-suicidal self-injury (NSSI) by self-poisoning, presenting to UK Accident and Emergency Departments.

METHOD: A scoping review of all studies including RCTs of psychiatric and psychological therapy treatments. Studies were selected according to types of engagement and intervention received. All studies including RCTs available in databases since 1998 in the Wiley version of the Cochrane controlled trials register in 1998 till 2021, Psych INFO, Medline, Google Scholar and from manually searching of journals were included. Studies that included information on repetition of the NSSI behaviour were also included. Altogether this amounts to 3900 randomized study participants with outcome data.

RESULTS: Seven trials reported repetition of NSSI as an outcome measure which were classified into four categories. Problem-solving therapy is indicated as a promising therapy and has shown to significantly reduce repetition in participants who NSSI by overdosing than patients in the control treatment groups consisting of standard after care.

CONCLUSION: The data show that manualized cognitive therapy psychological intervention was more effective than TAU after care. However, these differences are not statistically significant with p = .15; CI 0.61, 1.0 which crosses the line of no effect. And psychodynamic interpersonal therapy is more effective than the standard treatment. Despite being only one study in this subgroup the analysis shows a statistical significance with p = .009, CI 0.08; 0.7.

PMID:36151829 | DOI:10.1080/09540261.2022.2108313

Int Rev Psychiatry. 2022 May-Jun;34(3-4):266-273. doi: 10.1080/09540261.2022.2034603. Epub 2022 Feb 7.

ABSTRACT

Homophobic bullying is a major social issue, especially in the school settings. This may be particularly common in many Western countries but it appears globally. Bullying causes both short and long-term problems hence its prevention must be seen as a relevant and urgent step in educational settings. Psycho-educational programs should be promoted in order to help eliminate school-children’s prejudices and bias about gay and lesbian peers, homophobic bullying. 191 school-children (n = 101 females, n = 90 males), aged 12-14 years old, attending a secondary school in Foggia (Italy) were recruited and assessed at baseline (T0) and 2 months (T1) after receiving a systematized, repeated psycho-education aimed to promote their awareness on sexual variations, and reduce homophobic prejudices and stereotypes. They were assessed for their empathy quotients, their knowledge of gender- related stereotypes, homophobic attitudes, anger, emotional regulation, before (T0) and after the intervention (T1) in a standardized manner. The psychoeducational program significantly reduced homophobia levels towards gays (-9.38%) and lesbians (-5.42%,) as well as improved emotional adjustment (+25.9%) and pro-sociality (+3.85%) among school-children (0.0486≤ all p < 0.0001). Also, a statistically significant improvement of empathy (+11.3%) and levels of state anger (+0.35%) has been significantly reported. This study reports on the benefits of a repeated, systematic, prospective psycho-educational intervention conducted in the school-setting leading to an improvement of empathy, pro-sociality, emotional regulation and a reduction of homophobic attitudes and anger among students.

PMID:36151823 | DOI:10.1080/09540261.2022.2034603

Int Rev Psychiatry. 2022 May-Jun;34(3-4):282-291. doi: 10.1080/09540261.2022.2076583. Epub 2022 May 27.

ABSTRACT

In several countries, no gender identity- and sexual orientation-related data is routinely collected, if not for specific health or administrative/social purposes. Implementing and ensuring equitable and inclusive socio-demographic data collection is of paramount importance, given that the LGBTI community suffers from a disproportionate burden in terms of both communicable and non-communicable diseases. To the best of the authors’ knowledge, there exists no systematic review addressing the methods that can be implemented in capturing gender identity- and sexual orientation-related data in the healthcare sector. A systematic literature review was conducted for filling in this gap of knowledge. Twenty-three articles were retained and analysed: two focussed on self-reported data, two on structured/semi-structured data, seven on text-mining, natural language processing, and other emerging artificial intelligence-based techniques, two on challenges in capturing sexual and gender-diverse populations, eight on the willingness to disclose gender identity and sexual orientation, and, finally, two on integrating structured and unstructured data. Our systematic literature review found that, despite the importance of collecting gender identity- and sexual orientation-related data and its increasing societal acceptance from the LGBTI community, several issues have to be addressed yet. Transgender, non-binary identities, and also intersex individuals remain often invisible and marginalized. In the last decades, there has been an increasing adoption of structured data. However, exploiting unstructured data seems to overperform in identifying LGBTI members, especially integrating structured and unstructured data. Self-declared/self-perceived/self-disclosed definitions, while being respectful of one’s perception, may not completely be aligned with sexual behaviours and activities. Incorporating different levels of information (biological, socio-demographic, behavioural, and clinical) would enable overcoming this pitfall. A shift from a rigid/static nomenclature towards a more nuanced, dynamic, ‘fuzzy’ concept of a ‘computable phenotype’ has been proposed in the literature to capture the complexity of sexual identities and trajectories. On the other hand, excessive fragmentation has to be avoided considering that: (i) a full list of options including all gender identities and sexual orientations will never be available; (ii) these options should be easily understood by the general population, and (iii) these options should be consistent in such a way that can be compared among various studies and surveys. Only in this way, data collection can be clinically meaningful: that is to say, to impact clinical outcomes at the individual and population level, and to promote further research in the field.

PMID:36151822 | DOI:10.1080/09540261.2022.2076583

Am J Ind Med. 2022 Sep 24. doi: 10.1002/ajim.23430. Online ahead of print.

ABSTRACT

OBJECTIVES: Fragmented industry and occupation surveillance data throughout the COVID-19 pandemic has left public health practitioners and organizations with an insufficient understanding of high-risk worker groups and the role of work in SARS-CoV-2 transmission.

METHODS: We drew sequential probability samples of noninstitutionalized adults (18+) in the Michigan Disease Surveillance System with COVID-19 onset before November 16, 2020 (N = 237,468). Among the 6000 selected, 1839 completed a survey between June 23, 2020, and April 23, 2021. We compared in-person work status, source of self-reported SARS-CoV-2 exposure, and availability of adequate personal protective equipment (PPE) by industry and occupation using weighted descriptive statistics and Rao-Scott χ² tests. We identified industries with a disproportionate share of COVID-19 infections by comparing our sample with the total share of employment by industry in Michigan using 2020 data from the US Bureau of Labor Statistics.

RESULTS: Employed respondents (n = 1244) were predominantly female (53.1%), aged 44 and under (54.4%), and non-Hispanic White (64.0%). 30.4% of all employed respondents reported work as the source of their SARS-CoV-2 exposure and 78.8% were in-person workers. Work-related exposure was prevalent in Nursing and Residential Care Facilities (65.2%); Justice, Public Order, and Safety Activities (63.3%); and Food Manufacturing (57.5%). By occupation, work-related exposure was highest among Protective Services (57.9%), Healthcare Support (56.5%), and Healthcare Practitioners (51.9%). Food Manufacturing; Nursing and Residential Care; and Justice, Public Order, and Safety Activities were most likely to report having adequate PPE “never” or “rarely” (36.4%, 27.9%, and 26.7%, respectively).

CONCLUSIONS: Workplaces were a key source of self-reported SARS-CoV-2 exposure among employed Michigan residents during the first year of the pandemic. To prevent transmission, there is an urgent need in public health surveillance for the collection of industry and occupation data of people infected with COVID-19, as well as for future airborne infectious diseases for which we have little understanding of risk factors.

PMID:36151779 | DOI:10.1002/ajim.23430