Nevin Manimala

Mycoses. 2022 Jul 16. doi: 10.1111/myc.13498. Online ahead of print.

ABSTRACT

BACKGROUND: The diagnosis of superficial fungal infections is still mostly based on direct microscopic examination with Potassium Hydroxide solution. However, this method can be time consuming and its diagnostic accuracy rates vary widely depending on the clinician’s experience.

OBJECTIVES: This study presents a deep neural network structure that enables the rapid solutions for these problems and can perform automatic fungi detection in grayscale images without dyes.

METHODS: 160 microscopic full field photographs containing the fungal element, obtained from patients with onychomycosis, and 297 microscopic full field photographs containing dissolved keratin obtained from normal nails were collected. Smaller patches containing fungi (n=1835) and keratin (n=5238) were extracted from these full field images. In order to detect fungus and keratin, VGG16 and InceptionV3 models were developed by the use of these patches. The diagnostic performance of models was compared with 16 dermatologists by using 200 test patches.

RESULTS: For the VGG16 model, the InceptionV3 model and 16 dermatologists; mean accuracy rates were 88.10%±0.8%, 88.78%±0.35%, and 74.53%±8.57%, respectively; mean sensitivity rates were 75.04%±2.73%, 74.93%±4.52%, and 74.81%±19.51%, respectively; and mean specificity rates were 92.67%±1.17%, 93.78%±1.74%, and 74.25%±18.03%, respectively. The models were statistically superior to dermatologists according to rates of accuracy and specificity but not to sensitivity (p < 0.0001, p < 0.005, and p > 0.05, respectively). Area under curve values of the VGG16 and InceptionV3 models were 0.9339 and 0.9292, respectively.

CONCLUSION: Our research demonstrates that it is possible to build an automated system capable of detecting fungi present in microscopic images employing the proposed deep learning models. It has great potential for fungal detection applications based on AI.

PMID:35842749 | DOI:10.1111/myc.13498

J Forensic Sci. 2022 Jul 16. doi: 10.1111/1556-4029.15095. Online ahead of print.

ABSTRACT

Latent fingermark age determination is a relatively new subdiscipline of friction ridge pattern analysis that has the potential to ascertain two key pieces of information: the “who” and the “when” from a single evidence item. In this proof-of-concept study, the sensitivity and suitability of a series of 3D and 2D chronomorphometrics, ie, quantitative measurement of form as a function of time, are examined under various temperatures (55, 21, 4, and -20°C) at 6 months. 3D imaging with an optical profiler (OP) in tandem with a conventional 2D fingermark enhancing method, ie powdering with titanium dioxide, is the technique selected. From a chronomorphometric perspective, the 3D-OP detects micrometer variations in surface texture with regard to the heights (Sa and Ra) and volume (Vu) of the ridges, whereas 2D imaging provides information on color contrast (MI and IA), the fingermark visual quality score (QS), and the relative area extension of color-coded maps of ridge clarity (BlueGreen, BG). Statistical analyses have revealed different degrees of sensitivity of the 2D and 3D metrics for detecting the effect of temperature and time, being 3D the most discriminating. In these tested conditions, warmer temperatures (55 and 21°C) have shown the most impact on ridge degradation with the lowest levels observed at -20°C. The concurrent application of 2D and 3D metrics would be considered the best approach to advance the knowledge on fingermark aging processes and possible mathematical models.

PMID:35842746 | DOI:10.1111/1556-4029.15095

Equine Vet J. 2022 Jul 16. doi: 10.1111/evj.13863. Online ahead of print.

ABSTRACT

BACKGROUND: The equestrian discipline of eventing tests athletes’ and horses’ skill over three phases: dressage, jumping, and cross-country. Falls during cross-country can be particularly serious and result in serious or fatal injury for both horse and athlete. Cross-country course and fence design are crucial contributory factors to safety.

OBJECTIVES: To provide descriptive statistics and identify fence-level risk factors for horses competing in Fédération Equestre Internationale (FEI) events worldwide.

STUDY DESIGN: Retrospective cohort study.

METHODS: Data were collected for every horse start worldwide in all international (CI), championship (CH), Olympics (OG), and World Equestrian Games (WEG) eventing competitions between January 2008 and December 2018 and univariable logistic regression, followed by multivariable logistic regression were applied. The final model was built in a stepwise bi-directional process, with each step assessed by the Akaike information criterion.

RESULTS: Risk factors were identified at fence level covering aspects of fence design and course design. Ten fence types were at increased odds of a fall occurring compared to square spread fences, and seven types were at reduced odds. Fences with an approach downhill (odds ratio 1.35, 95% confidence interval 1.19-1.52), with landing into water (OR 1.82, CI 1.62-2.01), frangible devices (OR 1.28, CI 1.15-1.41), and later elements of combined obstacles (OR 1.33 CI 1.25-1.42 for the second element, OR 1.21 CI 1.10-1.32 for later elements) were associated with increased risk of falls occurring.

MAIN LIMITATIONS: Although the data set covers every international competition worldwide, it does not include national-level competitions.

CONCLUSIONS: It is recommended that the most challenging fences are placed near the beginning of the course, and not in downhill or water settings. The complexity of individual elements in combined fences should be reduced. Adopting evidence-based course design is a crucial intervention for reducing the incidence of horse falls and associated serious and fatal injuries to horse and human athletes. This article is protected by copyright. All rights reserved.

PMID:35842735 | DOI:10.1111/evj.13863

BMC Sports Sci Med Rehabil. 2022 Jul 16;14(1):131. doi: 10.1186/s13102-022-00512-3.

ABSTRACT

BACKGROUND: Reliable and valid instruments are needed to estimate physical activity levels. The aim was to culturally adapt the “Rapid Assessment of Physical Activity” (RAPA) into Hungarian and to investigate the validity and reliability of this adapted version in the elderly over 50 years.

METHODS: In our cross-sectional study 222 subjects were recruited in Hungary between December 2020 and January 2021(age 61.1 ± 7.9 years, 28% male). Criterion validity of RAPA and International Physical Activity Questionnaire (IPAQ)-Hungarian long version was tested by Spearman’s rank correlation. The examination of repeatability was based on a group of 32 people, and on the one-week test-retest reliability approach, and in addition to this during the statistical analysis intra-class correlation coefficient was calculated. To examine the sensitivity and specificity of the RAPA, negative and positive physical activity values were calculated from the results of the long version of the IPAQ and the RAPA. We tested 4 hypotheses (3 validity, 1 reliability). We considered acceptable validity and reliability if > 75% of hypotheses were confirmed.

RESULTS: All of the hypotheses (100%) were confirmed. Based on results of the validity testing of the newly adapted questionnaire was showed a moderate correlation between the examined measurement tools (R = 0.542, p < 0.001). The test-retest results of the questionnaire (N = 32, R = 0.988, p < 0.001) showed strong association.

CONCLUSION: RAPA showed fair to moderate validity and strong test-retest reliability similar to other studies. Based on our study’s results the RAPA is a valid and reliable questionnaire to measure the elderly Hungarian population’s physical activity.

PMID:35842730 | DOI:10.1186/s13102-022-00512-3

Int J Retina Vitreous. 2022 Jul 16;8(1):47. doi: 10.1186/s40942-022-00397-x.

ABSTRACT

BACKGROUND AND OBJECTIVE: To examine the relationship between gene expression profile class and tumor thickness reduction as measured by ultrasonography in response to plaque brachytherapy using a single-center, retrospective cohort study.

METHODS: A total of 15 patients with choroidal melanoma who underwent biopsy for gene expression profiling and were treated with plaque brachytherapy from a single institution from 12/8/14 through 12/19/19 were retrospectively reviewed for clinical characteristics and rate of tumor regression. Ultrasonographic B-scan tumor height was recorded just prior to plaque placement and following plaque removal in the patient’s chart to assess percent reduction in tumor thickness from baseline.

RESULTS: A total of 15 patients met inclusion criteria and were analyzed in this study. Minimum follow-up was 6 months after plaque removal. The percent regression in tumor thickness from baseline as measured by ultrasonography was greater for class 2 tumors than for class 1 tumors at 12-month follow up after treatment, and this difference was statistically significant (P = 0.012). There was no statistical significance in reduction at 3 months (P = 0.46) and 9 months (P = 0.10) after plaque brachytherapy. Although not statistically significant, class 2 tumors appeared to regress more rapidly than class 1 tumors in response to radiation.

CONCLUSIONS: In this study, class 2 choroidal melanoma tumors show a more rapid anatomic response to treatment than class 1 tumors at 12 months post plaque brachytherapy.

PMID:35842719 | DOI:10.1186/s40942-022-00397-x

Implement Sci Commun. 2022 Jul 16;3(1):75. doi: 10.1186/s43058-022-00323-0.

ABSTRACT

BACKGROUND: Implementation science has grown rapidly as a discipline over the past two decades. An examination of how publication patterns and other scholarly activities of implementation scientists are weighted in the tenure and promotion process is needed given the unique and applied focus of the field.

METHODS: We surveyed implementation scientists (mostly from the USA) to understand their perspectives on the following matters: (1) factors weighted in tenure and promotion for implementation scientists, (2) how important these factors are for success as an implementation scientist, (3) how impact is defined for implementation scientists, (4) top journals in implementation science, and (5) how these journals are perceived with regard to their prestige. We calculated univariate descriptive statistics for all quantitative data, and we used Wilcoxon signed-rank tests to compare the participants’ ratings of various factors. We analyzed open-ended qualitative responses using content analysis.

RESULTS: One hundred thirty-two implementation scientists completed the survey (response rate = 28.9%). Four factors were rated as more important for tenure and promotion decisions: number of publications, quality of publication outlets, success in obtaining external funding, and record of excellence in teaching. Six factors were rated as more important for overall success as an implementation scientist: presentations at professional meetings, involvement in professional service, impact of the implementation scientist’s scholarship on the local community and/or state, impact of the implementation scientist’s scholarship on the research community, the number and quality of the implementation scientist’s community partnerships, and the implementation scientist’s ability to disseminate their work to non-research audiences. Participants most frequently defined and described impact as changing practice and/or policy. This expert cohort identified Implementation Science as the top journal in the field.

CONCLUSIONS: Overall, there was a significant mismatch between the factors experts identified as being important to academic success (e.g., tenure and promotion) and the factors needed to be a successful implementation scientist. Findings have important implications for capacity building, although they are largely reflective of the promotion and tenure process in the USA.

PMID:35842690 | DOI:10.1186/s43058-022-00323-0

Eur J Med Res. 2022 Jul 16;27(1):120. doi: 10.1186/s40001-022-00752-6.

ABSTRACT

Pseudomonas aeruginosa is an adaptable bacterial pathogen that infects a variety of organs, including the respiratory tract, vascular system, urinary tract, and central nervous system, causing significant morbidity and mortality. As the primary goal of this study, we wanted to determine how pigment color production differed between clinical strains of P. aeruginosa, and whether or not that variation was associated with multidrug resistance or the ability to form biofilms. We screened in total 30.1% of yellow, 39.8% green and 30.1% of no pigment-producing P. aeruginosa strains from a total of 143 various clinical isolates. Yellow pigment-producing strains presented significant resistance to antibiotics groups, including β-lactam (91.5%), aminoglycosides (70.5%), and carbapenems (51.9%) compared to green and non-pigmented strains. Notably, 16.3% of yellow pigment-producing strains were resistant to colistin which is used as a last-resort treatment for multidrug-resistant bacteria, whereas only 2.3% of non-pigmented and 1.8% of green pigmented strains were resistant to colistin. Aside from that, yellow pigment-producing strains were frequent producers of enzymes belonging to the lactamase family, including ESBL (55.6%), MBL (55.6%), and AmpC (50%). Compared to the green groups (7.14%) and non-pigmented groups (28.5%), they had a higher frequency of efflux positive groups (64.2%). Notably, when compared to non-pigmented groups, green pigment-producing strains also displayed antibiotic susceptibility behavior similar to yellow pigment-producing strains. The majority of yellow pigment-producing strains outperformed the green and non-pigmented strains in terms of MIC levels when compared to the other two groups of strains. Despite the fact that previous studies have demonstrated a direct correlation between multidrug resistance behaviors and biofilm production, no such statistically significant association between pigment and biofilm formation was found in our investigation. Our research has demonstrated that the correlation of bacterial pigments on their susceptibility to antimicrobial agents. Yellow pigment-producing P. aeruginosa strains posed a significant problem due to the lack of alternative agents against such transformed strains, which may be associated with the development of multidrug resistance.

PMID:35842687 | DOI:10.1186/s40001-022-00752-6

Syst Rev. 2022 Jul 16;11(1):143. doi: 10.1186/s13643-022-02020-4.

ABSTRACT

BACKGROUND: Shift work, i.e., non-standard work hours, has been associated with both short- and long-term sickness absence. However, findings are inconsistent and inconclusive. Thus far, no comprehensive meta-analytic synthesis on the relationship between shift work and sickness absence has been published. The aims of the planned systematic review and meta-analysis are (1) to establish whether shift work is associated with sickness absence, (2) to determine if specific shift work characteristics relate to sickness absence (e.g., length and frequency of spells), and (3) to identify moderating factors affecting the relationship between shift work and sickness absence.

METHODS: Eligible studies will be identified using a predefined search strategy in several electronic databases (MEDLINE, Web of Science, PsychInfo, EMBASE, and ProQuest) and comprise peer-reviewed papers reporting original empirical findings on the association between shift work and sickness absence. Mainly observational studies with cross-sectional, prospective, or retrospective research design and case-control studies will be included. Risk of bias will be assessed using an adapted checklist previously employed to evaluate studies on sickness absence. To carry out the meta-analytic synthesis, a random effects meta-analysis will be conducted using the Comprehensive Meta-Analysis software. The review and meta-analysis will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Heterogeneity will be evaluated by Cochran’s Q test and the I² statistics.

DISCUSSION: The review and meta-analysis will be the first to conduct a meta-analytic synthesis of the evidence on the association between exposure to shift work and sickness absence, as well as identify relevant moderators affecting the relationship between shift work and sickness absence. Aggregation of the existing evidence will improve the knowledge on the association between shift work and sickness absence. Such knowledge can be used to guide scheduling of shift work to promote work schedules that are less detrimental to health and contribute to reduced sickness absence and higher work- and leisure-time productivity.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022301200.

PMID:35842678 | DOI:10.1186/s13643-022-02020-4

Crit Care. 2022 Jul 16;26(1):217. doi: 10.1186/s13054-022-04080-3.

ABSTRACT

BACKGROUND: Neurologic manifestations are increasingly reported in patients with coronavirus disease 2019 (COVID-19). Yet, data on prevalence, predictors and relevance for outcome of neurological manifestations in patients requiring intensive care are scarce. We aimed to characterize prevalence, risk factors and impact on outcome of neurologic manifestations in critically ill COVID-19 patients.

METHODS: In the prospective, multicenter, observational registry study PANDEMIC (Pooled Analysis of Neurologic DisordErs Manifesting in Intensive care of COVID-19), we enrolled COVID-19 patients with neurologic manifestations admitted to 19 German intensive care units (ICU) between April 2020 and September 2021. We performed descriptive and explorative statistical analyses. Multivariable models were used to investigate factors associated with disorder categories and their underlying diagnoses as well as to identify predictors of outcome.

RESULTS: Of the 392 patients included in the analysis, 70.7% (277/392) were male and the mean age was 65.3 (SD ± 3.1) years. During the study period, a total of 2681 patients with COVID-19 were treated at the ICUs of 15 participating centers. New neurologic disorders were identified in 350 patients, reported by these centers, suggesting a prevalence of COVID-19-associated neurologic disorders of 12.7% among COVID-19 ICU patients. Encephalopathy (46.2%; 181/392), cerebrovascular (41.0%; 161/392) and neuromuscular disorders (20.4%; 80/392) were the most frequent categories identified. Out of 35 cerebrospinal fluid analyses with reverse transcriptase PCR for SARS-COV-2, only 3 were positive. In-hospital mortality was 36.0% (140/389), and functional outcome (mRS 3 to 5) of surviving patients was poor at hospital discharge in 70.9% (161/227). Intracerebral hemorrhage (OR 6.2, 95% CI 2.5-14.9, p < 0.001) and acute ischemic stroke (OR 3.9, 95% CI 1.9-8.2, p < 0.001) were the strongest predictors of poor outcome among the included patients.

CONCLUSIONS: Based on this well-characterized COVID-19 ICU cohort, that comprised 12.7% of all severe ill COVID-19 patients, neurologic manifestations increase mortality and morbidity. Since no reliable evidence of direct viral affection of the nervous system by COVID-19 could be found, these neurologic manifestations may for a great part be indirect para- or postinfectious sequelae of the infection or severe critical illness. Neurologic ICU complications should be actively searched for and treated.

PMID:35842675 | DOI:10.1186/s13054-022-04080-3

Radiat Oncol. 2022 Jul 16;17(1):123. doi: 10.1186/s13014-022-02097-0.

ABSTRACT

BACKGROUND AND PURPOSE: The study evaluated the differences in leaf positioning deviations by the log files of three advanced accelerators with two delivery techniques, and established specific assessment parameters of leaf positioning deviations for different types of accelerators.

METHODS: A total of 420 treatment plans with 5 consecutive treatment log files were collected from the Trilogy, TrueBeam and Halcyon accelerators. Millennium MLC was equipped on the Trilogy and TrueBeam accelerators. A jawless design and dual-layer MLC were adopted on the Halcyon accelerator. 70 IMRT and 70 VMAT plans were selected randomly on each accelerator. The treatment sites of all plans included head and neck, chest, breast, pelvis and other sites. The parsing tasks for 2100 log files were proceeded by SunCheck software from Sun Nuclear Corporation. The maximum leaf root mean square (RMS) errors, 95th percentile errors and percentages of different leaf positioning errors were statistically analyzed. The correlations between these evaluation parameters and accelerator performance parameters (maximum leaf speed, mean leaf speed, gantry and arc angle) were analyzed.

RESULTS: The average maximum leaf RMS errors of the Trilogy in the IMRT and VMAT plans were 0.44 ± 0.09 mm and 0.79 ± 0.07 mm, respectively, which were higher than the TrueBeam’s 0.03 ± 0.01 mm, 0.03 ± 0.01 mm and the Halcyon’s 0.05 ± 0.01 mm, 0.07 ± 0.01 mm. Similar data results were shown in the 95th percentile error. The maximum leaf RMS errors were strongly correlated with the 95th percentile errors (Pearson index > 0.5). The leaf positioning deviations in VMAT were higher than those in IMRT for all accelerators. In TrueBeam and Halcyon, leaf position errors above 1 mm were not found in IMRT and VMAT plans. The main influencing factor of leaf positioning deviation was the leaf speed, which has no strong correlation with gantry and arc angles.

CONCLUSIONS: Compared with the quality assurance guidelines, the MLC positioning deviations tolerances of the three accelerators should be tightened. For both IMRT and VMAT techniques, the 95th percentile error and the maximum RMS error are suggested to be tightened to 1.5 and 1 mm respectively for the Trilogy accelerator. In TrueBeam and Halcyon accelerators, the 95th percentile error and maximum RMS error of 1 and 0.5 mm, respectively, are considered appropriate.

PMID:35842671 | DOI:10.1186/s13014-022-02097-0