Tag: pubmed

Clin Chem Lab Med. 2022 Mar 28. doi: 10.1515/cclm-2021-1349. Online ahead of print.

ABSTRACT

OBJECTIVES: Medical laboratory performance is a relative concept, as are quality and safety in medicine. Therefore, repetitive benchmarking appears to be essential for sustainable improvement in health care. The general idea in this approach is to establish a reference level, upon which improvement may be strived for and quantified. While the laboratory community traditionally is highly aware of the need for laboratory performance and public scrutiny is more intense than ever due to the SARS-CoV-2 pandemic, few initiatives span the globe. The aim of this study was to establish a good practice approach towards benchmarking on a high abstraction level for three key dimensions of medical laboratory performance, generate a tentative snapshot of the current state of the art in the region of Europe, Middle East, and Africa (EMEA), and thus set the stage for global follow-up studies.

METHODS: The questionnaire used and previously published in this initiative consisted of 50 items, roughly half relating to laboratory operations in general with the other half addressing more specific topics. An international sample of laboratories from EMEA was approached to elicit high fidelity responses with the help of trained professionals. Individual item results were analyzed using standard descriptive statistics. Dimensional reduction of specific items was performed using exploratory factor analysis and assessed with confirmatory factor analysis, resulting in individual laboratory scores for the three subscales of “Operational performance”, “Integrated clinical care performance”, and “Financial sustainability”.

RESULTS: Altogether, 773 laboratories participated in the survey, of which 484 were government hospital laboratories, 129 private hospital laboratories, 146 commercial laboratories, and 14 were other types of laboratories (e.g. research laboratories). Respondents indicated the need for digitalization (e.g. use of IT for order management, auto-validation), automation (e.g. pre-analytics, automated sample transportation), and establishment of formal quality management systems (e.g. ISO 15189, ISO 9001) as well as sustainably embedding them in the fabric of laboratory operations. Considerable room for growth also exists for services provided to physicians, such as “Diagnostic pathways guidance”, “Proactive consultation on complex cases”, and “Real time decision support” which were provided by less than two thirds of laboratories. Concordantly, the most important kind of turn-around time (TAT) for clinicians, sample-to-result TAT, was monitored by only 40% of respondents.

CONCLUSIONS: Altogether, the need for stronger integration of laboratories into the clinical care process became apparent and should be a main trajectory of future laboratory management. Factor analysis confirmed the theoretical constructs of the questionnaire design phase, resulting in a reasonably valid tool for further benchmarking activities on the three aimed-for key dimensions.

PMID:35344647 | DOI:10.1515/cclm-2021-1349

Magn Reson Med. 2022 Mar 28. doi: 10.1002/mrm.29233. Online ahead of print.

ABSTRACT

PURPOSE: We evaluated the impact of PET respiratory motion correction (MoCo) in a phantom and patients. Moreover, we proposed and examined a PET MoCo approach using motion vector fields (MVFs) from a deep-learning reconstructed short MRI scan.

METHODS: The evaluation of PET MoCo was performed in a respiratory motion phantom study with varying lesion sizes and tumor to background ratios (TBRs) using a static scan as the ground truth. MRI-based MVFs were derived from either 2000 spokes (MoCo₂₀₀₀ , 5-6 min acquisition time) using a Fourier transform reconstruction or 200 spokes (MoCo_P2P200 , 30-40 s acquisition time) using a deep-learning Phase2Phase (P2P) reconstruction and then incorporated into PET MoCo reconstruction. For six patients with hepatic lesions, the performance of PET MoCo was evaluated using quantitative metrics (SUV_max , SUV_peak , SUV_mean , lesion volume) and a blinded radiological review on lesion conspicuity.

RESULTS: MRI-assisted PET MoCo methods provided similar results to static scans across most lesions with varying TBRs in the phantom. Both MoCo₂₀₀₀ and MoCo_P2P200 PET images had significantly higher SUV_max , SUV_peak , SUV_mean and significantly lower lesion volume than non-motion-corrected (non-MoCo) PET images. There was no statistical difference between MoCo₂₀₀₀ and MoCo_P2P200 PET images for SUV_max , SUV_peak , SUV_mean or lesion volume. Both radiological reviewers found that MoCo₂₀₀₀ and MoCo_P2P200 PET significantly improved lesion conspicuity.

CONCLUSION: An MRI-assisted PET MoCo method was evaluated using the ground truth in a phantom study. In patients with hepatic lesions, PET MoCo images improved quantitative and qualitative metrics based on only 30-40 s of MRI motion modeling data.

PMID:35344592 | DOI:10.1002/mrm.29233

Blood. 2022 Mar 28:blood.2022015506. doi: 10.1182/blood.2022015506. Online ahead of print.

ABSTRACT

Allogeneic hematopoietic stem cell transplantation (HSCT) is the gold standard curative therapy for infants and children with many inborn errors of immunity (IEI), but adolescents and adults with IEI are rarely referred for transplant. Lack of published HSCT outcome data outside small, single-center studies and perceived high risk of transplant related mortality have delayed the adoption of HSCT for IEI patients presenting or developing significant organ damage later in life. Allogeneic hematopoietic stem cell transplantation (HSCT) is the gold standard curative therapy for infants and children with many inborn errors of immunity (IEI), but adolescents and adults with IEI are rarely referred for transplant. Lack of published HSCT outcome data outside small, single-center studies and perceived high risk of transplant related mortality have delayed the adoption of HSCT for IEI patients presenting or developing significant organ damage later in life. This large retrospective, multicenter HSCT outcome study reports on 329 IEI patients (age range 15-62.5 years at HSCT). Patients underwent first HSCT between 2000 and 2019. Primary endpoints were overall survival (OS) and event-free survival (EFS). We also evaluated the influence of IEI-subgroup and IEI-specific risk factors at HSCT, including infections, bronchiectasis, colitis, malignancy, inflammatory lung disease, splenectomy, hepatic dysfunction and systemic immunosuppression. At a median follow-up of 44.3 months, the estimated OS at 1 and 5 years post-HSCT for all patients was 78% and 71% and EFS was 65% and 62%, respectively, with low rates of severe acute (8%) or extensive chronic (7%) GVHD. On univariate analysis, OS and EFS were inferior in patients with primary antibody deficiency, bronchiectasis, prior splenectomy, hepatic comorbidity, and with higher HCT-CI scores. On multivariable analysis EFS was inferior in those with a higher number of IEI-associated complications. Neither age nor donor had a significant effect on OS or EFS. We have identified age-independent risk factors for adverse outcome, providing much needed evidence to identify which patients are most likely to benefit from HSCT. At a median follow-up of 44.3 months, the estimated OS at 1 and 5 years post-HSCT for all patients was 78% and 71% and EFS was 65% and 62%, respectively, with low rates of severe acute (8%) or extensive chronic (7%) GVHD. On univariate analysis, OS and EFS were inferior in patients with primary antibody deficiency, bronchiectasis, prior splenectomy, hepatic comorbidity, and with higher HCT-CI scores. On multivariable analysis EFS was inferior in those with a higher number of IEI-associated complications. Neither age nor donor had a significant effect on OS or EFS. We have identified age-independent risk factors for adverse outcome, providing much needed evidence to identify which patients are most likely to benefit from HSCT.

PMID:35344580 | DOI:10.1182/blood.2022015506

PLoS Genet. 2022 Mar 28;18(3):e1010120. doi: 10.1371/journal.pgen.1010120. Online ahead of print.

ABSTRACT

Dobzhansky-Muller incompatibilities (DMIs) are a major component of reproductive isolation between species. DMIs imply negative epistasis and are exposed when two diverged populations hybridize. Mapping the locations of DMIs has largely relied on classical genetic mapping. Approaches to date are hampered by low power and the challenge of identifying DMI loci on the same chromosome, because strong initial linkage of parental haplotypes weakens statistical tests. Here, we propose new statistics to infer negative epistasis from haplotype frequencies in hybrid populations. When two divergent populations hybridize, the variance in heterozygosity at two loci decreases faster with time at DMI loci than at random pairs of loci. When two populations hybridize at near-even admixture proportions, the deviation of the observed variance from its expectation becomes negative for the DMI pair. This negative deviation enables us to detect intermediate to strong negative epistasis both within and between chromosomes. In practice, the detection window in hybrid populations depends on the demographic scenario, the recombination rate, and the strength of epistasis. When the initial proportion of the two parental populations is uneven, only strong DMIs can be detected with our method unless migration prevents parental haplotypes from being lost. We use the new statistics to infer candidate DMIs from three hybrid populations of swordtail fish. We identify numerous new DMI candidates, some of which are inferred to interact with several loci within and between chromosomes. Moreover, we discuss our results in the context of an expected enrichment in intrachromosomal over interchromosomal DMIs.

PMID:35344560 | DOI:10.1371/journal.pgen.1010120

PLoS One. 2022 Mar 28;17(3):e0266145. doi: 10.1371/journal.pone.0266145. eCollection 2022.

ABSTRACT

Honey bees are crucial for pollination services globally and produce important hive products including honey, royal jelly, pollen, and propolis that are being used commercially in food, cosmetics, and alternative medicinal purposes. Among the bee products, royal jelly (RJ) has long attracted scientists’ interest because of its importance in honey caste differentiation. The present research was carried out to determine the acceptance rate of queen cells, and RJ production between the hygienic and non-hygienic lines. Further, this study unveils the effect of pollen substitute diets on the queen cell acceptance rate and RJ yields between both bee stocks. Results showed that the uncapped brood cells and dead brood’s removal percentage was significantly more in hygienic bee colonies in comparison to non-hygienic bee colonies (p < 0.05). The average percentage of larval acceptance was statistically higher in hygienic lines (64.33 ± 2.91%) compared to non-hygienic lines (29.67 ± 1.20%). Similarly, the RJ mean weight per colony differed statistically between both bee stocks (p<0.001), which were 12.23 ± 0.52 g and 6.72 ± 0.33 g, respectively. Moreover, our results demonstrated that a significant difference was observed in larval acceptance rate, RJ yields (per colony and per cup) between both bee stocks those fed on various diets. However, no significant difference was recorded in RJ yields (per colony and per cup) between both bee stock that feeds on either commercially available pollen or pollen substitute. This study may provide future applications in helping bee breeders to choose the bees that carry a higher level of hygienic behavior with high RJ production traits.

PMID:35344573 | DOI:10.1371/journal.pone.0266145

PLoS One. 2022 Mar 28;17(3):e0263265. doi: 10.1371/journal.pone.0263265. eCollection 2022.

ABSTRACT

In the last century, the increase in traffic, human activities and industrial production have led to a diffuse presence of air pollution, which causes an increase of risk of several health conditions such as respiratory diseases. In Europe, air pollution is a serious concern that affects several areas, one of the worst ones being northern Italy, and in particular the Po Valley, an area characterized by low air quality due to a combination of high population density, industrial activity, geographical factors and weather conditions. Public health authorities and local administrations are aware of this problem, and periodically intervene with temporary traffic limitations and other regulations, often insufficient to solve the problem. In February 2020, this area was the first in Europe to be severely hit by the SARS-CoV-2 virus causing the COVID-19 disease, to which the Italian government reacted with the establishment of a drastic lockdown. This situation created the condition to study how significant is the impact of car traffic and industrial activity on the pollution in the area, as these factors were strongly reduced during the lockdown. Differently from some areas in the world, a drastic decrease in pollution measured in terms of particulate matter (PM) was not observed in the Po Valley during the lockdown, suggesting that several external factors can play a role in determining the severity of pollution. In this study, we report the case study of the city of Pavia, where data coming from 23 air quality sensors were analyzed to compare the levels measured during the lockdown with the ones coming from the same period in 2019. Our results show that, on a global scale, there was a statistically significant reduction in terms of PM levels taking into account meteorological variables that can influence pollution such as wind, temperature, humidity, rain and solar radiation. Differences can be noticed analyzing daily pollution trends too, as-compared to the study period in 2019-during the study period in 2020 pollution was higher in the morning and lower in the remaining hours.

PMID:35344546 | DOI:10.1371/journal.pone.0263265

PLoS Negl Trop Dis. 2022 Mar 28;16(3):e0010262. doi: 10.1371/journal.pntd.0010262. Online ahead of print.

ABSTRACT

BACKGROUND: American Samoa completed seven rounds of mass drug administration from 2000-2006 as part of the Global Programme to Eliminate Lymphatic Filariasis (LF). However, resurgence was confirmed in 2016 through WHO-recommended school-based transmission assessment survey and a community-based survey. This paper uses data from the 2016 community survey to compare different spatial and non-spatial methods to characterise clustering and hotspots of LF.

METHOD: Non-spatial clustering of infection markers (antigen [Ag], microfilaraemia [Mf], and antibodies (Ab [Wb123, Bm14, Bm33]) was assessed using intra-cluster correlation coefficients (ICC) at household and village levels. Spatial dependence, clustering and hotspots were examined using semivariograms, Kulldorf’s scan statistic and Getis-Ord Gi* statistics based on locations of surveyed households.

RESULTS: The survey included 2671 persons (750 households, 730 unique locations in 30 villages). ICCs were higher at household (0.20-0.69) than village levels (0.10-0.30) for all infection markers. Semivariograms identified significant spatial dependency for all markers (range 207-562 metres). Using Kuldorff’s scan statistic, significant spatial clustering was observed in two previously known locations of ongoing transmission: for all markers in Fagali’i and all Abs in Vaitogi. Getis-Ord Gi* statistic identified hotspots of all markers in Fagali’i, Vaitogi, and Pago Pago-Anua areas. A hotspot of Ag and Wb123 Ab was identified around the villages of Nua-Seetaga-Afao. Bm14 and Bm33 Ab hotspots were seen in Maleimi and Vaitogi-Ili’ili-Tafuna.

CONCLUSION: Our study demonstrated the utility of different non-spatial and spatial methods for investigating clustering and hotspots, the benefits of using multiple infection markers, and the value of triangulating results between methods.

PMID:35344542 | DOI:10.1371/journal.pntd.0010262

PLoS One. 2022 Mar 28;17(3):e0266021. doi: 10.1371/journal.pone.0266021. eCollection 2022.

ABSTRACT

The distortion measurement plays an important role in panoramic image processing. Most measurement algorithms judge the panoramic image quality by means of weighting the quality of the local areas. However, such a calculation fails to globally reflect the quality of the panoramic image. Therefore, the multi-region adjacent pixels correlation (MRAPC) is proposed as the efficient feature for no-reference panoramic images quality assessment in this paper. Specifically, from the perspective of the statistical characteristics, the differences of the adjacent pixels in panoramic image are proved to be highly related to the degree of distortion and independent of image content. Besides, the difference map has limited pixel value range, which can improve the efficiency of quality assessment. Based on these advantages, the proposed MRAPC feature collaborates with the support vector regression to globally predict the quality of panoramic images. Extensive experimental results show that the proposed no-reference panoramic image quality assessment algorithm achieves higher evaluation performance than the existing algorithms.

PMID:35344545 | DOI:10.1371/journal.pone.0266021

PLoS One. 2022 Mar 28;17(3):e0264513. doi: 10.1371/journal.pone.0264513. eCollection 2022.

ABSTRACT

BACKGROUND: Minimally invasive surgery is commonly used to treat patients with colorectal cancer, although it can cause surgical site infections (SSIs) that can affect the oncologic outcome. Use of a gentamicin-collagen sponge may help reduce the occurrence of SSIs. We aimed to determine the effectiveness of a gentamicin-collagen sponge in reducing SSIs in minimally invasive surgery for colorectal cancer.

METHODS: We retrospectively reviewed the records of 310 patients who were diagnosed with colorectal cancer at our hospital and underwent minimally invasive surgery between December 1, 2018, and February 28, 2021. Propensity score matching was conducted with a 1:1 ratio using logistic regression. The primary outcome was the incidence of SSIs in the mini-laparotomy wound. The secondary endpoints were factors affecting the incidence of SSIs.

RESULTS: After propensity score matching, 130 patients were assigned to each group. There were no differences in clinical characteristics between the two groups. SSIs occurred in 2 (1.5%) and 3 (2.3%) patients in the gentamicin-collagen sponge and control groups, respectively (p<0.999). The following factors showed a statistically significant association with SSIs: body mass index >25 kg/m2 (odds ratio, 39.0; 95% confidence interval, 1.90-802.21; p = 0.018), liver disease (odds ratio, 254.8; 95% confidence interval, 10.43-6222.61; p = 0.001), and right hemicolectomy (odds ratio, 36.22; 95% confidence interval, 2.37-554.63; p = 0.010).

CONCLUSION: Applying a gentamicin-collagen sponge to the mini-laparotomy wound did not reduce the frequency of SSIs. Further studies should be conducted on whether the selective use of gentamicin-collagen sponges may help reduce SSIs in high-risk patients.

PMID:35344540 | DOI:10.1371/journal.pone.0264513

Retina. 2022 Mar 24. doi: 10.1097/IAE.0000000000003477. Online ahead of print.

ABSTRACT

PURPOSE: To investigate concordance in symptom onset, area of dark autofluorescence (DAF) and growth rate (GR) between Stargardt disease (STGD1) siblings at an age-matched time-point.

METHODS: In this retrospective longitudinal study of sibling pairs with identical biallelic ABCA4 variants, age at symptom onset, best-corrected visual acuity (BCVA), atrophy area and effective radius of DAF on ultra-widefield fundus autofluorescence were recorded. Absolute intersibling differences for both eyes were compared to absolute interocular differences using the Mann-Whitney test.

RESULTS: We recruited 39 patients from 19 families. In 16 families, age-matched BCVA and DAF were compared between siblings. In 8 families, DAF GR was compared. The median (range) absolute difference in age at symptom onset between siblings was 3 (0-35) years. Absolute intersibling differences in age-matched BCVA were greater than interocular differences (p=0.01). Similarly, absolute intersibling differences in DAF area and radius were greater than interocular differences (p=0.04 for area and p=0.001 for radius). Differences between absolute interocular and intersibling GR were not statistically significant (p=0.44 for area GR and p=0.61 for radius GR).

CONCLUSIONS: There was significant discordance in age-matched BCVA and DAF beyond the expected limits of interocular asymmetry. Lack of significant intersibling differences in GR warrants further investigation.

PMID:35344533 | DOI:10.1097/IAE.0000000000003477