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JAMA Network Open Nov 2021COVID-19 has disproportionately affected racial and ethnic minority groups, and race and ethnicity have been associated with disease severity. However, the association... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
COVID-19 has disproportionately affected racial and ethnic minority groups, and race and ethnicity have been associated with disease severity. However, the association of socioeconomic determinants with racial disparities in COVID-19 outcomes remains unclear.
OBJECTIVE
To evaluate the association of race and ethnicity with COVID-19 outcomes and to examine the association between race, ethnicity, COVID-19 outcomes, and socioeconomic determinants.
DATA SOURCES
A systematic search of PubMed, medRxiv, bioRxiv, Embase, and the World Health Organization COVID-19 databases was performed for studies published from January 1, 2020, to January 6, 2021.
STUDY SELECTION
Studies that reported data on associations between race and ethnicity and COVID-19 positivity, disease severity, and socioeconomic status were included and screened by 2 independent reviewers. Studies that did not have a satisfactory quality score were excluded. Overall, less than 1% (0.47%) of initially identified studies met selection criteria.
DATA EXTRACTION AND SYNTHESIS
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Associations were assessed using adjusted and unadjusted risk ratios (RRs) and odds ratios (ORs), combined prevalence, and metaregression. Data were pooled using a random-effects model.
MAIN OUTCOMES AND MEASURES
The main measures were RRs, ORs, and combined prevalence values.
RESULTS
A total of 4 318 929 patients from 68 studies were included in this meta-analysis. Overall, 370 933 patients (8.6%) were African American, 9082 (0.2%) were American Indian or Alaska Native, 101 793 (2.4%) were Asian American, 851 392 identified as Hispanic/Latino (19.7%), 7417 (0.2%) were Pacific Islander, 1 037 996 (24.0%) were White, and 269 040 (6.2%) identified as multiracial and another race or ethnicity. In age- and sex-adjusted analyses, African American individuals (RR, 3.54; 95% CI, 1.38-9.07; P = .008) and Hispanic individuals (RR, 4.68; 95% CI, 1.28-17.20; P = .02) were the most likely to test positive for COVID-19. Asian American individuals had the highest risk of intensive care unit admission (RR, 1.93; 95% CI, 1.60-2.34, P < .001). The area deprivation index was positively correlated with mortality rates in Asian American and Hispanic individuals (P < .001). Decreased access to clinical care was positively correlated with COVID-19 positivity in Hispanic individuals (P < .001) and African American individuals (P < .001).
CONCLUSIONS AND RELEVANCE
In this study, members of racial and ethnic minority groups had higher risks of COVID-19 positivity and disease severity. Furthermore, socioeconomic determinants were strongly associated with COVID-19 outcomes in racial and ethnic minority populations.
Topics: COVID-19; Humans; Outcome Assessment, Health Care; Prevalence; Racial Groups; Social Class; United States
PubMed: 34762110
DOI: 10.1001/jamanetworkopen.2021.34147 -
CytoJournal 2021Effusion fluid cytology has propensity for both false positives (in up to 0.5%) and false negatives (in up to 30%) results. Methodical approach from collection step to... (Review)
Review
Effusion fluid cytology has propensity for both false positives (in up to 0.5%) and false negatives (in up to 30%) results. Methodical approach from collection step to final interpretation stage could prevent both false positives and false negatives, if the interpreter is familiar with various factors responsible for diagnostic pitfalls in effusion fluid cytology. For this discussion, these factors are categorized as mentioned below: Surface tension-related alterations in cytomorphologyImproper specimen processingMany faces of reactive mesothelial cells, overlapping with those of cancer cellsProliferation-related featuresDegenerative changes, such as nuclear hyperchromasia and cytoplasmic vacuolationUnexpected patterns and unusual entities.
PubMed: 35126611
DOI: 10.25259/CMAS_02_04_2021 -
Frontiers in Immunology 2023Purkinje cytoplasmic autoantibody type 1 (PCA-1)/anti-Yo autoimmunity is a common high-risk paraneoplastic neurological disorder, traditionally attributed antigenically...
BACKGROUND
Purkinje cytoplasmic autoantibody type 1 (PCA-1)/anti-Yo autoimmunity is a common high-risk paraneoplastic neurological disorder, traditionally attributed antigenically to cerebellar degeneration-related protein 2 (CDR2), predominantly affecting women with gynecologic or breast adenocarcinoma. Single-modality CDR2 testing may produce false-positive results. We assessed the performance characteristics of the more recently purported major PCA-1/Yo antigen, CDR2-like (CDR2L), side by side with CDR2, in a line blot format.
METHODS
CDR2 and CDR2L were tested in six specimen groups (serum and cerebrospinal fluid (CSF)). Group 1, PCA-1/Yo mouse brain indirect immunofluorescence assay (IFA) positives; Group 2, PCA-1/Yo IFA mimics; Group 3, suspected CDR2 line blot false positives; Group 4, consecutive patient samples tested for neural antibodies over 1 year; Group 5, healthy subject serums; and Group 6, polyclonal (non-specific) immunoglobulin G (IgG)-positive serums.
RESULTS
Group 1: Of 64 samples tested, all but two were CDR2 positive (both CSF samples) and all were CDR2L positive. In individual patients, CDR2L values were always higher than CDR2. The two "CDR2L-only" positives were CSF samples with low titer PCA-1/Yo by IFA with serum negativity but with typical clinical phenotype. Group 2: All 51 PCA-1/Yo mimics were CDR2/CDR2L negative. Group 3: Nine samples [six of 1289 (0.47%) serums and three of 700 CSF samples (0.43%) were PCA-1/Yo IFA negative/CDR2 positive; two of the six available (serums from the same patient) were also CDR2L positive; the other four CDR2L negative had low CDR2 values (17-22). Group 4: Twenty-two patients had unexpected CDR2 or CDR2L positivity; none had tissue IFA positivity. Eleven of the 2,132 serum (0.5%) and three of the 677 CSF (0.4%) samples were CDR2 positive; median value was 19 (range, 11-48). Seven of the 2,132 serum (0.3%) and three of the 677 CSF (0.4%) samples were CDR2L positive; median value was 18 (range, 11-96). Group 5: All 151 healthy serum samples were negative. Group 6: One of the 46 polyclonal serum samples was CDR2L positive. Optimum overall performance was accomplished by requiring both CDR2 and CDR2L positivity in serum (sensitivity, 100%; and specificity, 99.9%) and positivity for CDR2L in CSF (sensitivity, 100%; and specificity, 99.6%).
CONCLUSION
CDR2L provides additional PCA-1/anti-Yo sensitivity in CSF, and dual positivity with CDR2 provides additional specificity assurance in serum. Combining antigen-specific and tissue-based assays optimizes PCA-1/anti-Yo testing.
Topics: Animals; Mice; Humans; Female; Autoantibodies; Autoimmunity; Paraneoplastic Cerebellar Degeneration; Nerve Tissue Proteins; Cytoplasm; Neurodegenerative Diseases
PubMed: 37841252
DOI: 10.3389/fimmu.2023.1265797 -
PloS One 2022The purpose of this study was to analyse whether contextual (perception of motivational climate and positive and negative spontaneous self-talk in sports), personal...
The purpose of this study was to analyse whether contextual (perception of motivational climate and positive and negative spontaneous self-talk in sports), personal (positivity) and situational variables (positive and negative spontaneous self-talk employed in competition and precompetitive anxiety) predict performance in a competition of ensembles of rhythmic gymnastics. 258 female gymnasts between ages14 and 20 (M = 15.24, SD = 1.46) participated in the study, completing pre- and post-competition measures. The results of the path-analysis showed that both the task-involving climate and positivity predicted positive self-talk in sport. This predicted self-confidence which, in turn, positively predicted positive situational self-talk in competition. For its part, the perception of an ego-involving climate positively predicted the use of both negative and positive self-talk in sport. Negative self-talk in sports predicted negative situational self-talk in competition and somatic and cognitive anxiety. In turn, cognitive anxiety positively predicted negative situational self-talk. Finally, performance was positively predicted by positive situational self-talk and negatively by negative situational self-talk. These results explain the functioning of spontaneous self-talk at different levels of generality and its relationship with sports performance.
Topics: Anxiety; Athletic Performance; Female; Gymnastics; Humans; Male; Motivation; Self Concept
PubMed: 35325003
DOI: 10.1371/journal.pone.0265809 -
Genes Mar 2022Phenylketonuria (PKU) was the first disorder for which newborn screening (NBS) was introduced in the early 1960s. Slovenia started the NBS program for PKU in 1979, and...
Phenylketonuria (PKU) was the first disorder for which newborn screening (NBS) was introduced in the early 1960s. Slovenia started the NBS program for PKU in 1979, and the fluorimetric method was implemented in 1992, with a phenylalanine (Phe) cut-off set at 120 mol/L. This value has been in use for almost thirty years and has never been revised. We aimed to analyze the DBS samples and review the data from a large nationwide cohort of newborns to optimize the cut-off values for HFA screening to minimize the number of false positives while maintaining the highest level of sensitivity by detecting all those who needed to be treated. In the first prospective part of the study, we analyzed samples of all newborns in Slovenia in 2019 and 2020, and in the second retrospective part, we reviewed data from all known patients with hyperphenylalaninemia (HFA) in Slovenia born from 2000 to 2018. We defined true screening-positive cases as those that required a low-Phe diet. The sensitivity, specificity and positive predictive values of the modeling elevation of the Phe cut-off value from 120 µmol/L to 200 µmol/L were assessed. The number of recalls at the cut-off of 120 µmol/L was 108 out of 37,784 samples at NBS (2019-2020). Six newborns were defined as true positives and 102 samples as false positives. If the cut-off value was adjusted to 160 µmol/L, only 12 samples exceeded it and all six true positive newborns would be detected. Among the 360,000 samples collected at the NBS between 2000 and 2018, 72 HFA patients in need of a low-Phe diet were found. All the diagnosed cases would have been detected if the cut-off was set to 160 µmol/L. We demonstrated in a large group of newborns (400,000 in 20 years) that using the fluorimetric approach, a cut-off value of 160 µmol/L, rather than 120 mol/L, is safe and that there were no missing true positive patients who required treatment. By increasing the cut-off, this method becomes more precise, resulting in a significantly reduced rate of false positives and thus being less burdensome on both families and the healthcare system.
Topics: Humans; Infant, Newborn; Neonatal Screening; Phenylalanine; Phenylketonurias; Prospective Studies; Retrospective Studies
PubMed: 35328070
DOI: 10.3390/genes13030517 -
Frontiers in Psychology 2021Positive emotions are linked to numerous benefits, but not everyone appreciates the same kinds of positive emotional experiences. We examine how distinct positive...
Positive emotions are linked to numerous benefits, but not everyone appreciates the same kinds of positive emotional experiences. We examine how distinct positive emotions are perceived and whether individuals' perceptions are linked to how societies evaluate those emotions. Participants from Hong Kong and Netherlands rated 23 positive emotions based on their individual perceptions (positivity, arousal, and socially engaging) and societal evaluations (appropriate, valued, and approved of). We found that (1) there were cultural differences in judgments about all six aspects of positive emotions; (2) positivity, arousal, and social engagement predicted emotions being positively regarded at the societal level in both cultures; and (3) that positivity mattered more for the Dutch participants, although arousal and social engagement mattered more in Hong Kong for societal evaluations. These findings provide a granular map of the perception and evaluation of distinct positive emotions in two cultures and highlight the role of cultures in the understanding how positive emotions are perceived and evaluated.
PubMed: 34122207
DOI: 10.3389/fpsyg.2021.579474 -
Microbiology Spectrum Jun 2022The BacT/Alert system has been used for detecting the presence of bacteria in various clinical settings as well as in blood services, but it is associated with a...
The BacT/Alert system has been used for detecting the presence of bacteria in various clinical settings as well as in blood services, but it is associated with a relatively high incidence of false-positive results. We analyzed the results of our quality control sterility testing of blood products by BacT/Alert 3D to understand the mechanism of false-positive results. Anaerobic and aerobic bottles were inoculated with 10 mL of samples and cultured in BacT/Alert 3D for 10 days. Positive-reaction cases were classified as true positive if any bacterium was identified or false positive if the identification test had a negative result. The detection algorithm and the bottle graph pattern of the positive reaction cases were investigated. Among the 43,374 samples, 25 true positives (0.06%) and 29 false positives (0.07%) were observed. Although the detection algorithm of all true positives and 25 of 29 false positives was accelerating production of CO, a steep rise in the bottle graph was observed only in the true positives, and it was not observed in either of the false positives. Four of 29 false positives were dependent on high baseline scatter reflections. Furthermore, evaluating the bottle graph pattern of Streptococcus pneumoniae, a bacterium known to autolyze, we confirmed that no viable bacterium was detected even if a steep rise was observed. In conclusion, the bottle graph pattern of positive reactions allows the differentiation between true positives and false positives. In case of a steep rise without bacterium detection, the bacterium might have autolyzed. Moreover, positive reactions with high baseline scatter reflections, despite immediate loading of bottles after sampling, are potentially false positive. In clinical settings, false-positive results are treated as positive until bacterial identification. It may result in the discarding of blood products in blood centers or affect clinical decisions in hospitals or testing facilities. Moreover, the management of these samples is usually time- and labor-consuming. The results of our study may help clinicians and laboratory staff in making a more precise evaluation of positive reactions in BacT/Alert.
Topics: Bacteria; Bacteriological Techniques; Humans
PubMed: 35467361
DOI: 10.1128/spectrum.00055-22 -
Journal of Veterinary Internal Medicine Sep 2022There is currently no commercially available method in Canada to identify bovine leukemia virus (BLV)-positive cows with high proviral load (PVL).
BACKGROUND
There is currently no commercially available method in Canada to identify bovine leukemia virus (BLV)-positive cows with high proviral load (PVL).
OBJECTIVES
First, develop a model to predict PVL using common, commercially available, cost-effective diagnostic tests. Second, investigate the relationship between lymphocyte count and PVL in BLV-positive cows.
ANIMALS
A total of 339 BLV-positive and 62 BLV-seronegative cows on 15 dairy farms.
METHODS
Cross-sectional study. Blood and milk samples were collected from all lactating BLV-positive cows on each farm and 5 to 10 BLV-seronegative cows depending on herd size. Blood and milk samples were tested for anti-BLV antibodies using enzyme-linked immunosorbent assay (ELISA). Complete blood counts were performed on blood samples, and standard components analyses were obtained for milk samples. Proviral load was determined by quantitative polymerase chain reaction for each cow.
RESULTS
The inverse of lymphocyte count, the square of the inverse of lymphocyte count, and milk ELISA percent positivity were positively associated with increasing PVL in BLV-positive cows. For BLV-positive cows, lymphocyte count >5.2 × 10 /L predicted a high PVL (BLV:Bovine DNA of >1 in blood) with a sensitivity of 92.4% and a specificity of 79.8%. For BLV-positive cows, white blood cell count >10.8 × 10 /L predicted a high PVL, with a sensitivity of 85.5% and a specificity of 83.6%.
CONCLUSIONS AND CLINICAL IMPORTANCE
Based on these results, producers can implement commonly available diagnostic tests to identify cows with high probability of having high PVL, which may help in designing effective disease control strategies for BLV-positive herds.
Topics: Animals; Antibodies, Viral; Cattle; Cattle Diseases; Cross-Sectional Studies; Enzootic Bovine Leukosis; Female; Lactation; Leukemia Virus, Bovine; Prevalence; Proviruses
PubMed: 35950569
DOI: 10.1111/jvim.16506 -
JAMA Network Open Jan 2023Sialic acid-binding immunoglobulin-like lectin 15 (Siglec-15) is a novel immune checkpoint molecule that is highly homologous to programmed cell death ligand 1 (PD-L1),...
IMPORTANCE
Sialic acid-binding immunoglobulin-like lectin 15 (Siglec-15) is a novel immune checkpoint molecule that is highly homologous to programmed cell death ligand 1 (PD-L1), but information remains limited about its role in esophageal squamous cell carcinoma (ESCC).
OBJECTIVE
To explore the expression pattern and association of Siglec-15 with outcomes among patients with ESCC who received neoadjuvant chemoradiotherapy (CRT).
DESIGN, SETTING, AND PARTICIPANTS
This retrospective cohort study was conducted at an academic institution in China. Participants included patients with ESCC who underwent neoadjuvant CRT and esophagectomy between June 2002 and December 2018. Multiplexed immunofluorescence staining was used to evaluate the expression of Siglec-15 and PD-L1 in tumor cells (TCs) or tumor-associated macrophages based on pre-CRT biopsies. Different immune phenotypes have been proposed and further validated in an independent cohort. Data analysis was conducted from January to May 2021.
EXPOSURES
Siglec-15 or PD-L1 positivity vs negativity.
MAIN OUTCOMES AND MEASURES
Pathologic complete response (pCR), overall survival (OS), and recurrence-free survival (RFS).
RESULTS
Of 130 participants (median [range] age, 56 [42-73] years; 108 [83.1%] male participants) in the primary cohort, 58 patients (44.6%) achieved a pCR after neoadjuvant CRT. Siglec-15 and PD-L1 were detected in both TCs and macrophages. The percentage of Siglec-15-positive macrophages was notably higher than that of Siglec-15-positive TCs (median [IQR]: 34.4% [12.7%-64.3%] vs 4.8% [0.7%-25.6%]; P < .001). TC-Siglec-15 expression was significantly and positively associated with macrophage-Siglec-15 expression (r = 0.78; P < .001). Siglec-15 positivity was significantly associated with a higher rate of pCR (37 of 70 [52.9%] vs 21 of 60 [35.0%]; P = .04), more favorable OS (hazard ratio [HR], 0.46; 95% CI, 0.25-0.85; P = .01), and RFS (HR, 0.48; 95% CI, 0.26-0.88; P = .02). However, PD-L1 positivity in TCs was negatively associated with survival. Stratification analysis further revealed that patients with combined Siglec-15 positivity and PD-L1 negativity had better survival than those with other phenotypes. Major findings were reproducible in a validation cohort with 55 patients.
CONCLUSIONS AND RELEVANCE
In this cohort study of patients with ESCC receiving neoadjuvant CRT, Siglec-15 positivity was associated with a better pathological response and more favorable survival. Siglec-15 could serve as a novel biomarker to identify potential candidates that may benefit from immunotherapy combined with CRT.
Topics: Female; Humans; Male; B7-H1 Antigen; Cohort Studies; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Immunoglobulins; N-Acetylneuraminic Acid; Neoadjuvant Therapy; Phenotype; Prognosis; Retrospective Studies; Sialic Acid Binding Immunoglobulin-like Lectins
PubMed: 36648946
DOI: 10.1001/jamanetworkopen.2022.50965 -
Frontiers in Endocrinology 2023To explore the impact of diabetes itself and glycemic control status on tuberculosis (TB).
OBJECTIVES
To explore the impact of diabetes itself and glycemic control status on tuberculosis (TB).
METHODS
A total of 3393 patients with TB and diabetes mellitus (DM) who were hospitalized in the Public Health Clinical Center of Chengdu from January 1, 2019, to December 31, 2021, were retrospectively included and divided into three groups according to baseline glycemic control status: two groups according to glycemic status at discharge, two groups according to cavity occurrence, three groups according to sputum results, and three groups according to lesion location. The influencing factors and the differences in cavity occurrence, sputum positivity and lesion location among different glycemic control groups or between different glycemic status groups were analyzed.
RESULTS
In this TB with DM cohort, most of the subjects were male, with a male to female ratio of 4.54:1, most of them were 45-59 years old, with an average age of 57.44 ± 13.22 years old. Among them, 16.8% (569/3393) had cavities, 52.2% (1770/3393) were sputum positive, 30.4% (1030/3393) had simple intrapulmonary lesions, 68.1% (2311/3393) had both intra and extrapulmonary lesions, only 15.8% (537/3393) had good glycemic control,16.0% (542/3393) and 68.2% (2314/3393) had fair and poor glycemic control, respectively. Compared with the non-cavity group, the sputum-negative group and the extrapulmonary lesion group, the cavity group, sputum-positive group, intrapulmonary lesion group and the intra and extrapulmonary lesion group all had higher fasting plasma glucose (FPG) and glycosylated hemoglobin A 1c (HbA1c) and lower good glycemic control rates at admission (all <0.001). Another aspect, compared with the good glycemic control group, the poor glycemic control group had a higher cavity occurrence rate, sputum positive rate, and greater proportion of intrapulmonary lesions. Moreover, FPG and HbA1c levels and poor glycemic control were significantly positively correlated with cavity occurrence, sputum positivity, and intrapulmonary lesions and were the main risk factors for TB disease progression. On the other hand, cavity occurrence, sputum positivity, and intrapulmonary lesions were also main risk factors for hyperglycemia and poor glycemic control.
CONCLUSION
Diabetes itself and glycemic control status could impact TB disease. Good glycemic control throughout the whole process is necessary for patients with TB and DM to reduce cavity occurrence and promote sputum negative conversion and lesion absorption.
Topics: Humans; Male; Female; Adult; Middle Aged; Aged; Glycated Hemoglobin; Retrospective Studies; Tuberculosis, Pulmonary; Glycemic Control; Diabetes Mellitus; Tuberculosis; Hyperglycemia
PubMed: 38027218
DOI: 10.3389/fendo.2023.1250001