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Molecules (Basel, Switzerland) Jun 2022It is now more than 25 years since the first report of enantioselective analysis by capillary electrophoresis-mass spectrometry (CE-MS) appeared. This article reviews... (Review)
Review
It is now more than 25 years since the first report of enantioselective analysis by capillary electrophoresis-mass spectrometry (CE-MS) appeared. This article reviews the power of chiral CE-MS in resolving issues on the use of chiral selector incompatibility with MS and poor detectability encountered for chiral compounds by UV detection. The review begins with the general principles, requirements, and critical aspects of chiral CE-MS instrumentation. Next, the review provides a survey of MS-compatible chiral selectors (CSs) reported during the past decade, and the key achievements encountered in the time period using these CSs. Within the context of the strategies used to combine CE and MS, special attention is paid to the approaches that feature partial filling technique, counter-migration techniques, and direct use of CS, such as molecular micelles. In particular, the development and application of moving and fixed CS for EKC-MS, MEKC-MS, and CEC-MS demonstrate how various chiral compounds analyses were solved in a simple and elegant way during the 2010-2020 review period. The most noteworthy applications in the determination of chiral compounds are critically examined. The operating analytical conditions are detailed in the Tables, and the authors provide commentary on future trends of chiral separations by CE-MS.
Topics: Chromatography, Micellar Electrokinetic Capillary; Electrophoresis, Capillary; Mass Spectrometry; Micelles; Stereoisomerism
PubMed: 35807372
DOI: 10.3390/molecules27134126 -
Clinical Epigenetics Nov 2022The factors affecting cardioprotective collateral circulation are still incompletely understood. Recently, characteristics, such as CpG methylation of cell-free DNA...
BACKGROUND
The factors affecting cardioprotective collateral circulation are still incompletely understood. Recently, characteristics, such as CpG methylation of cell-free DNA (cfDNA), have been reported as markers with clinical utility. The aim of this study was to evaluate whether cfDNA methylation patterns are associated with the grade of coronary collateral circulation (CCC).
RESULT
In this case-control study, clinical and angiographic data were obtained from 143 patients (mean age, 58 years, male 71%) with chronic total coronary occlusion. Enzymatic methyl-sequencing (EM-seq) libraries were prepared using the cfDNA extracted from the plasma. Data were processed to obtain the average methylation fraction (AMF) tables of genomic regions from which blacklisted regions were removed. Unsupervised analysis of the obtained AMF values showed that some of the changes in methylation were due to CCC. Through random forest preparation process, 256 differentially methylated region (DMR) candidates showing strong association with CCC were selected. A random forest classifier was then constructed, and the area under the curve of the receiver operating characteristic curve indicated an appropriate predictive function for CCC. Finally, 20 DMRs were identified to have significantly different AMF values between the good and poor CCC groups. Particularly, the good CCC group exhibited hypomethylated DMRs. Pathway analysis revealed five pathways, including TGF-beta signaling, to be associated with good CCC.
CONCLUSION
These data have demonstrated that differential hypomethylation was identified in dozens of cfDNA regions in patients with good CCC. Our results support the clinical utility of noninvasively obtained epigenetic signatures for predicting collateral circulation in patients with vascular diseases.
Topics: Humans; Male; Middle Aged; Case-Control Studies; Cell-Free Nucleic Acids; Collateral Circulation; Coronary Artery Disease; DNA Methylation; Female
PubMed: 36320085
DOI: 10.1186/s13148-022-01349-w -
Healthcare (Basel, Switzerland) Sep 2022(1) Background: Cartilage degeneration with the natural aging process and the role of physical activity on cartilage wellness is still not clear. The objective of the... (Review)
Review
(1) Background: Cartilage degeneration with the natural aging process and the role of physical activity on cartilage wellness is still not clear. The objective of the present review was to understand how different physical activity interventions affect the cartilage and to propose a Standard Operating Procedure for an exercise program to maintain knee joint health; (2) Methods: Articles were collected on three different electronic databases and screened against the eligibility criteria. Results were collected in tables and the main outcomes were discussed narratively; (3) Results: A total of 24 studies have been included after the screening process and aerobic, strength, flexibility, postural balance, and mobility interventions were detected. Different protocols and types of interventions were adopted by the authors; (4) Conclusions: Physical activity interventions have mainly positive outcomes on cartilage structure, but the protocols adopted are different and various. A Standard Operating Procedure has been proposed for a physical intervention focalized on cartilage wellness that could be adopted as an intervention in the clinical setting. Furthermore, the creation of a standardized protocol wants to help scientific research to move in the same direction.
PubMed: 36292268
DOI: 10.3390/healthcare10101821 -
Diagnostics (Basel, Switzerland) May 2021The objective of this review was to compile validated functional shoulder assessment tools and analyse the methodological quality of their validations. Secondarily, we... (Review)
Review
The objective of this review was to compile validated functional shoulder assessment tools and analyse the methodological quality of their validations. Secondarily, we aimed to provide a comparison of the tools, including parameter descriptions, indications/applications, languages and operating instructions, to choose the most suitable for future clinical and research approaches. A systematic review (PRISMA) was conducted using: PubMed, WoS Scopus, CINHAL, Dialnet and reference lists until 2020. The main criteria for inclusion were that papers were original studies of validated tools or validation studies. Pre-established tables showed tools, validations, items/components, etc. The QUADAS-2 and COSMIN-RB were used to assess the methodological quality of validations. Ultimately, 85 studies were selected, 32 tools and 111 validations. Risk of bias scored lower than applicability, and patient selection got the best scores (QUADAS-2). Internal consistency had the highest quality and PROMs development the lowest (COSMIN-RB). Responsiveness was the most analysed metric property. Modified UCLA and SST obtained the highest quality in shoulder instability surgery, and SPADI in pain. The most approached topic was activities of daily living (81%). We compiled 32 validated functional shoulder assessment tools, and conducted an analysis of the methodological quality of 111 validations associated with them. Modified UCLA and SST showed the highest methodological quality in instability surgery and SPADI in pain.
PubMed: 34066777
DOI: 10.3390/diagnostics11050845 -
Annals of Translational Medicine Jun 2020Barn-integrated operating rooms have been used in an effort to save space and improve operating room efficiency during orthopedic surgeries. This study aimed to...
BACKGROUND
Barn-integrated operating rooms have been used in an effort to save space and improve operating room efficiency during orthopedic surgeries. This study aimed to investigate the feasibility of performing several thoracic surgeries in a barn-integrated operating room simultaneously.
METHODS
Both numerical simulation and field measurement approaches were applied to evaluate the performance of the ventilation system for the barn-integrated operating room. Computational fluid dynamics (CFD) method was applied to simulate airflow velocity field and particle concentration field. On-site test of airflow velocities were measured with a thermal anemometer. Bacteria-carrying particle (BCP) deposition and distribution was estimated using passive air sampling (PAS) and active air sampling (AAS) methods during mock surgeries.
RESULTS
The airflow distribution and concentration contours showed the barn-integrated operating room to be highly effective in controlling the concentration of airborne bacteria in the operating fields. The airflow and bacteria count met the current standard of GB50333-2013 Specifications, and there was no evidence of air mixing between cabins.
CONCLUSIONS
A barn-integrated operating room with several ultraclean operating tables in a single room would be a viable proposition for general thoracic surgeries in the future. As well as achieving a satisfactory level of contamination control, such an approach would reduce operating costs.
PubMed: 32647684
DOI: 10.21037/atm-20-4349 -
Anaesthesia Apr 2018
Topics: Electroencephalography; Entropy; False Positive Reactions; Humans; Intraoperative Awareness; Intraoperative Neurophysiological Monitoring; Operating Tables
PubMed: 29536520
DOI: 10.1111/anae.14256 -
American Journal of Obstetrics and... May 2018Sleep-disordered breathing (SDB) is common in pregnancy, but there are limited data on predictors.
BACKGROUND
Sleep-disordered breathing (SDB) is common in pregnancy, but there are limited data on predictors.
OBJECTIVES
The objective of this study was to develop predictive models of sleep-disordered breathing during pregnancy.
STUDY DESIGN
Nulliparous women completed validated questionnaires to assess for symptoms related to snoring, fatigue, excessive daytime sleepiness, insomnia, and restless leg syndrome. The questionnaires included questions regarding the timing of sleep and sleep duration, work schedules (eg, shift work, night work), sleep positions, and previously diagnosed sleep disorders. Frequent snoring was defined as self-reported snoring ≥3 days per week. Participants underwent in-home portable sleep studies for sleep-disordered breathing assessment in early (6-15 weeks gestation) and mid pregnancy (22-31 weeks gestation). Sleep-disordered breathing was characterized by an apnea hypopnea index that included all apneas, plus hypopneas with ≥3% oxygen desaturation. For primary analyses, an apnea hypopnea index ≥5 events per hour was used to define sleep-disordered breathing. Odds ratios and 95% confidence intervals were calculated for predictor variables. Predictive ability of the logistic models was estimated with area under the receiver-operating-characteristic curves, along with sensitivities, specificities, and positive and negative predictive values and likelihood ratios.
RESULTS
Among 3705 women who were enrolled, data were available for 3264 and 2512 women in early and mid pregnancy, respectively. The corresponding prevalence of sleep-disordered breathing was 3.6% and 8.3%, respectively. At each time point in gestation, frequent snoring, chronic hypertension, greater maternal age, body mass index, neck circumference, and systolic blood pressure were associated most strongly with an increased risk of sleep-disordered breathing. Logistic regression models that included current age, body mass index, and frequent snoring predicted sleep-disordered breathing in early pregnancy, sleep-disordered breathing in mid pregnancy, and new onset sleep-disordered breathing in mid pregnancy with 10-fold cross-validated area under the receiver-operating-characteristic curves of 0.870, 0.838, and 0.809. We provide a supplement with expanded tables, integrated predictiveness, classification curves, and an predicted probability calculator.
CONCLUSION
Among nulliparous pregnant women, logistic regression models with just 3 variables (ie, age, body mass index, and frequent snoring) achieved good prediction of prevalent and incident sleep-disordered breathing. These results can help with screening for sleep-disordered breathing in the clinical setting and for future clinical treatment trials.
Topics: Adolescent; Adult; Blood Pressure; Body Mass Index; Female; Humans; Hypertension; Maternal Age; Polysomnography; Pregnancy; Pregnancy Complications; Prevalence; Risk Factors; Sleep Apnea Syndromes; Snoring; Young Adult
PubMed: 29523262
DOI: 10.1016/j.ajog.2018.01.031 -
Indian Journal of Medical Microbiology 2012This review attempts to clarify the concepts of Laboratory Quality Management System (Lab QMS) for a medical testing and diagnostic laboratory in a holistic way and... (Review)
Review
This review attempts to clarify the concepts of Laboratory Quality Management System (Lab QMS) for a medical testing and diagnostic laboratory in a holistic way and hopes to expand the horizon beyond quality control (QC) and quality assurance. It provides an insight on accreditation bodies and highlights a glimpse of existing laboratory practices but essentially it takes the reader through the journey of accreditation and during the course of reading and understanding this document, prepares the laboratory for the same. Some of the areas which have not been highlighted previously include: requirement for accreditation consultants, laboratory infrastructure and scope, applying for accreditation, document preparation. This section is well supported with practical illustrations and necessary tables and exhaustive details like preparation of a standard operating procedure and a quality manual. Concept of training and privileging of staff has been clarified and a few of the QC exercises have been dealt with in a novel way. Finally, a practical advice for facing an actual third party assessment and caution needed to prevent post-assessment pitfalls has been dealt with.
Topics: Accreditation; Clinical Laboratory Techniques; Humans; Laboratories; Quality Assurance, Health Care
PubMed: 22664426
DOI: 10.4103/0255-0857.96647 -
Methods of Information in Medicine Jun 2022Receiver operating characteristic (ROC) analysis is commonly used for comparing models and humans; however, the exact analytical techniques vary and some are flawed. (Review)
Review
BACKGROUND
Receiver operating characteristic (ROC) analysis is commonly used for comparing models and humans; however, the exact analytical techniques vary and some are flawed.
OBJECTIVES
The aim of the study is to identify common flaws in ROC analysis for human versus model performance, and address them.
METHODS
We review current use and identify common errors. We also review the ROC analysis literature for more appropriate techniques.
RESULTS
We identify concerns in three techniques: (1) using mean human sensitivity and specificity; (2) assuming humans can be approximated by ROCs; and (3) matching sensitivity and specificity. We identify a technique from Provost et al using dominance tables and cost-prevalence gradients that can be adapted to address these concerns.
CONCLUSION
Dominance tables and cost-prevalence gradients provide far greater detail when comparing performances of models and humans, and address common failings in other approaches. This should be the standard method for such analyses moving forward.
Topics: Humans; Prevalence; ROC Curve; Research Design; Sensitivity and Specificity
PubMed: 34972233
DOI: 10.1055/s-0041-1740565 -
Journal of Applied Clinical Medical... Aug 2022Motion management of tumors within the lung and abdomen is challenging because it requires balancing tissue sparing with accuracy of hitting the target, while...
PURPOSE
Motion management of tumors within the lung and abdomen is challenging because it requires balancing tissue sparing with accuracy of hitting the target, while considering treatment delivery efficiency. Physicists can play an important role in analyzing four-dimensional computed tomography (4DCT) data to recommend the optimal respiratory gating parameters for a patient. The goal of this work was to develop a standardized procedure for making recommendations regarding gating parameters and planning margins for lung and gastrointestinal stereotactic body radiotherapy (SBRT) treatments. In doing so, we hoped to simplify decision-making and analysis, and provide a tool for troubleshooting complex cases.
METHODS
Factors that impact gating decisions and planning target volume (PTV) margins were identified. The gating options included gating on exhale with approximately a 50% duty cycle (Gate3070), exhale gating with a reduced duty cycle (Gate4060), and treating for most of respiration, excluding only extreme inhales and exhales (Gate100). A standard operating procedure was developed, as well as a physics consult document to communicate motion management recommendations to other members of the treatment team. This procedure was implemented clinically for 1 year and results are reported below.
RESULTS
Identified factors that impact motion management included the magnitude of motion observed on 4DCT, the regularity of breathing and quality of 4DCT data, and ability to observe the target on fluoroscopy. These were collated into two decision tables-one specific to lung tumors and another for gastrointestinal tumors-such that a physicist could answer a series of questions to determine the optimal gating and PTV margin. The procedure was used clinically for 252 sites from 213 patients treated with respiratory-gated SBRT and standardized practice across our 12-member physics team.
CONCLUSION
Implementation of a standardized procedure for respiratory gating had a positive impact in our clinic, improving efficiency and ease of 4DCT analysis and standardizing gating decision-making amongst physicists.
Topics: Four-Dimensional Computed Tomography; Humans; Lung Neoplasms; Motion; Movement; Radiosurgery; Radiotherapy Planning, Computer-Assisted; Respiration; Workflow
PubMed: 35737295
DOI: 10.1002/acm2.13705