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Frontiers in Psychology 2020Previous studies indicated that the balance of positive to negative affect (i.e., positivity ratio) is associated with subjective well-being and flourishing in the...
Previous studies indicated that the balance of positive to negative affect (i.e., positivity ratio) is associated with subjective well-being and flourishing in the general population. Moreover, a positivity ratio of 2.9 is considered a critical value discriminating between flourishing and non-flourishing individuals. To date, however, there is limited research on the positivity ratio on samples of teachers. The present study aimed to investigate whether the positivity ratio affects work engagement and well-being among teachers. Based on the broaden-and-build theory (Fredrickson, 2001) and work engagement model (Bakker and Demerouti, 2007), we predicted that positivity ratio (the ratio between positive and negative emotions) experienced by teachers would increase their work engagement, which in turn would positively affect their well-being. A sample of 1,335 teachers (762 women and 573 men) from Romania participated in the study. Results revealed that work engagement mediated the relationship between positivity ratio and well-being. Specifically, teachers with a higher ratio of positive to negative emotions reported more engagement (dedication, absorption, and vigor) and in consequence higher levels of subjective well-being (autonomy, environmental mastery, personal growth, self-acceptance, positive relations with others and purpose in life). Also, when investigating the positivity ratio according to participants' well-being, we found a mean of positivity ratio of 2.84 for the group of teachers with high levels of well-being, validating the proposed critical positivity ratio of 2.9. These findings support the importance of addressing positive emotions and positivity ratio in prevention and intervention programs with teachers.
PubMed: 32793041
DOI: 10.3389/fpsyg.2020.01608 -
Microbiology Spectrum Sep 2021Both the QuantiFERON-TB Gold Plus (QFT-Plus) and the QuantiFERON-TB Gold In-Tube (QFT-GIT) tests are interferon gamma (IFN-γ) release assays (IGRAs) intended to detect...
Both the QuantiFERON-TB Gold Plus (QFT-Plus) and the QuantiFERON-TB Gold In-Tube (QFT-GIT) tests are interferon gamma (IFN-γ) release assays (IGRAs) intended to detect cell-mediated immune responses to Mycobacterium tuberculosis antigens. In this study, we retrospectively analyzed performance data for both the QFT-GIT and QFT-Plus test systems from over 2 million samples. QFT-Plus and QFT-GIT testing was performed as specified in the respective package inserts at 23 Quest Diagnostics sites. Blood specimens were collected from individuals in all 50 states from November 2018 through December 2019. Retrospective analyses compared the proportion of positive, indeterminate, and conversion/reversion results. The overall proportion of QFT-positive results was 7% for both the QFT-Plus and QFT-GIT. The proportion of positive results was highest for QFT-GIT (7.5%) followed by the heparin 1-tube QFT-Plus (7.2%); a lower proportion of positives was observed with the 4-tube (all four QFT tubes were used in blood collection) QFT-Plus (6.0%). The proportions of indeterminate results for the 1-tube (heparin-only tube collection) and 4-tube QFT-Plus methods were less than 1% and 4%, respectively. This study indicates a higher proportion of positive results for M. tuberculosis than data from other studies. Additionally, the proportion of indeterminate QFT results were markedly lower when the sample was transported in one lithium-heparin tube instead of direct inoculation into 4 QFT-Plus tubes at the site of blood collection. In this study, we retrospectively analyzed results from both the QFT-GIT and QFT-Plus test systems from over 2 million blood specimens. The variables analyzed were (i) QFT positivity rates among various U.S. populations, (ii) indeterminate rates among various types of blood draws and how often an indeterminate result was resolved within 30 days after the initial draw, and (iii) the association of TB1 and TB2 antigen tubes with IGRA reversion and conversion events from serial QFT testing. This is, to our knowledge, the largest QFT study representing patients from an extensive geographic coverage across the United States and U.S. territories.
Topics: Adolescent; Adult; Aged; Antigens, Bacterial; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Interferon-gamma Release Tests; Male; Middle Aged; Mycobacterium tuberculosis; Retrospective Studies; Tuberculosis; United States; Young Adult
PubMed: 34319139
DOI: 10.1128/Spectrum.00096-21 -
Spatial and Spatio-temporal Epidemiology Aug 2020Identifying areas with low access to testing and high case burden is necessary to understand risk and allocate resources in the COVID-19 pandemic. Using zip code level... (Comparative Study)
Comparative Study
Identifying areas with low access to testing and high case burden is necessary to understand risk and allocate resources in the COVID-19 pandemic. Using zip code level data for New York City, we analyzed testing rates, positivity rates, and proportion positive. A spatial scan statistic identified clusters of high and low testing rates, high positivity rates, and high proportion positive. Boxplots and Pearson correlations determined associations between outcomes, clusters, and contextual factors. Clusters with less testing and low proportion positive tests had higher income, education, and white population, whereas clusters with high testing rates and high proportion positive tests were disproportionately black and without health insurance. Correlations showed inverse associations of white race, education, and income with proportion positive tests, and positive associations with black race, Hispanic ethnicity, and poverty. We recommend testing and health care resources be directed to eastern Brooklyn, which has low testing and high proportion positives.
Topics: Adult; Aged; Aged, 80 and over; COVID-19; COVID-19 Testing; Clinical Laboratory Techniques; Cluster Analysis; Communicable Diseases, Emerging; Coronavirus Infections; Disease Outbreaks; Female; Health Status Disparities; Healthcare Disparities; Humans; Male; Middle Aged; New York City; Pandemics; Pneumonia, Viral; Risk Assessment; Spatial Analysis; Urban Health; Urban Population
PubMed: 32807400
DOI: 10.1016/j.sste.2020.100355 -
Journal of the National Cancer Institute Jul 2020Some breast tumors expressing greater than 1% and less than 10% estrogen receptor (ER) positivity (ER-borderline) are clinically aggressive; others exhibit luminal...
BACKGROUND
Some breast tumors expressing greater than 1% and less than 10% estrogen receptor (ER) positivity (ER-borderline) are clinically aggressive; others exhibit luminal biology. Prior ER-borderline studies included few black participants.
METHODS
Using the Carolina Breast Cancer Study (phase I: 1993-1996; 2: 1996-2001; 3: 2008-2013), a population-based study that oversampled black women, we compared ER-borderline (n = 217) to ER-positive (n = 1885) and ER-negative (n = 757) tumors. PAM50 subtype and risk of recurrence score (ROR-PT, incorporates subtype, proliferation, tumor size) were measured. Relative frequency differences (RFD) were estimated using multivariable linear regression. Disease-free interval (DFI) was evaluated by ER category and endocrine therapy receipt, overall and by race, using Kaplan Meier and Cox models. Statistical tests were two-sided.
RESULTS
ER-borderlines were more frequently basal-like (RFD = +37.7%, 95% confidence interval [CI] = 27.1% to 48.4%) and high ROR-PT (RFD = +52.4%, 95% CI = 36.8% to 68.0%) relative to ER-positives. Having a high ROR-PT ER-borderline tumor was statistically significantly associated with black race (RFD = +26.2%, 95% CI = 9.0% to 43.3%). Compared to ER-positives, DFI of ER-borderlines treated with endocrine therapy was poorer but not statistically significantly different (hazard ratio [HR] = 2.03, 95% CI = 0.89% to 4.65%), whereas DFI was statistically significantly worse for ER-borderlines without endocrine therapy (HR = 3.33, 95% CI = 1.84% to 6.02%). However, black women with ER-borderline had worse DFI compared to ER-positives, even when treated with endocrine therapy (HR = 2.77, 95% CI = 1.09% to 7.04%).
CONCLUSIONS
ER-borderline tumors were genomically heterogeneous, with survival outcomes that differed by endocrine therapy receipt and race. Black race predicted high-risk ER-borderlines and may be associated with poorer endocrine therapy response.
Topics: Adult; Aged; Black People; Breast Neoplasms; Female; Humans; Immunohistochemistry; Middle Aged; Neoplasm Staging; North Carolina; Receptors, Estrogen; Transcriptome; White People; Young Adult
PubMed: 31742342
DOI: 10.1093/jnci/djz206 -
PloS One 2015Diagnostic clinical prediction rules (CPRs) are developed to improve diagnosis or decrease diagnostic testing. Whether, and in what situations diagnostic CPRs improve... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
Diagnostic clinical prediction rules (CPRs) are developed to improve diagnosis or decrease diagnostic testing. Whether, and in what situations diagnostic CPRs improve upon clinical judgment is unclear.
METHODS AND FINDINGS
We searched MEDLINE, Embase and CINAHL, with supplementary citation and reference checking for studies comparing CPRs and clinical judgment against a current objective reference standard. We report 1) the proportion of study participants classified as not having disease who hence may avoid further testing and or treatment and 2) the proportion, among those classified as not having disease, who do (missed diagnoses) by both approaches. 31 studies of 13 medical conditions were included, with 46 comparisons between CPRs and clinical judgment. In 2 comparisons (4%), CPRs reduced the proportion of missed diagnoses, but this was offset by classifying a larger proportion of study participants as having disease (more false positives). In 36 comparisons (78%) the proportion of diagnoses missed by CPRs and clinical judgment was similar, and in 9 of these, the CPRs classified a larger proportion of participants as not having disease (fewer false positives). In 8 comparisons (17%) the proportion of diagnoses missed by the CPRs was greater. This was offset by classifying a smaller proportion of participants as having the disease (fewer false positives) in 2 comparisons. There were no comparisons where the CPR missed a smaller proportion of diagnoses than clinical judgment and classified more participants as not having the disease. The design of the included studies allows evaluation of CPRs when their results are applied independently of clinical judgment. The performance of CPRs, when implemented by clinicians as a support to their judgment may be different.
CONCLUSIONS
In the limited studies to date, CPRs are rarely superior to clinical judgment and there is generally a trade-off between the proportion classified as not having disease and the proportion of missed diagnoses. Differences between the two methods of judgment are likely the result of different diagnostic thresholds for positivity. Which is the preferred judgment method for a particular clinical condition depends on the relative benefits and harms of true positive and false positive diagnoses.
Topics: Bias; Decision Support Techniques; Disease; Humans; Judgment; Risk Factors
PubMed: 26039538
DOI: 10.1371/journal.pone.0128233 -
Cureus Jan 2022Although there are studies in which the ideal number of lymph nodes for early-stage ovarian cancer is specified, no study has been found on the number of lymph nodes...
OBJECTIVE
Although there are studies in which the ideal number of lymph nodes for early-stage ovarian cancer is specified, no study has been found on the number of lymph nodes that should ideally be removed by systematic lymph node dissection, including advanced-stage patients. The present study was aimed to retrospectively investigate the number of lymph nodes that need to be removed to detect lymph node positivity and the effect of this number on prognosis.
METHODOLOGY
A total of 155 patients over the age of 18 who were diagnosed with ovarian cancer without secondary malignancy and who underwent surgical lymph node dissection were included in the study between 2015 and 2020.
RESULTS
A total of 155 patients underwent lymphadenectomy and the median number of removed lymph nodes was 24. Lymph node positivity was detected in 72 (46.4%) of these patients, while the median number of positive lymph nodes was 4 in the lymph node-positive group. A statistically significant positive correlation was found between the number of lymph nodes removed and the median overall survival (OS) (r = 0.546, p<0.001). At the same time, when the number of 24 lymph nodes, which is the median number of lymph nodes removed and the value found to detect lymph node positivity in the receiver operating characteristic (ROC) curve, is taken as cut off; mean OS was found to be statistically significantly higher in the group with adequate lymph node dissection compared to the group with insufficient lymph node dissection (46.46±35.22 vs 22.33±21.43; p < 0.001, respectively).
CONCLUSION
it was shown that more than 24 lymph nodes are required for adequate lymph node dissection in the patients included in the study, and thus it can contribute positively to the prognosis. With the support of more comprehensive and prospective studies conducted on this subject to this study, clearer data will emerge about the number of lymph nodes that should be removed in an ideal surgery.
PubMed: 35145776
DOI: 10.7759/cureus.20869 -
Journal of Thrombosis and Haemostasis :... Sep 2020High incidence of thrombosis in COVID-19 patients indicates a hypercoagulable state. Hence, exploring the involvement of antiphospholipid antibodies (aPL) in these...
BACKGROUND
High incidence of thrombosis in COVID-19 patients indicates a hypercoagulable state. Hence, exploring the involvement of antiphospholipid antibodies (aPL) in these patients is of interest.
OBJECTIVES
To illustrate the incidence of criteria (lupus anticoagulant [LAC], anticardiolipin [aCL] immunoglobulin G [IgG]/IgM, antibeta2-glycoprotein I antibodies [aβ2GPI] IgG/IgM) and noncriteria (anti-phosphatidyl serine/prothrombin [aPS/PT], aCL, and aβ2GPI IgA) aPL in a consecutive cohort of critically ill SARS-CoV-2 patients, their association with thrombosis, antibody profile and titers of aPL.
PATIENTS/METHODS
Thirty-one consecutive confirmed COVID-19 patients admitted to the intensive care unit were included. aPL were measured at one time point, with part of the aPL-positive patients retested after 1 month.
RESULTS
Sixteen patients were single LAC-positive, two triple-positive, one double-positive, one single aCL, and three aCL IgG and LAC positive. Seven of nine thrombotic patients had at least one aPL. Sixteen of 22 patients without thrombosis were aPL positive, amongst them two triple positives. Nine of 10 retested LAC-positive patients were negative on a second occasion, as well as the double-positive patient. Seven patients were aPS/PT-positive associated to LAC. Three patients were aCL and aβ2GPI IgA-positive.
CONCLUSION
Our observations support the frequent single LAC positivity during (acute phase) observed in COVID-19 infection; however, not clearly related to thrombotic complications. Triple aPL positivity and high aCL/aβ2GPI titers are rare. Repeat testing suggests aPL to be mostly transient. Further studies and international registration of aPL should improve understanding the role of aPL in thrombotic COVID-19 patients.
Topics: Adult; Aged; Aged, 80 and over; Antibodies, Anticardiolipin; Antibodies, Antiphospholipid; Antiphospholipid Syndrome; Blood Coagulation; COVID-19; Critical Care; Critical Illness; Female; Humans; Immunoglobulin G; Immunoglobulin M; Intensive Care Units; Lupus Coagulation Inhibitor; Male; Middle Aged; Prothrombin; Thrombosis; beta 2-Glycoprotein I
PubMed: 32619328
DOI: 10.1111/jth.14994 -
Journal of Pathology Informatics 2021Human immunodeficiency virus (HIV) screening has improved significantly in the past decade as we have implemented tests that include antigen detection of p24....
BACKGROUND
Human immunodeficiency virus (HIV) screening has improved significantly in the past decade as we have implemented tests that include antigen detection of p24. Incorporation of p24 detection narrows the window from 4 to 2 weeks between infection acquisition and ability to detect infection, reducing unintentional spread of HIV. The fourth- and fifth-generation HIV (HIV5G) screening tests in low prevalence populations have high numbers of false-positive screens and it is unclear if orthogonal testing improves diagnostic and public health outcomes.
METHODS
We used a cohort of 60,587 HIV5G screening tests with molecular and clinical correlates collected from 2016 to 2018 and applied machine learning to generate a classifier that could predict likely true and false positivity.
RESULTS
The best classification was achieved by using support vector machines and transformation of results with principle component analysis. The final classifier had an accuracy of 94% for correct classification of false-positive screens and an accuracy of 92% for classification of true-positive screens.
CONCLUSIONS
Implementation of this classifier as a screening method for all HIV5G reactive screens allows for improved workflow with likely true positives reported immediately to reduce infection spread and initiate follow-up testing and treatment and likely false positives undergoing orthogonal testing utilizing the same specimen already drawn to reduce distress and follow-up visits. Application of machine learning to the clinical laboratory allows for workflow improvement and decision support to provide improved patient care and public health.
PubMed: 34934521
DOI: 10.4103/jpi.jpi_7_21 -
Revista Espanola de Quimioterapia :... Apr 2021Clostridioides difficile (CD) is the most common cause of nosocomial diarrhea. Detection of CD toxin in patients' faecal samples is the traditional rapid method for the...
OBJECTIVE
Clostridioides difficile (CD) is the most common cause of nosocomial diarrhea. Detection of CD toxin in patients' faecal samples is the traditional rapid method for the diagnosis of CD infection. Various testing algorithms have been proposed: an initial screening test using a rapid test, and a confirmatory test (cytotoxicity neutralization assay, toxigenic culture, nucleic acid amplification test) for discordant results. The aim of this study was to evaluate the effectiveness of a two-step algorithm using an immunochromatographic test followed of a polymerase chain reaction (PCR).
METHODS
The specimens have been tested according to the following schedule: 1) Step one: All samples were tested for detection of glutamate dehydrogenase antigen (GDH) and toxin A/B using the C. diff QUIK CHEK Complete test. All GDH and toxins positive results were considered CD positives; 2) Step two: When the results were discrepant (only GDH+ or toxins+), the samples were confirmed using the PCR test BD MAX Cdiff. All PCR positive results were considered CD positives.
RESULTS
A total of 2,138 specimens were initially tested. 139 were positive for GDH and toxins. 160 discrepant results (148 GDH+ and 12 toxins+) were tested by PCR, 117 were positive (107/148 GDH+ and 10/12 toxins+).
CONCLUSIONS
The implementation of a PCR method showed an increase de 117 positive results (73.1% of discrepant). Considering the sensitivity of C.diff QUIK CHEK (instructions of manufacturer), the GDH discrepant results may be false negatives, y the samples PCR and toxins positives may be real positives results.
Topics: Bacterial Proteins; Bacterial Toxins; Clostridioides; Clostridioides difficile; Clostridium Infections; Enterotoxins; Feces; Glutamate Dehydrogenase; Humans; Polymerase Chain Reaction; Sensitivity and Specificity
PubMed: 33601876
DOI: 10.37201/req/010.2020 -
Cureus Jun 2023Prostate adenocarcinoma is the second-most common cause of cancer. Globally, many cancer-related deaths among men were noted due to prostate adenocarcinoma. CD44 plays...
INTRODUCTION
Prostate adenocarcinoma is the second-most common cause of cancer. Globally, many cancer-related deaths among men were noted due to prostate adenocarcinoma. CD44 plays a key role in mediating cell-to-cell and cell-to-matrix interaction, which further helps to maintain the integrity of tissue and also inhibits tumor metastasis.
MATERIALS AND METHODS
Cross-sectional study was done on chips from transurethral resections of the prostate (TURP) and prostatic core biopsy specimens. All specimens with clinically diagnosed and histopathologically confirmed prostatic adenocarcinoma were included in the study. Prostatic intraepithelial neoplasia (PIN), recurrent cases, and patients who had undergone radiotherapy/ chemotherapy prior to biopsy were excluded from the study. The sample size for the current study was 57 with an 8% prevalence value, 95% confidence interval, and 8% absolute error. Immunoreaction to CD44 antibody is membranous and was evaluated by calculating positively stained cell percentage and staining intensity. These two parameters were added to obtain a final score; a score of 0-3 was considered as negative, and a score of 4-6 was regarded as positive.
RESULTS
A statistically significant difference was only found between Gleason grade (p<0.001), clinical staging (p<0.002), nodal metastasis (p<0.015), and distant metastasis (p<0.020) with CD44 positive expression. The rest of the parameters like PSA (p=0.642) and age (p=0.051) did not correlate with CD44-positive expression. Out of 29 cases with positive CD44 expression, 100% positivity was seen in Gleason's grades 1, 2, and 3. This indicates that CD44 expression showed lesser positivity in poorly differentiated carcinoma. CD44 positivity was seen in 83.3% in the T2 stage. An inverse relationship between tumor staging and CD44 expression was observed with positive CD44 expression in lower tumor staging which implies loss of CD44 expression was associated with greater tumor aggressiveness. Lymph node metastasis cases showed more negative CD44 expression (59.5%) and the same was noted in patients without distant metastasis, that is in 61% of the subjects. Conclusion: Cells tend to lose the ability of CD44 expression as they progress from well-differentiated adenocarcinoma to poorly differentiated adenocarcinoma. CD44 expression suggests that the tumor is in a well-differentiated and gland-forming state as compared to Gleason's grade. Loss of CD44 expression suggests tumor aggressiveness. Thus, the upregulation of CD44 expression can be considered as a potential target for targeted therapy. As many targeted and gene therapies are in clinical trials, large-scale multicentered studies are needed for a better understanding of the clinical course of the disease.
PubMed: 37461792
DOI: 10.7759/cureus.40510