Rapid On-Site Cytologic Evaluation: A Feasibility Study Using Ancillary Interventional Pulmonary Personnel

Respiration ◽  
2021 ◽  
pp. 1-6
Author(s):  
Roshen Mathew ◽  
Nikhil Meena ◽  
Winnie Elma Roy ◽  
Chien Chen ◽  
Maggie Macchiraella ◽  
...  
Keyword(s):  
Adrenal Gland ◽  
Standard Error ◽  
Health Professionals ◽  
Proof Of Concept ◽  
Left Adrenal Gland ◽  
Respiratory Therapist ◽  
Asymptotic Standard Error ◽  
Individual Site ◽  
Training Interval ◽  
High Level

<b><i>Background:</i></b> Ancillary health professionals helping in a procedural service is a common practice everywhere. <b><i>Objectives:</i></b> This was a proof-of-concept study to assess feasibility of using ancillary personnel for rapid on-site cytologic evaluation (ROSE) at interventional pulmonary procedures. <b><i>Methods:</i></b> After a training interval, a respiratory therapist (RT) performed ROSE on consecutive interventional pulmonary specimens. Sample sites included lymph nodes, lung, liver, and the left adrenal gland. RT findings were subsequently correlated with blinded cytopathology-performed ROSE and with final histopathology results, with primary foci of adequacy and the presence or absence of malignancy. <b><i>Results:</i></b> Seventy consecutive cases involved 163 separate sites for ROSE analysis. <b><i>Adequacy:</i></b> There was a high level of concordance between RT-performed ROSE (RT-ROSE) and cytopathology ROSE (CYTO-ROSE). They agreed upon the adequacy of 159 specimens. The Cohen’s κ coefficient ± asymptotic standard error (ASE) was 0.74 ± 0.175, with <i>p</i> &#x3c; 0.0001. <b><i>Malignancy:</i></b> RT-ROSE concurred highly with CYTO-ROSE, with agreement on 150 (92%) of the 163 specimens. Cohen’s κ coefficient ± ASE was 0.83 ± 0.045, with <i>p</i> &#x3c; 0.0001. When the comparison was for malignancy by case rather than individual site, Cohen’s κ coefficient ± ASE was 0.68 ± 0.08, with <i>p</i> &#x3c; 0.0001. <b><i>Conclusion:</i></b> This study demonstrates that ancillary personnel supporting an interventional pulmonary service can be trained to perform initial ROSE. Cytopathology can be called after sampling and staining have produced adequate samples. This setup streamlines ROSE evaluation with regard to time and cost.

scholarly journals The relationship between time to a high COVID-19 response level and timing of peak daily incidence: an analysis of governments’ Stringency Index from 148 countries

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Yan Ma ◽  
Shiva Raj Mishra ◽  
Xi-Kun Han ◽  
Dong-Shan Zhu
Keyword(s):  
Standard Error ◽  
Daily Basis ◽  
Linear Regression Models ◽  
Response Level ◽  
Peak Number ◽  
Epidemic Curve ◽  
Government Response ◽  
Early Arrival ◽  
High Level ◽  
The Relationship

Abstract Background The transmission dynamics and severity of coronavirus disease 2019 (COVID-19) pandemic is different across countries or regions. Differences in governments’ policy responses may explain some of these differences. We aimed to compare worldwide government responses to the spread of COVID-19, to examine the relationship between response level, response timing and the epidemic trajectory. Methods Free publicly-accessible data collected by the Coronavirus Government Response Tracker (OxCGRT) were used. Nine sub-indicators reflecting government response from 148 countries were collected systematically from January 1 to May 1, 2020. The sub-indicators were scored and were aggregated into a common Stringency Index (SI, a value between 0 and 100) that reflects the overall stringency of the government’s response in a daily basis. Group-based trajectory modelling method was used to identify trajectories of SI. Multivariable linear regression models were used to analyse the association between time to reach a high-level SI and time to the peak number of daily new cases. Results Our results identified four trajectories of response in the spread of COVID-19 based on when the response was initiated: before January 13, from January 13 to February 12, from February 12 to March 11, and the last stage—from March 11 (the day WHO declared a pandemic of COVID-19) on going. Governments’ responses were upgraded with further spread of COVID-19 but varied substantially across countries. After the adjustment of SI level, geographical region and initiation stages, each day earlier to a high SI level (SI > 80) from the start of response was associated with 0.44 (standard error: 0.08, P < 0.001, R2 = 0.65) days earlier to the peak number of daily new case. Also, each day earlier to a high SI level from the date of first reported case was associated with 0.65 (standard error: 0.08, P < 0.001, R2 = 0.42) days earlier to the peak number of daily new case. Conclusions Early start of a high-level response to COVID-19 is associated with early arrival of the peak number of daily new cases. This may help to reduce the delays in flattening the epidemic curve to the low spread level. Graphic abstract

scholarly journals Using Participatory Design to Design an eHealth Well-Being Program

2021 ◽  
Vol 18 (14) ◽  
pp. 7250
Author(s):  
Yannick van Hierden ◽  
Timo Dietrich ◽  
Sharyn Rundle-Thiele
Keyword(s):  
Best Practices ◽  
Health Professionals ◽  
Participatory Design ◽  
Online Community ◽  
Well Being ◽  
Proof Of Concept ◽  
End User ◽  
Ehealth Intervention ◽  
Pilot Intervention ◽  
User Friendly

In recent years, the relevance of eHealth interventions has become increasingly evident. However, a sequential procedural application to cocreating eHealth interventions is currently lacking. This paper demonstrates the implementation of a participatory design (PD) process to inform the design of an eHealth intervention aiming to enhance well-being. PD sessions were conducted with 57 people across four sessions. Within PD sessions participants experienced prototype activities, provided feedback and designed program interventions. A 5-week eHealth well-being intervention focusing on lifestyle, habits, physical activity, and meditation was proposed. The program is suggested to be delivered through online workshops and online community interaction. A five-step PD process emerged; namely, (1) collecting best practices, (2) participatory discovery, (3) initial proof-of-concept, (4) participatory prototyping, and (5) pilot intervention proof-of-concept finalisation. Health professionals, behaviour change practitioners and program planners can adopt this process to ensure end-user cocreation using the five-step process. The five-step PD process may help to create user-friendly programs.

Effective Therapy of Insulinoma by Using Long-Acting Somatostatin Analogue. A Case Report and Literature Review

2011 ◽  
Vol 120 (02) ◽  
pp. 68-72 ◽  
Author(s):  
A. Jawiarczyk ◽  
M. Bolanowski ◽  
J. Syrycka ◽  
G. Bednarek-Tupikowska ◽  
M. Kałużny ◽  
...  
Keyword(s):  
Adrenal Gland ◽  
Somatostatin Receptors ◽  
Subcutaneous Administration ◽  
Pancreatic Neuroendocrine Tumor ◽  
Somatostatin Analogue ◽  
Left Adrenal Gland ◽  
Glucose Levels ◽  
Long Acting ◽  
The Right

AbstractWe are reporting a case of 68-year-old woman with insulinoma, after a non-successful tumor surgery and a long-term diazoxide treatment. She had a lot of hypoglycemia cases, and a weight gain of 50 kg. An abdominal CT scan demonstrated a tumor 28 mm in the diameter, in the head of the pancreas. The patient did not agree for the repeated insulinoma surgery. Furthermore, we found a lesion in the left adrenal gland (14 mm in the diameter) and in the right lung (8 mm in the diameter). Pheochromocytoma was diagnosed on the basis of hypertension, elevated levels of normetanephrine in the 24-h urine collection, and an elevated level of norepinephrine in a plasma sample. After the left adrenal gland removal we observed lower blood pressure. Since we had revealed the presence of somatostatin receptors by the somatostatin receptors scintigraphy, we decided to control hypoglycemia by a monthly subcutaneous administration of the long-acting lanreotide. Because of higher glucose levels (300–400 mg/dl) we started an intense insulin therapy. Nowadays, the patient feels better, she has lost 20 kg of her body weight, and we have observed normal blood glucose levels during the long-term lanreotide treatment. We have noticed neither side effects nor hypoglycemic episodes and we have reduced the dose of insulin. The presented case can be an evidence of the effective treatment of the pancreatic neuroendocrine tumor of insulinoma type, with somatostatin analogue.

scholarly journals Planning the Design and Execution of Student Performance Assessment in Serious Games

2021 ◽  
Vol 12 (1) ◽  
pp. 172-190
Author(s):  
Rháleff N. R. Oliveira ◽  
Rafaela V. Rocha ◽  
Denise H. Goya
Keyword(s):  
Performance Assessment ◽  
Student Performance ◽  
Serious Games ◽  
Proof Of Concept ◽  
Personalized Feedback ◽  
Student’S Performance ◽  
Good Internal Consistency ◽  
Learning Measurement ◽  
High Level

Serious Games (SGs) are used to support knowledge acquisition and skill development. For this, there is a need to measure the results achieved (both during and after students play) to ensure the game effectiveness. In this context, the aim is to develop and evaluate the AvaliaJS, a conceptual model to structure, guide and support the planning of the design and execution of the student's performance assessment in SGs. AvaliaJS has two artifacts: a canvas model, for high-level planning, and an assessment project document, for more detailed specifications of the canvas. To analyze and exemplify the use of the model, the artifacts were applied to three ready-made games as a proof of concept. In addition, the quality of AvaliaJS was evaluated by experts in SGs development and assessment using a questionnaire. The results of experts' answers confirm a good internal consistency (Cronbach's alpha α = 0.87) which indicates that AvaliaJS is correct, authentic, consistent, clear, unambiguous and flexible. However, the model will need to be validated during the process of creating a new game to ensure its usability and efficiency. In general, AvaliaJS can be used to support the team in the planning, documentation and development of artifacts and data collection in SGs, as well as in the execution of the assessment, learning measurement and constant and personalized feedback for students.

scholarly journals Development of an IoT System for Environmental Monitoring: Software

2021 ◽  
Author(s):  
Benjamin Secker
Keyword(s):  
Environmental Monitoring ◽  
Low Cost ◽  
Proof Of Concept ◽  
Embedded Devices ◽  
Data Loggers ◽  
Environmental Monitoring System ◽  
Use Of The Internet ◽  
High Level ◽  
Monitoring Software ◽  
The Internet Of Things

Use of the Internet of Things (IoT) is poised to be the next big advancement in environmental monitoring. We present the high-level software side of a proof-of-concept that demonstrates an end-to-end environmental monitoring system,<br><div>replacing Greater Wellington Regional Council’s expensive data loggers with low-cost, IoT centric embedded devices, and it’s supporting cloud platform. The proof-of-concept includes a Micropython-based software stack running on an ESP32 microcontroller. The device software includes a built-in webserver that hosts a responsive Web App for configuration of the device. Telemetry data is sent over Vodafone’s NB-IoT network and stored in Azure IoT Central, where it can be visualised and exported.</div><br>While future development is required for a production-ready system, the proof-of-concept justifies the use of modern IoT technologies for environmental monitoring. The open source nature of the project means that the knowledge gained can be re-used and modified to suit the use-cases for other organisations.

scholarly journals Shock vasopléjico luego de la resección de un fecromocitoma: el rol del azul de metileno

2021 ◽  
Author(s):  
Ramos Matías ◽  
Fratebianchi Franco ◽  
Verlangieri Stella
Keyword(s):  
Methylene Blue ◽  
Drug Therapy ◽  
Adrenal Gland ◽  
Adrenergic System ◽  
Left Adrenal Gland ◽  
Alternative Drug

We present a case of a patient with hypotension refractory to the administration of norepinephrine after laparoscopic pheochromocytoma resection in the left adrenal gland. We describe the use of methylene blue as an alternative drug therapy to the adrenergic system, as well as associated doses, contraindications and complications.

BECKWITH'S SYNDROME WITH EXTREME ORGAN HYPERPLASIA

PEDIATRICS ◽  
1973 ◽  
Vol 52 (3) ◽  
pp. 372-381
Author(s):  
Thomas F. Roe ◽  
Ann K. Kershnar ◽  
Jordan J. Weitzman ◽  
Luis Salinas Madrigal
Keyword(s):  
Adrenal Gland ◽  
Abdominal Mass ◽  
Severe Hypoglycemia ◽  
Immunoreactive Insulin ◽  
Left Adrenal Gland ◽  
Adrenal Steroid ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Pedunculated Tumor ◽  
The Right

A large newborn infant with hemihypertrophy, omphalocele, hepatomegaly, left upper quadrant abdominal mass, and zoster-like skin rash had severe hypoglycemia at 4 hours of age. Serum immunoreactive insulin levels were markedly elevated. Hypoglycemia was not controlled by vigorous medical therapy but blood glucose levels returned toward normal following subtotal excision of the markedly hyperplastic pancreas at 24 days of age. At 4½ months of age, a right upper quadrant abdominal mass was noted and urinary adrenal steroid levels were elevated. The right adrenal gland was found to be markedly hyperplastic and it was removed; the left adrenal gland was slightly hyperplastic. Between the ages of 5 and 8 months the umbilical stump enlarged progressively forming a large pedunculated tumor which was removed. This patient presents an unusually severe example of Beckwith's syndrome with both prenatal and postnatal organ overgrowth, severe hypoglycemia and hyperinsulinism.

A CASE OF MYELOLIPOMA OF THE LEFT ADRENAL GLAND ASSOCIATED WITH SUBCLINICAL CUSHING SYNDROME

1999 ◽  
Vol 60 (9) ◽  
pp. 2448-2452 ◽  
Author(s):  
Akiko TACHIMORI ◽  
Tetsuro ISHIKAWA ◽  
Naoyoshi ONODA ◽  
Naoto KITAHARA ◽  
Yoshinari OGAWA ◽  
...  
Keyword(s):  
Adrenal Gland ◽  
Cushing Syndrome ◽  
Left Adrenal Gland ◽  
Subclinical Cushing Syndrome ◽  
Subclinical Cushing
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