Lung MRI with hyperpolarised gases: current & future clinical perspectives

The use of pulmonary MRI in a clinical setting has historically been limited. Whilst CT remains the gold-standard for structural lung imaging in many clinical indications, technical developments in ultrashort and zero echo time MRI techniques are beginning to help realise non-ionising structural imaging in certain lung disorders. In this invited review, we discuss a complementary technique – hyperpolarised (HP) gas MRI with inhaled 3He and 129Xe – a method for functional and microstructural imaging of the lung that has great potential as a clinical tool for early detection and improved understanding of pathophysiology in many lung diseases. HP gas MRI now has the potential to make an impact on clinical management by enabling safe, sensitive monitoring of disease progression and response to therapy. With reference to the significant evidence base gathered over the last two decades, we review HP gas MRI studies in patients with a range of pulmonary disorders, including COPD/emphysema, asthma, cystic fibrosis, and interstitial lung disease. We provide several examples of our experience in Sheffield of using these techniques in a diagnostic clinical setting in challenging adult and paediatric lung diseases.

Download Full-text

Limits and Opportunities of SARS-CoV-2 Antigen Rapid Tests: An Experienced-Based Perspective

Pathogens ◽

10.3390/pathogens10010038 ◽

2021 ◽

Vol 10 (1) ◽

pp. 38

Author(s):

Verena Schildgen ◽

Sabrina Demuth ◽

Jessica Lüsebrink ◽

Oliver Schildgen

Keyword(s):

Clinical Setting ◽

Gold Standard ◽

Antigen Test ◽

Public Attention ◽

High Expectations ◽

Test Strategy ◽

Rapid Tests ◽

Pilot Sample ◽

Lateral Flow Tests ◽

Throat Washing

Background: Due to the steadily rising case numbers of SARS-CoV-2 infections worldwide, there is an increasing need for reliable rapid diagnostic devices in addition to existing gold standard PCR methods. Actually, public attention is focused on antigen assays including lateral flow tests (LFTs) as a diagnostic alternative. Therefore, different LFTs were analyzed regarding their performance in a clinical setting. Material and Methods: A pilot sample panel of 13 bronchoalveolar fluids (BALFs) and 60 throat washing (TW) samples with confirmed PCR results, as well as eight throat washes invalid by PCR, were tested with the BIOCREDIT test (RapiGEN), the PanbioTM assay (Abbott), and the SARS-CoV-2 rapid antigen test (Roche). Conclusion: The analyzed antigen test showed an interassay correlation of 27.4%, with overall specificities ranging from 19.4% to 87.1%, while sensitivities of the respective tests ranged between 33.3% and 88.1%. Because these assays did not entirely meet all high expectations, their benefit has to be carefully evaluated for the respective test strategy and setting.

Download Full-text

Assessing Parent Behaviours in Parent–Child Interactions with Deaf and Hard of Hearing Infants Aged 0–3 Years: A Systematic Review

Journal of Clinical Medicine ◽

10.3390/jcm10153345 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3345

Author(s):

Martina Curtin ◽

Evelien Dirks ◽

Madeline Cruice ◽

Rosalind Herman ◽

Lauren Newman ◽

...

Keyword(s):

Systematic Review ◽

Assessment Tool ◽

Child Language ◽

Evidence Base ◽

Deaf Children ◽

Clinical Tool ◽

Coding Systems ◽

Child Interaction ◽

Parent Child Interaction ◽

Parent Child

Background: Despite early identification and advancements in cochlear implant and hearing aid technology, delays in language skills in deaf children continue to exist. Good-quality parent–child interaction (PCI) is a key predictor for the successful development of deaf children’s signed and/or spoken language. Though professionals have standard assessments to monitor child language, a clinical tool to observe the quality of parental interaction is yet to be developed. Aims and methods: This systematic review with narrative synthesis aims to uncover which parent behaviours are assessed in PCI studies with deaf infants aged 0–3 years, how these behaviours are assessed, and which are correlated with higher scores in child language. Results: Sixty-one papers were included, spanning 40 years of research. Research included in the review assessed parents’ skills in gaining attention, joint engagement, emotional sensitivity, and language input. PCI was mostly assessed using coding systems and frame-by-frame video analysis. Some of the parent behaviours mentioned previously are associated with more words produced by deaf children. Conclusion: The results of the review provide the evidence base required to develop the content of a future clinical assessment tool for parent–child interaction in deafness.

Download Full-text

Lung Ultrasound Imaging, a Technical Review

Applied Sciences ◽

10.3390/app10020462 ◽

2020 ◽

Vol 10 (2) ◽

pp. 462 ◽

Cited By ~ 7

Author(s):

Libertario Demi ◽

Thomas Egan ◽

Marie Muller

Keyword(s):

Ultrasound Imaging ◽

Lung Diseases ◽

Lung Ultrasound ◽

Historical Overview ◽

Ultrasound Method ◽

Technical Review ◽

Technical Developments ◽

Potential Benefits ◽

Physical Phenomena

Lung ultrasound (LUS) is a growing and fascinating field of application for ultrasound imaging. Despite the difficulties in imaging an organ largely filled with air, the potential benefits originating from an effective ultrasound method focusing on monitoring and diagnosing lung diseases represent a tremendous stimulus for research in this direction. This paper presents a technical review where, after a brief historical overview, the current limitations of LUS imaging are discussed together with a description of the physical phenomena at stake. Next, the paper focuses on the latest technical developments of LUS.

Download Full-text

A Mini-Review on Functional Near-Infrared Spectroscopy (fNIRS): Where Do We Stand, and Where Should We Go?

Photonics ◽

10.3390/photonics6030087 ◽

2019 ◽

Vol 6 (3) ◽

pp. 87 ◽

Cited By ~ 24

Author(s):

Quaresima ◽

Ferrari

Keyword(s):

Infrared Spectroscopy ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Functional Neuroimaging ◽

Wide Spectrum ◽

Sport Performance ◽

Cortical Activation ◽

Clinical Tool ◽

Functional Near Infrared Spectroscopy ◽

Technical Developments

This mini-review is aimed at briefly summarizing the present status of functional near-infrared spectroscopy (fNIRS) and predicting where the technique should go in the next decade. This mini-review quotes 33 articles on the different fNIRS basics and technical developments and 44 reviews on the fNIRS applications published in the last eight years. The huge number of review articles about a wide spectrum of topics in the field of cognitive and social sciences, functional neuroimaging research, and medicine testifies to the maturity achieved by this non-invasive optical vascular-based functional neuroimaging technique. Today, fNIRS has started to be utilized on healthy subjects while moving freely in different naturalistic settings. Further instrumental developments are expected to be done in the near future to fully satisfy this latter important aspect. In addition, fNIRS procedures, including correction methods for the strong extracranial interferences, need to be standardized before using fNIRS as a clinical tool in individual patients. New research avenues such as interactive neurosciences, cortical activation modulated by different type of sport performance, and cortical activation during neurofeedback training are highlighted.

Download Full-text

THUR 071 Towards an integrated tool for pnes assessment

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2018-abn.29 ◽

2018 ◽

Vol 89 (10) ◽

pp. A8.2-A8

Author(s):

d’Ersu Eleanor ◽

Al-Mayhani Talal ◽

Sidhu Meneka

Keyword(s):

Clinical Practice ◽

Conversation Analysis ◽

Gold Standard ◽

Reliability And Validity ◽

Epileptic Seizures ◽

List Type ◽

Clinical Tool ◽

Medical Assessment ◽

Diagnostic Challenge ◽

Autonomic Activation

IntroductionPsychogenic non-epileptic seizures (PNES) can present a real diagnostic challenge, with subsequent impact on the course of the disorder and its management. A number of studies have looked into predictive factors for PNES. However, no guidance is available for applying the findings of these studies in clinical practice.AimThe aim is to combine the most recognised discriminative features into an integrated clinical tool, ultimately, to improve the predictive value of the medical assessment of patients with possible PNES in a clinic setting. This can be invaluable in centres with limited access to video telemetry (VT).MethodsThe following criteria were employed and compared with the results of VT as gold standard:Patient comorbiditiesConversation analysisReview of system questionnaireIctal semiology and autonomic activationPostictal prolactin and lactateResults and conclusionThis QIP will assess the reliability and validity of various criteria in recognising PNES clinically. Based on our findings, an integrated tool will then be designed as an adjunct to the standard medical assessment in settings where VT is not readily available.

Download Full-text

The Effect of Silver Nanofibers on the Deformation Properties of Blood Vessels: Towards the Development of New Nanotechnologies to Prevent Rupture of Aneurysms

Journal of Nanomaterials ◽

10.1155/2014/853120 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Miguel Gonzalez ◽

Daniel Rivera ◽

Alam Marcelino ◽

Gabriela Agront ◽

Rafael Rodriguez ◽

...

Keyword(s):

Blood Pressure ◽

Blood Vessel ◽

Mechanical Stress ◽

Blood Vessels ◽

Human Body ◽

Clinical Setting ◽

Failure Strength ◽

Clinical Tool ◽

Deformation Properties ◽

Clinically Significant

An aneurysm is the result of a widening or ballooning of a portion of a blood vessel. The rupture of an aneurysm occurs when the mechanical stress acting on the inner wall exceeds the failure strength of the blood vessel. We propose an innovative approach to prevent the rupture of an aneurysm based on the use of nanotechnology to improve the strength of the blood vessel. We present results on the effect of silver nanofibers on the resistance toward deformation of blood vessels. The silver nanofibers are grown on the surface of the blood vessels. The nanofibers are120±30 nm in diameter and2.7±0.8 μm in length. The deformation per applied force of blood vessels was found to decrease from 0.15 m/N in control blood vessels to 0.003 m/N in blood vessels treated with the nanofibers. This represents an increase in the resistance towards deformation of a factor of 50. The increase in the resistance towards deformation is clinically significant since blood pressure increases by factors slightly larger than one in the human body. Treatment of blood vessels with silver nanofibers is a potential translational clinical tool for preventing rupture of aneurysms in a clinical setting.

Download Full-text

The Strategy and Advantage in Use of an Electronic Probe for Attachment Measurement

Advances in Dental Research ◽

10.1177/08959374930070020501 ◽

1993 ◽

Vol 7 (2) ◽

pp. 152-157 ◽

Cited By ~ 14

Author(s):

W.B. Clark ◽

I. Magnusson ◽

Y.Y. Namgung ◽

M.C.K. Yang

Keyword(s):

Clinical Setting ◽

Gold Standard ◽

Large Error ◽

Gingival Tissue ◽

Time Interval ◽

Error Sources ◽

Designed Experiments ◽

Electronic Probe ◽

Periodontal Probing ◽

Attachment Level

Attachment level has been used as the "gold standard" for assessment of the progression of periodontal disease. However, the measurement of attachment level by periodontal probing can be subject to a large number of error sources. Recently, we have designed experiments by using an electronic probe to identify the magnitude of error components due to the instrument, gingival tissue condition, position or probing angle, and time interval between replicate probings. Even with a very careful clinical setting, a few percent of uncontrollable large errors or outliers could not be avoided. A previously used 'option-3' probing scheme to reduce the unexpected large error is justified from the mathematical viewpoint.

Download Full-text

Virtual reality as a clinical tool in mental health research and practice

Dialogues in Clinical Neuroscience ◽

10.31887/dcns.2020.22.2/lvalmaggia ◽

2020 ◽

Vol 22 (2) ◽

pp. 169-177 ◽

Cited By ~ 2

Keyword(s):

Mental Health ◽

Virtual Reality ◽

Virtual Worlds ◽

Ecological Validity ◽

Evidence Base ◽

Mental Health Research ◽

Clinical Settings ◽

Clinical Tool ◽

Ethical Implications ◽

Controlled Environments

Virtual reality (VR) is a potentially powerful technology for enhancing assessment in mental health. At any time or place, individuals can be transported into immersive and interactive virtual worlds that are fully controlled by the researcher or clinician. This capability is central to recent interest in how VR might be harnessed in both treatment and assessment of mental health conditions. The current review provides a summary of the advantages of using VR for assessment in mental health, focusing on increasing ecological validity of highly controlled environments, enhancing personalization and engagement, and capturing real-time, automated data in real-world contexts. Considerations for the implementation of VR in research and clinical settings are discussed, including current issues with cost and access, developing evidence base, technical challenges, and ethical implications. The opportunities and challenges of VR are important to understand as researchers and clinicians look to harness this technology to improve mental health outcomes.

Download Full-text

CORRELATION BETWEEN WDF, WNR, AND RET ABNORMAL SCATTERGRAM DETECTED BY SYSMEX XN-1000 AND PARASITEMIA OF MALARIA PATIENTS IN MERAUKE HOSPITAL

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v26i1.1521 ◽

2019 ◽

Vol 26 (1) ◽

pp. 91

Author(s):

Merylin Ranoko ◽

Aryati Aryati ◽

Arifoel Hajat

Keyword(s):

General Hospital ◽

Health Problem ◽

Gold Standard ◽

Blood Count ◽

Complete Blood Count ◽

Cross Sectional Study ◽

Response To Therapy ◽

Sectional Study ◽

Cross Sectional ◽

Degree Of Severity

Malaria remains a health problem in Indonesia. Microscopic examination with Giemsa staining is the gold standard for diagnosing malaria. The density of parasites correlates with the degree of severity and response to therapy of malaria. Malaria-causing plasmodium can be detected by Sysmex XN-1000 which is marked by abnormalities in the WDF, WNR and RET scattergram. This research aimed to determine the correlation of WDF, WNR and RET abnormal scattergram detected by Sysmex XN-1000 and the parasitemia index of malaria at the Merauke General Hospital. This was a cross-sectional study with observational approach conducted between November 2017 – February 2018 at the Merauke General Hospital. Positive malaria samples were stained with Giemsa, their parasitemia index was calculated, routine complete blood count using Sysmex XN-1000 was performed, and the scattergram abnormalities were then analyzed. There were 65 positive malaria samples as follows: P.falciparum (35%), P.vivax (60%), P.ovale (3.1%), and P.malariae (1.5%), but the species did not correlate with parasitemic index (p=0.691). Abnormalities of WDF and WNR scattergram were predominantly found than RET scattergram (80% vs. 27.7%). P.vivax predominantly caused abnormalities of the WDF and WNR scattergram in 36 of 39 samples (92.3%), whereas P.falciparum predominantly caused abnomalities of the RET scattergram in 14 of 23 samples (60.9%). There was 95% positivity of an abnormality in WDF/WNR/RET scattergram with a cut-off of > 5,0165.5/µL. There was correlation between WDF, WNR, RET scattergram detected by Sysmex XN-1000 and the parasitemia index.

Download Full-text

Integrated Care Search: Development and validation of a PubMed search filter for retrieving the integrated care research evidence

10.21203/rs.2.16850/v3 ◽

2020 ◽

Author(s):

Raechel A. Damarell ◽

Suzanne Lewis ◽

Camilla Trenerry ◽

Jennifer J. Tieman

Keyword(s):

Integrated Care ◽

Gold Standard ◽

Research Evidence ◽

Evidence Base ◽

Standard Test ◽

Advisory Group ◽

Search Filter ◽

Filter Performance ◽

Search Filters ◽

Development And Validation

Abstract Background Integrated care is an increasingly important principle for organising healthcare. Integrated care models show promise in reducing resource wastage and service fragmentation whilst improving the accessibility, patient-centredness and quality of care for patients. Those needing reliable access to the growing research evidence base for integrated care can be frustrated by search challenges reflective of the topic's complexity. The aim of this study is to report the empirical development and validation of two search filters for rapid and effective retrieval of integrated care evidence in PubMed. One filter is optimised for recall and the other for precision.Methods An Expert Advisory Group comprising international integrated care experts guided the study. A gold standard test set of citations was formed from screening Handbook Integrated Care chapter references for relevance. This set was divided into a Term Identification Set (20%) for determining candidate terms using frequency analysis; a Filter Development Set (40%) for testing performance of term combinations; and a Filter Validation Set (40%) reserved for confirming final filter performance. In developing the high recall filter, recall was steadily increased while maintaining precision at ≥ 50%. Similarly, the high precision filter sought to maximise precision while keeping recall ≥ 50%. For each term combination tested, an approximation of precision was obtained by reviewing the first 100 citations retrieved in Medline for relevance.Results The gold standard set comprised 534 citations. The search filter optimised for recall ('Broad Integrated Care Search') achieved 86.0%-88.3% recall with corresponding low precision (47%-53%). The search filter optimised for precise searching ('Narrow Integrated Care Search') demonstrated precision of 73%-95% with recall reduced to between 55.9% and 59.8%. These filters are now available as one-click URL hyperlinks in the website of International Foundation for Integrated Care.Conclusions The Broad and Narrow Integrated Care Search filters provide potential users, such as policy makers and researchers, seamless, reliable and ongoing access to integrated care evidence for decision making. These filters were developed according to a rigorous and transparent methodology designed to circumvent the challenges of information retrieval posed by this complex, multifaceted topic.

Download Full-text