Evaluation of Digital Drawing Tests and Paper-and-Pencil Drawing Tests for the Screening of Mild Cognitive Impairment and Dementia: A Systematic Review and Meta-analysis of Diagnostic Studies

Digital drawing tests have been proposed for cognitive screening over the past decade. However, the diagnostic performance is still to clarify. The objective of this study was to evaluate the diagnostic performance among different types of digital and paper-and-pencil drawing tests in the screening of mild cognitive impairment (MCI) and dementia. Diagnostic studies evaluating digital or paper-and-pencil drawing tests for the screening of MCI or dementia were identified from OVID databases, included Embase, MEDLINE, CINAHL, and PsycINFO. Studies evaluated any type of drawing tests for the screening of MCI or dementia and compared with healthy controls. This study was performed according to PRISMA and the guidelines proposed by the Cochrane Diagnostic Test Accuracy Working Group. A bivariate random-effects model was used to compare the diagnostic performance of these drawing tests and presented with a summary receiver-operating characteristic curve. The primary outcome was the diagnostic performance of clock drawing test (CDT). Other types of drawing tests were the secondary outcomes. A total of 90 studies with 22,567 participants were included. In the screening of MCI, the pooled sensitivity and specificity of the digital CDT was 0.86 (95% CI = 0.75 to 0.92) and 0.92 (95% CI = 0.69 to 0.98), respectively. For the paper-and-pencil CDT, the pooled sensitivity and specificity of brief scoring method was 0.63 (95% CI = 0.49 to 0.75) and 0.77 (95% CI = 0.68 to 0.84), and detailed scoring method was 0.63 (95% CI = 0.56 to 0.71) and 0.72 (95% CI = 0.65 to 0.78). In the screening of dementia, the pooled sensitivity and specificity of the digital CDT was 0.83 (95% CI = 0.72 to 0.90) and 0.87 (95% CI = 0.79 to 0.92). The performances of the digital and paper-and-pencil pentagon drawing tests were comparable in the screening of dementia. The digital CDT demonstrated better diagnostic performance than paper-and-pencil CDT for MCI. Other types of digital drawing tests showed comparable performance with paper-and-pencil formats. Therefore, digital drawing tests can be used as an alternative tool for the screening of MCI and dementia.

STAndard Reporting of CAries Detection and Diagnostic Studies (STARCARDDS)

Aim The aim of this paper is to present recommendations from an international workshop which evaluated the methodology and reporting of caries diagnostic studies. As a unique feature, this type of studies is focused on caries lesion detection and assessment, and many of them are carried out in vitro, because of the possibility of histological validation of the whole caries spectrum. This feature is not well covered in the existing reporting STARD guideline within the EQUATOR Network. Participants and methods An international working group of 13 cariology researchers was formed. The STARD checklist was reviewed and modified for caries detection and diagnosis purposes, in a three-step process of evaluation, consensual modification, and delivery during three 2-day workshops over 18 months. Special attention was paid to reporting requirements of caries studies that solely focus on reliability. Results The STARD checklist was modified in 14/30 items, with an emphasis on issues of sample selection (tooth selection in in vitro studies), blinding, and detailed reporting of results. Conclusion Following STARCARDDS (STAndard Reporting of CAries Detection and Diagnostic Studies) is expected to result in complete reporting of study design and methodology in future caries diagnosis and detection experiments both in vivo and in vitro, thus allowing for better comparability of studies and higher quality of systematic reviews. Clinical relevance Standardization of caries diagnostic studies leads to a better comparability among future studies, both in vivo and in vitro.

Analysis of the episootic situation of cattle leukemia in the Siberian Federal District

The analysis of the epizootic situation of cattle leukemia in the Siberian Federal District as a whole and in individual regions of the district is given. The study was carried out in the Republics of Altai, Tuva and Khakassia, in the Altai and Krasnoyarsk Territories and in five regions: Irkutsk, Kemerovo, Novosibirsk, Omsk and Tomsk. The materials of diagnostic studies obtained by veterinary specialists of the Siberian Federal District for 2017-2019 are presented. This information has been analyzed and summarized both for the Siberian Federal District as a whole and for its individual constituent entities. Studies show the spread of bovine leukemia virus infection in the whole district. A tense epizootic situation with cattle leukemia was noted, since the Siberian Federal District ranks second in Russia in terms of the number of adverse locations (322). However, compared to 2017, the number of adverse locations in 2019 decreased by 57, sick animals - by 977 heads, infected animals - by 70836 heads. The number of adverse locations has decreased slightly, while the number of infected animals in some regions has increased. As of January 1, 2020, no hematologically sick animals were found in the Republics of Altai, Khakassia, Buryatia and Tuva, but the number of animals infected with BLV increased. The experience of individual regions of the country that are free from BLV infection (Sverdlovsk, Vologda, Leningrad, Murmansk, Arkhangelsk, Kostroma, Kirov regions, Khanty-Mansi Autonomous District, etc.) shows that bovine leukemia is an infection that can be controlled. It is possible to eliminate the disease in herds of cattle with any level of BLV infection as a result of carrying out complex health-improving measures, as well as organizational and veterinary-sanitary measures with the obligatory removal of sick and BLV infected animals from the herd.

ANATOMICAL STUDY OF THE POSTEROLATERAL LIGAMENT COMPLEX OF THE KNEE: LCL AND POPLITEUS TENDON

ABSTRACT Objective: To analyse the distances between the femoral insertions of the popliteus tendon (PT) and the lateral collateral ligament (LCL) through dissections of cadaveric specimens in a mixed population. Methods: Fresh cadavers were dissected, and the anthropometric data of all specimens were recorded. The distances from the origin of the PT to the LCL in the femoral region and the diameter of each structure were measured using a digital calliper. Results: In total, 11 unpaired knees were dissected, eight men and three women, with an average age of 71.5 ± 15.2 years, weight of 57.2 ± 15.6 kg, and a mean height of 170.5 ± 8.2 cm. The distance from the center of the femoral footprint of the LCL to the PT was 10.0 ± 2.4 mm. The distances between the edges closest to each other and those more distant from each other were 3.1 ± 1.1 mm and 16.3 ± 2.4 mm, respectively. Conclusion: The distance between the midpoints of the PT and the LCL in our mixed population is smaller than the distances often reported in the literature. PLC reconstruction with separate tunnels for the LCL and PT may not be technically possible for individuals of any population. Level of Evidence III, Diagnostic studies.

Pigments—the palette of organic colourants in wall paintings

The present contribution deals with the use of organic colourants in wall paintings, polychrome pottery and painted stone artworks, i.e. painted artworks on inorganic supports. The term organic colourants is referred to the chemical nature of these compounds but not to the way of application; therefore, organic colourants can be dyes, lakes or pigments. The use of organic colourants in wall paintings has been given little attention in the past, perhaps on the assumption that they were rarely used by ancient artists. Recent diagnostic studies, however, brought evidence that their use was not fragmentary; on the contrary, there seems to be continuity in the centuries, at least with regard to the most widely used such as madder, Tyrian purple and indigo. Sources, alteration phenomena, identification methods and analytical evidence is given for the main organic colourants with concern to red, yellow, green, purple and blue hues. Drawbacks and issues are discussed with concern to the identification techniques.

Systematic review and meta-analysis of diagnostic studies of proximal surface caries

Aim This systematic review and meta-analysis aimed to assess the diagnostic accuracy and reliability of commonly used caries detection methods for proximal caries diagnostics. Visual examination (VE), bitewing radiography (BWR), laser fluorescence (LF), and fibre-optic transillumination (FOTI) were considered in detail. Material and methods PRISMA guidelines for the reporting of systematic reviews and meta-analyses were applied. The mnemonic PIRDS (problem, index test, reference test, diagnostic and study type) concept was used to guide the literature search. Next, studies that met the inclusion criteria were stepwise selected and evaluated for their quality with a risk of bias (RoB) assessment tool. Studies with low/moderate bias and sufficient reporting were considered for meta-analysis. The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR), and area under the ROC curve (AUC) were calculated. Results From 129 studies meeting the selection criteria, 31 in vitro studies and five clinical studies were finally included in the meta-analysis. The AUC values for in vitro VE amounted to 0.84 (caries detection) and 0.85 (dentin caries detection). BWR ranged in vitro from 0.55 to 0.82 (caries detection) and 0.81–0.92 (dentin caries detection). LF showed higher AUC values for overall caries detection (0.91) and dentin caries detection (0.83) than did other methods. Clinical data are limited. Conclusion The number of diagnostic studies with low/moderate RoB was found to be low and indicates a need for high-quality, well-designed caries diagnostic studies. Clinical relevance BWR and LF showed good diagnostic performance on proximal surfaces. However, because of the low number of includable clinical studies, these data should be interpreted with caution.