Comparison of Taiwanese and European Calibration Factors for Heart-to-Mediastinum Ratio in Multicenter 123I-mIBG Phantom Studies.

Background: Cross-calibration of 123I-labeled meta-iodobenzylguanidine (mIBG) myocardial-derived indices is essential to extrapolate findings from several clinical centers. Here, we conducted a phantom study to generate conversion coefficients for the calibration of heart-to-mediastinum ratios and compare them between Taiwan and Europe. Methods: We used an acrylic phantom dedicated to 123I-mIBG planar imaging to calculate the conversion coefficients of 136 phantom images derived from 36 Taiwanese institutions. A European phantom image database including 191 images from 27 institutions was used. Conversion coefficients were categorized into five collimator types: low-energy (LE) high-resolution (LEHR), LE general-purpose (LEGP), extended LEGP (ELEGP), medium-energy (ME) GP (MEGP), and ME low-penetration (MELP) collimators. Results: The conversion coefficients were 0.53 ± 0.039, 0.59 ± 0.032, 0.79 ± 0.032, 0.96 ± 0.038, and 0.99 ± 0.050 for LEHR, LEGP, ELEGP, MEGP, and MELP collimators, respectively. The Taiwanese and European conversion coefficients for the LEHR, LEGP, and MELP collimators did not significantly differ. The coefficient of variation was slightly higher for the Taiwanese than the European conversion coefficients (3.7%-7.5% vs. 2.3%-5.6%). Conclusions: We calculated conversion coefficients for various types of collimators used in Taiwan using a 123I-mIBG phantom. In general, the Taiwanese and European conversion coefficients were comparable. These findings further corroborated and highlighted the need for 123I-mIBG standardization using the phantom-determined conversion coefficients.

Machine learning-based speech recognition system for nursing documentation - A pilot study.

PURPOSE: Considering the significant workload of nursing tasks, enhancing the efficiency of nursing documentation is imperative. This study aimed to evaluate the effectiveness of a machine learning-based speech recognition (SR) system in reducing the clinical workload associated with typing nursing records, implemented in a psychiatry ward. METHODS: The study was conducted between July 15, 2020, and June 30, 2021, at Cheng Hsin General Hospital in Taiwan. The language corpus was based on the existing records from the hospital nursing information system. The participating ward's nursing activities, clinical conversation, and accent data were also collected for deep learning-based SR-engine training. A total of 21 nurses participated in the evaluation of the SR system. Documentation time and recognition error rate were evaluated in parallel between SR-generated records and keyboard entry over 4 sessions. Any differences between SR and keyboard transcriptions were regarded as SR errors. FINDINGS: A total of 200 data were obtained from four evaluation sessions, 10 participants were asked to use SR and keyboard entry in parallel at each session and 5 entries were collected from each participant. Overall, the SR system processed 30,112 words in 32,456 s (0.928 words per second). The mean accuracy of the SR system improved after each session, from 87.06% in 1st session to 95.07% in 4th session. CONCLUSION: This pilot study demonstrated our machine learning-based SR system has an acceptable recognition accuracy and may reduce the burden of documentation for nurses. However, the potential error with the SR transcription should continually be recognized and improved. Further studies are needed to improve the integration of SR in digital documentation of nursing records, in terms of both productivity and accuracy across different clinical specialties.

Sex Differences between Urinary Phthalate Metabolites and Metabolic Syndrome in Adults: A Cross-Sectional Taiwan Biobank Study.

BACKGROUND: Phthalates are widely used in consumer products, food packaging, and personal care products, so exposure is widespread. Several studies have investigated the association of phthalate exposure with obesity, insulin resistance, and hypertension. However, little is known about the associations of phthalate exposure with sex, age, and menopausal status in metabolic syndrome (MetS). The purpose of this study was to investigate the association between 11 urinary phthalate metabolite concentrations and metabolic syndrome in adults. METHODS: We conducted a cross-sectional analysis of 1337 adults aged 30-70 years from the Taiwan Biobank 2016-2020. Prevalence odds ratios (POR) and 95% confidence intervals (CIs) were calculated using logistic regression and stratified by sex, age, and menopausal status. RESULTS: Participants with MetS comprised 16.38%. Higher concentrations of MEP metabolites were associated with more than two- to three-fold increased odds of MetS in males and males ≥ 50 years (adj. POR Q3 vs. Q1 = 2.13, 95% CI: 1.01, 4.50; p = 0.047 and adj. POR Q2 vs. Q1 = 3.11, 95% CI: 0.13, 8.63; p = 0.029). When assessed by menopausal status, postmenopausal females with higher ∑DEHP concentrations had more than nine-fold higher odds of MetS compared with postmenopausal females with the lowest ∑DEHP concentrations (adj. POR Q3 vs. Q1 = 9.58, 95% CI: 1.18, 77.75; p = 0.034). CONCLUSIONS: The findings suggest differential associations between certain phthalate metabolites and MetS by sex, age, and menopausal status.

Semi-quantification of the minimum detectable difference of imaging quality of gamma camera SPET for four radionuclides via an innovative PMMA phantom with a V-shaped slit: interpretation of a feasibility study.

OBJECTIVE: An indigenous polymethyl metacrylate (PMMA) phantom with a V-shaped slit and a correlated technique for semi-quantifying the minimum detectable difference (MDD) of single photon emission tomography (SPET) via gamma camera scanning are proposed and validated using four radionuclides. MATERIALS AND METHODS: Radio-actinide solutions of gallium-67 (67Ga), technetium-99m (99mTc), iodine-131 (131I) and thallium-201 (201Tl) were diluted to 11c.c. and thoroughly injected into the continuous zig zag slit of the PMMA phantom. Either depth or edge of the slit between two lines of the V-shape was customized from deep or wide to change into shallow or narrow gradually. Thus, the quantified MDD could be easily evaluated, according to the revised Student's t-test evaluation. The revised Student's t-test was calculated by both full width at half maximum (FWHM) and edge width between two adjacent peaks that were acquired from the original data matrix of SPET. The derived MDD was indicated as for radionuclide, depth, width in mm: For 67Ga, 2.9, 2.13, for 99mTc, 2.5, 0.66, for 131I, 4.7, 2.38 and for 201Tl, 3.3, 2.00, respectively. RESULTS: Technetium-99m had the highest and 131I had the lowest MDD among the four radionuclides. Furthermore, two adjacent peaks of 67Ga could be easily identified with fewer counts than for 201Tl (depth, 2.9 vs. 3.3mm), but its MDD was poorer (width: 2.13 vs.2.00mm). The revised Student's t-test analysis proved to be an acceptable technique for the MDD identification. CONCLUSION: The proposed new combination of PMMA phantom with a V-slit and the revised Student's t-test proved to be instrumental in the MDD of SPET optimization analysis.