LOW CERTAINTY OF EVIDENCE SUPPORTS THE APPLICATION OF (AI) FOR THE AUTOMATIC DETECTION OF CEPHALOMETRIC LANDMARKS WITH PROSPECTS FOR IMPROVEMENTS.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Artificial Intelligence for Detecting Cephalometric Landmarks: A Systematic Review and Meta-analysis. J Digit Imaging. 2023 Jun;36(3):1158-1179. doi:10.1007/s10278-022-00766-w. SOURCE OF FUNDING: The study was financed in part by the Coordenacao de Aperfeicoamentode Pessoal de Nivel Superior-Brazil (CAPES)-Finance Code 001. TYPE OF STUDY/DESIGN: Systematic review and meta-analysis.

Accuracy of a smartphone-assisted novel labeling method for marking target axial position in cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the convenience and accuracy of a novel smartphone-assisted “any-point two-step method” for finding the target axial position in cataract phacoemulsification combined with intraocular lens(IOL)implantation.METHODS: Prospective observational study. A total of 62 cases(62 eyes)of patients with age-related cataracts who underwent cataract phacoemulsification combined with IOL implantation in our hospital from October 2021 to April 2022 were selected. They were randomly divided into two groups: 31 cases(31 eyes)in the control group were applied with the “traditional two-step method” using slit lamp to mark the target axial position of the IOL, and 31 cases(31 eyes)in the experimental group were applied with the smartphone-assisted “two-step method” to mark the target axial position of the IOL. The Callisto eye navigation system was used as a standard reference, and the deviation of the reference marking point(deviation-1), the deviation of the target axial marking point(deviation-total), and the deviation of the angle from the reference marking point to the target axial marking point(deviation-2)were calculated and recorded as the preoperative axial marking time.RESULTS:Both deviation-1 and deviation-total values were lower in the experimental group than those in the control group(1.06°±1.39° vs 2.48°±2.23°, 1.77°±1.54° vs 2.81°±1.58°, all P<0.01), but there was no significant difference in the deviation-2 values between the two groups(1.35°±1.40° vs 1.48°±1.79°, P>0.05). The preoperative axial marking took shorter time in the experimental group than in the control group(1.77±1.70 min vs 2.88±3.20 min, P<0.01).CONCLUSION: The smartphone-assisted “any-point two-step method” for finding the target axial position in cataract phacoemulsification combined with IOL implantation is simple, time-saving, and accurate compared with the “traditional two-step method”.

Single laboratory evaluation of umbilical cord blood units processing methodologies for banking.

OBJECTIVE: To compare the efficiency of 3 different processing methods (Sepax, AutoXpress [AXP], and manual processing with hydroxyethyl starch [HES] sedimentation) used at Stemlab during a 10-year period. METHODS: Historical data were compiled and the analytical results obtained for the 3 different methods were compared. RESULTS: The manual processing (HES) method yielded the highest level of total nucleated cell recovery after processing, and the AXP system yielded the highest CD34+ cell number. The red blood cell reduction was also significantly higher with the HES method. Also, HES showed comparable results to Toticyte technology for umbilical cord blood (UCB) processing. CONCLUSION: These results show that the HES method is as effective as automated technologies for UCB volume reduction; hence, it is a suitable methodology for private and public UCB banks. The HES method also proved to be superior to Toticyte technology for medical applications, with higher recovery yields of total nucleated cells after thawing and equivalent CD34+ cell recovery and functionality.

Standardization of Manual Method of Immunohistochemical Staining for Breast Cancer Biomarkers at Tertiary Cancer Care Center: An Audit.

Immunohistochemistry (IHC) is a necessary ancillary technique in surgical pathology laboratories, particularly for oncology tissue specimens. Automation in the IHC technique has an advantage over manual methods in terms of quality, except for the cost of the equipment. Thus, the manual method of IHC staining is the preferred method of choice in countries with limited resources. However, standardization of all steps in the preanalytic phase is critical to obtain reliable immunohistochemistry test results. The current audit was conducted to describe the preanalytic factors affecting manual IHC methods. The most important preanalytic factors were fixative, the composition of dehydrate, pH, drying of sections, and heat-mediated antigen retrieval method (HMAR). The domestic pressure cooker method was found to be the best for HMAR.

Comparison Between Manual and Automated Methods of Counting Reticulocytes and the Effect of Sample Storage on Reticulocyte Count: A Cross-Sectional Study from Southern India.

Reticulocyte count is a basic test in hematology. This study was done to compare manual and automated methods and to study the effect of sample storage on reticulocyte count. Analyses of samples (n = 86) were done at 2, 6, 24 and 48 h after blood collection. Manual counting was done from both freshly prepared slide and stored slide by microscopy on new methylene blue stained smears. Automated enumeration was on Sysmex XT-2000i analyser (Ret search II). The values of immature reticulocyte fraction (IRF) and low fluorescence reticulocytes (LFR) were also recorded. Comparison between two methods was done by Spearman's correlation and Mann-Whitney test. Effect of storage was analysed by repeated measures ANOVA. There was strong positive correlation between both manual and automated methods at 2, 6, 24 and 48 h. The differences between the manual and automated methods were not significant at 2, 6 and 24 h (p 0.975, 0.967 and 0.227). The difference between the freshly prepared slide and stored slide were significant at 6, 24 and 48 h (p 0.015, 0.004 and 0.001). The change in reticulocyte count with time, decrease in IRF and increase in LFR were not significant up to 6 h but were significant at 24 and 48 h after blood collection. Both the methods were accurate and correlated well with each other. Freshly prepared smears for manual counting were better than counting on stored slide. Up to 6 h after blood collection results obtained by both methods are acceptable.

Evaluation of audible leak versus pressure volume loop closure for polyvinyl chloride cuff and polyurethane microcuff in endotracheal tube inflated with air: a prospective randomized study.

Cuff pressure of endotracheal tube (ETT) must be high enough to seal the trachea, and must be low enough to allow adequate perfusion of tracheal mucosa. Compared with polyvinyl chloride (PVC) cuffed tubes, polyurethane cuffed tubes protect more efficiently. Different methods of ETT cuff pressure maintenance in practice have been reported. We planned to compare ETT cuff pressure using different techniques in PVC and polyurethane microcuff tubes in a prospective randomized study. Eighty surgical patients between 16-65 years belonging to American Society of Anesthesiologists physical status I-III, scheduled for orotracheal intubation under general anaesthesia, were included. All enrolled patients were randomized into four groups (n = 20 per group), followed by corresponding treatments, including intubation by PVC ETT or polyurethane microcuff ETT and cuff inflation by auscultation of audible leak or pressure volume loop. Amount of air required to inflate cuff was more in polyurethrane tube as compared to polyvinyl tube. While comparing the two methods of cuff inflation, less volume of air was required in pressure volume loop method. We concluded that PVC cuff tube and polyurethane microcuff tube both are safe tubes used in adult patients. However, when inflated using same technique polyurethane microcuff tubes required larger volume to inflate cuff. Further, pressure generated in polyurethane microcuff tubes in much lower than PVC tubes. The study was approved by the Institutional Ethics Committee of Pt B D Sharma, PGIMS, Rohtak (No. IEC/Th/18/Anst15) on January 20, 2018 and registered with Clinical Trials Registry-India (registration No. CTRI/2019/01/017170) on January 18, 2019.

Comparison of the Orientation of the Corneal Steep Meridian Determined by Image-Guided System and Manual Method in the Same Eye.

PURPOSE: To evaluate the difference between the preoperative marking methods for toric intraocular lens (IOL) implantations using an image-guided system (IGS) and the manual marking method in the same eye. PATIENTS AND METHODS: In this retrospective case series, 82 patients (101 eyes) who underwent cataract surgery using both manual and IGS (VERION, Alcon  Laboratories) marking were enrolled. First, preoperative reference marks were placed at 6 o'clock and 3 or 9 o'clock position under slit-lamp biomicroscope in the outpatient department using the manual method. Using the reference unit of IGS, the ocular surface data were captured and overlaid. The difference was then measured (preoperative axis misalignment). In the operating room, the orientation of the steep meridian of the manual method was determined based on this reference mark under the surgical microscope. Just before surgery, the digital degree gauge of IGS was overlaid on the ocular surface, and the difference was then measured (total axis misalignment). We calculated the intraoperative axis misalignment by subtracting preoperative axis misalignment from the total axis misalignment. RESULTS: Mean absolute preoperative, intraoperative, and total axis misalignment values were 3.87±3.95 degrees, 5.46±4.42 degrees, and 4.98±4.49 degrees, respectively. In preoperative, intraoperative, and total misalignment, the ratios of 10 degrees or greater were 10 (14.7%), 12 (17.6%), and 20 (19.8%) eyes, respectively. CONCLUSION: The manual method that determines the fixed position of the toric intraocular lens (IOL) may cause large misalignment compared with the IGS, suggesting that using manual method could sometimes result in a large misalignment of toric IOL implantation.

Semi-Automated Assessment of Human Islet Viability Predicts Transplantation Outcomes in a Diabetic Mouse Model.

In clinical and experimental human pancreatic islet transplantations, establishing pretransplant assessments that accurately predict transplantation outcomes is crucial. Conventional in vitro viability assessment that relies on manual counting of viable islets is a routine pretransplant assessment. However, this method does not correlate with transplantation outcomes; to improve the method, we recently introduced a semi-automated method using imaging software to objectively determine area-based viability. The goal of the present study was to correlate semi-automated viability assessment with posttransplantation outcomes of human islet transplantations in diabetic immunodeficient mice, the gold standard for in vivo functional assessment of isolated human islets. We collected data from 61 human islet isolations and 188 subsequent in vivo mouse transplantations. We assessed islet viability by fluorescein diacetate and propidium iodide staining using both the conventional and semi-automated method. Transplantations of 1,200 islet equivalents under the kidney capsule were performed in streptozotocin-induced diabetic immunodeficient mice. Among the pretransplant variables, including donor factors and post-isolation assessments, viability measured using the semi-automated method demonstrated a strong influence on in vivo islet transplantation outcomes in multivariate analysis. We calculated an optimized cutoff value (96.1%) for viability measured using the semi-automated method and showed a significant difference in diabetes reversal rate for islets with viability above this cutoff (77% reversal) vs. below this cutoff (49% reversal). We performed a detailed analysis to show that both the objective measurement and the improved area-based scoring system, which distinguished between small and large islets, were key features of the semi-automated method that allowed for precise evaluation of viability. Taken together, our results suggest that semi-automated viability assessment offers a promising alternative pretransplant assessment over conventional manual assessment to predict human islet transplantation outcomes.

Use of the Sysmex XT-4000i hematology analyzer in the differentiation of cerebrospinal fluid cells in children.

BACKGROUND: Routine analysis of pleocytosis and cellular composition of cerebrospinal fluid (CSF) is carried out with a phase-contrast microscope. The use of hematological analyzers seems to be an alternative to the manual method. The aim of the study was to assess the usefulness of the automated technique for counting and differentiating CSF cells in children. METHODS: The study group consisted of 59 children (28 girls and 31 boys) aged from 4 to 17 years suffering from viral and bacterial meningitis. Children were divided into three subgroups according to CSF cell count: 1st group had a pleocytosis of 6-50 cells/µL, 2nd group-51-100 cells/µL, and 3rd group->100 cells/µL. A reference group involved 32 children (17 girls and 15 boys) aged from 2 to 18 years with a normal range of 0-5 cells/µL. Examination of CSF was performed in parallel by two different method, manual and automated. RESULTS: The analysis of pleocytosis revealed that the values obtained by the manual method were statistically significantly lower in relation to the values obtained by automated technique in subgroups I and II. The number of mononuclear and polymorphonuclear cells in subgroups I, II, and III determined by both manual and automated methods was comparable. CONCLUSION: We conclude that automated method cannot fully replace the previously used manual method and some of the dubious cases, such as samples with low pleocytosis rates or abnormal cells indicated by the analyzer, will still require microscopic examination.

Discrimination between malignant and benign mass-like lesions from breast dynamic contrast enhanced MRI: semi-automatic vs. manual analysis of the signal time-intensity curves.

Purpose: To investigate the performance of a new semi-automatic method for analyzing the signal time-intensity curve (TIC) obtained by breast dynamic contrast enhancement (DCE)-MRI. Methods: In the conventional method, a circular region of interest was drawn manually onto the map reflecting the maximum slope of increase (MSI) to delineate the suspicious lesions. The mean TIC was determined subjectively as one of three different wash-out patterns. In the new method, the lesion area was identified semi-automatically. The mean TIC was categorized quantitatively. In addition to the MSI, other quantitative parameters were calculated, including the signal intensity slope (SIslope), initial percentage of enhancement (Einitial), percentage of peak enhancement (Epeak), early signal enhancement ratio (ESER), and second enhancement percentage (SEP). The performances were compared with receiver operating characteristic (ROC) analysis and Wilcoxon's test. Results: For TIC categorization results, the diagnostic accuracy rates were 61.54% with the traditional manual method and 76.92% with the new method. For the mean MSI values from the manual method, the accuracy was 63.41%. For the mean TIC derived using the semi-automatic method, the diagnostic accuracy were 82.05% for SIslope, 67.31% for MSI, 61.53% for Einitial, 64.75% for Epeak, 64.74% for ESER, and 52.56% for SEP, respectively. For the lesion regions identified by the semi-automatic method, the diagnostic accuracy for above mentioned parameters were 80.13%, 69.87%, 61.54%, 63.47%, 64.74% and 55.13%, respectively. Conclusion: With respect to the analysis of TIC from breast DCE-MRI, the results demonstrated that the new method increased the diagnostic accuracy, and should be considered as a supplementary tool for distinguishing benign and malignant lesions.

Evaluation of detection performance of urinary vanilmandelic acid on automatic biochemical analyzer / 医疗卫生装备

Objective To evaluate the automatic biochemical analyzer when used to detect urinary vanilmandelic acid (VMA), and to compare it with manual method. Methods The automatic biochemical analyzer using homogenous enzyme immunoassay technology was compared with the manual method on accuracy, precision, linear range, recovery rate, anti-interference capability and etc when used to detect VMA.The comparison was also carried out on positive rate and etc when the two methods were used to test the urine specimens of the healthy subjects and suspected patients of hypertension, hyperthyroidism and hypothyroidism. Results The two methods both had the results on accuracy, precision, linear range, recovery rate, anti-interference capability meet the requirements described in the instruction of reagent kit, while the analyzer gained advantages over the manual method.The positive rates by the two methods for testing urine specimens were similar,while the analyzer behaved better in diagnosing the patient with critical value.Conclusion The analyzer proves better than the manual method when used to detect VMA,and thus is worthy promoting in clinical trial.

Comparative Analysis of Clinical Samples Showing Weak Serum Reaction on AutoVue System Causing ABO Blood Typing Discrepancies.

BACKGROUND: ABO blood typing in pre-transfusion testing is a major component of the high workload in blood banks that therefore requires automation. We often experienced discrepant results from an automated system, especially weak serum reactions. We evaluated the discrepant results by the reference manual method to confirm ABO blood typing. METHODS: In total, 13,113 blood samples were tested with the AutoVue system; all samples were run in parallel with the reference manual method according to the laboratory protocol. RESULTS: The AutoVue system confirmed ABO blood typing of 12,816 samples (97.7%), and these results were concordant with those of the manual method. The remaining 297 samples (2.3%) showed discrepant results in the AutoVue system and were confirmed by the manual method. The discrepant results involved weak serum reactions (<2+ reaction grade), extra serum reactions, samples from patients who had received stem cell transplants, ABO subgroups, and specific system error messages. Among the 98 samples showing ≤1+ reaction grade in the AutoVue system, 70 samples (71.4%) showed a normal serum reaction (≥2+ reaction grade) with the manual method, and 28 samples (28.6%) showed weak serum reaction in both methods. CONCLUSIONS: ABO blood tying of 97.7% samples could be confirmed by the AutoVue system and a small proportion (2.3%) needed to be re-evaluated by the manual method. Samples with a 2+ reaction grade in serum typing do not need to be evaluated manually, while those with ≤1+ reaction grade do.

Comparative Analysis of Clinical Samples Showing Weak Serum Reaction on AutoVue System Causing ABO Blood Typing Discrepancies

BACKGROUND: ABO blood typing in pre-transfusion testing is a major component of the high workload in blood banks that therefore requires automation. We often experienced discrepant results from an automated system, especially weak serum reactions. We evaluated the discrepant results by the reference manual method to confirm ABO blood typing. METHODS: In total, 13,113 blood samples were tested with the AutoVue system; all samples were run in parallel with the reference manual method according to the laboratory protocol. RESULTS: The AutoVue system confirmed ABO blood typing of 12,816 samples (97.7%), and these results were concordant with those of the manual method. The remaining 297 samples (2.3%) showed discrepant results in the AutoVue system and were confirmed by the manual method. The discrepant results involved weak serum reactions (<2+ reaction grade), extra serum reactions, samples from patients who had received stem cell transplants, ABO subgroups, and specific system error messages. Among the 98 samples showing ≤1+ reaction grade in the AutoVue system, 70 samples (71.4%) showed a normal serum reaction (≥2+ reaction grade) with the manual method, and 28 samples (28.6%) showed weak serum reaction in both methods. CONCLUSIONS: ABO blood tying of 97.7% samples could be confirmed by the AutoVue system and a small proportion (2.3%) needed to be re-evaluated by the manual method. Samples with a 2+ reaction grade in serum typing do not need to be evaluated manually, while those with ≤1+ reaction grade do.

Comparison of automatic and manual methods for preparation of leukocyte-reduced red blood cell and plasma / 医疗卫生装备

Objective To compare the leukocyte-reduced red blood cells and plasmas respectively prepared by automated blood components separator and manual method so as to provide theoretical basis for automatic and standardized flow of blood components preparation.MethodsThe prepared red blood cells and plasma were measured on the hemoglobin concentration,mean corpuscular volume (MCV),red blood cell count (RBC),haematocrit (HCT),mean corpuscular hemoglobin (MCH),mean corpuscular hemoglobin concentration (MCHC),average red blood cell volume distribution width,plasma weight and protein content after the first separation,preparation time and etc.These results obtained from different methods were compared and analyzed.Results The plasma weight after the first separation which was one-off prepared were (267.57 ±16.31) g (by automatic method) and (246.06±22.48) g (by manual method) (P＜0.05) respectively.The preparation time were (66.66±9.01) s (by automatic method) and (162.33±22.00) s (by manual method) (P＜0.05) respectively.Other results had no significant difference (P＞0.05).Conclusion All blood components products in this research meet the criterion of GB 18469-2012.However,the quality and separation efficiency of products made by automatic blood component separator are obviously higher than those by manual method.

Computer-based method of bite mark analysis: A benchmark in forensic dentistry?

AIM: The study aimed to determine the technique with maximum accuracy in production of bite mark overlay. MATERIALS AND METHODS: Thirty subjects (10 males and 20 females; all aged 20-30 years) with complete set of natural upper and lower anterior teeth were selected for this study after obtaining approval from the Institutional Ethical Committee. The upper and lower alginate impressions were taken and die stone models were obtained from each impression; overlays were produced from the biting surfaces of six upper and six lower anterior teeth by hand tracing from study casts, hand tracing from wax impressions of the bite surface, radiopaque wax impression method, and xerographic method. These were compared with the original overlay produced digitally. RESULTS: Xerographic method was the most accurate of the four techniques, with the highest reproducibility for bite mark analysis. The methods of wax impression were better for producing overlay of tooth away from the occlusal plane. CONCLUSIONS: Various techniques are used in bite mark analysis and the choice of technique depends largely on personal preference. No single technique has been shown to be better than the others and very little research has been carried out to compare different methods. This study evaluated the accuracy of direct comparisons between suspect's models and bite marks with indirect comparisons in the form of conventional traced overlays of suspects and found the xerographic technique to be the best.

Comparation of Two Different Methods for Rotavirus and Adenovirus Antigens Detection / 现代检验医学杂志

Objective To compare the detecting results of rotavirus (RV)and adenovirus (AdV)antigens using auto stool pretreatment system (machine method)and manual method.Methods A total of 100 stools collectecd from diarrear patients admitted in gastroenterology outpatient department from September 2014 to Octorber 2014 in Peking University Medical College Hospital were detected to identify RV and AdV antigens using machine method and manual method respectively,and the nucletic acids of positive samples were detected by liquid chip method to verify the results.Results The RV,AdV and co-infection antigen positive detection rate using machine method were 17.0% (17/100),25.0% (25/100)and 12.0% (12/100)respectively,whereas those using the manual method were 4.0% (4/100),13.0% (13/100)and 2.0% (2/100),re-spectively.Taking the nucletic acids detection as the golden method,the false positive detection rate of RV,AdV and co-in-fection antigen using machine method were 23.5% (4/17),20.0% (5/25)and 33.3% (4/12)respectively,whereas those u-sing the manual method were 75.0% (3/4),69.2% (9/13)and 50.0% (1/2),respectively.χ2 test for paired data for RV and AdV positive detection rate,false positive detection rate of RV and false positive detection rate of AdV using two meth-ods were statistically significant (χ2 =15.0,52.8 and 47.5,P values <0.05).Two methods for detecting RV and AdV had poor consistency (Kappa value was 0.25,Kappa values <0.4).Conclusion Machine method has much more advantage on RV and AdV positive detection rate and false positive detection rate than manual method,which is good for clinical applica-tion.

A Novel Method of Somatic Cell Nuclear Transfer with Minimum Equipment.

Somatic cell nuclear transfer (SCNT) is an exceptional experimental biology technique with an arguably great contribution to our current understanding of developmental plasticity. Many students and young researchers are interested in taking advantage of SCNT virtues in their experiments but the cost of micromanipulation microscopes, intensive training programs, and also the sophisticated process of SCNT may dissuade them from entering this amazing field of science. Here, we describe the details of a streamlined manual method of SCNT that can be performed using very basic equipment found in every embryology laboratory: the Pasteur pipette and stereomicroscope. The overall method introduced is very simple and a person with no previous experience in cloning can learn and adopt the basic routines of this technique independently.

Comparison of body fluid count and classification results detected by Sysmex XE-5000 automatic blood cell analyzer and manual method / 国际检验医学杂志

Objective To compare the body fluid count results detected by Sysmex XE-5000 automatic blood cell analyzer and manual method .Methods A total of 300 cases of body fluid specimens (including cerebrospinal fluid and fluid of serous cavity ) were analyzed .RBC ,WBC counting and classification were respectively detected by XE-5000 and manual method of improvement Neubauer counting plate .Results The fresh specimens without contain a large number of cell clusters ,which RBC counts(RBC-BF)(100-10 000)× 106/L ,and WBC counts(WBC-BF) (9-50)× 106/L ,showed there were a linear relationship between the in-strument method(r=0 .998 5 ,0 .986 3) .In the range ,there was no significant difference between XE-5000 and manual method(t=9 .96 ,P>0 .05) .Also in this range the results of instrument correlated with those of manual method(r= 0 .989 3 ,0 .971 7 , 0 .924 9) .For those specimens which contain a large number of cell clusters ,RBC-BF and WBC-BF were a badly linear relationship between the instrument method(r=0 .564 8 ,0 .456 1) .Conclusion Body fluid specimens which are fresh and do not contain a large number of cell clusters ,in the range of RBC-BF (100 -10 000) × 106/L ,WBC-BF (9 -50) × 106/L ,Sysmex XE-5000 automatic blood cell analyzer could ensure the results have good accuracy .

A comparative study of overlay generation methods in bite mark analysis.

AIM: To evaluate the best method of overlay generation out of the three methods, i.e., manual, photocopying, and computer assisted method. MATERIALS AND METHODS: Impressions of maxillary and mandibular arches of 25 individuals participating in the study were made and dental study models were prepared. Overlay production was done by manual, photocopying, and computer assisted methods. Finally, the overlays obtained by each method were compared. RESULTS: Kruskal Wallis ANOVA H test was used for the comparison of manual, photocopying, and computer assisted overlay generation methods. H value being highest in case of computer assisted overlays, thus, making it the best method of overlay generation out of the three methods. CONCLUSION: We conclude that the method of computer assisted overlay generation is the best among the three methods used in our study.