Introduction
Recent automated hematology analyzers (HAs) can identify and report nucleated red blood cells (NRBC) count as a separate population out of white blood cells (WBC). The aim of this study ...was to investigate the analytical performances of NRBC enumeration on five top of the range HAs.
Methods
We evaluated the within‐run and between‐day precision, limit of blank (LoB), limit of detection (LoD), and limit of quantitation (LoQ) of XE‐2100 and XN‐module (Sysmex), ADVIA 2120i (Siemens), BC‐6800 (Mindray), and UniCel DxH 800 (Beckman Coulter). Automated NRBC counts were also compared with optical microscopy (OM).
Results
The limits of detection for NRBC of the BC‐6800, XN‐module, XE‐2100, UniCel DxH 800, and ADVIA 2120i are 0.035×109/L, 0.019×109/L, 0.067×109/L, 0.038×109/L, and 0.167×109/L, respectively. Our data indicated excellent performance in terms of precision. The agreement with OM was excellent for BC‐6800, XN‐module, and XE‐2100 (Bias 0.023, 0.019, and 0.033×109/L, respectively). ADVIA 2120i displayed a significant constant error and UniCel DxH 800 both proportional and small constant error.
Conclusion
Regards to NRBC counting, the performances shown by BC‐6800, XN‐module, and XE‐2100 are excellent also a low count, ADVIA 2120i and UniCel DxH 800 need to be improved.
Background
The aims of this study were to compare the diagnostic accuracy of blood smear review criteria, by means of three different panel rules, those proposed by: the International Consensus Group ...for Hematology 41‐ICGH rules, the Italian Survey IS rules and the Working Group on Hematology‐SIBioC (WGH) consensus rules (WGH rules).
Methods
This study is based on 2707 peripheral blood (PB) samples referred for routine hematological testing to the WGH‐associated laboratories displaced all over the Italian territory. The PB samples were processed on seven different hematology analyzers (HAs): Advia 2120i, XE‐2100, BC‐6800, ABX Pentra, XN‐1000, Cell‐DYN Sapphire, and DxH800, respectively. All the results provided by the HAs were analyzed through the application of three different blood smear review criteria: that is, the 41‐ICGH, IS, and WGH rules. Finally, data were compared with those obtained by optical microscopy (OM), as the current gold standard.
Results
The overall the agreement OM classification with ICGH, IS, and WGH panel rules is 0.83, 0.83, and 0.85, respectively. The false negatives are 2.1%, 3.0%, and 2.9%, while false positives are 15.1%, 13.7%, and 11.7%, respectively. All the seven HAs showed variable interinstrument performance, as three different criteria for OM review were adopted on each of them from time to time.
Conclusion
These results presented show that the customization of validation rules is necessary for enhancing the quality of hematological testing and optimizing workflow.
Treatment of lesions located in saphenous vein grafts (SVGs) is associated with increased procedural risk and a high rate of restenosis.
We conducted a randomized, multicenter trial to evaluate the ...usefulness of a polytetrafluoroethylene (PTFE)-covered stent compared with a bare stainless steel (SS) stent for prevention of restenosis and major adverse cardiac events (MACE) in patients undergoing SVG treatment. The primary end point was angiographic restenosis at 6 months. Secondary end points were 30-day and 6-month MACE rates, defined as the cumulative of death, myocardial infarction (MI), and target lesion revascularization. Between September 1999 and January 2002, 301 patients with SVG lesions were randomized to either the PTFE-covered JoStent coronary stent graft (PTFE group, n=156) or the SS JoFlex stent (control group, n=145). Angiographic and procedural success rates were similar between the 2 groups (97.4% versus 97.9% and 87.3% versus 93.8%, respectively). The incidence of 30-day MACE was higher in the PTFE group (10.9% versus 4.1%, P=0.047) and was mainly attributed to MI (10.3% versus 3.4%, P=0.037). The primary end point, the restenosis rate at 6-month follow-up, was similar between the 2 groups (24.2% versus 24.8%, P=0.237). Although the 6-month non-Q-wave MI rate was higher in the PTFE group (12.8% versus 4.1%, P=0.013), the cumulative MACE rate was not different (23.1% versus 15.9%, P=0.153).
The study did not demonstrate a difference in restenosis rate and 6-month clinical outcome between the PTFE-covered stent and the SS stent for treatment of SVG lesions. However, a higher incidence of nonfatal myocardial infarctions was found in patients treated with the PTFE-covered stent.
Remote monitoring is increasingly used in the follow-up of patients with cardiac implantable electronic devices. Data on paediatric populations are still lacking. The aim of our study was to ...follow-up young patients both in-hospital and remotely to enhance device surveillance.
This is an observational registry collecting data on consecutive patients followed-up with the CareLink system. Inclusion criteria were a Medtronic device implanted and patient's willingness to receive CareLink. Patients were stratified according to age and presence of congenital/structural heart defects (CHD).
A total of 221 patients with a device - 200 pacemakers, 19 implantable cardioverter defibrillators, and two loop recorders--were enrolled (median age of 17 years, range 1-40); 58% of patients were younger than 18 years of age and 73% had CHD. During a follow-up of 12 months (range 4-18), 1361 transmissions (8.9% unscheduled) were reviewed by technicians. Time for review was 6 ± 2 minutes (mean ± standard deviation). Missed transmissions were 10.1%. Events were documented in 45% of transmissions, with 2.7% yellow alerts and 0.6% red alerts sent by wireless devices. No significant differences were found in transmission results according to age or presence of CHD. Physicians reviewed 6.3% of transmissions, 29 patients were contacted by phone, and 12 patients underwent unscheduled in-hospital visits. The event recognition with remote monitoring occurred 76 days (range 16-150) earlier than the next scheduled in-office follow-up.
Remote follow-up/monitoring with the CareLink system is useful to enhance device surveillance in young patients. The majority of events were not clinically relevant, and the remaining led to timely management of problems.
In this work two cytokines were used in combination with inactivated bacteria (bacterin) to test the bovine conjuctival immune response to the pathogen Moraxella bovis, the causative agent of ...Infectious bovine keratoconjunctivitis (IBK). Treatments using the bacterin vaccine combined with interleukin-2 and interferon-α as adjuvants (Group A), the bacterin vaccine only (Group B), and controls without treatment (Group C), were applied by ocular spraying to evaluate the local immune response in the corneal structure of cattle experimentally infected with M. bovis. Six weeks after infection, 14 out of a total of 34 animals presented different corneal lesions; 9 corresponding to the control group C, 4 to the group B and only one to the group A. According to the clinical manifestations, a numeric score was calculated. Control animals presented the highest score value (12 points), followed by group B (7.5 points) and group A (1 point). These results suggest that the addition of cytokines to M. bovis treatments can reduce not only eye injuries caused by IBK but also the number of diseased animals.
During silver electrodeposition on Au nanoparticle (NP)-covered highly oriented pyrolitic graphite, a transition from an initial growth of microsized particles to the growth of dendrites with pine ...tree shape (nanotrees) is observed, which is an advancement for material growth with hierarchical surface roughness. Using kinetic Monte Carlo simulations of an electrodeposition model, those results are explained by the interplay of diffusive cation flux in the electrolyte and relaxation of adsorbed atoms by diffusion on quenched crystal surfaces. First, simulations on NP-patterned substrates show the initial growth of faceted silver particles, followed by the growth of nanotrees with shapes similar to the experiments. Next, simulations on electrodes with large prebuilt particles explain the preferential nanotree growth at corners and edges as a tip effect. Simulations on wide flat electrodes relate the nanotree width with two model parameters describing surface diffusion of silver atoms: maximal number of random hops (G) and probability of hop per neighbor (P). Finally, simulations with small electrode seeds confirm the transition from initially compact particles to the nucleation of nanotrees and provide estimates of the transition sizes as a function of those parameters. The simulated compact and dendritic deposits show dominant (111) surface orientation, as observed in experiments. Extrapolations of simulation results to match microparticle and nanotree sizes lead to G = 4 × 1011 and P = 0.03, suggesting to interpret those sizes as diffusion lengths on the growing surfaces and giving diffusion coefficients 2 to 3 × 10–13 m2/s for deposited silver atoms. These results may motivate studies to relate diffusion coefficients with atomic-scale interactions.
Metal additive manufacturing (AM) is a layer-by-layer process that makes the direct manufacturing of various industrial parts possible. This method facilitates the design and fabrication of complex ...industrial, advanced, and fine parts that are used in different industry sectors, such as aerospace, medicine, turbines, and jewelry, where the utilization of other fabrication techniques is difficult or impossible. This method is advantageous in terms of dimensional accuracy and fabrication speed. However, the parts fabricated by this method may suffer from faults such as anisotropy, micro-porosity, and defective joints. Metals like titanium, aluminum, stainless steels, superalloys, etc., have been used-in the form of powder or wire-as feed materials in the additive manufacturing of various parts. The main criterion that distinguishes different additive manufacturing processes from each other is the deposition method. With regard to this criterion, AM processes can be divided into four classes: local melting, sintering, sheet forming, and electrochemical methods. Parameters affecting the properties of the additive-manufactured part and the defects associated with an AM process determine the method by which a certain part should be manufactured. This study is a survey of different additive manufacturing processes, their mechanisms, capabilities, shortcomings, and the general properties of the parts manufactured by them.
We study the formation of deposits with dendritic morphology using numerical simulations of a model of electrodeposition and diffusion of the adsorbed material. The model considers a diffusive flux ...of cations in solution, the instantaneous adsorption and reaction in contact with the film surface, and random walks of mobile atoms on that surface, with a maximum of G hops per atom and a detachment probability ϵ per neighbor at the current position. For low temperature or large current, which corresponds to small G, the deposits are similar to the diffusion-limited aggregates growing from the flat electrode; for high temperature or very small current, which is represented by large G or ϵ, the deposits have thick rounded columns with sporadic ramification. In these conditions, the growth direction is controlled by the orientation of the electrode and of the cation flux. For the balanced conditions of adsorbate diffusion and current (typically 102 ≲ G ≲ 104 and ϵ ≲ 0.1, but also for larger G and very small ϵ), the films have a hierarchical dendritic morphology with the shape of maple leaves. The dendrite tips propagate in directions forming 45° with the electrode and are formed by three concurrent terraces, as a consequence of the simulations in a simple cubic lattice. The average dendrite size increases as a power law of G and is consequently expected to decrease with the applied current. The lowest energy configurations (terraces) are shown to be stable within the timescale of crystallization of an atomic layer, but the weakly bonded atoms have sufficiently large mobility to create those configurations. Thus, the dendritic morphology depends on the interplay between the energetics of the crystal and the electric current, which may help the interpretation of dendrite growth with other crystalline structures. The dendrite shape obtained here resembles those observed in some electrodeposited films of gold, zinc, and palladium, and the effect of the electric current on the dendrite size agrees with the observations in the electrodeposition of silver and gold. Assuming that the adsorbate diffusion is thermally activated, we propose that the average dendrite size is a ratio between an Arrhenius factor and a power law of the current; this suggests a method to estimate the microscopic energy barrier of diffusion, which may differ from the macroscopic activation energy.
Introduction:
Randomized clinical trials showed that bortezomib, in addition to conventional chemotherapy, improves survival and disease progression in multiple myeloma (MM) patients not eligible for ...stem cell transplantation. The aim of this retrospective population-based cohort study is the evaluation of both clinical and economic profile of bortezomib-based versus conventional chemotherapy in daily clinical practice.
Methods:
Healthcare utilization databases of six Italian regions were used to identify adult patients with non-transplant MM, who started a first-line therapy with bortezomib-based or conventional chemotherapy. Patients were matched by propensity score and were followed from treatment start until death, lost to follow-up or study end-point. Overall survival (OS) and restricted mean survival time (RMST) were estimated using the Kaplan–Meier method. Association between first-line treatment and risk of death was estimated by a conditional Cox proportional regression model. Average mean cumulative costs were estimated and compared between groups.
Results:
In the period 2010–2016, 3509 non-transplant MM patients met the inclusion criteria, of which 1157 treated with bortezomib-based therapy were matched to 1826 treated with conventional chemotherapy. Median OS and RMST were 33.9 and 27.9 months, and 42.9 and 38.4 months, respectively, in the two treatment arms. Overall, these values corresponded to a HR of death of 0.79 (95% CI 0.71–0.89) over a time horizon of 84 months. Average cumulative cost were 83,839 € and 54,499 €, respectively, corresponding to an incremental cost-effectiveness ratio of 54,333 € per year of life gained, a cost coherent with the willingness-to-pay thresholds frequently adopted from Western countries.
Conclusions:
These data suggested that, in a large cohort of non-transplant MM patients treated outside the experimental setting, first-line treatment with bortezomib-based therapy was associated with a favourable effectiveness and cost-effectiveness profile.
In algebraic topology it is well known that, using the Mayer–Vietoris sequence, the homology of a space
X
can be studied by splitting
X
into subspaces
A
and
B
and computing the homology of
A
,
B
, ...and
A
∩
B
. A natural question is: To what extent does persistent homology benefit from a similar property? In this paper we show that persistent homology has a Mayer–Vietoris sequence that is generally not exact but only of order 2. However, we obtain a Mayer–Vietoris formula involving the ranks of the persistent homology groups of
X
,
A
,
B
, and
A
∩
B
plus three extra terms. This implies that persistent homological features of
A
and
B
can be found either as persistent homological features of
X
or of
A
∩
B
. As an application of this result, we show that persistence diagrams are able to recognize an occluded shape by showing a common subset of points.
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