Diagnostic accuracy of contrast-enhanced CT for neck abscesses : A systematic review and meta-analysis of positive predictive value

Objectives To review the diagnostic accuracy of contrast-enhanced computed tomography (CT) in differentiating abscesses from cellulitis in patients with neck infections, using surgical findings as the reference standard. Materials and methods Previous studies in the last 32 years were searched from PubMed and Embase. Because of partial verification bias (only positive abscess findings are usually verified surgically), sensitivity and specificity estimates are unreliable, and we focused on positive predictive value (PPV). For all studies, PPV was calculated as the proportion of true positives out of all positives on imaging. To estimate pooled PPV, we used both the median with an interquartile range and a model-based estimate. For narrative purposes, we reviewed the utility of common morphological CT criteria for abscesses, such as central hypodensity, the size of the collection, bulging, rim enhancement, and presence of air, as well as sensitivity and specificity values reported by the original reports. Results 23 studies were found reporting 1453 patients, 14 studies in children (771 patients), two in adults (137 patients), and seven including all ages (545 patients). PPV ranged from 0.67 to 0.97 in individual studies, had a median of 0.84 (0.79–0.87), and a model-based pooled estimate of 0.83 (95% confidence interval 0.80–0.85). Most morphological CT criteria had considerable overlap between abscesses and cellulitis. Conclusions The pooled estimate of PPV is 0.83 for diagnosing neck abscesses with CT. False positives may be due to limited soft tissue contrast resolution. Overall, none of the morphological criteria seem to be highly accurate for differentiation between abscess and cellulitis.© 2022 Hagelberg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.fi=vertaisarvioitu|en=peerReviewed

Kinoglede for pensjonister : En studie om hvordan Trondheim Kino kan kommunisere med pensjonister i dagens digitale verden.

Formålet med denne bacheloroppgaven er å se nærmere på hvordan man kan ta i bruk ulike kommunikasjonstiltak og virkemidler for å nå en eldre målgruppe, som for eksempel pensjonister. Denne oppgaven er ikke blitt gitt i oppdrag av Trondheim Kino, men har vært til hjelp under arbeidet. Vi har fått informasjon fra innsiden da to av oss er ansatt ved Trondheim Kino, samtidig som ledelsen ga uttrykk for at dette er et reelt problem. Problemstillingen for denne bacheloroppgaven er derfor: “På hvilken måte kan pensjonisters behov være med på å endre hvordan Trondheim Kino bør kommunisere med dem?” - Hvilke behov har pensjonister når det kommer til informasjonshenting? Denne problemstillingen legger til rette for utvikling av en kommunikasjonsstrategi, og for å finne tiltak som kan gjøre kommunikasjonen enklere. Vi har benyttet kvantitative forskningsmetoder ved å samle inn data fra bedriften, foretatt en spørreundersøkelse, hvor vi etterpå anvendte SPSS for å analysere undersøkelsen. Vi har også brukt kvalitative forskningsmetoder som observasjoner, fokusintervjuer og stunt-intervjuer. Dette har gitt oss funn som viser at pensjonister både liker og ønsker å dra på kino, men at de har for lite kjennskap om matinévisningene. Matiné er visning av film på dagtid med lavere lyd tilpasset eldre. De trenger derfor en form for påminnelse, i form av hjulpen kjennskap, slik at de fullfører customer journey ved å kjøpe billetter. Resultatene er brukt videre til utvikling av en kreativ løsning i den praktiske delen vi presenterer en kommunikasjonsstrategi og et konsept for hvordan vi skal kommunisere med pensjonister

Diagnostic accuracy of contrast-enhanced CT for neck abscesses: A systematic review and meta-analysis of positive predictive value

ObjectivesTo review the diagnostic accuracy of contrast-enhanced computed tomography (CT) in differentiating abscesses from cellulitis in patients with neck infections, using surgical findings as the reference standard.Materials and methodsPrevious studies in the last 32 years were searched from PubMed and Embase. Because of partial verification bias (only positive abscess findings are usually verified surgically), sensitivity and specificity estimates are unreliable, and we focused on positive predictive value (PPV). For all studies, PPV was calculated as the proportion of true positives out of all positives on imaging. To estimate pooled PPV, we used both the median with an interquartile range and a model-based estimate. For narrative purposes, we reviewed the utility of common morphological CT criteria for abscesses, such as central hypodensity, the size of the collection, bulging, rim enhancement, and presence of air, as well as sensitivity and specificity values reported by the original reports.Results23 studies were found reporting 1453 patients, 14 studies in children (771 patients), two in adults (137 patients), and seven including all ages (545 patients). PPV ranged from 0.67 to 0.97 in individual studies, had a median of 0.84 (0.79–0.87), and a model-based pooled estimate of 0.83 (95% confidence interval 0.80–0.85). Most morphological CT criteria had considerable overlap between abscesses and cellulitis.ConclusionsThe pooled estimate of PPV is 0.83 for diagnosing neck abscesses with CT. False positives may be due to limited soft tissue contrast resolution. Overall, none of the morphological criteria seem to be highly accurate for differentiation between abscess and cellulitis.</p

Proteomic characterization and three-dimensional electron microscopy study of PSII-LHCII supercomplexes from higher plants

This work was supported by funds from the European Commission (ArtipHyction project (303435) FCH-JU-2011-1; Eco2CO2 project (309701) FP7-NMP2012)

Perceptual abstraction and attention

This is a report on the preliminary achievements of WP4 of the IM-CleVeR project on abstraction for cumulative learning, in particular directed to: (1) producing algorithms to develop abstraction features under top-down action influence; (2) algorithms for supporting detection of change in motion pictures; (3) developing attention and vergence control on the basis of locally computed rewards; (4) searching abstract representations suitable for the LCAS framework; (5) developing predictors based on information theory to support novelty detection. The report is organized around these 5 tasks that are part of WP4. We provide a synthetic description of the work done for each task by the partners

A widespread family of bacterial cell wall assembly proteins

Teichoic acids and acidic capsular polysaccharides are major anionic cell wall polymers (APs) in many bacteria, with various critical cell functions, including maintenance of cell shape and structural integrity, charge and cation homeostasis, and multiple aspects of pathogenesis. We have identified the widespread LytR–Cps2A–Psr (LCP) protein family, of previously unknown function, as novel enzymes required for AP synthesis. Structural and biochemical analysis of several LCP proteins suggest that they carry out the final step of transferring APs from their lipid-linked precursor to cell wall peptidoglycan (PG). In Bacillus subtilis, LCP proteins are found in association with the MreB cytoskeleton, suggesting that MreB proteins coordinate the insertion of the major polymers, PG and AP, into the cell wall

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London