Diagnosis and management of abelchia or R-CPD: a scoping review

An Introduction to Scoping Reviews.

BackgroundDigital microscopy combined with artificial intelligence (AI) is increasingly being implemented in health care, predominantly in advanced laboratory settings. However, AI-supported digital microscopy could be especially advantageous in primary health care settings, since such methods could improve access to diagnostics via automation and a decreased need for experts on-site. To our knowledge, no scoping or systematic review has previously examined the use of AI-supported digital microscopy in primary health care laboratories, and a scoping review could guide future research by providing insights into the challenges of implementing these novel methods.ObjectiveThis scoping review aimed to map published peer-reviewed studies on AI-supported digital microscopy in primary health care laboratories to generate an overview of the subject.MethodsA systematic search of the databases PubMed, Web of Science, Embase, and IEEE was conducted on October 2, 2024. The inclusion criteria in the scoping review were based on 3 concepts: using digital microscopy, AI, and comparison of the results with a standard diagnostic system, and 1 context, being performed in primary health care laboratories. Additional inclusion criteria were peer-reviewed diagnostic accuracy studies published in English, performed on humans and achieving a sample-level diagnosis. The study selection and data extraction were performed by 2 independent researchers (JVB and AS), and cases of disagreement were resolved through discussion with a third researcher (NL). The methodology is in accordance with the Joanna Briggs Institute methodology for scoping reviews.ResultsA total of 3403 papers were screened during the paper identification process, of which 22 (0.6%) were included in the scoping review. The samples analyzed were as follows: blood (n=12) for blood cell and malaria detection, urine (n=4) for urinalysis and parasite detection, cytology of atypical oral (n=1) and cervical cells (n=2), stool (n=2) for parasite detection, and sputum (n=1) for ferning patterns indicating inflammation. Both conventional (n=15) and specifically developed methods (n=7) were used in sample preparation. The AI-supported digital microscopy achieved comparable diagnostic accuracy to the reference standard for complete blood counts, malaria detection, identification of stool and genitourinary parasites, screening for oral and cervical cellular atypia, detection of pulmonary inflammation, and urinalysis. Furthermore, AI-supported digital microscopy achieved higher sensitivity than manual microscopy in 6/7 (85.7%) studies that used a reference standard that allowed for this comparison.ConclusionsAI-supported digital microscopy achieved comparable diagnostic accuracy to the reference standard for diagnosing multiple targets in primary health care laboratories and may be particularly advantageous for improving diagnostic sensitivity. With further research addressing challenges such as scalability and cost-effectiveness, AI-supported digital microscopy could improve access to diagnostics, especially in expert-scarce and resource-limited settings.

BACKGROUND Digital microscopy combined with artificial intelligence (AI) is increasingly being implemented in health care, predominantly in advanced laboratory settings. However, AI-supported digital microscopy could be especially advantageous in primary health care settings, since such methods could improve access to diagnostics via automation and a decreased need for experts on-site. To our knowledge, no scoping or systematic review has previously examined the use of AI-supported digital microscopy in primary health care laboratories, and a scoping review could guide future research by providing insights into the challenges of implementing these novel methods. OBJECTIVE This scoping review aimed to map published peer-reviewed studies on AI-supported digital microscopy in primary health care laboratories to generate an overview of the subject. METHODS A systematic search of the databases PubMed, Web of Science, Embase, and IEEE was conducted on October 2, 2024. The inclusion criteria in the scoping review were based on three concepts: using digital microscopy, AI, and comparison of the results to a standard diagnostic system; and one context, being performed in primary health care laboratories. Additional inclusion criteria were peer reviewed diagnostic accuracy studies in English performed on humans and achieving a sample level diagnosis. The study selection and data extraction were performed by two independent researchers, and cases of disagreement were solved through discussion with a third researcher. The methodology is in accordance with the JBI methodology for scoping reviews. RESULTS A total of 3,403 articles were screened during the article identification process, of which 22 (0.6%) were included in the scoping review. The samples analyzed were as follows: blood (n=12) for blood cell and malaria detection; urine (n=4) for urinalysis and parasite detection; cytology of atypical oral (n=1) and cervical cells (n=2); stool (n=2) for parasite detection; and sputum (n=1) for ferning-patterns indicating inflammation. Both conventional (n=15) and specifically developed methods (n=7) were used in sample preparation. The AI models used were based on both single (n=11) and multiple AI-algorithms (n=11) and all studies except one used convolutional neural networks. The AI-supported digital microscopy achieved comparable diagnostic accuracy to the reference standard for complete blood counts, malaria detection, identification of stool and genitourinary parasites, screening for oral and cervical cellular atypia, detection of pulmonary inflammation, and urinalysis. The AI-supported digital microscopy had higher sensitivity than manual microscopy in six out of seven (85.7%) studies that used a reference standard that allowed for this comparison. CONCLUSIONS AI-supported digital microscopy achieved comparable diagnostic accuracy to the reference standard for diagnosing multiple targets in primary health care laboratories and may be particularly advantageous for improving diagnostic sensitivity. However, many shared challenges, ranging from sample preparation to workflow integration, need to be addressed to enable real world implementation. CLINICALTRIAL JMIR Res Protoc 2024;13:e58149 doi:10.2196/58149 INTERNATIONAL REGISTERED REPORT RR2-10.2196/58149

IntroductionSub-Saharan Africa bears the greatest burden of HIV. Concomitant mental disorders are common, necessitating the integration of mental healthcare into routine HIV care. Consequently, it is necessary to holistically evaluate...

BackgroundDigital microscopy combined with artificial intelligence (AI) is increasingly being implemented in health care, predominantly in advanced laboratory settings. However, AI-supported digital microscopy could be especially advantageous in primary health care settings, since such methods could improve access to diagnostics via automation and lead to a decreased need for experts on site. To our knowledge, no scoping or systematic review had been published on the use of AI-supported digital microscopy within primary health care laboratories when this scoping review was initiated. A scoping review can guide future research by providing insights to help navigate the challenges of implementing these novel methods in primary health care laboratories.ObjectiveThe objective of this scoping review is to map peer-reviewed studies on AI-supported digital microscopy in primary health care laboratories to generate an overview of the subject.MethodsA systematic search of the databases PubMed, Web of Science, Embase, and IEEE will be conducted. Only peer-reviewed articles in English will be considered, and no limit on publication year will be applied. The concept inclusion criteria in the scoping review include studies that have applied AI-supported digital microscopy with the aim of achieving a diagnosis on the subject level. In addition, the studies must have been performed in the context of primary health care laboratories, as defined by the criteria of not having a pathologist on site and using simple sample preparations. The study selection and data extraction will be performed by 2 independent researchers, and in the case of disagreements, a third researcher will be involved. The results will be presented in a table developed by the researchers, including information on investigated diseases, sample collection, preparation and digitization, AI model used, and results. Furthermore, the results will be described narratively to provide an overview of the studies included. The proposed methodology is in accordance with the JBI methodology for scoping reviews.ResultsThe scoping review was initiated in January 2023, and a protocol was published in the Open Science Framework in January 2024. The protocol was completed in March 2024, and the systematic search will be performed after the protocol has been peer reviewed. The scoping review is expected to be finalized by the end of 2024.ConclusionsA systematic review of studies on AI-supported digital microscopy in primary health care laboratories is anticipated to identify the diseases where these novel methods could be advantageous, along with the shared challenges encountered and approaches taken to address them.International Registered Report Identifier (IRRID)PRR1-10.2196/58149

How is generalization managed in anomia research? An analysis of current practice and future directions

Background Studying empathy in borderline personality disorder (BPD) is essential because difficulties with interpersonal functioning are integral. Objectives This scoping and narrative review explores the aetiological theory that BPD is an innate anomaly of cognitive empathy, with a normal or heightened emotional empathy. Eligibility criteria and sources of evidence Ovid MEDLINE(R) ALL was searched using the terms empathy; theory of mind; mentalisation or mentalising; borderline empathy; emotion recognition and BPD. For inclusion in the scoping review, articles needed to empirically assess an empathic skill in people with BPD, or self-reported empathy in a BPD group compared to controls, or empathic skill as a ‘borderline feature’ in a nonclinical sample. Charting method The results of empirical studies were categorised as per their methodological approach, with results in the BPD group reported as comparable, enhanced or reduced compared to controls. Results 320 articles were returned, with 38 eligible. The majority affirmed that people with BPD have an anomalous empathetic ability, especially a deficient cognitive empathy. Furthermore, this is trait, evident early in development, correlates with syndrome severity, and is mediated by atypical neural networks. Conclusions This substantiates the theory that BPD is, at least in major part, an innate empathy anomaly.

Background. Reproducible reviews that have a systematized approach, such as scoping, mapping, rapid, and other non-systematic reviews (henceforth, referred to as Scoping et al. reviews), have become a necessary step in a wide range of observational studies for public health research. Nevertheless, the quality of such Scoping et al. reviews is never questioned or evaluated. We propose a general-purpose tool for assessing the quality and risk of bias of Scoping et al. reviews, using a collaborative evaluation.MethodsThis Scoping et al. reviews tool (DESCreview, Design tool for Evaluating risk of bias/quality in Systematized and sCoping reviews) consists of a nine-domain assessment with four possible probabilities of quality. It includes the following domains in three parts: (A) Items applicable to all Scoping et al. reviews (Selection of papers; Classification; Extraction; Conflict of interest; Specific domain relevant to the question); (B) Items applicable to some Scoping et al. reviews (Preregistration and protocol difference, Risk of bias); and (C) Items only applicable for systematic reviews (Meta-analysis (if applicable), Strength of evidence). Each of the nine domains is rated from “Very high quality with low risk of bias” to “Very low quality with high risk of bias”. The overall confidence is assigned by combining all the nine domains into an overall strength rated: high, moderate, low, critically low. These four categories would be included in the review as the “calibration”. We also propose a collaborative evaluation, involving all potentially interested colleagues, using an online questionnaire. In the absence of a reference method, the validation study will be based on a comparison with AMSTAR-2, and feedback from user experience resulting in the production of a paper after one year of testing.DiscussionDESCreview allow simple general-purpose tool for assessing the quality and risk of bias of systematized review in occupational and public health. The originality also lies in the collaborative validation process.

Scoping reviews, mapping reviews, and evidence and gap maps are evidence synthesis methodologies that address broad research questions, aiming to describe a bigger picture rather than address a specific question about intervention effectiveness. They are being increasingly used to support a range of purposes including guiding research priorities and decision making. There is however a confusing array of terminology used to describe these different approaches. In this commentary, we aim to describe where there are differences in terminology and where this equates to differences in meaning. We demonstrate the different theoretical routes that underpin these differences. We suggest ways in which the approaches of scoping and mapping reviews may differ in order to guide consistency in reporting and method. We propose that mapping and scoping reviews and evidence and gap maps have similarities that unite them as a group but also have unique differences. Understanding these similarities and differences is important for informing the development of methods used to undertake and report these types of evidence synthesis.

BackgroundPeople with dementia (PwD) vary in the degree of awareness they show about their situation, both generally concerning the diagnosis and more specifically around certain aspects or objects of awareness such as awareness of memory impairment, altered daily activities or social functioning. The extent of awareness or lack of awareness has consequences for well-being of PwD and carers, impacting on rates of hospital admission, institutionalization, mood, adjustment to diagnosis, outcomes from intervention and carer burden. An accurate estimation of a person’s awareness could therefore be useful in a clinical setting to support PwD and their carers in making appropriate choices for health and care decisions, and could facilitate safe management by health care professionals, e.g. in an acute care setting. There is a range of different approaches to measuring awareness reported in the dementia research literature, with varying estimates of the frequency of lack of awareness, reflecting different methodologies and populations. The majority of the methods have been developed for research purposes and may not be suitable for clinical use. There are no recent scoping or systematic reviews of the available methods.MethodWe will conduct a scoping review of published studies that have assessed awareness in people with dementia of all types, and all degrees of severity. The systematic search will include the electronic databases PubMed, Embase, PsycInfo, CINAHL, Web of Science and Cochrane Library, using search terms for dementia (“dement*” or “Alzheimer*” or “Pick’s disease”) and “awareness”, “unawareness”, “anosognosia”, “insight”, “denial”, “metacognit*” or “discrepanc*” identified from pilot searches. Findings will be mapped and described according to the method used, the setting and diagnosis and the object of awareness studied if specified. Validated measures will be identified.DiscussionThis scoping review will provide an overview of the methods used to measure awareness in people with dementia, allowing comparison of the methods along with identification of validated measures. The methods or components will be appraised for potential clinical use, and gaps in research will be highlighted.

This scoping review aimed to map global evidence on upstream interventions which promote oral health and reduce socioeconomic inequalities in oral health. A review was undertaken in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. A multistranded comprehensive search strategy was employed to identify relevant studies. Article texts were retrieved and assessed for eligibility against the inclusion criteria. Key findings were extracted and summarised. A total of 99 articles (74 empirical studies and 25 systematic, scoping and umbrella reviews) were included in the scoping review. The review findings revealed a limited number of upstream interventions specifically focused on promoting oral health and reducing oral health inequalities. Legislative and regulatory measures (e.g., advertising controls), fiscal measures (e.g., sugar-sweetened beverage taxation) and specific oral health interventions (e.g., water fluoridation) have shown a positive impact on promoting oral health. In addition, fiscal measures, food subsidies targeted at low-income groups and improvements to housing/work environments have proven effective in reducing socioeconomic inequalities in general health outcomes. Despite a very detailed and thorough search of the global literature, this scoping review identified a limited number of upstream interventions that specifically focused on improving oral health, and an even smaller number of upstream interventions that tackled oral health inequalities. However, the review did identify three levels of upstream intervention including: policies tackling the broader socio-political determinants of health; policies combating non-communicable diseases (NCDs) linked to oral health; and some specific interventions (e.g., water fluoridation) focusing on oral health. The upstream approach to prevention remains highly relevant to public health policy and provides a guiding principle for future strategic action to promote oral health and tackle oral health inequalities.

Acute abdominal pain (colic) is the most common reason for emergency veterinary treatment in the horse. Consolidation of data through a systematic review is important to inform evidence-based medicine and clinical guidelines, but there are currently no published systematic reviews on colic in the horse. The aim of this study was to identify, categorize and appraise the evidence on factors associated with increased risk of developing abdominal pain (colic) due to gastrointestinal disease in the adult horse. A scoping review was performed to identify and categorize evidence on all risk factors for colic. A systematic review of management-related risk factors was then performed following PRISMA guidelines. Both searches were conducted in Medline, CAB s and Web of Science databases, and publications were assessed against inclusion and exclusion criteria. For the scoping review, study and participant characteristics of included publications and key results were extracted and tabulated. For the systematic review, cohort, case-control or cross-sectional studies investigating acute abdominal pain in horses within two weeks of management changes were assessed. Study characteristics, participant characteristics and study results of included publications for the systematic review were extracted and tabulated. Included publications were appraised using the Joanna Briggs Institute Critical Appraisal Tools for cohort, case-control and cross-sectional studies. The scoping review search identified 3,756 publications. Fifty eight studies met final inclusion criteria, and 22 categories of risk factors were identified. These were grouped into three broad areas: horse-related factors, management-related factors and environment-related factors. The largest body of evidence related to management change. The systematic review of management change identified 410 publications: 14 met inclusion criteria for analysis. These consisted of one cohort, eight case-control and five cross-sectional studies. The studies were conducted between 1990–2008, and the majority of studies were located in the USA (8/14) or UK (3/14). The risk factors related to management change that were assessed were feed, carer, exercise, pasture, water and housing. The largest bodies of evidence for increased risk of colic associated with management change were changes in feed (5/14 publications) and recent change in housing (3/14). Most studies (8/14) did not meet the JBI criterion on confounding factors. There was marked heterogeneity of study methodologies and measures. This is the first study to use a combined scoping and systematic review to analyse evidence for modifiable risk factors for a common condition in the horse. It provides a comprehensive review that will be a key resource for researchers, veterinary practitioners and horse owners. It identified modifiable risk factors associated with an increased risk of colic which should be a key target for preventative health programmes. The findings from the critical appraisal were used to develop recommendations for future research to improve the quality of evidence-based veterinary medicine.

Objective: Scoping reviews use a systematic approach to synthesize a body of knowledge. The use of scoping review methodology is increasingly common. Despite recommendations to guide the conduct of scoping reviews, inconsistencies exist with regards to their methodology and reporting. In this case-study, we reflect on our experience using the PRISMA Extension for Scoping Reviews (PRISMAScR): Checklist and Explanation to improve reporting for a scoping review we initially conducted prior to the release of the PRISMA-ScR reporting guidelines. Study Design and Methods: We evaluated the scoping review against 22 criteria included in the PRISMA-ScR. For each criterion, we provided a rating representing the degree to which we felt the scoping review met the individual criterion in the PRISMAScR. We also provided comments to substantiate our ratings, along with recommended revisions for the scoping review and considerations for future scoping reviews. Results: We identified a number of strengths in the initial reporting of our scoping review , as well as opportunities for improvement. The most substantial areas for zmprovement included the protocol registration, data items and data charting process. Based on our evaluation, we made revisions to the scoping review manuscript to improve our reporting. Conclusion: Our evaluation helps to highlight the value of using reporting guidelines to improve reporting of scoping reviews, while also exposing several challenges. In future, we recommend consulting the guidelines during the initial preparation of the scoping review manuscript rather than retrospectively. What is already known about the topic? The use of scoping review methodology is becoming increasingly common. While recommendations to guide the conduct of scoping reviews have been published, inconsistencies exist in both scoping review methodology and reporting. What this paper adds: Despite some challenges, we found the PRISMAScR to be an effective tool to guide a structured reflection on our scoping review reporting. We encourage authors completing scoping reviews to make use of the PRISMA-ScR to guide their own scoping review reporting.

Background: Cataracts remain the leading cause of blindness globally, and surgery is the primary treatment. Inadequate postoperative care can lead to serious complications, including endophthalmitis. Nurse-led education is critical for prevention, and its impact can be strengthened through a management function approach. Purpose: To review nursing education strategies for preventing postoperative cataract infection from a management function perspective. Method: A scoping review was conducted following PRISMA guidelines using the PCC framework (P: nurse, C: educational management, C: postoperative cataract infection). Searches were performed in PubMed (MeSH terms) and Science Direct (standard keywords) for English-language, full-text articles published between 2014 and 2024. Narrative, integrative, scoping, and systematic reviews, as well as meta-analyses, were excluded. Results: The search retrieved 166 articles (75 PubMed, 91 Science Direct). After screening and eligibility assessment, 12 articles were included. Although none explicitly examined management functions, analysis revealed their implicit application. Educational interventions, when systematically planned, organized, implemented, and evaluated, enhanced effectiveness in preventing postoperative cataract infections. Conclusion: Incorporating a structured management function approach can improve the effectiveness of nursing education in preventing postoperative cataract infections. No studies were found that directly applied this framework in cataract postoperative care, indicating a gap for future research.

Post-Seclusion and/or Restraint Review in Psychiatry: A Scoping Review