Quality Assessment Research Articles

Economic Evaluation of Prevention Interventions for Child Sexual Exploitation or Child Sexual Abuse: A Systematic Review.

Child sexual abuse, including sexual exploitation, is a global issue, affecting 8% to 31% of girls and 3% to 17% of boys worldwide. This systematic review aims to synthesize economic evidence on the cost-effectiveness of community interventions to prevent child sexual abuse/exploitation to inform decision-making. A systematic search was conducted on eight databases for studies published until April 2023. Gray literature was searched using Google. The inclusion criteria were economic evaluation of interventions targeted at children, perpetrators/offenders, or professionals addressing child sexual abuse/exploitation. There was no limitation by country, but an English language abstract was required for non-English articles. Studies without a specific focus on child sexual abuse/exploitation, such as physical, emotional, and domestic violence-related abuse, were excluded. All costs were adjusted to US$ 2023. Reporting quality assessment was conducted using the Consolidated Health Economic Evaluation Reporting Standards 2022 checklist. Of 5,180 screened articles, 17 were included in the final synthesis, with most from the United States and focused on tertiary prevention delivered to offenders. While the intervention components varied across studies, all demonstrated promising and cost-effective results. The findings highlight a small but growing body of economic evidence for child sexual abuse/exploitation interventions. The existing economic evaluation evidence is dominated by tertiary prevention, which focuses on offenders and child victims and highlights the need for more research and action on primary and secondary preventative interventions for general and at-risk populations.

Zinc, copper, and selenium levels in vitiligo: a systematic review and meta-analysis

AbstractVitiligo is a dermatological disease characterized by loss of melanocytes, causing non-scaly white macules on the skin. Zinc, copper, and selenium are important micronutrients that play a role in the normal functioning of the body and have been found to potentially aid in vitiligo treatment, although the relationship between their serum levels and vitiligo is not yet fully understood. This is a systematic review aimed at assessing the levels of serum zinc, copper, and selenium and their association with vitiligo. This review was performed following the Preferred Reporting Items of the systematic Review and Meta-Analysis (PRISMA) checklist and Cochrane guidelines. A comprehensive literature search was conducted on PubMed, Google Scholar and 41 studies published between 1970 and 2022 including 3353 vitiligo cases and 10,638 controls were included in the meta-analysis conducted from August 2022 till September 2023. The quality of the studies was assessed using the National Heart Lung and Blood Institute Study Quality Assessment tool, and the risk of bias was represented using the RobVis tool. The statistical analysis was performed using Review Manager (RevMan) Version 5.4. This meta-analysis indicate a significant decline in serum zinc levels (Z = 4.97; P < 0.0001; SMD = − 0.86; 95% CI − 1.19 to − 0.52) in vitiligo group with high statistical heterogeneity (Tau2 = 0.74; Chi2 = 513.95, d.f. = 26 [P < 0.00001]; I2 = 95%). Similarly for serum copper levels there was decline (Z = 2.43; P < 0.0001; SMD = − 0.50; 95% confidence interval [CI] − 0.91 to − 0.10) in vitiligo group and high statistical heterogeneity (Tau2 = 0.92; Chi2 = 475.10, d.f. = 22 [P < 0.00001]; I2 = 95%). On the other hand, there was a increase of serum selenium levels in the vitiligo group (Z = 0.56; P < 0.0001; SMD = 0.23; 95% confidence interval [CI], 0.58 to 1.04) and the results reveals high statistical heterogeneity among studies (Tau2 = 1.93; Chi2 = 406.44, d.f. = 11 [P < 0.00001]; I2 = 97%) in vitiligo patients compared to healthy controls. Publication bias was not found for the studies analysed. This study analyses the association of serum micronutrient levels and vitiligo among patients and controls from published research along with sub-group analysis specific to Asian populations using a meta-analysis. Low serum levels of Zinc and copper and high selenium levels are associated with Vitiligo.

Assessment and Modeling of Water Quality in the Niger River: A Comprehensive Study Using Water Quality Indices and Intelligent Techniques

The Niger River is essential to the livelihoods of those in Bamako and its neighboring areas, providing vital resources for drinking water, agriculture, livestock, industry, and fishing. Given its significance across these sectors, there is a pressing need to establish an effective water resource management strategy that incorporates a thorough qualitative assessment of the river's water quality. This research seeks to characterize the water quality of the Niger River by employing Water Quality Indices (WQI) and intelligent modeling techniques. To fulfil this objective, various physicochemical parameters, including pH, electrical conductivity (EC), nitrate (NO3-), nitrite (NO2-), and iron (Fe), were collected from 40 sampling points along the river during three distinct periods: December 2017, March 2018, and July 2018. The study utilized a weighted arithmetic approach to compute the WQIs, while the predictive models were developed using two of the most famous and effective modeling techniques namely Multiple Linear Regression (MLR) and Artificial Neural Networks (ANN). In order to evaluate the predictive performance of the models, the dataset was partitioned into three distinct segments, allocating 60% for training purposes, 20% for validation, and the remaining 20% for testing, with the segments organized in a sequence from upstream to downstream. The performance of both models was evaluated using metrics such as the correlation coefficient (r²), Root Mean Square Error (RMSE), and Mean Absolute Error (MAE). The computed Water Quality Indices (WQIs) vary from 0.44 to 1887.40, indicating a diverse range of water quality across the samples analyzed. The classification of these samples reveals that 62.5% are considered excellent, while 15% are categorized as good, another 15% as poor, 2.5% as very poor, and 5% as unsuitable for consumption. Furthermore, the results derived from ANN with five inputs, one hidden layer (13 neurons) and one output (WQI) demonstrates superior efficiency in assessing water quality.

A reliable and valid assessment of upper limb movement quality after stroke: the observational Drinking Task Assessment.

To develop and evaluate the reliability and validity of a new observational Drinking Task Assessment (DTA) designed to assess quality of movement in task performance after stroke. Reliability and validity. The DTA measures movement time and movement quality (smoothness, trunk, shoulder, elbow, and grasp movements) on a 4-level ordinal scale. Thirty participants with chronic stroke were assessed independently by 2 therapists. Intra-class correlation (ICC), standard error of measurement (SEM) and minimal real difference (MRD), weighted kappa, percentage of agreement, and Svensson method were used for reliability assessment. Motion capture-based kinematics and established clinical scales were used to evaluate validity. The absolute SEM and MRD for movement time were 0.4 and 1 s (11%), respectively. The ICC (≥ 0.93) and weighted kappa (0.71-1.0) showed good to excellent agreement for intra- and inter-rater reliability. DTA showed strong correlations with Fugl-Meyer Assessment (0.74), Action Research Arm Test (0.93), and kinematic measures of smoothness (0.93), trunk displacement (0.91), elbow extension (0.73), and shoulder movements (0.56), indicating good construct validity. The new DTA proved to be a reliable and valid tool for assessment of movement quality during task performance after stroke.

Development and Validation of a Novel Holistic Skin Quality Assessment Scale.

Radiant skin is a common patient request and the result of multiple contributing factors. Currently, there is no standardized methodological approach that facilitates assessment of skin quality from a holistic perspective. To develop a holistic methodological process to assess skin quality using a scale that helps identify treatment priorities, facilitates conversation with the subject, and helps manage expectations, supports long-term treatment plans, and tracks treatment progress over time. Ten global experts (dermatologists and esthetic physicians) identified the main measurable aspects that contribute to skin quality, and these were combined to form the Skin Quality Assessment Scale (SQS). The scale comprises four overarching skin quality domains containing nine measurable aspects: texture (pores, lines, scars); discoloration (redness, pigmentation, dullness); firmness (laxity); and hydro-lipid balance (oiliness, dryness). Each aspect is graded on a 4-point severity scale (0 = none to 3 = severe). The SQS was validated by a large group of practicing clinicians. Practicing clinicians (> 40, 78% dermatologists) were surveyed; prior to reviewing the scale, 67% did not use any scale but 81% believed a holistic SQS was needed. After reviewing the scale, 100% agreed the scale provides a holistic assessment of skin quality. In addition, 95% agreed the scale helps assess all key aspects of skin quality with subjects and 98% deemed it valuable for their clinic. The SQS represents a holistic assessment tool that engages with and manages subjects' expectations, identifies treatment priorities, creates a long-term treatment plan, and visualizes the skin quality improvement over time.

The Role of Language in Remote Healthcare Triage: AMeta-Aggregative Review.

To provide an overview of evidence on the role of language in remote healthcare services prioritisation, from now on termed triage. This study synthesises literature, to better understand how language affects triage interactions, aiming to improve these processes. We conducted a meta-aggregative review. A systematic search in Scopus from inception to September 2023 identified 437 studies on language in remote healthcare triage, of which 23 were included. Information was selected using both inductive and deductive coding, focusing on six linguistic features of interaction that have been described in the literature on studies using conversation analysis: turn-taking organisation, overall structure, sequence organisation, turn design, lexical choice, and epistemological and other forms of asymmetry. The process followed the RAMESES Publication Standards for Meta-narrative Reviews. Two main findings emerged. First, all six linguistic features are present in triage conversations, indicating that language involves more than just what is said. It also matters, for example, how and when a question is asked. Second, computerised decision support systems (CDSS) significantly affect conversation flow and dynamics. Language in triage involves more than literal speech and is heavily influenced by CDSS. Our study suggests that quality assessments of triage conversations should consider not only what is said but cover all relevant aspects of language. The influence of computerised decision support systems (CDSS) on linguistic features highlights the need for systems to be adaptable, to improve conversation quality and better addressing caller needs rather than focusing on one-size-fits-all questions. This review highlights the complex role of language in triage conversations and its impact on interaction. It calls for a broader view of language in quality assessments, recognising that both call-takers and callers contribute to call quality. Insights from this review can help developers enhance question types, sequence, and delivery methods of computerised decision support systems. Finally, education for call-takers in healthcare sectors may be improved based on our findings. No patient or public contribution.

Age Is a Key Factor Influencing the Choice of Treatment for Primary Patellar Dislocation: A Systematic Review and Meta-analysis.

Primary patellar dislocation has a certain recurrence rate after either conservative or surgical treatment, and the optimal treatment for patients with primary patellar dislocation of different ages remains unclear. This study aims to compare the clinical efficacy of surgical and conservative treatments for primary patellar dislocation across different age groups. According to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist, we conducted a systematic search for randomized controlled trials. We searched the PubMed, EMBASE, Cochrane Library, and Web of Science databases for randomized controlled trials of primary patellar dislocation treated surgically or conservatively up to January 2023. Data searching, extraction, analysis, and quality assessment were carried out in accordance with the Cochrane Collaboration guidelines. A total of nine studies with 433 patients were included in our study. There was no statistically significant difference between the two treatment modalities in terms of Kujala score, pain score, patient satisfaction, reoperation, and Tegner score. The rate of re-dislocation after surgical treatment is lower than that after conservative treatment. Subgroup analysis based on mean age showed that when the age was >20 years, Kujala scores were higher after surgical treatment than after conservative treatment (p < 0.0001, 95% confidence interval [CI] = 10.41-21.30). When the age was ≤20 years, the difference in Kujala scores between the two treatment modalities was not statistically significant. When the age was >20 years, the recurrence rate of patellar dislocation was lower after surgical treatment than after conservative treatment (p = 0.009, 95% CI = 0.08-0.70). When the age was ≤20 years, the difference in the recurrence rate of patellar dislocation between the two treatment modalities was not statistically significant. When the age of patients with primary patellar dislocation is ≤20 years, both surgical and conservative treatments result in similar clinical outcomes. When the age is >20 years, better clinical outcomes can be achieved by opting for surgical treatment. Therefore, surgery may be a better option for patients with primary patellar dislocation whose age is >20 years.

Preoperative Smoking-Cessation Interventions to Prevent Postoperative Complications: A Quality Assessment and Overview of Systematic Review Evidence

Multiple systematic reviews have investigated the effectiveness of preoperative interventions for smoking-cessation, although relatively few have focused on the prevention of surgical complications. This overview of systematic reviews aimed to describe the types of smoking interventions studied to prevent postoperative complications, summarize the results, and evaluate the quality of the reviews and strength of evidence to inform clinicians, health practitioners, policy developers, and government bodies. Comprehensive searches of Cochrane Library, MEDLINE, EMBASE, CINAHL, and Johanna Briggs Institute databases were conducted to identify systematic reviews of preoperative smoking-cessation interventions to prevent surgical complications (inception—May 14, 2024). Search results were independently screened by 2 reviewers for articles meeting the eligibility criteria. Data on key review characteristics and included studies were extracted: aim, search strategy, included studies, risk of bias, population, sample size, intervention, comparator, main findings, and conclusions. Quality appraisal of the reviews was undertaken using the AMSTAR 2 tool and evidence certainty was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Sixty-seven full-text articles from 838 citations were screened, resulting in 6 included systematic reviews with 12 primary studies reporting postoperative complications. Four reviews which included all primary studies, provided moderate to high strength of evidence. There was high-certainty evidence suggesting interventions started ≥4 weeks before surgery incorporating multiple behavioral support sessions and pharmacotherapy are needed to prevent postoperative complications, particularly the incidence of surgical site infections. High-certainty evidence also indicates the duration of smoking-cessation is important, with benefits amplified for longer periods. However, medium- to high-certainty evidence suggests interventions initiated &lt;4 weeks before surgery even with multiple behavioral support sessions (with or without pharmacotherapy), and interventions commenced &gt;4 weeks before surgery but with only 1 interventional component, increase quit rates but do not reduce complications. This overview provides the most up-to-date summary and quality assessment of systematic review evidence on the effectiveness of preoperative smoking-cessation interventions to prevent surgical complications. The evidence supports providing smoking-cessation interventions which include multiple behavioral support sessions and pharmacotherapy implemented at least 4 weeks before surgery to reduce postoperative complications. Consequently, anesthesiologists need to work with primary care physicians, consultants, and surgeons to optimize smoking-cessation interventions way in advance of surgery.

Impacts from air pollution on respiratory disease outcomes: a meta-analysis

IntroductionAir pollution is widely acknowledged as a significant factor in respiratory outcomes, including coughing, wheezing, emergency department (ED) visits, and even death. Although several literature reviews have confirmed the association between air pollution and respiratory outcomes, they often did not standardize associations across different studies and overlooked other increasingly impactful pollutants such as trace metals. Recognizing the importance of consistent comparison and emissions of non-exhaust particles from road traffic, this study aims to comprehensively evaluate the standardized effects of various criteria pollutants and trace metals on respiratory health.MethodsWe conducted a comprehensive meta-analysis of peer-reviewed journal articles on air pollution and respiratory outcomes published between 1 January 2000, and 1 June 2024. The study included children (age &amp;lt; 18 years), adults (age ≥ 18 years), and all age groups exposed to criteria pollutants established by the US Environmental Protection Agency National Ambient Air Quality Standards and over 10 trace metals. Using databases, such as PubMed, MEDLINE, Web of Science Core Collection, and Google Scholar, we identified 579 relevant articles. After rigorous screening and quality assessment using the Newcastle-Ottawa Scale, 50 high-quality studies were included. We converted various reported outcomes (e.g., odds ratios, relative risk, and percent increase) to a standardized odds ratio (OR) for comparability and performed meta-analyses using R 4.4.0 and related packages, ensuring the robustness of our findings.ResultsOur meta-analysis indicated significant associations between air pollutants and respiratory outcomes. For particulate matter with diameter ≤ 2.5 μm (PM2.5), the overall ORs for children, adults, and combined age groups were 1.31, 1.10, and 1.26, respectively, indicating a consistent positive association. Similar positive associations were observed for particulate matter with diameter ≤ 10 μm (PM10) and other pollutants, with children showing higher susceptibility than adults. The analysis of trace metals also showed significant associations; however, these findings require cautious interpretation due to the small number of studies.ConclusionOur study supports associations between air pollutants, including non-exhaust trace metals, and respiratory outcomes across different age groups. The findings underscore the need for stringent environmental health policies and further research, especially in regions with higher pollution levels. The future studies should consider long-term and short-term exposures separately and include diverse populations to improve the accuracy and generalizability of the results.

Comparative Efficacy of Self-ligating Bracket Systems versus Conventional Bracket Systems in Orthodontic Treatment: A Systematic Review

Abstract This systematic review aimed to compare the efficacy of self-ligating bracket (SLB) systems with conventional bracket systems in orthodontic treatment. A comprehensive search of electronic databases was conducted to identify relevant studies published up to 11. Inclusion criteria encompassed comparative studies evaluating orthodontic treatment outcomes between SLB and conventional bracket systems. Data extraction and quality assessment were performed independently by two reviewers. Key outcome measures included treatment duration, complications, patient-reported outcomes and clinical effectiveness. A total of 11 studies met the inclusion criteria and were included in the systematic review. Findings indicated comparable treatment durations between SLB and conventional bracket systems, with significant differences in complication rates. Patient-reported outcomes suggested more levels of comfort and satisfaction with SLB systems. In addition, clinical effectiveness measures, such as tooth alignment and occlusal outcomes, showed significant discrepancies in favour of SLB systems. However, there was variability amongst studies regarding specific clinical parameters assessed. Based on the findings of this systematic review, SLB systems demonstrate comparable efficacy to conventional bracket systems in orthodontic treatment. While both SLB systems exhibit lesser treatment durations, complication rates and patient-reported outcomes, further research is warranted to elucidate potential differences in specific clinical parameters and long-term treatment outcomes.

Online reviews explain differences in coastal and inland tourists’ satisfaction

To achieve a comprehensive understanding of the factors influencing tourist satisfaction, there has recently been an increasing interest in the information provided by online reviews. In this regard, a rather unexplored issue concerns the causal relationship between topics and emotions expressed by consumers in the written text and their overall quality assessment given through a rating system. This study aims to contribute to filling this gap by investigating whether there are differences between coastal and inland Sardinian hotels in the topics and emotions expressed by online reviewers and how both affect customer satisfaction. To this end, we apply the new TOBIAS method which models the impact of topics, moods, and emotions contained in reviews on the level of satisfaction expressed by customers through the number of stars. The novelty of this method is that it combines natural language processing and causal inference to explain the customer’s overall quality rating.

Longitudinal assessment of health-related quality of life after SARS-CoV-2 infection and the associations with clinical and social characteristics in a general practice population

BackgroundWe aimed to investigate the longitudinal impact of COVID-19 and the effects of clinical and psychosocial factors, accounting for post-COVID conditions (PCC), on the mental and physical aspect of health-related quality of life (HRQoL) of patients diagnosed with COVID-19.MethodsData from the Nivel Corona Cohort were used, which includes individuals with an established SARS-CoV-2 infection that received four questionnaires over a year’s time with questions regarding HRQoL (SF-12), symptoms and social characteristics. PCC was determined based on questionnaire data. Data on medical history and healthcare utilization were obtained from electronic health records from general practice. A repeated measures linear mixed model was used to explore associations between clinical and social characteristics, and the course of mental and physical HRQoL after a SARS-CoV-2 infection, taking PCC into account.ResultsOne hundred fifty-eight individuals of whom it was possible to determine whether they had PCC or not were included in this study. Seventy-six (48.1%) developed PCC, which was associated with a persistent reduction in both physical and mental HRQoL. Hospitalization during the acute phase of the infection had a negative impact on the physical HRQoL, which decreased over time. Females, people older than 53, and those with increased resilience and mental HRQoL before infection were more likely to report a more positive mental HRQoL over time.ConclusionThe negative association PCC has with both mental and physical HRQoL for at least six months, calls for more research to support patients with PCC.

A systematic review and meta-analysis of the anti-inflammatory benefits of curcumin supplementation in individuals with metabolic syndrome and related diseases

Several randomized controlled studies (RTCs) have investigated the potential beneficial effects of curcumin in inflammatory process in metabolic syndrome. These studies have presented results controversial and inconclusive. In the present study, we aimed to conduct a systematic review and meta‐analysis of RCTs to assess the effect of curcumin supplementation on inflammatory markers such as tumor necrosis factor‐alpha (TNF‐α), C‐reactive protein (CRP), and interleukin‐6 (IL‐6) among in patients with metabolic syndrome and related disorders. PubMed, Scopus, Web of Science, and SciELO were searched from inception up to September 2023. The review has been registered at PROSPERO (CRD42023447460). Weighted mean differences (WMDs) were reported. P-values &lt; 0.05 were considered significant. By employing the Cochrane tool, RCTs were assessed for bias risk. Assessment of study quality was conducted using the GRADE approach. Publication bias was evaluated using funnel plots and Egger’s tests. In total, 26 studies were included in the meta-analysis, including 27 arms. The meta‐analysis indicated that curcumin supplementation significantly decreased CRP (-0.75mg/dL, 95 % CI: -1.10, -0.39; p= &lt;.0001), IL-6 (-1.41pg/mL, 95 % CI: -2.04, -0.77; p = &lt;.0001), and TNF‐α (-3,15pg/mL, 95 % CI: -4.52, -1.48; p = 0.0001) levels. Thus, this meta-analysis suggests that curcumin supplementation may exert anti-inflammatory effects, however, additional trials are needed to validate these results and reduce heterogeneity between studies.

Sleep quality and thermal comfort assessment in the hot and humid climate of Malaysia

Sleep quality and thermal comfort assessment in the hot and humid climate of Malaysia

Sex Differences in Elderly People’s Sleep: A Cross-Sectional Study

Background and Objectives: Sex differences are unclear in geriatric sleep medicine, and most evidence comes from inference from preclinical bases or clinical studies conducted on younger people. The aim of this study is to explore sex differences in sleep quality and daytime sleepiness in a cohort of elderly people. Materials and Methods: This cross-sectional study involved subjects aged 65 years or older undergoing multidimensional evaluation, including sleep quality and daytime sleepiness assessment with validated tools. Results: This study included 226 subjects (69.5% women), the majority of whom showed poor sleep quality (64.2%). A logistic regression model put one before the other sleep quality and gender. It initially showed that men were about half likely as women to have poor sleep quality (OR 0.48, 95%CI 0.27–0.86). Nonetheless, after adjusting for cognitive status and mood, the difference became smaller and insignificant (OR 0.72, 95%CI 0.38–1.38). Conclusions: Sex differences in elderly people’s sleep quality seem to not be independent, appearing to be affected by alterations in cognitive status and mood.

Is there enough evidence supporting the clinical adoption of clear cell likelihood score (ccLS)? An updated systematic review and meta-analysis

ObjectiveTo review the evidence for clinical adoption of clear cell likelihood score (ccLS) for identifying clear cell renal cell carcinoma (ccRCC) from small renal masses (SRMs).MethodsWe distinguished the literature on ccLS for identifying ccRCC via systematic search using PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and Wanfang Data until 31 March, 2024. The risk of bias and concern on application was assessed using the modified quality assessment of diagnostic accuracy studies (QUADAS-2) tool. The level of evidence supporting the clinical adoption of ccLS for identifying ccRCC was determined based on meta-analyses.ResultsEight MRI studies and three CT studies were included. The risk of bias and application were mainly related to the index test and flow and timing, due to incomplete imaging protocol, unclear rating process, and inappropriate interval between imaging and surgery. The diagnostic odds ratios (95% confidence intervals) of MRI and CT ccLS were 14.69 (9.71–22.22; 6 studies, 1429 SRM, 869 ccRCC), and 5.64 (3.34–9.54; 3 studies, 296 SRM, 147 ccRCC), respectively, for identifying ccRCC from SRM. The evidence level for clinical adoption of MRI and CT ccLS were both rated as weak. MRI ccLS version 2.0 potentially has better diagnostic performance than version 1.0 (1 study, 700 SRM, 509 ccRCC). Both T2-weighted-imaging with or without fat suppression might be suitable for MRI ccLS version 2.0 (1 study, 111 SRM, 82 ccRCC).ConclusionccLS shows promising diagnostic performance for identifying ccRCC from SRM, but the evidence for its adoption in clinical routine remains weak.Critical relevance statementAlthough clear cell likelihood score (ccLS) demonstrates promising performance for detecting clear cell renal cell carcinoma, additional evidence is crucial to support its routine use as a tool for both initial diagnosis and active surveillance of small renal masses.Key PointsClear cell likelihood score is designed for the evaluation of small renal masses.Both CT and MRI clear cell likelihood scores are accurate and efficient.More evidence is necessary for the clinical adoption of a clear cell likelihood score.Graphical

VISTA: vision improvement via split and reconstruct deep neural network for fundus image quality assessment

AbstractWidespread eye conditions such as cataracts, diabetic retinopathy, and glaucoma impact people worldwide. Ophthalmology uses fundus photography for diagnosing these retinal disorders, but fundus images are prone to image quality challenges. Accurate diagnosis hinges on high-quality fundus images. Therefore, there is a need for image quality assessment methods to evaluate fundus images before diagnosis. Consequently, this paper introduces a deep learning model tailored for fundus images that supports large images. Our division method centres on preserving the original image’s high-resolution features while maintaining low computing and high accuracy. The proposed approach encompasses two fundamental components: an autoencoder model for input image reconstruction and image classification to classify the image quality based on the latent features extracted by the autoencoder, all performed at the original image size, without alteration, before reassembly for decoding networks. Through post hoc interpretability methods, we verified that our model focuses on key elements of fundus image quality. Additionally, an intrinsic interpretability module has been designed into the network that allows decomposing class scores into underlying concepts quality such as brightness or presence of anatomical structures. Experimental results in our model with EyeQ, a fundus image dataset with three categories (Good, Usable, and Rejected) demonstrate that our approach produces competitive outcomes compared to other deep learning-based methods with an overall accuracy of 0.9066, a precision of 0.8843, a recall of 0.8905, and an impressive F1-score of 0.8868. The code is publicly available at https://github.com/saifalkhaldiurv/VISTA_-Image-Quality-Assessment.

Employment quality in the new socio-economic reality: theoretical and methodological foundations

The article contains scientific arguments for aggravating social and labor problems, especially employment in its various manifestations. It substantiates the need to update the theoretical and methodological foundations of employment in general and its quality in particular. A modern view of the employment institute is presented. The author's concept of employment quality has been revealed. The proposed conceptology of employment quality is based on the latest theoretical and methodological foundations and opens new horizons for further scientific and applied research. First of all, it concerns development of theoretical, methodological and applied principles of employment quality assessment. It is proven that the newest trend of the current digital age is the emergence and intensive reproduction of gaps in the quality of jointly distributed labor as part of various types of both standard and especially non-standard forms of employment. The article's key quintessence is the authors' vision of employment quality as a prerequisite for sustainable people-dimensional development and justification of the need to move the institute of employment quality to the epicenter of theoretical and applied research, which should become a platform for scientific support of formation and implementation of a new social and labor policy. Further research in the field of scientific support for social and labor development has received scientific interpretation.

Clinical application of an optimized reference measurement procedure for serum digoxin using bracketing calibration method by ID-LC-MS/MS.

Digoxin, a cardiac glycoside, is widely used in the treatment of cardiovascular diseases. Due to its narrow therapeutic range, precise monitoring of its blood concentration is essential. Areference measurement procedure (RMP) is pivotal for ensuring result accuracy and comparability. The RMP for serum digoxin by ID-LC-MS/MS was optimized with sample pre-treatment and detection processes, and the bracketing calibration method was used, which facilitates more accurate measurement, especially for extreme concentrations. The performance of this optimized RMP was thoroughly evaluated. The limit of detection (LoD) was 0.05 ng/mL (0.06 nmol/L) and the lowest limit of quantification (LLoQ) was 0.10 ng/mL (0.13 nmol/L). The intra- and inter-assay imprecisions were 2.24%, 2.51%, 1.40% and 1.72%, 1.65%, 0.97% at 0.5, 2.0, 5.0 ng/mL, respectively. Recoveries were 99.63 to 101.42% and thelinear response ranged from 0.1 to 10.0 ng/mL. The relative bias was 0.41% and 2.00% of our results compared with the median of all participating reference laboratories for IFCC-RELA (External Quality Assessment Scheme for Reference Laboratories in Laboratory Medicine) 2023A and 2023B. The uncertainty, calibration and measurement capability (CMC) of this method were also evaluated. The optimized RMP was applied in the Trueness Verification Plan of Southern China, which indicates significant differences among clinical systems, highlighting the need for standardization efforts. In addition, two commonly used clinical systems which employed immunoassay methods were compared with this optimized RMP, and 26 individual serum samples were analyzed. The good correlations indicate the feasibility of standardization for serum digoxin. The optimized RMP serves as an accurate reference baseline for routine methods, aiming to enhance the accuracy and precision of measurements in clinical laboratories.

Comparative Approach to Performance Estimation of Pulsed Wave Doppler Equipment Based on Kiviat Diagram

Quality assessment of ultrasound medical systems is a demanding task due to the high number of parameters to quantify their performance: in the present study, a Kiviat diagram-based integrated approach was proposed to effectively combine the contribution of some experimental parameters and quantify the overall performance of pulsed wave Doppler (PWD) systems for clinical applications. Four test parameters were defined and assessed through custom-written measurement methods based on image analysis, implemented in the MATLAB environment, and applied to spectral images of a flow phantom, i.e., average maximum velocity sensitivity (AMVS), velocity measurements accuracy (VeMeA), lowest detectable signal (LDS), and the velocity profile discrepancy index (VPDI). The parameters above were scaled in a standard range to represent the four vertices of a Kiviat plot, whose area was considered the overall quality index of the ultrasound system in PWD mode. Five brand-new ultrasound diagnostic systems, equipped with linear array probes, were tested in two different working conditions using a commercial flow phantom as a reference. The promising results confirm the robustness of AMVS, VeMeA, and LDS parameters while suggesting further investigations on the VPDI.