Ergonomic Microscope: Need of the Hour

Validation of AI-assisted ThinPrep® Pap test screening using the GeniusTM Digital Diagnostics System

Advances in whole-slide imaging and artificial intelligence present opportunities for improvement in Pap test screening. To date, there have been limited studies published regarding how best to validate newer AI-based digital systems for screening Pap tests in clinical practice. In this study, we validated the Genius™ Digital Diagnostics System (Hologic) by comparing the performance to traditional manual light microscopic diagnosis of ThinPrep® Pap test slides. A total of 319 ThinPrep® Pap test cases were prospectively assessed by six cytologists and three cytopathologists by light microscopy and digital evaluation and the results compared to the original ground truth Pap test diagnosis. Concordance with the original diagnosis was significantly different by digital and manual light microscopy review when comparing across: (i) exact Bethesda System diagnostic categories (62.1% vs 55.8%, respectively, p = 0.014), (ii) condensed diagnostic categories (76.8% vs 71.5%, respectively, p = 0.027), and (iii) condensed diagnoses based on clinical management (71.5% vs 65.2%, respectively, p = 0.017). Time to evaluate cases was shorter for digital (M = 3.2 min, SD = 2.2) compared to manual (M = 5.9 min, SD = 3.1) review (t(352) = 19.44, p < 0.001, Cohen's d = 1.035, 95% CI [0.905, 1.164]). Not only did our validation study demonstrate that AI-based digital Pap test evaluation had improved diagnostic accuracy and reduced screening time compared to light microscopy, but that participants reported a positive experience using this system.

[Ergonomic parameters of the pathologist's workplace as important factors in the prevention of occupational musculoskeletal diseases]

BACKGROUND

More than 80% of pathologists suffer from various manifestations of disorders of the musculoskeletal system. The daily duties of pathologists include several hours of work at a microscope and a computer. Microscopes are often not optimized for ergonomics and do not allow the doctor to take the correct sitting position, most often working with a microscope requires leaning forward.

OBJECTIVE

To study the ergonomic properties of the workplace of a pathologist and develop specific practical recommendations for long-term work at a microscope.

MATERIAL AND METHODS

The study included microscopes with an adjustable and non-adjustable angle of inclination of the tube and height-adjustable chairs. We identify following ergonomic parameters: pathologist height; angle of inclination of the back of the chair; angle of inclination of the microscope tube; angle of inclination of the neck; chair height. The study included 21 participants. Statistical processing and analysis were made using single-factor and multifactorial correlation analysis.

RESULTS

A strong positive linear correlation was identified (r=0.80; p<0.05) between the height of test person and angle of inclination of the microscope tube. A strong positive linear correlation was established (r=0.91; p<0.05) between the test person height and the angle of inclination of the neck for microscopes with non-adjustable 31°-angle of inclination of the tube. For microscopes with non-adjustable 45°-angle of inclination of the tube a strong polynomial correlation of the second degree (r=0.85; p<0.05) was found. A moderate negative linear correlation was found between the height of the pathologist and his tilt angle neck with both adjustable and non-adjustable tube angle of the microscope.

CONCLUSION

In this study for the first-time exact correlation dependencies between key ergonomic parameters of pathologist's workplace were evaluated. This study showed that only microscopes with an adjustable angle of inclination of the tube allow to achieve an optimal body position.

Blocking substance P signaling reduces musculotendinous and dermal fibrosis and sensorimotor declines in a rat model of overuse injury

Purpose/Aim: Substance P-NK-1R signaling has been implicated in fibrotic tendinopathies and myositis. Blocking this signaling with a neurokinin 1 receptor antagonist (NK1RA) has been proposed as a therapeutic target for their treatment.Materials and Methods: Using a rodent model of overuse injury, we pharmacologically blocked Substance P using a specific NK1RA with the hopes of reducing forelimb tendon, muscle and dermal fibrogenic changes and associated pain-related behaviors. Young adult rats learned to pull at high force levels across a 5-week period, before performing a high repetition high force (HRHF) task for 3 weeks (2 h/day, 3 days/week). HRHF rats were untreated or treated in task weeks 2 and 3 with the NK1RA, i.p. Control rats received vehicle or NK1RA treatments.Results: Grip strength declined in untreated HRHF rats, and mechanical sensitivity and temperature aversion increased compared to controls; these changes were improved by NK1RA treatment (L-732,138). NK1RA treatment also reduced HRHF-induced thickening in flexor digitorum epitendons, and HRHF-induced increases of TGFbeta1, CCN2/CTGF, and collagen type 1 in flexor digitorum muscles. In the forepaw upper dermis, task-induced increases in collagen deposition were reduced by NK1RA treatment.Conclusions: Our findings indicate that Substance P plays a role in the development of fibrogenic responses and subsequent discomfort in forelimb tissues involved in performing a high demand repetitive forceful task.

Musculoskeletal complaints, absenteeism and associated factors among cytotechnologists: cross-sectional study

Background

Cytotechnologists are laboratory professionals who analyze cytology slides under optical microscopes. Static postures, speed and repetitive movements are associated with occurrence of musculoskeletal complaints.

Objective

To establish the main musculoskeletal complaints among cytotechnologists at the National Cancer Institute, Brazil, test associations between absenteeism due to musculoskeletal complaints and individual and occupational variables, and characterize absenteeism related to diseases of the musculoskeletal system in 2016 and 2017.

Method

Cross-sectional study in which we administered the Nordic Musculoskeletal Questionnaire and tested associations between exposure variables and absenteeism. We also analyzed morbidity records kept at the Occupational Health Division (OHD) to establish the main disorders related to absenteeism. Associations were investigated by means of Fisher's test using SPSS version 20.0. The significance level was set to p<0.05.

Results

34.4% of the sample required sick leave due to musculoskeletal complaints. The most affected body site was the neck (18%). As per the OHD records, sickness absenteeism was mainly due to diseases of the musculoskeletal system and connective tissue (25%). We found statistically significant association of absenteeism with length in the job and body mass index.

Conclusion

Diseases of the musculoskeletal system and connective tissue were the main reason for missing work days. Absenteeism was associated with length in the job and high body mass index.