Basic Laboratory Research Articles

Verification of analytical performance of sodium assay on the Abbott architect ci8200: Experience of the central laboratory Mohammed VI Oujda

Introduction: Sodium is the main extracellular cation. It plays a fundamental role in maintaining osmotic pressure and hydroelectrolyte balance, and is therefore implicated in many pathological conditions. Sodium determination is a basic biochemistry laboratory test. Objective: the aim of our work is to verify the method of sodium determination by potentiometry on the Architect CI 8200 automated system (Abbott), in order to meet the quality requirements for laboratory accreditation under standard NF ISO 15189. Materials and methods: following the recommendations of NF EN ISO 15189, we evaluated the repeatability, intermediate precision, accuracy and uncertainty of measurement of the serum sodium assay on the Architect CI 8100 automated system, as well as a mirror comparison of the two Architect CI 8100 1 and 2. The CV values obtained were compared with those set by learned societies (SFBC and RICOS). Results and discussion: The results obtained show satisfactory repeatability for the 3 low, medium and high levels, with CV1= 1.1%, CV2=0.8% and CV3= 0.76% respectively, and satisfactory intra-laboratory reproducibility for the 3 low, medium and high levels, with CV1= 1.05%, CV2= 0.95% and CV3= 0.75% respectively. For comparison, the Bland-Altman diagram showed that the mean bias between the two automata was of the order of 0.29%, the correlation coefficient r= 0.98 with a mean difference of 0.40 mmol/l, a standard deviation of 0.675 mmol/l and a linear regression equation Y = 1.027 X - 4.073. Corrective measures were envisaged to remedy the various errors identified. To solve any malfunction in a sustainable way, it is essential to search for the anomaly by applying the Ishikawa diagram. Conclusion: The results obtained have enabled us to verify the performance of the sodium assay method and compare it with the analytical objectives set, in order to meet the regulatory and normative requirements to which our laboratory is committed.

Analysis of Basic Laboratory Skills of Science Education Students Using Pictorial-Based Instruments

Laboratory skills are an important aspect of natural sciences in schools and higher education, often linked to psychomotor aspects of learning. Several studies have developed several methods that can be used to evaluate laboratory skills, for example, the use of observation sheets equipped with rubrics. However, often using this method requires a longer learning time. Therefore, there is a need for research that examines how to evaluate students' basic laboratory skills. This research aims to analyze students' basic laboratory skills using pictorial-based instruments. This research method uses descriptive qualitative. This instrument is equipped with pictures that provide visualization. The basic laboratory skills are focused on experiments on making standard solutions from solids, making standard solutions from concentrated solutions, and acid-base titrations. Based on the analysis, it was found that the basic laboratory skills of science students in the experiment of making standard solutions from solids contained six basic skills, including selecting tools, weighing solids, transferring solids into a beaker, putting them in a volumetric flask, marking the solution, reading the meniscus mark. In the experiment of making a standard solution, there are five basic skills, namely selecting tools, taking the stock solution, transferring it into a volumetric flask, marking the solution, and reading the meniscus mark. The titration experiment consists of 8 skills, including selecting equipment, taking the analyte solution, taking the titrant solution, adding a titration indicator, using the titration technique, observing the endpoint of the titration, reading the meniscus, and calculating the solution's concentration.

Sistemik inflamatuar yanıt indeksin(SIRI) kronik total oklüzyon öngörülmesinde rolü: yararlı mı değil mi?

Aim: Inflammation is very important in the pathogenesis of atherosclerosis and CAD. Chronic total occlusion (CTO) is a chronic form of CAD and is common in patients with severe CAD. The aim of this study was to determine the association of the systemic inflammatory response index (SIRI), a marker of inflammation, with CTO. 
 
 Materials and Methods: Our study was retrospective and included 100 CAD patients with CTO and 100 CAD patients without CTO. SIRI was compared between the two groups.
 
 Results: Among the basic clinical and laboratory characteristics of the patients, age, white blood cell, and neutrophil counts were statistically higher in the CTO group (p=0.044, p=0.044, p=0.036, respectively). SIRI parameters were similar between the groups, and no statistical difference was observed (p=0.111). According to the ROC analysis, the optimum cut-off value for SIRI was >1040 (sensitivity 70.0% and specificity 44.0%).
 
 Conclusion: SIRI is not a useful predictor for the detection of CTO.

Retroperitoneal abscess as a presentation of colon cancer: The largest case set analysis to date, which extracted from our unit and the literature.

Colon cancer with retroperitoneal abscess is a rare and easily misdiagnosed disease and has only been reported via case. There is an urgent need to conduct a dataset analysis for such patients, which is crucial to improving the survival rate and quality of life of these patients. Patients with colon cancer associated with retroperitoneal abscess were extracted from our hospital and the PubMed, EMBASE and Web of Science databases. Clinical information, including the patients' basic characteristics, clinical symptoms, laboratory tests, imaging examinations, treatment methods and prognosis was analyzed. Sixty-one patients were analyzed, with an average age of 65 years. The proportions of right and left colon cancers were 63.9% and 36.1%, respectively. A total of 98.0% of the patients had adenocarcinoma. Many patients have insidious symptoms such as fever and weight loss. At the first medical visit, pain was the most common symptom (71%), with pain in the thigh (21.8%), abdomen (21.8%), and waist and back (14.5%) ranking among the top three. The misdiagnosis rate of the patients referred to our department was 75%, while the overall misdiagnosis rate in the literature was 43.9%. Laboratory tests show that these patients often have elevated white blood cells and anemia. CT examination showed that 87.2% of patients had an iliopsoas muscle abscess, and tumors were not simultaneously detected in 37.2%. A total of 33.9% of patients had local abscesses of the iliopsoas muscle, 26.4% had drainage into the subcutaneous tissue of the waist and upper buttocks, and 22.6% had drainage around the adductor muscle group of the thigh. These patients have a variety of treatments, and many patients have undergone multiple and unnecessary treatments. Thirteen patients died after surgery, and 6 died in the hospital, of whom four were patients undergoing direct surgery, and the other 7 died after discharge due to cachexia. Colorectal cancer with retroperitoneal abscess is a relatively rare and easily misdiagnosed subtype of colon cancer. It is more likely to occur in right-sided colon adenocarcinoma. The main clinical symptom is pain caused by the drainage of pus to the corresponding areas of the waist, abdomen, and legs. CT is the preferred diagnostic method. Actively treating the abscess and then transitioning to standard colon cancer treatment can prevent patient death and improve treatment quality.

Diagnostic value of α1-MG and URBP in early diabetic renal impairment.

Aims/Introduction: Diabetic kidney disease (DKD) is defined as diabetes with impaired renal function, elevated urinary albumin excretion, or both. DKD is one of the most common microvascular complications of diabetes and plays an important role in the cause of end-stage renal disease (ESRD). About 5% of people with type 2 diabetes (T2DM) already have kidney damage at the time they are diagnosed, but other triggers of renal insufficiency, such as obesity, hyperlipidemia, glomerular atherosclerosis are often present, making it difficult to define "diabetic kidney disease" or "diabetic nephropathy" precisely in epidemiology or clinical practice. Therefore, the aim of this study is to identify diabetic patients with CKD at an early stage, and evaluate the value of tubular injury markers including α1-microglobulin (α1-MG), β2-microglobulin (β2-MG), N-acetyl-beta-D-glucosaminidase (NAG) and Urinary retinol binding protein (URBP) in the development of diabetes to DKD. Materials and methods: We recruited a total of 182 hospitalized patients with T2DM in the First Affiliated Hospital of Zhengzhou University from February 2018 to April 2023. We collected basic clinical characteristics and laboratory biochemical parameters of the patients. Based on their levels of urinary albumin creatinine ratio (UACR) and glomerular filtration rate (GFR), patients were divided into DM group (UACR≤30mg/g and eGFR≥90mL/min/1.73m2, n = 63) and DKD group (UACR>30mg/g or eGFR<90mL/min/1.73m2, n = 119) excluding other causes of chronic kidney disease. We further developed diagnostic models to improve the ability to predict the risk of developing DKD by screening potential risk factors using univariate and multivariate logistic regression analysis. Calibration plots and curve analysis were used to validate the model and clinical usefulness. Next, we screened patients with relatively normal estimated glomerular filtration rate (eGFR) (≥90mL/min/1.73m2) to investigate whether tubular injury markers could accurately predict the risk of DKD in patients with normal renal function. We defined the rate of GFR decline as a prognostic indicator of renal function in patients and collected the information of the re-hospitalized DKD patients to determine whether the relevant indicators had an impact on the renal prognosis. Results: The patients with DKD had higher levels of tubular injury markers than patients with DM. URBP, α1-MG, eGFR were statistically different in both univariate and multivariate logistic regression analyses and displayed great predictive power after modeling with an area under curve of 0.987. The calibration curve showed medium agreement. Decision curve showed it would add more net benefits for clinical decision. After adjusting eGFR and serum creatinine (Scr), URBP was demonstrated to be associated with early renal function impairment. Conclusion: Tubular injury markers play an important role in early diabetic renal function impairment.

Department Of Electrical And Electronics Engineering

The department has good infrastructural facilities and is equipped with full fledged laboratories such as Basic Electrical lab Electrical Machines Lab- I and II Power Electronics lab Electrical Measurements lab Advanced Electrical Engineering lab and Electrical Workshop The department also has audio visual facilities with LCD and OHP for effective teaching

A National Survey on Coma Epidemiology, Evaluation, and Therapy in India: Revisiting the Curing Coma Campaign Come Together Survey.

The limited representation from developing countries in the original COME TOGETHER survey gave us an impetus to conduct this survey in the Indian subcontinent. This cross-sectional online survey was conducted from August through September 2022. Participants were health care physicians caring for patients with coma and disorders of consciousness. Fischer's exact test or the Mann-Whitney U-test was used to compare respondents who agreed or disagreed with the preestablished coma definition. Fleiss κ values were calculated to assess agreement among respondents. A p value less than 0.05 was considered statistically significant. The survey was completed by 130 physicians. We found substantial interrater agreement on absence of wakefulness (71.54%; κ = 0.71), Glasgow Coma Score ≤ 8 (78.46%; κ = 0.78), and failure to respond purposefully to visual, verbal, or tactile stimuli (66.15%; κ = 0.66). Reported common etiologies of coma included traumatic brain injury (50.76%), ischemic stroke (30%), and intracerebral hemorrhage (29.23%). The most common clinical assessment tools used for coma included the Glasgow Coma Score (92.3%) and neurological examination (60.8%). Neurological examination was the most commondiagnostic tool used(100%), followed by magnetic resonance imaging (89.2%), basic laboratory studies (88.5%), and head computed tomography/angiography (86.9%). Pharmacological interventions used to stimulate arousal in patients with coma were sedation vacation (91.5%), electrolyte/endocrine correction (65.4%), osmotic therapy with mannitol (60%), hypertonic saline (54.6%), modafinil (46.9%), and antidote for drugs (45.4%). Among the nonpharmacological interventions, sensory stimulation (57.7%) was the most commonly used modality. The most common discharge disposition for comatose patients who survived hospitalization were home with or without services (70.0%). Differences from the global survey were noted regarding the following: traumatic brain injury being the most common etiology of coma in India, more frequent practice of sedation interruption, less frequent use of electroencephalography in India, rare use of pharmacological neurostimulants, and home being the most common discharge disposition in India.

Surface Passivation Method for the Super-repellence of Aqueous Macromolecular Condensates.

Solutions of macromolecules can undergo liquid-liquid phase separation to form droplets with ultralow surface tension. Droplets with such low surface tension wet and spread over common surfaces such as test tubes and microscope slides, complicating in vitro experiments. The development of a universal super-repellent surface for macromolecular droplets has remained elusive because their ultralow surface tension requires low surface energies. Furthermore, the nonwetting of droplets containing proteins poses additional challenges because the surface must remain inert to a wide range of chemistries presented by the various amino acid side chains at the droplet surface. Here, we present a method to coat microscope slides with a thin transparent hydrogel that exhibits complete dewetting (contact angles θ ≈ 180°) and minimal pinning of phase-separated droplets in aqueous solution. The hydrogel is based on a swollen matrix of chemically cross-linked polyethylene glycol diacrylate of molecular weight 12 kDa (PEGDA), and can be prepared with basic chemistry laboratory equipment. The PEGDA hydrogel is a powerful tool for in vitro studies of weak interactions, dynamics, and the internal organization of phase-separated droplets in aqueous solutions.

Study of transcription factor 7-like 2 (TCF7L2) gene polymorphism in cirrhotic patients with diabetes

Patients with chronic liver disease (CLD) as chronic hepatitis C (CHC) are at high risk of diabetes type 2 (T2D). Genetic factors are suggested to modulate diabetes development in cirrhotic patients. TCF7L2 gene has been reported to be associated with type 2 diabetes, but the association of TCF7L2 with cirrhotic patients with diabetes is unclear. We aimed to study the TCF7L2 gene polymorphisms (rs 290487) in cirrhotic patients with diabetes.Method The study was assessed on 25 cirrhotic patients with type 2 diabetes who were compared to 25 cirrhotic HCV patients (nondiabetic), 25 diabetic type 2 patients, and 25 age- and gender-matched healthy control groups. After the collection of relevant clinical data and basic laboratory tests, single-nucleotide polymorphism (SNP) in the TCF7L2 gene (rs290487) was performed by a real-time PCR technique.Results Cirrhotic patients with diabetes presented significantly poorer liver function, higher incidence of cirrhotic complications, and higher glucose levels compared with cirrhotic nondiabetic patients. The TCF7L2 rs290487 TT variant showed significantly increased diabetes risk in cirrhotic patients compared with CC and CT genotypes.Conclusions TCF7L2 rs290487 polymorphism could be associated with increased diabetic risk in cirrhotic patients.

THU386 Non-diabetic Ketoacidosis As A Rare Complication Of Colitis And Gastritis

Abstract Disclosure: J. Bosques-Lorenzo: None. J.J. Irizarry-Garcia: None. J. Baez-Torres: None. J. Colon-Castellano: None. Background: Starvation ketoacidosis is a rare cause of metabolic acidosis that is often under-recognized. To our knowledge, no cases of starvation ketoacidosis secondary to colitis and gastritis have been reported. Clinical Case: A 91 y/o male presented to the ER with nausea, vomiting, left lower quadrant abdominal pain, and anorexia that progressed for the previous two days. Physical examination was remarkable for a fragile man, acutely over chronically ill, with reduced skin turgor, dry oral mucosa, but a benign abdominal examination. Vitals signs upon arrival were stable. Basic laboratories showed hypoglycemia at 64 mg/dL (70 - 99 mg/dL), low CO2 17.7 mEq/dL (24 -32 mEq/dL), Na 137 mEq/dL (135 - 145 mEq/dL), Cl 94 mEq/dL (100- 110 mEq/dL). High anion gap metabolic acidosis was demonstrated (25 mEq/L). Renal function was preserved and within the patient's baseline, lactic acidosis was ruled out with normal levels in the laboratory, and CBC was negative for leukocytosis. Patient denied alcohol ingestion upon questioning. There were no suspected infectious foci. Abdomino-pelvic CT scan with oral contrast demonstrated colonic, rectal, and gastric inflammation. Case reevaluation and assessment of the data and history of present illness, led to B-hydroxybutyrate measurement. Surprisingly, ketones levels came back markedly elevated at confirming starvation ketoacidosis in the setting of colitis and gastritis. Patient was treated with aggressive intravenous fluids with normal saline for the first 24 hours, IV glucose to correct hypoglycemia, electrolytes were replaced as needed, and stomach antacids for symptomatic relief of abdominal discomfort. We slowly progressed diet as tolerated and electrolytes were carefully monitored for refeeding syndrome. Few days later the patient was discharged home with full resolution of symptoms. Conclusion: Metabolic acidosis secondary to ketoacidosis is mostly visualized to be exclusive for diabetic patients, leading to under-recognition of starvation ketoacidosis. This is the first case of starvation ketoacidosis secondary to colitis and gastritis. Understanding its association can lead to prompt recognition and treatment, especially in the non-diabetic population. Presentation: Thursday, June 15, 2023

CYP19A1 promotes gastric cancer as part of a lipid metabolism-related gene signature related to the response of immunotherapy and prognosis

BackgroundIncreasing evidence suggests that the metabolism of lipids plays a crucial role in the progression of gastric cancer. However, the expression of lipid metabolism-related genes (LMGs) still does not serve as a prognostic biomarker in gastric cancer.MethodsWe obtained transcriptome data for 751 LMGs and divided STAD patients into two subtypes based on differences in LMGs expression. Then, we analyzed genetic changes in two subtypes as well as immune features to determine their differences. We also constructed a prognostic risk model related to LMGs for individualized comprehensive evaluations.ResultsIn this study, two lipid metabolic (LM) subtypes were identified anchored in the expression profiles of LMGs. Clinical information, genomic alterations, immune features, and immunotherapy response varied significantly between the two LM subtypes. A risk model based on LMGs was also developed to assess prognosis and distinguish patients with high risk from those at low risk. The prognosis differed significantly between the two risk groups of patients. In STAD patients, the risk score was strongly correlated with genomic alterations and immune profile scores. Also, the risk score was an excellent predictor of immune checkpoint inhibitors (ICIs) response. Anchored in preliminary results derived from the aforementioned bioinformatic analysis, we chose CYP19A1 as our target gene and the expression of CYP19A1 was verified in several common gastric cancer cell lines. Then, we carried out the Western blotting, CCK-8 assay, colony formation assay, wound healing assay, and transwell assay to explore the effects of CYP19A1 on malignant biological behavior, and positive consequences were obtained.ConclusionsIn this study, STAD patients were divided into two subtypes based on LMGs expression. It is possible to assess the prognosis of a patient and the response to immunotherapy using the established prognostic risk model. A series of basic laboratory experiments also verified the functional role of CYP19A1 in gastric cancer.

Is Pulmonary Involvement a Distinct Phenotype of Post-COVID-19?

(1) Background: COVID-19 infection often provokes symptoms lasting many months: most commonly fatigue, dyspnea, myalgia and mental distress symptoms. In this study, we searched for clinical features of post-COVID-19 condition (PCC) and differences between patients with and without pulmonary involvement. (2) Methods: A total of 282 patients with a mean age of 57 years (SD +/- 12 years) underwent assessment up to 12 weeks after COVID-19 recovery. The course of acute disease, past medical history and clinical symptoms were gathered; pulmonary function tests were performed; radiographic studies were assessed and follow-up examinations were conducted. Patients with and without detectable pulmonary lesions were divided into separate groups. (3) Results: Patients within the pulmonary group were more often older (59 vs. 51 y.o.; p < 0.001) males (p = 0.002) that underwent COVID-19-related hospitalization (p < 0.001) and were either ex- or active smokers with the median of 20 pack-years. We also managed to find correlations with hypertension (p = 0.01), liver failure (p = 0.03), clinical symptoms such as dyspnea (p < 0.001), myalgia (p = 0.04), headache (p = 0.009), sleeplessness (p = 0.046), pulmonary function tests (such as FVC, TLCO, RV and TLC; p < 0.001) and several basic laboratory tests (D-dimer, cardiac troponin, WBC, creatinine and others). (4) Conclusions: Our results indicate that initial pulmonary involvement alters the PCC, and it can be used to individualize clinical approaches.

Prediction of recurrent ischaemic stroke using radiomics data and machine learning methods in patients with acute ischaemic stroke: protocol for a multicentre, large sample, prospective observational cohort study in China

IntroductionStroke is a leading cause of mortality and disability worldwide. Recurrent strokes result in prolonged hospitalisation and worsened functional outcomes compared with the initial stroke. Thus, it is critical to...

Evaluating Childcare Support in NCI Designated Cancer Centers for Patients with Young Children Undergoing Treatment

The daily nature of radiotherapy treatment can be challenging for parents diagnosed with cancer who have young children. Access to affordable and convenient childcare can be a considerable hurdle to treatment adherence. We aim to determine the breadth of childcare services and support provided by NCI-designated cancer centers to decrease the burden and stress of receiving radiotherapy treatment of patients with children. We conducted a cross-sectional survey of the 70 NCI-designated cancer centers. Centers were originally contacted by phone call utilizing their publicly available website, and the researcher asked to speak with the radiation oncology department social worker. Calls were conducted from June 2022 through February 2023. As a result of low response rate, a second methodological design was developed through a collaboration with Association for Directors of Radiation Oncology Programs (ADROP) whereby their listserv was utilized to connect with social workers. For both query designs, social workers were asked what childcare services are offered by the center, if such services are internal, if patients are referred to external organizations, as well as if such organizations operate charitably or require payment for their services. Centers were stratified by type of childcare support offered and compared across private versus public institutions. Sixty-three of the 70 NCI-designated cancer centers were contacted for data collection, excluding 6 identified as basic laboratories and 1 center serving only pediatric patients. Contact was established with the social work department of 39 cancer centers (62%), of which only 19 (49%) had a radiation oncology departmental social worker. Response data were gathered from 11 (58%) total centers regarding their childcare services. Of the centers surveyed, 10 (91%) indicated the primary form of support offered was via referral to external organizations. Four centers (36%) described offering financial support for childcare, three of which are privately-funded institutions. When queried about the need for childcare support provided by cancer centers, 4 of the 5 surveyed public institutions expressed a need for expansion of these services; the 6 private institutions denied a need for these services among their patient population. Lack of access to childcare presents a significant burden to adherence to radiotherapy among parents undergoing radiotherapy with young children. Our study showed that external community organizations currently play a crucial role in providing childcare support to parents with cancer and demonstrates an inequity between private and public institutions in the perceived need of childcare support for their patients as well as ability to offer direct financial support.

Age-dependent effect on contralateral testicular compensation after testicular loss

To study compensatory changes in testicular growth and the hormonal axis after unilateral orchiectomy in a neonatal, prepubertal, and pubertal/adult murine model. This is the first study to use a neonatal mouse survival surgery model. A laboratory-based study examining a control, neonatal, prepubertal, and pubertal/adult mouse model. University-based basic science research laboratory. Control, neonatal (2-4 days of life), prepubertal (12-21 days of life), and pubertal/adult (42-44 days of life) C57BL/6 mouse models. Unilateral orchiectomy in the neonatal, prepubertal, and pubertal/adult mouse models at their respective ages. Body and testis weight and testicular length in the long axis were measured in a blinded fashion. In a similar way, testosterone, luteinizing hormone (LH), and follicle-stimulating hormone were assessed. Testes from neonatal and prepubertal mice weighed more (110.5, 12.2 and 103.0, 7.2 mg, respectively) than the control mice (91, 11.9 mg). There was no difference between the postpubertal group and the control group. The degree of compensatory hypertrophy was greater in the neonatal group but not in the prepubertal group when compared with the postpubertal group. Differences in follicle-stimulating hormone and testosterone were not statistically significant between the experimental and control arms. LH was significantly elevated in all experimental groups compared with the control. This is the first study to assess testicular compensatory hypertrophy using a neonatal mouse survival surgery model. Testicular hypertrophy occurs when unilateral loss occurs before puberty, but not in adulthood in mice. Earlier testis loss may contribute to a greater degree of growth. Functionally, the unilateral testis can maintain eugonadal testosterone levels, but higher levels of LH are required after hemicastration to sustain eugonadal testosterone levels.

Improved analysis of derivatized steroid hormone isomers using ion mobility-mass spectrometry (IM-MS).

Over the last decade, applications of ion mobility-mass spectrometry (IM-MS) have exploded due primarily to the widespread commercialization of robust instrumentation from several vendors. Unfortunately, the modest resolving power of many of these platforms (~40-60) has precluded routine separation of constitutional and stereochemical isomers. While instrumentation advances have pushed resolving power to >150 in some cases, chemical approaches offer an alternative for increasing resolution with existing IM-MS instrumentation. Herein we explore the utility of two reactions, derivatization by Girard's reagents and 1,1-carbonyldiimidazole (CDI), for improving IM separation of steroid hormone isomers. These reactions are fast (≤30min), simple (requiring only basic lab equipment/expertise), and low-cost. Notably, these reactions are structurally selective in that they target carbonyl and hydroxyl groups, respectively, which are found in all naturally occurring steroids. Many steroid hormone isomers differ only in the number, location, and/or stereochemistry of these functional groups, allowing these reactions to "amplify" subtle structural differences and improve IM resolution. Our results show that resolution was significantly improved amongst CDI-derivatized isomer groups of hydroxyprogesterone (two-peak resolution of Rpp = 1.10 between 21-OHP and 11B-OHP), deoxycortisone (Rpp = 1.47 between 11-DHC and 21-DOC), and desoximetasone (Rpp = 1.98 between desoximetasone and fluocortolone). Moreover, characteristic collision cross section (DTCCSN2) measurements can be used to increase confidence in the identification of these compounds in complex biological mixtures. To demonstrate the feasibility of analyzing the derivatized steroids in complex biological matrixes, the reactions were performed following steroid extraction from urine and yielded similar results. Additionally, we applied a software-based approach (high-resolution demultiplexing) that further improved theresolving power (>150). Overall, our results suggest that targeted derivatization reactions coupled with IM-MS can significantly improve the resolution of challenging isomer groups, allowing for more accurate and efficient analysis of complex mixtures.

Association between the Clinical, Laboratory and Ultrasound Characteristics and the Etiology of Peripheral Lymphadenopathy in Children.

Peripheral lymphadenopathy affects most children at least once in a lifetime and represents a major reason for concern. Therefore, we aimed to identify the most common causes of peripheral lymphadenopathy in hospitalized children and to determine the clinical, laboratory and ultrasound characteristics that enable fast, easy and accurate etiological diagnosis. We performed a cross-sectional study including 139 children who were hospitalized because of peripheral lymphadenopathy. Ultrasound of lymph nodes was performed in 113 (81.3%) patients. Lymphadenopathy was generalized in nine (6.5%) patients. Malignant etiology was established in only three (2.2%) patients. Bacterial lymphadenitis, infectious mononucleosis (IM) and cat scratch disease (CSD) were diagnosed in 66 (47.5%), 31 (22.3%) and 29 (20.9%) patients, respectively. Bacterial lymphadenitis was significantly associated with neutrophilia (p < 0.01), and increased C-reactive protein levels (p < 0.01). IM was associated with pharyngitis (p < 0.01), leukocytosis without neutrophilia (p = 0.03) and increased blood liver enzyme levels (p < 0.01). CSD was associated with recent contact with a cat (p < 0.01), absence of a fever (p < 0.01) and normal white blood cell count (p < 0.01). Thorough history and clinical examination in combination with a few basic laboratory tests enable fast and accurate differentiation between the most common etiologies of lymphadenopathy in children to avoid unnecessary procedures and hospitalizations.

Machine learning-based mortality prediction in hip fracture patients using biomarkers.

The purpose of this retrospective study was to assess whether mortality following a hip fracture can be predicted by a machine learning model trained on basic blood and lab test data as well as basic demographic data. Additionally, the purpose was to identify the key variables most associated with 1-, 5-, and 10-year mortality and investigate their clinical significance. Input data included 3751 hip fracture patient records sourced from the Medical Information Mart for Intensive Care IV database, which provided records from in-hospital database systems at the Beth Israel Deaconess Medical Center. The 1-year mortality rate for all patients studied was 21% and for those aged 80+ was 29%. We assessed 10 different machine learning classification models, finding LightGBM to have the strongest 1-year mortality prediction performance, with accuracy of 81%, AUC of 0.79, sensitivity of 0.34, and specificity of 0.98 on the test set. The strongest-weighted features of the 1-year model included age, glucose, red blood cell distribution width, mean corpuscular hemoglobin concentration, white blood cells, urea nitrogen, prothrombin time, platelet count, calcium levels, and partial thromboplastin time. Most of these were also in the top 10 features of the LightGBM 5- and 10-year prediction models trained. Testing for these high-ranking biomarkers in new hip fracture patients can aid clinicians in assessing the likelihood of poor outcomes for hip fracture patients, and additional research can use these biomarkers to develop a mortality risk score.

Biochemical markers of iron status and iron accumulation in peritoneal dialysis patients treated with ferric citrate.

Hyperphosphataemia is a common complication of kidney disease. Current dialysis techniques do not provide enough phosphorus clearance, hence the need to use phosphorus binders. Treatment options include calcium carbonate, calcium acetate, lanthanum carbonate, sevelamer hydrochloride and iron-based binders. Patients receiving peritoneal dialysis (PD) with sustained elevated ferritin levels exceeding 800 ng/mL are at a higher risk of death. We identify PD patients treated with iron-based binders and compare ferritin and risk of iron accumulation to patients treated with non-iron-based binders. All records of patients receiving PD at Emory dialysis centres until 30 October 2021 were reviewed for phosphorus binders. Basic demographics and laboratory data were time-referenced to the days on treatment with a particular binder. Patients were followed until discontinuation of the phosphorus binder, death, transplant, transfer to another dialysis provider or censoring at 36 months after medication was started. Compared to calcium acetate and sevelamer, ferric citrate utilisation in PD patients resulted in a sustained increase in ferritin. The proportion of patients with a ferritin equal to or greater than 800 ng/dL and transferrin saturation greater than 40% increased over time in patients treated with ferric citrate and was higher during the second and third year of follow-up compared to baseline values and to patients treated with calcium acetate or sevelamer. Two patients (7%) treated with ferric citrate developed clinically significant haemosiderosis. Use of ferric citrated in PD resulted in significant iron accumulation as judged by ferritin levels.

Translational evaluation of on/off alternative reinforcement cycling.

Cycling between the availability and unavailability of reinforcement for alternative responding has successfully reduced resurgence in basic laboratory evaluations, but this approach represents a marked departure from current standards of care when treating problem behavior, warranting careful translation before its use clinically. Therefore, with extinction arranged for target responding across groups in Phase 2, we evaluated the effects of cycling between the availability and unavailability of differential reinforcement of alternative behavior (DRA) using a computer-based task with adult humans recruited through Amazon MTurk. Two control groups experienced constant DRA in Phase 2, with one group experiencing a dense DRA schedule and another group experiencing a lean DRA schedule. The cycling DRA group tended to show greater reductions in target responding and improved discrimination in Phase 2 and less target responding across Phases 2 and 3 than the lean DRA and dense DRA groups. These preliminary findings suggest that on/off DRA cycling procedures may produce more desirable treatment outcomes than constant DRA without producing negative side effects; however, further research is needed to confirm these possibilities.