Diagnostic Center Research Articles

Features of tuberculosis’ course in fibrosing occupational interstitial lung disease

ABSTRACT. Our own observation of the course of tuberculosis in fibrosing occupational interstitial lung disease – ILD (idiopathic fibrosing alveolitis – IFA) in a patient who was being treated at the Zaporizhzhia Regional Phthisiopulmonology Clinical Treatment and Diagnostic Center is presented. The patient had a long work experience (about 7 years) at a dangerous enterprise related to the filling and repair service of powder fire extinguishers. It is possible to determine the following features of the course of tuberculosis in fibrosing professional ILD (IFA) in the presented case: tuberculosis was diagnosed in patient with untreated IFA and progressively increasing respiratory and heart failure, which led to the progression of the tuberculosis process; tuberculosis was initially chemoresistant (RifTB) and was accompanied by fibrinous endobronchitis; dissemination on the X-ray in the lungs had the following character: small multiple foci that merge and cover the pulmonary pattern mainly next to the lungs’ roots and basal parts of the lungs. Considering the presence of a long professional route at a dangerous enterprise, increasing shortness of breath, the patient was not given a timely computed tomography of the lungs, which is the most important component of the IFA diagnosis. As a result, IFA was not diagnosed in a time, which led to the lack of necessary IFA treatment (hormonal therapy and cytostatics). A sharp progression of IFA began after the addition of chemoresistant disseminated tuberculosis. Due to this, respiratory and heart failure progressively increased, which became the direct cause of death.

Hemoglobin Variants in Patients Attending Aden Diagnostic Center by High Performance Liquid Chromatography

Introduction: High performance liquid chromatography (HPLC) is emerging as the method of choice for initial screening and diagnosis of hemoglobinopathies. The use of alkaline and acid gel electrophoresis may result in incorrect diagnosis of hemoglobinopathies. The aim of the study is to investigate the hemoglobin pattern using the HPLC and to correlate the hematological profile with the types of hemoglobin. Methods: A cross-sectional study was conducted in Aden Diagnostic Center from July– December 2022. Over a six-month period, 250 samples of patients aged between six months to thirty years, were evaluated by HPLC for detection of hemoglobinopathies using the Lifotronic Hemoglobin Analyzer H9: β-thalassemia Analysis Mode. Red blood cell and red cell indices were determined using automated hematology analyzer. Results: A total of 152 samples (60.8%) showed different abnormal hemoglobin variants. Sixty-four (25.6%) were diagnosed to have sickle cell anemia, 46 (18.4%) as sickle cell trait, two (0.8) as beta – heterozygous thalassemia based on high level of HbA2 (>3.9%), four (1.6%) as beta – homozygous thalassemia (HbF 25–91%), 18 (7.2%) as compound heterozygous state of sickle - β+ thalassemia, 17 (6.8%) as beta thalassemia trait, and one (0.4%) sample had HbD variant on HPLC was diagnosed as HbD trait. Conclusion: H9-HPLC is suitable for the routine investigation of hemoglobinopatheis because it is very powerful tool in the evaluation of Hb variants, rapid assay time and accurate quantification.

A growth chart of brain function from infancy to adolescence based on EEG

In children, objective, quantitative tools that determine functional neurodevelopment are scarce and rarely scalable for clinical use. Direct recordings of cortical activity using routinely acquired electroencephalography (EEG) offer reliable measures of brain function. We developed and validated a measure of functional brain age (FBA) using a residual neural network-based interpretation of the paediatric EEG. In this cross-sectional study, we included 1056 children with typical development ranging in age from 1 month to 18 years. We analysed a 10- to 15-min segment of 18-channel EEG recorded during light sleep (N1 and N2 states). The FBA had a weighted mean absolute error (wMAE) of 0.85 years (95% CI: 0.69-1.02; n=1056). A two-channel version of the FBA had a wMAE of 1.51 years (95% CI: 1.30-1.73; n=1056) and was validated on an independent set of EEG recordings (wMAE=2.27 years, 95% CI: 1.90-2.65; n=723). Group-level maturational delays were also detected in a small cohort of children with Trisomy 21 (Cohen's d=0.36, p=0.028). A FBA, based on EEG, is an accurate, practical and scalable automated tool to track brain function maturation throughout childhood with accuracy comparable to widely used physical growth charts. This research was supported by the National Health and Medical Research Council, Australia, Helsinki University Diagnostic Center Research Funds, Finnish Academy, Finnish Paediatric Foundation, and Sigrid Juselius Foundation.

Analysis of the Therapeutic Approach to Drug-Sensitive Tuberculosis in Morocco: Retrospective Study from 2014 to 2017

In countries like Morocco, drug-sensitive tuberculosis remains a major public health burden. Effective management of this condition is crucial, not only to achieve positive therapeutic outcomes for patients but also to curb its emergence and transmission. This study presents a detailed analysis of the therapeutic approach to drug-sensitive tuberculosis in Morocco. This retrospective study provides an overview of the therapeutic protocol used to treat drug-sensitive tuberculosis. The study examined all tuberculosis patients registered at the Tuberculosis and Respiratory Diseases Diagnostic Center in Kenitra from 2014 to 2017. A total of 5207 tuberculosis cases were recorded, with men comprising the majority of patients (63%) in this group, with a sex ratio of 1.7. The most affected age groups were 15 to 24 years and 25 to 34 years. Urban areas had a representation of 53%. The study revealed that 54% of cases were pulmonary, and extrapulmonary tuberculosis accounted for 46%. There were two main stages to the treatment regimens recommended by the WHO. During the initial phase, 96% of patients received a two-month quadritherapy (for new cases), 3% received a three-month regimen (for retreatment cases), and 2% received a three-drug therapy (for those under 15 years). This phase was followed by a continuation phase (bitherapy) lasting four to ten months. 82% of cases showed positive progression, 13% of patients experienced loss to follow-up, 1% had transfers out, and 2% of patients died. The study emphasizes the importance of integrating patient support, education on treatment, and the use of new technologies to enhance the monitoring and follow-up of tuberculosis patients. These measures could help reduce the morbidity and mortality associated with tuberculosis, contributing to overall health improvement.
 Bangladesh Journal of Medical Science Vol. 23 No. 02 April’24 Page : 521-526

Test Center Location Problem: A Bi-Objective Model and Algorithms

The optimal placement of healthcare facilities, including the placement of diagnostic test centers, plays a pivotal role in ensuring efficient and equitable access to healthcare services. However, the emergence of unique complexities in the context of a pandemic, exemplified by the COVID-19 crisis, has necessitated the development of customized solutions. This paper introduces a bi-objective integer linear programming model designed to achieve two key objectives: minimizing average travel time for individuals visiting testing centers and maximizing an equitable workload distribution among testing centers. This problem is NP-hard and we propose a customized local search algorithm based on the Voronoi diagram. Additionally, we employ an ϵ-constraint approach, which leverages the Gurobi solver. We rigorously examine the effectiveness of the model and the algorithms through numerical experiments and demonstrate their capability to identify Pareto-optimal solutions. We show that while the Gurobi performs efficiently in small-size instances, our proposed algorithm outperforms it in large-size instances of the problem.

Abstract 807: An ethno-phenomenology based approach to study breast cancer disparity in rural India

Abstract There are fundamental lack of right methodologies to study the breast cancer disparity in rural India. Here, we have used an ethnographic-phenomenology approach to study the disparity in breast cancer care in Assam by using retrospective database of a rural cancer care non-profit clinic, the KaviKrishna Telemedicine Care (KTC), set up 1994 to develop a CBPR based cancer care (Abstract 3342, AACR 2019). Methodology: For one and half years, the doctors, researchers, nurses, caregivers, and physician assistants of KaviKrishna Laboratory and KaviKrishna Telemedicine Care were interviewed (total number: 15), and plus literature of the lab and the clinic were studied. Then, the breast cancer patients (n=10) and the families were subjected to ethnographies-phenomenology study to find their experiences of treatment and suffering. Next, thematic analysis and grounded theory were applied to come up with novel approaches to reduce breast cancer disparity. For comparison, 5 patients from rich urban families were interviewed. Results: We found that 10/10 patients found it extremely difficult to navigate the complexity of care in urban hospitals, but found the KTC approachable and comfortable. Importantly, these 10 breast cancer patients were positively responding to our KTC based care services/focussed group discussion (https://zenodo.org/records/8062404). They revealed positive experiences in emotionally and psychologically dealing with diagnostic, surgery, and chemotherapy processes. Next, our analysis of the last 25 years of the care data at KTC showed that in rural population, the loweconomic status, inadequate access to breast cancer detection clinics, lack of awareness,indecisive treatment protocols and social stigma are the main reasons for breast cancer disparity. Grounded theory-based analysis indicates that cancer biomarker study in rural populations can be a suitable method for early detection. Whole genome sequencing of cancer tissue frombiopsy samples shall provide landscape of mutation in the entire coding as well as noncodingregions. Mutation profiling along with correlation studies from patients can lead to discoveryof novel marker(s). Primary health care clinics in rural areas can be trained to collect patientsamples, isolate genomic DNA and perform PCR for the markers (a similar model asfollowed during Covid-19). The PCR samples can be sent to non-profit advanced diagnostic center such as KaviKrishna Lab to perform sequencing to study mutation markers. The method is also cost effective to both thecare givers and the patients as compared to setting up advanced diagnostic lab in every part ofrural area. Conclusion: The community based participatory research based model developed by KTC can be an effective strategy to reduce breast cancer disparity in the rural population since the primary health clinics shall act as a bridge between geologically isolated areas and modern technology. Citation Format: Debduti Dutta, Rupam Das, Chayanika Das, Tulika Sarma, Sonali Das, Anuja Dutta, Tutumoni Baishya, Lekhika Pathak, Bikul Das. An ethno-phenomenology based approach to study breast cancer disparity in rural India [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 807.

Brain Tumour Detection and Classification using Deep Convolutional Neural Network (DCNN)

Tumour is the undesired mass in the body. Brain tumour is the significant growth of brain cells. Manual method of classifying is time consuming and can be done at selective diagnostic centers only. Brain tumour classification is crucial task to do since treatment is based on different location and size of it. Magnetic Resonance Imaging (MRI) is most suitable way to do so. Hence there is a need to build such system which will automatically classify the brain tumour type based on input MR images only. The objective of the proposed system isto classify the brain tumour images into three sub-types: Meningioma, Glioma and Pituitary using convolutional neural network (CNN) and Support vector machine (SVM). Images from the dataset are downsized to reduce computation and some salt noise is added to make model robust and increase the dataset. The performance comparison is done on Google Colab and tensorflow platform in python language.

Telemedicine Screening for Diabetic Retinopathy Using Digital Technology: Foreign Experience

Background. Timely detection and treatment of diabetic retinopathy (DR) could prevent the development of blindness. However, large number of patients are diagnosed at late stages when effective treatment becomes impossible. In this context, active screening for DR plays an important role. Various screening programs have been developed, including programs using digital technologies.Objective. To analyze and summarize the literature data on digitalization of DR screening.Materials and methods. The study was carried out based on the results of a search in the PubMed / Medline bibliographic database and the Google system. The used keywords were “diabetes”, “retinopathy”, “telemedi-cine”, “digital technologies”, “artificial intelligence” and others. Relevant publications were selected by exam-ining the titles and abstracts of articles.Results. The study addressed the approaches to organizing the telemedicine programs of DR screening. The examples of innovative digital technologies for performing diagnostic studies as well as the characteristics of various electronic systems and devices are presented. It was noted that the DR screening could be performed in a local center with data transfer to a regional specialized diagnostic (analytical) center where telemedicine analysis is done. All diagnostic information is available to the diabetologist who prescribes and adjusts ther-apy. This operating principle facilitates the interaction between various specialists and thus increases the efficiency of screening.Discussion. Although the telemedicine screening for diabetic retinopathy has already been introduced in a number of countries, it is still at its early stages of development. Many modern technologies such as portable mobile devices could be adapted and used in the implementation of telemedicine programs. Deep machine learning algorithms and other artificial intelligence-based approaches demonstrate excellent results. Some systems have already received regulatory approval. Conclusions. The early diagnostics of diabetic retinopathy could be improved by integrating innovative screening technologies in a unified digital platform implemented in routine clinical practice.

Contrasting PRRSV temporal lineage patterns at the individual farm, production system, and regional levels in Ohio and neighboring states from 2017 to 2021

Porcine reproductive and respiratory virus (PRRSV), one of the most significant viruses in the swine industry, has been challenging to control due to its high mutation and recombination rates and complexity. This retrospective study aimed to describe and compare the distribution of PRRSV lineages obtained at the individual farm, production system, and regional levels. PRRSV-2 (type 2) sequences (n = 482) identified between 2017 – 2021 were provided by a regional state laboratory (Ohio Department of Agriculture, Animal Disease Diagnostic Center (ODA-ADDL)) collected from swine farms in Ohio and neighboring states, including Indiana, Michigan, Pennsylvania, and West Virginia. Additional sequences (n = 138) were provided by one collaborating swine production system. The MUSCLE algorithm on Geneious Prime® was used to align the ORF5 region of PRRSV-2 sequences along with PRRSV live attenuated vaccine strains (n = 6) and lineage anchors (n = 169). Sequenced PRRSV-2 were assigned to the most identical lineage anchors/vaccine strains. Among all sequences (n = 620), 29.8% (185/620) were ≥ 98.0% identity with the vaccine strains, where 93.5% (173/185) and 6.5% (12/185) were identical with the L5 Ingelvac PRRS® MLV and L8 Fostera® PRRS vaccine strains, respectively, and excluded from the analysis. At the regional level across five years, the top five most identified lineages included L1A, L5, L1H, L1C, and L8. Among non-vaccine sequences with production system known, L1A sequences were mostly identified (64.3% – 100.0%) in five systems, followed by L1H (0.0% - 28.6%), L1C (0.0% – 10.5%), L5 (0.0% – 14.4%), L8 (0.0% – 1.3%), and L1F (0.0% – 0.5%). Furthermore, among non-vaccine sequences with the premise identification available (n = 262), the majority of sequences from five individual farms were either classified into L1A or L5. L1A and L5 sequences coexisted in three farms, while samples submitted by one farm contained L1A, L1H, and L5 sequences. Additionally, the lineage classification results of non-vaccine sequences were associated with their restriction fragment length polymorphism (RFLP) patterns (Fisher’s exact test, p < 0.05). Overall, our results show that individual farm and production system-level PRRSV-2 lineage patterns do not necessarily correspond to regional-level patterns, highlighting the influence of individual farms and systems in shaping PRRSV occurrence within those levels, and highlighting the crucial goal of within-farm and system monitoring and early detection for accurate knowledge on PRRSV-2 lineage occurrence and emergence.

Possibilities of non-drug treatment methods in the correction of dyslipidemia and manifestations of individual components of the metabolic syndrome

Aim of the study was to identify the place of low-intensity electro-pulse therapy with biofeedback when it is included in the rehabilitation complex of patients with abdominal obesity to correct the quality of life and individual components of the metabolic syndrome.Material and methods. In the conditions of the outpatient diagnostic center of City Clinical Hospital No. 2 of Novosibirsk, 60 men and women with abdominal obesity, arterial hypertension and insulin resistance were examined, divided into 3 groups: 1st (main group, n = 25) in addition for standard therapy received a 15-day course of dynamic electroneurostimulation (DENS) from the Neurodance-PCM device; the 2nd (comparison group 1, n = 20), in addition to the basic complex, received DENS procedures from a placebo device, the 3rd (comparison group 2, n = 15) was treated with the use of only a basic therapeutic complex. The control group included 17 men and women without clinical manifestations from the endocrine and cardiovascular systems. The examination included examinations by an endocrinologist, a nutritionist, anthropometry and bioimpedance, assessment of quality of life parameters.Results. In group 1 patients, 1 month after the start of rehabilitation, there was a greater tendency than in the comparison groups to decrease the body mass index by 9.0 %, a correction of the percentage content in the body structure of fat mass by 1.4 times (p = 0.029) occurred, preprandial glycemia decreased by 1.4 times (p = 0.043) and the level of triglycerides in the blood serum – by 1.4 times (p = 0.044), the increased concentration of free leptin and resistin decreased (1.2 times, p = 0.039), the content of adiponectin in the blood serum increased by 1.2 times (p = 0.041), the quality of life improved 1 month after the start of rehabilitation according to the components of physical and psychological health, which is not observed in the placebo and standard treatment groups.Conclusions. The inclusion of DENS from the Neurodance-PCM device in the comprehensive rehabilitation of patients with abdominal obesity can contribute to the correction of anthropometry, bioimpedance, carbohydrate and adipokine metabolism indicators. This makes it possible to recommend the inclusion of low-intensity electro-pulse therapy in complex rehabilitation for the correction of quality of life indicators and individual components of the metabolic syndrome.

Longitudinal antimicrobial susceptibility trends of canine Staphylococcus pseudintermedius

Antimicrobial resistance within Staphylococcus pseudintermedius poses a significant risk for the treatment of canine pyoderma and as a reservoir for resistance and potential zoonoses, but few studies examine long-term temporal trends of resistance. This study assesses the antimicrobial resistance prevalence and minimum inhibitory concentration (MIC) trends in S. pseudintermedius (n=1804) isolated from canine skin samples at the Cornell University Animal Health Diagnostic Center (AHDC) between 2007 and 2020. Not susceptible (NS) prevalence, Cochran-Armitage tests, logrank tests, MIC50 and MIC90 quantiles, and survival analysis models were used to evaluate resistance prevalence and temporal trends to 23 antimicrobials. We use splines as predictors in accelerated failure time (AFT) models to model non-linear temporal trends in MICs. Multidrug resistance was common among isolates (47%), and isolates had moderate to high NS prevalence to the beta-lactams, chloramphenicol, the fluoroquinolones, gentamicin, the macrolides/lincosamides, the tetracyclines, and trimethoprim-sulfamethoxazole. However, low levels of NS to amikacin, rifampin, and vancomycin were observed. Around one third of isolates (38%) were found to be methicillin resistant S. pseudintermedius (MRSP), and these isolates had a higher prevalence of NS to all tested antimicrobials than methicillin susceptible isolates. Amongst the MRSP isolates, one phenotypically vancomycin resistant isolate (MIC >16 µg/mL) was identified, but genomic sequence data was unavailable. AFT models showed increasing MICs across time to the beta-lactams, chloramphenicol, the fluoroquinolones, gentamicin, and the macrolides/lincosamides, and decreasing temporal resistance (decreasing MICs) to doxycycline was observed amongst isolates. Notably, ATF modeling showed changes in MIC distributions that were not identified using Cochran-Armitage tests on prevalence, MIC quantiles, and logrank tests. Increasing resistance amongst these S. pseudintermedius isolates highlights the need for rational, empirical prescribing practices and increased antimicrobial resistance (AMR) surveillance to maintain the efficacy of current therapeutic agents. AFT models with non-linear predictors may be a useful, breakpoint-independent, surveillance tool alongside other modeling methods and antibiograms.

Photodynamic therapy for a patient with basal cell skin cancer of the lower eyelid (clinical case)

The article provides an example of successful treatment of a patient with basal cell skin cancer of the lower eyelid of the right eye, stage IB cT2aN0M0, with the presence of concomitant pathology – a decrease in the activity of plasma factor XII of blood coagulation (Hageman disease). The patient’s medical history is associated with long-term ineffective treatment of the tumor with Curaderm ointment. After diagnosis and further examination at the Moscow Research Institute named after. P.A. Herzen, at the Center for Laser and Photodynamic Diagnostics and Therapy of Tumors, the patient underwent organ-preserving treatment using photodynamic therapy. 1 course of photodynamic therapy with the photosensitizer chlorin e6 was carried out. Complete tumor regression was obtained; relapse-free follow-up period was 1 year

A multidisciplinary diagnostic centre for early detection of cancer in patients with non-specific symptoms: a service evaluation

Background/Aims Symptoms of malignancy are often vague and non-specific, leading to delayed diagnosis and treatment. The multidisciplinary diagnostic centre was established in 2017 to facilitate the shortest and safest route to detecting cancer in such cases. This study aimed to evaluate the service model and work towards a business case for more widespread adoption of the multidisciplinary diagnostic centre service. Methods Data from all patients managed by the service from 2017–21 were collected contemporaneously. After 51 months, service data were examined against the aims of the service, focusing on patient demographic characteristics, main reasons for referral, main diagnostic tests performed, patient outcomes and time from referral to discharge. Results Between 2 February 2017 and 30 April 2021, 899 patients were referred to the centre. Weight loss was the most common reason for referral. During this period, 96 (10.7%) patients were diagnosed with a cancer. Of these diagnoses, 42.9% were made within 28 days of referral, improving to 60.6% in the final year of the service evaluation. Conclusions The multidisciplinary diagnostic centre demonstrates the importance and potential of having a dedicated referral pathway for patients presenting with vague, concerning symptoms.

Parental involvement and adjustment during the diagnostic evaluation of autism spectrum disorder at two diagnostic centers

ObjectivesThe primary objective of this study was to determine the effects of permanent, mediated parental presence during all autism spectrum disorder diagnostic evaluations on parental adjustment (perceived parental stress and sense of parental competence) compared with procedures that traditionally only involve parents in pivotal periods of the diagnosis. The level of satisfaction with the diagnostic procedure and parents’ needs were also evaluated to complete this first objective. The secondary objective was to assess the effects of psychosocial, individual, and contextual variables on perceived parental stress and sense of parental competence. MethodsThe total sample of 49 parents was divided (using simple randomization) into two subgroups, each for a different procedure. Participants were met with once before the first consultation and once after. They completed self-reported questionnaires on parental stress, sense of parental competence, satisfaction with the procedure, social support, locus of control, and appraisal of life events. Statistical analysis was conducted using SPAD and SPSS software. ResultsThere was no difference between the two groups in the variables assessed. Satisfaction with the diagnostic procedure was high in both groups, but parents highlighted that they had important needs following the diagnosis. The child's level of autonomy, the presence of disruptive behaviors, and satisfaction with social support were found to be important for determining parental adjustment. ConclusionsSeveral hypotheses may explain the lack of differences between the two groups, including that parents may not yet have been in a position to benefit from the procedure aimed at integrating them. Our suggestion is that professional interventions should focus on improving the child's autonomy and helping the parent to develop a satisfactory support network. Finally, parents’ needs for the post-diagnosis phase should be given greater consideration, particularly in future research.

Abstract IA007: The WID-qEC test for simple and accurate endometrial cancer detection

Abstract Endometrial cancer incidence has been rising over the past ten years. Delays in diagnosis reduce survival and necessitate more aggressive treatment. We developed the WID-qEC test, a PCR-based test that evaluates DNA methylation in gene regions of GYPC and ZSCAN12, using 726 cervico-vaginal samples from women with and without endometrial cancer. So far, the WID-qEC test has been validated in an additional 1388 women in various settings, including a case/control study utilizing self-samples and a nested case/control set from a screening cohort including samples taken up to 3 years prior to endometrial cancer diagnosis. In a recent prospective observational study (the EPI-SURE study), the primary aim was to compare the performance of conventional index imaging tests (i.e., sonography) with the WID-qEC test for endometrial cancer detection. We invited all women aged ≥ 45 years with abnormal uterine bleeding attending a tertiary gynecological diagnostic referral center in the UK between June and November 2022 to participate. A cervicovaginal sample for the WID-qEC test was obtained prior to the current diagnostic pathway, and the test was performed blinded to the clinical outcome. Patients were followed until diagnostic resolution or until June 12, 2023. Four hundred of the eligible 474 women consented to study participation; one patient withdrew. Based on 603 index imaging tests (i.e., sonography), 186 (46.6%) women were recommended for a reference histology test (i.e., biopsy+/-hysteroscopy). Twelve cancers were diagnosed. 198 reference histology test procedures detected nine cancers and missed two; one further cancer was directly diagnosed at hysterectomy without a prior reference test. Endometrial thickness assessment from an ultrasound scan was possible in 379 (95.0%) of the 399 women and a pre-specified cut-off of ≥ 4.5mm had sensitivity, specificity, positive (PPV) and negative (NPV) predictive values of 90.9% (95% CI: 62.3-98.4), 79.1% (95% CI: 74.5-82.9), 11.8% (95% CI: 6.5-20.3) and 99.6% (95% CI: 98.0-99.9), respectively. Using a cut-off of &amp;gt; 3mm, the specificity was 45.8% (95% CI: 40.7–51.0) without a change in sensitivity. The WID-qEC test was possible in 390 (97.7%) of the 399 patients with 90.9% sensitivity (95% CI: 62.3-98.4), 92.1% specificity (95% CI: 88.9-94.4), a PPV of 25.6% (95% CI:14.6-41.1) and a NPV of 99.7% (95% CI: 98.3-99.9) when the pre-specified threshold (WID-qEC sumPMR ≥ 0.03) was applied. When a higher threshold was applied (WID-qEC sumPMR ≥ 0.3) the specificity increased to 97.3% (95% CI: 95.1-98.5) without a change in sensitivity. The WID-qEC test delivers fast results and shows improved performance compared with a combination of imaging index tests. Triage of women with abnormal uterine bleeding using the WID-qEC test could reduce the number of women requiring histological assessments for identification of potential malignancy and, specifically, reduce the false positive rate by up to 95% (from 52.6% based on the endometrial thickness of &amp;gt; 3mm to 2.6% based on a WID-qEC sumPMR ≥ 0.3). Citation Format: Martin Widschwendter, Iona Evans, Daniel Reisel, Allison Jones, Alba Bajrami, Simrit Nijjar, Sarah A Solangon, Rupali Arora, Elisa Redl, Lena Schreiberhuber, Isma Ishaq-Parveen, Julia Rothärmel, Chiara Herzog, Davor Jurkovic. The WID-qEC test for simple and accurate endometrial cancer detection [abstract]. In: Proceedings of the AACR Special Conference on Endometrial Cancer: Transforming Care through Science; 2023 Nov 16-18; Boston, Massachusetts. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(5_Suppl):Abstract nr IA007.

Discrete Event Simulation for Facility Layout Design of Precise Molecular Diagnostic Centers

Discrete Event Simulation for Facility Layout Design of Precise Molecular Diagnostic Centers

Examining Barriers to Early Hearing Diagnosis.

Many factors create barriers for early hearing detection and intervention (EHDI), especially those related to unfavorable social determinants of health (SDOH). The primary aim of this study was to evaluate diagnostic timing of infants at risk for congenital hearing loss in consideration of known barriers. Understanding the specific barriers to early diagnosis can inform interventions to improve timeliness of diagnosis and subsequent habilitation. A retrospective chart review was completed for infants referred for diagnostic audiologic testing at a tertiary urban-setting Children's Hospital from 2018 to 2021. After exclusion criteria were applied, 1,488 infants were included in the analysis. Various factors were recorded from electronic medical records including those specific to SDOH. Time to diagnosis was derived and compared across five factors of interest that have previously been shown to impact diagnostic timeline, including (a) insurance type, (b) race/ethnicity, (c) presence of middle ear dysfunction at first auditory brainstem response (ABR), (d) proximity to diagnostic center, and (e) diagnostic timing before and during/after the COVID-19 pandemic. Across the study time period, 77% of infants referred for diagnostic testing had confirmed diagnosis by the EHDI benchmark of 3 months. Analysis of time to diagnosis across factors of interest revealed no clinically significant differences for insurance type, race/ethnicity, proximity to diagnostic center, or timing in reference to the COVID-19 pandemic. Presence of middle ear dysfunction on first ABR was found to significantly protract final diagnostic timing. Although some known barriers for EHDI can be universal, other factors may have a differential impact on an infant's timeline to diagnosis based on their specific location, which can interact differently with additional known barriers. Understanding local challenges will serve to better guide programs in implementing facilitators that will address their specific needs for improved outcomes.

Modern Ways of Educating Parents of Children with Adhd

The relevance of the study is substantiated by the lack of modern programs of psychological and pedagogical education of parents of children with ADHD, taking into account the psychological characteristics and expectations of modern parents, against the backdrop of a growing number of children with these developmental characteristics who experience significant difficulties in the educational process. The main goal set by the authors is to identify effective modern methods of psychological education of parents of children with attention deficit hyperactivity disorder, applicable in the context of inclusive education. Methodology. In the course of the study, an analysis of current domestic and foreign scientific publications and scientific and methodological sources was carried out, the method of expert assessments was applied (a survey of specialists of the psychological and pedagogical support service of inclusive schools of the Novosibirsk region and employees of the Regional Center for Diagnostics and Counseling) and a method of studying pedagogical experience (an analysis of programs that are laureates of the “All-Russian competition of the best Psychological and pedagogical programs and technologies in the educational environment” 2021 and 2022 using the methodology of the evidence-based approach). Results. Theoretical analysis and a survey of experts confirmed the relevance of the problem of psychological and pedagogical education of parents, without whose active and competent participation in the organization of educational activities of children with attention deficit and hyperactivity, the efforts of specialists in psychological support of this specific group of children do not give the necessary effect. In addition, difficulties in organizing work with parents are identified and described, and it is shown that specialists face problems when choosing effective methods of education that take into account such features of modern parents as lack of time, orientation to digital sources of information, the need for active dialog interaction with specialists and visual provision of necessary information. It is confirmed that specialists of inclusive educational organizations need additional knowledge about the psychological characteristics of children with ADHD and their parents and in program and methodological materials with proven effectiveness. The results of the analysis of the programs-winners of the All-Russian competition led to conclusions about a clear shortage of program and methodological materials on psychological education of parents of children with ADHD, taking into account, among other things, the psychophysiological characteristics of parents of this group of children. It is shown that so far not all the award-winning programs provided in the register of the best psychological and pedagogical programs of the Federation of Educational Psychologists of the Russian Federation fully meet the criteria of practice with empirically proven effectiveness (evidence-based approach).

Risk of cancer and serious disease in Danish patients with urgent referral for serious non-specific symptoms and signs of cancer in Funen 2014–2021

BackgroundIn 2011, as the first European country, Denmark introduced the non-organ-specific cancer patient pathway (CPP) for patients presenting with non-specific symptoms and signs of cancer (NSSC). The proportion of patients with cancer over time is unknown.MethodsA retrospective cohort study of all patients with a NSSC-CPP investigational course in the province of Funen to the Diagnostic Centre in Svendborg from 2014 to 2021 was performed to evaluate the proportion of patients with cancer and serious disease over time.ResultsA total of 6698 patients were referred to the NSSC-CPP of which 20.2% had cancer. While the crude referral rate increased from 114 per 100,000 people in 2014 and stabilised to around 214 in 2017–2021, the cancer detection rate of the total yearly new cancers in Funen diagnosed through the NSSC-CPP in DC Svendborg increased from 3 to 6%.ConclusionsWith now high and stable conversion and crude referral rates, the NSSC-CPP is one of the largest CPPs in Denmark as measured by the number of new cancer cases found. Similar urgent referral programmes in other countries might fill an unmet medical need for patients presenting with serious non-specific symptoms and signs of cancer in general practice.

Evidence of Active Orbivirus Transmission in 2016 in Kansas and Nebraska.

Retrospective serological and case diagnostic data of endemic bluetongue virus (BTV) and epizootic hemorrhagic disease virus (EHDV) provide evidence of viral transmission among livestock and wildlife from 2016 in Kansas and Nebraska. Serological testing of mature cattle in nine distinct regional zones of Kansas revealed 76% to 100% had detectable antibodies to BTV and/or EHDV. Specimens tested in the Kansas Veterinary Diagnostic Laboratory (55 submissions) were 51% test positive for antibodies to BTV and/or EHDV. Specimens tested in the Nebraska Veterinary Diagnostic Center (283 submissions) were 25% test positive for antibodies to BTV and/or EHDV. Low disease incidence in white-tailed deer and other susceptible wild ungulates was observed during 2016. However, there were no confirmed reports of disease in livestock in either state. The reasons for emergence of significant clinical disease in livestock and wildlife populations remain undefined.