Common Clinical Tests Research Articles

A-367 Development of a Multimodal Point-of-Care Diagnostic Platform to Perform Rapid, Accurate, and Cost-Effective Molecular, Immunochemistry, Clinical Chemistry, and Cytometry Tests

Abstract Background Access to point-of-care (POC) testing can make a significant impact on the quality of care. However, because POC diagnostic platforms available today are expensive and only perform one type of test, clinicians are unable to implement all the POC tests they wish to perform. Fluxergy is developing a multimodal POC diagnostic platform that consolidates diverse diagnostic modalities into a single, compact platform to minimize the cost of POC testing and standardize testing workflow for the most common clinical chemistry, hematology, immunochemistry and molecular tests. This study describes feasibility studies performed to benchmark these assay modalities on the Fluxergy Analyzer. Methods Fluxergy Analyzer: The Fluxergy Analyzer integrates conventional detection systems—colorimetric, fluorometric, and electrochemical—into a singular POC platform. This unique design expands -omics testing capabilities, including molecular, immunochemistry, clinical chemistry, and hematology within a single instrument. Benchmarking Feasibility Studies: Molecular benchmarking was performed using a multiplex respiratory panel on contrived samples in UTM/VTM. Immunochemistry benchmarking was performed using a procalcitonin assay on spiked sodium citrate plasma samples. Cytometry benchmarking was performed using a white blood cell count (WBC) assay and testing contrived samples whole blood samples. Results For molecular testing, the Fluxergy Analyzer was able to accurately detect flu A, flu B, SARS-CoV-2, and RSV with agreements with the Luminex ARIES® Flu A/B & RSV Assay and Cepheid Xpert® SARS-CoV-2 test results. For immunochemistry testing, the Fluxergy Analyzer accurate quantified PCT levels at 0.3, 0.6, 1.25 and 2.5 ng/mL. For hematology testing, the Fluxergy Analyzer demonstrated a strong correlation across the reportable range against the standard of care HemoCue analyzer. For clinical chemistry testing, the Fluxergy Analyzer demonstrated a strong correlation against the Siemen’s epoc® Blood Analysis System. Conclusions The Fluxergy Analyzer is uniquely suited to offer a comprehensive menu of the most common POC tests on a single, cost-effective platform.

Digital screener of socio-motor agency balancing motor autonomy and motor control.

Dyadic social interactions evoke complex dynamics between two agents that, while exchanging unequal levels of body autonomy and motor control, may find a fine balance to synergize, take turns, and gradually build social rapport. To study the evolution of such complex interactions, we currently rely exclusively on subjective pencil and paper means. Here, we complement this approach with objective biometrics of socio-motor behaviors conducive to socio-motor agency. Using a common clinical test as the backdrop of our study to probe social interactions between a child and a clinician, we demonstrate new ways to streamline the detection of social readiness potential in both typically developing and autistic children by uncovering a handful of tasks that enable quantification of levels of motor autonomy and levels of motor control. Using these biometrics of autonomy and control, we further highlight differences between males and females and uncover a new data type amenable to generalizing our results to any social setting. The new methods convert continuous dyadic bodily biorhythmic activity into spike trains and demonstrate that in the context of dyadic behavioral analyses, they are well characterized by a continuous Gamma process that can classify individual levels of our thus defined socio-motor agency during a dyadic exchange. Finally, we apply signal detection processing tools in a machine learning approach to show the validity of the streamlined version of the digitized ADOS test. We offer a new framework that combines stochastic analyses, non-linear dynamics, and information theory to streamline and facilitate scaling the screening and tracking of social interactions with applications to autism.

Neutrophil extracellular traps protect the kidney from ascending infection and are required for a positive leukocyte dipstick test.

Lower urinary tract infection (UTI) is common but only rarely complicated by pyelonephritis. However, the mechanisms preventing extension to the kidney are unclear. Here, we identified neutrophil extracellular traps (NETs) in healthy human urine that provide an antibacterial defense strategy within the urinary tract. In both in vivo murine models of UTI where uropathogenic E. coli are inoculated into the bladder and ex vivo human urine models, NETs interacted with uromodulin to form large webs that entrapped the bacteria. Peptidyl arginine deiminase 4 (PADI4) inhibition in mice blocked NETosis and resulted in progression of cystitis into pyelonephritis, suggesting that NETosis of urinary neutrophils acts to prevent bacterial ascent into the kidney. Analysis of UK Biobank data revealed that genetic variants in PADI4 that associated with increased risk of rheumatoid arthritis in multiple genome-wide association studies were consistently associated with reduced susceptibility to UTI. Last, we showed that urine dipstick testing for leukocyte esterase was negative in the presence of intact blood neutrophils but became positive when neutrophils were stimulated to NET, and this could be prevented by selective PADI4 inhibition, demonstrating that this test does not detect absolute neutrophil count, as has long been assumed, but specifically detects neutrophils that have undergone NETosis. These findings highlight the role of NETosis in preventing ascending infections in the urinary tract and improve our understanding of one of the most common clinical tests in medicine.

Gait and Balance Assessments with Augmented Reality Glasses in People with Parkinson's Disease: Concurrent Validity and Test-Retest Reliability.

State-of-the-art augmented reality (AR) glasses record their 3D pose in space, enabling measurements and analyses of clinical gait and balance tests. This study's objective was to evaluate concurrent validity and test-retest reliability for common clinical gait and balance tests in people with Parkinson's disease: Five Times Sit To Stand (FTSTS) and Timed Up and Go (TUG) tests. Position and orientation data were collected in 22 participants with Parkinson's disease using HoloLens 2 and Magic Leap 2 AR glasses, from which test completion durations and durations of distinct sub-parts (e.g., sit to stand, turning) were derived and compared to reference systems and over test repetitions. Regarding concurrent validity, for both tests, an excellent between-systems agreement was found for position and orientation time series (ICC(C,1) > 0.933) and test completion durations (ICC(A,1) > 0.984). Between-systems agreement for FTSTS (sub-)durations were all excellent (ICC(A,1) > 0.921). TUG turning sub-durations were excellent (turn 1, ICC(A,1) = 0.913) and moderate (turn 2, ICC(A,1) = 0.589). Regarding test-retest reliability, the within-system test-retest variation in test completion times and sub-durations was always much greater than the between-systems variation, implying that (sub-)durations may be derived interchangeably from AR and reference system data. In conclusion, AR data are of sufficient quality to evaluate gait and balance aspects in people with Parkinson's disease, with valid quantification of test completion durations and sub-durations of distinct FTSTS and TUG sub-parts.

Are Clinical Balance Measures Linked to Cycling Performance?

Balance is paramount to safe and successful cycling, both in competition and recreation. Balance has been investigated in the return-to-cycling context, but its relationship to cycling performance is unknown. Our study aimed to analyse the relationship between balance, measured by common clinical balance tests, and cycling performance. Seven competitive cyclists participated in this cross-sectional correlational study. We collected field-based measures of cycling performance, including mean velocity, minimum and maximum velocity, mean corner speed, average lap time, and lean angle. Also, we measured balance via the balance error scoring system, the star excursion balance test, the lateral reach test, and the modified Bass test of dynamic balance. Strong correlations between cornering performance and cycling performance (r = 0.65–0.87, p < 0.01) were detected. Weak correlations between clinical balance tests and cycling performance (r = 0.33–0.53, p < 0.05) were observed. In conclusion, our study showed that improving cornering performance has the potential to improve overall cycling performance. We also found no clear correlations between our clinical balance tests and cycling performance. These weak correlations between postural control in standing and cycling performance suggest that standing balance and balancing during cycling are distinct motor control processes.

Pet travellers' unwanted companions: a parasitic voyage across Europe

In the modern world, country borders do not represent boundaries for the transmission of pathogens. This is also true for parasites that may travel with animals, particularly pets. Dogs and cats are moving across countries more than ever before as a result of adoption, commerce and travels with owners. In addition, climate change supports the establishment of parasites, particularly those transmitted by invertebrate intermediate hosts and vectors, into areas which were previously considered non-enzootic. Therefore, it is important for veterinarians to keep a vigilant eye on such parasitic infections in dogs and cats, be able to recognise compatible signs and feel confident in ordering specific diagnostic tests. This article presents parasites prevalently reported as imported from one European country to another. Furthermore, common clinical manifestations and diagnostic tests are summarised and the preventive measures that should be advised to pet owners are discussed. Raising awareness among veterinary practitioners and pet owners about the risk of parasites spreading in new areas is imperative for controlling and delaying globalisation of important, and potentially lethal, parasitic diseases.

Dual Tasking Affects the Outcomes of Instrumented Timed up and Go, Sit-to-Stand, Balance, and 10-Meter Walk Tests in Stroke Survivors.

Stroke can impair mobility, with deficits more pronounced while simultaneously performing multiple activities. In this study, common clinical tests were instrumented with wearable motion sensors to study motor-cognitive interference effects in stroke survivors (SS). A total of 21 SS and 20 healthy controls performed the Timed Up and Go (TUG), Sit-to-Stand (STS), balance, and 10-Meter Walk (10MWT) tests under single and dual-task (counting backward) conditions. Calculated measures included total time and gait measures for TUG, STS, and 10MWT. Balance tests for both open and closed eyes conditions were assessed using sway, measured using the linear acceleration of the thorax, pelvis, and thighs. SS exhibited poorer performance with slower TUG (16.15 s vs. 13.34 s, single-task p < 0.001), greater sway in the eyes open balance test (0.1 m/s2 vs. 0.08 m/s2, p = 0.035), and slower 10MWT (12.94 s vs. 10.98 s p = 0.01) compared to the controls. Dual tasking increased the TUG time (~14%, p < 0.001), balance thorax sway (~64%, p < 0.001), and 10MWT time (~17%, p < 0.001) in the SS group. Interaction effects were minimal, suggesting similar dual-task costs. The findings demonstrate exaggerated mobility deficits in SS during dual-task clinical testing. Dual-task assessments may be more effective in revealing impairments. Integrating cognitive challenges into evaluation can optimize the identification of fall risks and personalize interventions targeting identified cognitive-motor limitations post stroke.

Establishment and application of a nomogram diagram for predicting calcium oxalate stones in patients with urinary tract stones

This retrospective study aims to examine the correlation between calcium oxalate (CaOx) stones and common clinical tests, as well as urine ionic composition. Additionally, we aim to develop and implement a personalized model to assess the accuracy and feasibility of using charts to predict calcium oxalate stones in patients with urinary tract stones. A retrospective analysis was conducted on data from 960 patients who underwent surgery for urinary stones at the First Affiliated Hospital of Soochow University from January 1, 2010, to December 31, 2022. Among these patients, 447 were selected for further analysis based on screening criteria. Multivariate logistic regression analysis was then performed to identify the best predictive features for calcium oxalate stones from the clinical data of the selected patients. A prediction model was developed using these features and presented in the form of a nomogram graph. The performance of the prediction model was assessed using the C-index, calibration curve, and decision curve, which evaluated its discriminative power, calibration, and clinical utility, respectively. The nomogram diagram prediction model developed in this study is effective in predicting calcium oxalate stones which is helpful in screening and early identification of high-risk patients with calcium oxalate urinary tract stones, and may be a guide for urologists in making clinical treatment decisions.

Fall Risk Assessment in Stroke Survivors: A Machine Learning Model Using Detailed Motion Data from Common Clinical Tests and Motor-Cognitive Dual-Tasking.

Falls are common and dangerous for stroke survivors. Current fall risk assessment methods rely on subjective scales. Objective sensor-based methods could improve prediction accuracy. Develop machine learning models using inertial sensors to objectively classify fall risk in stroke survivors. Determine optimal sensor configurations and clinical test protocols. 21 stroke survivors performed balance, Timed Up and Go, 10 Meter Walk, and Sit-to-Stand tests with and without dual-tasking. A total of 8 motion sensors captured lower limb and trunk kinematics, and 92 spatiotemporal gait and clinical features were extracted. Supervised models-Support Vector Machine, Logistic Regression, and Random Forest-were implemented to classify high vs. low fall risk. Sensor setups and test combinations were evaluated. The Random Forest model achieved 91% accuracy using dual-task balance sway and Timed Up and Go walk time features. Single thorax sensor models performed similarly to multi-sensor models. Balance and Timed Up and Go best-predicted fall risk. Machine learning models using minimal inertial sensors during clinical assessments can accurately quantify fall risk in stroke survivors. Single thorax sensor setups are effective. Findings demonstrate a feasible objective fall screening approach to assist rehabilitation.

Активность сывороточной щелочной фосфатазы у самцов лосей Alces alces (Linnaeus 1758) различных возрастных групп

The moose has good prospects for hunting and game breeding. Peripheral blood indicators can provide information about their health status and adaptive capabilities, as well as non-infectious, infectious, and invasive pathologies. Serum alkaline phosphatase activity is one of the most common clinical biochem ical tests in this respect. &#x0D; The study involved blood samples obtained from male moose (n = 75) of four age groups: calves aged 6–7 months, young animals of 18 months old, adults of 2.5–7.5 years old, and adults aged ≥ 8.5 years. The biomaterial sampling was carried out in October – December in the southern taiga subzone, Kirov Region. The blood samples were obtained by cutting the jugular vein (Venae jugularis) immediately after the animal was shot during legal hunting. The blood serum tests involved a semi-automatic biochemical analyzer (Biochem SA High Technology, USA).&#x0D; The alkaline phosphatase activity in male European moose during different periods of ontogenesis demonstrated the following pattern. In the first months of life, the enzyme activity was as high as 222.16 ± 31.14 U/L. This process was typical of intense hydrolysis of organic phosphorus esters, including the exchange of macroergs caused by rapid osteogenesis. At 18 months, the demand for organophosphorus compounds in metabolic processes decreased (46.48 ± 44.09 U/L), as did the role of the enzyme in maintaining homeostasis. In adults of 2.5–7.5 years old, alkaline phosphatase activity dropped to 69.88 ± 11.31 U/L. In 8.5-year-old males, it was as low as 47.34 ± 4.74 U/L. All age groups demonstrated significant differences in alkaline phosphatase activity. Therefore, age had a significant effect on enzyme activity. The study also revealed a certain correlation between alkaline phosphatase activity and body weight.&#x0D; The dynamics of alkaline phosphatase activity in ontogenesis reflected homeostatic changes in the moose body. Indicators of alkaline phosphatase activity can serve as an efficiency marker and an additional criterion in standard selection methods in zootechnical practice.

USING INERTIAL MEASUREMENT UNITS (IMUS) TO DETECT MOBILITY DECLINES IN MIDDLE-AGED INDIVIDUALS

Abstract Valid and reliable assessments of mobility are routinely used in clinics to track patient progress, assess the need for assistive devices, and predict risk of falling. These tests require patients to perform tasks that span varying degrees of difficulty so that therapists can observe changes in mobility and balance that can occur as a function of age and neurological disease. Evidence suggests that subtle gait changes which begin in middle-age can predict the future onset of mobility difficulties. However, standard clinical tests which rely on visual observation are designed to capture easily observable balance and gait problems in patients, rather than small changes that begin in middle-age. In this study we examined mobility changes that occur as a function of age using a common clinical test, the Functional Gait Assessment (FGA). Both middle aged (n=8) and young adult (n=12) participants completed the FGA while wearing small sensors, called inertial measurement units (IMUs). IMUs were placed on each ankle and the trunk to capture subtle differences in gait patterns. Participants also completed a health history questionnaire. Preliminary data suggest gait variability was increased in middle-aged adults (especially towards the end of the gait cycle), in the more difficult tasks. Subtle changes in gait velocity and leg acceleration during the swing phase of gait also appears to emerge by middle-age. Using IMUs to capture changes in gait patterns of middle-aged participants may help to identify those who are at future risk of having mobility difficulties and significant health risk.

Deviation in White Blood Cell Count Measurement between WNR and WDF Channels on an Automated Hematology Analyzer XN-3000: A Case Report

BACKGROUND: At present, complete blood count (CBC) testing is one of the most common clinical tests. The XN-3000 used in our hospital utilizes the principles of impedance and semiconductor laser flow cytometry, which contains two types of leukocyte fractionation methods: White cell nucleated (WNR) and white cell differential (WDF) channels. CASE PRESENTATION: Herein, we present the case of a 63-year-old male patient who was admitted to our hospital for the treatment of non-small cell lung cancer (T4N3M1 [LYM, HEP, and OSS]). Biochemical data showed abnormal liver function and anemia. WNR results showed poor leukocyte and debris fractions compared with WDF results, and leukocyte counts were different between the two channels. However, the poor fractionation of the leukocyte and debris fractions in the WNR was resolved at the twofold dilution stage. To investigate the cause of the problem, precipitates affecting the WNR measurement were visually checked. Consequently, insoluble precipitates were observed in the WNR mixture of the specimen of the patient. In our hospital, we measure 1200 CBCs/day and very rarely encounter abnormal specimens such as in the presented case. Normally, leukocyte counts are reported in priority to those measured by the WNR channel; however, in this case, the switching function was effective in giving priority to WDF count results because of the appearance of abnormal WNR plots. However, a system that can promptly confirm events when results are reported is necessary. CONCLUSION: We very rarely encounter abnormal specimens such as in the presented case. Normally, leukocyte counts are reported in priority to those measured by the WNR channel; however, in this case, the switching function was effective in giving priority to WDF count results because of the appearance of abnormal WNR plots. However, a system that can promptly confirm events when results are reported is necessary. When no clinical request for WDF measurement was made, the WNR scattergram must be confirmed, dilution measurement, if necessary, must be performed, or the WDF must be measured and reported to the clinician as useful criteria for diagnosis.

Clinical reading-related oculomotor assessment in visual snow syndrome

PurposeVisual snow syndrome (VSS) is a complex neurological condition presenting with an array of sensory, motor, and perceptual dysfunctions and related visual and non-visual symptoms. Recent laboratory studies have found subtle, basic, saccadic-based abnormalities in this population. The objective of the present investigation was to determine if saccadic-related problems could be confirmed and extended using three common clinical reading-related eye movement tests having well-developed protocols and normative databases. MethodsThis was a retrospective analysis of 32 patients (ages 16–56 years) diagnosed with VSS in the first author's optometric practice. There was a battery of three reading-related tests: the Visagraph Reading Eye Movement Test, the Developmental Eye Movement (DEM) Test, and the RightEye Dynamic Vision Assessment Test, all performed using their standard documented protocols and large normative databases. ResultsA high frequency of oculomotor deficits was found with all three tests. The greatest percentage was revealed with the Visagraph (56%) and the least with the RightEye (23%). A total of 77% of patients failed at least one of the three tests. ConclusionThe present findings confirm and extend earlier investigations revealing a high frequency of saccadic-based oculomotor problems in the VSS population, now including reading-related tasks. This is consistent with the more general oculomotor/motor problems found in these individuals.

Potential application of peripheral blood biomarkers in intracranial aneurysms

Intracranial aneurysm (IA) counts are increasing yearly, with a high mortality and disability after rupture. Current diagnosis and treatment rely on costly equipment, lacking effective indicators for progression prediction and specific drugs for treatment. Recently, peripheral blood biomarkers, as common clinical test samples, reflecting the immune and inflammatory state of the body in real-time, have shown promise in providing additional information for risk stratification and treatment in IA patients, which may improve their outcomes after aneurysm rupture through anti-inflammatory therapy. Therefore, this paper reviewed the progress of potential biomarkers of IAs, including inflammatory blood indicators, cytokines, and blood lipids, aiming to aid individual management and therapy of aneurysms in clinical practices.

Lever-Test Accuracy in Detecting Anterior Cruciate Ligament (ACL) Tears: A Single Institution Experience.

Background One of the most often damaged ligaments in the knee is the anterior cruciate ligament (ACL). With the increased occurrence of ACL injuries, there is a greater need for clinical diagnostics to rule in or rule out a suspected rupture. The Lever Test, a novel clinical tool for diagnosing ACL rupture, has been presented, with preliminary trials indicating encouraging results. Methods This is a prospective, blinded, diagnostic accuracy study. The aim of this study was to evaluate the accuracy of the Lever Test and other common clinical tests (Anterior Drawer Test, Lachman Test, Pivot Shift Test) for diagnosing ACL injuries. The study enrolled 23 patients who had knee pain, instability, and locking symptoms. The clinical tests were performed on the patients in supine position before, during, and after anesthesia. The results of the clinical tests were compared with MRI findings to determine the sensitivity of each test. Results The patients consisted of 17 men and six women, with a mean age of 30.4±9.95 years. 18 patients had complete tears, four had partial tears, and one had intact ACL damage. 10 (44%) complained in the right knee, 13 (56%) in the left knee, and two (9%) had a generalized ligamentous laxity. 21 (91%) complained of giving away, 22 (96%) complained of knee pain, and 10 (43%) complained of locking of the knee. On the ipsilateral leg examination, pre-operative positivity of Lever Sign was 44%, Lachman 83%, and Anterior Drawer 67%. After being given anesthesia, test positivity rates were 44% for Lever Sign and 56% for Pivot Shift. Post-operative positivity of Lever Sign was 17%, Lachman 39%, and Anterior Drawer 35%. Mcnemar test p values were significant for the difference of positivity anterior drawer test (p=0.002) and were not significant on Lever Sign (p=0.7) and Lachman tests (p=0.13). Correlation analysis showed a weak but not statistically significant interrater reliability between MRI findings and Lever Sign (p=0.846) (Kappa= 0.2). On the contralateral leg examination, the pre-operative positivity of Lever Sign was 9%, Lachman 17%, and Anterior Drawer 22% Conclusion The study suggests that the Lever Test has lower accuracy than other clinical tests when comparing the results of tests with MRI findings. As a result, Lever Test should be used in combination with other clinical tests to accurately rule out suspected ACL injuries.

B-185 High Throughput ID-LCMSMS Method for Simultaneous Quantitation of Monosaccharides in Human Serum

Abstract Background Blood glucose is one of the most common clinical tests used for diagnosis and treatment of diabetes, with clinical analyzers being the typical instrumentation used in the clinical laboratory. While glucose is an important monosaccharide for management of diabetes, dietary fructose has shown associations with non-alcoholic fatty liver disease (NAFLD). However, only limited data on serum fructose in the general population are available. Clinical analyzers that can measure glucose and other monosaccharides simultaneously from human serum are unavailable. A high throughput ID-LC/MS/MS method is needed to allow simultaneous quantitation of monosaccharides from human serum to help better understanding the associations of monosaccharides with different diseases. Methods Calibrators, serum samples, and internal standards were transferred and subsequently processed on an automated liquid handler platform. Acetonitrile was added to precipitate monosaccharides from serum matrix and the precipitate was removed through filtration with 96-well protein removal plate. Clean extracts were injected on a LC-MS/MS system using a LC gradient consisting of acetonitrile and water. Quantitation was performed using stable-isotope labeled standards. Certified reference material NIST glucose SRM 917c and commercially available fructose, mannose and galactose were used for calibration. The analytical performance was assessed using NIST glucose SRM 965b serum materials and commercial serum material with monosaccharides spiked at different levels. Results The method demonstrated high level of specificity for glucose, fructose, mannose, and galactose with all monosaccharides being chromatographically baseline-resolved within 9 minutes. No interferences were detected when monitoring the QI/CI ratio in commercial serum materials. The method is highly linear (all R2 = 0.999) between 10–380 mg/dL and 0.04–12 mg/dL for glucose and other monosaccharides, respectively. The limit of detection was 0.19 mg/dL for glucose and 0.02–0.03 mg/dL for galactose, mannose, and fructose. For glucose, the imprecision and bias, determined with NIST SRM 965b measured over 5 days in duplicate, &amp;lt;4%CV and −1.44%, respectively. Inter-day imprecision, determined with samples at concentrations between 0.05 mg/dL to 9 mg/dL, was between 4 and 12%CV for all monosaccharides. The method demonstrated good agreement when compared with the CDC glucose GC-MS RMP with an intercept and slope of −1.7 (CI −4.05 to 0.38) and 1.03 (CI 1.01–1.06), respectively. The Pearson’s coefficient is 0.999. This method allows for measurement of 85 samples in one batch in a semi-automated manner. Conclusion The described high throughput LC/MS/MS method for simultaneous quantitation of four monosaccharides is sufficiently sensitive, selective, accurate and precise for measuring monosaccharides in epidemiological studies. Its suitability as comparator method for method comparison studies with regular clinical analyzers and point-of-care devices are currently ongoing.

A quantitative study of airway ultrasound in predicting difficult laryngoscopy: A prospective study

PurposeAs common clinical screening tests cannot effectively predict a difficult airway, and unanticipated difficult laryngoscopy remains a challenge for physicians. We herein used ultrasound to develop some point-of-care predictors for difficult laryngoscopy. MethodsThis prospective observational study included 502 patients who underwent laryngoscopy and a detailed sonographic assessment. Patients under 18 years old, or with maxillofacial deformities or fractures, limited mouth opening, limited neck movement or history of neck surgery were excluded from the study. Laryngoscopic views of all patients were scored and grouping using the modified Cormack-Lehane (CL) scoring system. The measurements acquired comprised tongue width, the longitudinal cross-sectional area of the tongue, tongue volume, the mandible-hyoid bone distance, the hyoid bone-glottis distance, the mandible-hyoid bone-glottis angle, the skin-thyrohyoid membrane distance, the glottis-superior edge of the thyroid cartilage distance (DGTC), the skin-hyoid bone distance, and the epiglottis midway-skin distance. ANOVA and Chi-square were used to compare differences between groups. Logistic regression was used to identify risk factors for difficult laryngoscopy and it was visualized by receiver operating characteristic curves and nomogram. R version 3.6.3 and SPSS version 26.0 were used for statistical analyses. ResultsDifficult laryngoscopy was indicated in 49 patients (CL grade Ⅲ – Ⅳ) and easy laryngoscopy in 453 patients (CL grade Ⅰ – Ⅱ). The ultrasound-measured mandible-hyoid bone-glottis angle and DGTC significantly differed between the 2 groups (p < 0.001). Difficult laryngoscopy was predicted by an area under the curve (AUC) of 0.930 with a threshold mandible-hyoid bone-glottis angle of 125.5° and by an AUC of 0.722 with a threshold DGTC of 1.22 cm. The longitudinal cross-sectional area of the tongue, tongue width, tongue volume, the mandible-hyoid distance, and the hyoid-glottis distance did not significantly differ between the groups. ConclusionDifficult laryngoscopy may be anticipated in patients in whom the mandible-hyoid bone-glottis angle is smaller than 125.5° or DGTC is larger than 1.22 cm.

Assessing the Accuracy of Common Clinical Tests for Detecting Palmaris Longus: A Prospective Study in a Tertiary Center.

Background Palmaris longus (PL) is a short-bellied muscle with a long tendon that merges with the palmar aponeurosis. It is supplied by the median nerve and acts as a tensor of the palmar aponeurosis and flexes the wrist. This tendon is commonly used for tendon transfers and as a donor for tendon graft. There are numerous clinical tests to detect the presence of PL like Schaeffer's test, Thompson's test, Mishra's test I, Mishra's test II, Pushpakumar's "two-finger sign" method, and AIIMS test. The principle of all these tests is to make the tendon prominent by eliciting its flexor action and then its identification by inspection and palpation. Objectives The tests that are consistently easy to perform with good understandability would be easy to explain to the general population (patients). The aim of our study is to find out the accuracy and easy comprehensibility of various tests using compulsive postures for detecting PL tendon clinically. Materials and Methods This is a prospective study on 137 participants. All the patients were subjected to six clinical tests to detect the presence or absence of PL tendon. The results were recorded for both hands by a single observer. Results Of the 137 participants, 75 were males (54.74%) and 62 were females (45.26%). The mean age was 21 years. The AIIMS test showed the maximum number of tendons, that is, 113 (82.4%) in the right hand and 108 (78.8%) in the left hand. In view of the ability to comprehend the tests, 119 (86.9%) subjects understood Schaeffer's test very easily. Conclusion According to this study, the AIIMS test best demonstrates the PL tendon, and Schaeffer's test was the test most easily understood by the subjects.

A Comparison of Walking Behavior during the Instrumented TUG and Habitual Gait.

The timed up and go test (TUG) is a common clinical functional balance test often used to complement findings on sensorimotor changes due to aging or sensory/motor dysfunction. The instrumented TUG can be used to obtain objective postural and gait measures that are more sensitive to mobility changes. We investigated whether gait and body coordination during TUG is representative of walking. We examined the walking phase of the TUG and compared gait metrics (stride duration and length, walking speed, and step frequency) and head/trunk accelerations to normal walking. The latter is a key aspect of postural control and can also reveal changes in sensory and motor function. Forty participants were recruited into three groups: young adults, older adults, and older adults with visual impairment. All performed the TUG and a short walking task wearing ultra-lightweight wireless IMUs on the head, chest, and right ankle. Gait and head/trunk acceleration metrics were comparable across tasks. Further, stride length and walking speed were correlated with the participants' age. Those with visual impairment walked significantly slower than sighted older adults. We suggest that the TUG can be a valuable tool for examining gait and stability during walking without the added time or space constraints.

Deep learning-based label-free hematology analysis framework using optical diffraction tomography

Hematology analysis, a common clinical test for screening various diseases, has conventionally required a chemical staining process that is time-consuming and labor-intensive. To reduce the costs of chemical staining, label-free imaging can be utilized in hematology analysis. In this work, we exploit optical diffraction tomography and the fully convolutional one-stage object detector or FCOS, a deep learning architecture for object detection, to develop a label-free hematology analysis framework. Detected cells are classified into four groups: red blood cell, abnormal red blood cell, platelet, and white blood cell. In the results, the trained object detection model showed superior detection performance for blood cells in refractive index tomograms (0.977 mAP) and also showed high accuracy in the four-class classification of blood cells (0.9708 weighted F1 score, 0.9712 total accuracy). For further verification, mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were compared with values obtained from reference hematology equipment, with our results showing reasonable correlation in both MCV (0.905) and MCH (0.889). This study provides a successful demonstration of the proposed framework in detecting and classifying blood cells using optical diffraction tomography for label-free hematology analysis.