Diagnostic Unit Research Articles

An electron–ion coincidence spectrometer for commissioning of a synchrotron radiation beamline: Absolute photon intensity and content of higher harmonic radiation

We describe the commissioning of a new electron-ion coincidence spectrometer used to diagnose the photon beam from a plane grating monochromator beamline at the ASTRID2 synchrotron radiation facility. The spectrometer allows determination of the absolute photon intensity by calibration to the photoabsorption cross sections of known gases, such as the rare gases Ar, Kr, and Xe presented here. The spectrometer operates at very low pressure (∼10-8-10-9 mbar) and-due to the coincidence electron-ion detection scheme-the detector efficiencies can be determined routinely; hence, the spectrometer can be recalibrated swiftly. By variation of a single potential of the spectrometer, the content of higher order radiation in the monochromatized synchrotron radiation can be analyzed. The layout and operation of the synchrotron radiation beamline at ASTRID2 and its additional photon diagnostic units are additionally described.

Multidrug-resistant Salmonella spp. in fecal samples of pigs with suspected salmonellosis in Antioquia, Colombia, 2019-2021.

To determine the proportion of Salmonella enterica in fecal samples of live pigs with suspected salmonellosis analyzed at the diagnostic unit of the University of Antioquia, Colombia between 2019 and 2021, and examine the serotypes and antimicrobial resistance patterns. This was a laboratory-based cross-sectional study of routine data on fecal samples received from pig farms in all nine subregions of Antioquia state, Colombia. Salmonella spp. detection at the university is done using enrichment, selective culture, and polymerase chain reaction. Serotypes were identified using the Kauffmann-White scheme and isolates were tested for antimicrobial susceptibility using broth microdilution. Of 653 samples tested, 149 (23%) were positive for S. enterica. Nine serotypes were identified. The most common were Salmonella Typhimurium (56%) and its monophasic variant (35%). Resistance to ampicillin (70%) was most frequently observed, followed by ciprofloxacin (55%), and sulfamethoxazole-trimethoprim (52%). No isolates were resistant to amikacin and gentamicin. Multidrug resistance (resistance to ≥ 3 classes of antibiotics) was observed in 61 (44%) isolates. Multidrug resistance was highest in S. Typhimurium (57%) compared with the other serotypes. Serotype was associated with multidrug resistance (p = 0.01), but age of the pig and sub-region were not. The proportion of Salmonella spp. and the associated high levels of multidrug resistance are of concern and may indicate irrational use of antimicrobials and poor management practices in pig production systems in the region. Strengthened surveillance is needed to monitor and improve farm management practices and the use of antimicrobials in farms in Colombia.

Особенности эмоционально-волевой устойчивости сотрудников полиции на различных этапах профессиогенеза

<p style="text-align: justify;">The article deals with the issues of emotional and volitional stability, acting as the leading ones in the system of moral and psychological support for the activities of the internal affairs bodies of the Russian Federation. The purpose of the article was to analyze the features of emotional and volitional stability of police officers of the territorial bodies of the Ministry of Internal Affairs of Russia and cadets of the educational organization of the Ministry of Internal Affairs of Russia. The sample is represented by two groups of 119 people, including police officers, 65 people, cadets of the educational organization of the Ministry of Internal Affairs of Russia — 54 people. The research methods were presented by the diagnostic unit: the questionnaire for assessing neuropsychic stability “Prognosis-2” (V.Yu. Rybnikov); the test “Lifestyle Analysis” (Boston stress tolerance test), the Individual typological questionnaire L.N. Sobchik, The methodology of the study of the volitional organization of the personality of A.A.Khokhlov, The test questionnaire of A.V. Zverkov and E.V. Eidman “The study of volitional self-regulation”. Research results. The presence of significantly significant differences (p≤0.05) between the groups was established, indicating a higher level of neuropsychic stability, stress resistance and emotional-volitional regulation of police officers, which is determined by age characteristics and character accentuations. The normative indicators in both groups were not exceeded, which generally reflects the quality of professional psychological selection and the stability of the personality of police officers.</p>

Abstract OT1-23-01: Development of a hoRizontal data intEgration classifier for NOn-invasive early diAgnosis of breasT cancEr: the RENOVATE trial

Abstract Background: The detection of breast lesions through self-examination or during screening tests is a frequent finding. Breast biopsy is required in case of radiologically suspect lesions, bestowing a high burden on both patients and national healthcare system, since only one every four biopsies is breast cancer (BC). To date, the assessment of circulating biomarkers failed to demonstrate clinical utility in the early diagnosis of BC, for its suboptimal accuracy and difficult transferability to clinical practice. The combination of novel cutting-edge methods for the assessment of circulating analytes in an integrated multiomic classifier may overcome such limitations, possibly allowing liquid biopsy to become a novel noninvasive procedure for the differential diagnosis of BC. Design: In the RENOVATE trial (NCT04781062), women with suspect (BI-RADS-4/5) breast lesions ≤ 2 cm (cT1) are asked, before biopsy, to donate ~ 35 mL of blood collected in four dedicated tubes and ~ 50 mL of urine at the Diagnostic Senology Unit of Ospedale Policlinico San Martino (Genoa, IT). Plasma cell-free DNA methylation and copy number alterations are assessed in a cohort of patients diagnosed with early BC and a matched set of patients with histologically proven benign lesions through cell-free methylated DNA immunoprecipitation and high throughput sequencing (cfMeDIPseq), as well as ultra-low pass whole genome sequencing (ULP-WGS). Thanks to the volume and quality of our sample set, other experimental techniques will be tested as well. Results from cfMeDIP-seq and ULP-WGS, possibly in combination with other findings, will be integrated in a unique classifier for the noninvasive differential diagnosis of suspect breast lesions. Eligibility criteria: Patients with radiologically suspect breast lesions ≤ 2 cm (i.e. BIRADS 4/5) are eligible. Patients with previous history of cancer, or diagnosed with autoimmune or active allergic diseases, acute or chronic hepatic, renal, or cardiac diseases, or acute or chronic infectious diseases are excluded from the present trial. Specific aims: The primary aim of the present trial is to develop a noninvasive classifier for the differential diagnosis of suspect breast lesions detected through mammography and/or ultrasound. For such purpose we will assess the performance of plasma cfMeDIPseq, ULP-WGS, and other promising techniques for the differential diagnosis of BC. Such techniques will be integrated in a unique classifier in order to reach the maximum possible accuracy. Statistical methods: Sample size was calculated with a semi-parametric simulation-based approach from beta-distributions of PBMC datasets: assuming to test 20,000 CpG regions, with 300 differentially methylated target CpGs, a target maximal difference in DNA methylation of 0.2 between groups and an FDR of 0.05, 1 – beta ~ 0.90 would be achieved with an overall sample size of 150 samples split in a 1:2 ratio. Target accrual and present accrual: Minimum target accrual is set at 49 patients with BC and 98 patients with benign lesions. To date, we have collected plasma samples from 74 eligible patients with BC and 115 eligible patients with benign lesions. A validation cohort accounting for ~30% of our sample set will be recruited at Istituto Nazionale dei Tumori (Milan, IT). Contact information: For further information, please contact Gabriele Zoppoli at gabriele.zoppoli@unige.it. Citation Format: Francesco Ravera, Martina Dameri, Isabella Lombardo, Mario Stabile, Alberto Tagliafico, Massimo Calabrese, Alberto Ballestrero, Lorenzo Ferrando, Gabriele Zoppoli. Development of a hoRizontal data intEgration classifier for NOn-invasive early diAgnosis of breasT cancEr: the RENOVATE trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT1-23-01.

Predictors of autism spectrum disorder diagnosis in a spanish sample of preterm children with very low birthweight: A cross-sectional study.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a higher likelihood of being diagnosed in preterm populations. Likewise, low birthweight has also been connected with an increased likelihood of ASD. The objectives were to study the frequency and define the relationship between ASD, gestational age, birthweight, and growth percentiles for preterm children. A sample of preterm children with very low birthweight was selected from the Spanish population at 7-10 years old. Families were contacted from the hospital, and they were offered an appointment to conduct a neuropsychological assessment. The children who showed signs of ASD were referred to the diagnostic unit for differential diagnosis. A total of 57 children completed full assessments, with 4 confirmed ASD diagnoses. The estimated prevalence was 7.02%. There were statistically significant weak correlations between ASD and gestational age (τb = -0.23), and birthweight (τb = -0.25), suggesting there is a higher likelihood of developing ASD for those born smaller or earlier in their gestation. These results could improve ASD detection and outcomes for this vulnerable population while also supporting and enhancing previous findings.

Design of a shattered pellet injector and preliminary bench tests of Ne pellet formation for EAST disruption mitigation

Shattered pellet injection (SPI) technology has been demonstrated as a novel effective method for disruption mitigation in tokamaks. To further verify the superiority and reliability of this technology, in this study, a SPI test stand based on in-situ gas formation technology was designed and constructed for Experimental Advanced Superconducting Tokamak (EAST). A pellet producer, a gas feeding system, a pumping system, diagnostic units, and a shatter chamber have been developed and are served as the main components of the SPI test stand. We experimentally demonstrated that the SPI test stand developed in this study can be used for forming and accelerating impurity pellets. On the test stand, Ne pellets with a diameter of ∼5 mm were successfully formed, and their length was varied from ∼7 mm to ∼15 mm by changing the heating power of the heat sinks after the formation of the pellets. The feasibility of pellet shattering was verified using a shatter tube (inner diameter: 15.7 mm) in the shatter chamber. The results showed that Ne pellets with a velocity of ∼150 m/s could be broken into fragments without removing the propellant gas by passing them through a ∼20° bent tube. The SPI test stand developed in this study and the experimental results presented in this paper will serve as the technical basis for developing a reliable SPI system on EAST and will be a good reference for the development of such systems on other fusion devices.

Radiology blues: Comparing occupational blue-light exposure to recommended safety standards.

The blue-light hazard is a well-documented entity addressing the detrimental health effects of high-energy visible light photons in the range of 305 nm - 450 nm. Radiologists spend long hours in front of multiple light-emitting diode (LED)-based diagnostic monitors emitting blue light, predisposing them to potentially higher blue-light dosages than other health professionals. The authors aimed to quantify the blue light that radiology registrars are exposed to in daily viewing of diagnostic monitors and compared this with international occupational safety standards. A limited cross-sectional observational study was conducted. Four radiology registrars at two academic hospitals in Bloemfontein from 01 October 2021 to 30 November 2021 participated. Diagnostic monitor viewing times on a standard workday were determined. Different image modalities obtained from 01 June 2019 to 30 November 2019 were assessed, and blue-light radiance was determined using a spectroscope and image analysis software. Blue-light radiance values were compared with international safety standards. Radiology registrars spent on average 380 min in front of a diagnostic display unit daily. Blue-light radiance from diagnostic monitors was elevated in higher-intensity images such as chest radiographs and lower for darker images like MRI brain studies. The total blue-light radiance from diagnostic display units was more than 10 000 times below the recommended threshold value for blue-light exposure. Blue-light radiance from diagnostic displays measured well below the recommended values for occupational safety. Hence, blue-light exposure from diagnostic monitors does not significantly add to the occupational health burden of radiologists. Despite spending long hours in front of diagnostic monitors, radiologists' exposure to effective blue-light radiance from monitors was far below hazardous values. This suggests that blue-light exposure from diagnostic monitors does not increase the occupational health burden of radiologists.

Assessment of the awareness of radiation protection and related concepts among nursing staff mainly working in diagnostic imaging units, cath-labs and operation theatres in Sri Lanka: A survey-based study

IntroductionThis study was carried out to evaluate the awareness of radiation protection, radiation types, medical imaging equipment and radiation effects among nurses for the first time in Sri Lanka. Since nurses are involved as direct caregivers in diagnostic and therapeutic radiography and radiation treatment procedures, they need to have a good understanding of the areas mentioned above. MethodsA self-administered questionnaire was used to collect data from 391 nurses working in hospitals, clinics, and other healthcare settings. Forwarded questions gathered the participants' demographic details and assessed their awareness of radiation protection, medical imaging equipment, radiation type and radiation effects. The average score per awareness area for each demographic characteristic was calculated based on the responses. Additionally, the percentage of participants who scored above 50 and 75 was calculated for each awareness area. ResultsThe majority were female participants (81.1%) and possessed a diploma in nursing (66.0%) with 10.8 years of average work experience. 92.3%, 74.7%, 69.8% and 22.3% of the participants scored more than 50 marks for the questions related to radiation protection, medical imaging equipment, radiation type and radiation effects, respectively. The level of nursing education and prior training in radiation protection significantly influenced all awareness areas, whereas participants with a graduate qualification in nursing and with prior radiation protection training scored the highest average marks. ConclusionBased on the scores obtained, the Sri Lankan nurses have satisfactory awareness of the essential concepts related to radiation types, medical imaging equipment and radiation protection. However, there is a significant lacking of awareness of radiation effects. This can be attributed to the fact that most participants did not have any formal training in radiation protection. The results implicate that proper training in radiation protection can significantly influence awareness of radiation protection and related concepts. Therefore, it is a timely requirement to initiate short awareness programs and continuing education programs on radiation protection for nurses working in specialised radiation units. Implications for practiceThe study suggests the necessity of initiating continuous education programs for nursing staff radiation protection to overcome the awareness gaps.

Characteristics of the Brain in ASD and Effective Ways of Teaching

Autism Spectrum Disorder (ASD) is a sort of neurodiversity that is characterized by repetitive behavior, limited interests, struggling in social interaction, expressing feelings, and many more. It is an innate disorder and combines several previously used definitions of mental syndromes and diseases into one diagnostic unit. Its signs can be noticed in infancy or early childhood, at two years old, or a little later. For instance, the child practices non-verbal communication speaks very little, and repeatedly makes the same movement with his fingers, arms, or legs. Such a person may have intact intelligence and the ability to live in society, but ASD is often associated with cognitive impairments of varying severity. A single cause of the appearance of ASD has not yet been found. Scientists identify only factors that can affect the likelihood of its occurrence, for instance, mutations, problems with pregnancy, or difficult ecological situations.

Possible post-COVID epilepsy: A review of epilepsy monitoring unit admissions during the two years of COVID-19 pandemic.

Large scale healthcare data shows that new-onset epilepsy is noted in 0.3% patients within 6months of COVID-19 infection. We analyzed diagnostic epilepsy monitoring unit (EMU) evaluations to identify and report such cases. We thoroughly reviewed our EMU database and identified patients having "COVID" or "Corona" virus mention in their medical record from 03/15/2020 to 02/28/2022. Patients with epilepsy prior to COVID infection were excluded. Among 62 patients without prior epilepsy evaluated in the EMU for new-onset spells after confirmed COVID-19 infection, three patients were diagnosed with focal epilepsy. These three women without epilepsy risk factors had seizure onset at the time of, or within one to three months of, COVID-19 diagnosis. Their 3T MRI imaging was non-lesional but revealed bilateral enlarged perivascular spaces. The video EEG monitoring was consistent with temporal or fronto-temporal lobe epilepsy in all three patients. Two of them developed drug-resistant epilepsy within six months of seizure onset. Our thorough analysis of diagnostic EMU evaluations during the two years of pandemic reveals three cases of post-COVID-19 epilepsy after non-symptomatic to mild disease. Although coincidental epilepsy onset cannot be ruled out, larger multicenter or national database investigations are needed to further analyze the possibility of post-COVID epilepsy.

ПЕДАГОГИЧЕСКОЕ МОДЕЛИРОВАНИЕ И ОЦЕНКА РЕЗУЛЬТАТИВНОСТИ ФОРМИРОВАНИЯ СОЦИАЛЬНО-ПРАВОВОЙ ПОЗИЦИИ БУДУЩЕГО ГОСУДАРСТВЕННОГО СЛУЖАЩЕГО

Modeling the process of forming the socio-legal position of a future civil servant allows us to present the process taking into account its essential characteristics and possible risks. The logic of formation is represented by a process model consisting of target, methodological, socio-legal, content-technological and performance-diagnostic blocks. The target block of the process model highlights the leading direction of activity: to form the socio-legal position of the future civil servant. The methodological basis is the activity approach and its complementary principles of socio-legal orientation, resourcefulness, team design and visualization. In the socio-legal block, based on the norms of law and the content of the Federal State Educational Standard in the direction of training 38.03.04 State and Municipal Administration, the value, knowledge and behavioral dominants of the socio-legal position of the future civil servant are highlighted. The content and technology block represents the interaction of the subjects of the “teacher — future civil servant — regional employer” process at the stages of the work of the “Premier Project” Factory organized at the university. The effective diagnostic unit determines the correspondence of the components (value, knowledge, behavioral), criteria (axiological, epistemological, praxiological) and indicators (awareness, validity, stability) to the formation of the socio-legal position of the future civil servant. The result of the process model is the formed socio-legal position of the future civil servant. The evaluation of the effectiveness of the modeled process was carried out when the model was introduced into the educational practice of the university. The conducted diagnostics of the formation of the socio-legal position of the future civil servant revealed in the ascertaining experiment the predominance of low and medium levels of formation of the socio-legal position of the future civil servant in the educational community; in the forming experiment, an increase in the proportion of students who have a high level of formation of this quality.

Using a Complex Sensorimotor Reaction to Predict School Performance

In recent years, the number of students with learning difficulties has increased. Often, children with a high level of intellectual development cannot cope with the primary school program. The success of studying at school is largely determined by the level of development of the executive function. There is evidence that the results of sensorimotor tests coincide with the results of the evaluation of executive function. The purpose of the study: to find a connection between the results of sensorimotor tests and the academic performance of elementary school students. The study involved 108 children aged 9-11 years. Annual marks in all subjects for grades 2 and 3 were taken into account. The diagnostic unit consisted of 7 hardware and software tests that evaluated various parameters of simple and complex sensorimotor reactions. Results. Factorial and regression analysis of the data were carried out, statistically significant relationships between academic performance and indicators of complex sensorimotor tests were revealed. The tests included three main elements of executive function: inhibitory control, working memory and cognitive flexibility. The results of certain sensorimotor tests predict academic performance in grades 2 and 3. Apparently, this is due to the fact that the tests simulate the learning process in real conditions when it is necessary to show cognitive flexibility. The relationship of academic performance with simple sensorimotor reactions has not been revealed. Conclusion. The use of certain sensorimotor tests for older preschoolers and first grade students will allow identifying children at risk of learning difficulties before these difficulties arise and have a negative impact on the development of the child's personality. The use of software and hardware complexes for conducting sensorimotor tests makes it possible to examine large groups of children in a short time, which is convenient in educational institutions. The results of testing of younger schoolchildren will help to develop an optimal educational route for each child, taking into account the peculiarities of the functioning of the nervous system.

The diagnostic continua of the soils of Europe

Diagnostic horizons, properties and materials are commonly applied building units of national and international soil classification systems. The presence, depth or absence of diagnostic information supports the process of objective soil classification, such as the World Reference Base (WRB). While the diagnostic units and associated descriptive qualifiers convey information that reflect pedogenesis, they also indicate important, and often complex properties that are related to soil fertility and other soil functions. The spatial extent or the continuum of diagnostic information is often different from the spatial extent of the mapping units in general soil maps (mostly reflecting soil types). This paper presents the spatial distribution of selected diagnostic units and qualifiers for the European Union and describes their significance for key soil functions. The derivation of selected diagnostics was performed based on the information provided in the European Soil Database and by taking into consideration the definitions, rules and allocation procedure of soils to the appropriate Reference Soil Group (RSG) defined by the WRB key. The definition of the presence/absence of the diagnostic units were performed by extracting information related to the first level of the WRB classification and to the qualifiers provided by the ESDB on the Soil Taxonomic Units (STU) level. The areal percentage of the STUs (thus, the derived diagnostics) within Soil Mapping Units (SMUs) was calculated and was visualized on separate maps. The study demonstrated the importance of the spatial information that the diagnostic elements convey, especially related to soil functions.

Evaluation of Wang-Koch optimisation of axial length for intraocular lens power calculation in myopic eyes

Background: Refractive outcome has become more relevant in myopic patients. Refractive surprises are mainly caused by errors in axial length (AL) measurement.Aim: This study aimed to evaluate the accuracy of intraocular lens (IOL) power calculation in myopic eyes using the AL measured by optical biometry versus an optimised AL calculated by the Wang-Koch method.Setting: Ophthalmology Department, Cairo University and Ophthalmic Diagnostic and Laser Unit, Cairo University Hospitals, both in Cairo, Egypt.Methods: A prospective study of 30 eyes of 23 patients with ALs greater than 25.0 mm that underwent phacoemulsification with IOL implantation in the capsular bag. The LENSTAR was used for preoperative IOL power calculation using the Holladay 1 formula and the LENSTAR AL (group 1), and for back-calculation of the prediction error (PE) for the same 30 eyes using the Holladay 1 formula and the optimised AL (group 2). Postoperative PEs and mean absolute errors (MAEs) were calculated six weeks after surgery.Results: The postoperative spherical equivalent was within ± 1.00 dioptre (D) of predicted in 86.7% and 90.0% of eyes, respectively, (p = 0.69). However, 66.7% of eyes had a hyperopic outcome in group 1, in comparison to 20.0% that would be left hyperopic using the optimised AL in group 2 (p 0.05).Conclusion: The Wang-Koch method of optimising the AL would have significantly reduced the percentage of eyes rendered hyperopic using the LENSTAR AL from 66.7% to 20.0%. This difference represents a clinically significant improvement in IOL power prediction in these eyes.

Tegumentary Leishmaniasis in Northeastern Italy from 2017 to 2020: A Neglected Public Health Issue

Tegumentary leishmaniasis (TL) includes cutaneous (CL) and mucosal (ML) leishmaniasis; despite being endemic in southern Europe, it is often underdiagnosed and underreported. This study aimed to retrospectively examine data collected from patients with TL in a selected area of northeastern Italy (Emilia-Romagna region, RER). A network of 10 diagnostic units within RER was established, and TL cases diagnosed in RER from 2017 to 2020 were evaluated. A total of 135 TL cases were collected (62% male, 38% female); patients ranged from 1 to 84 years, with a median age of 57. Among these cases, 113 (84%) were notified to the public health authorities. The average annual incidence of TL was 0.76 cases per 100,000 inhabitants. Infections were acquired within the RER in 84% of cases; the 113 autochthonous cases were distributed in the foothills areas of the region. We provide evidence of a defined spatial distribution of TL cases in a selected area of northeastern Italy, as well as a relevant number of ML cases. Our observations suggest the need to raise awareness about TL among clinicians and pathologists, promote the molecular confirmation of cases by reference laboratories, and encourage the establishment of surveillance networks for this neglected disease.

Quantitative G6PD Deficiency Screening in Routine Malaria Diagnostic Units in the Brazilian Amazon (SAFEPRIM): An Operational Mixed-Methods Study.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency testing is not routinely performed before primaquine treatment in most Plasmodium vivax endemic areas, despite the risk of primaquine-associated hemolysis. This is due to the operational challenges associated with pragmatic G6PD testing and as such needs to be addressed. This mixed-methods operational study was aimed at implementing the quantitative point-of-care StandardTM G6PD (SD Biosensor, Korea) screening test in malaria treatment units (MTUs) in the municipalities of Rio Preto da Eva and Mâncio Lima, in the Brazilian Amazon, between mid-January 2020 and December 2020. In total, 1286 P. vivax cases were treated based on the Standard G6PD test: 1230 had activity equal to or greater than 4.0 U/g Hb, and 56 less than 4.0 U/g Hb. No G6PD deficient (G6PDd) genotypes were found in 96 samples from the 1230, and only 21 of the 56 G6PDd cases had confirmed G6PDd genotypes. Evaluations were conducted on the proficiency of health care professionals (HCPs) training to perform the test, the reliability of testing performed in the field, and the perceptions of HCPs and patients about the implementation. Post-training proficiency was 73.4% after a 4-hour training session. This study revealed that locations with lower malaria caseloads will need regular refresher training. The test was well accepted by both HCPs and patients. Signs and symptoms of hemolysis were not always associated with malaria treatment drugs by HCPs and patients. Point-of-care quantitative G6PD testing can be performed at MTUs in the Brazilian Amazon to inform treatment decisions with primaquine. Limitations related to technical and cultural aspects need to be addressed further when expanding screening to larger areas.

Cohort study of diagnostic delay in the clinical pathway of patients with chronic wounds in the primary care setting

ObjectivesExact wound diagnosis is essential for successful wound management and a holistic care of the patient suffering from a wound. Wound management has been traditionally seen as a nursing area,...

Matters of the Autistic Mind: What Is the Role of Material Objects in Social Interaction?

Matters of the Autistic Mind: What Is the Role of Material Objects in Social Interaction? Derek Strijbos*, MD, PhD (bio) Is autism a condition internal to the person that causes problems in social interaction? Or should we conceive of autism primarily at the level of interaction, as a “two-way” phenomenon (Krueger & Maiese, 2018) that develops in the relation between the person with autism and her social-material environment? Over the last decade or so, this issue has increasingly gained interest, not only in academia, but also in the field of mental health care and in the wider public domain. Much is at stake here. Framing autism as an internal deficit or rather as an interaction phenomenon has far-reaching implications for scientific research and clinical practice. It steers the focus of autism research by determining the kind of research questions we deem scientifically and clinically relevant. In mental health care, it influences the way in which we conceive of the problems people with autism struggle with and seek help for. Are the social difficulties that people with autism experience to be framed in terms of their lack of “theory of mind” (e.g., Baron Cohen, 2000)? Or should we rather start our clinical inquiry with the acknowledgment of a “double empathy problem” (Milton, 2012) that shapes the social interaction between the autistic individual and non-autistic people, health care professionals included? More generally, are the problems experienced by people with autism to be explained with reference to internal mental dysfunction? Or should rather we take as our primary diagnostic unit of analysis the structural mismatch in needs, interests, experienced salience and perceived possibilities between the person with autism and the wider social world? These background assumptions regarding the nature of autism shape diagnostic case formulations, guide treatment interventions and determine the tone of the therapeutic relationship. Beyond scientific and clinical interests, the issue also has wider societal implications. Framing autism as a difference rather than a disorder, voices in the recovery and (neuro) diversity movement have suggested that the problems experienced by people with autism are first and foremost social—or rather societal—problems originating from a failure of society to make room for autistic forms of life (cf. Silberman, 2015). [End Page 213] I think it is important to keep these wider issues in mind when reading Boldsen’s paper. First, as Boldsen herself makes clear, her inquiry into the role of material objects in the immediate environment in shaping social interaction for people with autism is motivated by phenomenological, enactivist and externalist conceptions of mind and cognitive science. These philosophical views argue against the internalist understanding of mind and mental (dys)functioning still prevalent in mainstream autism research and treatment programs. These philosophical views explicitly endorse a relational view of mind, thereby making room for a relational view of autism (e.g., De Haan, 2020; De Jaegher, 2013; Fuchs, 2018; Gallagher & Varga, 2015). Second, Boldsen’s study is one of few empirical attempts to take seriously the idea that the material environment plays an important role in shaping social interaction for people with autism. Straddling the divide between the “social” and “non-social” characteristics of autism, this idea has significant potential for both research and clinical practice. Scientifically, it opens up a whole new range of empirical questions as to how (shared) engagement with material objects enables people with autism to regulate their sensory, affective and cognitive attunement within the social world. Clinically, it motivates both health-care professionals and service users to take even more seriously the possibility that the shaping of the physical environment and the handling of material objects in social situations might play an important role in facilitating attunement and synchronization and reducing social stress and overstimulation. And as Boldsen highlights at the end of her paper, these considerations also point toward broader societal questions regarding the shaping of material niches that afford autistic ways of social life. Interpreting the qualitative data of her field-work study, Boldsen suggests two ways in which material things can sustain and facilitate social interaction for people with autism: first, material things solicit sensory engagement for the persons with autism in virtue of their sensible qualities...

Concordance of the filmarray blood culture identification panel 2 and classical microbiological methods in a bacteriemia diagnostic unit

Our study evaluates the effectiveness of the FilmArray Blood Culture Identification Panel 2 in a rapid bacteremia diagnostic system, using bacteriological culture as a reference. A total of 2042 positive blood cultures were analyzed, the FilmArray was performed for 175. Concordance was higher in monomicrobial bacteremia (95%) than in polymicrobial bacteremia's (72.2%). For detecting bacterial resistance mechanisms, concordance was very high (100% for Gram-positive bacteria and 98.12% for Gram-negative). This methodology provides significant improvements in response time and is especially useful for the detection of monomicrobial bacteremia.

Forearm Arteriovenous Fistula Maturation Delay due to Juxta-Anastomotic Stenosis: Role of Percutaneous Angioplasty

Introduction: Arteriovenous fistula is the optimal vascular access for hemodialysis as it has the best long-term patency rate and the lowest complication rate. Although we are still lacking consensus, surgery has been advocated as the best treatment option for maturation delay. We proposed to evaluate the results of endovascular approach of arteriovenous fistula’s maturation delay in our hospital. Methods: We conducted a retrospective study, selecting patients referred to our diagnostic and therapeutic angiography unit due to arteriovenous fistula delayed maturation, between April 2017 and June 2020. Results: Thirty-four patients were referred to our center due to maturation delay, of which six (17.7%) were excluded as the diagnosis was not confirmed and six (17.7%) because the lesions were not suitable for percutaneous angioplasty. The other 22 patients (64.7%) were subjected to percutaneous endovascular treatment. Mean age was 67.3 ± 13.8 years. Eighteen patients (81.8%) had maturation delay due to peri-anastomotic stenosis; 12 (66.7%) were forearm fistulas (all radio-cephalic). Mean follow-up time was 21.2 ± 11.2 months. Eleven (91.7%) fistulas were salvaged, although four (33.3%) needed reintervention. Primary and assisted primary patencies at 6 and 12 months were 66.7% vs 91.7% and 58.3% vs 91.7%, respectively. Conclusion: Our results point out that endovascular treatment is a good treatment option for maturation delay of forearm arteriovenous fistulas due to juxta-anastomotic stenosis. Even though surgical treatment appears to have better primary patency, a step-by-step approach seems to be a valid strategy, as our assisted primary patency shows.