Laboratory Test Results Research Articles

Nutritional therapy among adult patients with severe burns: A retrospective observational study.

The objective of this study was to examine the effects of nutritional therapy in adult patients with severe burns. Sixty adult patients with severe burns were enrolled. Data on nutritional intake through enteral nutrition (EN) or parenteral nutrition (PN) on days 7, 14, 21, and 28 post-injury were collected. Patients were divided into target and non-target groups according to whether their energy or protein intake reached the target. Age, length of ventilation, and total bilirubin (TBIL), albumin (ALB), prealbumin (pALB), and C-reactive protein (CRP) concentrations of patients were recorded. The percentage of protein targets with protein delivery was lower than that of energy target with energy delivery. The ratio of PN protein to total protein was lower than that of PN energy to total energy on days 7, 14, 21, and 28 (p<0.001, p<0.001, p=0.001, and p=0.003, respectively). Compared to the non-target group on day 21, the target group was younger, had lower TBIL on day 7, higher ALB and pALB on day 21, and lower CRP on day 14 (p=0.025, p=0.021, p=0.028, p=0.029, and p=0.049, respectively). Multivariate logistic regression analysis showed that older age and longer ventilation were independent risk factors in patients who did not meet the nutritional target on day 21 (p=0.026 and p=0.043, respectively). The protein intake of adult patients with severe burns was low. Compared to the non-target group, the target group had better laboratory test results. Older age and longer ventilation were independent risk factors for patients not meeting the nutritional target.

Surgically managed incarcerated umbilical hernias in calves hold favorable prognosis: a retrospective analysis of 19 cases (2004-2021).

To describe the clinical signs, surgical management, postoperative complications, and outcomes following herniorrhaphy in calves with incarcerated umbilical hernias. This was a retrospective case series. The electronic medical record databases of 2 veterinary teaching hospitals were searched to identify the records of calves that underwent herniorrhaphy for correction of irreducible umbilical hernias between January 1, 2004, and December 31, 2021. Data collected included signalment, medical history, results of clinical examination and laboratory testing, ultrasonographic and surgical findings (incarceration vs strangulation), postoperative complications, and outcome. 19 calves with incarcerated umbilical hernias underwent surgical correction. The incarcerated gastrointestinal tract was identified as the abomasum in 11 calves and jejunum in 8 calves. In 9 calves, the intraoperative identification of strangulation led to 4 intestinal resections and 4 partial abomasectomies, with 1 calf being euthanized intraoperatively. Postoperative complications were reported in 3 calves that underwent intestinal resection. Sixteen calves (84%) survived to discharge and had a median survival time of 1,995 days after surgery. No statistically significant differences were observed between calves with or without gastrointestinal tract strangulation in the short-term survival rate, survival time, or number of lactations after surgery. This study demonstrated that herniorrhaphy for incarcerated umbilical hernias in calves is associated with a favorable prognosis. Postoperative complications are, however, more frequent in calves with strangulated gastrointestinal tract. Surgical intervention for incarcerated umbilical hernias in calves generally yields a positive prognosis, particularly in the absence of gastrointestinal tract strangulation, highlighting the importance of timely diagnosis and treatment.

Single-Centre Analysis of Magnetic Resonance Imaging of Sacroiliac Joints in a Paediatric Population

Background: Sacroiliitis in children is usually connected with one of the subtypes of juvenile idiopathic arthritis (JIA), such as enthesitis-related arthritis, psoriatic arthritis, or undifferentiated arthritis. The main diagnostic method is magnetic resonance imaging (MRI) of the sacroiliac joints, which can reveal bone marrow edema (BME) as a sign of an active inflammation process. This research aimed to retrospectively investigate the associations between the clinical presentation, laboratory test results, and MRI results of the sacroiliac joints of children. Methods: A total of 152 paediatric patients who underwent MRI of the sacroiliac joints were included in this single-centre study. The mean age of patients was 13.91 ± 2.97, while the female-to-male ratio was 1.36:1. JIA diagnosis was confirmed in 91 (59.87%) patients. Results: The main symptom reported by 128 (83.21%) patients was chronic pain, while in another 40 (31.25%) patients, it was chronic back pain. Patients with arthritis and BME in the sacroiliac joints were more likely to report chronic back pain, while patients with JIA but without BME in the sacroiliac joints were often positive for anti-nuclear antibodies (ANA). The widening of any joint contour was observed in 43 (28.29%) patients, and reduced joint mobility was observed in 61 (40.13%). Elevation of inflammatory blood parameters occurred in 31 (20.39%) patients, but this was not statistically related to BME presence in the sacroiliac joints. Radiological findings included BME (n = 36; 23.68% of examinations), joint space narrowing (n = 10; 27.78% of examinations), erosions (n = 7; 19.44% of examinations), and joint fluid (n = 7; 19.44% of examinations). There was a statistically significant relationship between the presence of BME in the sacroiliac joints and all of the above radiological findings. Conclusions: The radiological findings of MRI of the sacroiliac joints are significantly statistically related to chronic back pain in patients, while there is no relationship between any inflammatory blood parameter and the presence of BME.

ROsulord® sAfety for Patients with Dyslipidemia Study: A Non-interventional, Multicenter, Prospective, Observational Study in South Korea.

The ROsulord® sAfety for patients with Dyslipidemia study (ROAD study) in the Republic of Korea investigated the safety and efficacy of rosuvastatin in routine clinical practice. This non-interventional, multicenter, prospective, observational study was conducted over a period of approximately 4.6years and involved 14,243 participants. During this study, we assessed the adverse events, changes in laboratory test results, and efficacy endpoints associated with rosuvastatin use. The findings revealed a notably low adverse event rate of 1.63%, indicating a favorable safety profile for rosuvastatin in the management of dyslipidemia. Importantly, no clinically significant incidences of statin-associated myopathy, hepatotoxicity, or diabetes were observed during the study period. Moreover, this study demonstrated significant improvements in lipid profiles among patients receiving rosuvastatin treatment, with a reduction in total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels. These improvements contributed to a lower cardiovascular risk in the study population. Overall, these findings suggest that rosuvastatin is safe and effective in managing dyslipidemia in real-world clinical settings, providing clinicians with valuable insights into the benefits and risks associated with statin therapy in this patient population.

Development of Time-Aggregated Machine Learning Model for Relapse Prediction in Pediatric Crohn's Disease.

Pediatric Crohn's disease (CD) easily progresses to an active disease compared to adult CD, making it important to predict and minimize CD relapses. However, prediction of relapse at various time points (TPs) during pediatric CD remains understudied. We aimed to develop a real-time aggregated model to predict pediatric CD relapse in different TPs and time windows (TWs). This retrospective study was conducted on children diagnosed with CD between 2015 and 2022 at Severance Hospital. Laboratory test results and demographic data were collected starting at 3 months after diagnosis, and cohorts were formed using data from six different TPs at 1-month intervals. Relapse-defined as a pediatric CD activity index ≥30 points-was predicted, and TWs were 3-7 months with 1-month intervals. The feature importance of the variables in each setting was determined. Data from 180 patients were used to construct cohorts corresponding to the TPs. We identified the optimal TP and TW to reliably predict pediatric CD relapse with an area under the receiver operating characteristic curve score of 0.89 when predicting with a 3-month TW at a 3-month TP. Variables such as C-reactive protein levels and lymphocyte fraction were found to be important factors. We developed a time-aggregated model to predict pediatric CD relapse in multiple TPs and TWs. This model identified important variables that predicted relapse in pediatric CD to support real-time clinical decision making.

Risk Factors for Recurrence of Atrial Fibrillation within 3 Years after Radiofrequency Ablation

Background: Atrial fibrillation is chronic cardiovascular disease, particularly in older patients. Radiofrequency ablation can successfully treat this condition and restore sinus rhythm. However, the postoperative recurrence rate is relatively high. This investigation aimed to address the factors that might increase the risk of recurrence after radiofrequency ablation. Methods: We studied patients who had a successful radiofrequency ablation in our center between 2017 and 2020. We collected information about these patients before the procedure, including their age, sex, obesity, medical history, preoperative laboratory test results, and cardiac ultrasound findings. We divided patients into two groups: those who had atrial fibrillation again within three years and those who did not. We compared the information we collected about these two groups to see if there were any differences to explain why some people had atrial fibrillation again and others did not. We used a statistical method called multivariate logistic regression to analyze these data. Results: After reviewing the patients based on specific criteria, we included 297 patients in our final analysis. Within three years after surgery, 109 patients (36.7%) had a recurrence, whereas 188 (63.3%) did not. When we compared the two groups, we found that older patients, those with obesity, a longer history of atrial fibrillation, a larger left atrium, persistent atrial fibrillation, and higher levels of C-reactive protein before surgery were likely to have atrial fibrillation again within three years (p &lt; 0.05). Our statistical analysis revealed that these factors were independent predictors of atrial fibrillation recurrence. Conclusions: Age, obesity, duration of atrial fibrillation, the size of left atrium, the type of atrial fibrillation, and C-reactive protein (CRP) levels before surgery are closely related to atrial fibrillation recurrence within 3 years after radiofrequency ablation.

Safety of direct oral anticoagulants in patients with atrial fibrillation aged 80 years and older: clinical risk factors

BACKGROUND: Direct oral anticoagulants (DOACs) are associated with bleeding, particularly in the geriatric population. Most studies focus on predicting major bleeding, but clinically relevant non-major bleeding (CRNMB) is equally important in practice. АIM: To assess the ability of clinical factors to predict the risk of CRNMB with the use of DOACs in patients with atrial fibrillation (AF) aged 80 years and older. MATERIALS AND METHODS: A total of 367 patients on DOACs with non-valvular AF aged 80 years and older were evaluated; the median age was 84 [82; 88] years. Key characteristics of the groups were analyzed, including gender, age, and body mass index. CHA2DS2-VASc and HAS-BLED scales were used to assess the risk of ischemic stroke and bleeding, respectively. Comorbidities, Charlson Comorbidity Index, and risk factors of chronic non-communicable diseases were considered. In addition, number of medications taken, physical examination data, history of atherosclerosis, and laboratory test results were collected. RESULTS: In univariate analysis, significant risk factors for the development of CRNMB with all DOACs included higher walking frequency (p=0.022), lower heart rate (p=0.08), and history of gastric and duodenal ulcer [odds ratio 5.34; 95% confidence interval (CI) 2.31–12.0; p 0.001]. In multivariate analysis, a model for predicting CRNMB was developed using age, type of DOAC, liver disease, acute cerebrovascular accident, history of gastric and duodenal ulcer as predictors. The resulting model had a predictive accuracy of 62.6% (95% CI 57.4–67.6), a sensitivity of 66.5% (95% CI 59.4–73.1), and a specificity of 58.2% (95% CI 50.4–65.7). CONCLUSION: The study identified specific modifiable, potentially modifiable, and non-modifiable risk factors for developing CRNMB in AF patients aged 80 years and over taking DOACs. An electronic system to support medical decision making, risk factor management, and public quality of life can be created using results of the study.

Medication Prescription Policy for US Veterans With Metastatic Castration-Resistant Prostate Cancer: Causal Machine Learning Approach.

Prostate cancer is the second leading cause of death among American men. If detected and treated at an early stage, prostate cancer is often curable. However, an advanced stage such as metastatic castration-resistant prostate cancer (mCRPC) has a high risk of mortality. Multiple treatment options exist, the most common included docetaxel, abiraterone, and enzalutamide. Docetaxel is a cytotoxic chemotherapy, whereas abiraterone and enzalutamide are androgen receptor pathway inhibitors (ARPI). ARPIs are preferred over docetaxel due to lower toxicity. No study has used machine learning with patients' demographics, test results, and comorbidities to identify heterogeneous treatment rules that might improve the survival duration of patients with mCRPC. This study aimed to measure patient-level heterogeneity in the association of medication prescribed with overall survival duration (in the form of follow-up days) and arrive at a set of medication prescription rules using patient demographics, test results, and comorbidities. We excluded patients with mCRPC who were on docetaxel, cabaxitaxel, mitoxantrone, and sipuleucel-T either before or after the prescription of an ARPI. We included only the African American and white populations. In total, 2886 identified veterans treated for mCRPC who were prescribed either abiraterone or enzalutamide as the first line of treatment from 2014 to 2017, with follow-up until 2020, were analyzed. We used causal survival forests for analysis. The unit level of analysis was the patient. The primary outcome of this study was follow-up days indicating survival duration while on the first-line medication. After estimating the treatment effect, a prescription policy tree was constructed. For 2886 veterans, enzalutamide is associated with an average of 59.94 (95% CI 35.60-84.28) more days of survival than abiraterone. The increase in overall survival duration for the 2 drugs varied across patient demographics, test results, and comorbidities. Two data-driven subgroups of patients were identified by ranking them on their augmented inverse-propensity weighted (AIPW) scores. The average AIPW scores for the 2 subgroups were 19.36 (95% CI -16.93 to 55.65) and 100.68 (95% CI 62.46-138.89). Based on visualization and t test, the AIPW score for low and high subgroups was significant (P=.003), thereby supporting heterogeneity. The analysis resulted in a set of prescription rules for the 2 ARPIs based on a few covariates available to the physicians at the time of prescription. This study of 2886 veterans showed evidence of heterogeneity and that survival days may be improved for certain patients with mCRPC based on the medication prescribed. Findings suggest that prescription rules based on the patient characteristics, laboratory test results, and comorbidities available to the physician at the time of prescription could improve survival by providing personalized treatment decisions.

TCKAN: a novel integrated network model for predicting mortality risk in sepsis patients.

Sepsis poses a major global health threat, accounting for millions of deaths annually and significant economic costs. Accurately predicting the risk of mortality in sepsis patients enables early identification, promotes the efficient allocation of medical resources, and facilitates timely interventions, thereby improving patient outcomes. Current methods typically utilize only one type of data-either constant, temporal, or ICD codes. This study introduces a novel approach, the Time-Constant Kolmogorov-Arnold Network (TCKAN), which uniquely integrates temporal data, constant data, and ICD codes within a single predictive model. Unlike existing methods that typically rely on one type of data, TCKAN leverages a multi-modal data integration strategy, resulting in superior predictive accuracy and robustness in identifying high-risk sepsis patients. Validated against the MIMIC-III and MIMIC-IV datasets, TCKAN surpasses existing machine learning and deep learning methods in accuracy, sensitivity, and specificity. Notably, TCKAN achieved AUCs of 87.76% and 88.07%, demonstrating superior capability in identifying high-risk patients. Additionally, TCKAN effectively combats the prevalent issue of data imbalance in clinical settings, improving the detection of patients at elevated risk of mortality and facilitating timely interventions. These results confirm the model's effectiveness and its potential to transform patient management and treatment optimization in clinical practice. Although the TCKAN model has already incorporated temporal, constant, and ICD code data, future research could include more diverse medical data types, such as imaging and laboratory test results, to achieve a more comprehensive data integration and further improve predictive accuracy.

Impact of encounters on patient app use: results of a tethered mobile personal health record usage pattern analysis.

The adoption of tethered mobile personal health records provides not only medical information to patients but also various convenience functions related to hospital use, thereby increasing accessibility to healthcare services and promoting patient engagement. We analyse the tethered mobile personal health records app's usage logs to determine how it can contribute to improving medical service accessibility and patient engagement. Log data, that comprised menu type, log time, and date, were collected from the mobile personal health records app of a tertiary referral hospital. Clinical information, including patients' demographics and visit type, was collected from the clinical research warehouse system. The usage log was analysed in terms of the type of visit, service function, and time period. Outpatients accounted for 34% of the total app usage and was the most app-accessed visit type. The most utilized menu functions were lab test and visit schedule for visits or non-visits. For Inpatient and Health check-ups, menu usage patterns showed a focus on lab test results. While investigations and other menu usage showed double peaks in the morning and afternoon, peak usage of lab test results correlated with inpatient blood sampling times, which was around 9 am. App menus to access health information, particularly blood tests, emerged as the most accessed menu. Hence, when compared with blood sampling times and hospital information system usage patterns, encounters occurring in the hospital majorly impacted patient app use. For improved patient engagement, improving lab test function should be the priority.

A Visco-Elasto-Plastic Constitutive Law for Deformation Prediction of High Concrete Face Rockfill Dams

Deformation predictions in high Concrete Face Rockfill Dams tend to underestimate observed settlements due to scale effect and breakage phenomena that cannot be adequately captured by laboratory tests. This paper presents a Visco-Elasto-Perfectly Plastic (VEPP) model for predicting deformations in high Concrete Face Rockfill Dams (CFRDs) that addresses these challenges incorporating explicitly key rockfill parameters like grain size and post-compaction porosity, which influence both the non-linear elastic and plastic behaviors of rockfill. The VEPP model enables deformation prediction while using standard laboratory test results. The model’s effectiveness was demonstrated through its application to the 233 m high Shuibuya Dam, the tallest CFRD in the world. The VEPP model predictions closely align with observed deformations throughout the dam’s construction, impoundment, and early operational stages. By using physically meaningful parameters, the model reduces the uncertainty associated with the empirical assessment of model parameters using back-analysis from similar projects. While the VEPP model offers improved predictive accuracy, particularly during early design phases, further advancements could be achieved by refining the creep formulation and accounting for grain size evolution during construction. This approach has the potential to optimize the design and construction of future high CFRD construction.

Definitions and Characteristics of Patient Digital Twins Being Developed for Clinical Use: Scoping Review.

The concept of digital twins, widely adopted in industry, is entering health care. However, there is a lack of consensus on what constitutes the digital twin of a patient. The objective of this scoping review was to analyze definitions and characteristics of patient digital twins being developed for clinical use, as reported in the scientific literature. We searched PubMed, Scopus, Embase, IEEE, and Google Scholar for studies claiming digital twin development or evaluation until August 2023. Data on definitions, characteristics, and development phase were extracted. Unsupervised classification of claimed digital twins was performed. We identified 86 papers representing 80 unique claimed digital twins, with 98% (78/80) in preclinical phases. Among the 55 papers defining "digital twin," 76% (42/55) described a digital replica, 42% (23/55) mentioned real-time updates, 24% (13/55) emphasized patient specificity, and 15% (8/55) included 2-way communication. Among claimed digital twins, 60% (48/80) represented specific organs (primarily heart: 15/48, 31%; bones or joints: 10/48, 21%; lung: 6/48, 12%; and arteries: 5/48, 10%); 14% (11/80) embodied biological systems such as the immune system; and 26% (21/80) corresponded to other products (prediction models, etc). The patient data used to develop and run the claimed digital twins encompassed medical imaging examinations (35/80, 44% of publications), clinical notes (15/80, 19% of publications), laboratory test results (13/80, 16% of publications), wearable device data (12/80, 15% of publications), and other modalities (32/80, 40% of publications). Regarding data flow between patients and their virtual counterparts, 16% (13/80) claimed that digital twins involved no flow from patient to digital twin, 73% (58/80) used 1-way flow from patient to digital twin, and 11% (9/80) enabled 2-way data flow between patient and digital twin. Based on these characteristics, unsupervised classification revealed 3 clusters: simulation patient digital twins in 54% (43/80) of publications, monitoring patient digital twins in 28% (22/80) of publications, and research-oriented models unlinked to specific patients in 19% (15/80) of publications. Simulation patient digital twins used computational modeling for personalized predictions and therapy evaluations, mostly for one-time assessments, and monitoring digital twins harnessed aggregated patient data for continuous risk or outcome forecasting and care optimization. We propose defining a patient digital twin as "a viewable digital replica of a patient, organ, or biological system that contains multidimensional, patient-specific information and informs decisions" and to distinguish simulation and monitoring digital twins. These proposed definitions and subtypes offer a framework to guide research into realizing the potential of these personalized, integrative technologies to advance clinical care.

Mechanical Performance and Life Cycle Assessment of Soil Stabilization Solutions for Unpaved Roads from Northeast Brazil

This article presents the results of laboratory tests conducted to identify the granulometric stabilization and chemical improvement techniques used in an experimental segment of the unpaved BR-030 highway in the Maraú Peninsula, Bahia. The segment was designed to evaluate the performance of primary coating sections stabilized with sand, clayey gravel, reclaimed asphalt pavement (RAP), and simple graded crushed stone (GCS), as well as chemically improved with Portland cement and hydrated lime. The laboratory campaign focused on mechanical resistance, resilient modulus, and permanent deformation tests. In this research, chemical improvement with the addition of 2% Portland cement presented the most promising results for potential application in the section of the BR-030 highway intended to remain unpaved. Additionally, a life cycle assessment (LCA) revealed that mechanical stabilization of the primary coating has the lowest environmental impacts, making it a suitable and sustainable option among stabilization methods.

Characteristics and eye disease distribution of HIV-infected or AIDS patients: a single-center study

Objective: To explore the characteristics and eye disease distribution of human immunodeficiency virus (HIV)-infected or acquired immune deficiency syndrome (AIDS) patients reported by Beijing Tongren Hospital, Capital Medical University. Methods: A retrospective case series study was conducted. Data of HIV-infected or AIDS patients who were reported for the first time in the Chinese Center for Disease Control and Prevention Information System by Beijing Tongren Hospital, Capital Medical University from January 1, 2012 to December 31, 2021 were collected. Epidemiological data such as the patient's gender and age were recorded, and information such as the patient's clinical diagnosis, department classification, and laboratory test results were retrieved from the hospital's outpatient and emergency system and laboratory information system. Results: A total of 191 HIV-infected or AIDS patients were included, with an average age of (36.71±13.52) years, including 177 males and 14 females. The proportion of male and female patients showed no statistically significant change over the years (P>0.05). Most cases were initially diagnosed in the department of ophthalmology (75 cases, 38.22%), followed by the department of dermatology (49 cases, 25.65%). There were 42 cases (56.00%) reported in the fundus group, 10 cases (13.33%) in the cataract group, 8 cases (10.67%) in the refractive center, and other cases in the glaucoma, cornea, and ocular tumor groups. The ophthalmological diagnoses included uveitis (21 cases, 28.00%), retinopathy (13 cases, 17.33%), cataract (11 cases, 14.67%), refractive error (7 cases, 9.33%), glaucoma (4 cases, 5.33%), retinal detachment (3 cases, 4.00%), vitreous hemorrhage (3 cases, 4.00%), cytomegalovirus retinitis (2 cases, 2.67%), ocular tumor (2 cases, 2.67%), optic neuropathy (2 cases, 2.67%), conjunctivitis (2 cases, 2.67%), keratoconus (1 case, 1.33%), chronic dacryocystitis (1 case, 1.33%), lacrimal duct obstruction (1 case, 1.33%), corneal endothelial decompensation (1 case, 1.33%), and ectropion (1 case, 1.33%). Some patients had co-infections with syphilis, hepatitis B, and hepatitis C. Conclusions: There are undiagnosed HIV-infected or AIDS patients in some departments of non-infectious general hospitals, and the ophthalmological manifestations are mostly uveitis and retinopathy. Ophthalmologists should pay attention to the HIV infection or AIDS infection status of patients with eye diseases such as uveitis and retinopathy to reduce the risk of occupational exposure.

An audit to review compliance to cisplatin hydration guidelines within the royal Marsden NHS hospital

Abstract Introduction Cisplatin is a cytotoxic agent that forms the backbone of many cancer regimens.1 Cisplatin exhibits good anti-tumour activity however it can accumulate in the renal proximal tubules, leading to nephrotoxicity. It is therefore essential that adequate hydration with diuretics and fluids alongside is administered prior, during and after cisplatin infusion to promote renal perfusion.2 The local policy for intravenous hydration for cisplatin-based regimens states that adult patients are to be weighed prior to treatment and weighed again after treatment to ensure they have not developed fluid retention.3 This audit was necessary following the implementation of the new electronic prescribing system, where nurses no longer got prompted to weigh patients in the same way they did before. Aim To assess the level of compliance with current locally approved guidelines for cisplatin hydration administration since the launch of the new electronic prescribing system (EPIC). Methods Ethics approval was not required for this audit as retrospective use of anonymous data. Compiled records of 262 patients who were prescribed cisplatin-containing regimens from 17th March 2023 until 31st November 2023 were used to identify patients for inclusion in the audit. Data collection was performed retrospectively using a data collection form and a pilot study was carried out on 20 patients. A sample size of 144 patients was obtained using the Raosoft sample size calculator to achieve a 95% confidence interval with a 5% margin of error accepted.3 All data were collected by the auditor. Patients’ hospital numbers were then individually searched on EPIC to identify if weights were recorded pre- and post-administration of cisplatin. Treatment plans and medical notes on EPR were checked to identify if escalation was appropriately followed where patients gained &amp;gt;2 kg and, in this case to see if furosemide 20mg tablet was given. In addition, laboratory test results and structured notes were reviewed to ascertain if an increase in serum creatinine occurred and if patients were admitted to hospital as a consequence. Data was directly input into Microsoft excel for data analysis. Results The majority of cisplatin administration episodes (72%) did have the patient’s weight recorded before and after treatment. Of the remaining 28% where the weight was missing or incomplete, 4 episodes resulted in a documented AKI and 3 of these episodes were severe enough to warrant hospital admission. Discussion and conclusion The results demonstrate a lack of documentation of patient’s weights across RMH. Only 72% of patients who were administered IV cisplatin at RMH between 17th March 2023 and 31st November 2023 were recorded. This falls below the local guidance, which recommends all patients (100%) should be weighed pre- and post- cisplatin administration. Documentation is critical to ensure a clear audit trail and to enable identification pf patients who may be at higher risk of developing fluid retention. This therefore needs improvement. A limitation of the audit is the increased potential for human error due to the way data was collected. The requirement to search through all structured notes and observations flowsheet was time consuming and intensive, increasing the likelihood documentation may have been missed.

EFFECTIVE DOSAGE OF CORROSION INHIBITORS FOR OILFIELD EQUIPMENT PROTECTION FROM LOCALIZED CARBON DIOXIDE CORROSION

The article presents the results of laboratory tests of the industrial corrosion inhibitor VITERASOYUZ-2000 of the BP-2 brand (class of imidazolines) used in the oil and gas industry. In 2021, one of the vertically integrated companies purchased 20 thousand tons of this reagent, which is 10 % of the total purchased volume. The volume of corrosion inhibitors purchased by the company annually (~ 200 thousand t) is 97 % a product of domestic manufacturers. The main line of inhibitors purchased in 2021 is represented by the following brands: Sonkor (&gt; 40 thousand t), Azol (~ 40 thousand t), Kormaster (&gt; 30 thousand t), UnoKem (~ 30 thousand t), VITERASOYUZ (~ 20 thousand t), Scimol (&gt; 10 thousand t), ETK (~ 10 thousand t), others (~ 20 thousand t). These reagents were used to inhibit carbon dioxide, hydrogen sulfide and mixed corrosion of oilfield equipment.In order to evaluate the effectiveness of inhibitors in suppressing local carbon dioxide corrosion and determine their effective dosage laboratory studies were performed using a specially developed authors’ technique. A distinctive feature of the technique is the modeling of an essential feature of corrosion processes occurring in real oilfield systems in the presence of carbon dioxide – a high rate of local corrosion exceeding the corrosion rate by 2–9 times. The standard environment and conditions of laboratory experiments used in laboratory tests make it possible to reproduce local corrosion damage visible and measured using a needle micrometer (&gt; 0.01 mm) on corrosion control samples by the weight method. It is shown that the protective effect of the corrosion inhibitor VITERASOYUZ-2000 of the BP-2 brand in relation to local corrosion is achieved at a dosage of 100–150 mg/dm3.The practical significance of the research is shown by a retrospective analysis of data from weight (gravimetric) corrosion monitoring during industrial testing of corrosion inhibitors, which confirm that the use of «traditional» dosages of 15–40 mg/dm3 (based on the total volume of liquid = oil + water) with a high protective effect against corrosion consumption («general corrosion») do not provide a protective effect against local corrosion. It is noted that in some cases, corrosion inhibitors, due to reducing corrosion consumption, can not help only reduce the rate of local corrosion, but, on the contrary, stimulate its development. The target of the tests is to increase the reliability of pipeline operation and environmental safety while reducing the increase in accidents and the number of failures.

Epidemiological, Clinical, Laboratory, and Radiological Characteristics of Children and Adolescents Diagnosed with Hashimoto's Thyroiditis: A Single-Center Experience.

This study aimed to investigate the epidemiological, clinical, laboratory, and radiological characteristics of children diagnosed with Hashimoto's thyroiditis and to present the experiences of a referral center. This study included 200 pediatric patients diagnosed with Hashimoto's thyroiditis between January 2020 and May 2024 at a single center. The data were extracted and compiled from the participants' medical records, including clinical information, physical examination findings, laboratory test results, and radiological imaging. Mean age of the study population was 11.3 ± 3.2 years at diagnosis, with a female predominance. At the time of clinical presentation, 8.5% of the study participants were 6 years of age or younger. The majority of patients, comprising 39.5% of the cohort, exhibited euthyroid thyroid function. Additionally, 33.5% of the patients were classified as having subclinical hypothyroidism, 22% demonstrated overt hypothyroidism, and 5% presented with hyperthyroidism. Approximately one-third of the study participants were referred for further evaluation due to the identification of abnormal thyroid function test results during routine screening examinations. 48% of the patients had a documented family history of thyroid disease. At diagnosis, 39.5% were prepubertal. The rate of overt hypothyroidism was higher in prepubertal patients compared to pubertal patients (41.8% vs. 9.1%, P < .005). Mean gland volume SDS was 2.61 ± 3.69, and 45.5% had goiter. Thyroid nodular lesions were identified in 5.5% of the study participants. Fine-needle aspiration biopsy was performed on five patients, revealing benign findings in three cases and atypia of undetermined significance in the remaining two cases. Patints with subclinical hypothyroidism who have a baseline TSH level exceeding 8.5 mIU/L at initial presentation and do not receive treatment are likely to progress to overt hypothyroidism during subsequent follow-up. Prepubertal cases were more frequently observed compared to previous reports, and the course of hypothyroidism was more severe in prepubertal patients. These findings suggest a potential shift towards earlier onset of autoimmunity in children. Further studies are warranted to substantiate this observation.

Determination of Recovery by Total Restitution or Compensation Using Multifrequency Vestibular Tests and Subjective Functional Scales in a Human Model of Vestibular Neuritis.

Vestibular Neuritis (VN) can induce unilateral acute vestibular syndrome (AVS). This study aimed to identify predictive factors of recovery from vestibular neuritis considering total restitution and/or compensation. In this longitudinal study, 40 patients were included. The initial assessment, performed within 36 to 72 h from the onset (T0), included medical history taking (general and specific), including screening for cardiovascular risk factors (CVRFs), and a battery of diagnostic vestibular tests, comprising the bithermal caloric test (BCT), video head impulse test (VHIT), and skull vibration-induced nystagmus (SVIN) test. All patients also completed a Dizziness Handicap Inventory (DHI). All assessments were repeated 90 ± 15 days later (T3). Subjective compensation criteria were based on the DHI total score, and objective compensation criteria were based on laboratory test results. Four groups of patients (A, B, C, D) were delineated by combining patients with normal vs. abnormal vestibular tests and patients with normal vs. abnormal DHI. CVRFs (but not age or body mass index (BMI)) were associated with a poorer recovery of symptoms. The BCT (lateral semicircular canal paresis %), VHIT (lateral semicircular canal gain), and SVINT (nystagmus slow phase velocity) recovered to normal values in 20%, 20%, and 27% of patients, respectively, at T3. Vascular risk factors (hypercholesterolemia) are correlated with patients who do not recover their symptoms via either total restitution or compensation. There was no significant difference between high- and low-frequency vestibular tests in patients recovering from their symptoms. Some patients with objective recovery may continue to have persistent subjective symptoms.

Experimental Evaluation of Under Slab Mats (USMs) Made from End-of-Life Tires for Ballastless Tram Track Applications.

The growing population of urban areas results in the need to deal with the noise pollution from the transportation system. This study presents experimental test results of static and dynamic elastic characteristics of under slab mats (USMs) according to the procedure of DIN 45673-7. Prototype USMs based on recycled elastomeric materials, i.e., SBR granules and fibres produced from waste car tires, are analysed. Vibration isolation mats with different thicknesses (10, 15, 20, 25, 30, and 40 mm), densities (500 and 600 kg/m3), and different degrees of space filling (no holes, medium holes, large holes) are considered. Moreover, a practical application of the laboratory test results of USMs in the design of ballastless track structures of two different types (with a concrete slab and longitudinal beams) is presented. Deflections of the rail and the floating slab system, as well as stresses acting on the mat, are determined according to EN 16432-2. The use of shredded rubber from recycled car tires as a material component of sustainable and environmentally friendly tram track structures may be one of the most effective ways to manage rubber waste within the current trend toward a circular economy, and this study intends to introduce methods for experimental identification and analytical selection of basic static and dynamic parameters of prototype USMs.

The Incidence, Risk Factors, and Predictive Model of Obstructive Disease in Post-Tuberculosis Patients.

To assess the incidence and risk factors of tuberculosis-associated obstructive pulmonary disease (TOPD) in individuals with treatment-naive pulmonary tuberculosis (PTB) and develop a predictive model to enhance its management. The incidence of TOPD among patients with treatment-naive PTB in Xinjiang, China, was followed up for one year. Patient characteristics, such as demographics, medical histories, laboratory test results, lung radiological evidence, and pulmonary function, were collected upon hospital admission and throughout follow-up visits. Risk factors associated with TOPD were evaluated by multivariate logistic regression analysis, and then a predictive model was established using LASSO regression. Of the 159 included patients, 69 (43.4%) developed TOPD during the follow-up period. Multivariate regression analysis identified age, body mass index, ESR, and symptom duration as significant risk factors. Subsequently, a model formula was derived from these factors to predict TOPD. Utilizing a cut-off value of 0.435, the model demonstrated a sensitivity of 89% and a specificity of 83%. In Xinjiang, the prevalence of TOPD appears notably high among treatment-naive PTB patients. Our findings, such as the risk factors and predictive model, may facilitate the early detection and improved interventions for TOPD among patients with PTB, potentially leading to better patient outcomes.