Laboratory Test Results Research Articles

Evaluation of indirect indices in the insulin resistance assessment in patients with different body mass index

Introduction: Insulin resistance (IR) is a complex pathophysiological condition with multifactorial etiology characterized by a reduced responsiveness of target tissues to insulin (INS). Indirect indices based on mathematical models and derived from laboratory parameters have become increasingly popular in the past two decades. In this study, we evaluated their ability to predict IR in a population with different body mass index (BMI). Methods: The matched case–control study was conducted in 2021 and 2022. Secondary data from 129 subjects were obtained from medical records, including demographic characteristics, anthropometric measurements, and biochemical laboratory test results. The studied group consisted of 91 subjects with a suspected diagnosis of IR who were further categorized according to BMI, while control group consisted from 38 age- and gender-matched subjects. Six widely used indirect indices were calculated: Homeostatic Model Assessment for IR (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), McAuley index (MCAi), metabolic score for IR (METS-IR), triglyceride to glucose index (TyG), and TyG to BMI (TyG-BMI). Results: Significant differences between the subgroups were found in the mean values for HOMA-IR, TyG, TyG-BMI, and METS- IR, while the control group had the highest mean values for the indirect indices QUICKI and MCAi (p < 0.001). HOMA-IR, TyG, and TyG-BMI showed statistical significance in predicting IR regardless of BMI (p < 0.05). In the obese group, TyG-BMI had good predictive power for discriminating IR (area under the curve [AUC] = 0.820), with a sensitivity and specificity of 84.1% and 87.7%, respectively. HOMA-IR showed moderate predictive power to discriminate IR in the obese group (AUC = 0.720), with a sensitivity and specificity of 70.4% and 89.1%, respectively. Conclusion: As IR is a multifactorial disease, indirect indices combining laboratory and anthropometric data can significantly help in predicting and mitigating complications.

Investigation of ADAMTS-13 levels in patients with COVID-19 infection.

Coronavirus disease 2019 (COVID-19) patients are predisposed to thrombotic events. COVID-19 coagulopathy can be associated with ADAMTS-13 (a disintegrin-like and metalloprotease with thrombospondin type I repeats 13) levels. ADAMTS-13, the cleaving protease of highly thrombogenic ultra-large von Willebrand Factor (vWF) multimers, was rarely investigated in COVID-19 patients and inconsistent results were obtained. We measured ADAMTS-13 levels of patients admitted to emergency department. A prospective study was carried out with 180 individuals at the Emergency Department of Uşak Training and Research Hospital. The patients were divided into three groups: mild COVID-19 (group 2), severe COVID-19 with oxygen saturation below 94% (group 3), and control group (group 1). ADAMTS-13 levels were analyzed with an enzyme linked immunosorbent assay (ELISA) kit (SunRed, Shanghai, China). Demographic data, clinical findings, and routine laboratory test results (alanine aminotransferase (ALT), aspartate aminotransferase (AST), white blood cell, lymphocyte, platelet, C-reactive protein (CRP), lactate dehydrogenase (LDH), prothrombin time, international normalized ratio (INR), partial thromboplastin time, D-dimer, creatinine, urea) were evaluated. ADAMTS-13 serum levels were slightly lower in groups 2 and 3 compared to the control group, with no significant difference between the ADAMTS-13 median values (p > 0.05). Groups 1 and 2 exhibited comparable outcomes. Group 3 demonstrated notably elevated levels of CRP, LDH, D-dimer, AST, ALT, creatinine; and decreased platelet counts and INR levels (p < 0.05). COVID-19-associated coagulopathy is still unclear. Based on our data, ADAMTS-13 levels cannot be used as a biomarker to help stratify patients' risks at the time of admission.

Occurrence and predictors of laboratory abnormalities during outpatient parenteral antimicrobial therapy – A multicenter cohort study to inform laboratory test monitoring

ObjectivesEvidence on the optimal frequency of laboratory testing during outpatient parenteral antimicrobial therapy (OPAT) is lacking. Therefore, we investigated how often and when laboratory abnormalities occur during OPAT and which factors are associated with these abnormalities. MethodsWe performed a multicenter cohort study in four Dutch hospitals among adult patients receiving OPAT and collected routinely obtained laboratory test results. Incidence and incidence rates were calculated for various laboratory abnormalities. Survival analysis was performed to visualize the time to the first occurrence of laboratory abnormalities and Poisson regression analysis to compare the number of abnormalities in the first and second 30 OPAT days among patients receiving OPAT for ≥60 days. Predictors were identified using a multivariable Cox proportional hazard regression model. Results45.1% of 1152 included patients developed laboratory abnormalities, but only 2% led to OPAT discontinuation. Hepatotoxicity was most common (33.9 events/1000 OPAT days), with a time-dependent decrease in the occurrence of the first hepatotoxic event, while hypokalemia was rare (1.7 events/1000 OPAT days). In the subgroup of patients receiving ≥60 days of OPAT, nephrotoxicity was more common in days 31-60. We observed partly toxicity-specific associations between antibiotic type, concomitant medication, baseline laboratory values, patient characteristics, and the occurrence of laboratory abnormalities. ConclusionsWhile laboratory abnormalities are frequently observed during OPAT, they rarely lead to discontinuation of OPAT. Specific patient, treatment and laboratory characteristics were associated with the occurrence of laboratory abnormalities. Based on our results, we recommend a more personalized laboratory monitoring policy with less blood sampling.

Retrospective evaluation of stuttering cases with and without PANDAS comorbidity

Purpose: The aim of this study is to evaluate the clinical, demographic, and autoimmune characteristics of stuttering cases with and without Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) comorbidity. Materials and Methods: The study included 271 children and adolescents aged 2-17 years who were brought to our outpatient clinic between 2012 and 2022 and diagnosed with stuttering. The demographic information and medical characteristics of the patients and their families, such as infections, allergies, rheumatic diseases, and tonsillectomy or penicillin prophylaxis, were evaluated retrospectively. Their routine laboratory test results were also documented. Results: In total, 55 girls (20.3%) and 216 (79.7%) boys at a mean age of 7.6±3.6 years were included. Forty-eight cases (17%) were in the PANDAS group, and 223 (82.3%) were in the non-PANDAS group. The comparison of the PANDAS and non-PANDAS groups showed that the PANDAS group had significantly higher rates of history of tonsillectomy, history of adenoidectomy, and history of frequent infections. The rates of psychiatric, autoimmune, and allergic diseases in the families of the cases in the PANDAS group were significantly higher. The PANDAS group had a significantly greater frequency of comorbid conditions such as obsessive-compulsive disorder, tics, attention-deficit/hyperactivity disorder, and anxiety, as well as a greater mean number of comorbid conditions with at least one diagnosis. Additionally, the age at onset of psychiatric symptoms and the mean age of cases were higher in the PANDAS group. The mean initial anti-streptolysin O level of the PANDAS group was 326.5±335.3 IU/mL, while the mean level in the non-PANDAS group was 155.6±215.1 IU/mL. Conclusion: Both the individuals in the PANDAS group and their families had high rates of comorbidities and inflammatory and autoimmune disorders. In cases of stuttering, there is a need to evaluate these conditions, determine the required methodologies, and explain the relevant pathophysiological mechanisms.

Effective Laboratory Diagnosis of Parasitic Infections of the Gastrointestinal Tract: Where, When, How, and What Should We Look For?

(1) Introduction: Gastrointestinal parasites (GIPs) are one of the most common causes of disease in the world. Clinical diagnosis of most parasitic diseases is difficult because they do not produce characteristic symptoms. (2) Methods: The PubMed, Science Direct, and Wiley Online Library medical databases were reviewed using the following phrases: "parasitic infections and diagnostics", "intestinal parasites", "gastrointestinal parasites", "parasitic infections and diagnostics", and their combinations. (3) Results and Conclusions: Correct diagnosis of GIP involves determining the presence of a parasite and establishing a relationship between parasite invasion and disease symptoms. The diagnostic process should consider the possibility of the coexistence of infection with several parasites at the same time. In such a situation, diagnostics should be planned with consideration of their frequency in each population and the local epidemiological situation. The importance of the proper interpretation of laboratory test results, based on good knowledge of the biology of the parasite, should be emphasized. The presence of the parasite may not be causally related to the disease symptoms. Due to wide access to laboratories, patients often decide to perform tests themselves without clinical justification. Research is carried out using various methods which are often unreliable. This review briefly covers current laboratory methods for diagnosing the most common gastrointestinal parasitic diseases in Europe. In particular, we provide useful information on the following aspects: (i) what to look for and where to look for it (suitability of feces, blood, duodenal contents, material taken from endoscopy or biopsy, tissue samples, and locations for searching for eggs, cysts, parasites, parasite genetic material, and characteristics of immune responses indicating parasitic infections); (ii) when material should be collected for diagnosis and/or to check the effectiveness of treatment; (iii) how-that is, by what methods-laboratory diagnostics should be carried out. Here, the advantages and disadvantages of direct and indirect methods of detecting parasites will be discussed. False-positive or false-negative results are a problem facing many tests. Available tests have different sensitivities and specificities. Therefore, especially in doubtful situations, tests for the presence of the pathogen should be performed using various available methods. It is important that the methods used make it possible to distinguish an active infection from a past infection. Finally, we present laboratory "case reports", in which we will discuss the diagnostic procedure that allows for the successful identification of parasites. Additionally, we briefly present the possibilities of using artificial intelligence to improve the effectiveness of diagnosing parasitic diseases.

Comparison and Analysis of Clinical Characteristics of Common COVID-19 and NSIP Patients

Objective: To investigate the relationship between coronavirus disease 2019 (COVID-19) and non-specific interstitial pneumonia (NSIP), with a focus on the clinical features of COVID-19 and NSIP, and the key points of differential diagnosis. Methods: The clinical data of 20 patients with common-type COVID-19 and NSIP admitted to Linyi People’s Hospital from January 21, 2020, to June 21, 2022, were retrospectively analyzed. Gender, age, history of residence in Hubei province, underlying diseases, clinical manifestations, laboratory test results (including blood routine indexes, inflammatory markers, liver function indexes, and coagulation indexes), and computed tomography (CT) scan images were compared between the two groups. Results: COVID-19 patients were younger than NSIP patients (P &lt; 0.05). Nine COVID-19 patients had a travel history to Hubei province, while none of the NSIP patients did (P &lt; 0.05). Eight COVID-19 patients had underlying chronic conditions, fewer than the NSIP group (12 patients; P &lt; 0.05). Both groups experienced symptoms such as shortness of breath, expectoration, fatigue, and runny nose, but fever and cough were more severe and more frequent in the COVID-19 group. Compared to normal reference ranges, both groups exhibited normal white blood cell counts (WBC) and liver function indexes, but elevated lymphocyte counts (LYMP), inflammatory markers, and coagulation indexes, with reduced neutrophil counts (NE). WBC and LYMP were higher in the COVID-19 group compared to the NSIP group. Male patients in the COVID-19 group had higher erythrocyte sedimentation rates and C-reactive protein values than those in the NSIP group, while procalcitonin levels were lower in the COVID-19 group, although the differences were not statistically significant (all P &gt; 0.05). The NE count in the COVID-19 group was significantly lower than in the NSIP group (P &lt; 0.05). Alanine aminotransferase, total bilirubin, and indirect bilirubin were significantly higher in the COVID-19 group compared to the NSIP group (P &lt; 0.05). Chest CT scans of both groups showed bilateral patchy ground-glass opacities, but the lesions in COVID-19 patients were scattered. NSIP patients’ chest CTs showed diffuse lesions centered around the hilum or multiple lesions in both lungs, with pleural involvement being rare. Conclusion: While there are certain specific clinical, laboratory, and imaging findings in both COVID-19 and NSIP, the specificity of these features is not high. Differentiating the two requires careful consideration of epidemiological history, nucleic acid testing, and antigen-antibody levels.

A Review on Geotechnical Properties of Soil Profile

The geotechnical properties and litho-stratigraphic soil profile of soils in Ikole area of Ekiti State were investigated from the analysis of results of laboratory tests on disturbed and undisturbed soil and water samples obtained from 3 borings. The investigation revealed a subsurface stratification made up of reddish brown granitic clayey sand from existing ground level to a depth of 9m to 12.0m. This is underlain by a layer of mottled, brown, decomposed micaceous sand to a depth of 16.5m - 18m immediately after which are layers of mottled grey, decomposing quartzite sand to about 18.0m to 19.0m depth. This is further underlain by fragments of freshly weathered granitic rock to the termination depth of 19.5m. The consistency limits indicate LL of 44 – 58% and PL of 18 – 26% while the quick undrained triaxial tests indicate undrained cohesion within the range (128.4 - 157) kN/m2 and undrained angle of internal friction (15.0 - 20.0)0. Groundwater was encountered between 6.5m to 7.5m below the existing ground level during the course of soil exploration. The water in the area has pH values of 5.79 to 7.05, the chloride content values range between 12.0mg/l and 16.0mg/l while sulphate content varies from 6.12mg/l to 7.10mg/l.

Взаимосвязь сывороточной концентрации глобулина, связывающего половые гормоны, с возрастом и уровнем тестостерона у мужчин.

Introduction. An age-associated increase in serum levels of sex hormone binding globulin (SHBG) is considered to be one of the factors leading to the development of male hypogonadism. Aim of the study: to study the relationship between the concentration of sex hormone-binding globulin in the blood serum and the age of the man, the level of total and free testosterone. Materials and methods. A single-center retrospective cross-sectional study was conducted. The results of laboratory tests of 162 male patients aged from 18 to 56 years (median – 34 years) were analyzed. The level of total testosterone and sex hormone binding globulin (SHBG) was determined by chemiluminescent immunoassay. The level of free testosterone was determined by the calculation method according to Vermeullen. Statistical analysis was performed using SPSS Statistics v23. Results. Correlation analysis did not reveal a significant relationship between age and SHBG levels, as well as between age and total testosterone levels. Serum SHBG concentration showed a significant (p &lt; 0.001) strong positive (r=0.61) correlation with the total level and a significant (p=0.042) but very weak positive (r=0.162) correlation with the level of free testosterone Comparison of free testosterone levels in groups of patients with SHBG levels below 16 nmol/l, from 16 to 69 nmol/l and above 69 nmol/l did not reveal significant differences (p=0.163). All patients with free testosterone levels less than 225 pmol/l have total testosterone levels below 12 nmol/l. Among men with total testosterone less than 12 nmol/L, only 27% had free testosterone levels below 225 pmol/l. Conclusion. Serum SHBG levels in men 18-56 years old are not significantly associated with age. An increase in serum SHBG concentration in men is accompanied by an increase in the level of total testosterone, but does not have a significant effect on the concentration of free testosterone. Determining the level of SHBG and calculating free testosterone is advisable to carry out in patients with total testosterone levels less than 12 nmol/l, since with total testosterone values more than 12 nmol/l, the concentration of free testosterone always corresponds to normal values, and with total testosterone values less than 12 nmol/l only 27% of patients have a reduced concentration of free testosterone.

Clinical Analysis of Improved Lateral Approach Lesion Clearance, Autologous Iliac Bone Interbody Fusion, and Posterior Internal Fixation for Lumbar Tuberculosis

Objective: To explore the clinical efficacy of improved lateral approach lesion clearance, autologous iliac bone interbody fusion, and posterior internal fixation for treating lumbar tuberculosis. Methods: Thirty lumbar tuberculosis patients enrolled from January 2022 to June 2023 were selected and divided into two groups based on the surgical method. The control group (15 cases) underwent traditional posterior open lesion clearance and conventional lumbar posterior reconstruction surgery. The observation group (15 cases) received improved lateral approach lesion clearance, autologous iliac bone interbody fusion, and posterior internal fixation. Comparisons were made on surgical conditions, time to ambulation after surgery, complication rates, laboratory test results, ASIA scores, VAS scores, ODI index, and cure rates. Results: The observation group had superior surgical outcomes compared to the control group, with shorter time to ambulation after surgery (P &lt; 0.05). The complication rate in the observation group was lower than in the control group (P &lt; 0.05). Laboratory test results post-surgery were better in the observation group (P &lt; 0.05). ASIA scores were higher in the observation group (P &lt; 0.05). There were no significant differences in VAS scores and ODI index between the two groups (P &gt; 0.05). The cure rate was higher in the observation group (P &lt; 0.05).Conclusion: Improved lateral approach lesion clearance, autologous iliac bone interbody fusion, and posterior internal fixation for lumbar tuberculosis resulted in a smooth surgical process, faster recovery, and better safety. This method improved laboratory results, neurological function, and cure rates.

Proficiency testing within Eurotransplant.

Eurotransplant is responsible for the international allocation of organs between eight countries in Europe. All HLA laboratories affiliated to Eurotransplant must be EFI or ASHI-accredited and must participate in the Eurotransplant external proficiency testing (EPT) program, organized by the Eurotransplant Reference Laboratory (ETRL). EPT within Eurotransplant has a long tradition, starting in 1978. The current EPT program consists of the following schemes: HLA typing including serology, CDC crossmatching, HLA-specific antibody detection, and identification. Participants enter the results of laboratory tests using a web-based application. Assessed results are visible on the website. An additional component called "patient-based cases" runs since 2016. Results are summarized and published on the EPT website. Furthermore, these results are discussed during the annual extramural tissue typers meeting, which is organized by the ETRL. Thanks to this EPT program, the performance of all HLA laboratories affiliated to Eurotransplant can be monitored and corrected, if necessary. Because all affiliated laboratories are assessed in the same EPT program, where these laboratories show to be consistent in most of their results, Eurotransplant EPT has proven to be an efficient tool to create a more uniform level of quality of histocompatibility testing within Eurotransplant.

Efficacy of Postoperative Oral Nutritional Supplements in Geriatric Hip Fracture Patients Undergoing Total Hip Arthroplasty.

Background/Objectives: Geriatric hip fracture patients have an increased risk of malnutrition. Proper nutritional supply in the perioperative period is very important for their recovery. Oral nutritional supplements (ONSs) are recommended in geriatric hip fracture patients to improve dietary intake and prevent complications. This study aimed to evaluate the efficacy of postoperative ONSs after total hip arthroplasty in geriatric hip fracture patients. Methods: A retrospective study of elderly patients who underwent total hip arthroplasty for hip fracture was conducted. Data from patients who received ONSs postoperatively until hospital discharge (ONS group, n = 69) were compared with patients who did not receive ONSs (control group, n = 168). Laboratory test results, including serum protein and albumin levels, length of hospital stay, and the incidence of postoperative medical complications of the two groups, were analyzed. Results: Preoperative serum protein and albumin levels were significantly higher in the control group (p = 0.002 and p = 0.010, respectively). However, the degree of decline for both protein and albumin levels was significantly less in the ONS group (p < 0.001 for both). Serum albumin levels were significantly higher in the ONS group at postoperative two-week follow-up (p = 0.006). The length of hospital stay was shorter in the ONS group (p < 0.001). The incidence of postoperative delirium was significantly higher in the control group (p = 0.007). Conclusions: In geriatric hip fracture patients, postoperative ONSs can improve postoperative nutritional status, shorten the length of hospital stay, and reduce the incidence of postoperative delirium.

Efficacy and safety of transcatheter arterial chemoembolization followed by hepatic arterial infusion chemotherapy combined with TKI and PD-1 inhibitors as first-line treatment for advanced hepatocellular carcinoma

To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) followed by hepatic arterial infusion chemotherapy (HAIC) combined with TKI drugs and PD-1 inhibitors as the first-line treatment for advanced hepatocellular carcinoma (HCC). We retrospectively analyzed the data of 70 patients with advanced HCC treated in the Department of Oncology of Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine between July, 2020 and June, 2023. 23 of the patients received TACE combined with HAIC and TKI (TACE+HAIC+ TKI group) and 47 received TACE combined with HAIC, PD-1 inhibitors and TKI (TACE+HAIC+PD-1+TKI group). The clinical characteristics, laboratory test results, efficacy, outcomes and adverse events of the patients were compared between the two groups. The TACE+HAIC+TKI and TACE+HAIC+PD-1+TKI groups had significantly different objective remission rates (ORR; 60.87% vs 36.17%, P=0.031), comparable disease control rates (95.65% vs 93.62%, P=0.068), and different median progression-free survival (PFS) time (10.2 vs 11.8 months, P=0.003) and median overall survival (OS) time (15.7 vs 19.5 months, P=0.035). After propensity score matching (PSM), the median PFS and OS time of the two groups was 10.1 vs 14.5 months (P= 0.024) and 14.2 vs 21.2 months (P=0.221), respectively. The 1-year PFS rates of the 2 groups were 24.0% vs 52.2%, and the 1-, 2-and 3-year OS rates were 72.3% vs 93.1%, 23.9% vs 63.8%, and 23.9% vs 36.5%, respectively. The incidence of proteinuria was significantly higher in TACE+HAIC+PD-1+TKI group than in TACE+HAIC+TKI group (21.28% vs 0, P=0.025), but the incidences of grade 3-4 treatment-related adverse events were all similar between the two groups. The first-line treatment with TACE+HAIC+PD-1+TKI is safe and effective for advanced HCC and can significantly prolong the survival of the patients.

Development and Application of a Novel Tsunami Monitoring System Based on Submerged Mooring.

Real-time data transmission and reliable operation are essential for a tsunami monitoring system to provide effective data. In this study, a novel real-time tsunami monitoring system is designed based on a submersible mooring system. This system is equipped with a data acquisition and tsunami wave identification algorithm, which can collect the measured data of the pressure sensor and detect a tsunami wave in real time. It adopts the combination design of underwater inductive coupling transmission and a redundant BeiDou communication device on the water surface to ensure the reliability of real-time data transmission. Compared with traditional tsunami monitoring buoys, it has the advantages of reliable communication, good concealment, high security, and convenient deployment, recovery, and maintenance. The results of laboratory and sea tests show that the system has high reliability of data transmission, stable overall operation of the system, and good application prospects in the field of real-time tsunami monitoring and early warning.

Carbon Sequestration Capacity after Ecological Restoration of Open-Pit Mines: A Case Study in Yangtze River Basin, Jurong City, Jiangsu Province

Open-pit mining seriously damages the original vegetation community and soil layer and disturbs the carbon cycle of vegetation and soil, causing instability in the mining ecosystem and decrease in the carbon sequestration capacity of the mining area. With the deepening of environmental awareness and the influence of related policies, the ecological restoration of open-pit mines has been promoted. The mining ecosystem is distinct owing to the disperse distribution of mines and small scale of single mines. However, the carbon sequestration capability of mines after ecological restoration has not been clearly evaluated. Therefore, this study evaluated the carbon sequestration capacity of restoration mines, taking the mines of the Yangtze River Basin in Jurong City, Jiangsu Province as the research objects. Firstly, the visual effects of the vegetation and soil in their current status were determined through field investigation, the methods for sampling and data collection for the vegetation and soil were selected, and the specific laboratory tests such as the vegetation carbon content and soil organic carbon were clarified. Meanwhile, the evaluation system consisting of three aspects and nine evaluation indexes was established by using the analytic hierarchy process (AHP) and fuzzy comprehensive evaluation (FCE). The process of evaluation included the following: the establishment of the judgment matrix, calculation of the index weight, determination of the membership function, and establishment of the fuzzy membership matrix. Finally, the evaluation results of the restoration mines were determined with the ‘excellent, good, normal and poor’ grade classification according to the evaluation standards for each index proposed considering the data of the field investigation and laboratory tests. The results indicated that (1) the evaluation results of the mines’ carbon sequestration capacity were of excellent and good grade at a proportion of 62.5% and 37.5%, which was in line with the field investigation results and demonstrated the carbon sequestration capacity of all the restored mines was effectively improved; and (2) the weights of the criterion layer were ranked as system stability &gt; vegetation &gt; soil with the largest value of 0.547, indicating the stability of the system is the main factor in the carbon sequestration capacity of the mines and the sustainability of the vegetation community and the stability of soil fixation on the slope. The proposed evaluation system effectively evaluates the short-term carbon sequestration capability of the restoration mining system according to the visual effects and the laboratory testing results, objectively reflecting the carbon sequestration capacity via qualitative assessment and quantitative analysis. The evaluation method is relatively applicable and reliable for restoration mines and can provide a reference for similar ecological restoration engineering.

Accelerating rare disease detection: an experience of multidisciplinary team model in undiagnosed diseases program in a children's hospital.

A definite diagnosis goes undiscovered for a percentage of children with undiagnosed disorders, with significant medical, psychological, and social effects. Other than specialized clinical centers, exceptional molecular studies, common procedures, and devoted activities at the national and international levels, children with complex undiagnosed disorders require innovative approaches. In March 2016, Children's hospital of Fudan university represented the Children's Undiagnosed Diseases Program (UDP). The purpose of this study is to describe the project findings and underline the critical significance of multidisciplinary teamwork in China's undiagnosed rare illnesses program. We investigated the 758 cases in our UDP system retrospectively. Demographic information, laboratory test results, and genetic information were gathered. Between January 2017 and December 2021, 758 cases were examined. Males made up 436 (57.5%) of the total. Over half of the patients were children under the age of five. The average patient course time preceding admission to UDP was 6.0 months (95% CI 10.512.6). These patients visited an average of 1.8 clinics during their diagnostic journey. Except for 69 individuals (90.9%), all had more than one presenting symptom in various organs: 460 (60.7%) had neurology difficulties, 151 (19.9%) had endocrine problems, and 141 (18.6%) had immunology problems. UDP has a diagnosis rate of 61.3%. Genetic testing was performed on 469 of the 758 patients, for a genetic diagnosis rate of 15.8%. The UDP method has a sensitivity of 94.5%, a specificity of 86.4%, a positive predictive value of 92.8%, and an negative predictive value of 89.5%. Our UDP targets an unmet need, namely the diagnosis of patients with complicated, multisystem illnesses. Using a multidisciplinary team model approach, this UDP pilot study achieved a reasonable diagnosis success rate, increasing the possibility of more diagnoses and new scientific discoveries of difficult and rare diseases.

The Effects of Diet, Dietary Supplements, Drugs and Exercise on Physical, Diagnostic Values of Urine Characteristics.

Background/Objectives: This review summarizes the current knowledge about factors that affect the physical characteristics of urine. It highlights proper urine sample collection and displays factors like diet, hydration status, and medications that can alter urine color, odor, clarity, specific gravity and pH. Results: Urinalysis is a minimally invasive examination of a patient's health, especially concerning nephrological and endocrinological abnormalities, as well as dietary habits and stimulants used. Certain deviations in appearance, composition or frequency/pain during urination may indicate an ongoing disease process in the body. Based on laboratory results, further medical treatment is determined. The reason for a change in the color of the urine, for its clouding or intense odor may be a disease, as well as the consumption of food, medication, intensive physical exercise or inadequate hydration of the body. Well-standardized procedures for collecting, transporting, preparing and analyzing samples should become the basis for an effective diagnostic strategy in urinalysis. It is worth noting that pharmacists in pharmaceutical care are often the first people to whom a patient turns for health advice and for the interpretation of simple laboratory tests. Acquiring the ability to interpret the results of laboratory tests and the principles of proper sampling for laboratory tests is indispensable in the process of possible counseling and providing reliable answers to patients' questions. Conclusions: Although urinalysis is not recommended as a routine screening tool for the general population, it can prove to be a valuable source of patient health data in some cases as the data will be useful to physicians and pharmacists to more effectively diagnose and better care for patients.

Organic electronic-based neutron detectors

In recent decades organic electronics has entered the mainstream of consumer electronics, driven by innovations in scalability and low power applications, and low-cost fabrication methods. The potential for using organic semiconductor electronic devices as radiation detectors, and in particular for neutron detection is reported. We report results of laboratory tests using α particles as well as the response to thermal and fast neutrons covering the energy range 0.025 eV to 16.5 MeV. GEANT4 simulations are used to provide a detailed understanding of the performance and potential of this emerging technology for radiation detection.

Using Pseudo-Color Maps and Machine Learning Methods to Estimate Long-Term Salinity of Soils

Soil salinity assessment methods based on remote sensing data are a common topic of scientific research. However, the developed methods, as a rule, estimate relatively small areas of the land surface at certain moments of the season, tied to the timing of ground surveys. Considerable variability of weather conditions and the state of the earth surface makes it difficult to assess the salinity level with the help of remote sensing data and to verify it within a year. At the same time, the assessment of salinity on the basis of multiyear data allows reducing the level of seasonal fluctuations to a considerable extent and revealing the statistically stable characteristics of cultivated areas of land surface. Such an approach allows, in our opinion, the processes of mapping the salinity of large areas of cultivated lands to be automated considerably. The authors propose an approach to assess the salinization of cultivated and non-cultivated soils of arid zones on the basis of long-term averaged values of vegetation indices and salinity indices. This approach allows revealing the consistent relationships between the characteristics of spectral indices and salinization parameters. Based on this approach, this paper presents a mapping method including the use of multiyear data and machine learning algorithms to classify soil salinity levels in one of the regions of South Kazakhstan. Verification of the method was carried out by comparing the obtained salinity assessment with the expert data and the results of laboratory tests of soil samples. The percentage of “gross” errors of the method, in other words, errors when the predicted salinity class differs by more than one position compared to the actual one, is 22–28% (accuracy is 0.78–0.72). The obtained results allow recommending the developed method for the assessment of long-term trends of secondary salinization of irrigated arable land in arid areas.

Congenital cytomegalovirus diagnosis: healthcare claims data of linked pregnant people-infant pairs, United States, 2018—2023

Objective To describe maternal demographics and compare clinical characteristics of infants with congenital cytomegalovirus (cCMV) identified through diagnostic codes and laboratory data in the United States during 2018–2023. Methods We used a CDC-licensed subset of HealthVerity data, which contained linked pregnant people-infant claims data from publicly and privately insured individuals during 2018–2023 (2023 Quarter 3 HealthVerity Maternal Outcomes Masterset data). We identified infants with cCMV using diagnostic codes or positive laboratory test results within 45 days of birth. Results Among 744 (4.6 per 10,000 live births) infants with cCMV during 2018–2023, 599 (81%) were identified by a diagnostic code only. Among 732 linked pregnant people, 91 (12%) had a diagnosis of CMV infection during pregnancy, with a similar distribution by age group and insurance type, but a lower proportion were Black as compared to those without CMV infection during pregnancy (14% vs. 29%, respectively). Overall, 452 (61%) infants had ≥1 cCMV-related clinical sign at birth and 185 (25%) had valganciclovir prescriptions. Eighty-eight (68%) infants identified by a positive laboratory test only had no cCMV-related signs and none had valganciclovir prescriptions. Conclusions Using healthcare claims data, we found a minimal overlap of cCMV identified by diagnostic codes and laboratory test results. A minority of linked pregnant people with infants with cCMV had a CMV diagnosis during pregnancy. cCMV surveillance will help better understand the validity of ICD codes to identify infants with cCMV, describe the spectrum of disease, and monitor the use of antivirals.

Utilization of Buton Granular Asphalt (BGA) as Asphalt and Filler Content Substitution Material – in Asphalt Concrete Mixture- Wearing Course

Roads are one of the infrastructure that is urgently needed in improving the accessibility of an area and has a crucial role as a connecting infrastructure that facilitates the transportation of people and goods. This road must be able to handle the volume of traffic according to the plan, so planning must ensure smooth transportation. Asbuton can be used as a binding material on road pavements. However, the use of buton asphalt as a road construction material in Indonesia has not had a significant impact on infrastructure development carried out by the government. The purpose of this study is to analyze the characteristics of Marshall’s test value using Buton Granural Asphalt as a substitute for filler and Fine Aggregate in the mixture of Asphalt Concrete – Wearing Course (AC – WC). The type of data used is primary data obtained from laboratory test results and secondary data obtained from SNI Bina Marga 2018 rev.2. The results showed that with the addition of 19% BGA (Buton Granular Asphalt) as a filler and fine aggregate material, the stability of the mixture could be increased up to 2369,8 kg with the addition of BGA, when compared to aggregate without BGA, the stability value was higher. Based on the test of the characteristics of the 0% BGA mixture marshall obtained a density value of 2,304 t/m³, stability of 1240,6 kg, fatigue of 3.4 mm, Marshall Quotient (MQ) of 366,0 kg/mm, VMA of 16,3%, VFB of 76.2%, VIM of 3.9%. Marshall testing on a mixture of 19% BGA obtained a density value of 2325,0 t/m³, Stability of 2369,8 kg, Fatigue of 3.4 mm, Marshall Quotient(MQ) of 697,1 kg/mm, VMA of 15,4%, VFB of 80,0%, VIM of 3.1%. All test parameters meet the standards set out in the 2018 General Bina Marga specification for revision 2 road and bridge construction work, so that AC-WC asphalt concrete with 0% and 19% BGA substitution can be used.