Reactive Test Research Articles

Evaluation of pharmacogenomic testing to identify cytochrome P450 and SLCO1B1 enzymes and adverse drug events: A non-experimental observational research.

A laboratory-initiated preemptive and reactive cytochrome P450 and SLCO1B1 PGx testing protocol was evaluated in a private toxicology laboratory with the intent of identifying enzyme frequencies and associated adverse drug events. This study involved non-experimental observational research. During the retrospective medical chart review, patient demographics, statements of medical necessity, and PGx testing data were collected. Frequencies and percentages were calculated for the collected data, and statistical analysis was performed using Intellectus online software. A total of 192 PGx patient records from September 2019 to October 2021 were retrospectively reviewed. For patient demographics, men (n = 118; (61%)) were the majority gender identified among the patient population and Caucasians (n = 112; (58%)) followed by African Americans (n = 37; (19%)) were the most identified ancestry. The mean age of the patients was 69 (±9) years. CYP1A2 hyperinducers, followed by CYP3A5 poor metabolizers and CYP2B6 intermediate metabolizers, are the most encountered cytochrome P450 and SLCO1B1 enzymes. Regarding drug-gene interactions, 41 patients had 1 interaction, 29 had 2, and 31 had 3 or more interactions. For drug-drug interactions, 35 patients had 1 interaction, 15 had 2, and 30 had 3 or more interactions. Overall, 123 patients showed a minor or greater impact on drug-drug or drug-gene interactions. Overall, our study identified cytochrome P450 and SCLCO1B1 enzyme frequencies and patients experiencing actionable adverse drug events. By raising awareness of PGx test results through individualized clinician training, education, and interventions, these adverse events can be promptly identified and resolved.

Completion of paired serological testing algorithms for spotted fever rickettsiosis and ehrlichiosis, North Carolina: 2017-2020.

Ehrlichia and Rickettsia are tick-borne pathogens capable of causing severe disease. Paired serological testing, involving both acute and convalescent samples, remains the primary method of diagnostic confirmation and source of surveillance data. Yet few patients complete recommended testing algorithms. We examined the demographic, clinical, and geographic factors associated with obtainment of convalescent samples for patients with suspected ehrlichiosis and spotted fever rickettsiosis using results from a large academic center in North Carolina between 2017 and 2020. Over 4400 patients underwent serological testing of an acute sample for Rickettsia (N = 4224) and Ehrlichia (N = 2339); however, only 15.0% (662/4,415) had testing performed on a convalescent sample. Over the study period, the proportion of convalescent testing completed increased from 4% to 23% for Ehrlichia, 7% to 11% for Rickettsia, and 12% to 28% for both. A reactive test on the acute sample, undergoing testing for both pathogens, and proximity to a health facility were significantly associated with obtainment and testing of a convalescent sample. The presence of a reactive acute titer for Ehrlichia and Rickettsia had 8.3 (95% CI: 6.3, 10.9) and 8.2 (95% CI: 6.5, 10.3) times the probability of obtainment of a convalescent sample compared to non-reactive results, respectively. Our findings suggest that clinicians' knowledge of tick-borne disease testing practices, in addition to patient distance to health facilities, contribute to poor performance of testing completion. Moreover, these results highlight the need for more investment in public health surveillance and ultimately, assays that are not dependent on convalescent testing.

The effect of time of day and menstrual cycle on physical performance and psychological responses in elite female Tunisian volleyball players

BackgroundThe influence of circadian rhythms and menstrual cycle phases on athletic performance and psychological responses is critical for optimizing training and competition strategies for female athletes. This study aimed to investigate the effects of time of day and menstrual cycle phases on the physical performance and psychological responses of elite female Tunisian volleyball players.MethodsThirteen elite female volleyball players were assessed during three different phases of their menstrual cycle (menstrual, follicular, and luteal) and at two different times of day (morning and evening). Physical performance was evaluated using the Modified Agility Test (MAT), Reactive Agility Test (RAT), and Repeated Sprint Ability (RSA) Test. Psychological responses were measured using the Profile of Mood States (POMS), Hooper’s Questionnaire, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Vis-Morgen Questionnaire, and Spiegel Questionnaire.ResultsSignificant effects of menstrual cycle, time of day, and competition on physical performance, cognitive function, mood, and sleep parameters were found. Physical performance, including the Countermovement Jump (CMJ), the Modified Agility T-test (MAT) and the Reactive Agility test (RAT), was higher in the afternoon than in the morning across all menstrual phases (CMJ: p < 0.001, η² = 0.836; MAT: p < 0.001, η² = 0.777; RAT: p < 0.001, η² = 0.859). After the competition, performance decreased significantly, especially in the follicular and luteal phases. As measured by the Stroop test, cognitive function showed significant diurnal effects (p < 0.001, η² = 0.910), with pre-competition performance being better in the afternoon. Mood disturbances (POMS) increased after the competition, especially in the morning and during the luteal phase (p < 0.001, η² = 0.961). Sleep parameters were significantly influenced by time and menstrual cycle, with higher fatigue (Hooper score: p < 0.001, η² = 0.754) and poorer sleep quality (PSQI: p < 0.001, η² = 0.627) in the morning, especially after the competition.ConclusionOur results suggest that aligning high-intensity training and competitions with afternoon circadian peaks may enhance physical and cognitive performance in elite female athletes. Recovery strategies and workload adjustments should account for menstrual phases, particularly reducing morning demands during the luteal phase to mitigate fatigue and mood disruptions. Integrating circadian timing with menstrual cycle monitoring offers a practical, evidence-based approach to optimize athlete readiness and resilience.

A comparative analysis of the different HIV testing techniques used in Zambia: data from a clinical performance study

BackgroundApproximately 40 million people globally are living with HIV (PLWH) and more than 50% of these PLWH reside in Eastern and Southern Africa. Zambia has an adult HIV-1 prevalence (ages 15–49) of 11.1 [10.5–11.6] %, among the highest in the world (UNAIDS, 2021). In 2020, 1.5 million people were estimated living with HIV-1 in Zambia. Despite the success of many HIV preventative strategies, and worldwide sensitization to know one’s status, there remains a substantial number of people with HIV who are unaware of their infection and are still infecting others. Globally, about 20% of HIV infections are due to transmissions from recently infected individuals. As Zambia’s adult HIV prevalence is about 11.1%, if 3rd generation RDTs are used for first time HIV testing, all the people tested that are within the acute period will be given a false negative result. Hence the need to develop better first line HIV testing techniques.MethodA quantitative descriptive approach was used to analyze samples of 2564 participants, between the ages of 15 to 95 years from two Lusaka sites. The 2564 participants were subjected to OraQuick ADVANCE Rapid HIV-1/2 Antibody Test and Abbot Determine™ HIV-1/2 antibody test, if Reactive on either test, the result was confirmed on Uni-Gold™ Recombigen® HIV-1/2 rapid test as a confirmatory RDT. An EDTA tube of blood for each of the 2564 participants was collected and sent to the central laboratory for further testing on fourth generation Abbot ARCHITECT HIV Ag/Ab Combo and then any discrepancies were confirmed on Genscreen™ ULTRA HIV Ag-Ab. Using a systematic analysis technique, quantitative methods were applied to evaluate different variables and compare them against each other to find relationships. The data were cleaned using Microsoft excel and were analyzed using SPSS version 25.0.ResultsThe Abbot ARCHITECT HIV Ag/Ab Combo fourth generation assay was used as the gold standard, of the total 2564 tested 267 (10.4%) were reactive tests and 2297(89.6%) non-reactive. OraQuick ADVANCE Rapid HIV-1/2 test detected 245(9.6%) reactive tests and 2319 (90.4%) non-reactive, Abbot Determine™ HIV-1/2 test detected 249(9.7%) true reactive tests and 2315 (90.3%) non-reactive, all reactive tests on the first two RDTs were confirmed on Uni-Gold™ Recombigen® HIV-1/2 rapid test which detected 247 (9.6%) reactive and 2317 (90.4%) non-reactive. These results show that compared to the gold standard the 3 RDTs missed more than 18 (6.7% of the total 267) reactive results. This means that in every 15 tests done, 1 result is a false negative.ConclusionThird generation RDTs were unable to detect a good number of acute positive cases and are therefore unreliable. There is therefore need for the use 4th generation Rapid test to capture the positive cases currently being missed out.

Genetic polymorphisms affect the metabolism of antituberculosis drugs

The introduction of genetics into medicine has unlocked the ability to predict drug efficacy and/or toxicity, and pharmacogenomics makes an important contribution to personalized medicine and pharmacotherapy. Pharmacogenetic testing identifies genetic variants that alter the response to a drug. At the same time, up to 95 % of the population is a carrier of at least one genetic variant; however, a patient may be a carrier of several genetic variants at the same time, which may be important not only in cases of prescription of a particular drug but also of other drugs during the future life. In this regard, two pharmacogenetic approaches are relevant — reactive or preventive testing. The current trend is pharmacogenetic panel testing as a model for precision medicine. In a multiplex panel model, several gene variants affecting drug response are tested simultaneously, and the data are stored for future use.However, practicing physicians have difficulty with genetic information because of low awareness of pharmacogenomics or lack of proper infrastructure and IT tools. Despite the publication of pharmacogenomics guidelines in the US (CPIC) and in the European Union (DPWG), most patients are still treated according to standard clinical practice. It was strategically important to establish interdisciplinary working groups — pharmacogenomics consortia — in the USA and the European Union, the purpose of which is to introduce pharmacogenetics into widespread clinical practice. The activities of these consortia and the results achieved are presented. In the work of consortia, various studies are used to analyze the level of knowledge on pharmacogenomics, applicationof pharmacogenetic testing, and clinical results, including different methodological approaches. The foreign experience (USA, European Union, China) in the dissemination and implementation of pharmacogenomics in real clinical practice is presented.

A National Study Among Diverse US Populations of Exposure to Prescription Medications with Evidence-Based Pharmacogenomic Information.

Tailoring pharmacogenomic (PGx) implementation to diverse populations is vital to promoting health equity. We assessed prescriptions for medications with potentially actionable PGx information to identify patient characteristics associated with differential PGx medication exposure. We analyzed the nationally-representative MEPS dataset of adults who reported receiving prescriptions between 2014 and 2021. PGx medications include those the FDA and CPIC designate as having drug-gene associations supported by scientific evidence. With the primary outcome being PGx prescriptions, we performed Poisson regression adjusted for all other relevant covariates. In our final population (N = 119,722, 72% White/20% Black/4% Asian/8% Hispanic), 61% were prescribed a PGx medication, 56% were female, and 97% held health insurance coverage. Adults with private health insurance (65%) or public Medicaid/Medicare coverage (32%) were more likely to have PGx prescriptions than the uninsured (3%). Individuals with cardiovascular conditions [adjusted IRR (aIRR) = 1.45, 95% CI 1.41, 1.48], high cholesterol [aIRR = 1.37, 95% CI 1.35, 1.40], high blood pressure [aIRR = 1.14, 95% CI 1.12, 1.16], and cancer [aIRR = 1.02, 95% CI 1.00, 1.04] were more likely to receive PGx prescriptions. Self-reported Blacks were less likely than Whites to receive PGx medications [aIRR = 0.92, 95% CI 0.90, 0.94], and among those with health conditions, the likelihood of PGx medication exposure for underrepresented groups (Blacks, Hispanics, and Asians) was lower than for Whites. Our study using a comprehensive list of PGx medications in a nationally representative dataset indicates that certain populations are differentially exposed to genomically informed medications. This may suggest that if implementing a pharmacogenomics program based on reactive testing initiated by a prescription, a small underrepresentation of the Black population could be expected because of an underlying prescription disparity. Secondly, if implementing a pharmacogenomics program based on targeted preemptive testing, using clinical indication/comorbidity may be a reasonable way to enrich the population for prescriptions that would benefit from genotype tailoring.

The Contribution of Perceptual-Cognitive Skills to Reactive Agility in Early and Middle Adolescent Soccer Players.

Horníková, H, Hadža, R, and Zemková, E. The contribution of perceptual-cognitive skills to reactive agility in early and middle adolescent soccer players. J Strength Cond Res 39(3): e478-e484, 2025-Agility performance increased from childhood to mid-adolescence, followed by a plateau until early adulthood. Because adolescence is crucial for the development of perceptual-cognitive skills, the question is whether and to what extent its contribution to reactive agility increases during developmental periods of adolescence in invasive sports athletes. This study investigated the association of reactive agility with the speed of decision making, sprint speed, and explosive strength in early and middle adolescent soccer players. They performed reactive and preplanned Y-shaped agility tests, choice reaction time test, modified half T-test, 30-m sprint (10 m split), and countermovement jump (CMJ). The reactive agility time in both age groups significantly correlated with 30-m sprint time ( r = 0.839, p < 0.001, and r = 0.745, p = 0.001, respectively), pre-planned Y-shaped agility time ( r = 0.828, p < 0.001, and r = 0.644, p = 0.007, respectively), 10-m sprint time ( r = 0.823, p < 0.001, and r = 0.775, p < 0.001, respectively), time in modified half T-test ( r = 0.723, p < 0.001, and r = 0.630, p = 0.009, respectively), and CMJ height ( r = -0.744, p < 0.001, and r = -0.615, p = 0.013, respectively), although with the index of reactivity in middle adolescent soccer players only ( r = 0.615, p = 0.011). Based on R2 , the explained proportion of variance was 53.6% for linear sprint speed and 30.1% for a change of direction speed in early adolescence, whereas it was 54.6% for acceleration speed and 31.8% for decision-making in middle adolescence. This indicates the significant contribution of speed factors to reactive agility in both adolescent groups, whereas perceptual-cognitive factors in middle adolescent soccer players only. It seems that even during the relatively short period of adolescence, the changes occur in the contribution of perceptual-cognitive skills to reactive agility in athletes practicing invasive sports.

Alternative training methods in soccer

Abstract The increasing level of physical fitness among soccer players necessitates the exploration of alternative training methods to enhance overall performance. Perceptual–cognitive skills are crucial for sport-specific capabilities such as decision making and reactive agility, enabling athletes to extract visual information from foveal, parafoveal, and peripheral vision. This study focuses on optimizing the utilization of peripheral vision in sports, addressing the demand for specialized training techniques and investigating additional avenues for practicing soccer-specific skills. This study assessed the impact of a 6-week intervention on the perceptual–cognitive performance of elite youth soccer players by examining peripheral perception, response time, and task-switching during soccer-specific motion execution. Outcomes were measured through a reactive agility test, a simulated decision-making task, and a maximal sprinting speed test. Using a pre–post design, 22 healthy male participants were divided into an experimental group and an active control group. The experimental group engaged in sport-specific tasks designed to enhance their perceptual–cognitive skills. Results revealed that the experimental group demonstrated significant improvements in reaction time during both the reactive agility test with and without a ball, an increase in the number of correct decisions in the simulated decision-making task, and a noteworthy enhancement in maximum sprinting speed, while handling a ball compared to the control group. While further research is needed to translate these findings into practical field settings, this study indicates that soccer-specific demands, extending beyond physical aspects, can be effectively targeted and improved.

Public health implications of diagnosing and treating acute HIV.

The earliest months of HIV infection are characterized by high viral loads and elevated transmissibility, particularly during the acute (preseroconversion) phase. Transmission prevention during early HIV requires diagnostic tools that narrow the window between viral acquisition and reactive test, followed by rapid linkage to effective antiretroviral therapy (ART). Here, we review recent advances related to diagnosing and treating persons during early HIV, with a particular focus on acute HIV infection (AHI). Point-of-care (POC) fourth-generation antigen/antibody tests have mixed performance, often dependent on the pretest probability of early infection within the screened population. Risk score algorithms demonstrate the potential for prioritizing resource-intensive tests, such as POC HIV RNA, to those most likely to have AHI, but their predictive performance varies across populations, complicating implementation. Emerging and re-emerging infections, including SARS-CoV-2 and mpox, present opportunities for and challenges to symptom-driven AHI screening. Daily oral ART with standard first-line regimens quickly suppresses viremia during AHI, but long-acting injectable drugs are yet to be explored for this indication. Few practice-changing results related to diagnosing or treating persons with early HIV have been released in the last 18 months. Accurate POC HIV RNA tests could leapfrog fourth-generation POC assays, but they remain unavailable for routine use. Implementation science approaches are needed to guide use of evidence-based strategies for early HIV screening, and additional research on same-day ART linkage, including injectable ART, could produce dramatic impacts on forward transmission during this period.

Universal opt-out syphilis screening in a UK emergency department.

Universal opt-out syphilis screening in a UK emergency department.

P-498. One Small Step for Man, One Giant Leap for Ending the HIV Epidemic

Abstract Background To achieve the goal to “End the HIV Epidemic” by 2030, unique interventions are needed to increase testing and subsequently link people with HIV (PWH) to care for rapid start of antiretroviral therapy (ART). Extending testing to include emergency department (ED) based HIV screening initiatives are effective in new case identification, earlier detection, and are encouraged by Centers for Disease Control and Prevention guidelines. Collaborations of infectious diseases (ID) providers with ED providers provides improved linkage to care for HIV and rapid initiation of ART. We describe our combined ED and ID HIV testing and linkage to care program. Methods This is a retrospective analysis of newly diagnosed PWH at Henry Ford Health (HFH) via reactive HIV fourth generation test by an ED based opt-out HIV screening program from 7/16/2020 – 10/28/2023. A best practice alert (BPA) prompted providers to order an HIV screening test for patients ages 18-65 years old without a previously documented HIV fourth generation test. Patients were informed of the test when ordered and could opt-out of testing if desired. Follow up and linkage to care was provided by a team of ID providers. Results During the study period, a total of 48,725 fourth generation HIV screening tests were performed, of which 629 tests were reactive (1.24% of tests performed). Of the reactive tests, 86 patients (0.18% of all tests) were found to have a new diagnosis of HIV. Median CD4 cell count was 297 cells/mm3 (IQR: 98-614), 34 patients required hospitalization with 7 (8%) admitted with an opportunistic infection. Excluding the 34 patients hospitalized, the median time from positive result to first attended appointment was 5 days (IQR 2-13) and median time from screening test result to initiation of ART was 6.5 days (IQR: 4-16). At 3- or 6- months following HIV diagnosis, 40 (47%) had an HIV-1 follow-up viral load reported (see Table 1). Conclusion HIV testing and early linkage to care are two key pillars of the “End the HIV Epidemic” initiative. As shown by our study, collaboration between ED and ID providers ensures increased testing in the ED, improved linkage to care, and rapid start of ART which will help in achieving the goals of these two pillars. Disclosures Indira Brar, MD, Gilead: Advisor/Consultant|Gilead: Grant/Research Support|Gilead: Honoraria|Merck: Grant/Research Support|ViiV Healthcare: Grant/Research Support|ViiV Healthcare: Honoraria

391. Modified Human Immunodeficiency Virus Testing Algorithm in Rural Missouri (MOdified HIV testing algorithm)

Abstract Background Universal screening for human immunodeficiency virus (HIV) is essential for timely and accurate diagnosis of HIV. The Centers for Disease Control and Prevention (CDC) recommends an algorithm that begins with HIV-1/HIV-2 Ag/Ab combination assay (HIV screening), which if reactive, is followed by HIV-1/HIV-2 antibody differentiation assay. If the differentiation assay is negative (discordant results), nucleic acid test for HIV RNA should follow. The University of Missouri Health Care (MUHC) sends the antibody differentiation assay to a reference laboratory, leading to delays in turn-around-time (TAT). As MUHC performs HIV-1 RNA testing in-house, we modified our own HIV screening algorithm to reflex HIV-1 RNA testing following a reactive HIV screening, with the goal of reducing TAT. Human Immunodeficiency Virus Screening Algorithm The above is the screening algorithm for human immunodeficiency virus (HIV) recommended by the Centers for Disease Control and Prevention utilized during period 1. Methods Data from positive HIV screening tests was collected from two periods: period 1 (1/1/2021-12/29-2022), in which MUHC followed the screening algorithm recommended by the CDC (Figure 1); and period 2 (12/30/2022-12/31/2023) in which MUHC followed the Modified HIV testing algorithm (Figure 2). In both algorithms, if the test that follows a reactive HIV screening is positive, the patient is determined to have confirmed HIV infection. If negative, additional testing is performed to determine if reactive HIV screening was false positive or true positive. The TAT were collected and the differences in TAT between the two periods were analyzed using a two-sample t-test. MOdified Human Immunodeficiency Virus Screening Algorithm Above is the modified HIV screening algorithm utilized during period 2 in which the HIV-1 RNA is the first test following the reactive HIV screening test. Results 47 positive HIV screenings tests were analyzed in period 1 and 66 in period 2. The mean TAT between a reactive HIV screening and the differentiation assay result in period 1 was 3.6 days, whereas the TAT between a reactive HIV screening and the HIV RNA result in period 2 was 2.3 days (p 0.04). A higher percentage of tests were resulted in 1-3 days in period 2 compared to period 1 (77.2% vs 68.1%). Turn Around Time Comparison On the left is the data from first period where University of Missouri Healthcare utilized the CDC recommended algorithm. The data on the right is from the second period utilizing the modified algorithm. Conclusion At our institution, after modification of the HIV testing algorithm to reflex RNA testing after a reactive HIV screening, patients received a faster confirmation of HIV diagnosis compared to CDC’s algorithm. This intervention could expedite linkage to care and initiation of antiretroviral therapy, especially at small and midsize institutions that often do not have the differentiation assay in-house. Disclosures Dima Dandachi, MD, MPH, Gilead Sciences: Grant/Research Support|ViiV Healthcare: Grant/Research Support|ViiV Healthcare: Honoraria

P-2188. Hepatitis C Screening: Before and After Study of Hepatitis C Risk Score Alerts in CHORUS

Abstract Background Hepatitis C (HCV) screening rates remain low despite recommendations of one-time screening for asymptomatic adults and annual screening for people at higher risk of HCV acquisition. We sought to determine if alerts in CHORUS™, a clinical decision support system (CDSS), could improve the screening to diagnosis ratio. Methods A machine learning-based model calculated a percent chance of returning a positive HCV test for individuals eligible for HCV screening at selected OPERA® clinics. Alerts providing the risk score and factors contributing to the score were disseminated to clinics via CHORUS ahead of their upcoming visits in the 16JAN2023-16AUG2023 period (with alerts) but not the 16JAN2022-16AUG2022 period (without alerts). Individuals were then followed through 17OCT of each period; HCV testing and diagnosis were described among individuals who completed a clinic visit. Results A total of 20,699 (before period) and 22,852 (after period) HCV screening-eligible individuals visited the clinics (Figures 1 &amp; 2). Population characteristics were similar between study periods (Table 1). The proportions of individuals with a detectable HCV viral load (VL) among those who received any HCV test (antibody [Ab], VL, or genotype) over follow-up were 1% in both the before (36/4930) and after (40/5249) periods. However, the proportions of individuals receiving a VL test after a reactive Ab test and of those, the proportions with active HCV infection, were higher in the after period (94% &amp; 56%) than in the before period (85% &amp; 42%) (Figure 3). Conclusion In this before and after study, the proportion of screened individuals with active HCV infection was the same in both study periods, regardless of the alerts. Since HCV risk scores were disseminated for all 22,852 individuals ahead of their visits in the after period, alert-fatigue may have occurred. Additionally, providers may be cautious in following artificial intelligence-guided alerts. However, the proportion of VL tests with detectable virus was much higher after alerts, possibly suggesting heightened awareness of risk factors from the alerts or of HCV in general. As the HCV classification model is refined, future studies may consider alerting for only individuals with a high percent chance of infection. Disclosures Douglas Dieterich, MD, Gilead: Advisor/Consultant|Gilead: Honoraria Rachel P. Weber, PhD, EMD Serono: Research support to my employer|Gilead Sciences: Research support to my employer|Merck &amp; Co.: Research support to my employer|TheraTechnologies: Research support to my employer|ViiV Healthcare: Research support to my employer Ricky K. Hsu, MD, EMD Serono: Advisor/Consultant|EMD Serono: Honoraria|Gilead: Grant/Research Support|Gilead: Honoraria|Merck: Honoraria|ViiV: Advisor/Consultant|ViiV: Grant/Research Support|ViiV: Honoraria Jennifer S. Fusco, BS, EMD Serono: Research support to my employer|Gilead Sciences: Research support to my employer|Merck &amp; Co.: Research support to my employer|TheraTechnologies: Research support to my employer|ViiV Healthcare: Research support to my employer Annie Son, MBA, Gilead Sciences: Employee|Gilead Sciences: Stocks/Bonds (Public Company) Bruce Kreter, PharmD, Akero Therapeutics: Stocks/Bonds (Public Company)|Bristol-Myers Squibb: Stocks/Bonds (Public Company)|Eli Lilly: Stocks/Bonds (Public Company)|Gilead Sciences: Stocks/Bonds (Public Company)|Merck: Stocks/Bonds (Public Company)|Novo Nordisk: Stocks/Bonds (Public Company)|Pfizer: Stocks/Bonds (Public Company) Gregory P. Fusco, MD, MPH, EMD Serono: Research support to my employer|Gilead Sciences: Research support to my employer|Merck &amp; Co.: Research support to my employer|TheraTechnologies: Research support to my employer|ViiV Healthcare: Research support to my employer

P-99. Comparative Analysis of False Positive Results in Low and High Risk U.S. Populations: New Access HIV Ag/Ab combo Assay vs. Abbott ARCHITECT HIV Ag/Ab Combo Assay

Abstract Background The fully automated 4th gen HIV Ag/Ab combo assay by Beckman Coulter, Inc. on the DxI 9000 Access Immunoassay analyzer allows for separate reporting of HIV-1 p24 Ag and HIV-1/HIV-2 Ab results, with a time to first result of ̴30 minutes and a sample volume of 60µL. To evaluate its performance, a U.S. multisite study was conducted to compare the Access HIV Ag/Ab combo assay with the ARCHITECT HIV Ag/Ab Combo assay. False positive rates were assessed in low and high risk U.S. populations with unknown HIV status by comparing the new Access HIV Ag/Ab combo assay with the ARCHITECT HIV Ag/Ab Combo assay.1 Footnotes Methods The evaluation tested 6,981 low risk and 799 high risk samples (adult, pregnant, pediatric) at 3 clinical trial sites. Following the CDC recommended algorithm, samples that initially tested reactive were subjected to duplicate testing, if repeatedly reactive, were further confirmed using the HIV 1/2 differentiation assay (Geenius HIV-1/2 Supplemental Assay, Bio-Rad), and the HIV-1 RNA PCR Assay (Aptima HIV-1 Quantitative Dx Assay, Hologic, Inc).2 Results The Access HIV Ag/Ab combo assay showed a lower incidence of false positive results (n=25) in the low risk group with a specificity of 99.6% (n=6981; 95% CI: 99.5-99.8%) compared to the ARCHITECT HIV Ag/Ab Combo assay (n=87) with a specificity of 98.8% (n=6981; 95% CI: 98.5-99.0%). Similarly, in the high risk group, the Access HIV Ag/Ab combo assay yielded fewer false positive results (n=1) with a specificity of 99.9% (n=799; 95% CI: 99.3-100.0%) than the ARCHITECT HIV Ag/Ab Combo assay (n=11) with a specificity of 98.6% (n=799; 95% CI: 97.6-99.2%). Conclusion Falsely reactive HIV test results can have significant consequences for patients and healthcare providers. Selecting an appropriate HIV assay with high sensitivity and specificity is essential. This study provides evidence that the Access HIV Ag/Ab combo assay is an attractive alternative to the ARCHITECT HIV Ag/Ab Combo assay with fewer false positive results, suggesting improved accuracy in identifying HIV infections in both low and high risk U.S. populations. Disclosures Fred S. Apple, PhD, Mindray: Advisor/Consultant|Werfen: Advisor/Consultant Robert H. Christenson, PhD, DABCC, FADLM, FACC, Beckman Coulter: Advisor/Consultant|Beckman Coulter: Grant/Research Support|Beckman Coulter: Honoraria|Becton Dickinson: Advisor/Consultant|Becton Dickinson: Grant/Research Support|Becton Dickinson: Honoraria|QuidelOrtho: Advisor/Consultant|QuidelOrtho: Grant/Research Support|QuidelOrtho: Honoraria|Roche Diagnostics: Advisor/Consultant|Roche Diagnostics: Board Member|Roche Diagnostics: Grant/Research Support|Roche Diagnostics: Honoraria|Siemens Healthineers: Advisor/Consultant|Siemens Healthineers: Board Member|Siemens Healthineers: Grant/Research Support|Siemens Healthineers: Honoraria

The impact of technologies on the development of repetitive speed in handball, basketball and volleyball

Introduction and objective: The study focused on identifying the differences regarding the implementation of a program that uses Fitlight technology and targets the development of simple and reactive repetitive speed in manual and bilateral manual executions. Methodology: There were 311 subjects in the study, including 243 student-athletes (handball, basketball, and volleyball) and 65 recreational subjects (control group). Study phasing: initial testing; implementing a 6-week experimental program using the Fitlight technology to improve manual, repetitive speed; final testing. Study tests: the Tapping the plates test-unilateral execution with the dominant hand (TP_dominant hand), the random reactive plate touching test_unilateral execution with the dominant hand (TPR_dominant hand), Touching the plates test- bilateral execution (TP_bilateral), Test Touching the plates bilateral execution-random reactive (TPR_bilateral). Results: The ANOVA analysis highlighted significant differences between the male and female groups, respectively, for all four versions of the Tapping Plate Test, for p&lt;0.05. While analyzing the results of the male/female sports game groups, the most significant differences in progress were recorded in TP_dominant hand between Volleyball-Basketball with 0.179/0.126 executions; TPR_ dominant hand between Volleyball-Basketball -0.126/0.086 executions; TP_bilateral between Volleyball-Basketball -0.154/-0.173 executions; bilateral TPR_ between Volleyball-Handball -0.016/-0.033 executions. Analyzing the study results, we found that the control group recorded lower results than all the experimental groups. Conclusions: The Fitlight technology positively impacted the environment of simple and reactive repetitive speed as part of practicing an experimental program of specific exercises adapted to team sports games.

The Relationship Between CXR Imaging and Thoracic CT in Third Semester Pregnant Women Was Confirmed by the Reactive Antibody Rapid Test as an Intervening Variable with PCR Swab Results Before the Action/Delivery

Objective: This study explores the relationship between Chest X-Ray (CXR) imaging and Thoracic CT scans in third-trimester pregnant women, with the Reactive Antibody Rapid Test as an intervening variable, in relation to PCR swab results before delivery. Theoretical Framework: CXR and Thoracic CT are hypothesized to provide complementary diagnostic information in managing respiratory conditions during pregnancy, with the Reactive Antibody Rapid Test potentially influencing the accuracy of these modalities in predicting PCR outcomes. Method: A quantitative cross-sectional design with proportional purposive sampling was used. Sixty-two third-trimester pregnant women who underwent CXR, Thoracic CT, and PCR swab tests were included. Data from medical records were analyzed using Importance-Performance Analysis (IPA) to assess the predictive power of CXR and CT imaging in conjunction with antibody test results. Results and Discussion: The study revealed that the performance of CXR and Thoracic CT imaging (x = 4.07) exceeded expectations (y = 2.73) when correlated with PCR swab results. The Reactive Antibody Rapid Test, however, showed mixed results, particularly when CXR findings were inconclusive. The study discusses the need for better integration of imaging and antibody test results to optimize pre-delivery care. Research Implications: The findings suggest that while CXR and Thoracic CT are valuable diagnostic tools for managing respiratory conditions in pregnant women, including antibody test results could improve diagnostic accuracy. Hospitals should refine protocols to better integrate these tests. Originality/Value: This study is one of the first to examine the relationship between CXR, Thoracic CT, and Reactive Antibody Rapid Test results in the context of PCR swab outcomes before delivery in third-trimester pregnant women.

Challenges in HIV Diagnosis Algorithm: Experience of the Confirmation Laboratory.

This study aimed to evaluate the effectiveness of the algorithm used in HIV diagnosis and to propose an effective new algorithm for rapid diagnosis. In accordance with CDC algorithm, our laboratory uses Architect HIVAg/Ab for screening and Geenius HIV1/2 and Artus HIVirus-1 QS-RGQ for confirmation. The Geenius test was used as a reflex and the HIV-1-RNA required clinician order. The HIVAg/Ab test was performed in 82,882 sera and found to be reactive in 262 (0.3%). HIV-antibody confirmatory testing was performed on 79% of samples with a reactive screening test, and the presence of HIV-1 antibodies was confirmed in 51% (105/206). Half of the samples with positive-screening but negative-antibody confirmatory results were tested for HIV1-RNA, and viremia was detected in 5, confirming acute HIV1 infection. HIV1-RNA was not ordered for 49 samples with positive-screening and negative antibody-confirmation tests, and 16 of these were considered false-reactive by the clinician. The Geenius assay result was indeterminate in 1.45% (3/206) of the samples. In the algorithm, the number of Geenius tests would have been reduced by 25% if HIV-1-RNA had been applied as a reflex test to HIV-Ag/Ab positive samples and Geenius testing had been performed on RNA negative samples. A retrospective analysis showed that the HIV diagnostic algorithm was not fully implemented. An important factor was that clinicians did not order HIV-1-RNA-PCR from ELISA reactive and Geenius test negative patients. Requesting HIV-1 RNA PCR as a reflex test is thought to prevent patient losses and shorten the turnaround time of the HIV diagnosis.

Exploiting Dual-Wavelength Depolarization of Skin-Tissues for Camera-Based Perfusion Monitoring.

Perfusion index (PI), the ratio between variable pulsatile (AC) and non-pulsatile (DC) components in a photoplethysmographic (PPG) signal, is an indirect and non-invasive measure of peripheral perfusion. PI has been widely used in assessing sympathetic block success, and monitoring hemodynamics in anesthesia and intensive care. Based on the principle of dual-wavelength depolarization (DWD) of skin tissues, we propose to investigate its opportunity in quantifying the skin perfusion contactlessly. The proposed method exploits the characteristic changes in chromaticity caused by skin depolarization and chromophore absorption. The experimental results of DWD, obtained with the post occlusive reactive hyperemia test and the local cooling and heating test, were compared to the PI values obtained from the patient monitor and photoplethysmography imaging (PPGI). The comparison demonstrated the feasibility of using DWD for PI measurement. Clinical trials conducted in the anesthesia recovery room and operating theatre further showed that DWD is potentially a new metric for camera-based non-contact skin perfusion monitoring during clinical operations, such as the guidance in anesthetic surgery.

Effects of 2 consecutive badminton matches on motor and cognitive abilities among adult elite badminton players: An observational study.

The goal of our study was to investigate the effect of 2 consecutive badminton matches among elite badminton players on visuomotor integration, dynamic balance ability, inhibitory control, short-term memory capacity, and changes in cardiovascular fitness. Badminton is the fastest racket sport regarding the speed of the shuttle leaving the racket. The play with open move skills is characterized by series of short range and high intensity workload phases. The effectiveness is affected by the execution of the specific movement techniques within a certain time period and the optimal function of decision-making techniques. The experiment included a tournament with 2 simulated matches among elite, adult, male badminton players. The quality of visuomotor integrity and dynamic balance task were measured with Blazepod modified adapted Y-Balance Test induced reactive balance test, pre and post matches. Stroop test was used to evaluate the inhibition capability, and Digit Span Test was applied to measure the cognitive short-term capacity. Remarkable changes could not be detected in the visuomotor reaction in each time points. Gradual increase was observed in balance errors due to the dominant leg (right) support. Digit Span Test decreased between pre and post match measurements, however, significant changes (P < .01) could be detected after the restitution period between pre and post match. No alteration could be seen with Stroop test in each time points, nevertheless, notable increase in false results were observed at the 4th measurements points. Heart rate did not remarkably differ. In summary, the intensive, consecutive strength had a negative effect on peripheral system, and therefore on dynamic balance control. Cognitive ability indicated gradual deterioration, but showed optimal regeneration between loads.

Features of isolated systolic and resistant arterial hypertension in patients with type 2 diabetes mellitus

Hypertension and type 2 diabetes mellitus (DM) are often combined and mutually enhance the adverse effects on vascular and renal prognosis. One of the features of hypertension in type 2 diabetes is the frequent occurrence of isolated systolic hypertension (ISG) and resistant hypertension (RH). Objective. To study the features of the structure and function of the left ventricle (LV), categories of circadian rhythm during outpatient blood pressure monitoring (OBPM), as well as the structure and function of blood vessels in people with type 2 diabetes, depending on the presence or absence of ISG and RH. Materials and methods. An observational descriptive one-step study was conducted 139 patients with hypertension in combination with type 2 diabetes (64 men and 75 women aged 73.9±11.7 years). ISAG was isolated if systolic blood pressure (BP) exceeded 140 mmHg, and diastolic blood pressure was less than 90 mmHg. RH was determined if, despite lifestyle changes and taking three classes of antihypertensive drugs, it was not possible to achieve target blood pressure levels. All patients underwent OBPM, echocardiography, ultrasound examination of the brachiocephalic arteries and a reactive hyperemia test. Results. Among 139 patients with hypertension in combination with type 2 DM, systolic-diastolic hypertension was present in 80 (57.6%) cases, ISG in 59 (42.4%), RH in 57 (41.0%), hypertension without resistance to antihypertensive treatment in 82 (59.0%). Conclusions. Patients with ISG characterized by more pronounced and eccentric LV hypertrophy (LVH), types II and III of LV diastolic dysfunction (DD), the "non-dipper" category in OBPM, as well as a significant thickening of the intima-media complex (IMC) of the common carotid artery (CCA). Patients with RH characterized by more pronounced and concentric LVH, types II and III of LV DD, the "night-peaker" category in OBPM, significant thickening of the IMC CCA and impaired brachial artery response in the reactive hyperemia test.