Diagnostic Test Results Research Articles

Myeloid/Lymphoid Neoplasms With Fibroblast Growth Factor Receptor 1 Rearrangement: A US Real-World Chart Review

Abstract Introduction/Objective Myeloid/lymphoid neoplasms (MLN) with fibroblast growth factor receptor 1 gene (FGFR1) rearrangement (MLNFGFR1) is a rare and aggressive hematologic malignancy characterized by molecular disruption of FGFR1 at the 8p11 locus. This real-world study describes demographic and clinical characteristics, diagnostic testing, and clinical outcomes in patients with MLNFGFR1 in the US. Methods/Case Report Probable MLNFGFR1 cases (n=51) were identified from a retrospective, physician-abstracted (5/29/2020-6/23/2020) chart review of patients within the US Cardinal Health Oncology Provider Extended Network (feasibility survey). In a subsequent full chart review (12/29/2020-3/4/2021), 33 of these probable MLNFGFR1 cases were considered to be confirmed based on additional 8p11/FGFR1 testing result data collected. Descriptive analyses of demographic/clinical characteristics, diagnostic testing, and clinical outcomes of patients with confirmed MLN FGFR1 were performed. Results (if a Case Study enter NA) The mean age at initial MLNFGFR1 diagnosis was 65.9 (SD 13.5) years, 60.6% patients were male, and 63.6% were white. Patients were managed by 12 physicians,10 in community practices. FGFR1 translocations were identified by karyotyping in 72.7% of patients. Rearrangements in FGFR1 were detected by fluorescence in situ hybridization, next generation sequencing, and/or real-time polymerase chain reaction in 66.7%, 21.2% and 6.1% of patients, respectively. FGFR1 rearrangement was detected in bone marrow aspirate and peripheral blood in 90.9% and 9.1% of patients, respectively. Fusion partners ZMYM2 and CPSF6 were reported in 46.2% and 15.4% of patients, respectively, and BCR, CUX1, RANBP2, TPR, and MYO18A were reported in 7.7% of patients each. Conclusion Although rare, patients with MLNFGFR1 do present in US community practice settings. Conventional cytogenetics can identify FGFR1 translocations which can be confirmed by FISH with FGFR1 break-apart probes. NGS can be used to identify cryptic rearrangements when clinical suspicion is high but no rearrangement is present on FISH. In addition to diagnosis, RT-PCR is also useful to assess molecular response.

Evaluating the clinical validity of genes related to hemostasis and thrombosis using the Clinical Genome Resource gene curation framework

BackgroundInherited bleeding, thrombotic, and platelet disorders (BTPDs) are a heterogeneous set of diseases, many of which are very rare globally. Over the past 5 decades, the genetic basis of some of these disorders has been identified, and recently, high-throughput sequencing has become the primary means of identifying disease-causing genetic variants. ObjectivesKnowledge of the clinical validity of a gene-disease relationship is essential to provide an accurate diagnosis based on results of diagnostic gene panel tests and inform the construction of such panels. The Scientific and Standardization Committee for Genetics in Thrombosis and Hemostasis undertook a curation process for selecting 96 TIER1 genes for BTPDs. The purpose of the process was to evaluate the evidence supporting each gene-disease relationship and provide an expert-reviewed classification for the clinical validity of genes associated with BTPDs. MethodsThe Clinical Genome Resource (ClinGen) Hemostasis/Thrombosis Gene Curation Expert Panel assessed the strength of evidence for TIER1 genes using the semiquantitative ClinGen gene-disease clinical validity framework. ClinGen Lumping and Splitting guidelines were used to determine the appropriate disease entity or entities for each gene, and 101 gene-disease relationships were identified for curation. ResultsThe final outcome included 68 Definitive (67%), 26 Moderate (26%), and 7 Limited (7%) classifications. The summary of each curation is available on the ClinGen website. ConclusionExpert-reviewed assignment of gene-disease relationships by the ClinGen Hemostasis/Thrombosis Gene Curation Expert Panel facilitates accurate molecular diagnoses of BTPDs by clinicians and diagnostic laboratories. These curation efforts can allow genetic testing to focus on genes with a validated role in disease.

OGC P56 Preliminary results from the use of a symptom response questionnaire following pyloric dilatation for delayed gastric emptying post-oesophagectomy

Abstract Background Patient symptom burden following oesophago-gastrectomy is high with numerous potential underlying causes which can often overlap. Diagnostic test results and the symptom response to a given intervention may provide important insights, yet there are no validated questionnaires to support the latter. Delayed gastric emptying is a common problem after oesophagectomy, significantly affecting patients' quality of life. The most common treatment option is to perform an endoscopic pyloric dilatation. However, there is no tool available to measure its effect on patient's quality of life. We have developed a symptom response questionnaire to evaluate the impact of the pyloric dilatation procedure. Methods With patient involvement, a symptom response to treatment questionnaire was developed based on validated EORTC symptom questions. Although designed to assess symptom response to any intervention, consecutive patients referred for suspected delayed gastric emptying who received an endoscopic pyloric dilatation from a single center were included in this study. Patients were contacted by telephone at two and four weeks after the procedure to complete the symptom response questionnaire. The investigators contacting the patients were neither their surgeon nor the one who performed the endoscopic procedure. We excluded all patients receiving other endoscopic treatment than a pyloric dilatation. Results 27 patients responded to the questionnaire at 2 and 4 weeks. The main reported symptoms were dysphagia in 15 patients (58%) and reflux in 6 patients (21%). An improvement in symptom frequency was noted in 23 patients (85%) at two weeks. A subsequent worsening in the patient symptom frequency was noted in 3 patients (8.8%) between two and four weeks. Regarding the severity of the symptom, an improvement was observed in 24 out of 27 patients (88%) after two weeks, and no patients reported a worsening of symptom severity at the four-weeks call. Conclusions The symptom response questionnaire aimed at evaluating the impact of pyloric dilatation was easily implemented and well-received by the patients for completion. By providing a structured and patient-centred approach, this questionnaire can serve as a basis for monitoring and understanding the effectiveness of endoscopic interventions in improving the quality of life for patients with delayed gastric emptying. An electronic version of the questionnaire has been developed and will be tested in the near future.

Diagnostic Utility of Cerebrospinal Fluid Biomarkers in Patients with Rapidly Progressive Dementia.

This study was undertaken to apply established and emerging cerebrospinal fluid (CSF) biomarkers to improve diagnostic accuracy in patients with rapidly progressive dementia (RPD). Overlap in clinical presentation and results of diagnostic tests confounds etiologic diagnosis in patients with RPD. Objective measures are needed to improve diagnostic accuracy and to recognize patients with potentially treatment-responsive causes of RPD. Biomarkers of Alzheimer disease neuropathology (amyloid-β 42/40 ratio, phosphorylated tau [p-tau181, p-tau231]), neuroaxonal/neuronal injury (neurofilament light chain [NfL], visinin-like protein-1 [VILIP-1], total tau), neuroinflammation (chitinase-3-like protein [YKL-40], soluble triggering receptor expressed on myeloid cells 2 [sTREM2], glial fibrillary acidic protein [GFAP], monocyte chemoattractant protein-1 [MCP-1]), and synaptic dysfunction (synaptosomal-associated protein 25kDa, neurogranin) were measured in CSF obtained at presentation from 78 prospectively accrued patients with RPD due to neurodegenerative, vascular, and autoimmune/inflammatory diseases; 35 age- and sex-matched patients with typically progressive neurodegenerative disease; and 72 cognitively normal controls. Biomarker levels were compared across etiologic diagnoses, by potential treatment responsiveness, and between patients with typical and rapidly progressive presentations of neurodegenerative disease. Alzheimer disease biomarkers were associated with neurodegenerative causes of RPD. High NfL, sTREM2, and YKL-40 and low VILIP-1 identified patients with autoimmune/inflammatory diseases. MCP-1 levels were highest in patients with vascular causes of RPD. A multivariate model including GFAP, MCP-1, p-tau181, and sTREM2 identified the 44 patients with treatment-responsive causes of RPD with 89% accuracy. Minimal differences were observed between typical and rapidly progressive presentations of neurodegenerative disease. Selected CSF biomarkers at presentation were associated with etiologic diagnoses and treatment responsiveness in patients with heterogeneous causes of RPD. The ability of cross-sectional biomarkers to inform upon mechanisms that drive rapidly progressive neurodegenerative disease is less clear. ANN NEUROL 2024;95:299-313.

Peningkatan Minat Belajar Melalui Metode Role Playing berbasis PBL pada Kurikulum Merdeka

Implementing learning in an independent curriculum gives teachers freedom in designing learning. Based on the results of observations and diagnostic tests carried out in class, this shows low interest. The PBL learning model using the role-playing method is believed to be able to increase interest in learning biology through fun activities and student involvement. This research includes classroom action research, which consists of planning, implementation, observation, and reflection stages in two cycles carried out in the 2022–2023 academic year in class XA of BPPT Darus Sholah Superior High School. Data on learning interest was obtained from observation sheets and closed questionnaires. The results of the research showed that there was an increase in the average score from cycle I to cycle II, namely from 67.93% to 77.12%, so that the PBL model using the role-playing method could increase students' interest in learning biology lessons.

Suitability Analysis of Gram Staining with Blood Culture in Bacteremia

Bacteremia is a serious bloodstream infection, requiring blood culture as the gold standard for definitive diagnosis and rational therapy, but it is time-consuming. The Gram stain should be considered as an alternative test, as it is easier and faster to determine empirical antibiotic therapy in order to minimize the use of broad-spectrum antibiotics. This study aimed to analyze the suitability of Gram staining results with blood cultures in bacteremia. Cross-sectional study design from August to September 2022 at Dr. Wahidin Sudirohusodo Hospital and Labuan Baji Hospital, Makassar. The study sample used specimens from automatic positive blood culture bottles of new bacteremia patients. Gram staining and sub-culture were performed to determine the type of Gram-positive or negative bacteria. Appropriate statistical analysis was used to compare the two methods. A total of 78 research samples were obtained. The results of subculture vs. Gram staining showed Gram-positive bacteria in 45 vs. 42 samples and Gram-negative bacteria in 33 vs. 36 samples, respectively. A comparative test using the Wilcoxon test showed no significant difference for the 2 tests, p-value = 0.257 (p > 0.05). The results of the Gram diagnostic test on culture showed high sensitivity and specificity, respectively: 88.9%, and 93.9% for Gram-positive bacteria, 93.9% and 88.9% for Gram-negative bacteria. Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were 95.32% and 95.32% for Gram-positive, 86.11%, and 95.23 % for Gram-negative bacteria, respectively. There is a suitability between Gram stain and automatic blood culture results with high diagnostic value. Gram staining is expected to be a guide for selecting empirical therapy based on Gram's classification until the AST test results come out.

Prognosis, Risk Factors, and Clinical Features of Intraocular Recurrence in Primary Vitreoretinal Lymphoma

PurposeTo investigate the clinical features, risk factors, and prognosis of the intraocular recurrence in primary vitreoretinal lymphoma (PVRL). DesignRetrospective case-control study. Participants97 eyes of 51 patients diagnosed with PVRL between 2011/12 and 2021/1 were enrolled in this study. 14 patients among them had experienced intraocular recurrence. MethodsDate on demographic and ophthalmic characteristics, results of diagnostic tests, treatments, prognosis of intraocular recurrence and non-recurrence PVRL patients were collected and compared. Multivariate logistic regression was used to identify independent risk factors. And receiver operating characteristic curve was conducted to determine the cut-off values. Main Outcome MeasuresClinical features and risk factors. Results14 (19 eyes) of 51 PVRL patients had intraocular recurrences, resulting in a recurrence rate of 27.5% over a mean follow-up period of 42.5 months. No difference was observed in central nervous system lymphoma (CNSL) relapse rate (54.3% vs. 64.3%, p=0.523) and median time to CNSL (36.5 95%CI [24.6-48.3] vs. 37.3 95%CI [24.8-49.8], p=0.777) between intraocular non-recurrence and intraocular recurrence groups. Furthermore, there were no statistically significant difference in the survival outcomes, such as mortality (28.6% vs. 29.7%, p=1.000) and median overall survival (70.8 95%CI [54.0-87.7] vs. 59.2 95%CI [44.8-73.6], p=0.297), between these two groups. Younger onset age (odds ratio [OR] 0.90, 95% confidence intervals [CI] 0.84-0.98, p=0.010), isolated PVRL (OR 35.3, 95%CI 2.08-600.0, p=0.014), and no history of intravitreal chemotherapy (OR 7.72, 95%CI 1.37-43.6, p=0.021) were identified as independent risk factors for intraocular recurrences. Of the patients with intraocular recurrence, 23.6% were asymptomatic and were diagnosed during routine follow-up. The rate of interleukin-10 (IL-10) /IL-6>1 was significantly lower than that at diagnosis (43.8% vs. 92.3%, p=0.008). However, the rate of IL-10≥50 pg/mL was high (81.3%) and not significantly different from that at diagnosis (92.3%, p=0.606). ConclusionsThis study did not identify an impact of intraocular recurrence on CNS manifestations or survival outcomes in patients with PVRL. Younger patients have a higher risk of intraocular recurrence, and combined systemic and intravitreal chemotherapy may reduce intraocular recurrence. Regular ophthalmic follow-up and IL-10 testing are recommended to detect intraocular recurrence.

The Effectiveness and Safety of Cupping Therapy on CV8 Shenque for Urticaria; a Protocol for Systematic Review and Meta-Analysis.

Urticaria is a common mast-cell-driven disease that poses a great burden on patients and society. Suggested therapeutic methods include avoidance of triggers and the use of medications, such as H1-antihistamines; however, limitations remain regarding efficacy, dealing with comorbidities, and adverse events. Cupping therapy (CT) at CV8 Shenque has been used in traditional Chinese medicine for the treatment of various dermatological diseases, including urticaria. The efficacy of the treatment has been revealed by previous clinical trials and case reports. This study was performed to provide a protocol for a systematic review and meta-analysis to analyze the effectiveness and safety of CT at CV8 Shenque for urticaria patients. Searches of electronic databases using manual searches and contact with the corresponding authors will be performed using predefined criteria for all randomized controlled trials on CT at CV8 Shenque for urticaria patients. Every part of the process will be conducted by two independent researchers, with conflicts being solved by a third author. The primary outcomes will be symptom scores, quality of life, and effective rate. Secondary outcomes will be adverse events and diagnostic test results. RevMan 5.4 software will be used to perform the meta-analysis. The Cochrane Collaboration "Risk of bias" tool will be used for risk of bias judgments. Our study will evaluate the effectiveness and safety of CT at CV8 Shenque as a treatment option for urticaria. This systematic review is the first to investigate the effect of CT at CV8 Shenque for urticaria patients. Our study will provide objective evidence of an alternative approach to urticaria for clinicians and patients. PROSPERO (Registration number: CRD42023434913).

A Diagnostic Study on English Spelling Errors Among the Elementary School Children in India

Learning the four skills of the English language is a requirement for pupils to utilize the language effectively, given the importance of learning it for both school and profession. Spelling – an important part of writing skill – is considered to be fundamental for written texts. The real meaning of a piece of writing can be changed by spelling mistakes, making it more challenging to understand. In India, teaching spelling is frequently overlooked while teaching English as a second language. The research attempts to determine the current level of spelling proficiency among Indian primary school students as well as the gaps and issues they encounter when spelling English words. The research approach used for this investigation was a form of descriptive survey. Children attending Jalpaiguri Municipal Corporation's elementary school in West Bengal, India, served as the study's sample. Normal probability curves and Ogive were created to analyze the frequency distribution of the English Diagnostic Test results. Central tendencies of the sample and sub-samples were studied. According to the study, spelling proficiency among elementary school students differs significantly depending on whether they attend government or non-government schools, even though there is no statistically significant difference between them based on gender and the medium of instruction they receive.

An Analysis of the Biotin-(Strept)avidin System in Immunoassays: Interference and Mitigation Strategies.

An immunoassay is an analytical test method in which analyte quantitation is based on signal responses generated as a consequence of an antibody-antigen interaction. They are the method of choice for the measurement of a large panel of diagnostic markers. Not only are they fully automated, allowing for a short turnaround time and high throughput, but offer high sensitivity and specificity with low limits of detection for a wide range of analytes. Many immunoassay manufacturers exploit the extremely high affinity of biotin for streptavidin in their assay design architectures as a means to immobilize and detect analytes of interest. The biotin-(strept)avidin system is, however, vulnerable to interference with high levels of supplemental biotin that may cause elevated or suppressed test results. Since this system is heavily applied in clinical diagnostics, biotin interference has become a serious concern, prompting the FDA to issue a safety report alerting healthcare workers and the public about the potential harm of ingesting high levels of supplemental biotin contributing toward erroneous diagnostic test results. This review includes a general background and historical prospective of immunoassays with a focus on the biotin-streptavidin system, interferences within the system, and what mitigations are applied to minimize false diagnostic results.

Performance of the Equities and Bond Markets in Nigeria: A Comparative Investigation

This work comparatively examined the performance of the Nigerian equities and bond markets vis-à-vis the output of the Nigerian economy from 1987 – 2019. Number of listed securities, number of deals, value of deals and market capitalization were the market performance indicators considered, while real GDP was used to measure output of the Nigerian economy. Data for the study were sourced from Central Bank of Nigeria (CBN) and Securities and Exchange Commission (SEC) Statistical bulletins. The data generated for the study were subjected to stationarity test using ADF criterion, co-integration test using bounds approach, and diagnostic tests which covered testing for the presence of serial correlation, heteroscedasticity and distribution of the error term. Stationarity test result revealed that all the variables were integrated of order zero or one. Co-integration test result showed that a long-run relationship exists between the variables. Diagnostic test results indicated that both models were not serially correlated while the variances of the random variables were not heteroscedastic. However, the errors of the models were not normally distributed. Nevertheless, the ARDL model for parameter estimation process revealed that lagged real GDP, number and value of deals in the equities market have positive relationships with current period real GDP; while number of listed securities and market capitalization has negative relationships with real GDP. Additionally, only number of listed securities and number of deals in the equities market were statistically significant. In the bond market, all the variables except number of listed securities have positive relationships with real GDP, but none of the considered market performance indicators was statistically significant in the market. Nonetheless, the equities market has about 67.58% influence on real GDP in Nigeria; while bond market has about 45.22% influence on the country’s real GDP within the per

Prenatal cfDNA Screening for Emanuel Syndrome and Other Unbalanced Products of Conception in Carriers of the Recurrent Balanced Translocation t(11;22): One Laboratory's Retrospective Experience.

Prenatal cell-free DNA screening (cfDNA) can identify fetal chromosome abnormalities beyond common trisomies. Emanuel syndrome (ES), caused by an unbalanced translocation between chromosomes 11 and 22, has lacked a reliable prenatal screening option for families with a carrier parent. A cohort of cases (n = 46) sent for cfDNA screening with indications and/or results related to ES was queried; diagnostic testing and pregnancy outcomes were requested and analyzed. No discordant results were reported or suspected; there were ten true positives with diagnostic confirmation, six likely concordant positives based on known translocations and consistent cfDNA data, and twenty-six true negatives, by diagnostic testing or birth outcomes. For cases with parental testing, all affected ES cases had maternal translocation carriers. Expanded cfDNA may provide reassurance for t(11;22) carriers with screen negative results, and screen positive results appear to reflect a likely affected fetus, especially with a known maternal translocation. Current society guidelines support the use of expanded cfDNA screening in specific circumstances, such as for translocation carriers, with appropriate counseling. Diagnostic testing is recommended for prenatal diagnosis of ES and other chromosome abnormalities in pregnancy. To our knowledge, this cohort is the largest published group of cases with prenatal screening for carriers of t(11;22).

Neglected SARS-CoV-2 variants and potential concerns for molecular diagnostics: a framework for nucleic acid amplification test target site quality assurance.

During the COVID-19 pandemic, SARS-CoV-2 detection using nucleic acid amplification tests (NAATs) played a key role in clinical management and public health interventions. However, mutations could jeopardize NAAT-based detection if they occur in the NAAT target site, potentially resulting in false negative results. However, mutation monitoring is challenged as the exact location of commercial NAAT target sites is not divulged by manufacturers. This study sequenced commercial SARS-CoV-2 NAAT target sites to assess the impact of mutations occurring in these regions. The resulting sequences for the Xpert, Cobas, and ID NOW SARS-CoV-2 assays were queried against SARS-CoV-2 genome databases to identify mutations in circulating strains. Synthetic DNAs and clinical specimens harboring NAAT target site mutations were used to assess mutation impact. Of 17,600 NAAT target site mutation occurrences in a genome database, 269 compromised target detection. These represented 24 unique mutations that reduced NAAT target sensitivity and nine led to target detection failure. Only seven of these mutations were previously recognized. Overall, this reactive strategy along with passive surveillance identified 29 novel mutations that compromised detection with Xpert and Cobas targets. Knowledge of commercial NAAT target sites, paired with a strategy for mutation impact assessment and ongoing genetic surveillance, provided a robust framework for commercial NAAT target site quality assurance. The question remains of who should be responsible for NAAT target site quality assurance, but collaborative efforts between methods users, industry, and regulatory agencies would be ideal. Molecular tests like polymerase chain reaction were widely used during the COVID-19 pandemic but as the pandemic evolved, so did SARS-CoV-2. This virus acquired mutations, prompting concerns that mutations could compromise molecular test results and be falsely negative. While some manufacturers may have in-house programs for monitoring mutations that could impact their assay performance, it is important to promptly report mutations in circulating viral strains that could adversely impact a diagnostic test result. However, commercial test target sites are proprietary, making independent monitoring difficult. In this study, SARS-CoV-2 test target sites were sequenced to monitor and assess mutations impact, and 29 novel mutations impacting SARS-CoV-2 detection were identified. This framework for molecular test target site quality assurance could be adapted to any molecular test, ensuring accurate diagnostic test results and disease diagnoses.

Minimizing uncertainty in prevalence estimates

Estimating prevalence q, the fraction of a population with a specific medical condition, is fundamental to epidemiology. Traditional methods address this task by using a diagnostic test outcome r∈Γ⊂Rn to classify and count samples, but such approaches suffer from bias and uncontrolled uncertainty. Recently we showed that unbiased prevalence estimates can be constructed in terms of measures of conditional probability distributions on arbitrary sets D± that partition Γ. In this work, we minimize the variance of this estimator by optimizing the partition itself. In particular, we employ a bathtub principle to recast optimization over the D± in terms of a one-dimensional problem depending only on the total probability mass in these sets. Using symmetry, we show that the resulting objective function is well behaved and can be numerically optimized.

Correlation of SARS-CoV-2 in Wastewater and Individual Testing Results in a Jail, Atlanta, Georgia, USA.

Institution-level wastewater-based surveillance was implemented during the COVID-19 pandemic, including in carceral facilities. We examined the relationship between COVID-19 diagnostic test results of residents in a jail in Atlanta, Georgia, USA (average population ≈2,700), and quantitative reverse transcription PCR signal for SARS-CoV-2 in weekly wastewater samples collected during October 2021‒May 2022. The jail offered residents rapid antigen testing at entry and periodic mass screenings by reverse transcription PCR of self-collected nasal swab specimens. We aggregated individual test data, calculated the Spearman correlation coefficient, and performed logistic regression to examine the relationship between strength of SARS-CoV-2 PCR signal (cycle threshold value) in wastewater and percentage of jail population that tested positive for COVID-19. Of 13,745 nasal specimens collected, 3.9% were COVID-positive (range 0%-29.5% per week). We observed a strong inverse correlation between diagnostic test positivity and cycle threshold value (r=-0.67; p<0.01). Wastewater-based surveillance represents an effective strategy for jailwide surveillance of COVID-19.

Collaboration during the diagnostic decision‐making process: When does it help?

AbstractWhen making complex decisions, such as a medical diagnosis, decision makers typically gather, analyze, and synthesize (integrate) information. In a previous study, we showed that delegating such complex decisions to collaborating pairs increases decision quality substantially compared to that of individuals, without requiring different information gathering. Given the higher costs associated with teamwork, however, it is of great practical interest to understand when in the process the performance benefits of teams may arise, so that particular subtasks can be delegated to teams when most appropriate. We thus conducted an experimental study in which fourth‐year medical students (n = 109) worked either in pairs or alone on two separate subtasks of the diagnostic process: (1) analyzing diagnostic test results (e.g., X‐rays) and (2) integrating previously interpreted test results into diagnoses. Linear mixed‐effects models revealed a small benefit of collaborating pairs over individuals in both subtasks. We conclude that collaborating with a peer may pay off both when analyzing information and when integrating it into a diagnosis as it provides the opportunity to correct each other's errors and to make use of a greater knowledge base. These findings encourage the strategic use of collaboration with a colleague when making complex decisions. Further research into the underlying processes is needed.

Mining equipment diagnostics in a mine shaft dewatering system – case study

Maintenance issues in mines are particularly important due to the type and complexity of equipment in operation or working in hostile (even extreme) conditions. In this context, the need to ensure continuous/regular maintenance of machinery, identify potential hazards and ensure operational safety seems to be a challenge. Moreover, selecting an appropriate maintenance method is crucial for a mine, both economically and in technical/organizational terms. This study aims to present the preliminary results of diagnostic tests for pumps performing operational tasks in a mine shaft dewatering system. In addition, this study focused on a detailed discussion of the basic elements of the mine shaft dewatering system and the technical objects studied. A preliminary operational test plan for the investigated pumps operating in the mine shaft dewatering system is also presented. This enabled a discussion of the results obtained from the tests of the first quarter of 2023. The tests used three basic diagnostic methods: vibration analysis, thermal imaging and acoustic testing. Potential directions for further research in the analyzed area were also indicated.

B-150 Impact of Clinical Catastrophic Events on Individual Reference Values for 20 Analytes: Results of a Six-Measurement Study.

Abstract Reference values are an essential aspect of clinical laboratory testing, providing a basis for comparison of results against established norms for specific patient populations. These reference values are used to evaluate diagnostic test results, monitor disease progression, and assess treatment effectiveness. The accuracy and reliability of these values are crucial to the diagnosis and treatment of disease and illness and also important in the monitoring of disease progression and treatment effectiveness. By tracking changes in test results over time, healthcare providers can assess the effectiveness of treatments and make adjustments as needed. This information is critical in the management of chronic conditions such as diabetes and hypertension. Despite their importance, reference values can be subject to variability due to a variety of factors. These include differences in laboratory testing procedures, variations in patient populations, and differences in the methods used to establish reference ranges. To address these issues, clinical laboratories can use individual references calculated based on previous test results. Nevertheless, individual reference values can be subjected to pathophysiological alterations that can modify the values of specific analytes. The aim of this study was to investigate the impact of a clinical catastrophic event, specifically troponin levels above 1000, on the calculation of individual reference values for 21 analytes. Six measurements were taken before and after the event from a sample of 5 to 450 patients. The results showed that the mean and covariance coefficient of the majority of the analytes remained unchanged despite the presence of the clinical event. Applying a Wilcoxon test to the mean before and after the event 10 out of the 21 analytes differ significantly before and after the event. These analytes included glucose, BNP, chloride, gamma GT, hematocrit, hemoglobin, potassium, C-reactive protein and urea. The mean and covariance of the remaining 11 analytes, which included platelets, creatinine, alkaline phosphatase, magnesium, sodium, AST, ALT, TSH, fibrinogen, prothrombin time, and activated partial thromboplastin time (aPTT), were not significantly impacted by the clinical event. These results suggest that despite the presence of a clinical catastrophic event, individual reference values can still be calculated for the majority of the analytes. This is important for the accurate interpretation of clinical laboratory test results, especially in the presence of acute illnesses or injuries. However, caution should be exercised when interpreting results for the three analytes that were significantly impacted by the event. Further studies are needed to determine if similar results can be obtained for other clinical catastrophic events and analytes.

Acute and early-onset cardiotoxicity in children and adolescents with cancer: a systematic review

BackgroundCardiotoxicity is among the most important adverse effects of childhood cancer treatment. Anthracyclines, mitoxantrone and radiotherapy involving the heart are its main causes. Subclinical cardiac dysfunction may over time progress to clinical heart failure. The majority of previous studies have focused on late-onset cardiotoxicity. In this systematic review, we discuss the prevalence and risk factors for acute and early-onset cardiotoxicity in children and adolescents with cancer treated with anthracyclines, mitoxantrone or radiotherapy involving the heart.MethodsA literature search was performed within PubMed and reference lists of relevant studies. Studies were eligible if they reported on cardiotoxicity measured by clinical, echocardiographic and biochemical parameters routinely used in clinical practice during or within one year after the start of cancer treatment in ≥ 25 children and adolescents with cancer. Information about study population, treatment, outcomes of diagnostic tests used for cardiotoxicity assessment and risk factors was extracted and risk of bias was assessed.ResultsOur PubMed search yielded 3649 unique publications, 44 of which fulfilled the inclusion criteria. One additional study was identified by scanning the reference lists of relevant studies. In these 45 studies, acute and early-onset cardiotoxicity was studied in 7797 children and adolescents. Definitions of acute and early-onset cardiotoxicity prove to be highly heterogeneous. Prevalence rates varied for different cardiotoxicity definitions: systolic dysfunction (0.0–56.4%), diastolic dysfunction (30.0–100%), combinations of echocardiography and/or clinical parameters (0.0–38.1%), clinical symptoms (0.0–25.5%) and biomarker levels (0.0–37.5%). Shortening fraction and ejection fraction significantly decreased during treatment. Cumulative anthracycline dose proves to be an important risk factor.ConclusionsVarious definitions have been used to describe acute and early-onset cardiotoxicity due to childhood cancer treatment, complicating the establishment of its exact prevalence. Our findings underscore the importance of uniform international guidelines for the monitoring of cardiac function during and shortly after childhood cancer treatment.

Diagnosis of periprosthetic joint infections in patients who have rheumatoid arthritis.

To investigate the optimal thresholds and diagnostic efficacy of commonly used serological and synovial fluid detection indexes for diagnosing periprosthetic joint infection (PJI) in patients who have rheumatoid arthritis (RA). The data from 348 patients who had RA or osteoarthritis (OA) and had previously undergone a total knee (TKA) and/or a total hip arthroplasty (THA) (including RA-PJI: 60 cases, RA-non-PJI: 80 cases; OA-PJI: 104 cases, OA-non-PJI: 104 cases) were retrospectively analyzed. A receiver operating characteristic curve was used to determine the optimal thresholds of the CRP, ESR, synovial fluid white blood cell count (WBC), and polymorphonuclear neutrophil percentage (PMN%) for diagnosing RA-PJI and OA-PJI. The diagnostic efficacy was evaluated by comparing the area under the curve (AUC) of each index and applying the results of the combined index diagnostic test. For PJI prediction, the results of serological and synovial fluid indexes were different between the RA-PJI and OA-PJI groups. The optimal cutoff value of CRP for diagnosing RA-PJI was 12.5 mg/l, ESR was 39 mm/hour, synovial fluid WBC was 3,654/μl, and PMN% was 65.9%; and those of OA-PJI were 8.2 mg/l, 31 mm/hour, 2,673/μl, and 62.0%, respectively. In the RA-PJI group, the specificity (94.4%), positive predictive value (97.1%), and AUC (0.916) of synovial fluid WBC were higher than those of the other indexes. The optimal cutoff values of synovial fluid WBC and PMN% for diagnosing RA-PJI after THA were significantly higher than those of TKA. The specificity and positive predictive value of the combined index were 100%. Serum inflammatory and synovial fluid indexes can be used for diagnosing RA-PJI, for which synovial fluid WBC is the best detection index. Combining multiple detection indexes can provide a reference basis for the early and accurate diagnosis of RA-PJI.