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Objective Despite evidence-based guidelines stating that lipase alone should be used in the diagnosis of suspected acute pancreatitis, health care providers continue to order amylase or amylase and lipase together. The purpose of this study was to assess the utilization of appropriate laboratory testing related to the diagnosis of acute pancreatitis. Methods The study used a retrospective cross-sectional design. The timeframe was from January 1, 2020, to December 31, 2020. A retrospective chart review was used to collect data for the following: patient-provider encounter notes, patient demographics, provider demographics, differential and final diagnosis, and laboratory test results. Data analysis include stratification of categorical variables and calculation of cost savings. Results For the 12-month period, this study found 2567 (9.3%) of all amylase and lipase tests to be unnecessary. Amylase tests (1881; 73.2%) made up the most unnecessary tests followed by lipase tests (686; 26.7%). An analysis of test-ordering behavior by providers revealed that 81.5% of all unnecessary tests were ordered by MDs. Finally, this study estimated a total cost savings of $128,350 if all unnecessary tests were eliminated. Conclusion Our study demonstrated that amylase and lipase tests have been overutilized in the diagnosis of acute pancreatitis. [ABSTRACT FROM AUTHOR]

Background Transfusion services aim to maintain sufficient blood inventory to support patients, even with challenges introduced by COVID-19. Objectives To review blood usage and wastage before, during, and after COVID-19 surges, and to evaluate effects on inventory. Methods In a retrospective review, we evaluated the association between time periods corresponding to the initial wave of COVID-19 (pre–COVID-19, quarantine, and postquarantine) and blood usage/wastage. Data were stratified by period, and χ 2 testing was used to examine the association between these time periods and blood usage/wastage. Results In the period before COVID-19, the transfusion service used more units, and in the period after quarantine, more units went to waste. Across all time periods, the most-used product was RBCs, and the most wasted product was plasma. A statistically significant association existed between usage (χ 2 [6/3209 (0.2%)]) = 24.534; P ≤.001; Cramer V = 0.62), wastage (χ 2 [6/775 (0.8%)]) = 21.673; P =.001; Cramer V = 0.118), and time period. The postquarantine period displayed the highest wastage costs ($51,032.35), compared with the pre–COVID-19 period ($29,734.45). Conclusion Changes in blood inventory use and waste are significantly associated with the onset and continuation of COVID-19. [ABSTRACT FROM AUTHOR]

In this paper, first we consider some partitioned matrices having some special kind of blocks, and we obtain their eigenvalues and eigenvectors. From these, we deduce several results on the eigenvalues of partitioned matrices in the literature. Next we consider an extension of a generalized join of graphs introduced by Hedetniemi (On classes of graphs defined by special cutsets of lines. In: Many facets of graph theory. Proceedings of the conference held at Western MiGammagan University, Kalamazoo/Mi, 1968. Lecture notes in mathematics, vol 110, pp 171–189, 1969), we call it the M -join of H k . The spectra of partitioned matrices allow to detect the adjacency, the Laplacian and the signless Laplacian spectrum of old and new type of join of graphs. Further, we have constructed several pairs of simultaneously A-cospectral, L-cospectral and Q-cospectral graphs. [ABSTRACT FROM AUTHOR]

Primary amebic meningoencephalitis (PAM) is a fulminant fatal human disease caused by the free-living amoeba Naegleria fowleri. Infection occurs after inhalation of water containing the amoeba, typically after swimming in bodies of warm freshwater. N. fowleri migrates to the brain where it incites meningoencephalitis and cerebral edema leading to death of the patient 7 to 10 days postinfection. Although the disease is rare, it is almost always fatal and believed to be underreported. The incidence of PAM in countries other than the United States is unclear and possibly on track to being an emerging disease. Poor prognosis is caused by rapid progression, suboptimal treatment, and underdiagnosis. As diagnosis is often performed postmortem and testing is only performed by a few laboratories, more accessible testing is necessary. This article reviews the current methods used in the screening and confirmation of PAM and makes recommendations for improved diagnostic practices and awareness. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to examine appropriate utilization of antinuclear antibody (ANA) screening tests with follow-up subserology tests (reflex testing) for diagnosing systemic autoimmune rheumatic disorder (SARD). Methods We conducted a retrospective chart review of 3003 SARD-test orders at an academic teaching hospital from January to December 2019. Testing patterns were categorized as American College of Rheumatology (ACR)-recommended reflex testing, panel testing, or single subserology testing. We described testing patterns, assessed their diagnostic accuracy, and explored factors associated with reflex testing. Results Reflex testing accounted for 79.7% of SARD test-ordering, whereas improper testing (panel or single subserology) accounted for the other 20.3%. Reflex testing was associated with significantly more SARD diagnoses than improper testing (P  = .004). Testing patterns were significantly associated with race/ethnicity (P  = .008), with reflex testing being less frequent than improper testing in Hispanics and Whites. Conclusion In summary, one-fifth (20.3%) of testing patterns for suspected SARD did not follow the ACR-recommended guidelines for using reflex testing. Use of reflex testing was associated with an increased frequency of SARD diagnosis. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to evaluate the effects of Pan Genera Detection (PGD) testing on reducing platelet product wastage and transfusion service costs. Methods We conducted a retrospective cross-sectional study comparing the number of platelet apheresis units wasted before (March 2017 to February 2019) and after (March 2019 to February 2021) PGD implementation. The PGD testing was performed before transfusion on days 6 and 7. Cost analysis considered the costs of platelet units wasted ($500.00/unit) and PGD test supplies and performance (estimated $26.50 per test). Paired samples t -test was used to compare platelet wastage pre- and post-PGD implementation. Results The number of wasted platelet units decreased from pre-PGD (419) to post-PGD (195), representing a significant decrease in platelet wastage from 17.5% to 9.2% (P  < .0001). During the post-PGD period, 366 and 133 units were tested on days 6 and 7, with 28 and 36 units discarded each day, allowing transfusion of an additional 302 platelet units. Costs from platelet wastage decreased from $209,500.00 pre-PGD to $97,500.00 post-PGD. Conclusion Our results showed that PGD testing effectively reduced platelet wastage, extended platelet availability, and reduced transfusion service costs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to investigate the presence of silicon dioxide (SiO2) nanoparticles in o-toluidine monomer as a reactant and ammonium persulfate as an oxidant to obtain the poly(o-toluidine) (POT)/SiO2 nanocomposites by oxidative polymerization method. Design/methodology/approach: Fourier transformation infrared spectroscopy, X-ray diffraction and field emission scanning electron microscopy were used to characterize the structural properties of the composite. POT/SiO2 nanocomposites were mixed with acrylic resin through a solution mixing method and the composites were coated onto the surface of mild steel. Electrochemical measurements were used to determine the corrosion protection efficiency (P.E.%) of polymer composite coatings using 3.5% NaCl solution as corrosion environment. Findings: The results obtained reveals that the POT/SiO2/acrylic resin composite coatings have got higher corrosion P.E.% than that of POT/acrylic resin coatings. Originality/value: The formation of uniformly passive layer in the POT/SiO2 composite was used to enhance the P.E.% on mild steel surface. The POT/SiO2/acrylic resin nanocomposites showed effective anticorrosive behavior on mild steel in 3.5% NaCl solution. [ABSTRACT FROM AUTHOR]

Diagnostic Management Teams (DMTs) are one strategy for reducing diagnostic errors. This study examined errors in serology test selection after a positive antinuclear antibody (ANA) test in patients with suspected systemic autoimmune rheumatic disorder (SARD). This retrospective study included 246 patient cases reviewed by our ANA DMT from March to August 2019. The DMT evaluated the appropriateness of tests beyond ANA screening tests (overutilization, underutilization, or both) based on American College of Rheumatology recommendations and classified cases into diagnostic error or no error groups. Errors were quantified, and patient and provider characteristics associated with diagnostic errors were assessed. Among 246 cases, 60.6% had at least one diagnostic error in test selection. The number of sub-serology tests ordered was 2.4 times higher in the diagnostic error group than in the no error group. The likelihood of at least one diagnostic error was higher in males and African American/Black patients, although the differences were not statistically significant. Providers from general internal medicine, primary care, and non-rheumatology specialties were approximately two times more likely to make diagnostic errors than rheumatology specialists. Diagnostic errors in test selection after a positive ANA for patients with suspected SARD were common, although there were fewer errors when ordered by rheumatology specialists. These findings support the need to develop strategies to reduce diagnostic errors in test selection for autoimmunity evaluation and suggest that implementation of a DMT can be useful for providing guidance to clinicians to reduce overutilization and underutilization of laboratory tests. [ABSTRACT FROM AUTHOR]

In this study, the performance of carbon cloth (CC) modified with iodine (I2) doped polythiophene nanoparticles (PTh-NP) as an anode was investigated in a double chamber microbial fuel cell (MFC) for the purpose of simultaneous power generation and lead (Pb2+) removal using Shewanella putrefaciens as the biocatalyst. The CC with I2 doped PTh-NP displayed good electrochemical characteristics compared to pristine CC and the CC with undoped PTh-NP. A further increase in the electrical conductivity using the modified CC with biofilm was observed, which matured after 51 h, as evident from cyclic voltametry. The removal of lead for concentrations, viz., 20 ppm, 30 ppm, and 40 ppm, was analyzed. The optimum concentration was found to be 30 ppm with a maximum power density of 0.84 W/m2 and a current density of 1.45 A/m2 at an optimum resistance of 250 ohms. At the end of the process, total organic carbon (TOC) and Pb2+ removal of 95.1% and 89.6%, respectively, were obtained at the optimum concentration. Hence, this study demonstrates the possibility of utilizing MFC for treating low concentrated metal wastewater. [ABSTRACT FROM AUTHOR]