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Background: Bipolar disorder is one of the most burdensome severe mental disorders, characterized by high levels of personal and social disability. Patients often need an integrated pharmacological and non-pharmacological approach. Lithium is one of the most effective treatments available not only in psychiatry, but in the whole medicine, and its clinical efficacy is superior to that of other mood stabilizers. However, a declining trend on lithium prescriptions has been observed worldwide in the last 20 years, supporting the notion that lithium is a 'forgotten drug' and highlighting that the majority of patients with bipolar disorder are missing out the best available pharmacological option. Based on such premises, a narrative review has been carried out on the most common "misconceptions" and "stereotypes" associated with lithium treatment; we also provide a list of "good reasons" for using lithium in ordinary clinical practice to overcome those false myths. Main text: A narrative search of the available literature has been performed entering the following keywords: "bipolar disorder", "lithium", "myth", "mythology", "pharmacological treatment", and "misunderstanding". The most common false myths have been critically revised and the following statements have been proposed: (1) Lithium should represent the first choice for the treatment of patients with bipolar disorder; (2) lithium treatment is effective in different patients' groups suffering from bipolar disorder; (3) Drug–drug interaction risk can be easily managed during lithium treatment; (4) The optimal management of lithium treatment includes periodical laboratory tests; (5) Slow-release lithium formulation has advantages compared to immediate release formulation; (6) Lithium treatment has antisuicidal properties; (7) Lithium can be carefully managed during pregnancy. Conclusions: In recent years, a discrepancy between evidence-based recommendations and clinical practice in using lithium treatment for patients with bipolar disorder has been highlighted. It is time to disseminate clear and unbiased information on the clinical efficacy, effectiveness, tolerability and easiness to use of lithium treatment in patients with bipolar disorder. It is necessary to reinvigorate the clinical and academic discussion about the efficacy of lithium, to counteract the decreasing prescription trend of one of the most effective drugs available in the whole medicine. [ABSTRACT FROM AUTHOR]

Background: Onychomycosis is the commonly encountered problem especially in adults. Appears as a simple cosmetic problem infected nails, but have significant effect on patients emotional, occupational and social aspects, also serve as reservoir of mycotic infection and can give rise to repeated skin infections. Dermatophytes are the principal pathogens. Objectives: Isolation and identification of fungal agents causing onychomycosis and to study the predisposing factors with their clinical presentations. Methods: Appropriate samples from 50 patients with a diagnosis of onychomycosis were included in study for a duration of one year, from July 2012 to August-2013. Nails were collected in sterile black craft paper envelopes of 5x5 cms after disinfection and nail borings from nail bed. These were subjected to 20 to 40% KOH mount, routine Culture on SDA with antibiotics and cycloheximide. Isolates were identified based on colony morphology and biochemical reactions. Results: In a sample size of 50, dermatophytes were predominant agents 70.58% compared to non-dermatophytes 29.4%, 78% were males and 22% were females. In these cases distal and lateral sububgual onychomycosis (60%) was the most common clinical presentation followed by proximal subungual onychomycosis (20%). Total positive culture cases were 17 (34%), among which Trichophyton rubrum 41.17% was predominant followed by T.mentagrophytes 17.6%. Conclusion: Not all nail dystrophies are fungal in origin, an accurate laboratory diagnosis of onychomycosis is must, as been shows in this study. Dermatophytes were predominant etiological agents among which T.rubrum was most common Changing. Systemic and local predisposing factors were diabetes, anemia, traumatic injury, hands submerged in water for prolonged time. [ABSTRACT FROM AUTHOR]

With more than 23 million infections and more than 814,000 deaths worldwide, the coronavirus disease-2019 (COVID-19) pandemic is still far from over. Several classes of drugs including antivirals, antiretrovirals, anti-inflammatory, immunomodulatory, and antibiotics have been tried with varying levels of success. Still, there is lack of any specific therapy to deal with this infection. Although less than 30% of these patients require intensive care unit admission, morbidity and mortality in this subgroup of patients remain high. Hence, it becomes imperative to have general principles to guide intensivists managing these patients. However, as the literature emerges, these recommendations may change and hence, frequent updates may be required. [ABSTRACT FROM AUTHOR]

Laboratory investigations provide physicians with objective data to aid in disease diagnosis, clinical decision making, and patient follow up. Clinical interpretation of laboratory test results relies heavily on the availability of appropriate population-based reference intervals (i.e. normative values) or decision limits developed through clinical outcome studies. Although reference intervals are fundamental to accurate laboratory test interpretation, and thus critically important to healthcare, the need for sound evidence-based reference intervals has been largely overlooked, particularly in the pediatric population. In the field of pediatric laboratory medicine, accurate age- and sex-specific reference intervals established using samples from healthy children and adolescents have not been readily available, forcing many clinical laboratories to report adult reference intervals with pediatric test results. When pediatric reference intervals are available, they have often been established with a small sample size, inpatient or outpatient samples, outdated methodologies, and/or inappropriate statistical procedures. To address these unacceptable limitations, several national and global initiatives have begun to close the critical evidence gaps in pediatric reference intervals. Notably, the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) has made significant strides towards improving pediatric healthcare in Canada and globally. The present report is a white paper summarizing CALIPER, and provides a comprehensive compendium of the data generated through this project over the past decade as a single resource for clinical laboratory specialists, clinicians, and other healthcare workers. CALIPER launched an outreach campaign in 2008 to recruit healthy community children and adolescents, and developed a robust statistical algorithm, in accordance with the Clinical and Laboratory Standards Institute (CLSI) guidelines, to develop accurate age- and sex-specific pediatric reference intervals. The first CALIPER direct reference interval study was published in 2012, with age- and sex-specific reference intervals reported for 40 common biochemical markers. To date, CALIPER has collected health information and blood samples from over 9700 community children and adolescents, and has established a comprehensive database of age- and sex-specific reference intervals for over 100 biomarkers of pediatric disease. CALIPER has also performed a series of transference and verification studies to expand the applicability of the CALIPER database to five major analytical platforms, including Abbott, Beckman, Ortho, Roche, and Siemens. Through novel knowledge translation initiatives, the CALIPER Reference Interval Database has been made freely available online (www.caliperproject.ca) as well as on a mobile application (CALIPER Reference App), and it is used by clinical laboratories across Canada, the United States, and globally. In addition to establishing this comprehensive pediatric reference interval database, CALIPER has also performed a series of sub-studies, including examining how reference intervals are affected by pre-analytical factors (i.e. sample stability at specific storage conditions, fasting status and time of sample collection), biological variation (i.e. intraindividual and interindividual biological variation, reference change values), and ethnicity and pubertal development stage. In this white paper, extensive tables of pediatric reference intervals are provided for easy reference for clinical laboratories worldwide. All data reported have been published in over 20 peer reviewed publications and are also available through the CALIPER Reference Interval Database as well as the CALIPER Reference App for mobile devices. [ABSTRACT FROM AUTHOR]

Context.--Whole slide imaging (WSI) represents a paradigm shift in pathology, serving as a necessary first step for a wide array of digital tools to enter the field. Its basic function is to digitize glass slides, but its impact on pathology workflows, reproducibility, dissemination of educational material, expansion of service to underprivileged areas, and intrainstitutional and interinstitutional collaboration exemplifies a significant innovative movement with far-reaching effects. Although the benefits of WSI to pathology practices, academic centers, and research institutions are many, the complexities of implementation remain an obstacle to widespread adoption. In the wake of the first regulatory clearance of WSI for primary diagnosis in the United States, some barriers to adoption have fallen. Nevertheless, implementation of WSI remains a difficult prospect for many institutions, especially those with stakeholders unfamiliar with the technologies necessary to implement a system or who cannot effectively communicate to executive leadership and sponsors the benefits of a technology that may lack clear and immediate reimbursement opportunity. Objectives.--To present an overview of WSI technology-- present and future--and to demonstrate several immediate applications of WSI that support pathology practice, medical education, research, and collaboration. Data Sources.--Peer-reviewed literature was reviewed by pathologists, scientists, and technologists who have practical knowledge of and experience with WSI. Conclusions.--Implementation of WSI is a multifaceted and inherently multidisciplinary endeavor requiring contributions from pathologists, technologists, and executive leadership. Improved understanding of the current challenges to implementation, as well as the benefits and successes of the technology, can help prospective users identify the best path for success. [ABSTRACT FROM AUTHOR]

Laboratory-based testing does not reach many individuals in lower-resource settings who could benefit from access to appropriate tests for diagnosis and therapy. A critical issue is laboratory-based testing often requires an environment with a high level of resources and supporting infrastructure that is not available in many areas of the world. The current report describes the conversion of a laboratory-based test for phenylalanine detection to a simple paper-based test appropriate for use in low-resource settings. The paper-based test is easy to operate, with all reagents stored dry on the card, is compatible with visible detection for clinically relevant concentrations of phenylalanine, and has a time to result of 10 minutes. Next steps for test development are discussed in the context of the potential for the paperbased Phe test to be used as a newborn PKU screening test in settings that are not well served by existing screening approaches. [ABSTRACT FROM AUTHOR]

A simple approach to the evaluation of blood coagulation using a microfluidic paper-based lateral flow assay (LFA) device for point-of-care (POC) and self-monitoring screening is reported. The device utilizes whole blood, without the need for prior separation of plasma from red blood cells (RBC). Experiments were performed using animal (rabbit) blood treated with trisodium citrate to prevent coagulation. CaCl2 solutions of varying concentrations are added to citrated blood, producing Ca2+ ions to re-establish the coagulation cascade and mimic different blood coagulation abilities in vitro. Blood samples are dispensed into a paper-based LFA device consisting of sample pad, analytical membrane and wicking pad. The porous nature of the cellulose membrane separates the aqueous plasma component from the large blood cells. Since the viscosity of blood changes with its coagulation ability, the distance RBCs travel in the membrane in a given time can be related to the blood clotting time. The distance of the RBC front is found to decrease linearly with increasing CaCl2 concentration, with a travel rate decreasing from 3.25 mm min−1 for no added CaCl2 to 2.2 mm min−1 for 500 mM solution. Compared to conventional plasma clotting analyzers, the LFA device is much simpler and it provides a significantly larger linear range of measurement. Using the red colour of RBCs as a visible marker, this approach can be utilized to produce a simple and clear indicator of whether the blood condition is within the appropriate range for the patient's condition. [ABSTRACT FROM AUTHOR]

Microfluidic paper-based analysis devices (μPADs) have undergone tremendous development in recent years and now provide a feasible low-cost alternative to traditional laboratory tests for the diagnosis of many common diseases and disorders. As such, they are of great interest and importance in developing regions of the world with a lack of medical resources and associated infrastructures. This review examines the advances made in microfluidic paper-based diagnostic technology in the past five years and describes the application of microfluidic paper-based assays to the detection of many common human diseases using 3 non-invasive samples sources such as saliva, tears and sweat. The review commences by introducing the basic principles of fluid transport in microfluidic paper-based devices. The structures and actuation systems used in common paper-based devices are then introduced and explained. A systematic review of recent proposals for the application of paper-based devices to the diagnosis of common human diseases is then presented. The review concludes with a brief discussion of the challenges facing the microfluidics paper-based diagnosis field in the coming years and the emerging opportunities for future research. [ABSTRACT FROM AUTHOR]

Background Human immunodeficiency virus (HIV)/AIDS and tuberculosis (TB) continue to be a significant global burden, disproportionately affecting low- and middle-income countries (LMICs). While much progress has been made in treating these epidemics, this has led to a rise in liver complications, as patients on ARTs and anti-TBs are at an increased risk of drug-induced liver injury (DILI). Therefore, patients on these medicines require consistent screening of liver function. Due to logistical barriers, gold standard DILI screening fails to be executed at the point-of-care in LMICs. For this reason, we used cost-effectiveness analysis to gauge the efficacy of a paper-test that could be implemented in these settings. Methods We used a Markov Model to simulate HIV and TB coinfected patient care in LMICs using both publicly available data and data from Village Health Works in Burundi. We compared the cost-effectiveness of two screening interventions for liver function monitoring: 1. paper-based point-of-care testing, and 2. gold-standard laboratory testing. These interventions were compared against baseline clinical monitoring. Results The paper test showed a 56% increase in efficacy over clinical monitoring alone. The paper-test is more cost-effective than the gold-standard method, at a ceiling cost of $1.60 per test. Conclusions With this information, policy makers can be informed as to the large potential value of paper-based tests when gold standard monitoring is not achievable. Scientists and engineers should also keep these analyses in mind and while in development limit the cost of an ALT screening test to $1.60. [ABSTRACT FROM AUTHOR]

Background: The editors of the Indian Journal of Cancer (IJC) have not, so far, objectively analyzed the editorial processes involving author, referee, and editor data of the journal. Hence, we aimed at doing so in this audit.Methods: We retrospectively analyzed manuscripts submitted to the IJC from April 1, 2020, to May 31, 2020, for data related to the peer-review process. Microsoft Excel was used to enter the retrieved information and to carry out the statistical analysis.Results: Three hundred and nineteen manuscripts were submitted during the study period. Of these, three were excluded from the study. Of the 316, 79 (25%) were articles on laboratory medicine; 182 (57.6%) were original articles. About half of the submitted manuscripts (166, 52.5%) were desk-rejected. Of the remaining 149 manuscripts, 105 did not follow the instructions to contributors (ITC) and required a median number of two revisions (range = 1-5) to satisfy the ITC. To review 107 manuscripts, 536 external referees were invited; of them 306 did not respond, 79 declined the invitation, and 151 accepted the invitation. Of these 151, 132 reverted with comments. Of the 200 Indians who were invited as referees, 118 (59%) accepted the invitation, whereas of the 336 non-Indian referees, only 33 (9.8%) did. Of the 107 Indian and 25 non-Indian referees who sent their comments, 86 (80.4%) and 19 (88%), respectively, offered useful comments. The median number of days to decision: for desk-rejection was 1 day (range = 0 - 42) days, for rejection after peer-review was 67 (range = 4 - 309) days, and for acceptance was 133.5 (range = 42 - 305) days. Decision has not yet been taken for 14 manuscripts.Conclusion: The study provides evidence that it is difficult to get referees. Also, a significant number of authors do not read or follow the ITC. We suggest that the time taken for a decision can be appreciably improved if these issues are addressed. [ABSTRACT FROM AUTHOR]

The article discusses principles to be essential in order to ensure a good supply for accredited laboratories including appreciation of the special specialist areas of diagnostic medicine in the laboratory, reliable framework conditions, and quality of laboratory supply.

Since the beginning of 2020, Coronavirus Disease 19 (COVID-19) has attracted the attention of the World Health Organization (WHO). This paper looks into the infection mechanism, patient symptoms, and laboratory diagnosis, followed by an extensive assessment of different technologies and computerized models (based on Electrocardiographic signals (ECG), Voice, and X-ray techniques) proposed as a diagnostic tool for the accurate detection of COVID-19. The found papers showed high accuracy rate results, ranging between 85.70% and 100%, and F1-Scores from 89.52% to 100%. With this state-of-the-art, we concluded that the models proposed for the detection of COVID-19 already have significant results, but the area still has room for improvement, given the vast symptomatology and the better comprehension of individuals' evolution of the disease. [ABSTRACT FROM AUTHOR]

Laboratory medicine and health care systems are changing rapidly due to increasing demands from the public regarding availability, quality and equity and these changes are significantly affecting the role of laboratory professionals. New competencies should be defined to be in alignment with the mission and vision of both clinical laboratories and health care systems, and, first and foremost to meet patients' and clinicians' needs. Aim of this paper is to review the content of already published Manifesto(s) and to move the discussion towards a new Manifesto for the future of laboratory professional. [ABSTRACT FROM AUTHOR]

Quality in laboratory medicine is defined as "an unfinished journey", as the more essential the laboratory information provided, the more assured its quality should be. In the past decades, the Journal Clinical Chemistry and Laboratory Medicine has provided a valuable forum for garnering new insights into the analytical and extra-analytical phases of the testing cycle, and for debating crucial aspects of quality in clinical laboratories. The impressive number of papers published in the Journal is testimony to the efforts made by laboratory professionals, national and international scientific societies and federations in the quest to continuously improve upon the pre-, intra- and post-analytical steps of the testing cycle, thus enhancing the quality of laboratory information. The paper appearing in this special issue summarizes the most important and interesting contributions published in the Journal, thus updating our knowledge on quality in laboratory medicine and offering further stimuli to identify the most valuable measures of quality in clinical laboratories. [ABSTRACT FROM AUTHOR]

Development in the medical field is getting fast every day. People's interest in improving their expectancy of life, their life quality, and the significant investments in medical laboratories modify the diagnosis methods, application protocols, and surgical techniques. One of the most significant milestones in the medical field have been incorporating computers to improve data analysis during the last years. Nowadays, it is a fact that computers can help physicians, i.e., the use of artificial intelligence techniques. This paper proposes a multistage prediction-based approach and a rule-based system for the treatment of abdominal aortic aneurysms. The first step is to develop a neural network model to predict 30-day mortality during and after aortic endovascular procedures. The second step aims to infer a rule-based system from the previous model. The results show that with only eight features the final predictive model can obtain an accuracy of around 87%. Furthermore, a decision tree with the same accuracy can be inferred from this model using three features and four rules [ABSTRACT FROM AUTHOR]

This paper reports on research into co-creation labs as a tool for exploring environmental communication. Co-creation labs are novel spaces for experimentation, social learning, and trans-disciplinary as well as cross-sectoral collaboration for sustainability transformations. This paper examines the approach taken by researchers to theorising, via a repurposing of the 2×2 scenario matrix, a series of "labs" that represent diverse spaces in which to explore co-creative convergence through transformative learning processes. In addition, examples from work done to date are offered to illustrate progress in implementing these labs and testing the strengths and weaknesses of these co-creative spaces. [ABSTRACT FROM AUTHOR]

From the moment the SARS-CoV-2 virus was identified in December 2019, the COVID-19 disease spread around the world, causing an increase in hospitalisations and deaths. From the beginning of the pandemic, scientists tried to determine the major cause that led to patient deaths. In this paper, the background to creating a research model was diagnostic problems related to early assessment of the degree of damage to the lungs in patients with COVID-19. The study group comprised patients hospitalised in one of the temporary COVID hospitals. Patients admitted to the hospital had confirmed infection with SARS-CoV-2. At the moment of admittance, arterial blood was taken and the relevant parameters noted. The results of physical examinations, the use of oxygen therapy and later test results were compared with the condition of the patients in later computed tomography images and descriptions. The point of reference for determining the severity of the patient's condition in the computer imagery was set for a mild condition as consisting of a percentage of total lung parenchyma surface area affected no greater than 30%, an average condition of between 30% and 70%, and a severe condition as greater than 70% of the lung parenchyma surface area affected. Patients in a mild clinical condition most frequently had mild lung damage on the CT image, similarly to patients in an average clinical condition. Patients in a serious clinical condition most often had average levels of damage on the CT image. On the basis of the collected data, it can be said that at the moment of admittance, BNP, PE and HCO3− levels, selected due to the form of lung damage, on computed tomography differed from one another in a statistically significant manner (p < 0.05). Patients can qualify for an appropriate group according to the severity of COVID-19 on the basis of a physical examination and applied oxygen therapy. Patients can qualify for an appropriate group according to the severity of COVID-19 on the basis of BNP, HCO3 and BE parameters obtained from arterial blood. [ABSTRACT FROM AUTHOR]

Infectious diseases seriously threaten the lives of children. Timely and accurate detection of pathogenic microorganisms and targeted medication are the keys to the diagnosing and treatment of infectious diseases in children. The next-generation metagenomic sequencing technology has attracted great attention in infectious diseases because of its characteristics such as no culture, high throughput, short detection cycle, wide coverage, and a good application prospect. In this paper, we review the studies of metagenomic next-generation sequencing in pediatric infectious diseases and analyze the challenges of its application in pediatric diseases. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to analyze the trends in publications on ramp lesions of the meniscus in the current literature. We hypothesized that publications on ramp lesions have increased rapidly in recent years due to increased knowledge of both clinical and radiological pathology. Methods: A Scopus search performed on 21/01/23 retrieved 171 documents. A similar search strategy was employed to carry out a search for ramp lesions on PubMed with no time filters and only English articles. The articles were downloaded into Excel software, and citations for PubMed articles were determined from the iCite website. Analysis was performed using Excel. Using Orange software, data mining was performed from the titles of all articles. Results: There are a total of 126 publications from 2011 to 2022 with a total of 1778 citations in PubMed. Of all publications, 72% were published in the last 3 years, from 2020 to 2022, indicating an exponential increase in interest in this subject in recent years. Similarly, 62% of the citations were aggregated by the years 2017–2020, both years included. When the journals were analyzed according to the number of citations, the American Journal of Sports Medicine (AJSM) topped with 822 citations (46% of all citations) and 25 publications, followed by Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA) with 27 articles and 388 citations (22% of all citations). When analyzed by citations per publication for different types of studies, randomized clinical trials (RCTs) were the most cited, with 32 citations per publication, followed by basic science articles with 31.5. Most of the basic science articles were cadaver studies examining anatomy, technique, and biomechanics. Technical notes were the third most cited at 18.64 per publication. While the USA is the country that leads publications, France is in a significant second position contributing to research on this topic, followed by Germany and Luxembourg. Conclusions: Global trend analysis suggests that ramp lesion research has significantly increased and that the number of papers on the topic is steadily increasing. We found that the publications and citations presented a rising trend, the majority of the highly cited papers were contributed by a few centers, and the most cited were randomized clinical trials and basic science studies. The long-term outcomes of conservatively and surgically treated ramp lesions have attracted the most research interest. [ABSTRACT FROM AUTHOR]

The analytical quality of the clinical laboratory results has shown a significant improvement over the past decades, thanks to the joint efforts of different stakeholders, while the comparability among the results produced by different laboratories and methods still presents some critical issues. During these years, Clinical Chemistry and Laboratory Medicine (CCLM) published several papers on the harmonization issue over all steps in the Total Testing Process, training an important number of laboratory professionals in evaluating and monitoring all the criticisms inherent to the pre-analytical, as well as analytical and post analytical phases: from the consensus statement on the most informative testing in emergency setting, to the prevention and detection of hemolysis or to patients identification and tube labeling procedures, as far as to different approaches to harmonize hormones measurements or to describe new reference methods or to harmonize the laboratory report. During these years the commitment of the journal, devoted to the harmonization processes has allowed to improve the awareness on the topic and to provide specific instruments to monitor the rate of errors and to improve patients safety. [ABSTRACT FROM AUTHOR]

Distribution-free tolerance regions are hyper-rectangles in terms of the number of variables that include at least a pre-specified proportion of normal subjects with a confidence bounded from below by a prescribed probability. This paper has two main goals. The first is to propose an innovative method for constructing multidimensional tolerance regions that work well when the only assumption that can be made about the underlying distribution is that it is continuous. Although our proposal is, in essence, an extension of the Wilks-Wald method to higher dimensions, this research is far less immediate and straightforward than it has appeared to many authors, who, moreover, have not really used it in practical work. In particular, the order statistics dividing the regions are not fixed beforehand, but are determined by an optimization procedure. The second goal is to suggest a way of overcoming a problem of practical importance concerning the order in which the variables are included, which has remained unsolved since the introduction of the argument almost eighty years ago. This device facilitates the search for a good solution while avoiding being drawn away into the black hole of combinatorial computations. Simulation and applications to laboratory medicine data illustrate the advantages of using the method presented in this paper. [ABSTRACT FROM AUTHOR]

Introduction: in spite of the introduction of automated systems for urine sediment analysis, microscopy examination remains the gold standard. External Quality Assessment (EQA) programs on urine sediment are rare. This paper provides an analysis of results from 2012 to date of the EQA Italian program (Centro di Ricerca Biomedica, Regione Veneto) which involves today 255 laboratories. Methods: the EQA program includes four surveys/year. Participants are asked to identify and provide the clinical association of the presence of specific particles (2 surveys) and formulate the diagnosis of clinical cases presented (2 surveys). In 11 years, 202 images were proposed: 64 cells (9 types), 10 lipids (4 types), 59 casts (16 types), 36 crystals (13 types), 14 microorganisms (5 types), 19 contaminants (8 types) and 22 clinical cases were presented. Results: the correct identification rate (median; interquartiles) was very high for micro organisms (96.4; 91.9-99.9); high for crystals (92.2; 80.2-96.3) and lipids (91.1; 90.5-93.6); followed by casts (87.7; 80.1-91.8); contaminants (87.3; 77.2-96.0) and cells (82.8; 74.4-91.3). For clinical associations, the rate of correct answers was 96.5 (range 48.7- 100%). For clinical cases, due to the overall rate of particle misidentification throughout surveys, only 58.6% (44.9- 68.8%) of participants achieved access to clinical diagnosis. Of these, 92,0% (78.1-95.5%) were able to indicate the correct diagnosis. Conclusions: the program can be used as a tool to improve the identification of urine particles and the knowledge of their clinical significance and to encourage specialists of laboratory medicine to correlate urine findings with other laboratory data and the clinical history of the patient, an aspect that improves the value of the day by day work. [ABSTRACT FROM AUTHOR]

Background The South-East Asia (SEA) region bears a significant proportion of the world's communicable disease burden. The onset of the COVID-19 pandemic has further affected the situation. A well-established laboratory-based surveillance (LBS) can reduce the burden of infectious diseases. In light of this, the review collated the existing literature on LBS system in the region and the modifications adopted by the surveillance systems during the pandemic. Methodology We followed the guidelines for scoping review as prescribed by Arskey and O'Malley. We comprehensively searched three databases (PubMed, Scopus and CINAHL) and supplemented it with grey literature search. The screening of the articles was conducted at the title and abstract followed by full-text screening. This was followed by data extraction using a pre-tested data extraction tool by two independent reviewers. The results were presented narratively. Results Including 75 relevant articles and documents, we compiled a list of surveillance systems. A shift from paper to dual (paper and electronic) modalities was identified across the countries. This largely low- and middle-income countries (LMIC) area face challenges in reporting, resources, and collaboration-related issues. While some countries have well-established National Reference Laboratories; others have more private than public-owned laboratories. Given the COVID-19 pandemic, modifications to the existing laboratory capacities to enable real-time surveillance was identified. Laboratory capacity complemented with genomic surveillance can indubitably aid in disease detection and control. Limitations due to inaccessible government portals, and language barriers are acknowledged. This review identified a comprehensive list of surveillance systems in the region, challenges faced in using these surveillance systems and inform the decision makers about the benefits of integrating fragmented surveillance systems. Conclusion Regionally and nationally integrated genomic and laboratory surveillance systems justify capital investments, as their payoffs rationalise such costs owing to economies of scale over time. Further, as data flows are harmonized and standardized, algorithm- and computing-based pattern recognition methods allow for targeted and accurate disease prediction when integrated with, potentially, climate and weather systems data. Trained human resources are a sine qua non to optimize such investments, but in the medium to long run, such investments will buttress initiatives in other arenas at the regional level. [ABSTRACT FROM AUTHOR]

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Simple Summary: Metastatic breast cancer is an aggressive disease that early diagnostic attempts is of an utmost importance. A machine learning model that utilizes NCA and MRMR in this work is attempting to isolate pertinent dysregulated miRNA's for the different four cancer stages. This work compares the current clinical diagnostic approaches with the proposed ML model results. Determining the tumor origin in humans is vital in clinical applications of molecular diagnostics. Metastatic cancer is usually a very aggressive disease with limited diagnostic procedures, despite the fact that many protocols have been evaluated for their effectiveness in prognostication. Research has shown that dysregulation in miRNAs (a class of non-coding, regulatory RNAs) is remarkably involved in oncogenic conditions. This research paper aims to develop a machine learning model that processes an array of miRNAs in 1097 metastatic tissue samples from patients who suffered from various stages of breast cancer. The suggested machine learning model is fed with miRNA quantitative read count data taken from The Cancer Genome Atlas Data Repository. Two main feature-selection techniques have been used, mainly Neighborhood Component Analysis and Minimum Redundancy Maximum Relevance, to identify the most discriminant and relevant miRNAs for their up-regulated and down-regulated states. These miRNAs are then validated as biological identifiers for each of the four cancer stages in breast tumors. Both machine learning algorithms yield performance scores that are significantly higher than the traditional fold-change approach, particularly in earlier stages of cancer, with Neighborhood Component Analysis and Minimum Redundancy Maximum Relevance achieving accuracy scores of up to 0.983 and 0.931, respectively, compared to 0.920 for the FC method. This study underscores the potential of advanced feature-selection methods in enhancing the accuracy of cancer stage identification, paving the way for improved diagnostic and therapeutic strategies in oncology. [ABSTRACT FROM AUTHOR]

Developing reliable ultrasonic-guided wave monitoring systems requires a significant amount of inspection data for each application scenario. Experimental investigations are fundamental but require a long period and are costly, especially for real-life testing. This is exacerbated by a lack of experimental data that includes damage. In some guided wave applications, such as pipelines, it is possible to introduce artificial damage and perform lab experiments on the test structure. However, in rail track applications, laboratory experiments are either not possible or meaningful. The generation of synthetic data using modelling capabilities thus becomes increasingly important. This paper presents a variational autoencoder (VAE)-based deep learning approach for generating synthetic ultrasonic inspection data for welded railway tracks. The primary aim is to use a VAE model to generate synthetic data containing damage signatures at specified positions along the length of a rail track. The VAE is trained to encode an input damage-free baseline signal and decode to reconstruct an inspection signal with damage by adding a damage signature on either side of the transducer by specifying the distance to the damage signature as an additional variable in the latent space. The training data was produced from a physics-based model that computes virtual experimental response signals using the semi-analytical finite element and the traditional finite element procedures. The VAE reconstructed response signals containing damage signatures were almost identical to the original target signals simulated using the physics-based model. The VAE was able to capture the complex features in the signals resulting from the interaction of multiple propagating modes in a multi-discontinuous waveguide. The VAE model successfully generated synthetic inspection data by fusing reflections from welds with the reflection from a crack model at specified distances from the transducer on either the right or left side. In some cases, the VAE did not exactly reconstruct the peak amplitude of the reflections. This study demonstrated the potential and highlighted the benefit of using a VAE to generate synthetic data with damage signatures as opposed to using superposition to fuse the damage-free responses containing reflections from welds with a damage signature. The results show that it is possible to generate realistic inspection data for unavailable damage scenarios. [ABSTRACT FROM AUTHOR]

Clustering algorithms are usually iterative procedures. In particular, when the clustering algorithm aims to optimise an objective function like in k-means clustering or Gaussian mixture models, iterative heuristics are required due to the high non-linearity of the objective function. This implies higher computational costs and the risk of finding only a local optimum and not the global optimum of the objective function. In this paper, we demonstrate that in the case of one-dimensional clustering with one main and one noise cluster, one can formulate an objective function, which permits a closed-form solution with no need for an iteration scheme and the guarantee of finding the global optimum. We demonstrate how such an algorithm can be applied in the context of laboratory medicine as a method to estimate reference intervals that represent the range of "normal" values. [ABSTRACT FROM AUTHOR]

Simple Summary: This paper reports a case of puerperal metritis (PM) caused by Histophillus somni (H. somni) in a Holstein cow. PM is characterized by an abnormally enlarged uterus and a fetid watery red-brown uterine discharge within the first 21 days postpartum, showing clinical signs associated with systemic illness, such as decreased milk yield, dullness, toxemia, and fever (>39.5 °C). Cows with PM need fast and complete treatment to prevent very serious consequences for the cow's health, which could lead to death. A pure culture of H. somni was obtained and identified in the uterine discharge. To the authors' knowledge, this is the first report of H. somni's ability to act as a unique causative agent of puerperal metritis, suggesting under-reporting or lack of diagnosis. This manuscript aims to report the clinical and laboratory diagnosis of puerperal metritis (PM) in a dairy cow, caused by H. somni as a unique pathogen. The cow showed signs of systemic illness, including a sudden drop in milk production, a rectal temperature of 40.4 °C, tachypnea, dehydration, and completely fluid, brown, and fetid uterine discharge. Pure cultures of H. somni were identified and submitted to the Kirby–Bauer disc diffusion method for antibiotic sensitivity. The study showed that H. somni was resistant to tetracyclines and cephalosporins (Ceftiofur), antibiotics commonly used to treat uterine infections in dairy cows. To the authors' knowledge, this case describes for the first time PM caused by H. somni as a primary pathogen. Our results should lead to the inclusion of H. somni as a primary pathogen of metritis in laboratory diagnoses on a routine basis, which, in turn, may help to elucidate the incidence of H. somni as a causative agent of uterine infections in cows. If the incidence of H. somni is remarkably high or frequent, researchers could consider the use of commercial vaccines nowadays destined for the prevention of bovine respiratory disease and which could perhaps be effective in the prevention of reproductive pathology caused by H. somni. [ABSTRACT FROM AUTHOR]

Detecting and locating high impedance faults (HIF) in overhead distribution networks (ODN) remains one of the biggest challenges for manufacturers and researchers due to the complexity of this phenomenon, where the electrical current magnitude is similar to that of the loads. To simulate HIF, the selection of the HIF model is important, because it has to correctly reproduce the characteristics of this phenomenon, so that it does not negatively influence the simulations results. Therefore, HIF models play a fundamental role in proposing solutions and validating the effectiveness of the proposed methods to detect and localize HIF in ODN. This paper presents a systematic review of HIF models. It is intended to facilitate the selection of the HIF model to be considered. The models are validated based on experimental data from medium voltage (MV) laboratories, specifically, recorded waveforms from two HIF tests conducted in an MV lab were analyzed and compared with three established HIF models. The efficacy of these models was assessed against MV lab test data to ensure a precise representation of both transient and steady-state conditions for fault conductance and current waveforms. The findings show that the two nonlinear resistor models better approximate the waveforms obtained in the experimental tests performed in this study. [ABSTRACT FROM AUTHOR]

With the continuous development of society, people's attention to the body is also increasing. This article explains and analyzes the clinicopathological characteristics of a more serious disease, lymphoma, and the effect of treatment. In the previous studies of this type of disease, the collected data was very limited, and the theory for data analysis was also lacking. The direct result was that the analysis of such disease types was not complete, and it was difficult to obtain statistical significance, which made the clinical guidance weak. In order to improve this problem, this paper applies the sampling theory in statistics to the clinicopathological characteristics of lymphoma and the effect of treatment. Through the scientific analysis of such samples, it is hoped to provide some ideas for clinical treatment. In the sampling theory, this paper selects two methods, Bayesian algorithm and adaptive sampling theory, and introduces the corresponding methods for the correlation analysis of the clinicopathological characteristics and curative effect of lymphoma according to the above two methods. These related processing methods start from a large number of samples and provide sufficient computational support for the final experiments. Experiments show that the score of clinical symptoms of lymphoma is not less than 96%, which means that the patient is in a state of recovery. When the evaluation score is between 63% and 96%, the corresponding treatment has a significant effect. These results show that, in the analysis of the clinicopathological characteristics of lymphoma and related treatment effects, by using the Bayesian algorithm in the sampling theory and the adaptive sampling theory, the data results can well correspond to the clinical effects. [ABSTRACT FROM AUTHOR]

Large-scale, multi-site collaboration is becoming indispensable for a wide range of research and clinical activities in oncology. To facilitate the next generation of advances in cancer biology, precision oncology and the population sciences it will be necessary to develop and implement data management and analytic tools that empower investigators to reliably and objectively detect, characterize and chronicle the phenotypic and genomic changes that occur during the transformation from the benign to cancerous state and throughout the course of disease progression. To facilitate these efforts it is incumbent upon the informatics community to establish the workflows and architectures that automate the aggregation and organization of a growing range and number of clinical data types and modalities ranging from new molecular and laboratory tests to sophisticated diagnostic imaging studies. In an attempt to meet those challenges, leading health care centers across the country are making steep investments to establish enterprise-wide, data warehouses. A significant limitation of many data warehouses, however, is that they are designed to support only alphanumeric information. In contrast to those traditional designs, the system that we have developed supports automated collection and mining of multimodal data including genomics, digital pathology and radiology images. In this paper, our team describes the design, development and implementation of a multi-modal, Clinical & Research Data Warehouse (CRDW) that is tightly integrated with a suite of computational and machine-learning tools to provide actionable insight into the underlying characteristics of the tumor environment that would not be revealed using standard methods and tools. The System features a flexible Extract, Transform and Load (ETL) interface that enables it to adapt to aggregate data originating from different clinical and research sources depending on the specific EHR and other data sources utilized at a given deployment site. [ABSTRACT FROM AUTHOR]

Pheochromocytoma is a rare neuroendocrine neoplasm. It is characterized by overproduction of catecholamines, which causes clinical symptoms associated with elevated blood pressure values, and can even lead to life-threatening complications. The tumor can be associated with genetic syndromes such as multiple endocrine neoplasia type 2 (MEN-2) or von Hippel–Lindau syndrome (VHL), and currently available and constantly evolving genetic testing makes it possible to detect the inherited form and plan appropriate therapy. Management of pheochromocytoma is based on initial laboratory diagnosis, confirmation by imaging studies, determination of hormonal activity and resulting therapy. Surgical resection by laparoscopic approach is the most recommended. For unresectable tumors or advanced disease with distant metastases, systemic therapies under development currently allow the cure or inhibition of tumor progression. In this paper, we will review advances in management of pheochromocytoma over the past decade and potential directions for future research. [ABSTRACT FROM AUTHOR]

Squamous differentiation of prostate cancer, which accounts for less than 1% of all cases, is typically associated with androgen deprivation treatment (ADT) or radiotherapy. This entity is aggressive and exhibits poor prognosis due to limited response to traditional treatment. However, the underlying molecular mechanisms and etiology are not fully understood. Previous findings suggest that squamous cell differentiation may potentially arise from prostate adenocarcinoma (AC), but further validation is required to confirm this hypothesis. This paper presents a case of advanced prostate cancer with a combined histologic pattern, including keratinizing SCC and AC. The study utilized whole-exome sequencing (WES) data to analyze both subtypes and identified a significant overlap in driver gene mutations between them. This suggests that the two components shared a common origin of clones. These findings emphasize the importance of personalized clinical management for prostate SCC, and specific molecular findings can help optimize treatment strategies. [ABSTRACT FROM AUTHOR]