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Objectives: To investigate the diagnostic and therapeutic landscape for patients with connective tissue disease (CTD) and CTD-associated pulmonary arterial hypertension (CTD-PAH) in acute-care general hospitals in Japan. Methods: We conducted a retrospective cohort study by analysing the Medical Data Vision (MDV) database from April 2008 to September 2020. CTD patients who prescribed immunosuppressants were included in cohort 1, and CTD-PAH patients extracted from cohort 1 were included in cohort 2. Patient characteristics, diagnostic screening frequencies for PAH, and initial PAH-specific treatment patterns were assessed. Results: Overall, 16,648 patients with CTD and 81 patients with CTD-PAH were included in cohorts 1 and 2, respectively. The frequencies of screening tests for PAH, including brain natriuretic peptide (BNP), transthoracic echocardiogram (TTE), and 'diffusing capacity' of the 'lungs for carbon monoxide' (DLCO), among CTD patients were 0.7, 0.3, and 0.1 tests/person-year, respectively. The most common initial PAH-specific treatment therapy was monotherapy (87.7%), followed by dual therapy (7.4%) and triple therapy (2.5%). Conclusion: This is the first study to describe the patient flow from PAH diagnosis to initial PAH-specific treatment for real-world patients who were followed regularly due to CTD in Japanese clinical practice. [ABSTRACT FROM AUTHOR]

ALBA screening instrument (ASI) has been demonstrated to be an effective, cheap, and noninvasive clinical instrument to screen for Lewy body dementia (LBD). We aimed to determine the validity and reliability of the Turkish version of ASI (ASI-T) in patients with LBD and to investigate the discriminative power of the test in patients with Alzheimer's Disease (AD), LBD, and cognitively healthy older adults (controls). 172 older adults over 60 years of age (43 with LBD, 41 AD, and 88 controls) were included. The sensitivity and specificity of the instrument were determined. A significant difference was found in ASI-T total score between people with LBD versus the controls (t=-9.259; p < 0.001), and versus patients with AD (t = 3.490; p = 0.001). Internal consistency of the ASI-T was good(Cronbach's alpha = 0.81). The cutoff score of 7 showed sensitivity (86%) and specificity (81%) (AUC= 0.888,CI0.95, p < 0.001) compared to controls. Also, compared to AD, it showed sensitivity (86%) and specificity(70%) (AUC = 0.590,CI.95, p < 0.001). Moreover, ASI-T demonstrated a significant concurrent validity with MMSE (r = −0.62; p < 0.001) and MoCA (r = −0.54; p = 0.003). In factor analysis, the five subscales accounted for 60% of the total variance. Our findings suggested that the ASI-T is a reliable, valid, and effective instrument for screening LBD. With acceptable psychometric properties, it has the power to distinguish patients with LBD from controls or those with AD. [ABSTRACT FROM AUTHOR]

Delirium is often the first symptom of incipient acute illness or complications and must therefore be detected promptly. Nevertheless, routine screening for delirium in acute care hospital wards is often inadequate. We recently implemented a simple, user-friendly delirium screening test (RMA) that can be administered during ward rounds and routine nursing care. The test was found to be non-inferior to 4AT in terms of sensitivity and specificity. However, the dominant factors to take into account when assessing the performance of a test added to the routine work of busy acute care hospital wards are ease of administration, real-life amenability and the ability of the staff to adhere to testing requirements. In this study, we evaluated the prevalence of daily RMA tests that were not administered as scheduled and the impact of these omissions on the overall real-world performance of RMA. Using point-in-time assessments of 4AT by an external rater, we found that complete RMA was administered in 88.8% of the days. Physicians omitted significantly more tests than nurses, but their results were more specific for delirium. Omissions reduced the sensitivity and specificity of RMA for delirium (compared to 4AT) from 90.7% to 81.7%, and from 99.2% to 87.8%, respectively. Ideally, the number of omitted RMA tests should be minimized. However, if over 85% of the daily quota of complete tests are administered, the sensitivity and specificity of RMA for diagnosing delirium as soon as it appears remain at acceptable levels. [ABSTRACT FROM AUTHOR]

Objectives The measurement of VOCs release in the headspace of a bacterial culture represents a new approach to rapidly assess antimicrobial susceptibility. Herein, we evaluated the diagnostic performance of the VITEK® REVEAL™ system directly from a collection of Gram-negative positive blood cultures. Materials and methods One hundred and twenty-eight positive blood cultures were included in the analysis (Enterobacterales, n  = 95; Pseudomonas aeruginosa , n  = 21; Acinetobacter baumannii complex, n  = 12). Samples were processed using VITEK® REVEAL™ according to the manufacturer's recommendations, and MICs of 22 antimicrobials were compared with those obtained using reference methods. Categorical agreement (CA), essential agreement (EA) and categorical errors were calculated. Results Overall, 2220 strain/antibiotic pair combinations were analysed. Of these, most were classified as resistant by reference antimicrobial susceptibility testing (1091/2220; 48.7%). The overall CA and EA were 97.6% and 97.7%, respectively. CA ranged from 97.5% in Enterobacterales to 97.9% in both P. aeruginosa and A. baumannii complex. The overall number of categorical discrepancies were: 18 very major errors (1.6%), 13 major errors (1.2%) and 22 minor errors (2.4%). EA ranged from 95.2% in P. aeruginosa to 98.1% in Enterobacterales. Screening test for ESBL phenotype was positive, indeterminate and negative in 13.7%, 32.6% and 27.4% of Enterobacterales isolates tested by both VITEK® REVEAL™ and the reference method, showing 100% CA. Conclusions VITEK® REVEAL™ represents a reliable tool to obtain antimicrobial susceptibility results of the main Gram-negative species directly from positive blood cultures with time to results of less than 8 h. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Inorganic Analytical Chemistry / Zhongguo Wuji Fenxi Huaxue is the property of Beijing Research Institute of Mining & Metallurgy Technology Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

PurposeMethodResultsConclusionTo report a case of seroreversion in a patient with HIV-associated bilateral CMV retinitis and the challenges associated with detection of this phenomenon in late stages of HIV.Retrospective single case report.The clinical picture of the patient on presentation was suggestive of viral retinitis. PCR confirmed a diagnosis of CMV retinitis. Serology for HIV-1 & 2 was negative. A viral load of HIV and CD-4 count confirmed his sero status to be positive for HIV. Improvement in visual acuity and slow resolution of the lesion was noted with both anti-viral for CMV and HIV. A repeat HIV-1 testing was positive with an improvement in CD4 count.In highly suspicious individual, with a negative serology (post screening test) for HIV, the disease status should be confirmed by testing the individual for HIV viral load and CD4 count. [ABSTRACT FROM AUTHOR]

Objective: Teleneuropsychology refers to the application of neuropsychology using video teleconferencing (VTC) techniques, whose methodology facilitates access to remote populations, a need that has increased due to the COVID-19 pandemic. Numerous investigations have documented the equivalence of different screening assessments (Mini Mental State Examination, Montreal Cognitive Assessment (MoCA) test and the Repeatable Battery for the Assessment for Neuropsychological Status) when applied via teleneuropsychology. The goal of the present work is to test the equivalence of the Brief Neuropsychological Battery in Spanish (NEUROPSI Breve), a neuropsychological screening instrument standardized for Spanish-speaking population that has reported a high sensitivity (91.6%) for identifying dementia, when applied in the VTC modality. Method: In total, 32 Mexicans between 16 and 70 years were assessed, both in traditional (face-to-face) and VTC format with a 20 min wait between each application. Each participant was randomly assigned into one of four groups that were generated from the established conditions: the first application could be face-to-face or by VTC modality and an adapted or original version of NEUROPSI Breve would be applied; for the second application, the remaining modality and instrument would be used. Statistical analysis was carried out using the IBM Statistical Package for the Social Sciences (SPSS) software (v. 25). Results: The Wilcoxon signed-rank test presented statistically significant differences (Z = −2.79, P =.005). However, when applied to each one of the four evaluation groups, the Wilcoxon signed-rank test showed no statistically significant differences; the same results were found when starting with the original or adapted instrument, and when starting with the face-to-face modality (P <.005). However, differences are shown when starting with the online (VTC) modality (groups B and C) (P =.028). Conclusions: The NEUROPSI Breve is applicable in both modalities, satisfying the needs of the population and the evaluation guidelines. [ABSTRACT FROM AUTHOR]

Edible oils (EdO), such as sunflower, are preferably chosen for frying because they get soaked less and are very light. Nevertheless, there is the possibility that they can be adulterated with thermally deteriorated oil such as the leftover oil after the frying process of meat with breadcrumbs (TDO A) or potatoes (TDO B). It may harm our health and the environment, requiring a fast and reliable screening test for such adulterants. In this study, Fourier transform infrared spectroscopy based on the attenuated total reflectance (ATR–FITR) sampling technique was studied to directly determine TDO A or TDO B as adulterants in EdO-TDO binary mixtures. We proposed quantification methods based on the simple linear regression analysis of IR spectral intensity (peak height or peak area) on adulterant concentration 0 ÷ 70% (v/v). The methods proposed proved to be accurate (% recovery in the range of 98.0 ÷ 101.1%), precise (RSD < 2.7%), and technically simple (total analysis time of 5–10 min). [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the validity of a modified STOP-Bang questionnaire with different body mass index reference as a screening tool for obstructive sleep apnea in Korean population. Methods: The medical records of 1417 participants who underwent overnight Level I polysomnography were retrospectively analyzed. Predictive parameters were calculated for each of the 3 groups classified by obstructive sleep apnea severity with a cut-off value of 3 or 4. Responses to modified and traditional questionnaires were comparatively analyzed by receiver-operator characteristic curves and area under the receiver-operator characteristic curves. Results: The optimal cut-off values of the modified and traditional questionnaires were both 3.5. The area under the receiver-operator characteristic curve of modified STOP-Bang questionnaire for any obstructive sleep apnea group was 0.786 ± 0.018, which was significantly higher than that of the traditional questionnaire. The modified STOP-Bang questionnaire with a cut-off value ≥4 showed significantly higher sensitivity than the traditional one for any obstructive sleep apnea group. The diagnostic accuracy of the modified questionnaire was also significantly higher for the any obstructive sleep apnea group when the cut-off value was 4. Conclusion: The modified STOP-Bang questionnaire, with a cut-off value of 4, can be used as an alternative to the traditional screening tool for the Korean population. [ABSTRACT FROM AUTHOR]

IntroductionEarly diagnosis of cancer enhances treatment planning and improves prognosis. Many masses presenting to veterinary clinics are difficult to diagnose without using invasive, time-consuming, and costly tests. Our objective was to perform a preliminary proof-of-concept for the HT Vista device, a novel artificial intelligence-based thermal imaging system, developed and designed to differentiate benign from malignant, cutaneous and subcutaneous masses in dogs.MethodsForty-five dogs with a total of 69 masses were recruited. Each mass was clipped and heated by the HT Vista device. The heat emitted by the mass and its adjacent healthy tissue was automatically recorded using a built-in thermal camera. The thermal data from both areas were subsequently analyzed using an Artificial Intelligence algorithm. Cytology and/or biopsy results were later compared to the results obtained from the HT Vista system and used to train the algorithm. Validation was done using a "Leave One Out" cross-validation to determine the algorithm's performance.ResultsThe accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the system were 90%, 93%, 88%, 83%, and 95%, respectively for all masses.ConclusionWe propose that this novel system, with further development, could be used to provide a decision-support tool enabling clinicians to differentiate between benign lesions and those requiring additional diagnostics. Our study also provides a proof-of-concept for ongoing prospective trials for cancer diagnosis using advanced thermodynamics and machine learning procedures in companion dogs.

During the COVID-19 pandemic, health systems, including federally qualified health centers, experienced disruptions in colorectal cancer (CRC) screening. National organizations called for greater use of at-home stool-based testing followed by colonoscopy for those with abnormal test results to limit (in-person) colonoscopy exams to people with acute symptoms or who were high risk. This stool-test-first strategy may also be useful for adults with low-risk adenomas who are due for surveillance colonoscopy. We argue that colonoscopy is overused as a first-line screening method in low- and average-risk adults and as a surveillance tool among adults with small adenomas. Yet, simultaneously, many people do not receive much-needed colonoscopies. Delivering the right screening tests at intervals that reduce the risk of CRC, while minimizing patient inconvenience and procedural risks, can strengthen health-care systems. Risk stratification could improve efficiency of CRC screening, but because models that adequately predict risk are years away from clinical use, we need to optimize use of currently available technology—that is, low-cost fecal testing followed by colonoscopy for those with abnormal test results. The COVID-19 pandemic highlighted the urgent need to adapt to resource constraints around colonoscopies and showed that increased use of stool-based testing was possible. Learning how to adapt to such constraints without sacrificing patients' health, particularly for patients who receive care at federally qualified health centers, should be a priority for CRC prevention research. [ABSTRACT FROM AUTHOR]

This study aims to investigate the validation of the Rapid Interactive Screening Test for Autism in Toddlers (RITA-T) in Turkish toddlers between 18 and 36 months of age. Children aged 18–36 months were referred to the department of child psychiatry for concerns of autism spectrum disorder, language disorder, developmental delay, and typically developing children were enrolled. A total of 81 toddlers participating in the study received clinical interviews according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) and the Childhood Autism Rating Scale. They received the translated RIT-T from reliably trained and blinded providers. Parents completed the Modified Checklist for Autism in Toddlers form. A cut-off score was calculated based on the sensitivity, specificity, positive, and negative predictive values of the RITA-T total score that best differentiates autism spectrum disorder diagnosis. For all participants, the RITA-T total score correlated with the Modified Checklist for Autism in Toddlers (r = 0.715) and the Childhood Autism Rating Scale total score (r = 0.825). Using a cut-off score of ⩾17, the RITA-T had a sensitivity of.90 and a specificity of.927 for identifying autism spectrum disorder risk. The area under the curve was.977. Our findings demonstrate that the RITA-T is effective in Turkish toddlers for the early identification of autism spectrum disorder, early intervention settings, and allowing access to treatment. It is important to diagnose autism spectrum disorder at an early age and to start an early intervention program without delay. In this study, we aimed to validate the Rapid Interactive Screening Test for Autism in Toddlers (RITA-T) in a group of Turkish children and found that the RITA-T which has been shown to be a valid and reliable screening test for 18- to 36-month-old children in studies conducted in different countries, is also valid in Turkish children. Similar to previous studies, our results showed that the RITA-T has good sensitivity and specificity in distinguishing children with autism spectrum disorder. We think that our study will contribute to the timely initiation of early intervention programs for many children with autism by enabling a valid test to be used in screening programs. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the present research was to validate the use of the effectiveness of the Batería Neuropsicológica Computarizada de Tamizaje (BNCT) to detect Mild cognitive impairment (MCI) compared to a goldstandard neuropsychological assessment. We also compared the diagnostic accuracy of the BNCT with another frequently used screening test: the Montreal Cognitive Assessment (MoCA). Methods: Using a cross-sectional design and an intentional sampling we selected 23 elderly adults who completed a neuropsychological assessment and who were diagnosed as MCI. The average age was 74.7 years, all presented subjective complaints of cognitive impairment not of enough severity as to interfere with their instrumental activities for daily living and fulfilled the diagnostic clinical criteria of MCI according to Petersen (1999). We compared the diagnostic accuracy of the BNCT and the MoCA with the results obtained by the neuropsychological battery. Results: According to the complete neuropsychological evaluation the 23 patients were classified as MCI. In the BNCT 91% of the patients were classified with MCI and showed alterations delay recall (56%), time orientation (48%), sequential drawing (43%), verbal memory (30%) and opposite reactions (26%). MoCA classified as MCI 79% of the patients and negative 21% of the sample. Tasks that predicted MCI were delay recall (81%), drawing of a cube (52%), clock drawing (47%), digit span (38%), subtraction (24%), phonological fluency (19%) and trial making (14%). Patients who were wrongly classified had low educational level (less than 5 years of schooling experience). According to the results of the complete neuropsychological battery, the BNCT provides better classification of subjects with MCI than the MoCA, since it uses norms according to age and education, while the MoCA does not consider these variables. [ABSTRACT FROM AUTHOR]

Objectives Cowden syndrome (CS) is a multisystem disease with an elevated lifetime risk of internal malignancy. We aim to assess the role of PTEN immunostain as a screening test for CS in a variety of common CS-associated neoplasms, with a particular focus on cutaneous tumors. Methods We retrospectively searched for patients meeting criteria for CS and/or demonstrating germline PTEN mutation from 2008 to 2022. We then performed PTEN immunostains on tumors of these patients as well as control cases. Results Our study included 30 patients with CS who had a total of 25 CS-associated malignancies (13 thyroid, 8 breast, and 4 endometrial carcinomas). Specifically, there were 11 patients with biopsy-confirmed CS-associated cutaneous neoplasms, including 1 patient with multiple trichilemmomas and 3 with multiple sclerotic fibromas. In total, 45 CS-associated tumors (6 trichilemmomas, 7 sclerotic fibromas, 5 thyroid carcinomas, 18 adenomatous thyroid nodules, 6 breast carcinomas, and 3 endometrial carcinomas) and 31 non-CS cases (9 trichilemmomas, 5 sclerotic fibromas, 8 adenomatous thyroid nodules, and 3 thyroid, 3 breast, and 3 endometrial carcinomas) were available for PTEN immunohistochemical staining. PTEN expression was lost in 43 (96%) of 45 CS-associated lesions and retained in 30 (97%) of 31 sporadic tumors. The overall sensitivity and specificity of PTEN loss of expression as a screening test for CS were 96% and 97%, respectively. Conclusions PTEN immunohistochemistry on CS-associated tumors, especially trichilemmomas, can serve as a readily accessible and cost-effective screening test for CS. [ABSTRACT FROM AUTHOR]

Objectives: Urine is the most used matrix in drug analysis; however, it is susceptible to adulteration or tampering. Urine creatinine is the most important urine integrity parameter used as an indicator of dilution. This study aimed to evaluate the prevalence of diluted urine samples and the change in positivity after creatinine normalization. Methods: Urine samples screened by the LC-MS/MS method over a 3.5-year period (n=21,927) were included in the study. Positivity rates were evaluated in both total and diluted urine samples. Additionally, the impact of creatinine normalization on samples with substance concentrations above the limit of quantitation (LOQ) and below the cut-off was investigated. Results: A total of 350,832 tests were conducted on 21,927 urine samples, resulting in an overall positivity rate of 21.2% (n=4652). The ratio of diluted urine was 1.6% (n=343), with 61.5% (n=211) testing negative (cut-off), and 15.2% (n=52) testing above LOQ and below cut-off. After creatinine normalization in diluted urines, the sample positivity rate increased from 23.3% (n=80) to 33.8% (n=116) (p<0.001), and the substance positivity rate increased from 2.3% (n=125) to 3.9% (n=212) (p<0.001). Conclusion: Precautions should be taken in reporting diluted urine samples to avoid reporting false negative results. The creatinine normalization approach shows promise in laboratories using quantitative screening methods such as LC-MS/MS for samples with substance concentrations above the LOQ and below the cut-off. However, more clinical and laboratory collaboration is needed for its routine application. [ABSTRACT FROM AUTHOR]

Objective This study retrospectively compared false-positive result frequencies of 3 syphilis serology screening tests and assessed whether false positivity was associated with pregnancy and age. Methods Results for 3 screening tests were retrieved from the laboratory database, including rapid plasma reagin (RPR) assay between October 2016 and September 2019, BioPlex 2200 Syphilis Total immunoassay between May 2020 and January 2022, and Alinity i Syphilis TP assay between February 2022 and April 2023. The false-positive result frequencies were calculated based on testing algorithm criteria. Results False-positive result frequency for BioPlex was 0.61% (90/14,707), significantly higher than 0.29% (50/17,447) for RPR and 0.38% (55/14,631) for Alinity (both P <.01). Patients with false-positive results were significantly older than patients with nonreactive results for RPR (median age: 36 vs 28, P <.001), but not for BioPlex or Alinity. For all 3 tests, the positive predictive values in pregnant women were lower than those in nonpregnant women or men. However, pregnant women did not exhibit a higher false-positive result frequency. Conclusion Although false-positive result frequencies were low overall for all 3 syphilis serology tests, there is a significant difference between different tests. Pregnancy was not associated with more false-positive results for all 3 tests. [ABSTRACT FROM AUTHOR]

The proactive identification of diseases through screening tests has long been endorsed as a means to preempt symptomatic onset. However, such screening endeavors are fraught with complications, such as diagnostic inaccuracies, procedural risks, and patient unease during examinations. These challenges are amplified when screenings for multiple diseases are administered concurrently. Selected Reaction Monitoring (SRM) offers a unique advantage, allowing for the high-throughput quantification of hundreds of analytes with minimal interferences. Our research posits that SRM-based assays, traditionally tailored for single-disease biomarker profiling, can be repurposed for multi-disease screening. This innovative approach has the potential to substantially alleviate time, labor, and cost demands on healthcare systems and patients alike. Nonetheless, there are formidable methodological hurdles to overcome. These include difficulties in detecting low-abundance proteins and the risk of model overfitting due to the multiple functionalities of single proteins across different disease spectrums – issues especially pertinent in blood-based assays where detection sensitivity is constrained. As we move forward, technological strides in sample preparation, online extraction, throughput, and automation are expected to ameliorate these limitations. The maturation of mass spectrometry's integration into clinical laboratories appears imminent, positioning it as an invaluable asset for delivering highly sensitive, reproducible, and precise diagnostic results. [ABSTRACT FROM AUTHOR]

Insulin resistance (IR) is a key risk factor for chronic metabolic diseases, but its laboratory diagnosis is still costly; thus, the triglyceride-glucose (TyG) index has been proposed as a surrogate method. Our aim was to provide a detailed analysis of cutoffs and test the hypothesis that the TyG index would present reasonable performance parameters for IR screening. This is a cross-sectional study with baseline data from 12,367 eligible participants of both sexes (aged 35–74 years) from the Brazilian Longitudinal Study of Adult Health. TyG correlation and agreement with the Homeostasis Model Assessment for Insulin Resistance were analyzed. Positive and negative predictive values (PV+, PV–) and likelihood ratio (LR+, LR–) were calculated. A moderate positive correlation between TyG and Homeostasis Model Assessment for Insulin Resistance was observed (Pearson r = 0.419). The area under the receiver operating characteristic curve of TyG for IR diagnosis was 0.742 and the optimal cutoff was 4.665, reaching a kappa agreement value of 0.354. For this cutoff, a PV+ of 59.3% and PV– of 76.0%, as well as an LR+ of 2.07 and LR– of 0.45 were obtained. Alternatively, because high sensitivity is desired for screening tests, selecting a lower cutoff, such as 4.505, increases the PV– to 82.1%, despite decreasing the PV+ to 50.8%. We conclude that TyG has important performance limitations for detecting IR, but that it may still be reasonably useful to help screening for IR in adults because it can be calculated from low-cost routine blood tests. Research on the TyG index's effectiveness in assessing insulin resistance yields varying outcomes. Our extensive study reveals notable limitations in TyG's diagnostic performance, especially in predictive values and likelihood ratios for IR diagnosis. Despite this, TyG remains reasonably useful for IR screening in adults, given its cost-effective calculation from routine blood tests. Combining TyG with other data can enhance insulin resistance screening for clinicians. Abbreviations: AUC, area under the curve; HOMA, Homeostasis Model Assessment for Insulin Resistance; IR, insulin resistance; ROC, receiver operating characteristic; TyG: triglyceride-glucose. [Display omitted] [ABSTRACT FROM AUTHOR]

Introduction Antimicrobial resistance in Neisseria gonorrhoeae compromises gonorrhoea treatment and rapid antimicrobial susceptibility testing (AST) would be valuable. We have developed a rapid and accurate flow cytometry method (FCM) for AST of gonococci. Methods The 2016 WHO gonococcal reference strains, and WHO Q, R and S (n  = 17) were tested against seven clinically relevant antibiotics (ceftriaxone, cefixime, azithromycin, spectinomycin, ciprofloxacin, tetracycline and gentamicin). After 4.5 h incubation of inoculated broth, the fluorescent dye Syto™ 9 was added, followed by FCM analysis. After gating, the relative remaining population of gonococci, compared with unexposed growth control samples, was plotted against antimicrobial concentration, followed by non-linear curve regression analysis. Furthermore, the response at one single concentration/tested antibiotic was evaluated with the intention to use as a screening test for detection of resistant gonococci. Results A dose-dependent response was seen in susceptible isolates for all tested antimicrobials. There was a clear separation between susceptible/WT and resistant/non-WT isolates for ceftriaxone, cefixime, spectinomycin, ciprofloxacin and tetracycline. In contrast, for azithromycin, only high-level-resistant isolates were distinguished, while resistant isolates with MICs of 4 mg/L were indistinguishable from WT (MIC ≤ 1 mg/L) isolates. For gentamicin, all tested 17 isolates were WT and FCM analysis resulted in uniform dose–response curves. Using a single antibiotic concentration and a 50% remaining cell population cut-off, the overall sensitivity and specificity for resistance detection were 93% and 99%, respectively. Conclusions By providing results in <5 h for gonococcal isolates, FCM-based AST can become a rapid screening method for antimicrobial resistance or antimicrobial susceptibility in gonococci. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the ability of Single Leg Squat (SLS) and Vertical Drop Jump (VDJ) tests to predict lower limb injuries in professional footballers. Methods. In a prospective cohort study SLS and VDJ scores were recorded before the start of the season and the lower limb injuries were recorded as followed up during a 9-month season (2021-2022). Logistic regression analysis was used to determine the accuracy of the prognosis of SLS and VDJ tests. Results. During the nine months of follow up, a total of twenty-five lower limb injuries (in twenty-three footballers) were recorded for 121 professional male footballers. The model explained 22% (Nagelkerke R2) of the variance in lower limb injury and correctly predicted 85.1% of cases. ROC analysis showed significant accuracy of the VDJ performance score of the footballer (AUC 0.659, 95%CI 3.639-63.434, p = 0.001, OR = 0.204) in discriminating between injured and uninjured players. The optimum cut-off level of the VDJ performance score of the football players was 0.5. Conclusions. VDJ test is a suitable tool for predicting lower limb injuries in professional male footballers, but SLS cannot be used as a reliable screening tool. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Laboratory Diagnostics / Diagnostyka Laboratoryjna is the property of Index Copernicus International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Gesture imitation, a simple tool for assessing visuospatial/visuoconstructive functions, is reportedly useful for screening and diagnosing dementia. However, gesture imitation performance in healthy older adults is largely unknown, as are the factors associated with lower performance. To address these unknowns, we examined the gesture imitation performance of a large number of community‐dwelling older adults aged ≥65 years in Arao City, Kumamoto Prefecture (southern Japan). Methods: The examiner presented the participants with eight gesture patterns and considered it a success if they could imitate them within 10 s. The success rate of each gesture imitation was calculated for three diagnostic groups: cognitively normal (CN) (n = 1184), mild cognitive impairment (MCI) (n = 237), and dementia (n = 47). Next, we reorganised the original gesture imitation battery by combining six selected gestures with the following scoring method: if the participants successfully imitated the gestures, immediately or within 5 s, two points were assigned. If they succeeded within 5–10 s, one point was assigned. The sensitivity and specificity of the battery were investigated to detect the dementia and MCI groups. Factors associated with gesture imitation battery scores were examined. Results: Except one complex gesture, the success rate of imitation in the CN group was high, approximately 90%. The sensitivity and specificity of the gesture imitation battery for discriminating between the dementia and CN groups and between the MCI and CN groups were 70%/88%, and 45%/75%, respectively. Ageing, male sex, and a diagnosis of dementia or MCI were associated with lower scores on the gesture imitation battery. Conclusion: Gesture imitation tasks alone may not be sufficient to detect MCI. However, by combining gestures with set time limits, gesture imitation tasks can be a low‐burden and effective method for detecting dementia, even in community medicine, such as during health check‐ups. [ABSTRACT FROM AUTHOR]

Screening in healthcare is the process of identifying apparently healthy individuals in a given population who either have an early stage asymptomatic disease or are at a higher risk of developing a disease. The goal of a screening test is an early diagnosis of a disease, which then can be effectively managed at an early stage resulting in a reduced disease-specific or overall mortality. It can be used for a variety of health conditions and across a broad spectrum of population depending on the health condition. Screening for cancers started in the mid-20th century with the introduction of screening for cervical cancers, and has since been tested for and extended to a number of other cancers. In this article we discuss the principles of cancer screening including characteristics of screening tests, benefits and limitations of screening programs in a population, followed by a brief overview of current cancer screening programs in the UK. [ABSTRACT FROM AUTHOR]

Introduction: Young sexual minority men (SMM) bear the greatest burden of anal human papillomavirus (HPV) infections. We assessed anal HPV genotype discordance between the Linear Array (LA) and SPF10 PCR-DEIA-LiPA25 (LiPA25). Methods: Discordance was assessed between LA and LiPA25 using self-collected anal swabs from 120 SMM aged 18–29 who were recruited in 2014–2016. Multiple-type infection was explored as a potential confounder of testing agreement, along with clinical and behavioral factors such as HIV status, syphilis status, incarceration history, health insurance coverage, having 3 or more sex partners in the past 6 months, and co-infection with HPV-16. Results: Significant discordance was found for HPV-6, -11, -16, -31, -42, -54, and -59. Exploratory analyses suggest higher prevalence of genotype discordance in those living with HIV, those with 3 or more sex partners, and those who were positive for 4 or more HPV types. Conclusions: Our results highlight the importance of HPV detection methods which may inform different interpretations of research assessing anal HPV natural history among SMM at highest risk for HPV.

Background: Neonate screening is a preventative measure that can contribute to early diagnosis of treatable diseases. Hypothyroidism in neonates is among the common preventable factors leading to intellectual disability. This study aims to describe the prevalence and experience with four-step screening to diagnose congenital hypothyroidism.Methods: The statistical population of this cross-sectional study included 392 preterm neonates (gestational ages less than 36 weeks and 6 days) in 2018-2019 from the health centers covered by Shahid Beheshti University of Medical Sciences (Tehran, Iran) who had been referred for screening. Neonates were screened in the first 3-6 days after birth and then on days 14, 42, and 72. In neonates with TSH serum levels of 10 mU/L, TSH-T4 was measured. Next, the physician decided on the medication based on the results.Results: At the primary screening of the neonates average TSH level was 2.08 ± 2.4 mU/L. Thirty-three neonates (8.4%) indicated disrupted screening results. The secondary screening of 388 neonates (98.97%) revealed an average TSH serum level of 1.9 ± 1.96 mU/L, and 19 (5.9%) indicated TSH serum levels higher than 5 (mU/L). The third screening test was performed on 382 (97.44%) of the neonates. The average TSH level was 1.3 ± 2.4 mU/L, 340 (85.96%) indicated normal levels, and 42 (11.47%) had unfavorable results. Finally, the fourth screening test was performed on 373 (95.15%) neonates. The mean TSH level was 2.21 ± 1.9 mU/L, which revealed 24 (6.12%) unfavorable test results. The percentage of hypothyroidism in neonates was 5.6% (23 cases). In this study, the prevalence of hypothyroidism was 4.33% (17 cases) in girls and 1.53% (6 cases) in boys. Conclusion: The results of this study revealed the high incidence rate of congenital hypothyroidism among preterm neonates. Therefore, preventing congenital hypothyroidism misdiagnosis requires a series of screening tests. Also, findings indicated that the results of screening tests for preterm neonates with prolonged GAs and higher birth weights are more accurate and reliable.

Release of new varieties requires qualitative as well as quantitative characters of the lines. For rice varieties, resistance to brown plant hopper (BPH) (Nilaparvata lugens, Stål) (Hemiptera: Delphacidae) is an important character that should be tested. The purpose of this study was to determine the resistance of new rice lines of rice cultivar to BPH. In this study, the tests were carried out on 6 (six) lines of candidate varieties developed by IPB University, namely TCIPB202101, TCIPB202102, TCIPB202103, TCIPB202104, TCIPB202105, and TCIPB202106. Resistance to BPH assays was conducted by screening and population development tests. Inpari 30 and Ciherang varieties were used as controls. The results showed that the TCIPB202106 line is the most resistant to BPH attack, while the TCIPB202103 line is the most susceptible to BPH attack. The average number of nymphs in the TCIPB202106 line was three times lower than those in Inpari 30 and Ciherang. The results of the population growth test were in line with the results of the screening test which indicated that the TCIPB202106 line is classified as moderately resistant to BPH.

The objectives of this research were to study the problems and needs related to screening for kindergarten students at risk from autism and to develop and study the effect of using mobile applications for screening for kindergarten students at risk from autism. The research was divided into three phases. Phase 1, the study of problems and needs related to a screening test for kindergarten students at risk at risk from autism from 50 kindergarten teachers by selecting a purposive sample according to the specified criteria. Phase 2, the mobile application development using the concept of the ADDIE Model; the efficiency was evaluated by 10 specialists by selecting a specific sample group according to the specified criteria, and Phase 3, study the results of using a mobile application by 34 teachers in kindergarten schools by selecting a specific sample group according to the specified criteria. The tools used in this research consisted of, - 1) a structured questionnaire, 2) a developed mobile application, 3) an application performance assessment form, and 4) a satisfaction questionnaire. Data were analyzed for percentage, mean, and standard deviation.The results of the study were as follows. 1) The results of the study of the problems and needs related to screening test for kindergarten students at risk students with autism in general, the schools applied management in caring for children with special needs at a medium level and the schools employed screening kindergarten children at medium risk of autism in all aspects, 2) The results of the development of a mobile application were systematically developed in 5 steps: analysis, design, development, implementation, and evaluation, with input factors that users could fill out for kindergarten screening, process factors that represent system functioning, and outcome factors that show screening and support results. The overall mobile application development results indicated that performance was at the highest level ( = 4.74, S.D. = 0.53) and technical design was at the highest level ( = 4.68, S.D. = 0.51), and 3) The results of using a mobile application for a screening test for kindergarten students at risk students from autism found that kindergarten teachers were satisfied with using the mobile application for screening test for at risk kindergarten students had at the highest level ( = 4.60, S.D. = 0.41)

Objectives: Early detection of cognitive impairment is essential for timely intervention. Currently, most widely used cognitive screening tests are influenced by language and cultural differences; therefore, there is a need for the development of a language‐neutral, visual‐based cognitive assessment tool. The Visual Cognitive Assessment Test (VCAT), a 30‐point test that assesses memory, executive function, visuospatial function, attention, and language, has demonstrated its utility in a multilingual population. In this study, we evaluated the reliability, validity, and diagnostic performance of the VCAT for screening early cognitive impairment in Chongqing, China Methods: A total of 134 individuals (49 healthy controls (HCs), 52 with mild cognitive impairment (MCI), and 33 with mild dementia) completed the Mini‐Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), VCAT, and domain‐specific neuropsychological assessments. The diagnostic performances of MMSE, MoCA, and VCAT were evaluated using the area under the curve (AUC), sensitivity, and specificity. Construct validity of the VCAT was assessed with well‐established domain‐specific cognitive assessments. Reliability was measured using Cronbach's alpha. Results: The VCAT and its subdomains demonstrated both good construct validity and internal consistency (α = 0.577). The performance of VCAT was comparable to that of MoCA and MMSE in differentiating mild dementia from nondemented groups (AUC: 0.940 vs. 0.902 and 0.977, respectively; p =.098 and.053) and in distinguishing cognitive impairment (CI) from HC (AUC: 0.929 vs. 0.899 and 0.891, respectively; p =.239 and.161), adjusted for education level. The optimal score range for VCAT in determining dementia, MCI, and HC was 0–14, 15–19, and 20–30, respectively. Conclusion: The VCAT proves to be a reliable screening test for early cognitive impairment within our cohort. Being both language and cultural neutral, the VCAT has the potential to be utilized among a wider population within China. [ABSTRACT FROM AUTHOR]

Understanding the susceptibility to spalling of concrete members in case of fire is important to evaluate the residual load-bearing capacity. The investigations of the spalling phenomenon of a concrete mixture using real scale members are necessary but expensive to carry out. Reducing the specimen size leads to an increase of boundary effects that can result in a reduced spalling or absence of spalling. In this study, fire tests were carried out on unrestrained, single-sided exposed, cuboid shaped specimens (0.6 m × 0.6 m × 0.29 m) as well as unrestrained and steel ring restrained cylindrical specimens (Ø = 0.47 m, h = 0.29 m), which induce different boundary conditions. These fire tests were carried out on two ordinary concrete mixtures. The two mixtures differ only in the type of aggregates (quartz gravel and basalt grit) and were used to investigate the influence of the thermal expansion of the aggregate on the spalling behaviour of the concrete. The results show a significant increase of the spalling depth due to the restrained thermal expansion achieved by the applied steel rings. Additionally, the type of aggregate has a direct influence on the spalling behaviour of a concrete mixture. The reduction of the boundary effects by the steel rings recreate the test conditions in the centre of a large concrete member. Thus, this type of specimen is suitable to determine the susceptibility to spalling of a material (screening-tests) as preliminary investigations to full scale fire tests. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to determine an optimal cutoff value for the newly available HemosIL-AcuStar-HIT-IgG assay (AcuStar) for the diagnosis of heparin-induced thrombocytopenia (HIT). Method We evaluated the performance of AcuStar using serotonin release assay (SRA) as the gold standard and incorporated 4T score calculation in a cohort of suspected HIT cases. Statistical analysis was performed to determine optimal cutoff value for the diagnosis of HIT. Result A diagnosis of HIT can be excluded with a platelet factor 4 (PF4) value of <0.4 U/mL by AcuStar and 4T score in the low-risk category (≤3). All other cases will require confirmation with a functional test. Conclusion Our study resulted in the implementation of a diagnostic algorithm for laboratory diagnosis of HIT, which incorporates pretest calculation of 4T score and AcuStar as a screening test, with reflex confirmation by SRA. This new algorithm resulted in extended hours of test availability and a more rapid turnaround time in reporting PF4 results. [ABSTRACT FROM AUTHOR]

Background: Neonate screening is a preventative measure that can contribute to early diagnosis of treatable diseases. Hypothyroidism in neonates is among the common preventable factors leading to intellectual disability. This study aims to describe the prevalence and experience with four-step screening to diagnose congenital hypothyroidism. Methods: The statistical population of this cross-sectional study included 392 preterm neonates (gestational ages less than 36 weeks and 6 days) in 2018-2019 from the health centers covered by Shahid Beheshti University of Medical Sciences (Tehran, Iran) who had been referred for screening. Neonates were screened in the first 3-6 days after birth and then on days 14, 42, and 72. In neonates with TSH serum levels of 10 mU/L, TSH-T4 was measured. Next, the physician decided on the medication based on the results. Results: At the primary screening of the neonates average TSH level was 2.08 ± 2.4 mU/L. Thirty-three neonates (8.4%) indicated disrupted screening results. The secondary screening of 388 neonates (98.97%) revealed an average TSH serum level of 1.9 ± 1.96 mU/L, and 19 (5.9%) indicated TSH serum levels higher than 5 (mU/L). The third screening test was performed on 382 (97.44%) of the neonates. The average TSH level was 1.3 ± 2.4 mU/L, 340 (85.96%) indicated normal levels, and 42 (11.47%) had unfavorable results. Finally, the fourth screening test was performed on 373 (95.15%) neonates. The mean TSH level was 2.21 ± 1.9 mU/L, which revealed 24 (6.12%) unfavorable test results. The percentage of hypothyroidism in neonates was 5.6% (23 cases). In this study, the prevalence of hypothyroidism was 4.33% (17 cases) in girls and 1.53% (6 cases) in boys. Conclusion: The results of this study revealed the high incidence rate of congenital hypothyroidism among preterm neonates. Therefore, preventing congenital hypothyroidism misdiagnosis requires a series of screening tests. Also, findings indicated that the results of screening tests for preterm neonates with prolonged GAs and higher birth weights are more accurate and reliable. [ABSTRACT FROM AUTHOR]

Criminal practices in which an individual becomes vulnerable and prone to sexual assault after ingesting drinks spiked with doping substances have become a social concern globally. As forensic protocols require a multi‐tiered strategy for chemical evidentiary analysis, the backlog of evidence has become a significant problem in the community. Herein, a fast, sensible, and complementary dual analytical methodology was developed using a single commercial paper substrate for surface‐enhanced Raman spectroscopy (SERS) and paper spray mass spectrometry (PS‐MS) analysis to identify psychotropic substances added to alcoholic beverages irrefutably. To study and investigate this criminal practice, pharmaceutical formulations containing distinct psychotropic substances (zolpidem, clonazepam, diazepam, and ketamine) were added to drinks typically consumed at parties and festivals (Pilsen beer, açaí Catuaba®, gin tonic, and vodka mixed with Coca‐Cola Zero®). A simple liquid–liquid extraction with a low‐temperature partitioning (LLE‐LTP) procedure was applied to the drinks and effectively minimized matrix effects. As a preliminary analysis, SERS spectra combined with Hierarchical Clustering Analysis (HCA) provided sufficient information to investigate the samples further. The presence of the protonated species for the psychotropic substances in the spiked drinks was readily verified in the mass spectra and confirmed by tandem mass spectrometry. Finally, the results demonstrate the potential of this methodology to be easily implemented into the routine of forensic laboratories and to be further employed at harm reduction tends at parties and festivals to detect contaminated beverages promptly and irrefutably as an efficient tool to prevent such crimes. [ABSTRACT FROM AUTHOR]

The Star Excursion Balance Test (SEBT) and its modification(mSEBT) as dynamic tests have been shown to have high reliability and validity for the prediction of lower extremities injuries including ACL ones. No previous study has compared mSEBT performance measures in different hormonal statuses of the menstrual cycle in naturally menstruating women. So aim of the study was comparison of mSEBT performance measures in days of the menstruation cycle with the peak of estrogen and progesterone hormones in naturally menstruating women. After a pilot study for estimation of sample size, mSEBT performance measures in a sample of 18 healthy women with regular menstrual cycles were compared two times in their cycles, first in the peak of estrogen (mid-cycle) and second in time of peak of progesterone (one week later). The test was performed 2 times using either the right or left leg as the stance and reach limb. No significant difference between days with estrogen and progesterone peaks with right or left reach limb was seen for the percentage of reach in any direction or the composite reach on the mSEBT performance. It seems that there is the same risk for lower extremities injuries in estradiol and progesterone peak days of normal menstruating women. • Use of the modified Star Excursion Balance Test as a valid and dynamic test. • No difference in balance performance between estradiol and progesterone days. • The same risk of leg injuries in estradiol and progesterone days. [ABSTRACT FROM AUTHOR]

Background: The aldosterone-to-renin activity ratio (ARR) is recommended as a screening test for primary aldosteronism (PA). The use of antihypertensive medication is one of the most important factors to take into account when interpreting the ARR. Objectives: The goal of this study was to compare the effect of various antihypertensive drug classes on biochemical testing and provide practical recommendations for antihypertensive medication regimens in patients suspected of having PA. Methods: We retrospectively investigated 4218 hypertensive patients who underwent PA detection between January 2020 and February 2023. Finally, 25 patients with essential hypertension (EH) and 39 with PA were involved. The enrolled EH patients were selected from EH patients with at least two screening tests with interfering medication changes for at least 4 weeks. Results: A total of 2/18 (11.1%) EH patients had opposite screening results after angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACEIs), dihydropyridine-calcium channel blockers (DHP-CCBs) and diuretics were withdrawn. A total of 3/3 (100%) of the patients were initially screened as positive but had results that tested negative after β-blockers withdrawal. A total of 3/39 (7.7%) PA patients were misdiagnosed with EH with drug effects. Only plasma renin activity was markedly reduced after antihypertensive medication washout (P = 0.0173). Conclusions: Not every patient receiving β-blockers, ACEIs, ARBs and DHP-CCBs with negative reports needed withdrawal or switching antihypertensive drugs. We recommend that patients be left on a regimen that includes β-blockers, ACEIs, ARBs, DHP-CCBs and spironolactone when determining the ARR during the initial test. [ABSTRACT FROM AUTHOR]

Speech therapy uses a combination of approaches to assess speech and language, including analysis of spontaneous speech, use of standardized scales and assessment by the child's parents and/or preschool teachers. In this paper, we present the Teddy Talk Test. Using a sample of sixteen children aged 4 to 5 years, we examined whether the test provided representative data on child language development. The parent questionnaire included information on the parents' education, the parents' native language, the child's gender and the language the parents speak with their child. It was found that the Teddy Talk Test has the characteristics of screening tests for speech and language: it is time-efficient, it covers receptive and expressive language tasks, and it allows for rapid assessment of speech and language in large numbers of children. However, since the Teddy Talk Test has not yet been evaluated, we do not know its value regarding sensitivity, specificity and predictive validity. [ABSTRACT FROM AUTHOR]

Simple Summary: This study investigates the potential of exosomal profiles as a tool for early detection of relapse and long-term outcomes in oral squamous cell carcinoma (OSCC) patients undergoing conventional therapy. Examining 27 OSCC patients, this study found a significant reduction in presurgical exosome levels after surgery. Patients experiencing relapse showed higher postsurgical exosome concentrations and larger sizes compared to disease-free individuals. Lower presurgical exosome levels were correlated with better disease-free survival. Receiver operating characteristic analysis indicated the promising diagnostic efficacy of presurgical exosome concentrations in identifying relapse (AUC = 0.82). The findings suggest that presurgical exosomal plasma levels independently predict early recurrence and survival in OSCC, proposing peripheral exosome detection as a novel tool for clinical management with implications for prognosis assessment. Background: Oral squamous cell carcinoma (OSCC) is characterized by an immunosuppressive tumor microenvironment. Their plasma-derived exosomes deliver immunomodulatory molecules and cargo that correlate significantly with clinical parameters. This study aims to assess the exosomal profile as a potential tool for early detection of relapse and long-term outcomes in OSCC patients undergoing conventional therapy. Methods: 27 OSCC patients with a median 38-month follow-up were included in this study. The relationship between NTA-derived parameters and clinical pathological parameters was examined, and receiver operating characteristic (ROC) curves were utilized to evaluate the diagnostic efficacy of these values in detecting cancer relapse. Results: Plasmatic levels of exosomes prior to surgery showed a drastic reduction after surgical intervention (8.08E vs. 1.41 × 109 particles/mL, p = 0.006). Postsurgical concentrations of exosomes were higher in patients who experienced relapse compared to those who remained disease-free (2.97 × 109 vs. 1.11 × 109 particles/mL, p = 0.046). Additionally, patients who relapsed exhibited larger exosome sizes after surgery (141.47 vs. 132.31 nm, p = 0.03). Patients with lower concentrations of exosomes prior to surgery demonstrated better disease-free survival compared to those with higher levels (p = 0.012). ROC analysis revealed an area under the curve of 0.82 for presurgical exosome concentration in identifying relapse. Conclusions: Presurgical exosomal plasmatic levels serve as independent predictors of early recurrence and survival in OSCC. All in all, our findings indicate that the detection of peripheral exosomes represents a novel tool for the clinical management of OSCC, with potential implications for prognosis assessment. [ABSTRACT FROM AUTHOR]

Due to the widespread use and environmental pollution of estrogenic chemicals, the need for screening tests to detect these compounds is felt more than ever. These compounds lead to cell proliferation. Therefore, studies used cell proliferation to evaluate estrogenic compounds was studied in this systematic review. This systematic review was performed with the keywords; DNA proliferation, cell proliferation, estrogenic component, estrogen, food, bioassay, screening, and detection. After initial screening and full text quality assessment, 16 manuscripts were selected and data were extracted. Four cell lines, MCF-7, MDA-MB-231, Ishikawa, and T47D cells were used in the studies. MCF-7 was more sensitive to estrogenic compounds than other lines. Most of the samples studied were plant compounds and mycotoxins and substances that migrate from packaging to food. This screening test is valid and has similar results as others. [ABSTRACT FROM AUTHOR]

ObjectivesThis study aimed to evaluate the screening performance of COPD-PS questionnaire, COPD-SQ questionnaire, peak expiratory flow (PEF), COPD-PS questionnaire combined with PEF, and COPD-SQ questionnaire combined with PEF for chronic obstructive pulmonary disease (COPD).MethodsThis was a cross-sectional study. We distributed self-designed surveys and COPD screening scales (COPD-PS questionnaire and COPD-SQ questionnaire) to residents who underwent physical examination in five community health centers in Haicang District, Xiamen City, from February 2023 to May 2023, and measured their lung function and PEF with a portable device. We used logistic regression to obtain the coefficients of COPD-PS questionnaire, COPD-SQ questionnaire, and PEF, and plotted the receiver operating characteristic curves of each tool for diagnosing COPD and moderate-to-severe COPD. We evaluated and compared the optimal cut-off points and scores of sensitivity, specificity, Youden index, and area under the curve (AUC) values, and assessed the screening efficiency of different methods.ResultsOf the 3,537 residents who completed the COPD-SQ questionnaire, COPD-PS questionnaire, and spirometry, 840 were diagnosed with COPD. We obtained the coefficients of COPD-PS questionnaire combined with peak expiratory flow (PEF), and COPD-SQ questionnaire combined with PEF, by logistic regression as −0.479-0.358 × PEF +0.321 × COPD-PS score and − 1.286-0.315 × PEF +0.125 × COPD-SQ score, respectively. The sensitivity of diagnosing COPD by COPD-SQ questionnaire, COPD-PS questionnaire, PEF, COPD-PS questionnaire combined with PEF, and COPD-SQ questionnaire combined with PEF were 0.439, 0.586, 0.519, 0.586, 0.612 respectively, and the specificity were 0.725, 0.621, 0.688, 0.689, 0.663 respectively, with ROC values of 0.606 (95%CI: 0.586–0.626), 0.640 (0.619–0.661), 0.641 (0.619–0.663), 0.678 (0.657–0.699), 0.685 (0.664–0.706) respectively. The sensitivity of diagnosing GOLD II and above by COPD-SQ questionnaire, COPD-PS questionnaire, PEF, COPD-PS questionnaire combined with PEF, and COPD-SQ questionnaire combined with PEF were 0.489, 0.620, 0.665, 0.630, 0.781 respectively, and the specificity were 0.714, 0.603, 0.700, 0.811, 0.629 respectively, with ROC values of 0.631 (95%CI: 0.606–0.655), 0.653 (0.626–0.679), 0.753 (0.730–0.777), 0.784 (0.762–0.806), 0.766 (0.744–0.789) respectively.ConclusionOur study found that the accuracy of COPD screening by COPD-SQ questionnaire and COPD-PS questionnaire can be improved by combining the results of PEF. The screening performance of COPD-SQ questionnaire combined with PEF is relatively better. In future research, further studies are needed to optimize the performance of screening tools and understand whether their use will affect clinical outcomes.

Background: Whether chemiluminescence immunoassay (CLIA) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) for plasma aldosterone concentration (PAC) measurement can be used interchangeably in primary aldosteronism (PA) screening is still controversial. The purpose of this study was to compare CLIA to LC-MS/MS for PAC measurement in PA screening. Methods: All participants underwent aldosterone-to-renin ratio (ARR) testing. PA was diagnosed by captopril challenge test or saline infusion test. PAC in screening test was measured with CLIA and LC-MS/MS. Plasma direct renin concentration in screening and confirmatory test was measured with CLIA. The concordance between CLIA and LC-MS/MS for PAC measurement in PA screening was analyzed. Results: Twenty-one healthy volunteers, 61 patients with essential hypertension (EH) and 43 PA patients were enrolled. Median PAC by CLIA was 84.7 % higher than that by LC-MS/MS in screening test (P

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. Currently, rates of infection are increasing across all populations worldwide, with disproportionate impact on men who have sex with men, adolescents, and young adults. Syphilis is well-known for its variability in disease progression and clinical presentation, which complicates prompt and accurate diagnosis. Acute care settings have become the frontline in the battle against this syphilis surge, and providers must be prepared to recognize syphilis presentation, initiate appropriate testing, and establish contact tracing for individuals who may have been exposed. The purpose of this manuscript is to serve as a teaching tool for syphilis diagnosis and treatment, and we present four cases that showcase the risks and variable clinical presentation, discussing the challenges involved in managing each case. The authors then summarize key learning points related to diagnosis, treatment, and follow-up.

Delirium is often the first symptom of incipient acute illness or complications and must therefore be detected promptly. Nevertheless, routine screening for delirium in acute care hospital wards is often inadequate. We recently implemented a simple, user-friendly delirium screening test (RMA) that can be administered during ward rounds and routine nursing care. The test was found to be non-inferior to 4AT in terms of sensitivity and specificity. However, the dominant factors to take into account when assessing the performance of a test added to the routine work of busy acute care hospital wards are ease of administration, real-life amenability and the ability of the staff to adhere to testing requirements. In this study, we evaluated the prevalence of daily RMA tests that were not administered as scheduled and the impact of these omissions on the overall real-world performance of RMA. Using point-in-time assessments of 4AT by an external rater, we found that complete RMA was administered in 88.8% of the days. Physicians omitted significantly more tests than nurses, but their results were more specific for delirium. Omissions reduced the sensitivity and specificity of RMA for delirium (compared to 4AT) from 90.7% to 81.7%, and from 99.2% to 87.8%, respectively. Ideally, the number of omitted RMA tests should be minimized. However, if over 85% of the daily quota of complete tests are administered, the sensitivity and specificity of RMA for diagnosing delirium as soon as it appears remain at acceptable levels.

Accurate lupus anticoagulant (LA) detection is crucial to antiphospholipid syndrome (APS) diagnosis. Detection is based on LA functional behavior in coagulation assays irrespective of epitope specificity. LA screening tests employ dilute phospholipids to accentuate in vitro inhibition by LAs, although they are not LA-specific and can be elevated by other coagulation abnormalities. Elevated screening tests are reflexed to mixing tests to distinguish between factor deficiency and inhibition. Confirmatory tests with high phospholipid concentration swamp LA to generate shorter clotting times than screening tests, whilst prolongation persists with non-phospholipid-dependent inhibitors. LA heterogeneity means that no single screening test detects every LA and the screen/mix/confirm medley must be applied to at least two assay types, usually dilute Russell’s viper venom time (dRVVT) and an LA-sensitive activated partial thromboplastin time (aPTT). Most laboratories restrict LA testing to these two assays, yet others, such as dilute prothrombin time (dPT), can perform with equal diagnostic efficacy, and additionally detect LA unreactive with dRVVT and aPTT. Converting clotting times to normalized ratios improves assay performance, and practitioners must choose between normal pooled plasma (NPP) clotting time denominators to reflect on-the-day assay performance, or reference interval (RI) mean clotting times to negate the effects of NPP variation. Cut-offs can be generated parametrically from normally distributed data, or different percentiles applied depending on the preferred balance between sensitivity and specificity. Sourcing sufficient donors for accurate cut-off estimations is problematic and transference exercises can be undertaken on low donor numbers. Analytical limitations of mixing tests have led to the adoption of alternative algorithms to the screen/mix/confirm test order, whilst some continue to rigidly apply the latter despite those limitations. Strategies to reduce or eliminate the effects of therapeutic anticoagulation have limitations, whilst the Taipan snake venom time (TSVT) screening test with an ecarin time (ET) confirmatory test is insensitive to vitamin K antagonist (VKA) and direct activated factor X anticoagulation.

Abstract Background Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in neonatal period. Most of neonatal sepsis-related morbidity and mortality can be prevented by early diagnosis and treatment with appropriate antimicrobial agents. Micro-erythrocyte sedimentation rate (m-ESR) is a simple, inexpensive, and rapid screening test for neonatal sepsis that can be done even in resource limited setups. Objectives To compare the efficacy of m-ESR with C-reactive protein (CRP) as a screening tool in neonatal sepsis. Methodology A retrospective chart-based analysis was done in division of neonatology, of our tertiary care hospital over a period of 21 months. A total of 202 suspected cases of neonatal sepsis with documented CRP and micro-ESR values were included. We evaluated the role of micro-ESR as a screening tool in neonatal sepsis in comparison with CRP. The validity and reliability of micro-ESR in comparison to CRP were estimated and its sensitivity, specificity, positive, and negative predictive value to diagnose sepsis were calculated. Results There was a significant correlation between micro-ESR and CRP with a moderate degree of agreement, especially in ‘late onset sepsis’ group. The overall sensitivity, specificity, positive predictive value and negative predictive value of micro-ESR were 67%, 84%, 58%, and 89% respectively. Conclusion Micro-ESR is a simple, inexpensive test comparable to CRP in screening for neonatal sepsis.

Abstract Objectives Early detection of cognitive impairment is essential for timely intervention. Currently, most widely used cognitive screening tests are influenced by language and cultural differences; therefore, there is a need for the development of a language‐neutral, visual‐based cognitive assessment tool. The Visual Cognitive Assessment Test (VCAT), a 30‐point test that assesses memory, executive function, visuospatial function, attention, and language, has demonstrated its utility in a multilingual population. In this study, we evaluated the reliability, validity, and diagnostic performance of the VCAT for screening early cognitive impairment in Chongqing, China Methods A total of 134 individuals (49 healthy controls (HCs), 52 with mild cognitive impairment (MCI), and 33 with mild dementia) completed the Mini‐Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), VCAT, and domain‐specific neuropsychological assessments. The diagnostic performances of MMSE, MoCA, and VCAT were evaluated using the area under the curve (AUC), sensitivity, and specificity. Construct validity of the VCAT was assessed with well‐established domain‐specific cognitive assessments. Reliability was measured using Cronbach's alpha. Results The VCAT and its subdomains demonstrated both good construct validity and internal consistency (α = 0.577). The performance of VCAT was comparable to that of MoCA and MMSE in differentiating mild dementia from nondemented groups (AUC: 0.940 vs. 0.902 and 0.977, respectively; p = .098 and .053) and in distinguishing cognitive impairment (CI) from HC (AUC: 0.929 vs. 0.899 and 0.891, respectively; p = .239 and .161), adjusted for education level. The optimal score range for VCAT in determining dementia, MCI, and HC was 0–14, 15–19, and 20–30, respectively. Conclusion The VCAT proves to be a reliable screening test for early cognitive impairment within our cohort. Being both language and cultural neutral, the VCAT has the potential to be utilized among a wider population within China.

Introduction: The Netherlands was one of the first countries in Europe to offer breast, colorectal and cervical cancer screening tests free of charge. Yet, a significant share of migrants in the Netherlands forgo the use of these preventive screenings. Qualitative research suggests, that lack of system knowledge on how the healthcare system operates (e.g. age eligibility of cancer screenings), is one factor contributing to this underuse among migrants. However, little is known about the extent to which migrants differ from natives in their system knowledge and about potential causes of this ethnic gap. The contribution of this study is therefore twofold: First, we examine whether migrants in the Netherlands have lower system knowledge regarding cancer screenings than the natives. Second, we examine which factors explain potential ethnic differences in system knowledge between migrants and non-migrants. Method: Using the Longitudinal Internet Study for Social Sciences (LISS), we matched newly collected data on system knowledge about healthcare with Health module (wave 14). To assess the difference in system knowledge among migrants and non-migrants, while taking into account potential selection bias, we applied propensity score matching, one-to-one matching procedure with no replacement. We compared first generation non - Western migrants (FNWM) and second-generation non-western migrants (SNWM) with their most similar non-migrants group regarding their knowledge about breast, colorectal, and cervical screening. A Blinder-Oaxaca decomposition with non-matched samples was used to examine which factors can explain the differences in system knowledge among migrants and non-migrants. Results: Our results show that first generation migrants have lower system knowledge about all three screening tests, while second generation migrants differ from non-migrants only with regard to knowledge about breast and colorectal cancer screenings. The ethnic differences found are not caused by personal or social factors such as education or income. Conclusion: We recommend Dutch healthcare policy makes to focus in the strengthen of cancer screening system knowledge among migrant populations in order to increase their participation in these screening programs.