A gas chromatography coupled to high-resolution mass spectrometry (GC-HR/MS) has been used as the standard method for the quantification of polychlorinated dibenzo-p-dioxins and furans (PCDDs/Fs), which are regulated at screening and action levels in the environment. However, several alternative methods have been attempted due to the disadvantage of its high cost. Although a gas chromatography with triple quadrupole mass spectrometry (GC-QqQ-MS/MS) has been used in a wide variety of sample matrices, showing that they are interchangeable, there has been a lack of comprehensive studies on statistical agreement with GC-HR/MS. In this study, a pairwise comparison of the total concentrations of PCDDs/Fs in 90 soil field samples obtained by two mass spectrometric methods was performed using the Passing-Bablok (P&B) regression and Bland-Altman (B&A) analysis for the method comparison. According to the result of the B&A analysis, the concentration range of PCDDs/Fs was between 98.2 and 1760 pg/g showed good agreement between two methods at the 95 % confidence level (CL). Although there was a large discrepancy between the two methods in the low concentrations (<16.5 pg/g of PCDDs/Fs), this result was similar to the P&B regression analysis. As the verification results by B&A and P&B regression analysis, the interchangeable concentration range between the two methods was confirmed to be adequate for the monitoring of PCDDs/Fs regulating levels in soils.

The article discusses the promising synergy between MXenes and polymers in developing advanced nanocomposites with diverse applications in biomedicine domains. MXenes, possessing exceptional properties, are integrated into polymer matrices through various synthesis and fabrication methods. These nanocomposites find applications in drug delivery, imaging, diagnostics, and environmental remediation. They offer improved therapeutic efficacy and reduced side effects in drug delivery, enhanced sensitivity and specificity in imaging and diagnostics, and effectiveness in water purification and pollutant removal. The perspective also addresses challenges like biocompatibility and toxicity, while suggesting future research directions. In totality, it highlights the transformative potential of MXenes-polymer nanocomposites in addressing critical issues across various fields.

Rheumatoid arthritis (RA) is a complex autoimmune disease causing chronic joint inflammation and, in more serious cases, organ involvement. RA typically affects people between the ages of 35 and 60; however, it can also afflict children younger than the age of 16 years and can also demonstrate a pattern of remission later in the disease course. Non-steroidal anti-inflammatory drugs, glucocorticoids, exercise, and patient education are all used in the management of RA, which is divided into symptomatic management and disease-modifying management (disease-modifying antirheumatic drugs) to reduce pain and inflammation, thereby preserving joint function. Janus kinase inhibitors (JAKis) have led to a substantial improvement in the management of RA. By specifically targeting the JAK-signal transducer and activator of transcription pathway, which is essential for immunological modulation, these inhibitors also demonstrate promise in treating various autoimmune illnesses, including inflammatory bowel diseases, giant cell arteritis, ankylosing spondylitis, and psoriatic arthritis. Tofacitinib, baricitinib, upadacitinib, peficitinib, delgocitinib, and filgotinib are examples of FDA-approved JAKis that have distinct properties and indications for treating a range of autoimmune illnesses. JAKis demonstrate a promising treatment approach for managing RA and other autoimmune diseases while enhancing patient outcomes and quality of life. However, due to major safety concerns and the need for long-term success, meticulous patient monitoring is essential.

OBJECTIVE: The purpose of this study was to research the neutrophil-lymphocyte ratio (NLR), lymphocyte-to-C-reactive protein ratio (LCR), and Fournier\'s Gangrene Severity Index (FGSI) for predicting prognosis and mortality in patients with Fournier\'s gangrene (FG).
METHODS: Patients diagnosed with FG and treated in a tertiary referral hospital in the period from January 2013 to June 2020 were reviewed. LCR, FGSI, and NLR values were calculated.
RESULTS: Our series included a total of 41 patients. Of the patients, 78% survived and 21.9% (n = 9) died. Survivors were significantly younger than non-survivors (p = 0.009). Hospital costs were higher in non-survivors and close to statistical significance (p = 0.08). The ROC analysis revealed that the FGSI, LCR, and NLR parameters were significant in identifying survivors and non-survivors (AUC = 0.941 [0.870-1.000], p < 0.001; AUC = 0.747 [0.593-0.900], p = 0.025; and AUC = 0.724 [0.548-0.900], p = 0.042).
CONCLUSIONS: A low LCR value can be used as a marker to assess mortality and disease severity in patients with Fournier\'s gangrene.
OBJECTIVE: Investigar el cociente neutrófilos-linfocitos (CNL), el cociente linfocitos-proteína C reactiva (CLP) y el índice de gravedad de la gangrena de Fournier (IGGF) para predecir el pronóstico y la mortalidad en pacientes con gangrena de Fournier (GF).
UNASSIGNED: Se revisaron los pacientes diagnosticados de GF y atendidos en un hospital de tercer nivel de referencia en el período de enero de 2013 a junio de 2020. Se calcularon los valores de CLP, IGGF y CNL.
RESULTS: Nuestra serie incluyó 41 pacientes, de los cuales el 78% sobrevivieron y el 21.9% (n = 9) fallecieron. Los supervivientes eran significativamente más jóvenes que los no supervivientes (p = 0.009). Los costes hospitalarios fueron mayores en los no supervivientes y cercanos a la significación estadística (p = 0.08). El análisis ROC reveló que los parámetros IGGF, CLP y CNL fueron significativos para identificar supervivientes y no supervivientes (AUC: 0.941 [0.870-1.000], p < 0.001; AUC: 0.747 [0.593-0.900], p = 0.025; AUC: 0.724 [0.548-0.900], p = 0.042).
CONCLUSIONS: Un valor bajo de CLP se puede utilizar como marcador para evaluar la mortalidad y la gravedad de la enfermedad en pacientes con GF.

BACKGROUND: Current clinical diagnosis pathway for lysosomal storage disorders (LSDs) involves sequential biochemical enzymatic tests followed by DNA sequencing, which is iterative, has low diagnostic yield and is costly due to overlapping clinical presentations. Here, we describe a novel low-cost and high-throughput sequencing assay using single-molecule molecular inversion probes (smMIPs) to screen for causative single nucleotide variants (SNVs) and copy number variants (CNVs) in genes associated with 29 common LSDs in India.
RESULTS: 903 smMIPs were designed to target exon and exon-intron boundaries of targeted genes (n = 23; 53.7 kb of the human genome) and were equimolarly pooled to create a sequencing library. After extensive validation in a cohort of 50 patients, we screened 300 patients with either biochemical diagnosis (n = 187) or clinical suspicion (n = 113) of LSDs. A diagnostic yield of 83.4% was observed in patients with prior biochemical diagnosis of LSD. Furthermore, diagnostic yield of 73.9% (n = 54/73) was observed in patients with high clinical suspicion of LSD in contrast with 2.4% (n = 1/40) in patients with low clinical suspicion of LSD. In addition to detecting SNVs, the assay could detect single and multi-exon copy number variants with high confidence. Critically, Niemann-Pick disease type C and neuronal ceroid lipofuscinosis-6 diseases for which biochemical testing is unavailable, could be diagnosed using our assay. Lastly, we observed a non-inferior performance of the assay in DNA extracted from dried blood spots in comparison with whole blood.
CONCLUSIONS: We developed a flexible and scalable assay to reliably detect genetic causes of 29 common LSDs in India. The assay consolidates the detection of multiple variant types in multiple sample types while having improved diagnostic yield at same or lower cost compared to current clinical paradigm.

The newly emerging liquid metal flexible electronics are gaining increasing applications over the world due to their outstanding adaptability and printability. Here, we proposed a generalized purpose thermo-activated hybrid transfer printing method for the rapid fabrication of multifunctional soft electronics, which can significantly reduce the difficulty facing existing technologies. This printing involves two delivery and deposition processes of liquid metals and the allied inks (toners) based on their adhesion selection mechanisms. Through developing office supplies, the laser printer could directly print toner masks on soft substrates, such as polydimethylsiloxane film. The heating plate was applied to remove the toner sacrificial mask after rolling liquid metal inks, resulting in retaining the liquid metal circuits on the target substrate. For illustration, diverse materials and inks are adapted to the strategy of constructing flexible electronics. Particularly, colorful circuits, flexible heaters, transparent circuitry, and soft programmable light-emitting diode array displays with multilayer circuits have been fabricated and tested. This general and easily accessible method allows for the rapid acquisition of user-designed soft electronics and is expected to promote the widespread use of flexible electronics in e-skin, sensing, displays, etc.

BACKGROUND: The diagnosis and treatment monitoring of hepatitis C is quite challenging. The screening test, i.e. antibody assay, is unable to detect acute cases, while the gold standard hepatitis C virus (HCV) reverse transcriptase polymerase chain reaction (RTPCR) assay is not feasible in resource-limited countries such as India due to high cost and infrastructure requirement. European Association for the Study of the Liver and World Health Organization have approved a new marker, i.e. HCV core antigen (HCVcAg) assay, as an alternative to molecular assay. In this study, we have evaluated HCVcAg assay for diagnosis and treatment monitoring follow-up in Indian population infected with hepatitis C.
METHODS: Blood specimen of 90 clinically suspected cases of acute hepatitis C were tested simultaneously for anti-HCV antibody assay via ELISA (enzyme-linked immunoassay), HCVcAg assay by chemiluminescence immune assay (CLIA) and HCV RTPCR VL (viral load) assay. Thirty-four HCV RTPCR positive patients were further enrolled in treatment monitoring group whose blood samples were tested at the beginning of treatment, two weeks, four weeks and 12 weeks via HCV core Ag assay and HCV RTPCR Viral Load assay.
RESULTS: Considering HCV RTPCR as gold standard, diagnostic performance of HCV core Ag assay and anti-HCV antibody assay was evaluated. The sensitivity and specificity of HCV core Ag assay were higher than that of anti-HCV Antibody assay, i.e. 88.3% and 100% vs. 23.3% and 83.3%, respectively. The overall diagnostic accuracy of HCV core Ag assay was 92.20%. Among treatment follow-up group, HCV core Ag levels correlated well with HCV viral load levels, at the beginning of treatment (baseline) till 12 weeks showing highly significant Spearman rank correlation coefficient of > 0.9 with HCV viral load levels.
CONCLUSIONS: HCV core Ag assay is a cost-effective, practically feasible substitute of HCV RTPCR viral load assay for diagnosis as well as long duration treatment monitoring of hepatitis C infection in resource-limited settings.

Hypoglycemia in the pediatric population tends to present in the newborn period or during metabolic crisis triggered by prolonged fasting and intercurrent illness. Current recommendations to investigate all children presenting with hypoglycemia for the first time are cumbersome and costly but necessary to identify those with serious conditions who predispose to hypoglycemia. We describe a practical and cost-effective method of evaluating children who present to the emergency department with previously undiagnosed hypoglycemia. Glucose and point-of-care (POC) beta-hydroxybutyrate levels should be measured on all children with a low screening POC glucose level, and a full history and physical examination will identify those requiring further investigation. This approach is suggested to identify patients with serious and life-threatening disease with the same fidelity as the currently recommended approach of performing a critical sample on all children with hypoglycemia. Our streamlined approach will reduce the cost to approximately 10% of the current approach per patient diagnosed with a serious underlying disease. Further, children without underlying hypoglycemia-predisposing disorders will be identified and discharged without unnecessary intervention.

BACKGROUND: Have you ever been in the trenches of a complicated study only to be interrupted by a not-so urgent phone-call? We were, repeatedly- unfortunately.
OBJECTIVE: To increase productivity of radiologists by quantifying the main source of interruptions (phone-calls) to the workflow of radiologists, and too assess the implemented solution.
METHODS: To filter calls to the radiology consultant on duty, we introduced an automatic voicemail and custom call redirection system. Thus, instead of directly speaking with radiology consultants, clinicians were to first categorize their request and dial accordingly: 1. Inpatient requests, 2. Outpatient requests, 3. Directly speak with the consultant radiologist. Inpatient requests (1) and outpatient requests (2) were forwarded to MRI technologists or clerks, respectively. Calls were monitored in 15-minute increments continuously for an entire year (March 2022 until and including March 2023). Subsequently, both the frequency and category of requests were assessed.
RESULTS: 4803 calls were recorded in total: 3122 (65 %) were forwarded to a radiologist on duty. 870 (18.11 %) concerned inpatients, 274 (5.70 %) outpatients, 430 (8.95 %) dialed the wrong number, 107 (2.23 %) made no decision. Throughout the entire year the percentage of successfully avoided interruptions was relatively stable and fluctuated between low to high 30 % range (Mean per month 35 %, Median per month 34.45 %).
CONCLUSIONS: This is the first analysis of phone-call interruptions to consultant radiologists in an imaging department for 12 continuous months. More than 35 % of requests did not require the input of a specialist trained radiologist. Hence, installing an automated voicemail and custom call redirection system is a sustainable and simple solution to reduce phone-call interruptions by on average 35 % in radiology departments. This solution was well accepted by referring clinicians. The installation required a one-time investment of only 2h and did not cost any money.

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