Point-of-care rapid diagnostic tests (POC-RDTs) are widely used to screen and diagnose hepatitis B virus (HBV) infection and are often the only available diagnostic tools in resource-limited settings. The aim of this study was to evaluate the validity of three hepatitis B surface antigen (HBsAg) POC-RDTs (Healgen®, Advanced Quality™ and Determine™) in an area with high prevalence of HBV in eastern Ethiopia. Results were compared with a commercial enzyme linked immunosorbent assay (ELISA) as gold standard. Quantification of HBsAg was performed in false negative samples. A total of 511 subjects were screened, of whom 81 (15.9 %) were HBsAg-positive with the gold standard. All three POC-RDTs were positive in 65 of the 81 positive samples, yielding a sensitivity (95 % confidence interval) of 80.2 % (70.3-87.5) and a specificity of 99.8 % (98.7-100 for Healgen® and Determine™; 98.6-100 for Advanced Quality™). False negatives were observed in 16 patients associated with low levels of HBsAg (median 1.5 IU/mL). All three POC-RDTs had reasonably high sensitivity and excellent specificity, but false negative results were observed in patients with low titres of HBsAg. Thus, these POC-RDTs might be useful to identify patients in need of HBV treatment, but cannot be recommended as blood donor screening tests.
For visual perspective taking (VPT) using the avatar task, examinations of neural processes using event related potentials (ERP) indicate a distinction between an early posterior perspective calculation process (P3) and a later frontal process (LFSW) managing perspective conflict. While it is unknown if these neural processes are affected in clinical populations, it is unclear if the avatar task can be applied to this group, due to the long duration and sensitivity to data loss. Thus, we performed a methodological study of the avatar task, testing the feasibility of a shortened experimental paradigm.
To investigate whether previously reported behavioural and ERP effects in the avatar task can also be seen if analysing all trials (matching/non-matching) jointly, and whether they remain robust if only a subset of the data is analysed.
Healthy individuals (n = 20) completed the avatar task with ERP measurement. ERP components (P3, LFSW) and behavioural data were investigated by A) comparing use of only matching trials (n = 384) versus all trials (n = 768), and B) examining if reduced duration of assessment, by analysing only a subset of the data, impacts ERP findings.
We observed minimal differences when analysing data from only matching trial types compared to all trial types. Further, ERP amplitudes and latency findings were replicated when analysing only a subset of the data.
The duration of the avatar task can be reduced to avoid long testing times, thus making it better suited for use in clinical populations.
The duration of the avatar task can be reduced to avoid long testing times, thus making it better suited for use in clinical populations.In 2019 California's Office of Environmental Health Hazard Assessment (OEHHA) initiated a review of the carcinogenic hazard potential of acetaminophen. In parallel with this review, herein we evaluated the mechanistic data related to the steps and timing of cellular events following therapeutic recommended (≤4 g/day) and higher doses of acetaminophen that may cause hepatotoxicity to evaluate whether these changes indicate that acetaminophen is a carcinogenic hazard. At therapeutic recommended doses, acetaminophen forms limited amounts of N-acetyl-p-benzoquinone-imine (NAPQI) without adverse cellular effects. Following overdoses of acetaminophen, there is potential for more extensive formation of NAPQI and depletion of glutathione, which may result in mitochondrial dysfunction and DNA damage, but only at doses that result in cell death - thus making it implausible for acetaminophen to induce the kind of stable, genetic damage in the nucleus indicative of a genotoxic or carcinogenic hazard in humans. The collective data demonstrate a lack of a plausible mechanism related to carcinogenicity and are consistent with rodent cancer bioassays, epidemiological results reviewed in companion manuscripts in this issue, as well as conclusions of multiple international health authorities.
Early prognostication after cardiac arrest would be useful. We aimed to develop a scoring model for early prognostication in unselected adult cardiac arrest patients.
We retrospectively analysed data of adult non-traumatic cardiac arrest patients treated at a tertiary hospital between 2014 and 2018. The primary outcome was poor outcome at hospital discharge (cerebral performance category, 3-5). Using multivariable logistic regression analysis, independent predictors were identified among known outcome predictors, that were available at intensive care unit admission, in patients admitted in the first 3 years (derivation set, N = 671), and a scoring system was developed with the variables that were retained in the final model. The scoring model was validated in patients admitted in the last 2 years (validation set, N = 311).
The poor outcome rates at hospital discharge were similar between the derivation (66.0%) and validation sets (64.3%). Age <59 years, witnessed collapse, shockable rhythm, adrenaline dose <2 mg, low-flow duration <18 min, reactive pupillary light reflex, Glasgow Coma Scale motor score ≥2, and levels of creatinine <1.21 mg dl
, potassium <4.4 mEq l
, phosphate <5.8 mg dl
, haemoglobin ≥13.2 g dl
, and lactate <8 mmol l
were retained in the final multivariable model and used to develop the scoring system. Our model demonstrated excellent discrimination in the validation set (area under the curve of 0.942, 95% confidence interval 0.917-0.968).
We developed a scoring model for early prognostication in unselected adult cardiac arrest patients. read more Further validations in various cohorts are needed.
We developed a scoring model for early prognostication in unselected adult cardiac arrest patients. Further validations in various cohorts are needed.read more
Top comments (0)