Journal of Applied Laboratory Medicine最新文献

Evaluating the Sensitivity, Selectivity, and Cross-Reactivity of Lateral Flow Immunoassay Xylazine Test Strips.

IF 1.8

Journal of Applied Laboratory Medicine Pub Date : 2025-04-04 DOI: 10.1093/jalm/jfaf037

Lena Scott, Katherine Davis, Ju Nyeong Park, Saman Majeed

{"title":"Evaluating the Sensitivity, Selectivity, and Cross-Reactivity of Lateral Flow Immunoassay Xylazine Test Strips.","authors":"Lena Scott, Katherine Davis, Ju Nyeong Park, Saman Majeed","doi":"10.1093/jalm/jfaf037","DOIUrl":"https://doi.org/10.1093/jalm/jfaf037","url":null,"abstract":"Background: The rise of xylazine-adulterated substances poses significant public health risks due to their severe side effects, creating an urgent need for reliable detection methods. Lateral flow immunoassay-based xylazine test strips (XTS) have emerged as a potential harm reduction tool for quick, easy, and field-based drug checking, but their effectiveness remains underexplored. Although commercial XTS from multiple vendors are available, the lack of regulatory standards raises concerns regarding their accuracy.Methods: This study evaluated the performance of commercially available XTS from 7 different vendors to investigate the interproduct comparison of sensitivity, precision, cross-reactivity, and stability over changes in human urine pH and extended storage under ambient and extreme temperature conditions.Results: All test strips maintained their sensitivity, reproducibility, and effectiveness despite urinary pH fluctuation and storage temperatures over 6 weeks. However, concentration-dependent false-positive results were observed when the strips were tested with drugs and adulterants commonly encountered in seized samples. Interfering compounds including lidocaine, levamisole, ketamine, methamphetamine, diphenhydramine, promethazine, and cetirizine displayed varying degrees of cross-reactivity with different XTS.Conclusions: This study underscores the variability in performance among commercially available XTS, highlighting their implications for use in harm reduction and forensic settings. While XTS are capable of detecting xylazine at low concentrations, the potential for false-positive results due to cross-reactivity with other drugs necessitates caution in their interpretation. Hence, XTS may serve as a viable harm reduction tool, provided that their cross-reactivity limitations are thoroughly documented and they are incorporated as part of a broader harm reduction strategy.","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Child with a Known Cancer Predisposition Syndrome and an Unusually Aggressive Clinical Course.

IF 1.8

Journal of Applied Laboratory Medicine Pub Date : 2025-04-03 DOI: 10.1093/jalm/jfaf001

Maya Ball-Burack, Francisco A Perez, Natalie Waligorski, Shannon M Stasi, Bonnie L Cole, Rebecca Ronsley, Christina Lockwood, Sarah E Leary, Vera Paulson, Michelle A Ting

引用次数: 0

M Protein Interference in Renal Function Assays: A Quest for True Kidney Function.

IF 1.8

Journal of Applied Laboratory Medicine Pub Date : 2025-04-03 DOI: 10.1093/jalm/jfaf028

Michelle P van der Helm, Brigitte A Wevers, Cees van Beek, Paul W Schenk, Angela Bikker-Koornneef

引用次数: 0

Correction to: ADLM Guidance Document on the Measurement and Reporting of Lipids and Lipoproteins.

IF 1.8

Journal of Applied Laboratory Medicine Pub Date : 2025-04-02 DOI: 10.1093/jalm/jfaf021

引用次数: 0

Commentary on A Child with a Known Cancer Predisposition Syndrome and an Unusually Aggressive Clinical Course.

IF 1.8

Journal of Applied Laboratory Medicine Pub Date : 2025-04-01 DOI: 10.1093/jalm/jfaf025

Sharon Markham Geaghan

引用次数: 0

Commentary on Rifampicin Interference in Urinary Normetanephrine.

IF 1.8

Journal of Applied Laboratory Medicine Pub Date : 2025-04-01 DOI: 10.1093/jalm/jfaf024

Sharon Markham Geaghan

引用次数: 0

Rifampicin Interference in Urinary Normetanephrine.

IF 1.8

Journal of Applied Laboratory Medicine Pub Date : 2025-04-01 DOI: 10.1093/jalm/jfaf023

Baptiste Gillardin, Jennifer Guillerme, Valéry Brunel, François Fraissinet, Guillaume Feugray

引用次数: 0

The Effect of Clinical Decision Support Intervention on Monitoring for Donor Specific Antibodies. 临床决策支持干预对监测捐献者特异性抗体的影响。

IF 1.8

Journal of Applied Laboratory Medicine Pub Date : 2025-03-29 DOI: 10.1093/jalm/jfaf030

Aja Aravamudhan, Carolynn Scalf, Michael P Greenwood, Penn Muluhngwi

{"title":"The Effect of Clinical Decision Support Intervention on Monitoring for Donor Specific Antibodies.","authors":"Aja Aravamudhan, Carolynn Scalf, Michael P Greenwood, Penn Muluhngwi","doi":"10.1093/jalm/jfaf030","DOIUrl":"https://doi.org/10.1093/jalm/jfaf030","url":null,"abstract":"Background: Following transplantation, it is recommended that human leukocyte antigen (HLA) donor specific antibody (DSA) monitoring for allograft surveillance be tailored to the patient's antibody-mediated rejection (AMR) risk and immunosuppression needs. However, at our institution, DSA orders were placed more frequently than recommended, with daily duplications due to inconsistent ordering across departments (outpatient, emergency, and inpatient). We evaluated the effectiveness of a non-interruptive clinical decision support (CDS) system integrated with computerized provider order entry (CPOE) in reducing redundant DSA orders.Methods: CDS included an indication prompt and test status indicator to help providers review test rationale and flag active orders. We then evaluated its impact of this intervention in 5-month periods before and after implementation, using statistical analyses to assess the differences with a t-test.Results: In the pre-implementation period, 82.5% (1504/1824) of DSA orders from 473 of 792 patients were duplicates, compared to 79.6% (1415/1778) from 463 of 826 patients post-implementation. After excluding cases without reported DSA and overlapping patients, each group had 466 unique patients. Duplicate orders decreased within 50 days post-implementation but increased beyond this period. Among renal transplant recipients, the fraction of duplicate orders within a week significantly dropped (pre-implementation n = 9, post-implementation n = 26, P = 0.009). DSA levels remained stable, suggesting the intervention did not impact detection rates.Conclusion: The CDS implemented reduced unwarranted duplicate orders within 2 weeks of a prior order without affecting long-term (>50 days) monitoring protocols, demonstrating the effectiveness of non-interruptive CDS-CPOE in improving HLA test ordering.","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

MedPromptExtract (Medical Data Extraction Tool): Anonymization and High-Fidelity Automated Data Extraction Using Natural Language Processing and Prompt Engineering. MedPromptExtract（医疗数据提取工具）：使用自然语言处理和提示工程进行匿名化和高保真自动数据提取。

IF 1.8

Journal of Applied Laboratory Medicine Pub Date : 2025-03-29 DOI: 10.1093/jalm/jfaf034

Roomani Srivastava, Lipika Bhat, Suraj Prasad, Sarvesh Deshpande, Barnali Das, Kshitij Jadhav

{"title":"MedPromptExtract (Medical Data Extraction Tool): Anonymization and High-Fidelity Automated Data Extraction Using Natural Language Processing and Prompt Engineering.","authors":"Roomani Srivastava, Lipika Bhat, Suraj Prasad, Sarvesh Deshpande, Barnali Das, Kshitij Jadhav","doi":"10.1093/jalm/jfaf034","DOIUrl":"https://doi.org/10.1093/jalm/jfaf034","url":null,"abstract":"Background: The labor-intensive nature of data extraction from sources like discharge summaries (DSs) poses significant obstacles to the digitization of medical records particularly for low- and middle-income countries (LMICs). In this paper we present a completely automated method, MedPromptExtract, to efficiently extract data from DS while maintaining confidentiality.Methods: The source of data were DSs from Kokilaben Dhirubhai Ambani Hospital (KDAH) of patients having acute kidney injury (AKI). A pre-existing tool, Expert-Informed Joint Learning aGgrEatioN (EIGEN), which leverages semi-supervised learning techniques for high-fidelity information extraction, was used to anonymize the DSs, and natural language processing (NLP) was used to extract data from regular fields. We used prompt engineering and a large language model (LLM) to extract custom clinical information from free-flowing text describing the patient's stay in the hospital. Twelve features associated with the occurrence of AKI were extracted. The LLM's responses were validated against clinicians' annotations.Results: The MedPromptExtract tool first subjected DSs to the anonymization pipeline, which took 3 seconds per summary. Successful anonymization was verified by clinicians, thereafter the NLP pipeline extracted structured text from the anonymized pdfs at the rate of 0.2 s per summary with 100% accuracy. Finally, DSs were analysed by the LLM pipeline using Gemini Pro for the 12 features. Accuracy metrics were calculated by comparing model responses to clinicians' annotations with 7 features achieving Area Under the Curve (AUC) above 0.9, indicating the high fidelity of the extraction process.Conclusions: MedPromptExtract serves as an automated adaptable tool for efficient data extraction from medical records with a dynamic user interface.","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Review on Toxicology Testing in Hair. 头发毒理学测试综述。

IF 1.8

Journal of Applied Laboratory Medicine Pub Date : 2025-03-28 DOI: 10.1093/jalm/jfaf026

Jacqueline A Hubbard

{"title":"Review on Toxicology Testing in Hair.","authors":"Jacqueline A Hubbard","doi":"10.1093/jalm/jfaf026","DOIUrl":"https://doi.org/10.1093/jalm/jfaf026","url":null,"abstract":"Background: Hair toxicology is a useful tool for detecting long-term drug use. This method offers several advantages, including the ability to trace historical patterns of drug intake. However, drug incorporation into hair is complex, influenced by numerous factors such as hair structure, physiological differences, external contamination, and the chemical properties of drugs. A comprehensive understanding of these factors is critical to accurately interpret hair toxicology results in both clinical and forensic settings.Content: The anatomy of hair plays a vital role in drug incorporation. Drugs can enter the hair via diffusion from the bloodstream, by passive deposition through sweat or sebum bathing the hair, or through external contamination. The analysis of drug incorporation has evolved significantly over time, and it is now possible to detect drug exposure even after a single ingestion. However, several factors such as decontamination protocols, extraction methods, melanin content (hair color), growth rates, contamination from drug particulates, and cosmetic hair treatments may affect the accuracy of hair toxicology results. Guidelines by expert societies have been published, but variations in sample preparation and analysis techniques remain.Summary: While hair toxicology holds promise for detecting long-term drug exposure, many variables must be considered to ensure accurate interpretation. Differences in physiological properties and external factors can complicate the results. Harmonized protocols and advanced techniques are necessary to minimize biases, particularly regarding racial differences in drug incorporation. Future research should aim to further harmonize methodologies and address these challenges to enhance the reliability of hair toxicology testing.","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0