Search

Objectives To evaluate the real-world performance and reference intervals of the Binding Site Freelite serum free light chain (SFLC) assay (Thermo Fisher Scientific), a global standard for diagnosis, prognostication, and response assessment for monoclonal gammopathies. Methods An informatics-based approach was used to retrospectively evaluate concordance between SFLC and the orthogonal Sebia HYDRASYS immunofixation assay results in a large clinical data set consecutively reported between 2010 and 2020. Results Among patients with monoclonal-negative results by both SFLC and Sebia HYDRASYS immunofixation assays, 25% (1226/5057) had κ/λ ratios (KLRs) outside the manufacturer-defined and International Myeloma Working Group–cited normal reference interval of 0.26 to 1.65. These results were consistent over the study period and were not affected by sex, age, impaired kidney function, or assay antisera lot variation. Assay drift, in addition to other potential factors, affected the KLR distribution. Using International Statistical Classification of Diseases (ICD) codes, kidney function data, and the central 95% of KLR values generated on the Optilite platform (Thermo Fisher Scientific), we derived a new reference interval of 0.67 to 2.13, reducing the KLR false-positive rate to 8%. However, normal KLR persisted among 16% (14/85) of samples with free λ chains by immunofixation, warranting caution during interpretation. Conclusions Our analysis indicated that revision of Freelite SFLC reference intervals improves assay interpretation and should prompt reconsideration of Freelite reference intervals worldwide. [ABSTRACT FROM AUTHOR]

The purpose of the Dissolved Oxygen Total Maximum Daily Load Project (DO TMDLProject) is to provide a comprehensive understanding of the sources and fate of oxygen consuming materials in the San Joaquin River (SJR) watershed between Channel Point and Lander Avenue (upstream SJR). When completed, this study will provide the stakeholders an understanding of the baseline conditions of the basin, provide input for an allocation decision, and provide the stakeholders with a tool for measuring the impact of any waterquality management program that may be implemented as part of the DO TMDL process. Previous studies have identified algal biomass as the most significant oxygen-demanding substance in the DO TMDL Project study-area between of Channel Point and Lander Ave onthe SJR. Other oxygen-demanding substances found in the upstream SJR include ammonia and organic carbon from sources other than algae. The DO TMDL Project study-area contains municipalities, dairies, wetlands, cattle ranching, irrigated agriculture, and industries that could potentially contribute biochemical oxygen demand (BOD) to the SJR. This study is designed to discriminate between algal BOD and other sources of BOD throughout the entire upstream SJR watershed. Algal biomass is not a conserved substance, but grows and decays in the SJR; hence, characterization of oxygen-demanding substances in the SJR is inherently complicated and requires an integrated effort of extensive monitoring, scientific study, and modeling. In order to achieve project objectives, project activities were divided into a number of Tasks with specific goals and objectives. In this report, we present the results of monitoring and research conducted under Task 4 of the DO TMDL Project. The major objective of Task 4 is to collect sufficient hydrologic (flow) and water quality (WQ) data to characterize the loading of algae, other oxygen-demanding materials, and nutrients from individual tributaries and sub-watersheds of the upstream SJR between Mossdale and Lander Avenue. This data is specifically being collected to provide data for the Task 6 Modeling effort. Task 4 provides input and calibration data for flow and WQ modeling associated with the low DO problems in the SJR watershed, including modeling on the linkage among nutrients, algae, and low DO. Task 4 is providing a higher volume of high quality and coherent data to the modeling team than was available in the past for the upstream SJR. The monitoring and research activities under Task 4 are integrated with the Modeling effort (Task 6) and are not designed to be a stand alone program. Although, the majority of analysis of the Task 4 data is occurring as part of the Task 6 Modeling program, analysis of Task 4 data independently of the modeling effort is also an important component of the DO TMDL Project effort. In this report, we present the results of monitoring and research conducted under Task 4. The major purposes of this report are to 1) document activities undertaken as part of the DOTMDL Project; 2) organize electronic data for delivery to State agencies, stakeholders and principal investigators (cooperators) on the DO TMDL Project; 3) provide a summary analysis of the data for reference and to assist stakeholders in planning watershed activities inresponse to the DO TMDL requirements; and 5) provide a preliminary scientific interpretation independently of the Task 6 Modeling effort. Due to the extensive scope of theTask 4 portion of the DO TMDL Project, the Task 4 March 2007 Interim Report is divided into a numbers of chapters and associated appendixes designed to be able to stand1-3 independently of each other. The purpose of this chapter is to provide an overview of Task 4 data collection and to explain the structure of the overall report.

Infant-parent play with toys is an early form of social communication, and the toy features (i.e., affordances), as well as the child's language competence, contribute to the developmental level of the play and the types of play actions that occur. This research, conducted in cooperation with a toy manufacturer, investigated how the affordances of a technology-enhanced toy were used by 26 infant-parent pairs during six clinical sessions of play with the toy. The types of play, the features of the toy that elicited play, the humor elicited by the toy, and the communicative interactions of the parent and child were observed. Results indicated that certain affordances of the toy were used in exploration, practice play, and social games and were related to episodes of child laughter. The communicative interactions of the parents and the language patterns used in the sessions grew in complexity as the children's language facility increased. The affordances of the toy played a role in a variety of parent-child interactions and joint attention experiences. (Contains 3 tables and 2 figures.)

This paper provides an overview of interdisciplinary assessment procedures and criteria for diagnosis of central auditory processing (CAP) disorders. It describes use of a CAP test battery consisting of four measures with results integrated with a comprehensive speech-language pathology assessment. Practical strategies for classroom utilization are noted. (Contains extensive references.) (Author/DB)

This auditory training program used an analytic distinctive feature approach to attempt to improve consonant recognition in single syllable words through listening and speechreading practice. Two hundred exercises addressed 3 auditory features: voicing, nasality, and sibilancy. The Phoneme Identification Test showed no statistical change in 26 severely hearing-impaired adults' pre-training/post-training performance. (Author/JDD)

Background: Merkel cell carcinoma (MCC) is an aggressive skin cancer with a recurrence rate of >40%. Of the 2000 MCC cases per year in the United States, most are caused by the Merkel cell polyomavirus (MCPyV). Antibodies to MCPyV oncoprotein (T-antigens) have been correlated with MCC tumor burden. The present study assesses the clinical utility of MCPyV-oncoprotein antibody titers for MCC prognostication and surveillance.Methods: MCPyV-oncoprotein antibody detection was optimized in a clinical laboratory. A cohort of 219 patients with newly diagnosed MCC were followed prospectively (median follow-up, 1.9 years). Among the seropositive patients, antibody titer and disease status were serially tracked.Results: Antibodies to MCPyV oncoproteins were rare among healthy individuals (1%) but were present in most patients with MCC (114 of 219 patients [52%]; P < .01). Seropositivity at diagnosis independently predicted decreased recurrence risk (hazard ratio, 0.58; P = .04) in multivariate analyses adjusted for age, sex, stage, and immunosuppression. After initial treatment, seropositive patients whose disease did not recur had rapidly falling titers that became negative by a median of 8.4 months. Among seropositive patients who underwent serial evaluation (71 patients; 282 time points), an increasing oncoprotein titer had a positive predictive value of 66% for clinically evident recurrence, whereas a decreasing titer had a negative predictive value of 97%.Conclusions: Determination of oncoprotein antibody titer assists in the clinical management of patients with newly diagnosed MCC by stratifying them into a higher risk seronegative cohort, in which radiologic imaging may play a more prominent role, and into a lower risk seropositive cohort, in which disease status can be tracked in part by oncoprotein antibody titer. Cancer 2017;123:1464-1474. © 2016 American Cancer Society. [ABSTRACT FROM AUTHOR]

Provides an overview on interdisciplinary assessment procedures and criteria for the diagnosis of central auditory processing disorders (CAPD) in the United States. CAP battery test components; Integration of CAP results into a comprehensive speech-language pathology assessment; Implications of CAP results for classroom environment of CAPD children.

This study investigated the effectiveness of expressive language therapy utilizing acoustic amplification on six preverbal prekindergarten chil dren with hearing-related specific language impairments. A multiple baseline single-subject design was used to compare the differences between measures of attention span and mean length of utterance (MLU) during individual language therapy under conditions of am plification and no amplification. No difference was identified for length of attention span. But increased MLUs were found under amplified therapy conditions for all the children. [ABSTRACT FROM PUBLISHER]

This study investigated the ability of young and older adults to use contextual cues to understand speech in ordinary listening situations. Key word recognition scores were obtained with the Speech Perception in Noise (SPIN) test. Sentence lists contained 50 key words preceded by a high predictability (HP), low predictability (LP), or a carrier phrase (CP) context accompanied by a varying background of multitalker babble. Comparison of the low context items vs the number of meaningfully rich items correctly identified provided an index of the listener's ability to use contextual information in the HP sentences. The LP and CP score reflected the individual's ability to recognize items based only on the acoustic-phonetic information of the key words. Most individuals were able to take some advantage of contextual cues in everyday sentences; however, the older listeners were more adversely affected by background noise than younger listeners. For clinical utilization of the SPIN test, further research is needed to develop normative data as a function of age to make it an “age-fair” test. [ABSTRACT FROM PUBLISHER]