Patch testing in occupational dermatology: Practical aspects in relation to the conditions in Germany

Allergic contact dermatitis is one of the most frequent occupational skin diseases. Targeted allergen avoidance can only be achieved by identification of the causative allergen. Therefore, patch testing is of utmost importance in occupational dermatology, not only in terms of assessing causal relationships but also regarding the implementation of prevention measures and evaluation of the legal criteria for an occupational skin disease in Germany (statutory occupational disease BK 5101). The lack of commercial patch test preparations poses a great diagnostic challenge. Patch testing of patient's own materials from their workplace is therefore very important to reduce diagnostic gaps. The performance and documentation of the patch test should be in line with current guidelines and recommendations to ensure the necessary test quality and comprehensibility of the test results.

Application of Three-Repetition Tests Scheme to Improve Integrated Circuits Test Quality to Near-Zero Defect

In this research, the normal distribution is assumed to be the product characteristic, and the DITM (Digital Integrated Circuit Test Model) model is used to evaluate the integrated circuits (IC) test yield and test quality. Testing technology lags far behind manufacturing technology due to the different rates of development of the two technologies. As a result, quality control will pose significant challenges in pursuing high-quality near-zero defect products (automotive and biomedical electronics and avionics, etc.). In order to ensure product quality, we propose an effective repeated testing method (three-repetition tests scheme, TRTS), which utilizes the move test guardband (TGB) to improve the test yield and test quality. Based on the data in the International Roadmap for Devices and Systems table in 2021, the DITM model is used to estimate the future trend of semiconductor chip test yield, and the retest method (TRTS) is applied improve the test results. The method of repeated testing can increase the test yield and increase the shipment of semiconductor products. By estimating the test cost and profit, the method of repeated testing can obtain chips with near-zero defects with more corporate profits through increased product shipments.

Influence of the Intensive Care Unit Environment on the Reliability of the Montreal Cognitive Assessment

Background: Neuropsychological screening becomes increasingly important for the evaluation of subarachnoid hemorrhage (SAH) and stroke patients. It is often performed during the surveillance period on the intensive (ICU), while it remains unknown, whether the distraction in this environment influences the results. We aimed to study the reliability of the Montreal Cognitive Assessment (MoCA) in the ICU environment. Methods: Consecutive stable patients with recent brain injury (tumor, trauma, stroke, etc.) were evaluated twice within 36 h using official parallel versions of the MoCA (ΔMoCA). The sequence of assessment was randomized into (a) busy ICU first or (b) quiet office first with subsequent crossover. For repeated MoCA, we determined sequence, period, location effects, and the intraclass correlation coefficient (ICC). Results: N = 50 patients were studied [n = 30 (60%) male], with a mean age of 57 years. The assessment's sequence ["ICU first" mean ΔMoCA -1.14 (SD 2.34) vs. "Office first" -0.73 (SD 1.52)] did not influence the MoCA (p = 0.47). On the 2nd period, participants scored 0.96 points worse (SD 2.01; p = 0.001), indicating no MoCA learning effect but a possible difference in parallel versions. There was no location effect (p = 0.31) with ΔMoCA between locations (Office minus ICU) of -0.32 (SD 2.21). The ICC for repeated MoCA was 0.87 (95% CI 0.79-0.92). Conclusions: The reliability of the MoCA was excellent, independent from the testing environment being ICU or office. This finding is helpful for patient care and studies investigating the effect of a therapeutic intervention on the neuropsychological outcome after SAH, stroke or traumatic brain injury.

Pulmonary function test quality in the elderly: a comparison with younger adults

BACKGROUND

Elderly patients may be at greater risk for misdiagnosis and inappropriate treatment as a consequence of pulmonary function test underutilization and tests being conducted with low quality expectations. This study sought to determine if elderly patients are able to achieve both spirometry and diffusion capacity (DLCO) quality scores comparable to a younger adult population.

METHODS

This was a retrospective review of pulmonary function data over a 22 month period. A list of every subject age ≥ 80 years (elderly group) and ages 40-50 years (control group) tested during the time period was compiled. The quality of spirometry and DLCO testing were examined.

RESULTS

Overall, 92.6% (139/150) of the elderly group and 91.5% (163/178) of the control group spirometry tests satisfied all American Thoracic Society/European Respiratory Society acceptability and reproducibility criteria (P = .84), and 84.9% (96/113) of the elderly group and 88.5% (108/122) of the control group DLCO tests satisfied all the acceptability and reproducibility criteria (P = .45).

CONCLUSIONS

Elderly patients referred to a hospital-based pulmonary function test lab can be expected to achieve spirometry and DLCO quality scores comparable to younger adult patients.