This study explored the prevalence and attributes of triage errors made by emergency responders during virtual reality simulations of mass casualty incidents.

The study analyzed errors made by 99 emergency responders during their triage and treatment of a mass casualty incident in virtual reality. Responders received training on the Sort, Assess, Life-saving Intervention, Treatment, Transport (SALT) protocol, then responded to a virtual bombed subway station. Responder accuracy, efficiency, and application of treatments were tracked. Error analysis was performed through the lens of human factors. Accordingly, errors were categorized by their nature: either perception, proficiency, or procedure.

Responders correctly triaged 70% of virtual patients, and 78% demonstrated relative efficiency. Interaction times between responders and patients averaged 20 seconds. The time to assess and treat all patients for life-threatening bleeding injuries across the entire scene averaged six minutes. Most errors were related to proficiency (e.g., competence or experience). However, procedural errors (shortcomings of SALT) and perceptual errors (degraded sensory input from programmed environmental chaos, i.e., virtual smoke/debris and louder sound) were also observed. Most errors were related to patients with either respiratory issues or multiple injuries.

Virtual reality (VR) offered a controlled environment for studying errors made by emergency responders in a mass casualty incident, which will lead to improved training and protocols to better prepare them for these events.

As the global incidence of heat-related illnesses escalates in the wake of climate change-induced heat waves, the critical necessity for reliable diagnostic tools becomes apparent. This scoping review aimed to summarize the existing body of published evidence on biomarkers that could potentially be utilized for the diagnosis of heat-related illness in the clinical setting.

We conducted a thorough search of 3 databases, including Embase, MEDLINE, on Ovid, and The Cochrane Library (Wiley) databases from October 11, 2022 up until January 15, 2024. We also manually included studies by searching the reference lists of the included articles. Studies that performed statistical validation were summarized in detail.

2877 citations were identified and screened, with 228 studies reviewed as full text. 56% of these studies were conducted within China or North America. The studies identified 113 biomarkers. Most common biomarkers studied were troponin I, IL-6, platelets, and ALT. The studies exhibited considerable variation, reflecting the diverse range of investigated biomarkers and the absence of standardized statistical validation for the biomarkers.

Numerous biomarkers have been evaluated in the literature, but none have been studied to impact clinical practice. There is significant variation in the methodology and statistical validation. There is a need for further research to identify clinically relevant biomarkers for heat related illnesses.

We aimed to evaluate serum soluble suppression of tumorigenicity-2 in children with congestive heart failure, to assess the diagnostic and prognostic values of soluble suppression of tumorigenicity-2 in these patients, and to correlate its levels with various clinical and echocardiographic data.

We included 60 children with congestive heart failure as the patient group. Sixty healthy children of matched age and sex served as the control group. Patients were evaluated clinically and by echocardiography. Serum level of suppression of tumorigenicity-2 was measured for patients at admission. All patients were followed up for death or readmission for a period of one year.

Soluble suppression of tumorigenicity-2 was significantly higher in children with congestive heart failure as compared to the control group. Soluble suppression of tumorigenicity-2 was significantly increased in patients with higher severity of congestive heart failure. There was a significant increase in soluble suppression of tumorigenicity-2 in patients with bad prognosis compared to those with good prognosis. There was a significant positive correlation between soluble suppression of tumorigenicity-2 and respiratory rate, heart rate, and clinical stage of congenital heart failure, while there was a significant negative correlation between soluble suppression of tumorigenicity-2 and left ventricular systolic and diastolic function. The best cut-off of soluble suppression of tumorigenicity-2 to diagnose congestive heart failure was > 3.6 with 87% sensitivity and 79% specificity. The cut-off point of soluble suppression of tumorigenicity-2 to diagnose congestive heart failure in children was ≥ 31.56 ng/ml, with 95% sensitivity and 91.37% specificity. Moreover, the cut-off point of soluble suppression of tumorigenicity-2 to predict bad prognosis in children with congestive heart failure was ≥ 255.5 ng/ml, with 92% sensitivity and 89.0% specificity.

Soluble suppression of tumorigenicity-2 is a good diagnostic and predictive biomarker in children with congestive heart failure.

Conversion disorder (a term that describes what was previously called hysteria) refers to motor or sensory symptoms, or both, that resemble a neurological disease, but that do not originate from or cannot be explained by a known physical disease.

To find reliable tools that can guide the difficult diagnosis of conversion disorder.

Bibliographic review

The exact prevalence of the disorder is unknown. It is estimated that approximately 5% of referrals to neurology are for this disorder. Approximately one third of patients referred to the neurologist have symptoms that cannot be explained by an organic disease. Involuntary movements are the most common motor manifestations of the conversive syndrome, being tremor one of the most frequent manifestations. The first differential diagnosis of conversion disorder is neurological disease. It is currently not necessary for the diagnosis to assess whether or not the symptoms are produced intentionally, as the assessment of conscious intentionality is unreliable. The neurological examination is the fundamental tool for the diagnostic approach, being even more enlightening than the complementary tests. Hoover’s sign, Babinski’s combined leg flexion, plantar flexion of the ankle, tremor and its distraction and synchronisation manoeuvres, as well as the clinical differences between epileptic seizures and non-epileptic seizures of psychogenic origin, are some of the reliable tools for a correct diagnosis.

The diagnosis of the disease should be one of exclusion. There must be clinical data showing clear evidence of incompatibility with a neurological disease and conversion symptoms do not correspond to known physiological mechanisms and anatomical pathways.

No significant relationships.

Bipolar disorder (BD) is a psychiatric disorder characterized by alternating episodes of high mood and low mood similar to depression. To differentiate BD patients from unipolar (UN) depressed patients remains a challenge and the clinical scales available failed to distinguish these 2 populations. ALCEDIAG developed EDIT-B, the first blood test able to make a differential diagnosis of BD. Based on RNA editing modifications measurement and AI, the test requires a simple blood draw and equipment available in most central laboratories. A first study on 160 UN and 95 BD patients allowed a differential diagnosis with an AUC of 0.935 and high specificity (Sp=84.6%) and sensitivity (Se=90.9%). A multicentric clinical study has been set up to validate these performances.

The objective of this project is to run a multicentric clinical study in Europe and assess the performances of the test.

The EDIT-B project, led by Alcediag, is supported by EIT-Health grant (European institute of Innovation and Technology) and gathers 4 clinical centers in 3 countries (France, Spain, Danemark), a CRO for the clinical study management (Aixial), a CRO for the development of a diagnostic kit (Veracyte), a diagnostic lab for molecular biology analyses (Synlab), and a regulatory company (PLG).

At the end of the study, the EDIT-B performance will be confirmed and the test will be CE-marked.

This test will address the needs of millions of patients suffering from misdiagnosis and therefore allow them to receive the correct treatment.

JDA, NS and DW are employees of Alcediag.

In Cameroon, skepticism and neglect of doctors towards patients with mental disorders is noted. In order to change this, it was important to have an objective assessment. Depressive disorders are the most common form of mental disorders and Douala has the second largest number of general practitioners in the country. Thus, we proposed to evaluate the behaviour of general practitioners in Douala in front of patients with depressive disorders.

Evaluate the frequency of depressive disorders in outpatient general consultation Evaluate the competence of general practitioners at diagnosing depressive disorders Evaluate the practices of general practitioners towards depressive disorders Evaluate obstacles faced by general practitioners regarding depressive disorders

We conducted a cross-sectional descriptive study from February to June 2017 in the outpatient department. For each general practitioner include, we had 3 patients who complete the patient health questionnaire to find out if the patient has depression. During each consultation, we filled out a clinical fact sheet to determine if the general practitioner had diagnosed a depressive disorder. If so, what care has he taken? Finally, we gave the general practitioner a questionnaire to know his difficulties when facing depression.

We obtained a frequency of 32.5% of depressive disorders in consultation of general medicine in Douala and a rate of diagnosis by general practitioners of 1.92%. Diagnosed cases have just received counseling.

in Cameroon, despite the low interest in depressive disorders, they constitute a public health issue in Douala, and surely in Cameroon; Because of its frequency and the harm, they inflict on patients.

I don’t have any conflict of interest

Neurosciences evolved very rapidly in last few years and helped the establishment of Liaison Psychiatry as a fundamental part of the general hospitals functioning. However, the use of this department by the other specialties still needs to be refined, as it is common to find wrong assessments in the referral of the patients.

We aim to study the concordance between the referral motives and the assessment by the psychiatry team.

Data was collected through the informatic registry. Contains patient data observed by a liaison psychiatrist in the period between 1st of July and 30th of September of 2020. In this period there were 80 requests, of which, 6 were refused for various reasons. We decided to study the concordance when one of these symptoms were in the request: anxious symptoms, depressive symptoms, psychotic symptoms and psychomotor agitation. 46 requests met this criteria.

The mean age was 63,3yo and 46% were older than 65yo. Most were women (54%) and 68% had history of psychiatry disorder. About 50% were requests from the Medicine wards. The concordance between the medical request and the psychiatry assessment was higher for psychomotor agitation (n=11; 64%) and depressive symptoms (n=23; 57%), but it was lower in anxious symptoms (n=3; 33%) and in psychotic symptoms (n=9; 33%). Most common diagnosis was delirium.

Non-psychiatrist doctors appear to have more difficulty when assessing anxious and psychotic symptoms. Those concordance percentages are in line with recent research. Actions should be taken to improve this, like academic training and standardization of referral.

No significant relationships.

Psychiatric diagnoses are derived from expert opinion (1). Since no objective tests or markers are on the horizon, clinical psychiatry is anchored to “the patient’s altered experience, expression and existence, associated with suffering in self and/or others”(2). Many studies have examined diagnostic stability over time. In the last years investigators have been reporting prospective and retrospective consistencies of diagnoses between two time points, specially in first episodes of psychosis (3).

To examine the prospective and retrospective stability of diagnostic categories 2 years after the first episode of psychosis

Data were examined from the First Episode Psychosis Program of Navarra (PEPsNA), a prospective observational study of a cohort of patients with first-episode psychosis in Navarra (Spain). Diagnosis was assigned using DSM-IV-TR at baseline and 24 months later. Diagnoses were divided into 5 categories: Affective psychosis, Schizophrenia spectrum psychosis, Schizoaffective disorder, acute psychosis and other diagnoses. Diagnostic change was examined using prospective and retrospective consistency

A total of 78 first-episode psychosis cases with baseline and 24 months follow-up were identified. Table 1 shows the diagnosis movement matrix, and Figure 1 its graphical representation. Of cases, 71.8% (56/78) had the same baseline and 24 months follow-up diagnosis. Prospective and retrospective consistencies are shown in Table 2

The prospective and retrospective consistencies of Schizophrenia spectrum psychosis and acute psychosis were higher than others. Affective psychosis and Schizoaffective disorder show very variable consistencies