Concordant Results Research Articles

Ecotypic variation in multiple traits of European beech: selection of suitable provenances based on performance and stability

Induced by climate change associated disturbances and further promoted by changes in forest management, the proportion of European beech, a highly competitive climax species, is increasing in Central Europe. However, its climatic stability is questioned by the recent loss of vitality. In this regard, the evaluation of seed sources used for reforestation receives great attention. Here, we present a multi-trait evaluation of height, basal area and stem quality assessed over 25 years for 85 provenances grown at three sites in northern, western and eastern Germany. Considerable provenance differentiation exists, explaining 21% (proportion of trees with acceptable stem form) to 45% (basal area) of the variance on single sites and 20 to 39% across sites, while provenance by environment interactions are absent. On the landscape level, this results in distinct patterns with spatially adjacent provenances showing a similar trait expression. These patterns are highly similar for height and basal area but divergent for stem form. They could be directly linked to geographic variables with multivariate regression tree analysis that captured 58% of the phenotypic variation, delineating eleven ‘ecotypes’ shaped by local adaptation. A selection based on two multi-trait indices gives highly concordant results. Particularly, the intermediate elevations of the central highlands in Western Germany host highly suitable provenances. Lower elevation provenances from continental climates in the south-east profit from the transfer to favorable growing conditions. Since the majority of provenances was already exposed to elevated temperatures compared to their origin during the observation period, this study gives a first indication for the potential benefits of assisted migration facing climate change.

Rapid on-site evaluation of touch imprint cytology in navigation bronchoscopy for small peripheral pulmonary nodules.

Rapid on-site evaluation (ROSE) of cytopathology plays an important role in determining whether representative samples have been taken during navigation bronchoscopy. With touch imprint cytology (TIC), histologic samples can be assessed using ROSE. Although advised by guidelines, there have been almost no studies on the performance of TIC during navigation bronchoscopy. The objective of this study was to evaluate the value of TIC-ROSE (forceps/cryobiopsy) in combination with conventional ROSE (cytology needle/brush). In this single-center, prospective cohort study, patients who had pulmonary nodules with an indication for navigation bronchoscopy were consecutively included. The primary outcome of the study was the concordance of ROSE and the procedural outcome. The concordance rates of TIC-ROSE and the combination of TIC-ROSE plus conventional ROSE were compared. Fifty-eight patients with 66 nodules were included. Conventional ROSE and TIC-ROSE were assessable in 61 nodules (90.9%) each. By combining both ROSE techniques, all sampled lesions were assessable. Combining conventional ROSE with TIC-ROSE showed concordant results in 51 of 66 cases (77.3%) versus 44 of 66 (66.7%) and 48 of 66 (72.8%) concordant results for conventional ROSE and TIC-ROSE alone, respectively, compared with the procedural outcome. There was no indication of tissue depletion as a result of TIC. The combined ROSE approach had a statistically significant higher concordance rate compared with conventional ROSE alone. TIC-ROSE is a cheap, easily implementable technique that can result in higher concordant ROSE outcomes. This could lead to more efficient procedures and possibly higher diagnostic results. In a monomodality sampling setting with only histologic samples, TIC can provide ROSE.

Improvement of laboratory testing services by implementation of quality assurance scheme

Introduction: The National AIDS Control Organization (NACO), Government of India and the Uttar Pradesh State AIDS Control Society (UPSACS) established the State Referral Laboratory (SRL) in the Department of Microbiology, Motilal Nehru Medical College, Prayagraj for HIV testing and monitoring of linked HIV Counselling and Testing Services (HCTS) in Uttar Pradesh.Methods: This is a retrospective study conducted from 2008 to 2021. In this evaluation period 10144 serum samples (9580 HIV negative, 555 HIV positive and 9 discordant) were received for retesting at SRL. The Quality Control serum samples received from testing sites consisted of 5% negative and 20% positive from all tested samples collected in the first seven days in the External Quality Assurance Scheme (EQAS) quarter month i.e. January, April, July and October. All samples were tested using rapid diagnostic kits procured by NACO/UPSACS with NACO testing strategy. All linked centres with SRL received 4 coded serum samples for proficiency testing (PT) which were tested similarly.Results: Of 10144 serum samples, 99.92% reported correct results and 0.08% reported discrepancy due to various issues. Similarly in the proficiency testing programme, of 4072 samples tested between 2010 to 2021 by testing sites, 4061 (99.07%) reported concordant results and the remaining14 (0.34%) samples reported indeterminate results. Of the 4072 samples, 14 shows discordant results by three different rapid tests based on different principles. Hands on training were provided for technicians who reported indeterminate results in PT or retesting.Conclusion: The tremendous increase in quality testing at peripheral centrally linked centres increase the reliability of HIV diagnosis at ground level. The study also concluded that continuous monitoring and mentoring of technicians of the diagnostic laboratories under EQAS improves their quality for HIV diagnosis.

Drug Resistance Tests for Mycobacterium Tuberculosis and Compatibility between Tests; From Past to Today

Objective: The gold standard for pulmonary tuberculosis diagnosis is the demonstration of Mycobacterium tuberculosis bacilli. Drug susceptibility test results of the bacilli obtained are crucial in tuberculosis treatment management. The various tests used to determine drug susceptibility must yield the same result. In the present study, we aimed to evaluate the compatibility of drug susceptibility test results obtained by Löwenstein-Jensen (L-J) and BACTEC 460TB methods from the past to the present. Material and Methods: Sputum results from 79 patients suspected of multidrug-resistant pulmonary tuberculosis (MDR-TB) clinically, radiologically, and bacteriologically were evaluated for isoniazid, rifampicin, ethambutol, and streptomycin between June 1997 and June 1998. Culture and drug sensitivity tests on the L-J medium were conducted at the Heybeliada Chest Diseases and Thoracic Surgery Center bacteriology laboratory, while culture and drug sensitivity tests with the BACTEC 460 TB system were performed at another center. The results were assessed for compatibility using the Kappa (κ) test, a tool for comparing two independent parameters. Results: All drug sensitivity tests for isoniazid, rifampicin, ethambutol, and streptomycin were collectively evaluated. It was determined that 263 (83.3%) of 316 drug sensitivity tests yielded concordant results, while 53 (16.7%) produced discordant results. The drug sensitivity tests using L-J and BACTEC 460TB methods indicated compatibility only for streptomycin (κ = 0.715). In contrast, they yielded different results for isoniazid (κ = 0.585), ethambutol (κ = 0.552), and rifampicin (κ = 0.507). Streptomycin exhibited compatibility, while isoniazid, ethambutol, and rifampicin showed incompatibility between the L-J and BACTEC 460TB methods. Conclusion: Drug sensitivity tests are pivotal in tuberculosis treatment management. While literature suggests compatibility between L-J and BACTEC 460TB methods, our study revealed incompatibility. Evaluation of drug sensitivities may lead to confusing results. Current practices involving studies in the same laboratory and genetic testing contribute to faster and more accurate outcomes in managing drug-resistant tuberculosis. Genetic tests and reference laboratories remain crucial for antituberculosis drug sensitivity, emphasizing their continued importance.

Resolving taphonomic and preparation biases in silicified faunas through paired acid residues and X-ray microscopy.

Paired petrography and acid maceration has shown that preferential silicification of shelly faunas can bias recovery based on taxon and body size. Here, silicified fossils from the Upper Ordovician Edinburg Formation, Strasburg Junction, Virginia, USA, were analyzed using X-ray tomographic microscopy (μCT) in conjunction with recovered residues from acid maceration of the same materials to further examine sources of potential bias. Results reveal that very small (<~1 mm) fossils are poorly resolved in μCT when scanning at lower resolutions (~30 µm), underestimating abundance of taxa including ostracods and bryozoans. Acid maceration, meanwhile, fails to recover poorly silicified fossils prone to disarticulation and/or fragmentation during digestion. Tests for patterns of breakage, however, indicate no significant size or taxonomic bias during extraction. Comparisons of individual fossils from 3-D fossil renders and maceration residues reveal patterns of fragmentation that are taxon-specific and allow the differentiation of biostratinomic and preparational breakage. Multivariate ordinations and cluster analyses of μCT and residue data in general produce concordant results but indicate that the variation in taxonomic composition of our samples is compromised by the resolvability of small size classes in μCT imaging, limiting the utility of this method for addressing paleoecological questions in these specific samples. We suggest that comparability of results will depend strongly on the sample size, taphonomic history, textural, and compositional characteristics of the samples in question, as well as μCT scan parameters. Additionally, applying these methods to different deposits will test the general applicability of the conclusions drawn on the relative strengths and weaknesses of the methods.

Abstract 156: Cerebral Edema in Patients Presenting With Large Ischemic Core Undergoing Thrombectomy versus Medical Therapy: Secondary Analysis of SELECT 2 Trial

Background: Endovascular thrombectomy (EVT) improves long-term outcome in patients presenting with large ischemic core but is associated with early neurological worsening (ENW), potentially related to cerebral edema post-reperfusion. We investigated whether EVT increases edema development, and the relationship between edema and ENW in a secondary analysis of the SELECT2 trial. Methods: SELECT 2 tested the efficacy and safety of EVT versus medical therapy in patients with large ischemic core (ASPECTS 3-5 or core volume ≥50ml on CT Perfusion[CTP]/MR diffusion). Core volume was defined as the larger of the CTP-CBF relative cerebral blood flow &lt;30% or the visible hypodensity on non-contrast CT. Cerebral edema was measured as the maximum midline shift (MLS) on 24h follow-up MRI or CT. ENW was defined as &gt;=4 point worsening in NIHSS at 24h compared to baseline. Probabilistic index model was used in multivariable analyses to assess ≥1 point improvement on modified Rankin Scale at 90-days. Results: After exclusion of 10 patients with hemicraniectomy, the median MLS in 327 patients was 2.75mm (IQR 0-5.85) in EVT and 0mm (IQR 0-4.02) in control patients (p=0.005). EVT was independently associated with greater MLS (adjusted odds ratio, aOR 1.50, 95%CI 1.17-1.92, p=0.0012) after adjusting for age and core volume. There was no interaction between EVT and core volume on the association with MLS (p&gt;0.79). Patient with ENW had greater MLS (5.05mm [IQR2.06-10.2] vs 0mm [IQR0-3.94, p&lt;0.001]) MLS was associated with development of ENW (aOR 1.22, 95%CI 1.13-1.32, p&lt;0.001), and lower likelihood of long-term functional improvement (adjusted generalized OR 0.96, 95%CI 0.92-0.97, p&lt;0.001, adjusted for core volume, EVT, age and baseline NIHSS). Sensitivity analysis testing alternative definitions of core volume (CTP core volume only and Hypodensity on non-contrast only) showed concordant results. Conclusion: In patients presenting with large ischemic core, EVT was associated with increased cerebral edema at 24h which, in turn, was associated with ENW. Despite overall benefit of EVT, EVT-related edema is independently associated with neurological deterioration and long-term disability and is therefore a potential treatment target to improve EVT outcomes.

SARS-CoV-2 infections among pregnant women, 2020, Finland-Cross-testing of neutralization assays.

We studied the development of the severe acute respiratory syndrome-related coronavirus(SARS-CoV-2) pandemic in southern Finland in 2020 and evaluated the performance of two surrogate immunoassays for the detection of neutralizing antibodies (NAbs). The data set consisted of 12 000 retrospectively collected samples from pregnant women in their first trimester throughout 2020. All the samples were initially screened for immunoglobulin G (IgG) with SARS-CoV-2 spike antibody assay (EIM-S1, Euroimmun) followed by confirmation with nucleocapsid antibody assay (Architect SARS-CoV-2, Abbott). Samples that were reactive (positive or borderline) with both assays were subjected to testing with commercial surrogate immunoassays of NeutraLISA (EIM) and cPassTM (GenScript Biotech Corporation) by using pseudoneutralization assay (PNAbA) as a golden standard. No seropositive cases were detected between January and March. Between April and December, IgG (EIM-S1 and Abbott positive) and NAb (PNAbA positive) seroprevalences were between 0.4% and 1.4%. NeutraLISAshowed 90% and cPass 55% concordant results with PNAbA among PNAbA negative samples and 49% and 92% among PNAbA positive samples giving NeutraLISA better specificity but lower sensitivity than cPass. To conclude, seroprevalence in pregnant women reflected that of the general population but the variability of the performance of serological protocols needs to be taken into account in inter-study comparison.

Portable Headband Electroencephalogram in the Detection of Absence Epilepsy.

The accuracy of headband electroencephalogram (EEG) was compared to traditional EEG in pediatric patients with absence epilepsy. This study enrolled 10 patients with previously diagnosed absence epilepsy and examined the concordance of headband EEG and traditional EEG in the follow-up EEG of treated absence epilepsy. The study found a concordant result in 80% of cases providing a signal that absence epilepsy is an effective target for headband EEG. The study showcases a need for further research in headband EEG technology and continued improvements in technology.

Experimental analysis on the effects of trace metals as micronutrients in enhancing biomethane production

Anaerobic digestion (AD) of microbial biomass has proven to be a significant breakthrough technique in producing biogas rich in methane. The quantity of biogas obtained by anaerobic digestion processes varies significantly based on the nature and characteristics of the substrates used. This research work focuses on the use of trace metals such as Fe, Cu, Zn, Mn, Mg, Ni in proper proportions to enhance the microbial consortium thus aiding in the production of biogas of desired quality. The substrate used for this study is Food Waste and Cow dung. Food waste from the college canteen was used as the substrate and cow dung was used as an inoculum for providing a catalytic effect in the anaerobic reactor. Food waste and cow dung in the ratio 75:25 was fed into the anaerobic digesters with varying concentrations of micronutrients supplemented to the reactors operating at a pH range maintained between 6.8 and 7.2 under room temperatures (22–27 ºC). The effect of these micronutrients on the anaerobic digestion process was observed by analysing the biogas yield, pH, alkalinity, total solids, and volatile solids of the samples. Sulphates of Fe, Cu, Mn, Ni and Chlorides of Zn and Mg was used in this study. Fe, Cu, Zn, Mn, Mg, Ni were fed to the anaerobic reactor at varying concentrations to arrive at the optimum dosage for the chosen substrates. The optimum dosage for the chosen substrate concentration was taken as that concentration which yielded maximum biogas yield with less retention time. Fe at concentrations varying from 1 mg/l–5 mg/l was fed to the anaerobic reactor and the optimum dosage for the chosen substrate concentration was noted at 1 mg/l. The reactor with an Fe concentration of 1 mg/l showed an increase in biogas production rate of about 68% compared to the sample without Fe supplementation as well as the ones with other dosages greater than 1 mg/l and less than 1 mg/l of Fe dosage. Each nutrient is subjected to an individual dosage analysis before arriving at the optimum dosage and then a mixture of the arrived optimum dosages will be analysed for further study. The process set-up will be conducted for a minimum retention period of 20 days and terminated when the results show a deep fall in the biogas production for consecutive days. Biogas produced for the nutrient supplementation of 1 mg/l of Fe, 0.5 mg/l of Cu, 1 mg/l of Zn, 0.5 mg/l of Mn, 1 mg/l of Mg and 0.5 mg/l of Ni yielded a biogas of 850 ml/g VS in 10 day retention time. Triplicate samples study were conducted and biogas yield measured daily to arrive at concordant results. The results showed an increase in the biomethane yields of the substrate by about 60% compared to the reactors which had no micronutrient supplementations. Furthermore, the study summarized that not all micronutrients are essential for a successful microbial metabolism to take place in an anaerobic digester as the micronutrient Manganese at varying dosages of 0.5 mg/l, 1 mg/l and 1.5 mg/l showed an antagonistic effect on the microbial activity in the reactor. The results obtained from this study showed a significant improvement in the quantity of biogas produced from the substrates supplemented with micronutrients at optimum dosages thus arriving at an efficient and effective method for treating waste in a sustainable way.

Efficient magnetic enrichment cascade single-step RPA-CRISPR/Cas12a assay for rapid and ultrasensitive detection of Staphylococcus aureus in food samples

Staphylococcus aureus (S. aureus) is a prevalent foodborne pathogen that could cause severe food poisoning. Thus, rapid, efficient, and ultrasensitive detection of S. aureus in food samples is urgently needed. Here, we report an efficient magnetic enrichment cascade single-step recombinase polymerase amplification (RPA)-CRISPR/Cas12a assay for the ultrasensitive detection of S. aureus. Magnetic beads (MBs) functionalized with S. aureus-specific antibodies were initially used for S. aureus enrichment from the complex matrix, with 98% capture efficiency in 5 min and 100-fold sensitivity improvement compared with unenriched S. aureus. Next, a single-step RPA-CRISPR/Cas12a-based diagnostic system with optimized extraction-free bacteria lysis was constructed. This assay could detect as low as 1 copy/μL (five copies/reaction) of extracted DNA template and 10 CFU/mL of S. aureus within 40 min. Furthermore, the assay could effectively detect S. aureus in real food samples such as lake water, orange juice, pork, and lettuce, with concordant results to qPCR assays. The proposed cascade signal-amplification assay eliminates the need for lengthy bacterial culture and complex sample preparation steps. Hence, the proposed assay shows great application potential for rapid, efficient, and ultrasensitive detection of pathogens in real food samples.

Geochronological and geochemical effects of zircon chemical abrasion: insights from single-crystal stepwise dissolution experiments

Abstract. Chemical abrasion in hydrofluoric acid (HF) is routinely applied to zircon grains prior to U–Pb dating by isotope dilution thermal ionization mass spectrometry (ID-TIMS) to remove radiation-damaged portions of grains affected by Pb loss. Still, many chemically abraded datasets exhibit evidence of residual Pb loss. Here we test how the temperature and duration of chemical abrasion affect zircon U–Pb and trace element systematics in a series of 4 h, single-crystal stepwise dissolution experiments at 180 and 210 ∘C. Microtextural data for the zircon samples studied are presented in a companion paper by McKanna et al. (2023). We find that stepwise dissolution at 210 ∘C is more effective at eliminating material affected by open-system behavior and enriched in U, common Pb (Pbc), and light rare earth elements (LREEs); reduces the presence of leaching-induced artifacts that manifest as reverse discordance; and produces more consistent and concordant results in zircon from the three rocks studied. We estimate that stepwise dissolution in three 4 h steps is roughly equivalent to a single ∼ 8 h leaching step due to the insulating properties of the PTFE sleeve in the Parr pressure dissolution vessel, whereas traditionally labs utilize a single 12 h leaching step. We conclude that a single 8 h leaching step at 210 ∘C should remove Pb loss effects in the majority of zircon and that this can be used as an effective approach for routine analysis. Further, we calculate time-integrated alpha doses for leachates and residues from measured radionuclide concentrations to investigate (1) the alpha dose of the material dissolved under the two leaching conditions and (2) the apparent minimum alpha dose required for Pb loss susceptibility: ≥ 6×1017 α g−1.

Systematic comparison of variant calling pipelines of target genome sequencing cross multiple next-generation sequencers.

Targeted genomic sequencing (TS) greatly benefits precision oncology by rapidly detecting genetic variations with better accuracy and sensitivity owing to its high sequencing depth. Multiple sequencing platforms and variant calling tools are available for TS, making it excruciating for researchers to choose. Therefore, benchmarking study across different platforms and pipelines available for TS is imperative. In this study, we performed a TS of Reference OncoSpan FFPE (HD832) sample enriched by TSO500 panel using four commercially available sequencers, and analyzed the output 50 datasets using five commonly-used bioinformatics pipelines. We systematically investigated the sequencing quality and variant detection sensitivity, expecting to provide optimal recommendations for future research. Four sequencing platforms returned highly concordant results in terms of base quality (Q20 > 94%), sequencing coverage (>97%) and depth (>2000×). Benchmarking revealed good concordance of variant calling across different platforms and pipelines, among which, FASTASeq 300 platform showed the highest sensitivity (100%) and precision (100%) in high-confidence variants calling when analyzed by SNVer and VarScan 2 algorithms. Furthermore, this sequencer demonstrated the shortest sequencing time (∼21h) at the sequencing mode PE150. Through the intersection of 50 datasets generated in this study, we recommended a novel set of variant genes outside the truth set published by HD832, expecting to replenish HD832 for future research on tumor variant diagnosis. Besides, we applied these five tools to another panel (TargetSeq One) for Twist cfDNA Pan-cancer Reference Standard, comprehensive consideration of SNP and InDel sensitivity, SNVer and VarScan 2 performed best among them. Furthermore, SNVer and VarScan 2 also performed best for six cancer cell lines samples regarding SNP and InDel sensitivity. Considering the dissimilarity of variant calls across different pipelines for datasets from the same platform, we recommended an integration of multiple tools to improve variant calling sensitivity and accuracy for the cancer genome. Illumina and GeneMind technologies can be used independently or together by public health laboratories performing tumor TS. SNVer and VarScan 2 perform better regarding variant detection sensitivity for three typical tumor samples. Our study provides a standardized target sequencing resource to benchmark new bioinformatics protocols and sequencing platforms.

RNASeq Analysis for Accurate Identification of Fusion Partners in Tumor Specific Translocations Detected by Standard FISH Probes in Hematologic Malignancies.

Fluorescence labeled DNA probes and in situ hybridization methods had shorter turn round time for results revolutionized their clinical application. Signals obtained from these probes are highly specific, yet they can produce fusion signals not necessarily representing fusion of actual genes due to other genes included in the probe design. In this study we evaluated discordance between cytogenetic, FISH and RNAseq results in 3 different patients with hematologic malignancies and illustrated the need to perform next generation sequencing (NGS) or RNASeq to accurately interpret FISH results. Bone marrow or peripheral blood karyotypes and FISH were performed to detect recurring translocations associated with hematologic malignancies in clinical samples routinely referred to our clinical cytogenetics laboratory. When required, NGS was performed on DNA and RNA libraries to detect somatic alterations and gene fusions in some of these specimens. Discordance in results between these methods is further evaluated. For a patient with plasma cell leukemia standard FGFR3 / IGH dual fusion FISH assay detected fusion that was interpreted as FGFR3-positive leukemia, whereas NGS/RNASeq detected NSD2::IGH. For a pediatric acute lymphoblastic leukemia patient, a genetic diagnosis of PDGFRB-positive ALL was rendered because the PDGFRB break-apart probe detected clonal rearrangement, whereas NGS detected MEF2D::CSF1R. A MYC-positive B-prolymphocytic leukemia was rendered for another patient with a cytogenetically identified t(8;14) and MYC::IGH by FISH, whereas NGS detected a novel PVT1::RCOR1 not previously reported. These are 3 cases in a series of several other concordant results, nevertheless, elucidate limitations when interpreting FISH results in clinical applications, particularly when other genes are included in probe design. In addition, when the observed FISH signals are atypical, this study illustrates the necessity to perform complementary laboratory assays, such as NGS and/or RNASeq, to accurately identify fusion genes in tumorigenic translocations.

Navigated intraoperative ultrasound in neuro-oncology: volumetric accuracy and correlation with high-field MRI.

The use of intraoperative techniques to detect residual tumors has recently become increasingly important. Intraoperative MRI has long been considered the gold standard; however, it is not widely used because of high equipment costs and long acquisition times. Consequently, real-time intraoperative ultrasound (ioUS), which is much less expensive than MRI, has gained popularity. The aim of the present study was to evaluate the capacity of ioUS to accurately determine the primary tumor volume and detect residual tumors. A prospective study of adult patients who underwent surgery for intra-axial brain tumors between November 2017 and October 2020 was performed. Navigated intraoperative ultrasound (nioUS) of the brain was used to guide tumor resection and to detect the presence of residual disease. Both convex (5-8 MHz) and linear array (6-13 MHz) probes were used. Tumor volume and residual disease were measured with nioUS and compared with MR images. A linear regression model based on a machine learning pipeline and a Bland-Altman analysis were used to assess the accuracy of nioUS versus MRI. Eighty patients (35 females and 45 males) were included. The mean age was 58 years (range 25-80 years). A total of 88 lesions were evaluated; there were 64 (73%) gliomas, 19 (21.6%) metastases, and 5 (5.7%) other tumors, mostly located in the frontal (41%) and temporal (27%) lobes. Most of the tumors (75%) were perfectly visible on ioUS (grade 3, Mair grading system), except for those located in the insular lobe (grade 2). The regression model showed a nearly perfect correlation (R2 = 0.97, p < 0.001) between preoperative tumor volumes from both MRI and nioUS. Ultrasonographic visibility significantly influenced this correlation, which was stronger for highly visible (grade 3) tumors (p = 0.01). For residual tumors, the correlation between postoperative MRI and nioUS was weaker (R2 = 0.78, p < 0.001) but statistically significant. The Bland-Altman analysis showed minimal bias between the two techniques for pre- and postoperative scenarios, with statistically significant results for the preoperative concordance. The authors' findings show that most brain tumors are well delineated by nioUS and almost perfectly correlated with MRI-based measurements both pre- and postoperatively. These data support the hypothesis that nioUS is a reliable intraoperative technique that can be used for real-time monitoring of brain tumor resections and to perform volumetric analysis of residual disease.

Efficacy of targeted next generation sequencing for pathogen detection in lower respiratory tract infections.

To investigate the diagnostic utility of targeted next-generation sequencing (tNGS) in the diagnosis of lower respiratory tract infections. Patients with lower respiratory tract infection in East Area of Yantai Yantaishan Hospital from December 2021 to September 2023 were retrospectively analyzed. Sputum samples were tested using both tNGS technology and conventional microbiological examination. Data were collected on general clinical features and test outcomes. The study evaluated the efficacy of tNGS by comparing its positive detection rate against traditional methods and analyzing detection differences among patients with varying clinical characteristics. Receiver operating characteristic (ROC) analysis was used to determine the diagnostic accuracy of both testing methods. A total of 281 patients were included, with corresponding sputum specimens. The tNGS method showed a higher positivity rate of 90.0%, significantly outperforming the conventional method's rate of 70.82% (P<0.05). Among 199 patients with concordant positive results, 38.22% fully agreed, while 53.40% completely disagreed between the two methods. Mycobacterium tuberculosis, Candida albicans, and Pseudomonas aeruginosa were the most frequently detected pathogens, respectively. tNGS significantly reduced the time required for pathogen detection (P<0.001) and identified a higher rate of mixed infections compared to conventional methods (49.11% vs 2.85%, P<0.001). Positive tNGS detection rates significantly differed between patients with abnormal vs normal C-reactive protein or procalcitonin levels. The AUC for tNGS was 0.867, indicating superior diagnostic accuracy over the conventional method (P<0.05). tNGS technology demonstrates a high positivity rate and rapid pathogen detection in lower respiratory tract infections, with notable advantages in identifying mixed infections. This method shows potential for enhancing diagnostic accuracy and treatment decisions in clinical settings.

Evaluation of an automated real-time transcription-mediated amplification (TMA) assay for detection and quantification of cytomegalovirus DNA in different clinical specimens

BackgroundReliable and fast detection and quantification of human cytomegalovirus (CMV) DNA in various diagnostic specimens is essential for care of immunocompromised or congenitally infected individuals. ObjectivesTo evaluate the analytical and clinical performance of the Panther Aptima® CMV (Hologic) quantitative real-time transcription mediated amplification (TMA) assay. Study designPerformance of the TMA assay run on the Hologic Panther Fusion was analysed for 32 proficiency testing samples and 21 quantitative reproducibility panel samples; additionally, we compared results of TMA assay and routine quantitative real-time PCR assays ("PCR-A"= Biomérieux CMV R-gene® or "PCR-B"= Laboratory-developed CMV-PCR) in 518 diagnostic specimens (254 plasma, 120 EDTA whole blood, 43 urine, 45 amniotic fluid and 56 breast milk) at two university hospital laboratories. ResultsAll proficiency panel samples were correctly identified and quantified by the TMA assay; replicate testing of the reproducibility panel samples showed good reproducibility within and between the two laboratories. Sensitivity in plasma and WB was higher for the TMA assay detecting low-level CMV-DNAemia in samples tested negative by routine PCR. Quantitative CMV-DNAemia values correlated well between TMA and real-time PCR. Similarly, urine, AF and BM specimens showed a high rate of concordant results (91%, 98% and 98%, respectively) among TMA and PCR with good correlation of quantitative values. ConclusionThe performance of the Aptima® CMV TMA assay for viral blood load testing compared well to established real-time PCRs. In addition, it can be useful for diagnostics in urine, amniotic fluid and breast milk specimens.

Who are the Better Candidates for Epilepsy Surgery?

The resective epilepsy surgery can be the effective procedure to get seizure-free outcome in these drug resistant epilepsy (DRE) patients. Class I evidence firmly establishes the superiority of epilepsy surgery over medical treatments in both seizure control and quality of life for DRE patients. For the effective identification of optimal surgical candidates, it's essential to understand the prognostic factors of epilepsy surgery based on the surgical methods employed. Established positive prognostic indicators for temporal resection include the presence of hippocampal sclerosis on magnetic resonance imaging (MRI), focal lesions on MRI, unilateral temporal spikes, concordant ictal electroencephalography (EEG), and a history of prolonged febrile convulsion. Potential negative predictors encompass preoperative secondary generalized tonic-clonic seizures, a normal MRI, postoperative EEG spikes, and age at the time of surgery. For neocortical epilepsy, the prognostic factors identified through multivariate analysis were the presence of a discrete lesion, localized hypometabolism on Fluorodeoxyglucose positron emission tomography (FDG-PET), and localized ictal EEG. A significant correlation was found between achieving a seizure-free outcome in no visible lesion on MRI (MR-negative) epilepsy patients and having concordance in two or more presurgical evaluations, specifically in interictal EEG, ictal EEG, FDG-PET, and ictal single-photon emission computed tomography. There was a marked improvement in the seizure-free outcome in MR-negative temporal lobe epilepsy (TLE) by the application of this strategy. The better surgical candidates for epilepsy surgery are the followings: patients displaying a discrete lesion on MRI with concordant video-EEG monitoring (VEM) results, patients diagnosed with unilateral hippocampal sclerosis who have concordant VEM results, patients with unilateral hippocampal sclerosis but discordant VEM results, patients with focal cortical dysplasia and concordant VEM results, and patients diagnosed with MR-negative TLE who exhibit two or more consistent results from presurgical evaluations.

Concordance of Dermoscopic Findings and Wood’s Lamp Findings in Melasma Patients

Objective: To find the concordance of Dermoscopic and Wood’s lamp findings in melasma patients. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Kharian Pakistan, from Nov 2020 to Sep 2021. Methodology: A total of sixty patients clinically classified as melasma were enrolled in the study. Clinical assessment was done, and patients were examined with Wood’s lamp and Dermoscope, and findings were recorded. Results: The results of concordance of Wood’s lamp findings and Dermoscopic findings were significant as analysed by Kappa Statistics where value of k was 0.597 and p-value was &lt;0.001. Conclusion: Dermoscopy is a newer and more advanced tool. It should be used as a screening and diagnostic tool for melasma and other pigmentation disorders in our Outpatient Departments for earlier subtyping of melasma, deciding the treatment choice and predicting prognosis.

Anisotropic Lens-Shaped Mesoporous Carbon with Bifunctional Dual Metal Single Atom Electrocatalyst for Na Seawater Battery

Seawater is a promising electrolyte that can replace conventional distilled water-based electrolytes in that they are affordable and abundant. In the Na seawater battery, oxygen evolution reaction and oxygen reduction reaction occur in a single electrode during the charge and discharge process respectively. To obtain high energy efficiency of the Na-seawater battery, both oxygen electrocatalytic activity should be improved. In addition, the electrochemical reaction occurring in natural seawater may be hindered by chlorine ions. Side reactions such as chlorine evolution reaction or poisoning of electrocatalyst may occur during the charge/discharge process. In this study, dual metal single atom (DSA) loaded anisotropic lens-shaped mesoporous carbon is prepared for an electrode material in a Na-seawater battery. The DSA loaded anisotropic lens-shaped mesoporous carbon is synthesized by polymer interfacial self-assembly of block copolymer (BCP, Poly(ethylene oxide)-b-polystyrene, PEO-b-PS) and immiscible homopolymer (Poly(methyl methacrylate), PMMA). During the self-assembly, pre-dissolved inorganic precursors assemble with BCPs constructing the ordered mesoporous structure. Followed by proper carbonization and chemical etching, DSA loaded anisotropic lens-shaped mesoporous carbon is prepared. Using the natural seawater, the half-cell performance on the rotating disk electrode (RDE) of DSA (Fe-Nx/Co-Nx) loaded mesoporous carbon shows the lower potential difference (EOER-EORR) than a single atom (Fe-Nx) loaded mesoporous carbon, commercial Pt/C (20 wt%) and commercial Ir/IrO catalyst. Based on the RDE result, electrocatalyst performance in seawater half-cell (Na || Seawater) exhibits a concordant result. In addition to the electrochemical results, the performance of the DSA electrocatalyst is confirmed by comparing the activities of chlorine and oxygen species on DSA model through density functional theory calculation.

Targeted next-generation sequencing for pulmonary infection diagnosis in patients unsuitable for bronchoalveolar lavage.

Targeted next-generation sequencing (tNGS) has emerged as a rapid diagnostic technology for identifying a wide spectrum of pathogens responsible for pulmonary infections. Sputum samples were collected from patients unable or unwilling to undergo bronchoalveolar lavage. These samples underwent tNGS analysis to diagnose pulmonary infections. Retrospective analysis was performed on clinical data, and the clinical efficacy of tNGS was compared to conventional microbiological tests (CMTs). This study included 209 pediatric and adult patients with confirmed pulmonary infections. tNGS detected 45 potential pathogens, whereas CMTs identified 23 pathogens. The overall microbial detection rate significantly differed between tNGS and CMTs (96.7% vs. 36.8%, p < 0.001). Among the 76 patients with concordant positive results from tNGS and CMTs, 86.8% (66/76) exhibited full or partial agreement. For highly pathogenic and rare/noncolonized microorganisms, tNGS, combined with comprehensive clinical review, directly guided pathogenic diagnosis and antibiotic treatment in 21 patients. This included infections caused by Mycobacterium tuberculosis complex, certain atypical pathogens, Aspergillus, and nontuberculous Mycobacteria. Among the enrolled population, 38.8% (81/209) of patients adjusted their treatment based on tNGS results. Furthermore, tNGS findings unveiled age-specific heterogeneity in pathogen distribution between children and adults. CMTs often fall short in meeting the diagnostic needs of pulmonary infections. This study highlights how tNGS of sputum samples from patients who cannot or will not undergo bronchoalveolar lavage yield valuable insights into potential pathogens, thereby enhancing the diagnosis of pulmonary infections in specific cases.