Conventional Tests Research Articles

The Role of Hepcidin, sTfR, and sTfR/Log Ferritin Index for the Differential Diagnosis of Iron Deficiency Anemia and Anemia of Chronic Disease

Background: In chronic diseases characterized by persistent inflammation, anemia of chronic disease (ACD) and iron deficiency anemia (IDA) are commonly encountered forms of anemia and can often co-occur. In such situations, the conventional iron status tests used for differential diagnosis are influenced by inflammation, reducing their diagnostic accuracy. The primary objective of this study was to assess the significance of hepcidin as a crucial diagnostic marker for ACD and to investigate the correlation between hepcidin and inflammation-related indicators. Furthermore, a significant secondary aim of this research was to ascertain the diagnostic role of novel biochemical markers, specifically soluble transferrin receptor (sTfR) and the derived sTfR/log ferritin index (sTfR-F index). Methods and Results: This study was conducted at the Laboratory Service of the University Hospital Center "Mother Teresa" and included a cohort of 187 subjects, comprising 156 patients (83 females and 73 males) who were admitted to and received treatment at the Rheumatology and Cardiology Departments of the "Mother Teresa" University Hospital Center in Tirana. Additionally, 31 individuals without anemia and inflammatory conditions were included as a control group. All subjects incorporated into the study were classified into five distinct groups based on a comprehensive analysis of their complete blood profiles, iron status, and inflammation-related biomarkers: IDA, ACD, ACD+IDA, RA/CHF patients without anemia, and the control group without anemia. The comparison between groups showed that the mean values of pro-hepcidin, TNFα, IL6, Hs-PCR, and ferritin are significantly decreased in IDA vs. ACD, while sTFR and sTfR-F index are significantly increased. In comparing ACD vs. ACD+IDA groups, ferritin increased significantly in the ACD group, while sTFR and sTfR-F index decreased significantly in ACD, compared to the ACD+IDA group. The ROC curves analysis of the biochemical parameters selected for the comparison of ACD vs IDA showed that the pro-hepcidin test is a perfect test for the differential diagnosis of ACD vs. IDA. The suggested cut-off value for pro-hepcidin was ≥153 ng/ml, yielding a sensitivity of 100% and a specificity of 100% for the diagnosis of ACD. As regards sTFR, the suggested cut-off value for the diagnosis of IDA vs. ACD was≥ 4.9 µg/ml resulting in 84% sensitivity and 100% specificity. The sTfR-F index was also very useful for the diagnosis of IDA vs. ACD: for a cut-off value of ≥2.06, the sensitivity was 90% and the specificity was 96%. sTfR resulted in a good test for the diagnosis of ACD+IDA vs. ACD: the cut-off value was ≥ 3.7µ/ml, the sensitivity was 92.3% and the specificity was 93.2%. Similarly, the parameter sTfR-F index resulted in a very good test for the diagnosis of ACD+IDA vs. ACD: for the suggested cut-off value of ≥2.3, the sensitivity was 92.3% and the specificity was 100%. Conclusion: As a result of the study, it was found that the pro-hepcidin test was a highly accurate test for distinguishing between ACD and IDA. Meanwhile, sTfR and the sTfR-F index proved to be excellent indicators for the differential diagnosis of IDA in chronic inflammatory conditions.

Improving pulmonary infection diagnosis with metagenomic next-generation sequencing of bronchoalveolar lavage fluid.

Introduction. Inappropriate use of antibiotics and inadequate therapeutic regimens for early-stage pulmonary infections are major contributors to increased prevalence of complications and mortality. Moreover, due to the limitations in sensitivity of conventional testing, there is an urgent need for more diagnostically efficient methods for the detection and characterization of pathogens in pulmonary infections.Hypothesis/Gap Statement. Metagenomic next-generation sequencing (mNGS) can contribute to the diagnosis and management of pulmonary infections.Aim. This study aimed to evaluate the clinical application and value of mNGS in the diagnosis of clinically suspected pulmonary infections by comparing with conventional testing.Methodology. In this study, the diagnosis performance of mNGS was evaluated using bronchoalveolar lavage fluid (BALF) samples from 143 patients with suspected lung infections. First, we conducted a prospective study on 31 patients admitted to Yuebei People's Hospital Affiliated to Shantou University Medical College to investigate the clinical value. Then a retrospective analysis was performed by including more patients (n=112) to reduce the random error. Pathogens were detected by mNGS and conventional methods (culture and PCR). Then, the types and cases of detected pathogens, as well as the specificity and sensitivity, were compared between the two methods. We evaluated the performance of mNGS in detecting bacterial, fungal, viral and mixed infections in BALF. The effect of disease severity in pulmonary infections on the integrity of mNGS pathogen detection was also explored.Results. The mNGS provided an earlier and more comprehensive pathogen profile than conventional testing, which in turn prompted a change in clinical medication, which led to improvement in eight patients (8/31=25.81 %) in the presence of other serious comorbidities. In a retrospective analysis, mNGS was much more sensitive than conventional testing in the diagnosis of pulmonary infections (95.33 % vs. 55.56 %; P<0.001), with a 39.77 % increase in sensitivity. The detection rate of mNGS for mixed infections was significantly higher than that of conventional testing methods for both common and severe pneumonia (48/67=71.64 % vs. 12/52=23.08 %, P<0.001; 44/59=74.58 % vs. 11/59=18.64 %, P<0.0001).Conclusion. The sensitivity of mNGS in the diagnosis of pathogenic microorganisms in pulmonary infections far exceeds that of conventional culture tests. As a complementary method to conventional methods, mNGS can help improve the diagnosis of pulmonary infections. In addition, mNGS pathogen integrity detection rate was similar in common and severe pneumonia. We recommend the prompt use of mNGS when mixed or rare pathogen infections are suspected, especially in immunocompromised individuals and/or critically ill individuals.

Validation of Korean Olfactory Questionnaire for Perioperative Olfactory Assessment in Endoscopic Endonasal Skull Base Surgery.

Objective: To analyze changes in olfactory function after endoscopic endonasal skull base surgery and compare performance of the olfactory questionnaire with those of conventional psychophysical tests. Methods: Patients were classified into 5 categories for olfactory function evaluation (normal, mild hyposmia, moderate hyposmia, severe hyposmia, and anosmia) based on a self-assessment. Patients also underwent the butanol threshold test (BTT), Cross-Cultural Smell Identification Test (CCSIT), and 11-item olfactory questionnaire. Subjects with normosmia preoperatively and who were followed up at least 6 months after surgery were analyzed. Receiver operating characteristic curves and confusion matrix analysis were performed for BTT, CCSIT, and olfactory questionnaire to compare their diagnostic abilities. The effects of age, preoperative olfaction, septal flap, tumor pathology, and tumor size on postoperative olfaction were evaluated using multivariate linear regression analysis. Results: Data from 108 patients were analyzed. Postoperative changes in the olfactory questionnaire were significantly associated with changes in the BTT and CCSIT. The area under the curve for postoperative self-olfactory function classification was highest for olfactory questionnaire (0.894), followed by BTT (0.767) and CCSIT (0.688). Patient age at the time of surgery and preoperative BTT score were significantly related to postoperative olfactory outcomes. Conclusion: The olfactory questionnaire correlated well with conventional psychosomatic olfactory function tests. In combination with clinical parameters and preoperative psychosomatic olfactory function tests, the olfactory questionnaire is suitable for assessing subjective olfactory function after endoscopic endonasal skull base surgery.

Nanopore targeted sequencing-based diagnosis of central nervous system infections in HIV-infected patients

BackgroundEarly and accurate etiological diagnosis is very important for improving the prognosis of central nervous system (CNS) infections in human immunodeficiency virus (HIV)-infected patients. The goal is not easily achieved by conventional microbiological tests. We developed a nanopore targeted sequencing (NTS) platform and evaluated the diagnostic performance for CNS infections in HIV-infected patients, with special focus on cryptococcal meningitis (CM). We compared the CM diagnostic performance of NTS with conventional methods and cryptococcal polymerase chain reaction (PCR).MethodsThis study included 57 hospitalized HIV-infected patients with suspected CNS infections from September 2018 to March 2022. The diagnosis established during hospitalization includes 27 cases of CM, 13 CNS tuberculosis, 5 toxoplasma encephalitis, 2 cytomegalovirus (CMV) encephalitis and 1 Varicella-zoster virus (VZV) encephalitis. The 2 cases of CMV encephalitis also have co-existing CM. Target-specific PCR amplification was used to enrich pathogen sequences before nanopore sequencing. NTS was performed on stored cerebrospinal fluid (CSF) samples and the results were compared with the diagnosis during hospitalization.Results53 (93.0%) of the patients were male. The median CD4 cell count was 25.0 (IQR: 14.0–63.0) cells/uL. The sensitivities of CSF culture, India ink staining, cryptococcal PCR and NTS for CM were 70.4% (95%CI: 51.5 − 84.1%), 76.0% (95%CI: 56.6 − 88.5%), 77.8% (59.2 − 89.4%) and 85.2% (95%CI: 67.5 − 94.1%), respectively. All those methods had 100% specificity for CM. Our NTS platform could identify Cryptococcus at species level. Moreover, NTS was also able to identify all the 5 cases of toxoplasma encephalitis, 2 cases of CMV encephalitis and 1 VZV encephalitis. However, only 1 of 13 CNS tuberculosis cases was diagnosed by NTS, and so did Xpert MTB/RIF assay.ConclusionsNTS has a good diagnostic performance for CM in HIV-infected patients and may have the ability of simultaneously detecting other pathogens, including mixed infections. With continuing improving of the NTS platform, it may be a promising alterative microbiological test for assisting with the diagnosis of CNS infections.

Resistencia a antibióticos de Staphylococcus aureus aislado de la cavidad bucal de participantes paraguayos de Coronel Oviedo, año 2021

A cross-sectional study was carried out to identify the resistance profile of Staphylococcus aureus colonizing the oral cavity of patients. Sampling was carried out with sterile swabs. Mannitol-positive colonies were cultured on blood agar, identifying S. aureus by conventional biochemical tests that included positive results for catalase, coagulase, DNAse and latex agglutination test for S. aureus. The resistance to 11 antibiotics was tested. Forty-three subjects were included; 83.7% presented oral pathologies, and 6.9% had a history of hospitalization, 18.6% mentioned having used antibiotics in the last three months. S. aureus was isolated in 3 patients; the 3 isolates presented resistance to penicillin, while 2 of the three isolates were resistant to oxacillin and cefoxitin. Resistance to erythromycin and clindamycin was also present in one patient. Two of the cases presented resistance to various drugs and didn´t report any risk factors.

Independent clinic-based evaluation of dual POCTs for screening for HIV and syphilis in men who have sex with men in Italy, Malta, Peru, and the United Kingdom

IntroductionGlobally, the incidence of HIV and syphilis can be reduced by the use of validated point of care tests (POCTs). As part of the WHO PRoSPeRo Network, we aimed to evaluate the performance, acceptability, and operational characteristics of two dual HIV/syphilis POCTs (Bioline HIV/Syphilis Duo (Abbott) and DPP® HIV-Syphilis assay (Chembio) for the screening of HIV and syphilis amongst men who have sex with men (MSM).Method and analysesA cross sectional study of 2,577 MSM in Italy, Malta, Peru, and the United Kingdom (UK) presenting to seven clinic sites, were enrolled. Finger prick blood was collected to perform POCTs and results compared with standard laboratory investigations on venepuncture blood. Acceptability and operational characteristics were assessed using questionnaires. Diagnostic meta-analysis was used to combine data from the evaluation sites.ResultsBased on laboratory tests, 23.46% (n = 598/2549) of participants were confirmed HIV positive, and 35.88% of participants (n = 901/2511) were positive on treponemal reference testing. Of all participants showing evidence of antibodies to Treponema pallidum, 50.56% (n = 455/900) were Rapid Plasma Reagin (RPR) test reactive. Of HIV positive individuals, 60.62% (n = 354/584) had evidence of antibodies to T. pallidum, and of these 60.45% (n = 214/354) exhibited reactive RPR tests indicating probable (co)infection. For Bioline POCT, pooled sensitivities and specificities for HIV were 98.95% and 99.89% respectively, and for syphilis were 73.79% and 99.57%. For Chembio pooled sensitivities and specificities for HIV were 98.66% and 99.55%, and for syphilis were 78.60% and 99.48%. Both tests can detect greater than 90% of probable active syphilis cases, as defined by reactive RPR and treponemal test results. These dual POCTs were preferred by 74.77% (n = 1,926) of participants, due to their convenience, and the operational characteristics made them acceptable to health care providers (HCPs).ConclusionsBoth the Bioline and the Chembio dual POCT for syphilis and HIV had acceptable performance, acceptability and operational characteristics amongst MSM in the PRoSPeRo network. These dual POCTs could serve as a strategic, more cost effective, patient and healthcare provider (HCP) friendly alternative to conventional testing; in clinical and other field settings, especially those in resource-limited settings.

Performance Evaluation of Asphalt and Asphalt Mixtures Modified by Fuel-Resistant Admixture

In the course of asphalt pavement usage, exposure to fuel infiltration accelerates particle detachment, leading to the occurrence of problems such as looseness and peeling. The aim of this study was to comprehensively evaluate the impact of a fuel-resistant modifier (FRM; 1%, 3%, 5%, 7%) on the performance of asphalt and asphalt mixture. Conventional physical tests and high–low temperature rheological tests were conducted on the fuel-resistant modified asphalt (FRMA). The results indicate that, with increased FRM content, the penetration and ductility of FRMA decreased, while the softening point increased. The high-temperature performance improved, but the low-temperature ductility declined. High–low temperature rheological test results demonstrate that the addition of FRM significantly enhanced the asphalt’s shear deformation resistance. A moderate amount of FRM modification improved the asphalt’s low-temperature crack resistance, but excessive FRM resulted in reduced flexibility. In addition, fuel-resistant modified asphalt mixture (FRMAM) specimens were prepared and evaluated for performance. In comparison to the base asphalt, FRM modification enhanced the resistance to oil erosion and peeling as well as the Marshall stability of asphalt mixtures. It reduced the scattering loss caused by fuel dissolution and improved both low-temperature indirect tensile (IDT) strength and high-temperature shear strength. A low content of FRM effectively reduced the sensitivity of asphalt mixtures to fuel infiltration, thus enhancing their road performance.

Online state of health estimation of lithium-ion batteries through subspace system identification methods

When Lithium-ion Batteries (LiBs) reach the end of their first life in electric vehicles (EVs), they can still be used in applications with lower power demands, a process known as second-life. However, to ensure that LiBs – or cells – removed from EVs operate safely, efficiently and reliably in a second application, several tests and procedures must be applied to study their internal conditions. Naturally, one of the most important parameters to be determined is the state of health (SoH). However, the available processes for determining the SoH of lithium-ion cells are limited by high costs, relatively long test times and the need for specific equipment, limiting the second-life market. Hence, this work proposes a methodology to estimate the SoH of lithium-ion cells, based on subspace system identification (SSI) methods, where the parameters estimated for the equivalent circuit model (ECM) of a given cell are associated with its SoH. To validate the proposed methodology, nine cell samples from the same manufacturer were considered, which were removed from heavy-duty EVs at the end of their first life. The obtained results showed that: (a) good approximations between the identified models and the actual cells were achieved, with root mean square error (RMSE) values as small as 1.32 mV; (b) SSI methods can be applied online, while the LiBs are still operating in the EV during their first life, eliminating the need of additional tests; and (c) there is a clear association between ECM parameters and the SoH, so it was possible to estimate the SoH of the samples with RMSE values varying from 2.11% to 3.34%. Therefore, the proposed methodology offers significant improvements when compared to the conventional capacity tests, including the possibility of estimating the SoH relatively fast, online and without the need for specific equipment.

Model Tests on Jacked Pile Penetration Characteristics Considering a Static Press-in Piling Machine

This study incorporates a static press-in piling machine into the conventional laboratory model tests for jacked piles. By conducting a comparative analysis between two tests, one involving the static press-in piling machine and the other focusing solely on pile jacking, this study aims to unveil the variations in penetration characteristics with pile sinking depth during the process of pile jacking under the constraint imposed by the static press-in piling machine. When considering the impact of the piling machine, the pile pressing force, pile sinking resistance, pile axial force, and unit side friction resistance of the pile body are higher compared to test results that only focus on pile jacking. There is an acceleration in the total side friction resistance within the depth range of 20 to 30 cm. Additionally, the reduction rate of axial force during the entire pile jacking process is 2% higher, with a general reduction in the “side resistance degradation” phenomenon. The soil pressure around the pile exhibits an initial increase followed by a decrease. The authors believe that the model box test of the jacked pile, considering the pile machine, would be more aligned with engineering practice.

Risk factors for hemorrhage in patients with long-term aspirin therapy undergoing emergency external ventricular drainage/intracranial pressure probe placement

BackgroundStudies have been inconclusive on the risk for hemorrhage in patients with a history of aspirin use who underwent emergency external ventricular drainage (EVD)/intracranial pressure (ICP) probe placement. The aim of this study was to explore hemorrhage-related risk factors in order to reduce the risk for hemorrhage in these patients. MethodsBetween July 2014 and July 2020, patients were retrospectively divided into EVD/ICP-related hemorrhage and non-hemorrhage groups. The collected data included age, gender, major diagnosis, medical history, imaging examinations, conventional coagulation test data, thromboelastography with platelet mapping (TEG-PM), surgical procedures and discharge conditions. ResultsIn total 94 patients, 21 in the hemorrhage group (15 males, 6 females) and 73 in the non-hemorrhage group (52 males, 21 females) were included. The majority of hemorrhages were recorded in EVD patients (19/21; 90.5%). Platelet AA pathway inhibition rate of ≥75% (sensitivity: 79.45% specificity: 52.38%) (P = 0.014) and SBP ≥125 mmHg (P = 0.006) were significantly related to hemorrhage. When the platelet AA pathway inhibition rate was ≥75% and the during-procedure SBP was ≥125 mmHg, the hemorrhage rate was significantly higher (83.3%) than with SBP <125 mmHg (6.7%) (P < 0.001). When the inhibition rate was <75%, there were no significant differences in the hemorrhage rates between the during-procedure SBP ≥125 mmHg group (17.2%) and the SBP <125 mmHg group (13.2%) (P > 0.05). Multivariate logistic regression analysis revealed that a platelet AA pathway inhibition rate ≥75% (OR = 5.183, 95% CI: 1.683–15.960) and during-procedure SBP ≥125 mmHg (OR = 4.609, 95% CI: 1.466–14.484) were independent risk factors for EVD/ICP-related hemorrhage. ConclusionPatients with long-term aspirin therapy, a platelet AA pathway inhibition rate ≥75% and during-procedure SBP ≥125 mmHg had a significantly higher risk of hemorrhage, which could be reduced by adjusting the SBP to <125 mmHg.

A Connectivity Metrics-Based Approach for the Prediction of Stress-Dependent Fracture Permeability

Rapid and accurate assessment of fracture permeability is critical for subsurface resource and energy development as well as rock engineering stability. Fracture permeability deviates from the classical cubic law under the effect of roughness, geological stress, as well as mining-induced stress. Conventional laboratory tests and numerical simulations are commonly costly and time-consuming, whereas the use of a connectivity metric based on percolation theory can quickly predict fracture permeability, but with relatively low accuracy. For this reason, we selected two static connectivity metrics with the highest and lowest prediction accuracy in previous studies, respectively, and proposed to revise and use them for fracture permeability estimation, considering the effect of isolated large-aperture regions within the fractures under increasing normal stress. Several hundred fractures with different fractal dimensions and mismatch lengths were numerically generated and deformed, and their permeability was calculated by the local cubic law (LCL). Based on the dataset, the connectivity metrics were counted using the revised approach, and the results show that, regardless of the connectivity metrics, the new model greatly improves the accuracy of permeability prediction compared to the pre-improved model, by at least 8% for different cutoff aperture thresholds.

Yield strength evaluation of 3D-printed Ti–6Al–4V components based on non-contact eddy-current measurement

The demand for metal additive manufacturing (AM), also known as three-dimensional (3D) printing, is increasing owing to its ability to produce components with complex shapes, heterogeneous material properties, low material waste, etc. However, for broader acceptance of metal AM, quality assurance of mechanical properties, such as elastic (Young's) modulus, Poisson's ratio, and ductility, is becoming critical in additively manufactured components. This study proposes a non-contact, non-destructive and automated eddy-current technique for yield strength estimation of additively manufactured Ti–6Al–4V components with the potential for online operation during metal AM. After conducting the eddy-current measurement at a specific inspection point within the Ti–6Al–4V component, the relationship between the eddy-current phase value and electrical conductivity is established. Subsequently, the yield strength of the Ti–6Al–4V component is estimated by utilizing the analytical relationship between yield strength and electrical conductivity, which is based on Andrew's research and the Hall–Petch relationship. For experimental validation, Ti–6Al–4V test specimens with different electrical conductivities (yield strengths) were fabricated by adjusting the cooling rate during metal direct energy deposition AM. Then, the yield strengths estimated using the proposed technique were compared with those obtained using conventional destructive tensile tests. The results show that the proposed technique can estimate the yield strength with an error rate of less than 8%. The uniqueness of this study lies in (1) the theoretical derivation of the relationship between the eddy-current phase value and yield strength, (2) non-destructive, non-contact, and automated estimation of the yield strength using eddy-current measurements, and (3) performance evaluation using additively manufactured Ti–6Al–4V specimens with different yield strengths.

Notch Fatigue Property of 7050-T7451 Aluminum Alloy under Bending Resonance Environment

Based on the electromagnetic shaker table, the resonant fatigue testing system and the corresponding conventional fatigue testing system were designed respectively. The fatigue life (S-N) curves of smooth and notched 7050-T7451 aluminum alloy specimens were measured in the range of 105-107 cycles, and the notch fatigue property of 7050-T7451 aluminum alloy under bending resonance environment was studied. The results indicate that the fracture mechanism under bending resonant fatigue environment is roughly the same as that under bending conventional fatigue loading. All the S-N curves obtained through resonant and conventional fatigue tests show a continuously downward trend, and there are no obvious fatigue limits. Notch fatigue property under bending resonance environment presents “stage characteristics”, which increases first and then decreases with the increase of cycles. There is a critical cycle number Nc at 8×105 cycles, corresponding to the maximum fatigue notch factor Kf-max (or the maximum notch sensitivity factor qmax). There are two critical cycles N1 and N2. When N1&lt;N&lt;N2, the notch fatigue property of the material and the corresponding structures under resonance environment requires more consideration than conventional fatigue loading.

An Atomic-Scale Vector Network Analyzer.

Electronic devices have been ever-shrinking toward atomic dimensions and have reached operation frequencies in the GHz range, thereby outperforming most conventional test equipment, such as vector network analyzers (VNA). Here the capabilities of a VNA on the atomic scale in a scanning tunneling microscope are implemented. Nonlinearities present in the voltage-current characteristic of atoms and nanostructures for phase-resolved microwave spectroscopy with unprecedented spatial resolution at GHz frequencies are exploited. The amplitude and phase response up to 9.3GHz is determined, which permits accurate de-embedding of the transmission line and application of distortion-corrected waveforms in the tunnel junction itself. This enables quantitative characterization of the complex-valued admittance of individual magnetic iron atoms which show a lowpass response with a magnetic-field-tunable cutoff frequency.

Immunogenicity and safety of RAZI recombinant spike protein vaccine (RCP) as a booster dose after priming with BBIBP-CorV: a parallel two groups, randomized, double blind trial

BackgroundThe immunity induced by primary vaccination is effective against COVID-19; however, booster vaccines are needed to maintain vaccine-induced immunity and improve protection against emerging variants. Heterologous boosting is believed to result in more robust immune responses. This study investigated the safety and immunogenicity of the Razi Cov Pars vaccine (RCP) as a heterologous booster dose in people primed with Beijing Bio-Institute of Biological Products Coronavirus Vaccine (BBIBP-CorV).MethodsWe conducted a randomized, double-blind, active-controlled trial in adults aged 18 and over primarily vaccinated with BBIBP-CorV, an inactivated SARS-CoV-2 vaccine. Eligible participants were randomly assigned (1:1) to receive a booster dose of RCP or BBIBP-CorV vaccines. The primary outcome was neutralizing antibody activity measured by a conventional virus neutralization test (cVNT). The secondary efficacy outcomes included specific IgG antibodies against SARS-CoV-2 spike (S1 and receptor-binding domain, RBD) antigens and cell-mediated immunity. We measured humoral antibody responses at 2 weeks (in all participants) and 3 and 6 months (a subgroup of 101 participants) after the booster dose injection. The secondary safety outcomes were solicited and unsolicited immediate, local, and systemic adverse reactions.ResultsWe recruited 483 eligible participants between December 7, 2021, and January 13, 2022. The mean age was 51.9 years, and 68.1% were men. Neutralizing antibody titers increased about 3 (geometric mean fold increase, GMFI = 2.77, 95% CI 2.26–3.39) and 21 (GMFI = 21.51, 95% CI 16.35–28.32) times compared to the baseline in the BBIBP-CorV and the RCP vaccine groups. Geometric mean ratios (GMR) and 95% CI for serum neutralizing antibody titers for RCP compared with BBIBP-CorV on days 14, 90, and 180 were 6.81 (5.32–8.72), 1.77 (1.15–2.72), and 2.37 (1.62–3.47) respectively. We observed a similar pattern for specific antibody responses against S1 and RBD. We detected a rise in gamma interferon (IFN-γ), tumor necrosis factor (TNF-α), and interleukin 2 (IL-2) following stimulation with S antigen, particularly in the RCP group, and the flow cytometry examination showed an increase in the percentage of CD3 + /CD8 + lymphocytes. RCP and BBIBP-CorV had similar safety profiles; we identified no vaccine-related or unrelated deaths.ConclusionsBBIBP-CorV and RCP vaccines as booster doses are safe and provide a strong immune response that is more robust when the RCP vaccine is used. Heterologous vaccines are preferred as booster doses.Trial registrationThis study was registered with the Iranian Registry of Clinical Trial at www.irct.ir, IRCT20201214049709N4. Registered 29 November 2021.

VARIATIONS IN SERUM CONCENTRATIONS OF Hs-CRP IN PERIODONTITIS AND HEALTHY SUBJECTS

CRP is a plasma protein that measures the acute phase response to systemic inflammation and is one of the markers of choice in monitoring numerous chronic diseases. Patients with periodontitis have specific haematological variations, such as higher C-reactive protein (CRP) levels and elevated pro-inflammatory mediator levels. This study aims to quantify Hs-CRP levels in periodontally healthy and diseased subjects and evaluate the relationship between periodontitis and Hs-CRP levels. This Case-control study recruited 120 patients from two study groups—60 cases of chronic periodontitis (moderate to severe) and 60 controls. Periodontitis is assessed by three different index scores, namely: Community periodontal index score (CPI), Clinical attachment level (CAL) and periodontal probing depth (PPD). The Hs-CRP is measured due to its high sensitivity to assess systemic inflammation, making it more effective than conventional CRP tests. Our study results indicate that Hs-CRP levels increase subsequently with the severity of the periodontal disease. Moreover, Clinical attachment level (CAL) is the most significant indicator of Periodontitis that correlates with systemic inflammation in the body. Hence, concluding that periodontitis, being an oral condition, can have a massive impact on general systemic health, and elevated Hs-CRP levels, considered a biomarker of chronic systemic inflammation, can be a future risk to several fatal systemic diseases.

An integrated machine learning-based model for joint diagnosis of ovarian cancer with multiple test indicators

ObjectiveTo construct a machine learning diagnostic model integrating feature dimensionality reduction techniques and artificial neural network classifiers to develop the value of clinical routine blood indexes for the auxiliary diagnosis of ovarian cancer.MethodsPatients with ovarian cancer clearly diagnosed in our hospital were collected as a case group (n = 185), and three groups of patients with other malignant otolaryngology tumors (n = 138), patients with benign otolaryngology diseases (n = 339) and those with normal physical examination (n = 92) were used as an overall control group. In this paper, a fully automated segmentation network for magnetic resonance images of ovarian cancer is proposed to improve the reproducibility of tumor segmentation results while effectively reducing the burden on radiologists. A pre-trained Res Net50 is used to the three edge output modules are fused to obtain the final segmentation results. The segmentation results of the proposed network architecture are compared with the segmentation results of the U-net based network architecture and the effect of different loss functions and region of interest sizes on the segmentation performance of the proposed network is analyzed.ResultsThe average Dice similarity coefficient, average sensitivity, average specificity (specificity) and average hausdorff distance of the proposed network segmentation results reached 83.62%, 89.11%, 96.37% and 8.50, respectively, which were better than the U-net based segmentation method. For ROIs containing tumor tissue, the smaller the size, the better the segmentation effect. Several loss functions do not differ much. The area under the ROC curve of the machine learning diagnostic model reached 0.948, with a sensitivity of 91.9% and a specificity of 86.9%, and its diagnostic efficacy was significantly better than that of the traditional way of detecting CA125 alone. The model was able to accurately diagnose ovarian cancer of different disease stages and showed certain discriminative ability for ovarian cancer in all three control subgroups.ConclusionUsing machine learning to integrate multiple conventional test indicators can effectively improve the diagnostic efficacy of ovarian cancer, which provides a new idea for the intelligent auxiliary diagnosis of ovarian cancer.

Utilizing metagenomic next-generation sequencing for pathogen detection and diagnosis in lower respiratory tract infections in real-world clinical practice.

Infectious etiologies of lower respiratory tract infections (LRTIs) by the conventional microbiology tests (CMTs) can be challenging. Metagenomic next-generation sequencing (mNGS) has great potential in clinical use for its comprehensiveness in identifying pathogens, particularly those difficult-to-culture organisms. We analyzed a total of 205 clinical samples from 201 patients with suspected LRTIs using mNGS in parallel with CMTs. mNGS results were used to guide treatment adjustments for patients who had negative CMT results. The efficacy of treatment was subsequently evaluated in these patients. mNGS-detected microorganisms in 91.7% (188/205) of the clinical samples, whereas CMTs demonstrated a lower detection rate, identifying microorganisms in only 37.6% (77/205) of samples. Compared to CMT results, mNGS exhibited a detection sensitivity of 93.5% and 95.4% in all 205 clinical samples and 180 bronchoalveolar lavage fluid (BALF) samples, respectively. A total of 114 patients (114/201; 56.7%) showed negative CMT results, among which 92 received treatment adjustments guided by their positive mNGS results. Notably, 67.4% (62/92) of patients demonstrated effective treatment, while 25% (23/92) experienced a stabilized condition. Subgroup analysis of cancer patients revealed that 41.9% (13/31) exhibited an effective response to treatment, and 35.5% (11/31) maintained a stable condition following medication adjustments guided by mNGS. mNGS demonstrated great potential in identifying microorganisms of clinical significance in LRTIs. The rapid turnaround time and reduced susceptibility to the impact of antimicrobial administration make mNGS a valuable supplementary tool for diagnosis and treatment decision-making for suspected LRTIs in clinical practice.

Determination of the anisotropy in mechanical properties of laser powder bed fusion Inconel 718 by ultrasonic testing

ABSTRACT This study aims to investigate the effects of build direction on the as-fabricated microstructure and mechanical properties of Inconel 718 specimens manufactured via the Laser Powder Bed Fusion (L-PBF) technique. The microstructures and mechanical properties of the specimens were characterized via SEM, EBSD,ultrasonic wave velocity measurements, hardness and tensile tests. For the as-fabricated condition, the highest tensile strength (1114 MPa) was obtained with the horizontally built specimens while the vertically built ones have the highest 40% elongation. The computational analysis produced results that closely aligned with the measured yield strength values of L-PBFed samples. Additionally, a strong correlation was observed between the hardness values and longitudinal ultrasound velocity of L-PBF Inconel 718 specimens. Consequently, the non-destructive ultrasonic evaluation provided valuable insights into the anisotropy of mechanical properties, complementing information obtained from conventional tensile tests.

Discrete Element Method Analyses of Bond Degradation Evolutions for Cemented Soils

The degradation of soil bonding, which can be described by the evolution of bond degradation variables, is essential in the constitutive modeling of cemented soils. A degradation variable with a value of 0/1.0 indicates that the applied stress is completely sustained by bonded particles/unbounded grains. The discrete element method (DEM) was used for cemented soils to analyze the bond degradation evolution and to evaluate the degradation variables at the contact scale. Numerical cemented soil samples with different bonding strengths were first prepared using an advanced contact model (CM). Constant stress ratio compression, one-dimensional compression, conventional triaxial tests (CTTs), and true triaxial tests (TTTs) were then implemented for the numerical samples. After that, the numerical results were adopted to investigate the evolution of the bond degradation variables BN and B0. In the triaxial tests, B0 evolves to be near to or larger than BN due to shearing, which indicates that shearing increases the bearing rate of bond contacts. Finally, an approximate stress-path-independent bond degradation variable Bσ was developed. The evolution of Bσ with the equivalent plastic strain can be effectively described by an exponential function and a hyperbolic function.