Gold Test Research Articles

Ultra-sensitive and specific detection of pathogenic nucleic acids using composite-excited hyperfine plasma spectroscopy combs sensitized by Au nanoarrays functionalized with 2D Ta2C-MXene

Accurate and rapid screening techniques on a population scale are crucial for preventing and managing epidemics like COVID-19. The standard gold test for nucleic acids in pathogenic infections is primarily the reverse transcription polymerase chain reaction (RT-PCR). However, this method is not suitable for widespread screening due to its reliance on large-scale equipment and time-consuming extraction and amplification processes. Here, we developed a collaborative system that combines high-load hybridization probes targeting N and OFR1a with Au NPs@Ta2C-M modified gold-coated tilted fiber Bragg grating (TFBG) sensors to enable direct nucleic acid detection. Multiple activation sites of SARS-CoV-2 were saturable modified on the surface of a homogeneous arrayed AuNPs@Ta2C-M/Au structure based on a segmental modification approach. The combination of hybrid probe synergy and composite polarisation response in the excitation structure results in highly specific hybridization analysis and excellent signal transduction of trace target sequences. The system demonstrates excellent trace specificity, with a limit of detection of 0.2 pg/mL, and achieves a rapid response time of 1.5 min for clinical samples without amplification. The results showed high agreement with the RT-PCR test (Kappa index = 1). And the gradient-based detection of 10-in-1 mixed samples exhibits high-intensity interference immunity and excellent trace identification. Therefore, the proposed synergistic detection platform has a good tendency to curb the global spread of epidemics such as COVID-19.

Comparative localization of the courses of superficial veins in rabbits' limbs using latex and VeinViewer systems.

The purpose of this study; It is to reveal whether the veinviewer device, which we have not encountered in animals, can be visualized in rabbits for thoracic and pelvic limb superficial veins. Therefore, the latex method was used as a "gold test" to verify VeinViewer precision. For this purpose, the project was designed with two stages. In the first stage, the extremities of 15 New Zealand white rabbits were imaged using the VeinViewer device, and the results were recorded. In the second stage, the latex injection method was applied to the same animals, the cadavers were dissected, and the obtained results were comparatively analysed. In the rabbits, it was determined that v. cephalica originated from v. jugularis or v. brachialis in the proximity of the insertion of m. omotransversarius and anastomosed with v. mediana at the middle 1/3 level of the antebrachium. It was found that the superficial venous circulation of the pelvic limbs was provided by the branches of v. iliaca externa and v. iliaca interna. The vena saphena medialis was determined to be present in pairs in 80% of the cadavers. All cadavers showed the presence of the ramus anastomoticus cum vena saphena mediali. Additionally, the superficial veins of both the thoracic limbs and pelvic limbs of the rabbits were imaged with the VeinViewer device, which provided results parallel with the results of the latex injection method. Considering that the findings obtained with the latex injection method and the VeinViewer device were compatible, the usage of this device can potentially be considered as an alternative to visualizing superficial veins in animals. Further morphological and clinical studies can prove that the method is applicable.

Latent Mycobacterial fortuitum infection presenting as ocular sarcoidosis

A 62-year-old lady presented with bilateral granulomatous uveitis and cystoid macular edema. A diagnosis of ocular sarcoidosis was made (revised International Workshop on Ocular Sarcoidosis [IWOS] criteria) on the basis of lymphopenia, negative Mantoux, and QuantiFERON TB gold tests. Enlarged mediastinal lymph nodes, subpleural nodules, and nodular interstitial thickening were seen on high-resolution computed tomography (HRCT) thorax. Non-necrotizing granulomato us inflammation, negative for mycobacteria on staining and GeneXpert, was noted on endobronchial ultrasound-guided transbronchial lymph node aspiration (EBUS-TBNA). However, culture grew Mycobacterium fortuitum after 3 weeks. This case highlights a rare presentation of latent M. fortuitum infection presenting as ocular sarcoidosis, speculating the coexistence of two diseases in an individual, one possibly triggering the other.

Concurrent syphilis, gonorrhea, and monkeypox: A case report.

Documented cases of monkeypox virus outside of Africa are rare, but as of August 22, 2022, the CDC was tracking 18,101 cases in the United States. Monkeypox rash can easily mimic other sexually transmitted infections, which may occur concurrently. This case report describes a 36-year old Caucasian man who has sex with men. The patient came in for a routine history and physical examination and disclosed a perianal rash. The patient had a medical history significant for undertreated HIV, ankylosing spondylitis, and homelessness. On examination, he had multiple perianal deep-seated ulcers that were swabbed for monkeypox and herpes simplex virus 1 and 2. Samples were also collected for syphilis, chlamydia, and gonorrhea. The swabs were positive for monkeypox and pharyngeal gonorrhea. At subsequent blood draw, he was found to have elevated titers for syphilis and a positive QuantiFERON-TB gold test. In summary, this case is a clear example of an individual with concurrent monkeypox virus and other sexually and nonsexually transmitted infections, highlighting the importance of careful identification of risk factors and testing for monkeypox virus even when the clinical presentation may depict a common sexually transmitted infection, such as the herpes simplex virus.

CRISPR/Cas13a-assisted rapid and portable HBV DNA detection for low-level viremia patients

ABSTRACT Background & Aims The WHO declared to eliminate hepatitis B virus (HBV) by 2030. However, an increasing number of patients are presenting with low-level viremia (LLV) with the widespread use of antiviral medications. The diagnostic efficiency and coverage area of HBV infection are low. Hence, this study intended to drive the HBV infection detection to effectively adaptable for any small to medium-sized laboratory or field survey. Methods We established, optimized, and evaluated a colloidal gold test strip for detection of HBV DNA based on CRISPR/Cas13a combined with recombinase-aided amplification (RAA) technology. Furthermore, 180 HBV-infected patients (including patients with different viral loads, LLV patients and dynamic plasma samples of patients on antiviral therapy) were enrolled for clinical validation. Results The strip detection of HBV DNA was established based on RAA-CRISPR-Cas13a technology with a sensitivity of 101 copies/μL and a specificity of 100%. HBV DNA gradient concentration plasmids and clinical samples were effectively identified by this approach. The positive coincidence rate for LLV patients was 87%, while the negative coincidence rate was 100%. The positive coincidence rate reached 100% in LLV patients (viral loading >100 IU/mL). The sensitivity, specificity, positive predictive agreement (PPA) and negative predictive agreement (NPA) values of dynamic plasma detection in patients on antiviral therapy were 100%, 92.15%, 93.75%, and 100%, respectively. Conclusions We develop rapid and portable RAA-CRISPR/Cas13a-based strip of HBV DNA detection for LLV patients. This study provides a visual and faster alternative to current PCR-based diagnosis for HBV infection.

Rapid and Simultaneous Detection of Aflatoxin B1, Zearalenone, and T-2 Toxin in Medicinal and Edible Food Using Gold Immunochromatographic Test Strip.

(1) Background: Medicinal and edible food and traditional Chinese medicine have been used to treat various diseases. However, their safety has not been thoroughly assessed. (2) Methods: An immunochromatographic test strip (ICS) was used for the first time to screen some mycotoxins, including aflatoxin B1 (AFB1), zearalenone (ZEN), and T-2 toxin, in medicinal and edible food and traditional Chinese medicine. Antibody/nano-gold particle coupling was used with the prepared ICS, and the pH, monoclonal antibody concentration, and antigen amount were optimized. The extraction sample solution was diluted 10 times with phosphate-buffered saline containing 0.5% Tween-20 and 0.05% sodium dodecyl sulfate to remove the complex matrix in medicinal and edible food. (3) Results: Under optimal conditions, the sensitivities of the developed ICS for AFB1, ZEN, and T-2 were 0.5, 5.0, and 5.0 ng/mL, respectively. Among the 30 medicinal and edible food samples tested, two samples (both of sand jujube kernels) were positive, and the results were verified by high-performance liquid chromatography and enzyme-linked immunosorbent assay and were consistent with the ICS test results. (4) Conclusions: The ICS could be used for rapid screening and simultaneous detection of mycotoxins at medicinal and edible food storage facilities.

P553 Active tuberculosis and opportunistic infections: Pooled safety analysis of ustekinumab through up to 5 years across all approved indications

Abstract Background Ustekinumab (UST) is an approved treatment for adults with inflammatory bowel disease (IBD: Crohn’s disease [CD] and ulcerative colitis [UC]), psoriasis (PsO), and psoriatic arthritis (PsA). Here, we present pooled safety analyses in these approved indications of patients (pts) with active tuberculosis (TB) and opportunistic infections (OIs) through 5 years (yrs) of UST treatment. Methods Pooled data included 13 Phase 2/3 UST studies through 5 yrs of CD and PsO, 2 yrs of UC, and 1 yr of PsA. OIs were identified by clinician review. Herpes zoster (HZ) was evaluated separately. Event rates per 100 pt yrs (PYs) are presented. Concomitant immunomodulators/corticosteroids were permitted in IBD and PsA pts. All pts who received ≥1 UST dose were included. In IBD, placebo (PBO) pts included data up to the first UST dose for pts initially treated with PBO, or >16 weeks after the last UST dose for UST pts who switched to PBO. Results Across all approved indications, 19 OIs including TB were reported, with rates in PBO of 0.40 and UST of 0.10 through 5 yrs in 13807 PYs of follow-up (Table 1); rates of HZ were 1.21 and 0.63, respectively. Of 19 OIs, 18 were in IBD pts and 1 in a PsO pt. Overall, 14/16 pts (12/13 UST) with OIs excluding TB were also receiving confounding concomitant medications. A total of 3 active TB cases (2 pts with CD and 1 pt with UC) were reported in PBO (n=2; 1 in a Hungarian CD pt 10 months after receiving last UST dose) and UST (n=1) pts (Table 1). One active TB case was reported in an asymptomatic South African CD pt treated with UST who had a positive QuantiFERON®-TB Gold test on routine screening and bronchial brushings positive for M. tuberculosis. Both CD pts completed TB treatment with disease resolution. The most common OIs were esophageal candidiasis (UST n=3; PBO n=2) and cytomegalovirus colitis (UST n=3; PBO n=1). Conclusion Rates of OIs, including active TB, in UST-treated pts were low across approved indications through up to 5 yrs with 13807 PYs of follow-up and not higher in UST pts vs PBO pts, suggesting no increased risk of OI with long-term UST treatment.

Preparation of Lateral Flow PVDF Membrane via Combined Vapor- and Non-Solvent-Induced Phase Separation (V-NIPS).

A large pore size Poly(vinylidene fluoride) (PVDF) membrane was prepared by the V-NIPS method using PVDF/N, N-dimethylacetamide (DMAc)/Polyvinyl pyrrolidone (PVP)/Polyethylene glycol (PEG) system. Firstly, the effect of different additive ratios on the membrane morphology and pore size was studied, and it was found that when the PVP:PEG ratio was 8:2, PVDF membranes with a relatively large pore size tend to be formed; the pore size is about 7.5 µm. Then, the effects of different exposure time on the membrane morphology and pore size were investigated, and it was found that as the vapor temperature increased, the pores on the surface of the membrane first became slightly smaller and then increased. Finally, the effects of different vapor temperatures on the membrane properties were discussed. The results showed that the as-prepared membrane exhibited suitable capillary flow rate and similar performance compared with a commercially available membrane in colloidal gold tests. The likely cause is that the amount of negative charge is less and the capillary migration rate is too fast. This paper provides a reference for the preparation of PVDF colloidal gold detection membrane.

Design and development of a lanthanide-labeled immunochromatographic strip for simultaneous detection of morphine, methamphetamine and ketamine in hair.

Colloidal gold immunoassay is the most widely used method in the field of drug detection. However, this method often has poor quantitative identification ability and low analytical sensitivity, which is not suitable for the analysis of hair poisoning ingredients. In order to solve these limitations, we developed an immunochromatographic test strip for simultaneously screening multiple drugs in this study. This hand-held test strip used fluorescent nanoparticles loaded with lanthanide chelates as the signal carrier of fluorescence reading, and conducted quantitative testing of various drugs based on the competitive immune reaction between the analyte and antigen. Under the optimal conditions, the competition curves of morphine (MOP), methamphetamine (MET) and ketamine (KET) were obtained on a single band. The detection limit (LOD) of this analytical method was 100-1000 times lower than that of colloidal gold test strips. The detection limits of MOP, MET and KET were 0.06 ng mL-1, 0.1 ng mL-1 and 1.0 ng mL-1, respectively. No cross-reaction was observed when morphine, methamphetamine and ketamine were tested simultaneously with this method. And 184 hair samples were tested simultaneously, and the detected amount was very close to the results of LC-MS. The immunochromatographic strip showed good stability in repeated tests, and the coefficient of variation was less than 15%. Fluorescence immunochromatography strips and handheld strip readers have the characteristics of portability, speed, ease of operation and high sensitivity, and may become powerful tools for screening drug abuse in hair in forensic medicine.

Annotation Projection-based Dependency Parser Development for Nepali

Building computational resources and tools for the under-resourced languages is strenuous for any Natural Language Processing task. This article presents the first dependency parser for an under-resourced Indian language, Nepali. A prerequisite for developing a parser for a language is a corpus annotated with the desired linguistic representations known as a treebank. With an aim of cross-lingual learning and typological research, we use a Bengali treebank to build a Bengali-Nepali parallel corpus and apply the method of annotation projection from the Bengali treebank to build a treebank for Nepali. With the developed treebank, MaltParser (with all algorithms for projective dependency structures) and a Neural network-based parser have been used to build Nepali parser models. The Neural network-based parser produced state-of-the-art results with 81.2 Unlabeled Attachment Score, 73.2 Label Accuracy, and 66.1 Labeled Attachment Score on the gold test data. The parser models have also been evaluated with the predicted Part-of-speech (POS)-tagged test data. A statistical POS tagger using Conditional Random Field has been developed for predicting the POS tags of the test data.

2143. Contact Investigation after Exposure to Active Pulmonary Tuberculosis in the Pediatric Cancer Center

Abstract Background The prevalence of tuberculosis (TB) in Korean children has decreased due to universal BCG vaccination and the national TB elimination project. However, exposure to TB in children has been consistently reported. There have been few reports of TB exposure in the pediatric hematology-oncology ward. Methods A mother of a pediatric cancer patient was diagnosed with active TB with a cavity. Contact investigation was performed on patients, their parents, and healthcare workers who were exposed to the index case. The criteria for close contact were exposure in the same space with the index patient for more than 8 hours continuously or a total of 40 hours in case of multiple exposures. The initial assessment was performed as soon as the index case was identified. The second evaluation was conducted 8–10 weeks after the initial exposure. Both tuberculin skin test (TST), TB Specific Interferon-Gamma (T-SPOT) tests, and chest radiography were used in immunocompromised pediatric patients. For immunocompetent adults, the QuantiFERON-TB Gold (QFT-G) test and chest radiography were performed. Results Total 23 patients and 29 parents were exposed. The median exposure duration of patients was 3 days (1–8 days). The initial evaluation did not detect TB infection in pediatric patients. However, at the second evaluation, five patients (17.4%) were diagnosed with latent TB infection (LTBI, three with positive TST and two with positive T-SPOT), and two patients (8.7 %) were diagnosed with active TB infection (lymphadenitis and pulmonary TB). Among the 29 parents, 11 individuals (37.9%) were diagnosed with LTBI at the initial evaluation, which was considered as preexisting LTBI before this exposure. No additional case of TB infection was identified in the second evaluation. Among exposed 24 healthcare workers, two (9.1%) were eventually confirmed as newly diagnosed LTBI. Conclusion TB exposure in pediatric hematology-oncology ward and outpatient chemotherapy clinic caused active TB or LTBI cases with an attack rate of 26% in children. The high LTBI rate, up to 38% among parents even before this exposure, needs further intervention such as routine LTBI evaluation and treatment for families of pediatric cancer patients to prevent a similar event. Disclosures Joon-sik Choi, MD, MS, Ministry of Trade, industry and Energy, Republic of Korea: Grant/Research Support Yae-Jean Kim, MD, PhD, Janssen: Grant/Research Support|Korean Society of Pediatric Infectious Diseases: Grant/Research Support|Ministry of Trade, Industry and Energy: Grant/Research Support|MSD: Grant/Research Support.

Rapid on-site PEDV detection using homogeneous fluorescence resonance energy transfer-based ELISA

The porcine epidemic diarrhea virus (PEDV) is a major pathogen of swine enteric diseases. Various etiology and serological methods have been employed for PEDV detection, but most of their applications are limited to laboratories. To extend PEDV detection to on-site applications, we design a homogeneous fluorescence resonance energy transfer (FRET)-based enzyme-linked immunosorbent assay (ELISA). Both donor and acceptor fluorescence microspheres modified PEDV antibodies can be linked only to the occurrence of PEDV antigen, thus generating FRET signals, which can be collected by our designed portable FRET immunoassay station (FRETIS). Verified by standard samples, FRET immunoassay reached high sensitivity with a detection limit as TCID50 (median tissue culture infective dose) of 10/mL, which is 10 times more sensitive than colloidal gold test strips; and verified by clinical samples, it was also proved with high accuracy, good selectivity, and repeatability. More importantly, FRET immunoassay could detect PEDV in a 96-well plate in 35 min with only one step of incubation without any further washing steps using field-portable devices and field-operable procedures, well supporting on-site applications. Considering these advantages, this reported FRET immunoassay provides a promising way for multi-sample on-site PEDV detection and can be potentially used in the swine industry.

Quantum Dot Nanobeads as Multicolor Labels for Simultaneous Multiplex Immunochromatographic Detection of Four Nitrofuran Metabolites in Aquatic Products

A multicolor immunochromatographic assay platform based on quantum dot nanobeads (QBs) for the rapid and simultaneous detection of nitrofuran metabolites in different aquatic products is documented. These metabolites include 3-amino-2-oxazolidinone (AOZ), 1-aminohydantoin (AHD), semicarbazide (SEM), and 3-amino-5-morpholino-methyl-1,3-oxazolidinone (AMOZ). QBs with emission colors of red, yellow, green, and orange were employed and functionalized with the corresponding antibodies to each analyte to develop a multicolor channel. The visual detection limits (cutoff values) of our method for AOZ, AHD, SEM, and AMOZ reached up to 50 ng/mL, which were 2, 20, 20, and 20 times lower than those of traditional colloidal gold test strips, respectively. The test strip is capable of detection within 10 min in real samples while still achieving good stability and specificity. These results demonstrate that the developed multicolor immunochromatographic assay platform is a promising technique for multiplex, highly sensitive, and on-site detection of nitrofuran metabolites.

Latent tuberculosis in adult hematopoietic stem cell transplantation recipients: Clinical experience from a previously endemic population.

Hematopoietic stem cell transplantation (HSCT) recipients may be at an elevated risk of developing active tuberculosis infection due to suppression in the cellular immune system. Herein, we aimed to evaluate the prevalence of latent tuberculosis and active tuberculosis in patients with allogeneic and autologous HSCT. In this cohort, data were obtained retrospectively from patients' records. The patients who were followed up in the bone marrow transplantation unit of the University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital between January 2016 and December 2019 were screened for the study. And the HSCT recipients who had tuberculin skin test and/or QuantiFERON-TB gold (QFT-GIT) test results were included in the study. A total of 361 patients were included in the study, 227 patients had autologous HSCT, and 134 patients had allogeneic HSCT. QFT-GIT was performed in 10 patients with allogeneic HSCT, and it was found positive in only 1 patient. Tuberculin skin test ≥5 mm was accepted as positive and was accepted to have latent tuberculosis, and it was positive in 18.2% (41) of the patients with autologous HSCT and was positive in 21.6% (29) of the patients with allogeneic HSCT. There was no significant difference between the 2 groups (P = .429). Isoniazid (INH) prophylaxis was started in 16.7% of patients with autologous HSCT and 22.4% of patients with allogeneic HSCT. During follow-up, active tuberculosis did not develop in any patients in both groups. There was no statistically significant difference found between allogeneic and autologous HSCT recipients regarding the prevalence of latent tuberculosis. Active tuberculosis infection did not develop in any of the patients who started INH prophylaxis. INH prophylaxis seems to be very efficient in preventing the reactivation of latent tuberculosis in patients going through allogeneic HSCT and/or autologous HSCT.

TUBERCULOUS TAMPONADE WITH A TWIST: A CASE OF TB AND COVID-19

TUBERCULOUS TAMPONADE WITH A TWIST: A CASE OF TB AND COVID-19

HEMORRHAGIC PLEURAL EFFUSION IN A PATIENT WITH CHRONIC LYMPHOCYTIC LEUKEMIA ON IBRUTINIB THERAPY

HEMORRHAGIC PLEURAL EFFUSION IN A PATIENT WITH CHRONIC LYMPHOCYTIC LEUKEMIA ON IBRUTINIB THERAPY

S932 Active Tuberculosis and Opportunistic Infections: Pooled Safety Analysis of Ustekinumab Through up to 5 Years Across All Approved Indications

Introduction: Ustekinumab (UST) is an approved treatment for adults with inflammatory bowel disease (IBD: Crohn’s disease [CD] and ulcerative colitis [UC]), psoriasis (PsO), and psoriatic arthritis (PsA). Here, we present pooled safety analyses in these approved indications of patients (pts) with active tuberculosis (TB) and opportunistic infections (OIs) through 5 years (yrs) of UST treatment. Methods: Pooled data included 13 Phase 2/3 UST studies through 5 yrs of CD and PsO, 2 yrs of UC, and 1 yr of PsA. OIs were identified by clinician review. Herpes zoster (HZ) was evaluated separately. Event rates per 100 pt yrs (PYs) are presented. Concomitant immunomodulators/corticosteroids were permitted in IBD and PsA pts. All pts who received ≥1 UST dose were included. In IBD, placebo (PBO) pts included data up to the first UST dose for pts initially treated with PBO, or >16 weeks after the last UST dose for UST pts who switched to PBO. Results: Across all approved indications, 19 OIs including TB were reported, with rates in PBO of 0.40 and UST of 0.10 through 5 yrs in 13807 PYs of follow-up (Table); rates of HZ were 1.21 and 0.63, respectively. Of 19 OIs, 18 were in IBD pts and 1 in a PsO pt. Overall, 14/16 pts (12/13 UST) with OIs excluding TB were also receiving confounding concomitant medications. A total of 3 active TB cases (2 pts with CD and 1 pt with UC) were reported in PBO (n=2; 1 in a CD pt 10 months after receiving UST 130 mg IV) and UST pts (n=1) (Table). One active TB case was reported in an asymptomatic South African CD pt treated with UST who had a positive QuantiFERON®-TB Gold test on routine screening and bronchial brushings positive for M. tuberculosis. Both CD pts completed TB treatment with disease resolution. The most common OIs were esophageal candidiasis (UST n=3; PBO n=2) and cytomegalovirus colitis (UST n=3; PBO n=1). Conclusion: Rates of OIs, including active TB, in UST-treated pts were low across approved indications through up to 5 years with 13807 PYs of follow-up and not higher in UST pts vs PBO, suggesting no increased risk of OI with long-term UST treatment. Table 1. - Opportunistic infections (OIs) and active tuberculosis (TB) in Inflammatory Bowel Disease (CD, UC) and Psoriatic studies (PsO, PsA) through up to 5 yrs; numbers of events per 100 patient-years (PYs) of follow-up Inflammatory Bowel Disease Indications a Psoriatic Indications a All Approved Indications Pooled Placebo b (n=1389) Ustekinumab c (n=2575) Placebo d (n=1112) Ustekinumab e (n=4135) Placebo b,d (n=2501) Ustekinumab c.e (n=6710) Total PYs of follow-up 916 3960 327 9847 1244 13807 Average duration of follow-up (weeks) 34.31 79.97 15.30 123.83 25.86 107.00 All OIs, event rates per 100 PYs [n] 0.55 [5] 0.33 [13] 0.00 [0] 0.01[1] 0.40 [5] 0.10 [14] OIs excluding TB 0.33 [3] 0.30 [12] 0.00 [0] 0.01 [1] 0.24 [3] 0.09 [13] TB 0.22 [2] 0.03 [1] 0.00 [0] 0.00 [0] 0.16 [2] 0.01 [1] aPsoriatic (PsO and PsA) trials evaluated subcutaneous ustekinumab (UST) 45/90 mg or placebo (PBO), generally at week 0 and 4, then every 12 weeks (q12w). IBD (CD and UC) trials generally evaluated a single intravenous UST dose (130 mg or weight range-based dosing of ∼6 mg/kg) or PBO induction dose at week 0, followed by subcutaneous UST 90 mg at week 8, then q8w or q12w.bCD and UC: includes data up to the first UST dose for patients who were initially treated with PBO; includes data at or after 16 weeks from the first UST dose onward, up to the dose adjustment if patients had a dose adjustment, for patients who crossed-over or re-randomized to PBO maintenancecCD and UC: includes data up to 16 weeks from the first UST dose for patients who crossed-over or re-randomized to PBO maintenance, and from the dose adjustment onward if patients had a dose adjustment from subcutaneous PBO to subcutaneous UST 90 mg q8wdPsoriatic diseases: includes data up to the time of early escape or crossoverePsoriatic diseases: includes data from the first UST dose onward for patients who early escaped or crossed-over from PBO

The clinical utility of tuberculin skin tests: a single-center experience.

Tuberculin skin test (TST) has played an essential in the diagnosis of latent tuberculosis infection (LTBI) for nearly a century. This study aimed to investigate the general characteristics of patients tested with TST in a tertiary hospital within two years. All patients who were evaluated to screen for tuberculosis and received a TST were included. The Mantoux method was used for TST administration. A total of 661 patients, 345 (52.2%) men and 316 (47.8%) women, with a mean age of 43.0 ±15.9 years, were included in the study. Accordingly, TST was performed prior to anti-TNF biological agent therapy for 50% (331) of the participants, for LTBI screening before solid organ and/or hematological stem cell transplantation for 20.4% (135), for screening following contact with tuberculosis for 25.1% (166), for screening of healthcare professionals for 1.1% (7), and medical report for 3.3% (22). 2.7% of the patients who took TST were diagnosed with active tuberculosis (14 with pulmonary tuberculosis and 4 with extrapulmonary tuberculosis). QuantiFERON-TB Gold (QFT) test was performed in 332 (50.2%) patients with anergic TST results. According to TST and QFT test results, 28.3% (187) of the patients were started on tuberculosis prophylaxis. While TST is most performed for LTBI screening prior to biological agent therapy, almost one-fourth of patients taking TST require tuberculosis prophylaxis. On the other hand, about half of the patients require an additional QFT test.

Differential activation of innate and adaptive lymphocytes during latent or active infection with Mycobacterium tuberculosis.

Most individuals infected with Mycobacterium tuberculosis (Mtb) have latent tuberculosis (TB), which can be diagnosed with tests (such as the QuantiFERON-TB Gold test [QFT]) that detect the production of IFN-γ by memory T cells in response to the Mtb-specific antigens 6 kDa early secretory antigenic target EsxA (Rv3875) (ESAT-6), 10 kDa culture filtrate antigen EsxB (Rv3874) (CFP-10), and Mtb antigen of 7.7 kDa (Rv2654c) (TB7.7). However, the immunological mechanisms that determine if an individual will develop latent or active TB remain incompletely understood. Here we compared the response of innate and adaptive peripheral blood lymphocytes from healthy individuals without Mtb infection (QFT negative) and from individuals with latent (QFT positive) or active TB infection, to determine the characteristics of these cells that correlate with each condition. In active TB patients, the levels of IFN-γ that were produced in response to Mtb-specific antigens had high positive correlations with IL-1β, TNF-α, MCP-1, IL-6, IL-12p70, and IL-23, while the proinflammatory cytokines had high positive correlations between themselves and with IL-12p70 and IL-23. These correlations were not observed in QFT-negative or QFT-positive healthy volunteers. Activation with Mtb-soluble extract (a mixture of Mtb antigens and pathogen-associated molecular patterns [PAMPs]) increased the percentage of IFN-γ-/IL-17-producing NK cells and of IL-17-producing innate lymphoid cell 3 (ILC3) in the peripheral blood of active TB patients, but not of QFT-negative or QFT-positive healthy volunteers. Thus, active TB patients have both adaptive and innate lymphocyte subsets that produce characteristic cytokine profiles in response to Mtb-specific antigens or PAMPs. These profiles are not observed in uninfected individuals or in individuals with latent TB, suggesting that they are a response to active TB infection.

Deep Learning-Aided Automated Pneumonia Detection and Classification Using CXR Scans.

The COVID-19 pandemic has caused a worldwide catastrophe and widespread devastation that reeled almost all countries. The pandemic has mounted pressure on the existing healthcare system and caused panic and desperation. The gold testing standard for COVID-19 detection, reverse transcription-polymerase chain reaction (RT-PCR), has shown its limitations with 70% accuracy, contributing to the incorrect diagnosis that exaggerated the complexities and increased the fatalities. The new variations further pose unseen challenges in terms of their diagnosis and subsequent treatment. The COVID-19 virus heavily impacts the lungs and fills the air sacs with fluid causing pneumonia. Thus, chest X-ray inspection is a viable option if the inspection detects COVID-19-induced pneumonia, hence confirming the exposure of COVID-19. Artificial intelligence and machine learning techniques are capable of examining chest X-rays in order to detect patterns that can confirm the presence of COVID-19-induced pneumonia. This research used CNN and deep learning techniques to detect COVID-19-induced pneumonia from chest X-rays. Transfer learning with fine-tuning ensures that the proposed work successfully classifies COVID-19-induced pneumonia, regular pneumonia, and normal conditions. Xception, Visual Geometry Group 16, and Visual Geometry Group 19 are used to realize transfer learning. The experimental results were promising in terms of precision, recall, F1 score, specificity, false omission rate, false negative rate, false positive rate, and false discovery rate with a COVID-19-induced pneumonia detection accuracy of 98%. Experimental results also revealed that the proposed work has not only correctly identified COVID-19 exposure but also made a distinction between COVID-19-induced pneumonia and regular pneumonia, as the latter is a very common disease, while COVID-19 is more lethal. These results mitigated the concern and overlap in the diagnosis of COVID-19-induced pneumonia and regular pneumonia. With further integrations, it can be employed as a potential standard model in differentiating the various lung-related infections, including COVID-19.