Greater Detection Rate Research Articles

Establishment of a Sensitive and Reliable Droplet Digital PCR Assay for the Detection of Bursaphelenchus xylophilus.

Pine wilt disease (PWD), which poses a significant risk to pine plantations across the globe, is caused by the pathogenic agent Bursaphelenchus xylophilus, also referred to as the pine wood nematode (PWN). A droplet digital PCR (ddPCR) assay was developed for the quick identification of the PWN in order to improve detection sensitivity. The research findings indicate that the ddPCR assay demonstrated significantly higher analysis sensitivity and detection sensitivity in comparison to traditional quantitative PCR (qPCR). However, it had a more limited dynamic range. High specificity was shown by both the ddPCR and qPCR techniques in the diagnosis of the PWN. Assessments of reproducibility revealed that ddPCR had lower coefficients of variation at every template concentration. Inhibition tests showed that ddPCR was less susceptible to inhibitors. There was a strong linear association between standard template measurements obtained using ddPCR and qPCR (Pearson correlation = 0.9317; p < 0.001). Likewise, there was strong agreement (Pearson correlation = 0.9348; p < 0.001) between ddPCR and qPCR measurements in the evaluation of pine wood samples. Additionally, wood samples from symptomatic (100% versus 86.67%) and asymptomatic (31.43% versus 2.9%) pine trees were diagnosed with greater detection rates using ddPCR. This study's conclusions highlight the advantages of the ddPCR assay over qPCR for the quantitative detection of the PWN. This method has a lot of potential for ecological research on PWD and use in quarantines.

Spatial patterns of anticoagulant rodenticides in three species of medium-sized carnivorans in Pennsylvania

Human influences on natural environments are now ubiquitous but manifest in multiple and unique ways depending on local environments and communities. Attempts to control, or mediate, local pests to residences or to agriculture can impart important negative consequences on systems. Secondary exposure to anticoagulant rodenticides (ARs) can cause numerous adverse effects on wild carnivores including death. Few studies have quantified AR prevalence, investigated their pathway of exposure, or associations with specific location types in the northeastern U.S. We hypothesized that ARs would be found in the mesocarnivore community throughout Pennsylvania and have the greatest detection rate in highly urbanized or agricultural landscapes. From 2019 through early 2022, we collected carcasses to obtain liver samples ( n = 265) from three species of carnivores: bobcats ( Lynx rufus (Schreber, 1777)), fishers ( Pekania pennanti (Erxleben, 1777)), and river otters ( Lontra canadensis (Schreber, 1777)). We used generalized linear models to test for differences in AR detection rates among species and spatial scales including the six Pennsylvania Game Commission regions and 23 wildlife management units. We detected ARs in all species (44.2% collectively), but detection rates differed among species. Our study is the first to document ARs within North American river otters.

A Big Data Analytical Framework for Intrusion Detection Based On Novel Elephant Herding Optimized Finite Dirichlet Mixture Models

For the purpose of identifying a wide variety of hostile activity in cyberspace, an Intrusion Detection System (IDS) is a crucial instrument. However, traditional IDSs have limitations in detecting zero-day attacks, which can lead to high false alarm rates. To address this issue, it is crucial to integrate the monitoring and analysis of network data with decision-making methods that can identify anomalous events accurately. By combining these approaches, organizations can develop more effective cybersecurity measures and better protect their networks from cyber threats. In this study, we proposed a novel called the Elephant Herding Optimized Finite Dirichlet Mixture Model (EHO-FDMM). This framework consists of three modules: capture and logging, pre-processing, and an innovative IDS method based on the EHO-FDMM. The NSL-KDD and UNSW-NB15 datasets are used to assess this framework's performance. The empirical findings show that selecting the optimum model that accurately fits the network data is aided by statistical analysis of the data. The EHO-FDMM-based intrusion detection method also offers a lower False Alarm Rate (FPR) and greater Detection Rate (DR) than the other three strong methods. The EHO-FDMM and exact interval of confidence bounds were used to create the suggested method's ability to detect even minute variations between legal and attack routes. These methods are based on correlations and proximity measurements, which are ineffective against contemporary assaults that imitate everyday actions.

Smart Intrusion Detection System for CAN Network Implemented using LSTM Strategy

In today's cars, communication between electronic control units is managed via the Controller Area Network (CAN) bus system. Nevertheless, the CAN bus system lacks means for authentication and authorisation, making it susceptible to attacks like denial-of-service, fuzzing, and spoofing. To identify and counteract CAN bus network intrusions, this study suggests an intrusion detection system based on a Long Short-Term Memory (LSTM) model. Extraction of attack-free data and attack injection produced the dataset used for testing and training. Findings show that the suggested LSTM model has a greater detection rate than the Survival Analysis approach and is efficient in defending current automobiles from assaults on the CAN bus network. The ability to identify these sorts of assaults is limited by the constraints of conventional intrusion detection systems (IDS) for CAN bus networks, such as statistical analysis, frequency-based analysis, and Hidden Markov Model (HMM). Using a Long Short-Term Memory (LSTM) based strategy, the objective of this article is to build a reliable IDS that can efficiently identify and counteract these assaults on the CAN bus network.

Improved Ant Colony Optimization and Machine Learning Based Ensemble Intrusion Detection Model

Internet of things (IOT) possess cultural, commercial and social effect in life in the future. The nodes which are participating in IOT network are basically attracted by the cyber-attack targets. Attack and identification of anomalies in IoT infrastructure is a growing problem in the IoT domain. Machine Learning Based Ensemble Intrusion Detection (MLEID) method is applied in order to resolve the drawback by minimizing malicious actions in related botnet attacks on Message Queue Telemetry Transport (MQTT) and Hyper-Text Transfer Protocol (HTTP) protocols. The proposed work has two significant contributions which are a selection of features and detection of attacks. New features are chosen from Improved Ant Colony Optimization (IACO) in the feature selection, and then the detection of attacks is carried out based on a combination of their possible properties. The IACO approach is focused on defining the attacker’s important features against HTTP and MQTT. In the IACO algorithm, the constant factor is calculated against HTTP and MQTT based on the mean function for each element. Attack detection, the performance of several machine learning models are Distance Decision Tree (DDT), Adaptive Neuro-Fuzzy Inference System (ANFIS) and Mahalanobis Distance Support Vector Machine (MDSVM) were compared with predicting accurate attacks on the IoT network. The outcomes of these classifiers are combined into the ensemble model. The proposed MLEID strategy has effectively established malicious incidents. The UNSW-NB15 dataset is used to test the MLEID technique using data from simulated IoT sensors. Besides, the proposed MLEID technique has a greater detection rate and an inferior rate of false-positive compared to other conventional techniques.

Self-Collection of Nose and Throat Swab Samples for SARS-CoV-2 Antigen Testing

&#x0D; The emergence of new variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised questions about the accuracy of currently available rapid antigen detection tests (RADTs) for the detection of these variants using the currently authorized sampling methods.&#x0D; Six Canadian provinces and 2 international jurisdictions have formally recommended people swab both their throat and nose when performing a RADT in response to the emergence of the Omicron variant. The evidence used to support these decisions was not clearly reported.&#x0D; Three pre-print non-peer reviewed publications (1 from Canada, 2 from the Netherlands) were identified regarding the diagnostic accuracy and clinical utility of RADTs using dual nasal and throat self-collected sample for suspected COVID-19. No relevant studies were identified that included children younger than 16 years old.&#x0D; Findings from these publications indicate that using self-collected combined nasal plus throat samples, instead of self-collected nasal samples for RADTs, resulted in greater detection rates without impacting true negative rates. Furthermore, combined nasal plus throat sampling is associated with high participant acceptability and tolerability, ease of use, and low incidence of harms (when reported). However, the limitations of these publications (e.g., non-peer reviewed pre-prints; dual nasal and throat sampling with swabs approved for nasal sampling only) should be taken into consideration when interpreting these findings.&#x0D; As new variants emerge and real-world clinical evaluations are published, regulatory bodies and/or RADT manufacturers could consider reassessing sampling methods, suitable swab types, and testing instructions.&#x0D;

RT-qPCR and ATOPlex sequencing for the sensitive detection of SARS-CoV-2 RNA for wastewater surveillance

During the coronavirus disease 2019 (COVID-19) pandemic, wastewater surveillance has become an important tool for monitoring the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within communities. In particular, reverse transcription-quantitative PCR (RT-qPCR) has been used to detect and quantify SARS-CoV-2 RNA in wastewater, while monitoring viral genome mutations requires separate approaches such as deep sequencing. A high throughput sequencing platform (ATOPlex) that uses a multiplex tiled PCR-based enrichment technique has shown promise in detecting variants of concern (VOC) while also providing virus quantitation data. However, detection sensitivities of both RT-qPCR and sequencing can be impacted through losses occurring during sample handling, virus concentration, nucleic acid extraction, and RT-qPCR. Therefore, process limit of detection (PLOD) assessments are required to estimate the gene copies of target molecule to attain specific probability of detection. In this study, we compare the PLOD of four RT-qPCR assays (US CDC N1 and N2, China CDC N and ORF1ab) for detection of SARS-CoV-2 to that of ATOPlex sequencing by seeding known concentrations of gamma-irradiated SARS-CoV-2 into wastewater. Results suggest that among the RT-qPCR assays, US CDC N1 was the most sensitive, especially at lower SARS-CoV-2 seed levels. However, when results from all RT-qPCR assays were combined, it resulted in greater detection rates than individual assays, suggesting that application of multiple assays is better suited for the trace detection of SARS-CoV-2 from wastewater samples. Furthermore, while ATOPlex offers a promising approach to SARS-CoV-2 wastewater surveillance, this approach appears to be less sensitive compared to RT-qPCR under the experimental conditions of this study, and may require further refinements. Nonetheless, the combination of RT-qPCR and ATOPlex may be a powerful tool to simultaneously detect/quantify SARS-CoV-2 RNA and monitor emerging VOC in wastewater samples.

Impact of Selection of Growth Chart in the Diagnosis of Suboptimal Fetal Growth and Neonatal Birthweight and Correlation with Adverse Neonatal Outcomes in a Third Trimester South Indian Antenatal Cohort; A Prospective Cross-Sectional Study

AbstractObjectives: To compare fetal and neonatal growth charts pertaining to different models (population-specific, universal reference, universal standard and fully customised) in detecting suboptimal fetal growth in the third trimester. Methods: This was a prospective observational study conducted at two fetal medicine centers. After applying the inclusion criteria [singleton pregnancies between 28 and 40 weeks, verified dates and estimated fetal weight (EFW) ≤ 25th centile as per the Hadlock chart], 292 women were consecutively recruited. Four fetal growth charts (Hadlock, Intergrowth, fully customised GROW, Sonocare) and three neonatal charts (Fenton, Intergrowth and fully customised GROW) were used in the study. The EFW and birthweight centiles were categorized into three groups: &lt; 3.0, 3.1–10th and &gt; 10th centiles. The charts were evaluated by their ability to detect pregnancies with uteroplacental insufficiency and/or development of adverse neonatal outcomes in the third trimester. Results: Significant difference was noted between the fetuses/neonates assigned as &lt; 3rd centile (Hadlock-9.3%, Sonocare-4.8%, Intergrowth- 6.8% and the fully customised GROW- 6.5%) and the neonatal charts (Fenton-18.5%, Intergrowth- 20.2% and fully customised GROW- 13.4%). At a cut-off of 3rd centile, the GROW chart had the highest sensitivity (84.2%) followed by Intergrowth (78.9%), Hadlock (70.37%) and Sonocare (64.29%). Similarly, for a cut-off of &lt; 10th, the sensitivity was GROW 70.27%, Sonocare 64%, Intergrowth 60.8% and Hadlock 50%. Amongst the neonatal charts, fully customised GROW chart had the greatest detection rate (&lt; 3rd = 74.36%, &lt; 10th = 70.27%). However, there was no significant difference between the charts in the detection of pregnancies with suboptimal fetal growth associated with uteroplacental insufficiency and/or adverse neonatal outcomes. Conclusion: Despite substantial discrepancy between the growth charts in diagnosing fetal smallness, adding multivessel Doppler negates significant differences between them in diagnosing suboptimal fetal growth associated with uteroplacental insufficiency and adverse neonatal outcomes.

Comparison between terrestrial mammals in evergreen forests and in seasonal dry forests in Western Ecuador: should efforts be focused on dry forests?

Abstract The Coast Region of Ecuador has been dramatically deforested, and most of the remaining natural vegetation is formed of fragmented patches, in which there is little knowledge of wild mammal populations. The objective of this study was to assess the presence and detection rate (DR) of medium and large-size mammals by using camera-traps in fragmented forests located outside the protected areas comparing the two main types of forest: seasonal dry and evergreen. We registered 18 different species, of which four had greater DRs in dry forests (Lycalopex sechurae, Odocoileus peruvianus, Simosciurus stramineus and Sylvilagus daulensis), four were more detected in evergreen forests (Cuniculus paca, Dasyprocta punctata, Dasypus novemcinctus and Procyon cancrivorus), and the remaining 10 species had no significant habitat preference. The mean species richness was similar in both ecosystems, but the number of detections was greater in the evergreen forests. Finally, two of the region’s four threatened species had higher DRs in dry forests. These results suggest that it is necessary to conserve both types of ecosystems to ensure the conservation of all mammals’ species. However, since dry forests are less protected and their threatened fauna suggests that conservation efforts should be particularly focused on them.

Better together: analysis of integrated acoustic and visual methods when surveying a cetacean community

Understanding the relative performance of data collection methods is critical for the production of robust results in any biological field study. This is particularly relevant for monitoring studies of rare and inconspicuous species, such as some cetaceans. Here, we compared how passive acoustic and visual survey methods performed when surveying a multispecies cetacean community in a large-scale survey area and whether the simultaneous application of these methods leads to complementary results. For both methods we compared (1) frequency of unscheduled survey stoppages, (2) detection ranges, (3) success in identifying species, (4) precedence of either method in synchronous detections, (5) detection rates, and (6) influence of sea state on detection rates. Data were collected during 4 surveys conducted between 2015 and 2017, using simultaneous visual and acoustic methods in the Santos Basin, Brazil. A total of 1492 h of simultaneous sampling yielded 617 detections, of which 46.5% (n = 287) were exclusively acoustic, 18.5% (n = 114) were exclusively visual, and 35% (n = 216) were corresponding detections of the same group made by each method, resulting in 108 paired detections. The simultaneous application of visual and acoustic methods was complementary. Acoustics were more efficient in detecting cetaceans—detecting first and further from the vessel and with a greater detection rate—whereas visual observation was more accurate for species identification. When used together, detection rates per species increased, reducing potential biases. By improving acoustic classification through visually confirmed sightings, this integrated approach has the potential to provide a reliable sound library for cetaceans in the Southwest Atlantic Ocean.

Up-to-date breast cancer imaging

Introduction. Breast cancer is a major health and economic problem in Serbia. On the one hand, most patients see a the doctor at an advanced stage of the disease, and on the other hand, screening response rate is low. Early detection increases the chances of survival. Digital mammography is the gold standard in breast cancer imaging, together with supplemental ultrasound and tomosynthesis. Mammography combined with tomosynthesis has a greater detection rate regardless of breast density, although the difference is more pronounced in high-density lesions, and it has fewer falsenegative results than mammography alone. Ultrasound, apart from being a complementary method, is ideal for ultrasound guided breast biopsy. Magnetic resonance mammography is an imaging method with the highest sensitivity in the detection of invasive breast cancer and has an important role in the evaluation of the post-therapeutic response and in preoperative preparation. Magnetic resonance spectroscopy measures the choline levels and helps to differentiate malignant from benign lesions. It is also a promising method for early assessment of the post-therapeutic response. Positron emission tomography is likely to gain more significant roles in breast cancer imaging in the near future, especially in measuring the treatment response.

Performance of viral and bacterial genetic markers for sewage pollution tracking in tropical Thailand

Identifying sewage contamination via microbial source tracking (MST) marker genes has proven useful for effective water quality management worldwide; however, performance evaluations for these marker genes in tropical areas are limited. Therefore, this research evaluated four human-associated MST marker genes (human polyomaviruses (JC and BK viruses [HPyVs]), bacteriophage crAssphage (CPQ_056), Lachnospiraceae Lachno3, and Bacteroides BacV6-21) for tracking sewage pollution in aquatic environments of Thailand. The viral marker genes, HPyV and crAssphage were highly sensitive and specific to sewage from onsite wastewater treatment plants (OWTPs; n = 19), with no cross-detection in 120 composite swine, cattle, chicken, duck, goat, sheep, and buffalo fecal samples. The bacterial marker genes, Lachno3 and BacV6-21, demonstrated high sensitivity but moderate specificity; however, using both markers could improve specificity to >0.80 (max value of 1.00). The most abundant markers in OWTP samples were Lachno3 and BacV6-21 (5.42–8.02 and nondetect–8.05 log10 copies/100 mL), crAssphage (5.28–7.38 log10 copies/100 mL), and HPyVs (3.66–6.53 log10 copies/100 mL), respectively. Due to their increased specificity, the abundance of viral markers were further investigated in environmental waters, in which HPyVs showed greater levels (up to 4.33 log10 copies/100 mL) and greater detection rates (92.7%) in two coastal beaches (n = 41) than crAssphage (up to 3.51 log10 copies/100 mL and 56.1%). HPyVs were also found at slightly lower levels (up to 5.10 log10 copies/100 mL), but at higher detection rates (92.6%), in a freshwater canal (n = 27) than crAssphage (up to 5.21 log10 copies/100 mL and 88.9%). HPyVs and crAssphage marker genes were identified as highly sensitive and specific for tracking sewage pollution in aquatic environments of Thailand. This study underlines the importance of characterizing and validating MST markers in host groups and environmental waters before including them in a water quality management toolbox.

Abstract WMP65: Prospective Validation of Predictive Features of Paroxysmal Atrial Fibrillation (PROPhecy): An Interim Analysis

Background: Atrial fibrillation (AF) has a distinct antithrombotic regimen for secondary stroke prevention. While 30-day cardiac monitoring has a greater detection rate for AF than 24-hour Holter, it is not widely accessible. Risk stratification may identify patients who could benefit most from prolonged monitoring. PROPhecy aims to prospectively validate predictive features for detection of AF found in EMBRACE, a trial using 30-day monitoring in individuals with an embolic stroke of undetermined source (ESUS). Methods: Participants were &gt; 55 years and within six months of ESUS, without evidence of AF/flutter on 24-hour Holter. All were given an event-triggered external loop recorder for 30 days. Primary outcome was detection of sustained ( &gt; 30 sec) or non-sustained AF/flutter on 30-day monitoring. Results: 150 of a planned 250 participants have completed long-term monitoring to date. Baseline characteristics are compared to EMBRACE (Table 1). Any AF/flutter was detected in 19.3% (EMBRACE, 16.1%). Burden of atrial premature beats in PROPhecy was low in comparison to EMBRACE and did not predict presence of AF on monitoring (Table 2). Left atrial volume index was a significant predictor of AF in both univariable and multivariable regression adjusted for age and sex (OR1.04 per mL/m 2 , 95% 1.01-1.08, p=0.02). Conclusion: Recruitment is ongoing. AF was detected in ~1/5 participants. The burden of atrial ectopy in our cohort is much lower than in EMBRACE despite similar patient characteristics and AF burden. Further work is required to assess the nature of these differences. Left atrial volume index may be helpful for risk stratification.

Results of low-dose computed tomography as a regular health examination among Chinese hospital employees

ObjectiveLung cancer is traditionally more prevalent in the elderly patients, men, and smokers. However, as low-dose computed tomography (LDCT) is increasingly popular, we hypothesized the disease spectrum might change. MethodsLDCT was performed as a part of regular health examinations in 8392 of 15,686 employees from 6 hospitals in different regions of China in 2012 to 2018. Clinicopathologic characteristics, including age, sex, smoking status, radiologic features, tumor histology, and pathologic stage, were retrospectively analyzed. ResultsLDCT incidentally detected lung cancer (pathologically confirmed) in a total of 179 (2.1%) hospital employees. The lung cancer detection rate was significantly greater in female than male (2.5% vs 1.3%, P = .001) patients. There was also a greater detection rate among nonsmokers than smokers, although statistical significance was not reached (2.2% vs 1.4%, P = .092). The lung cancer detection rate was 1.0% in the “age ≤40 years” group, 2.6% in the “40 < age ≤55 years” group, and 2.9% in the “age >55 years” group (P < .001). Among the hospital employees with lung cancer, 171 (95.5%) presented as ground-glass opacity, 177 (98.9%) were lung adenocarcinoma, 170 (95.0%) were early stage 0/IA, and 177 (98.9%) received curative surgical resection as the initial treatment. After a median follow-up of 38 months, no disease recurrence or death was observed among these patients. ConclusionsLDCT detected lung cancer in a significant proportion of young, female, and nonsmoking employees. The vast majority of these lung cancers were early stage, with extremely good prognosis.

Better resource utilization and quality of care for cervical cancer screening in low-resourced districts using an internet-based expert system.

Screening tools are critical in the early prevention of cervical cancers. Acetic-acid based colposcopy test provides an affordable solution but is often challenged by the lack of experienced doctors in under-developed districts. To evaluate the feasibility of an internet-based expert system to better utilize the expert knowledge. A centralized internet-based expert system was developed to upload acetowhite images acquired by an integrated colposcopy device at remote healthcare centers. The detection rates of high grade cervical intraepithelial neoplasia (CIN) during two consecutive years (installed in the second year) were collected at two study sites and twelve control sites. No difference in the detection rate was observed between study and control sites at baseline (year 1); however, greater detection rates were found at study sites after introducing the internet-based expert system (year 2). Comparing the detection rates at each site between year 1 and year 2, the study site exhibited improved detection rates. User feedbacks suggested "great learning experience from expert feedback" as the most recognized benefits. This study shows the feasibility of an internet-based expert system in screening cervical cancers and lays the foundation to future population-level application in under-developed districts.

Does habitat occupancy by lake trout and lake whitefish in large lakes match published thermal habitat envelopes?

AbstractHabitat occupancy patterns of lake trout (Salvelinus namaycush) and lake whitefish (Coregonus clupeaformis) in two large Canadian Shield lakes were modelled based on detections of fish from repeated depth‐stratified surveys over several summers. Lake trout and lake whitefish consistently occupied sites outside traditional thermal envelopes and were not detected at some sites within these ranges. This included the metalimnion and shallow epilimnion for lake trout and lake whitefish in Lake Opeongo. Physical habitat covariates were not important in defining lake trout habitat in both lakes. Physical habitat as represented by the hardness/softness gradient based on acoustic substrate surveys was important for lake whitefish in Lake Opeongo but not in Smoke Lake. In addition, thermal envelopes for lake whitefish differed between the lakes possibly because of differences in substrate slope. The wash zone of lakes, where the thermocline contacts the substrate, appears to be a physical habitat feature for lake whitefish in some lakes. Lake whitefish also exhibited diurnal activity behaviour that was reflected through greater detection rates in the morning versus the afternoon. By accounting for imperfect detection, true estimated overall occupancy of lake trout and lake whitefish increased 0.15–0.30 over naïve occupancy. Thermal habitat envelopes for lake trout and lake whitefish are wider than previously thought. Lake trout occupied a consistent thermal habitat envelope while lake whitefish varied between lakes likely because of lake specific differences in basin morphology and wash zone.

The validity of repeat prostate biopsy in prior biopsy negative patients: MRI-TRUS fusion guided biopsy.

95 Background: To investigate validity of magnetic resonance imaging (MRI)-transrectal ultrasound fusion target biopsy (Fusion-Bx) compared with transrectal ultrasound-guided biopsy (TRUS-Bx) by evaluating detection rate of prostate cancer (PCa). Methods: Medical records of 376 patients with prior negative TRUS-Bx who underwent repeat prostate biopsy between Aug. 2015 and Apr. 2017 were retrospectively reviewed. The cohort was stratified into two groups (TRUS-Bx and Fusion-Bx) and clinical and biopsy characteristics patterns were analyzed. Conventional systemic randomized 12-core biopsy was performed in TRUS-Bx group whereas Fusion-Bx group applied additional 2-croes of target biopsy against suspicious lesions in MRI. Results: There were total 195 and 181 patients in TRUS-Bx and Fusion-Bx group, respectively. The overall cancer detection rate was slightly higher in Fusion-Bx group, but no statistical significance was observed (24.6% vs 28.7%, p = 0.367). Fusion-Bx group showed a significantly greater detection rate in target core analysis (5.0% vs 17.7%, p = 0.044). In confirmed positive biopsy patients, Fusion-Bx group had a higher rate of clinically significant prostate cancer (CsPCa) cases, but failed to achieve statistical significance (85.4% vs 92.3%, p = 0.271). When the patients with highly or very highly suspicious MRI (maximum image grade 4-5) findings in Fusion-Bx group was compared to the whole cohort of TRUS-Bx group, Fusion-Bx group was significantly greater in terms of overall detection rate (24.6% vs 38.0%, p = 0.017) and CsPCa detection rate (85.4% vs 97.0%, p = 0.009). Higher the target image grade, greater biopsy yield was achieved. Conclusions: For the patients who underwent repeat biopsy due to prior negative results, fusion-Bx showed better clinical significance including detection rate. A further study with a larger cohort size and prospective design is still needed to confirm the validity of Fusion-Bx.

Mammography screening: A major issue in medicine

Mammography screening: A major issue in medicine

Improving the detection of evoked responses to periodic stimulation by using bivariate local spectral F-test – Application to EEG during photic stimulation

The spectral local F-test has been applied for detecting evoked responses to rhythmic stimulation that are embedded in the ongoing electroencephalogram (EEG). Based on the sampling distribution of a flat spectrum at the neighbourhood of the stimulation frequency, spectral peaks in an EEG signal that are due to the stimulation may be readily assessed. Nevertheless, the performance of the technique is strongly affected by both the signal-to-noise ratio (SNR) of the responses and the number of data segments used in the estimation. The present work aims at both deriving and evaluating a multivariate extension of local F-test by including the EEG collected at a second distinct derivation. The detection rate with this multivariate detector was found to be greater than that using a single channel in case of equal SNR in both signals. Monte Carlo simulation results showed that the probability of detection with this new detector saturates for signal-to-noise ratios above 12 dB and indicated a greater detection rate in practical situations, even when smaller SNR-values are found in the added signal (e.g. 5 dB for 16 neighbouring frequencies used in the estimation). The technique was next applied to the EEG from 12 subjects during intermittent, photic stimulation leading to superior performance in comparison with the univariate local F-test. Since a higher detection rate with the proposed technique is achieved without the need of increasing the number of data segments, it allows evoked responses to be detected faster, once the same detection rate may be accomplished with less segments. This might be useful in clinical practice.

ACMG 2016 Update on Noninvasive Prenatal Testing for Fetal Aneuploidy: Implications for India

AbstractACMG 2016 guidelines for noninvasive prenatal screening (NIPS) are examined in the Indian context, and recommendation made for their adoption. Currently in India, NIPS is not a test that can or should be offered directly to patients. Proper pre-test counseling is essential, during which, the different options should be explained so that the patients can choose the test most appropriate for their situation. NIPS has a greater detection rate than other screening methods (like biochemical screening or ultrasound markers of aneuploidy), and can be performed in place of conventional screening for Patau, Edwards, and Down syndromes, if the patient can afford the cost, and the ultrasound does not show a malformation that is not a part of aneuploidies. The NIPS should be performed at 12 weeks of gestation or later, to reduce ‘no calls’ due to low fetal fraction. In samples that contain less than 4% fetal fraction the confidence in the report is reduced. Testing for sex chromosomes can be included, as these abnormalities are associated with unpredictable prognosis (that is often burdensome), which proves unacceptable to most Indian couples. However, patients should be provided balanced information on the abnormality that has been detected and left to choose the course of action most suited to their situation. Screening for microdeletions can be done if the patient can afford the cost, as microdeletions are more frequent than aneuploidies in young mothers. In some cases diagnosis of a microdeletion is helpful in management of the disorder in the neonatal period leading to a better outcome. The vendors should fulfill their responsibility of educating the patients before offering the test, and giving clear reports in simple understandable language. It is hoped that more vendors will perform the tests locally so that they become cheaper and affordable, as they have greater detection rate than other screening methods.