Low Sensitivity Research Articles

Junctionless Structure Indium-Tin Oxide Thin-Film Transistors Enabling Enhanced Mechanical and Contact Stability.

In recent years, considerable attention has focused on high-performance and flexible crystalline metal oxide thin-film transistors (TFTs). However, achieving both high performance and flexibility in semiconductor devices is challenging due to the inherently conductive and brittle nature of crystalline metal oxide. In this study, we propose a facile way to overcome this limitation by employing a junctionless (JL) TFT structure via oxygen plasma treatment of the crystalline indium-tin oxide (ITO) films. The oxygen plasma treatment significantly reduced oxygen vacancies in the ITO films, contributing to the significant reduction in the carrier concentration from 4.67 × 1020 to 1.39 × 1016. Importantly, this reduction was achieved without inducing any noticeable structural changes in the ITO, enabling the successful realization of ITO JL TFTs with an adjustable threshold voltage. Furthermore, the ITO JL TFTs demonstrate good stability and reliability under various bias stress conditions, aging in the air atmosphere, and high-temperature processes. In addition, the ITO JL TFTs exhibit low light sensitivity due to the wide bandgap of ITO and further suppression of Vo defects, making them suitable for applications requiring stable performance under light exposure. To compare and analyze the flexibility of the JL structure and conventional structure with additional source/drain (S/D) junction in ITO TFTs with nonencapsulation, we utilized mechanical simulations and transmission line method (TLM). By employing the JL structure in ITO TFT through carefully optimized oxygen plasma treatment, we successfully mitigated stress concentration at the S/D-channel interface. This resulted in a JL ITO TFT that exhibited a change in contact resistance of less than 20% even after 20,000 bending cycles. Consequently, a stable and flexible ITO TFT with field-effect mobility (μFE) of 12.74 cm2/(V s) was realized, outperforming conventionally structured ITO TFTs with additional S/D junction, where the contact resistance nearly tripled.

Synthesis of a perylene diimide functionalized Sb2S3 nanocomposites and its application as a peroxidase mimic for colorimetric detection of H2O2 and glucose

N, N’-di (L-glutamic amine)-perylene-3,4,9,10-tetracarboxylic diimide (GAPDI) functionalized Sb2S3 nanocomposites (GAPDI-Sb2S3) were fabricated using a hydrothermal method and characterized. GAPDI-Sb2S3 nanocomposites can catalyze the oxidation of 3,3′,5,5′- tetramethyl benzidine (TMB) by H2O2. The experimental conditions including pH and temperature were optimized. GAPDI-Sb2S3 nanocomposites showed a strong affinity for TMB substrates, and their catalytic activity followed the Michaelis–Menten kinetics. The experimental results showed that GAPDI-Sb2S3 nanocomposites exhibited a low detection limit (LOD = 0.39 μM) and high sensitivity for H2O2 detection and showed good response to glucose detection with a LOD of 0.42 μM over arrange of 2–10 μM. These findings suggest broad application prospects in the fields of environmental chemistry, biotechnology, and biomedicine.

Selecting optimal wearables for measuring physiological arousal in robot-delivered mindfulness-based exercises

While social robots show promise for therapeutic interventions, accurate assessments of (vulnerable) participants' affective outcomes require attention. The careful selection of devices for recording autonomic processes in response to stress-inducing and relaxing exercises is essential to ensure data quality recordings and participants' comfort. This foundational study assessed two commonly utilized devices to record electrodermal activity (EDA), indexed through skin conductance, concerning their sensitivity to stress-relaxation manipulations and social validity during a robot intervention: a sock with a Shimmer device and a wrist-worn Empatica E4. We aimed to select the most sensitive and easy-to-wear one as a precursor to a larger intervention study featuring mindfulness-based relaxation exercises delivered by an NAO robot. The findings, based on 28 healthy Dutch-speaking adult volunteers wearing both devices, revealed sensitivity in detecting EDA variations in arousal following stressful (increase) and Robot-delivered mindfulness-based relaxation (decrease) exercises, further corroborated by self-reports. Bland-Altman results suggested little agreement between the two devices and lower sensitivity for the Empatica E4. No statistically significant differences concerning wearing comfort between the Empatica E4 and the Shimmer devices emerged. Although both devices independently showed sensitivity to stress/relaxation manipulation, the choice for one or the other should be informed by the activities in the intervention.

Applying Machine Learning Models Derived from Administrative Claims Data to Predict Medication Non-Adherence in Patients Self-Administering Biologic Medications for Inflammatory Bowel Disease

Abstract Background Adherence to self-administered biologic therapies is important to induce remission and prevent adverse clinical outcomes in inflammatory bowel disease. This study aimed to use administrative claims data and machine learning methods to predict nonadherence in an academic medical center test population. Methods A model-training dataset of beneficiaries with inflammatory bowel disease and first unique dispense of a self-administered biologic between June 30, 2016 and June 30, 2019 was extracted from the Commercial Claims and Encounters and Medicare Supplemental Administrative Claims Database. Known correlates of medication nonadherence were identified in the dataset. Nonadherence to biologic therapies was defined as a proportion of days covered ratio <80% at 1 year. A similar dataset was obtained from a tertiary academic medical center electronic medical record data for use in model testing. A total of 48 machine learning models were trained and assessed utilizing area under the receiver operating characteristic curve as the primary measure of predictive validity. Results The training dataset included 6,998 beneficiaries (n = 2,680 nonadherent, 38.3%) while the testing dataset included 285 patients (n = 134 nonadherent, 47.0%). When applied to test data, highest performing models had an area under the receiver operating characteristic curve of 0.55, indicating poor predictive performance. The majority of models trained had low sensitivity and high specificity. Conclusion Administrative claims-trained models were unable to predict biologic medication nonadherence in patients with inflammatory bowel disease. Future research may benefit from datasets with enriched demographic and clinical data in training predictive models.

Applying Machine Learning Models Derived from Administrative Claims Data to Predict Medication Non-Adherence in Patients Self-Administering Biologic Medications for Inflammatory Bowel Disease

Abstract Background Adherence to self-administered biologic therapies is important to induce remission and prevent adverse clinical outcomes in inflammatory bowel disease. This study aimed to use administrative claims data and machine learning methods to predict nonadherence in an academic medical center test population. Methods A model-training dataset of beneficiaries with inflammatory bowel disease and first unique dispense of a self-administered biologic between June 30, 2016 and June 30, 2019 was extracted from the Commercial Claims and Encounters and Medicare Supplemental Administrative Claims Database. Known correlates of medication nonadherence were identified in the dataset. Nonadherence to biologic therapies was defined as a proportion of days covered ratio <80% at 1 year. A similar dataset was obtained from a tertiary academic medical center electronic medical record data for use in model testing. A total of 48 machine learning models were trained and assessed utilizing area under the receiver operating characteristic curve as the primary measure of predictive validity. Results The training dataset included 6,998 beneficiaries (n = 2,680 nonadherent, 38.3%) while the testing dataset included 285 patients (n = 134 nonadherent, 47.0%). When applied to test data, highest performing models had an area under the receiver operating characteristic curve of 0.55, indicating poor predictive performance. The majority of models trained had low sensitivity and high specificity. Conclusion Administrative claims-trained models were unable to predict biologic medication nonadherence in patients with inflammatory bowel disease. Future research may benefit from datasets with enriched demographic and clinical data in training predictive models.

Nanostructured metallic enzymes mimic for electrochemical biosensing of glucose

In many domains, the creation of nonenzymatic glucose sensors with robust electrocatalytic activity and chemical stability is indispensable. However, the design of nanoarchitecture transition metals and their nanocomposites as sensing interfaces for nonenzymatic recognition groups remains a formidable challenge. This review discusses the engineered nanoarchitecture transition metals used as non-enzymatic glucose sensors, with a particular focus on their applications characterized by low cost, high sensitivity, and long-term durability. Central to our discussion is the imperative of crafting nanostructured transition materials with expansive specific surface areas and well-defined active sites to serve as electrochemical sensing platforms. Our objective is to shed light on the enhanced electrochemical behavior toward glucose without reliance on mediators or templates. Leveraging advancements in nanotechnology, this review seeks to elucidate strategies for refining conventional nanostructures to optimize enzyme-free glucose sensing applications. Additionally, we delve into the inherent challenges and potential applications of these sensors for detecting glucose and outline ways to develop better non-enzymatic electrochemical glucose sensors.

Traditional to technological advancements in Ganoderma detection methods in oil palm.

Ganoderma sp., the fungal agent causing basal stem rot (BSR), poses a severe threat to global oil palm production. Alarming increases in BSR occurrences within oil palm growing zones are attributed to varying effectiveness in its current management strategies. Asymptomatic progression of the disease and the continuous monoculture of oil palm pose challenges for prompt and effective management. Therefore, the development of precise, early, and timely detection techniques is crucial for successful BSR management. Conventional methods such as visual assessments, culture-based assays, and biochemical and physiological approaches prove time-consuming and lack specificity. Serological-based diagnostic methods, unsuitable for fungal diagnostics due to low sensitivity, assay affinity, cross-contamination which further underscores the need for improved techniques. Molecular PCR-based assays, utilizing universal, genus-specific, and species-specific primers, along with functional primers, can overcome the limitations of conventional and serological methods in fungal diagnostics. Recent advancements, including real-time PCR, biosensors, and isothermal amplification methods, facilitate accurate, specific, and sensitive Ganoderma detection. Comparative whole genomic analysis enables high-resolution discrimination of Ganoderma at the strain level. Additionally, omics tools such as transcriptomics, proteomics, and metabolomics can identify potential biomarkers for early detection of Ganoderma infection. Innovative on-field diagnostic techniques, including remote methods like volatile organic compounds profiling, tomography, hyperspectral and multispectral imaging, terrestrial laser scanning, and Red-Green-Blue cameras, contribute to a comprehensive diagnostic approach. Ultimately, the development of point-of-care, early, and cost-effective diagnostic techniques accessible to farmers is vital for the timely management of BSR in oil palm plantations.

Sensitivity analysis of turbine stage aerothermal characteristics and blade cooling performance considering combustor swirl and hot spot

This paper investigates the global sensitivity of high-pressure-turbine (HPT) first stage cascades aerothermal characteristics and blade cooling performance under the influence of combustor swirl and hot spot. The combustor outflow conditions impact on turbine working performance and robustness. This paper is focused on the influence of uncertain combustor swirling flow and hot spot, rather than deterministic working conditions. A simplified combustor outflow simulation method is firstly proposed, and the effects of combustor outflow are quantified by combining chaos polynomial expansion with Sobol’ decomposition method. The results show that different rotating directions of the swirl lead to restricted influences on the averaged aerothermal performance of the turbine stage, but significantly affects its robustness. The positive swirl increases the total pressure loss generated by the lower passage vortex of the stator cascade, and the high uncertainty region of the stator cascade total pressure loss profile is the combined products of the residual swirl and the interaction between the passage vortex and mainstream. The total pressure loss of the rotor cascade due to leakage vortex has low sensitivity to the hot spot and swirl strength, while the total pressure loss generated by the passage vortex is affected by hot spot temperature. Temperature distribution affected by the passage vortex is sensitive to swirl strength. Generally, uncertainty variance of stage aerothermal parameters with positive swirl is about 30% larger than that of the negative case, since the positive swirl has stronger interactions with the blades, leading to more significant uncertainty. However, the averaged heat transfer coefficients with positive swirl are 37% less sensitive, compared to the negative swirl case. The results give better understanding on the influence mechanisms of turbine inflow conditions, emphasize the meaning of investigating uncertain characteristics of the turbine cascades. Investigations of this article provide reference for robust turbine blade cooling design.

TB PCR in BAL and EBUS-TBNA samples for the diagnosis of pulmonary and mediastinal lymph node TB: retrospective TRiBE study

IntroductionThe role of Xpert Ultra in bronchoalveolar lavage (BAL) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) samples for pulmonary and mediastinal lymph node tuberculosis (TB) remains unclear.MethodsThis was a retrospective...

Performance characteristics of genus or species-specific Polymerase Chain Reaction (PCR) for the microbial diagnosis of joint infections: A systematic review and meta-analysis

Joint infections cause significant morbidity and mortality. Rapid diagnosis enables prompt initiation of appropriate antimicrobial therapy and surgical treatment. We conducted a systematic review and meta-analysis to evaluate the accuracy of genus- or species-specific polymerase chain reaction (PCR) in diagnosing joint infections. The literature databases were searched for articles from January 2010 to December 2022. The meta-analysis using the split component synthesis (SCS) method, included 20 studies with 2,457 adult participants. The pooled sensitivity, specificity, diagnostic odds ratio, and AUC of PCR were 49 % (95 % CI [37.9-60.2]), 95.7 % (95 % CI [91.6-97.8]), 21.32, and 0.82 respectively. Sensitivity was highest for sonicate fluid and lowest for periprosthetic tissue. The mean turnaround time to results was 4.7 hours (SD 1.1). PCR is a favourable option for diagnosing joint infections due to its rapid results, but it has low sensitivity. To enhance diagnostic yield, the test should be used in conjunction with other methods.

Design Method of Freeform Surface Optical Systems with Low Coupling Position Error Sensitivity.

Freeform off-axis reflective systems are significantly more difficult to align and assemble owing to their asymmetric surface shapes and system structures. In this study, a freeform surface system design method with low coupling position error sensitivity (FCPESM) was proposed. First, we established a mathematical model of a reflective system when it was perturbed by coupling position errors and used the clustering-microelement method to establish the coupling error sensitivity evaluation function. The evaluation function was then applied to the design process of a freeform surface off-axis three-mirror optical system. The results showed that the FCPESM optical design method can significantly relax the assembly tolerance requirements of optical systems on the basis of ensuring image performance. In this study, the reflective system was perturbed by tilt and decenter simultaneously, and the disturbance mechanism of position errors on optical systems was further improved. Through this research, freeform surface systems with both image performance and error sensitivity can be obtained, which makes freeform off-axis reflective systems with better engineering realizability.

The Utility of Real-Time PCR, Metagenomic Next-Generation Sequencing, and Culture in Bronchoalveolar Lavage Fluid for Diagnosis of Pulmonary Aspergillosis

Timely detection of Aspergillus infection is crucial given the high mortality rate of pulmonary aspergillosis (PA). Here, the diagnostic performances for PA of mycological culture, Aspergillus real-time Polymerase Chain Reaction (RT-PCR), and metagenomic next-generation sequencing (mNGS) assay from bronchoalveolar lavage fluid (BALF), were evaluated. Totally 139 patients with suspected fungal pneumonia were enrolled between December 2021 and July 2023, collecting 139 BALF samples for RT-PCR and culture, with 87 undergoing mNGS assay. The sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve (AUC) with 95% confidence intervals of these assays for PA were as follows: 35.3% (14.2–61.7%), 100.0% (94.0–100.0%), 100.0% (54.1–100.0%), 84.5% (79.3–88.6%), and 0.676 (0.560–0.779) for culture; 82.4% (56.6–96.2%), 98.3% (91.1–100.0%), 93.3% (66.4–99.0%), 95.2% (87.6–98.2%) and 0.903 (0.815–0.959) for same diagnostic performance of RT-PCR and mNGS; and 94.1% (71.3–99.9%), 96.7% (88.5–99.6%), 88.9% (67.1–96.9%), 98.3% (89.6–99.7%), 0.954 (0.880–0.989) for RT-PCR combining mNGS; RT-PCR, mNGS, and their combination significantly improved in AUC values over culture (p <0.001), but RT-PCR testing and mNGS had no significant difference with each other and their combination. Overall, the performance of culture was limited by low sensitivity, both RT-PCR and mNGS assays as single diagnostic tests are promising compared to culture and combined tests.

Different effects of bariatric surgery on epigenetic plasticity in skeletal muscle of individuals with and without type 2 diabetes

AimBariatric surgery is highly effective for the treatment of obesity in individuals without (OB11OB: individuals with obesity.) and in those with type 2 diabetes (T2D22T2D: individuals with obesity and type 2 diabetes.). However, whether bariatric surgery triggers similar or distinct molecular changes in OB and T2D remains unknown. Given that individuals with type 2 diabetes often exhibit more severe metabolic deterioration, we hypothesized that bariatric surgery induces distinct molecular adaptations in skeletal muscle, the major site of glucose uptake, of OB and T2D after surgery-induced weight loss. MethodsAll participants (OB, n = 13; T2D, n = 13) underwent detailed anthropometry before and one year after the surgery. Skeletal muscle biopsies were isolated at both time points and subjected to transcriptome and methylome analyses using a comprehensive bioinformatic pipeline. ResultsBefore surgery, T2D had higher fasting glucose and insulin levels but lower whole-body insulin sensitivity, only glycemia remained higher in T2D than in OB after surgery. Surgery-mediated weight loss affected different subsets of genes with 2,013 differentially expressed in OB and 959 in T2D. In OB differentially expressed genes were involved in insulin, PPAR signaling and oxidative phosphorylation pathways, whereas ribosome and splicesome in T2D. LASSO regression analysis revealed distinct candidate genes correlated with improvement of phenotypic traits in OB and T2D. Compared to OB, DNA methylation was less affected in T2D in response to bariatric surgery. This may be due to increased global hydroxymethylation accompanied by decreased expression of one of the type 2 diabetes risk gene, TET2, encoding a demethylation enzyme in T2D. ConclusionOB and T2D exhibit differential skeletal muscle transcriptome responses to bariatric surgery, presumably resulting from perturbed epigenetic flexibility.

High precision identification of dynamic model for accelerometer based on VMD

The dynamic model of accelerometer reflects characteristics of dynamic output changes over time, directly affecting dynamic measurement performance. To solve the problem of low identification accuracy due to pure delay, nonlinearity, and noise, a high-precision closed-loop identification method for dynamic model based on variational mode decomposition (VMD) is proposed. In particular, emphasis is placed on highlighting the issue that equivalent stiffness parameter is more susceptible to noise due to its low parameter sensitivity. Additionally, to address the effects of pure delay and nonlinearity on model identification, a dynamic model of accelerometer containing both is proposed. In response to the impact of noise on model identification, it is proposed to use VMD for noise separation and data reconstruction. Finally, a test platform is established for validation. And experimental results indicate that the model identified using the proposed method shows an increase in model matching degree (MMD) from 90% to 98.8%.

AK7-deficiency reversal inhibits ccRCC progression and boosts anti-PD1 immunotherapy sensitivity.

Clear cell renal cell carcinoma (ccRCC) is a common kidney cancer with subtle early symptoms, high recurrence rates, and low sensitivity to traditional treatments like radiotherapy and chemotherapy. Identifying novel therapeutic targets is critical. The expression level of adenylate kinases 7 (AK7) in ccRCC was examined by the TCGAportal and UALCAN databases. The effect of AK7 on proliferation, invasion and migration of ccRCC cell lines was evaluated by cell assay. The correlation between AK7 expression and prognosis, as well as its direct relationship with immunotherapy efficacy, was analyzed using CANCERTOOL and Kaplan-Meier plotter data. Moreover, the TISIDB database was used to study the relationship between AK7 and immune markers. The effect of overexpressed AK7 combined with PD1 monoclonal antibody on ccRCC was evaluated in animal experiments. The results showed that low level of AK7 expression was observed in ccRCC tissues. The expression of AK7 can regulate the proliferation, invasion, and migration of human ccRCC cell lines. The level of AK7 expression was associated with OS of ccRCC patients. This was potentially due to the negative connection between AK7 expression and CD8+ T cell depletion, indicating that immunotherapy might be less effective in individuals with low AK7 expression. Conversely, augmenting AK7 demonstrated an enhanced effectiveness of anti-PD1 therapy. The findings of our research strongly indicated that AK7 could serve as both a prognostic indicator and therapeutic target for patients with ccRCC. Moreover, the overexpression of AK7 combined with anti-PD1 held promising potential as a therapeutic approach for treating ccRCC.

Multi-scale modelling of location- and frequency-dependent synaptic plasticity induced by transcranial magnetic stimulation in the dendrites of pyramidal neurons.

Repetitive transcranial magnetic stimulation (rTMS) induces long-term changes of synapses, but the mechanisms behind these modifications are not fully understood. Al- though there has been progress in the development of multi-scale modeling tools, no com- prehensive module for simulating rTMS-induced synaptic plasticity in biophysically realistic neurons exists.. We developed a modelling framework that allows the replication and detailed prediction of long-term changes of excitatory synapses in neurons stimulated by rTMS. We implemented a voltage-dependent plasticity model that has been previously established for simulating frequency-, time-, and compartment-dependent spatio-temporal changes of excitatory synapses in neuronal dendrites. The plasticity model can be incorporated into biophysical neuronal models and coupled to electrical field simulations. We show that the plasticity modelling framework replicates long-term potentiation (LTP)-like plasticity in hippocampal CA1 pyramidal cells evoked by 10-Hz repetitive magnetic stimulation (rMS). This plasticity was strongly distance dependent and concentrated at the proximal synapses of the neuron. We predicted a decrease in the plasticity amplitude for 5 Hz and 1 Hz protocols with decreasing frequency. Finally, we successfully modelled plasticity in distal synapses upon local electrical theta-burst stimulation (TBS) and predicted proximal and distal plasticity for rMS TBS. Notably, the rMS TBS-evoked synaptic plasticity exhibited robust facilitation by dendritic spikes and low sensitivity to inhibitory suppression. The plasticity modelling framework enables precise simulations of LTP-like cellular effects with high spatio-temporal resolution, enhancing the efficiency of parameter screening and the development of plasticity-inducing rTMS protocols. First rigorously validated model of TMS-induced long-term synaptic plasticity in ex- tended neuronal dendrites that goes beyond point-neuron and mean-field modellingRobust simulations of experimental data on LTP-like plasticity in the proximal dendrites of CA1 hippocampal pyramidal cells evoked by 10 Hz repetitive magnetic stimulation (rMS)Replication of distal synaptic plasticity for a local electrical theta burst stimulation (TBS) protocolPrediction of distal and proximal LTP-like plasticity for rMS TBS1 Hz rMS does not induce long-term depression.

Density functional theory (DFT) study on the structures and energy properties of high energy density materials based on polynitroazofurazan derivatives

In this study, inspired by the structures of the heat resistant explosives 5,5’-bis(2,4,6-trinitrophenyl)-2,2′-bi(1,3,4-oxadiazole) and 2,6-bis(picrylamino)-3,5-dinitro-pyridine, five high energy and low sensitivity energetic materials have been designed by combining the energetic fragments with the high energy azofurazan skeleton, and structure - property relationships have been investigated by means of density function theory. All compounds have excellent explosive properties (Dv: 7946–8341 m/s; P: 27.6–30.9 GPa) and high positive heats of formation (816.85–940.28 kJ/mol). Among them, compounds 3 and 4 have the best explosive properties (3: Dv: 8318 m/s P:30.7 GPa; 4: Dv: 8341 m/s P: 30.9 GPa), which are comparable to 1,3,5-trinitrohexahydro-1,3,5-triazine. The h50 values indicate that all compounds have good impact sensitivity, comparable to 1,3,5,7-tetranitro-1,3,5,7-tetrazocane and 1,3,5-trinitrohexahydro-1,3,5-triazine and superior to hexanitrohexaazaisowurtzitane. In addition, bond dissociation energies, frontier molecular orbitals, and weak interaction, etc. are calculated to further investigate the relationship between structures and properties. The calculated results show that these compounds are expected to be the next generation of high energy density materials with an excellent balance of energetic properties and stability.

Real-World Biomarkers for Pediatric Takayasu Arteritis.

Childhood-onset Takayasu arteritis (TA) is a rare, heterogeneous disease with limited diagnostic markers. Our objective was to identify and classify all candidates for biomarkers of TA diagnosis in children reported in the literature. A systematic literature review (PRISMA) of MEDLINE, EMBASE, Wiley Cochrane Library, ClinicalTrias.gov, and WHO ICTRP for articles related to TA in the pediatric age group between January 2000 and August 2023 was performed. Data on demographics, clinical features, laboratory measurements, diagnostic imaging, and genetic analysis were extracted. We identified 2026 potential articles, of which 52 studies (81% case series) met inclusion criteria. A total of 1067 TA patients were included with a peak onset between 10 and 15 years. Childhood-onset TA predominantly presented with cardiovascular, constitutional, and neurological symptoms. Laboratory parameters exhibited a low sensitivity and specificity. Imaging predominantly revealed involvement of the abdominal aorta and renal arteries, with magnetic resonance angiography (MRA) being the preferred imaging modality. Our review confirms the heterogeneous presentation of childhood-onset TA, posing significant challenges to recognition and timely diagnosis. Collaborative, multinational efforts are essential to better understand the natural course of childhood-onset TA and to identify accurate biomarkers to enhance diagnosis and disease management, ultimately improving patient outcomes.

Assessment of the Sensitivity of Foodborne Cronobacter spp. Strains and Other Enterobacteria to Temperature Stresses and Chlorine-Containing Biocides.

We examined the effects of elevated temperatures and biocides on survivability of food isolates of Cronobacter spp. (C. sakazakii) and concomitant enterobacteriaceae obtained in microbiological control of infant nutrition products. Increased resistance of certain strains of Cronobacter, Enterobacter cloacae, and Pantoea spp. to thermal processing was revealed. Salmonella, Pantoea, and Cronobacter bacteria were least sensitive to antimicrobial action of chlorine-containing agents. The above properties varied in the strains of the same species. Specifically, only two of three examined isolates of Cronobacter spp. demonstrated lower sensitivity to heat in comparison with the enterobacterial test-cultures of other species.

Evaluating Pediatric Appendicitis Score and Alvarado Scoring System for Detecting Acute Appendicitis in Pediatric Population

Abstract Background Acute appendicitis is the most common surgical condition of children. About 1 to 10% of children presenting in surgical emergencies with acute abdomen fall within the domain of acute appendicitis. In few of these cases, clinical signs and symptoms at presentation are such that acute appendicitis is a clear diagnosis while more often it is challenging for a surgeon to make a clinical diagnosis of acute appendicitis. In these circumstances, explorations reveal negative appendectomies and an organ with potential functions can be lost. Objective To evaluate the Pediatric Appendicitis Score and Alvarado Scoring System in Detecting Acute Appendicitis in Pediatric Population in terms of applicability, safety, and specificity in the diagnosis of Acute Appendicitis among the study group and to suggest improvements and/or modifications to increase the predictive values of Pediatric Appendicitis Score and Alvarado Scoring System, decrease the rates of false diagnosis or reduce costs. Methods a prospective cohort study that was conducted on 50 patients aged under 14 years admitted to pediatric surgery department in Ain Shams University Hospital within a period of 6 months with an expected diagnosis of Acute appendicitis. Each patient was subjected to a detailed medical history taking (with emphasis on The age, gender, duration of pain, complaint complaints ofabdominal pain and duration, fever, nausea-vomiting, diarrhea or constipation), Clinical examination:(right lower quadrant sensitivity,defense, rebound tenderness, percussion/ cough/ right lower quadrant sensitivity with jumping). Laboratory investigations:(complete blood count, the total white blood cell (WBC) and total neutrophil counts c-reactive protein ) and Ultrasound examination. Alvarado score as well as PAS were calculated for each patient . the results were then compared to the intra operative findings confirming or excluding the diagnosis of acute appendicitis. Results in the study group that was 38% males and 62% females with ages ranging from 3 to 14 years .Pediatric appendicitis score (PAS) was found to significantly predict acute appendicitis in the studied patients at cutoff 5.0 with sensitivity, specificity, PPV and NPV was 60.5%, 100%, 100% and 71.9% respectively (p &amp;lt; 0.001). Alvarado score can significantly predict acute appendicitis in the studied patients at cutoff 4.0 with sensitivity, specificity, PPV and NPV was 79.1%, 85.7%, 84.7% and 80.4% respectively (p &amp;lt; 0.001). Conclusion The results of this study showed the higher sensitivity of Alvarado score and more specificity of the Pediatric Appendicitis score. However, the sensitivity, specificity, PPV, and NPV of these criteria were not considered enough to confirm the diagnosis of acute appendicitis alone. There is a need for new parameters in the scoring systems. Such as including ultrasonagraphic findings and additional laboratory investigations such as CRP.