Sample Acquisition Research Articles

Application of Deep Learning in Multitemporal Remote Sensing Image Classification

The rapid advancement of remote sensing technology has significantly enhanced the temporal resolution of remote sensing data. Multitemporal remote sensing image classification can extract richer spatiotemporal features. However, this also presents the challenge of mining massive data features. In response to this challenge, deep learning methods have become prevalent in machine learning and have been widely applied in remote sensing due to their ability to handle large datasets. The combination of remote sensing classification and deep learning has become a trend and has developed rapidly in recent years. However, there is a lack of summary and discussion on the research status and trends in multitemporal images. This review retrieved and screened 170 papers and proposed a research framework for this field. It includes retrieval statistics from existing research, preparation of multitemporal datasets, sample acquisition, an overview of typical models, and a discussion of application status. Finally, this paper discusses current problems and puts forward prospects for the future from three directions: adaptability between deep learning models and multitemporal classification, prospects for high-resolution image applications, and large-scale monitoring and model generalization. The aim is to help readers quickly understand the research process and application status of this field.

Optimization of endoscopic ultrasound-guided tissue sample acquisition for commercially available comprehensive genome profiling.

Optimal tumor samples are crucial for successful analysis using commercially available comprehensive genomic profiling (CACGP). However, samples acquired by endoscopic ultrasound-guided tissue acquisition (EUS-TA) are occasionally insufficient, and no consensus on the optimal number of needle passes required for CACGP exists. This study aimed to explore the optimal number of needle passes required for EUS-TA to procure an ideal sample fulfilling the prerequisite criteria of CACGPs. Patients who underwent EUS-TA for solid masses between November 2019 and July 2021 were retrospectively studied. The correlation between the acquisition rate of an ideal sample and the number of needle passes mounted on a microscope slide was evaluated. Additionally, the factors predicting a successful analysis were investigated in patients scheduled for CACGP using EUS-TA-obtained samples during the same period. EUS-TAs using 22- and 19-gauge (G) needles were performed in 336 and 57 patients, respectively. There was a positive correlation between the acquisition rate and the number of passes using a 22-G needle (38.9%, 45.0%, 83.7%, and 100% for 1, 2, 3, and 4 passes, respectively), while no correlation was found with a 19-G needle (84.2%, 83.3%, and 85.0% for 1, 2, and 3 passes, respectively). The analysis success rate in patients with scheduled CACGP was significantly higher with ideal samples than with suboptimal samples (94.1% vs 55.0%, P<0.01). The optimal estimated number of needle passes was 4 and 1-2 for 22- and 19-G needles, respectively.

An aquatic environmental DNA filtration system to maximize recovery potential and promote filtration approach standardization.

Aquatic environmental DNA (eDNA) has emerged as a promising approach to identify organisms in freshwater and marine environments. While the recovery of eDNA from water most commonly involves capture of biological debris on a filter matrix, practitioners are yet to converge on standardized approaches for filtration, particularly in the field. This lack of standardization has resulted in inconsistent handling of samples following collection, limiting interpretation of results across studies and burdening groups with inconvenient storage and transport logistics that may compromise eDNA integrity. A simple to assemble and low-cost ($350 USD) water filtration system is demonstrated that can be used in field and laboratory settings to reduce time between sample acquisition and eDNA filtration, maximizing eDNA sample recovery. Quantitative PCR is used to show the utility of the platform for laboratory and marine eDNA analysis. The resulting eDNA collection system is easily transported in a rugged water-resistant case, operates for more than eight hours on a 12-volt lead-acid battery, and has an unobstructed filtration rate of 150.05 ± 7.01 mL/min and 151.70 ± 6.72 mL/min with 0.22 µm and 0.45 µm Sterivex filters, respectively. We show that immediate sample filtration increases eDNA recovery in the laboratory, and demonstrate collections in aquaria and marine environments. We anticipate that providing easy to obtain, open hardware designs for eDNA sample collection will increase standardization of aquatic eDNA collection methods and improve cross-study comparisons.

Design of Man-Machine Synergic Lunar Coring Device and Its Coring Dynamic Analysis

The Moon is the closest extraterrestrial celestial body to the Earth. Sampling and analysis of lunar regolith or rocks can pave the way for the development and utilization of lunar resources. The acquisition of lunar regolith samples with original stratigraphic information by astronauts on the lunar surface is one of the essential missions in the manned lunar landing project. Therefore, to maintain the original stratigraphic information of the lunar samples during the sampling process while further improving the coring rate and sampling depth, a handheld dual-mode lunar regolith coring device is proposed in this paper. The device innovatively combines impact penetration and rotary drilling sampling, which allows the selection of a suitable sampling method according to the environment. In addition, this study designs a synergic coring device that can be operated by the astronaut and carried on the lander or rover based on the handheld coring device, which can ensure safe and stable coring mission. The mechanical analysis is carried out for the key properties in the coring device, the corresponding mechanical model is established, the structural parameters are optimally designed, and the performance analysis is carried out accordingly. Finally, the impact and drilling process of the coring device is simulated in explicit dynamics, and the results show that the optimized impact module can effectively penetrate the lunar rocks. The research work will provide technical reference and theoretical support for the design of human–machine synergic coring devices in manned lunar exploration missions.

Volumetric measurements of weak current-induced magnetic fields in the human brain at high resolution.

Clinical use of transcranial electrical stimulation (TES) requires accurate knowledge of the injected current distribution in the brain. MR current density imaging (MRCDI) uses measurements of the TES-induced magnetic fields to provide this information. However, sufficient sensitivity and image quality in humans in vivo has only been documented for single-slice imaging. A recently developed, optimally spoiled, acquisition-weighted, gradient echo-based 2D-MRCDI method has now been advanced for volume coverage with densely or sparsely distributed slices: The 3D rectilinear sampling (3D-DENSE) and simultaneous multislice acquisition (SMS-SPARSE) were optimized and verified by cable-loop experiments and tested with 1-mA TES experiments for two common electrode montages. Comparisons between the volumetric methods against the 2D-MRCDI showed that relatively long acquisition times of 3D-DENSE using a single slab with six slices hindered the expected sensitivity improvement in the current-induced field measurements but improved sensitivity by 61% in the Laplacian of the field, on which some MRCDI reconstruction methods rely. Also, SMS-SPARSE acquisition of three slices, with a factor 2 CAIPIRINHA (controlled aliasing in parallel imaging results in higher acceleration) acceleration, performed best against the 2D-MRCDI with sensitivity improvements for the and Laplacian noise floors of 56% and 78% (baseline without current flow) as well as 43% and 55% (current injection into head). SMS-SPARSE reached a sensitivity of 67 pT for three distant slices at 2 × 2 × 3 mm3 resolution in 10 min of total scan time, and consistently improved image quality. Volumetric MRCDI measurements with high sensitivity and image quality are well suited to characterize the TES field distribution in the human brain.

Perubahan Tarif Pajak Penghasilan, Ukuran Perusahaan Pada Struktur Modal Yang Dimoderasi Profitabilitas

A company always needs capital both for business opening and business development. The funding problem will not be separated from a company which includes how much the company's ability to meet the needs of funds that will be used to operate and develop its business. The optimal capital structure policy is where there is a good balance between risk and return which will ultimately maximize the value of the company. The company's goal of maximizing company value also means maximizing shareholder wealth. In a company that has gone public, the value of the company is reflected in the price of shares traded on the stock exchange. This study aims to determine the effect of changes in corporate income tax rates, company size on capital structure with profitability as a moderating variable. The sample in this study amounted to 26 companies with the object of trading and service companies listed on the IDX in 2019-2020 during the pandemic. Purposive sampling was chosen as the sample acquisition method. MRA is used as a sample testing selection with spss 26 as software. This study proves that capital structure cannot be influenced by changes in corporate income tax rates but company size can be influenced by profitability and company size and the results also show that changes in corporate income tax rates moderated by profitability do not affect capital structure, and weaken company size on capital structure

Thermal modeling of a dual‐purposed snap biopsy acquisition procedure in a suspected cancerous lesion

AbstractThe needle‐based biopsy procedure is common in cancer detection and patient‐specific targeted therapy, wherein a tissue sample from the potential diseased site is acquired and frozen instantly with the help of a coolant medium. While liquid nitrogen (LN2) is the most widely used coolant for preserving the acquired sample and performing biopsy tests on the same at a later time, cold ischemia leads to inevitable cell degradation beyond a threshold time. In an effort to circumvent this challenge, here we aim to put forward the concept of an integrated biopsy sample acquisition and cryotherapy procedure, by incorporating an exclusively designed cooling circuit in a conventional biopsy‐needle for freezing the sample in vivo as soon as it is acquired, while causing cryoablation in the surrounding tissues simultaneously. An enthalpy‐based approach is employed to develop a bioheat transfer model for the cryotherapy design, with illustrative simulation data presented for breast cancer. Our model is demonstrated by considering a constant LN2 cooling temperature of 77.15 K, and cooling powers ranging from 2 to 10 W. The model results elucidate procedure‐specific insights such as the thermal penetration depth and the cooling time on being subjected to the cryoablation. The cooling rates thus obtained are further assessed from the simultaneous considerations of cryopreservation and cryosurgery, deriving critical insights on tissue survival and damage for acting as a precursor to patient‐specific treatment planning.

Submersible Capillary Electrophoresis Analyzer: A Proof-of-Concept Demonstration of an In Situ Instrument for Future Missions to Ocean Worlds

We report here the first fully automated capillary electrophoresis (CE) system that can be operated underwater. The system performs sample acquisition and analysis by coupling CE to contactless conductivity detection. Using 5 M acetic acid as the background electrolyte (BGE), inorganic cations and amino acids at concentrations as low as 5.2 μM can be separated and identified. This technology could be augmented to include a variety of other detection modes. This system serves as an early prototype for potential future underwater explorers on ocean worlds of the outer solar system such as Europa or Enceladus. This work documents the first step in the development of this general-purpose technology platform.

UC-SFDA: Source-free domain adaptation via uncertainty prediction and evidence-based contrastive learning

Most unsupervised domain adaptation approaches learn domain-invariant features assuming that source and target domain data are available simultaneously. In practice, the availability of source samples is only sometimes possible. This paper establishes a novel source-free domain adaptation (SFDA) framework based on uncertainty prediction and a neighborhood-guided evidence-based contrastive learning scheme. First, we develop an evidence analyzer based on the uncertainty prediction principle of Dempster–Shafer (D–S) evidence theory, which improves the network capability for discriminating different types of samples. The transformer layer with a self-attention module is adopted to capture long-distance feature dependencies such that the proposed network has better generalization ability on multiple domains. Then, we offer a high-confidence target domain sample (HCS) acquisition strategy through evidence theory, entropy criterion, and distance information. A joint confidence enhancement scheme obtains the final HCS that generates pseudo-labels. Finally, we propose an optimization method based on evidence theory, evidence-based comparative learning, and internal neighborhood structure to ensure the separability between classes and compactness within categories. Experimental results show that the proposed framework performs superiorly on two standard datasets on multiple adaptation tasks. The code for this project is available at github.com/oolown/UC-SFDA.

BIOL-24. USING NEEDLE WASH SPECIMEN AFTER STEREOTACTIC BIOPSY TO DEVELOP PDOX MODELS OF DIPG AND DIFFUSE MIDLINE GLIOMAS

Abstract Obtaining viable tissue remains a major barrier for lab-based studies, especially in brain tumors deemed surgically unresectable such as diffuse midline gliomas. Surgical biopsy is performed for those tumors invested in deep and vital brain structures however, biopsied specimens are usually of small volume without additional tissue for research after clinical testing. To overcome the barrier of limited surgical specimen volume, we partnered with neurosurgeons to develop a protocol which procures viable cells from discarded biopsy needle after stereotactic biopsies to develop patient-derived orthotopic xenograft (PDOX) models. After procurement of surgical specimen and prior to disposal of biopsy needle, each stereotactic biopsy needle was washed with FBS media twice. Wash solution was collected and immediately transported on ice to the research lab. Cell number was counted for in vitro culture and for orthotropic in vivo tumor implantation. To date, 29 samples of biopsy needle washes have been obtained including 12 diffuse midline gliomas of the brain stem, 8 supratentorial diffuse midline gliomas, and 3 pineal region tumors with harvested cell number from no visible cells to 5.3 million cells (median 1 million). 14 tumors have been orthotopically implanted into matched locations of immunodeficient mouse brains. Tumor formation was confirmed in 4 out of 15 (28.5%), including 2 brain stem tumors, 1 infiltrating astrocytoma, and 1 midline glioma, after implantation of cell numbers as low as 12,500. 3 models were successfully sub-transplanted to passages II and III. Histological examination confirmed the replication of key pathological features of the originating patient tumors. In conclusion, we have developed a novel protocol to procure clinical specimen by using wash solution of stereotactic brain tumor biopsy needles for surgically unresectable tumors. Our work demonstrates a new possibility for clinical sample acquisition and tumor modeling, opening new frontiers in the field of pediatric brain tumor research.

Maximizing the potential for living cell banks to contribute to global conservation priorities.

Although cryobanking represents a powerful conservation tool, a lack of standardized information on the species represented in global cryobanks, and inconsistent prioritization of species for future sampling, hinder the conservation potential of cryobanking, resulting in missed conservation opportunities. We analyze the representation of amphibian, bird, mammal, and reptile species within the San Diego Zoo Wildlife Alliance Frozen Zoo® living cell collection (as of April 2019) and implement a qualitative framework for the prioritization of species for future sampling. We use global conservation assessment schemes (including the International Union for Conservation of Nature (IUCN) Red List of Threatened Species™, the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES), the Alliance for Zero Extinction, the EDGE of Existence, and Climate Change Vulnerability), and opportunities for sample acquisition from the global zoo and aquarium community, to identify priority species for cryobanking. We show that 965 species, including 5% of all IUCN Red List "Threatened" amphibians, birds, mammals, and reptiles, were represented in the collection and that sampling from within existing zoo and aquarium collections could increase representation to 16.6% (by sampling an additional 707 "Threatened" species). High-priority species for future cryobanking efforts include the whooping crane (Grus americana), crested ibis (Nipponia nippon), and Siberian crane (Leucogeranus leucogeranus). Each of these species are listed under every conservation assessment scheme and have ex situ populations available for sampling. We also provide species prioritizations based on subsets of these assessment schemes together with sampling opportunities from the global zoo and aquarium community. We highlight the difficulties in obtaining in situ samples, and encourage the formation of a global cryobanking database together with the establishment of new cryobanks in biodiversity-rich regions.

Impact of biliary stents in the performance of the EUS-guided tissue acquisition: A systematic review and meta-analysis

Introduction and aimPancreatobiliary tumours are challenging to diagnose exclusively by imaging methods. Although the optimum moment for carrying out the EUS is not well defined, it has been suggested that the presence of biliary stents may interfere with the proper staging of tumours and the acquisition of samples. We performed a meta-analysis to evaluate the impact of biliary stents on EUS-guided tissue acquisition yield. Material and methodsWe conducted a systematic review in different databases, such as PubMed, Cochrane, Medline, and OVID Database. A search was made of all studies published up to February 2022. ResultsEight studies were analyzed. A total of 3185 patients were included. The mean age was 66.9±2.7 years; 55.4% were male gender. Overall, 1761 patients (55.3%) underwent EUS guided tissue acquisition (EUS-TA) with stents in situ, whereas 1424 patients (44.7%) underwent EUS-TA without stents. The technical success was similar in both groups (EUS-TA with stents: 88% vs EUS-TA without stents: 88%, OR=0.92 [95% CI 0.55–1.56]). The type of stent, the needle size and the number of the passes were similar in both groups. ConclusionsEUS-TA has similar diagnostic performance and technical success in patients with or without stents. The type of stent (SEMS or plastic) does not seem to influence the diagnostic performance of EUS-TA. Future prospectives and RCT studies are needed to strengthen these conclusions.

Large-scale clinicogenomic models of solid tumor CNS metastasis.

2037 Background: Central nervous system (CNS) metastasis is a major cause of cancer death and morbidity, but the clinicogenomic covariates of CNS metastasis have been studied in small cohorts. We sought to i) determine whether models predicting patient time to CNS metastasis (ttCNS) trained on a large, automatically annotated clinicogenomic dataset could stratify ttCNS risk in an external, manually curated cohort and ii) use these data to study the genomic risk factors for metastasis at scale. Methods: We leveraged the AACR Project GENIE Biopharma Collaborative (BPC), a structured curation of electronic health records at four cancer centers using the PRISSMM method, to train natural language processing (NLP) algorithms to annotate metastatic sites from radiology reports. We applied these algorithms to all reports for MSK patients with tumor sequencing with our FDA-authorized targeted sequencing platform. We used the resulting clinicogenomic data to train random survival forests (RSF) to predict radiographically confirmed ttCNS from time of sample acquisition for patients with non-small cell lung (NSCLC, N = 7,263), breast (BRC, N = 5,195; HR+ N = 4,050, HER2+ N = 879, triple-negative (TNBC) N = 866), and colorectal cancer (CRC, N = 4,320) using stage, gene-level pathogenic alterations, pre-existing metastatic sites, histopathology, prior and current treatment, and patient demographics as variables, excluding those reaching the endpoint prior to sample acquisition. We also predicted time to bone, liver, and adrenal metastases. RSFs were validated in the manually curated, non-MSK BPC cohort. Results: RSFs had predictive power for ttCNS in validation datasets (NSCLC c-index: 0.66, BRC: 0.71 (HR+ only: 0.71, HER2+ only: 0.69, TNBC: 0.62), CRC: 0.67, all p &lt; 0.001). Pre-existing metastatic involvement, and genomic, histopathologic and clinical features had non-overlapping information for predicting ttCNS. We explored genomic covariates of ttCNS and other sites using Cox proportional hazards models adjusted for disease stage. Within individual cancer types, the hazard ratios of gene-level changes leading to the four considered sites of metastasis were correlated (Pearson R = 0.71-0.98); in all cancer types the highest correlations were between ttCNS and ttAdrenal metastases. Across cancer types, genomic alterations leading to metastatic sites were less correlated (R = -0.22-0.48). For example, CDKN2A/B and MYC alterations shortened ttCNS in NSCLC and HR+ BRC but not in HR- BRC. PTEN was associated with shortened ttCNS in TNBC and NSCLC but not CRC and other breast subtypes. Conclusions: Automatically annotated cohorts provide a means of studying drivers of metastasis at scale. Pre-existing non-CNS sites are associated with shorter ttCNS. Genomic alterations predisposing to CNS metastases frequently predispose to other organ metastases, although in general the genomics of organotropism are highly cancer-specific.

Luminal and basal subtyping of circulating tumor cells and influence on outcomes in patients with metastatic castration-resistant prostate cancer.

e17034 Background: Luminal and basal subtyping using PAM50 classifier and the prostate cancer classification system (PCS) have been shown to predict outcomes and treatment response in prostate cancer (PCa). However, these genomic classifiers rely on the acquisition of tumor samples, which are usually not available in patients with metastatic castration resistant PCa (mCRPC). Circulating tumor cells (CTC) are tumors cells shed into bloodstream and can serve as surrogates of tumor. In this study, we aimed to subtype circulating tumor cells with PAM50 and PCS classifiers and evaluate their prognostic performance in mCRPC patients. Methods: A CTC RNA assay was developed by combining NanoVelcro microfluidic system for enriching CTCs and Nanostring nCounter system for PAM50 and PCS profiling of CTCs. The PAM50 and PCS genes were refined through a bioinformatic pipeline to ensure the specific profiling of CTCs. The classification and prognostic performance of the refined CTC-PAM50 and CTC-PCS gene panels were validated in GenomeDx GRID database. For the clinical study, 50 blood samples from mCRPC patients before the initiation of androgen receptor signaling inhibitors (ARSI) (n = 34) or taxanes (n = 16) were analyzed with the CTC RNA assay. Kaplan-Meier analysis and log-rank test were used to evaluate the association between CTC-PAM50/PCS subtypes and survival. Results: The refined CTC-PAM50 (36 genes) and CTC-PCS (40 genes) classifiers retained their original classification and prognostic performance in the GenomeDx GRID cohort. In the clinical study, the CTC RNA assay classified the 50 mCRPC patients into luminal A (n = 14), luminal B (n = 22), and basal (n = 14) by CTC-PAM50 classifier; and PCS1 (n = 5), PCS2 (n = 24), and PCS3 (n = 21) by CTC-PCS classifier. Overall, patients assigned as PCS1 subtype had shorter overall survival than other subtypes (hazard ratio [HR] = 4.8). In addition, basal or PCS1 subtype showed worse biochemical progression free survival than other subtypes (ARSI group: Basal: HR = 2.5; PCS1: HR = 6.9. Taxanes group: Basal: HR = 5.0; PCS1: HR = 7.2). Conclusions: Luminal and basal subtyping of CTCs is prognostic and provides a noninvasive method for molecular profiling mCRPC patients.

Diagnostic Yield of Transabdominal Ultrasound-Guided Core Needle Method in Biopsies of Pancreatic Lesions.

In this study, it was aimed to contribute to the selection of the method to perform pancreatic lesion biopsies.Data of patients, who had undergone a percutaneous biopsy because of pancreatic masses in our institution in the period between January 2015 and November 2019, were evaluated retrospectively. The percutaneous biopsy method, the type of needle used in the procedure, and periprocedural complications were listed. Pathology and cytology reports in the archive were reviewed, and biopsy results were divided into 3 groups as benign, malignant, and inadequate. Of 308 patients included in the study, the diagnostic accuracy was verified in 124 patients through the assessment of surgical outcomes, results of biopsies from metastatic lesions, or follow-up findings. The verified results were classified as true-positives and true-negatives.Of a total of 308 patients included in the study, 23 underwent a fine-needle aspiration biopsy (FNAB) and 285 underwent a core needle biopsy (CNB). No statistical differences were observed in sample acquisition success and complications between the groups.Of the lesions with a confirmed pathological diagnosis, 67.74% were malignant and 32.26% were benign. The diagnosis was correct in 107 of 112 CNB patients (95.54%) and 9 of 12 FNAB patients (75.00%). When the success of the 2 methods was compared, it was found that outcomes of CNB were statistically more successful compared with those of FNAB.A transabdominal ultrasound-guided percutaneous CNB is a safe method with a high diagnostic yield to perform a biopsy of the pancreas.

Automated quality analysis in continuous downstream processes for small-scale applications

Development of integrated, continuous biomanufacturing (ICB) processes brings along the challenge of streamlining the acquisition of data that can be used for process monitoring, product quality testing and process control. Manually performing sample acquisition, preparation, and analysis during process and product development on ICB platforms requires time and labor that diverts attention from the development itself. It also introduces variability in terms of human error in the handling of samples. To address this, a platform for automatic sampling, sample preparation and analysis for use in small-scale biopharmaceutical downstream processes was developed. The automatic quality analysis system (QAS) consisted of an ÄKTA Explorer chromatography system for sample retrieval, storage, and preparation, as well as an Agilent 1260 Infinity II analytical HPLC system for analysis. The ÄKTA Explorer system was fitted with a superloop in which samples could be stored, conditioned, and diluted before being sent to the injection loop of the Agilent system. The Python-based software Orbit, developed at the department of chemical engineering at Lund university, was used to control and create a communication framework for the systems.To demonstrate the QAS in action, a continuous capture chromatography process utilizing periodic counter-current chromatography was set up on an ÄKTA Pure chromatography system to purify the clarified harvest from a bioreactor for monoclonal antibody production. The QAS was connected to the process to collect two types of samples: 1) the bioreactor supernatant and 2) the product pool from the capture chromatography. Once collected, the samples were conditioned and diluted in the superloop before being sent to the Agilent system, where both aggregate content and charge variant composition were determined using size-exclusion and ion-exchange chromatography, respectively. The QAS was successfully implemented during a continuous run of the capture process, enabling the acquisition of process data with consistent quality and without human intervention, clearing the path for automated process monitoring and data-based control.

A Kriging-assisted global reliability-based design optimization algorithm with a reliability-constrained expected improvement

Surrogate models have been extensively used in reliability-based design optimization (RBDO); however, few studies have focused on the global optimality of RBDO. This paper proposes a global RBDO framework that employs Kriging surrogate models to approximate both the objective function and performance functions. The proposed algorithm comprises two major modules: the global optimization module and the local optimization module. The former module aims to identify the interested region containing potential optima, while the latter module refines the local optima. To address the time-consuming acquisition of samples, two different infill strategies are implemented in these two modules. Furthermore, in addition to evaluating the optimal solution in the local optimization module for infill, a reliability-constrained expected improvement infill criterion is developed for the global optimization module. This criterion inherits the property of the expected improvement from the Kriging model, which balances the exploration and the exploitation of the objective space, while taking reliability into account by introducing the shifting vector into the calculation of the probability of feasibility. Numerical experiments indicate that the performance of the proposed infill criterion is significantly superior to others in searching for optima. Several examples verify the global optimization capability of the proposed algorithm and illustrate that it is more suitable for RBDO problems with multiple local optima.

Pengaruh Kualitas Pelayanan dan Citra Merek terhadap Kepuasan Pelanggan Jasa Transportasi Grab di Sidoarjo

Service Quality and Brand Image included in factors that can influence Customer Satisfaction. For this study aims to carry out an analysis influence about service quality and the influence of brand image for customer satisfaction grab transportation service in Sidoarjo. This population is customers who using Grab transportation services in Sidoarjo, for the sampling method is using a non-probability sampling method. As well as sampling technique for use purposive sampling technique and sample acquisition of 60 samples. This study for method use quantitative and data analysis techniques using PLS. The gain for this study is that Service Quality has a positive influence on customer satisfaction of Grab Transportation Services in Sidoarjo and Brand Image has a positive influence on customer satisfaction of Grab Transportation Services in Sidoarjo.&#x0D; Keywords: Brand Image; Customer satisfaction; Service quality

Direct Immunofluorescence of IgG on Formalin-Fixed Paraffin-Embedded Tissue by Heat-Induced Antigen Retrieval as a Sensitive Method for the Diagnosis of Pemphigus.

Direct immunofluorescence (DIF) on frozen sections (DIF-F) plays a key role in the identification and differential diagnosis of bullous dermatoses, which are a group of critical autoimmune diseases that include pemphigus, bullous pemphigoid (BP), and epidermolysis bullosa acquisita (EBA). However, this technique requires specialized laboratory equipment conditions, sample acquisition and sample preservation. In this study, the application value of DIF on paraffin-embedded tissue sections (DIF-P) detecting IgG using heat-induced antigen retrieval (HIAR) in the diagnosis of bullous dermatosis was explored. Samples from 12 patients with pemphigus vulgaris (PV), 10 patients with pemphigus foliaceus (PF), 17 patients with BP, and 4 patients with EBA were retrospectively studied for DIF-P IgG detection. Formalin-fixed, paraffin-embedded tissue (FFPE) was used, and the antigen retrieval method used in the experiment was HIAR. All patients were diagnosed with the autoimmune bullous disease (AIBD) based on clinical presentation, histopathology, DIF-F, and enzyme-linked immunosorbent assay (ELISA). Intercellular staining for IgG in the epidermis was successful in paraffin-embedded tissue sections in 11 of 12 PV samples and in all 10 PF samples. IgG at the basement membrane zone (BMZ) was not detected by immunofluorescent staining in 17 BP samples and 4 EBA samples. The detection of IgG by DIF-P using HIAR can be used for the diagnosis of pemphigus as an alternative method to DIF-F.

Impact of Variation in Practice in the Prenatal Reporting of Variants of Uncertain Significance by Commercial Laboratories: Need for Greater Adherence to Published Guidelines

ABSTRACT Ultrasound will identify fetal structural anomalies in up to 2% to 3% of pregnancies; these can vary from minor isolated defects to severe multisystem abnormalities. As genetic investigations into the causes can assist with prenatal and perinatal decision-making, various tests exist to assist in this endeavor. Rapid aneuploidy detection and chromosomal microarray analysis are both used for detecting chromosomal aneuploidy and microdeletions or duplications (termed copy number variations) for pregnancies with fetal abnormalities. Approximately 6% of fetuses with identifiable structural abnormalities have pathogenic copy number variations, and 32% have an abnormal karyotype. In the last 8 years, whole exome sequencing (WES) has been used for making a genetic diagnosis in the remaining undiagnosed pregnancies, and a recent meta-analysis determined an exome sequencing diagnostic yield of 31% following nondiagnostic chromosomal microarray analysis or karyotype. Use of exome sequencing is complicated, however, by its association with possibly detecting variants of uncertain significance (VUSs) and pathogenic/likely pathogenic (P/LP) variants in genes possibly noncausal for the prenatal phenotypes. Thus, the value of reporting VUSs is under debate, with various policies worldwide. This study's purpose was to evaluate the clinical impact of WES and targeted panel implementation at the clinical level when fetal structural anomalies suggest a single underlying gene disorder or syndrome. The study focus was the frequency of reporting VUSs, the diagnostic yield, and the contribution of reported VUSs toward a final diagnosis. This retrospective chart review at the Provincial Medical Genetics Program at BC Women's Hospital in Vancouver included patients undergoing WES between January 2016 and December 2020. Amniocentesis was used for obtaining fetal samples, except for 4 cases of sample acquisition at the time of pregnancy termination. A total of 124 patients underwent prenatal WES or panel testing at different commercial laboratories following the identification of fetal structural anomalies by ultrasound. Patients had either WES (n = 90) or panel testing (n = 31), with 3 patients undergoing both, as decided by the ordering clinical geneticist. Genetic diagnoses of variants classified by the laboratory as P or LP were obtained in 20 of 93 patients (21.5%) via prenatal WES and in 9 of 34 patients (26%) who underwent panel testing. The 2 tests' overall diagnostic yield was 23%. Of these, 20 patients (69%) were diagnosed with autosomal dominant disorders. Overall, 32% of patients with panel testing and 42% of patients who had WES had at least 1 VUS, and 23% of WES and 15% of panels reported more than 1 VUS. There was great variation in the reporting of VUSs between laboratories. The study uncovered a lack of strict adherence to guidelines for reporting of prenatal VUSs among various laboratories. One weakness (and strength) of the study is its use of multiple commercial laboratories for the WES, panel testing, and VUS reporting. Although this is beneficial to gain various perspectives (such as the lack of adherence to guidelines), it also diminishes the consistency of the results across the entire study because of varied procedures for diagnoses. In conclusion, this study reports on 124 pregnancies with fetal anomalies at a large tertiary care center experiencing the provision of prenatal WES (or targeted gene panels) with variant interpretation and sequencing outsourced to various laboratories. A result of 23% diagnostic yield for WES and panel testing occurred based on the laboratory-reported LP and P variants. The large number of VUSs reported by laboratories implies significant resource implications due to the time to review evidence and further examine or investigate the fetus and/or parent. This is essential, and the authors emphasize the complex nature of the required posttest genetic counseling. Based on these results, the authors strongly encourage strict adherence to recommendations on VUS reporting in the prenatal setting, with the importance of a multidisciplinary approach bringing laboratory and clinical expertise of prenatal genomics and genetics together.