Good Specificity Research Articles

Asthma diagnosis: a comparison of established diagnostic guidelines in adults with respiratory symptoms

Considerable variability exists between asthma diagnostic guidelines. We tested the performance characteristics of the European Respiratory Society (ERS), the National Institute for Health and Care Excellence (NICE) and the Global Initiative for Asthma (GINA) guidelines for the diagnosis of asthma in adults. In this prospective observational study (ISRCTN-11676160, May 2019-June 2022), participants referred from primary care with clinician-suspected asthma underwent comprehensive investigation including: spirometry, bronchodilator reversibility, fractional exhaled nitric oxide, peak expiratory flow variability, bronchial challenge testing with methacholine and mannitol, and responsiveness to inhaled corticosteroid therapy. Results were reviewed by a panel of asthma specialists to determine asthma diagnosis (reference standard) and compared to each diagnostic test and the ERS, NICE and GINA diagnostic algorithms (index tests). The sensitivity, specificity, positive predictive and negative predictive values were calculated. One hundred and forty adults were enrolled and 118 given a definitive diagnostic outcome [75 female; mean (SD) age 36 (12) years; 70 (59%) with asthma] and included in the analysis. Sensitivity of individual tests was poor (15-62%), but they provided good specificity at the most stringent thresholds (range: 88-100%). The sensitivity/specificity of ERS, NICE and GINA was 81/85%, 41/100% and 47/100%, respectively. Concordance between guidelines was only moderate (Cohen's Kappa 0.45-0.51). Current guidelines for the diagnosis of asthma in adults provide either excellent specificity but low sensitivity (GINA and NICE) or only reasonable sensitivity and specificity (ERS). All guidelines therefore have limitations with regards to their clinical application; new guidelines are needed but should be tested prospectively before roll out. This work was supported by the Manchester NIHR Biomedical Research Centre (BRC) (grant no. BRC-1215-20007, and NIHR203308), Asthma UK/Innovate (grant no. AUK-PG-2018-406), GSK ID 212474 and North West Lung Centre Charity.

Establishment of a Real-Time Fluorescence Isothermal Recombinase-Aided Amplification Method for the Detection of H9 Avian Influenza Virus.

The H9 subtype of avian influenza virus (AIV) has been characterized by its rapid spread, wide range of prevalence, and continuous evolution in recent years, leading to an increasing ability for cross-species transmission. This not only severely impacts the economic benefits of the aquaculture industry, but also poses a significant threat to human health. Therefore, developing a rapid and sensitive detection method is crucial for the timely diagnosis and prevention of H9 AIVs. In this study, a real-time fluorescent reverse transcription recombinase-aided isothermal amplification (RT-RAA) technique targeting the hemagglutinin (HA) of H9 AIVs was established. This technique can be used for detection in just 30 min at a constant temperature of 42 °C, and it exhibits good specificity without cross-reactivity with other viruses. Sensitivity tests revealed that the detection limit of RT-RAA was 163 copies per reaction, and the visual detection limit was 1759 copies per reaction at a 95% confidence interval, both of which are capable of detecting low concentrations of standards. Furthermore, RT-RAA was applied to detect 155 clinical samples, and compared to real-time fluorescent quantitative PCR (RT-qPCR), RT-RAA demonstrated high accuracy, with a specificity of 100% and a kappa value of 0.96, indicating good correlation. Additionally, with the assistance of a portable blue imaging device, we can visually observe the amplification products, greatly facilitating rapid detection in resource-limited environments. The RT-RAA detection method developed in this study does not require expensive equipment or highly skilled staff, making it beneficial for the accurate and low-cost detection of H9 AIVs.

A novel system with robust compatibility and stability for detecting Sugarcane yellow leaf virus based on CRISPR-Cas12a.

Sugarcane yellow leaf virus (SCYLV) can reduce sugarcane productivity. A novel detection system based on reverse transcription-multienzyme isothermal rapid amplification (RT-MIRA) combined with CRISPR-Cas12a, named RT-MIRA-CRISPR-Cas12a, was developed. This innovative approach employs crude leaf extract directly as the reaction template, streamlining the extraction process for simplicity and speed. Combining RT-MIRA and CRISPR-Cas12a in one reaction tube increases the ease of operation while reducing the risk of aerosol contamination. In addition, it exhibits sensitivity equivalent to qPCR, boasting a lower detection limit of 25 copies. Remarkably, the entire process, from sample extraction to reaction completion, requires only 52-57 minutes, just a thermostat water bath. The result can be observed and judged by the naked eye.IMPORTANCESugarcane yellow leaf disease (SCYLD) is an important viral disease that affects sugarcane yield. There is an urgent need for rapid, sensitive, and stable detection methods. The reverse transcription-multienzyme isothermal rapid amplification combined with CRISPR-Cas12a (RT-MIRA-CRISPR-Cas12a) method established in this study has good specificity and high sensitivity. In addition, the system showed good compatibility and stability with the crude leaf extract, as shown by the fact that the crude extract of the positive sample could still be stably detected after 1 week when placed at 4°C. RT-MIRA-CRISPR-Cas12a, reverse transcription polymerase chain reaction (RT-PCR), and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) were used to detect SCYLV on 33 sugarcane leaf samples collected from the field, and it was found that the three methods reached consistent conclusions. This Cas12a-based detection method proves highly suitable for the rapid on-site detection of the SCYLV.

Zika Virus NS1 Protein Detection Using Gold Nanoparticle-Assisted Dynamic Light Scattering.

The Zika virus (ZIKV) is a global health threat due to its rapid spread and severe health implications, including congenital abnormalities and neurological complications. Differentiating ZIKV from other arboviruses such as dengue virus (DENV) is crucial for effective diagnosis and treatment. This study presents the development of a biosensor for detecting the ZIKV non-structural protein 1 (NS1) using gold nanoparticles (AuNPs) functionalized with monoclonal antibodies employing dynamic light scattering (DLS). The biosensor named ZINS1-mAb-AuNP exhibited specific binding to the ZIKV NS1 protein, demonstrating high colloidal stability indicated by a hydrodynamic diameter (DH) of 140 nm, detectable via DLS. In the absence of the protein, the high ionic strength medium caused particle aggregation. This detection method showed good sensitivity and specificity, with a limit of detection (LOD) of 0.96 µg mL-1, and avoided cross-reactivity with DENV2 NS1 and SARS-CoV-2 spike proteins. The ZINS1-mAb-AuNP biosensor represents a promising tool for the early and accurate detection of ZIKV, facilitating diagnostic and treatment capabilities for arboviral infections.

A Novel Colorimetric Biosensor for the Detection of Catalase-Positive Staphylococcus aureus Based on an Onion-like Carbon Nanozyme

Staphylococcus aureus is one of the leading causes of skin and soft tissue infections, and it is even life-threatening if it enters the bloodstream, lung or heart. In the present work, we proposed a novel colorimetric biosensor for the detection of S. aureus through hydrogen peroxide consumption. An onion-like carbon nanozyme with high peroxidase-like activity was prepared, which competed with the endogenous catalase of S. aureus in consuming hydrogen peroxide. This reaction was further characterized by the colorimetric reaction of 3,3′,5,5′-tetramethylbenzidine. The results showed that our approach allowed for the simple and rapid determination of S. aureus, with a linear range of 2 × 104 to 2 × 107 CFU/mL. Moreover, our method displayed good selectivity, with Bacillus subtilis and Escherichia coli showing negligible responses at the concentration of 2 × 105 CFU/mL. The application of the as-prepared biosensor to analyze S. aureus in real water samples yielded recovery rates ranging from 95% to 112%, with relative standard deviations less than 7%. The method demonstrated good accuracy and specificity, which offers a novel approach for the simple and selective detection of S. aureus.

Meta-analysis and systematic review of the diagnostic value of contrast-enhanced spectral mammography for the detection of breast cancer

ObjectiveThe objective is to evaluate the diagnostic effectiveness of contrast-enhanced spectral mammography (CESM) in the diagnosis of breast cancer.DesignData sourcesPubMed, Embase and Cochrane libraries up to 18 June 2022.Eligibility criteria...

Synucleins As Biomarkers of Severity in Autism Spectrum Disorder.

Introduction Autism spectrum disorder (ASD) is a lifelong disorder affecting children quite early in life, manifested as delays in communication and stereotypic behaviors. To date, it is diagnosed clinically using the Diagnostic and Statistical Manual-5 (DSM-V) criteria due to the lack of biomarkers that can specifically denote the disorder. The role of synucleins in this context has been considered due to the increasing evidence of neurodegeneration in many autistic children. Synucleins are a group of soluble neuronal proteins primarily expressed in the central nervous system. They are of three types: α-, β-, and ɣ-synuclein. α-synuclein is involved in vesicle trafficking and release of neurotransmitters. There is no uniformity in the scientific community regarding their levels of autism, with few studies showing increasing levels and others to the contrary. Hence, the present study was conceived to analyze the levels of α-synuclein and β-synuclein in autistic children and to correlate with the disease severity. Objectives The main objectiveof the study was to assess the levels of α- and β-synuclein in autistic children of 2-8 years of age and to identify the correlation between the severity of core symptoms of autism and α- and β-synuclein levels. It is intended to assessthe possibility of using α- and β-synuclein/their ratioas a biomarker of the severity of autism. Materials and methods Plasma levels of α-synuclein and β-synuclein were measured in 160ASD childrenand 40 healthy age and sex-matched children by ELISA. Their symptom severity was assessed with CARS-2 ST and the Indian Scale of Autism Assessment (ISAA). Values of α- and β-synuclein were analyzed for correlation with the severity rating of ASD. Cut-off values ofα-synuclein and β-synuclein that discriminate the presence of autism and its severity were assessed using Jamovi 2.4.14 software. Results The results show that α-synuclein levels were significantly reduced (5.02 ± 0.586; range: 3.13-6.0 ng/ml) when compared with healthy controls (29.47 ± 18.62 ng/ml; range: 22.39- 36.56) with p < 0.001, and β-synuclein levels were elevated (1424 ng/ml ± 122; range: 1229-1616 ng/ml) when compared to control, though not significantly. Plasma levels of α-synuclein significantly correlate with disease severity with good diagnostic accuracy (86%), but β-synuclein levels did not correlate with severity. The fold changes of synucleins, especially the fold decrease in levels of α-synuclein, were discriminative for the diagnosis and severity with good sensitivity (93.6%), specificity (74.3%), positive predictive (92.6%), and negative predictive values (76.5%). The fold increase in β-synuclein did not have any significance in predicting the severity of autism. Conclusion The present study showed thatα-synuclein and β-synuclein were associated with ASD and can be used to assess its severity. A fold decrease inα-synuclein was found to have good discriminating value in differentiating the severity of autism. It may be of use especially in mild and high-functioning autism, when clinically distinguishing them may be difficult.

Performance of Wrist-Worn Pulse Oximeter for the Screening of Obstructive Sleep Apnea.

A sleep apnea monitor (BM2000A) is a wrist-worn device that measures oxygen saturation and pulse rate during sleep. This study aimed to evaluate the efficacy of the watch-like BM2000A for screening obstructive sleep apnea (OSA). 102 patients complaining of sleep breathing disorders were included; 81% were men and 19% were women. All participants underwent overnight simultaneous polysomnography (PSG) and BM2000A sleep monitoring. The number of apneas and hypopneas, apnea-hypopnea index (AHI), percentage of time spent with oxygen saturation under 90%, average oxygen saturation, lowest oxygen saturation, and duration of sleep were computed by the BM2000A and PSG. Then, these parameters were compared to validate the BM2000A. All parameters, measured with BM2000A, had a good correlation (r ≥ 0.6, p < 0.0001) with PSG-derived indexes, except for sleep time (r = 0.19, p = 0.061) and hypopnea index (r = 0.4, p < 0.0001). AHI had the strongest correlation (r = 0.87, p < 0.0001). The mean difference between AHI values calculated with PSG and wrist-worn pulse oximeter (WPO) was -17.66 events/h (95% CI: -50.39 to 15.06). In AHI ≥ 5, BM2000A had 90.7% sensitivity, 100% specificity, 91.2% accuracy, and 0.994 area under the curve. Using AHI ≥ 5, ≥ 15, and ≥30 as the screening criteria, optimal WPO-AHI cutoffs to improve the screening accuracy were 3.10, 8.92, and 13.05. BM2000A-derived results properly correlate with PSG and can provide OSA screening with good sensitivity and specificity.

PREDICTING RISK OF EMPLOYEE INJURY IN A PEDIATRIC HOSPITAL

PURPOSEHealthcare has one of the highest rates of non-fatal occupational injury as compared to other industries. Yet, evaluation of risk determinants and prediction algorithms in hospital settings remains limited. METHODSThis study examines risk factors for employee injuries in a large pediatric hospital and evaluates prediction algorithms using hospital surveillance data, incident reports, and work unit measures such as patient density and employee workload. We employed multiple statistical models and machine learning tools, including logistic regression (LR), random forest (RF), penalized logistic regression (PLR), Naïve Bayes, neural network (NN), XGBoost (XG), and mixed-effects logistic regression (GLMER) to predict employee injury risk for specific time periods. We used cross-validation and receiver-operator characteristic (ROC) curve analyses to assess model performance. RESULTSGLMER, LR, and PLR were superior to other models, with higher AUC values (∼0.76), indicating good discrimination ability, though accuracy and specificity varied across models. RF showed high accuracy and specificity and comparable AUC with the top performing models. Further analyses using GLMER revealed variability in employee injury risk across months, days, and hospital units, identifying peaks on Tuesdays and Saturdays and in April and July, with lows in March and June. CONCLUSIONOur findings highlight the significance of monitoring specific risk factors within pediatric hospital settings and pairing them with appropriate predictive algorithms to effectively predict and mitigate employee injuries. These insights indicate that continuous monitoring may help enhance employee safety. Future work should evaluate additional predictors that may be obtained from individual hospital units, which may inform targeted prevention strategies.

A Study of Cardiac Autonomic Neuropathy in Patient with Diabetes Mellitus.

Atherosclerotic coronary artery disease, diabetic cardiomyopathy, and cardiac autonomic neuropathy (CAN) are the three categories into which the cardiovascular consequences of diabetes can be grouped. After all other potential causes have been ruled out, cardiovascular autonomic neuropathy-often referred to as CAN in the literature-is defined as the impairment of autonomic regulation of the cardiovascular system. Finding people with CAN is crucial because, if detected early enough, comprehensive therapies focusing on lifestyle, glucose management, and cardiovascular risk factors can reverse the course of CAN and delay its progression. In order to better understand CAN in individuals with diabetes mellitus (DM) and how it relates to risk factors, the current study was conducted. Sixty consecutive diabetic patients were selected to be included in our study, diagnosed as per the American Diabetes Association (ADA) and the European Association for the Study of Diabetes. The presence of CAN was assessed with the help of Ewing's Battery, composed of five bedside tests. Out of 60 patients, a total of 53 patients (88.3%) with DM had CAN. Of these, 38.3% showed early CAN, 38.3% showed definite CAN, and 7% showed severe CAN. The abnormal E:I (exhalation/inhalation) ratio, noticed in 75% of patients, was the most frequently observed abnormal autonomic function test that tests the parasympathetic nervous system. The ECG's QTc interval prolongation provides good specificity for diagnosing CAN as well as assessing its severity, but the majority of cases showed low sensitivity. Since CAN has a significant association with mortality, every patient diagnosed with DM should be evaluated for CAN at the time of diagnosis as well as on an annual basis thereafter, as recommended by the ADA. Optimal glycemic management and lifestyle modification at the initial stages of diabetes may prevent CAN-related complications.

AC099850.3 promotes HBV-HCC cell proliferation and invasion through regulating CD276: a novel strategy for sorafenib and immune checkpoint combination therapy

BackgroundThis study investigates the molecular mechanisms of CC@AC&SF@PP NPs loaded with AC099850.3 siRNA and sorafenib (SF) for improving hepatitis B virus-related hepatocellular carcinoma (HBV-HCC).MethodsA dataset of 44 HBV-HCC patients and their survival information was selected from the TCGA database. Immune genes related to survival status were identified using the ImmPort database and WGCNA analysis. A prognostic risk model was constructed and analyzed using Lasso regression. Differential analysis was performed to screen key genes, and their significance and predictive accuracy for HBV-HCC were validated using Kaplan–Meier survival curves, ROC analysis, CIBERSORT analysis, and correlation analysis. The correlation between AC099850.3 and the gene expression matrix was calculated, followed by GO and KEGG enrichment analysis using AC099850.3 and its co-expressed genes. HepG2.2.15 cells were selected for in vitro validation, and lentivirus interference, cell cycle determination, CCK-8 experiments, colony formation assays, Transwell experiments, scratch experiments, and flow cytometry were performed to investigate the effects of key genes on HepG2.2.15 cells. A subcutaneous transplanted tumor model in mice was constructed to verify the inhibitory effect of key genes on HBV-HCC tumors. Subsequently, pH-triggered drug release NPs (CC@AC&SF@PP) were prepared, and their therapeutic effects on HBV-HCC in situ tumor mice were studied.ResultsA prognostic risk model (AC012313.9, MIR210HG, AC099850.3, AL645933.2, C6orf223, GDF10) was constructed through bioinformatics analysis, showing good sensitivity and specificity in diagnostic prediction. AC099850.3 was identified as a key gene, and enrichment analysis revealed its impact on cell cycle pathways. In vitro cell experiments demonstrated that AC099850.3 promotes HepG2.2.15 cell proliferation and invasion by regulating immune checkpoint CD276 expression and cell cycle progression. In vivo, subcutaneously transplanted tumor experiments showed that AC099850.3 promotes the growth of HBV-HCC tumors in nude mice. Furthermore, pH-triggered drug release NPs (CC@AC&SF@PP) loaded with AC099850.3 siRNA and SF were successfully prepared and delivered to the in situ HBV-HCC, enhancing the effectiveness of combined therapy for HBV-HCC.ConclusionsAC099850.3 accelerates the cell cycle progression and promotes the occurrence and development of HBV-HCC by upregulating immune checkpoint CD276 expression. CC@AC&SF@PP NPs loaded with AC099850.3 siRNA and SF improve the effectiveness of combined therapy for HBV-HCC.

Predicting informal dementia caregivers’ desire to institutionalize through mining data from an eHealth platform

BackgroundDementia is a leading factor in the institutionalization of older adults. Informal caregivers’ desire to institutionalize (DI) their care recipient with dementia (PwD) is a primary predictor of institutionalization. This study aims to develop a prediction model for caregivers’ DI by mining data from an eHealth platform in a high-prevalence dementia country.MethodsCross-sectional data were collected from caregivers registering on isupport-portugal.pt. One hundred and four caregivers completed the Desire to Institutionalize Scale (DIS) and were grouped into DI (DIS score ≥ 1) and no DI (DIS score = 0). Participants completed a comprehensive set of sociodemographic, clinical, and psychosocial measures, pertaining to the caregiver and the PwD, which were accounted as model predictors. The selected model was a classification tree, enabling the visualization of rules for predictions.ResultsCaregivers, mostly female (82.5%), offspring of the PwD (70.2), employed (65.4%), and highly educated (M 15 years of schooling), provided intensive care (Mdn 24 h. week) over a median course of 2.8 years. Two-thirds (66.3%) endorsed at least one item on the DIS (DI group). The model, with caregivers’ perceived stress as the root of the classification tree (split at 28.5 points on the Zarit Burden Interview) and including the ages of caregivers and PwD (split at 46 and 88 years, respectively), as well as cohabitation, employed five rules to predict DI. Caregivers scoring 28.5 and above on burden and caring for PwD under 88 are more prone to DI than those caring for older PwD (rules 1–2), suggesting the influence of expectations on caregiving duration. The model demonstrated high accuracy (0.83, 95%CI 0.75, 0.89), sensitivity (0.88, 95%CI 0.81, 0.95), and good specificity (0.71, 95%CI 0.56, 0.86).ConclusionsThis study distilled a comprehensive range of modifiable and non-modifiable variables into a simplified, interpretable, and accurate model, particularly useful at identifying caregivers with actual DI. Considering the nature of variables within the prediction rules, this model holds promise for application to other existing datasets and as a proxy for actual institutionalization. Predicting the institutional placement of PwD is crucial for intervening on modifiable factors as caregiver burden, and for care planning and financing.

Discovery unbalanced DNA mixtures and evaluation mixing ratio via a droplet digital PCR method.

Small amounts of DNA from a perpetrator collected during crime-scene investigations can be masked by large amounts of DNA from the victim. These samples can provide important information for the perpetrator's conviction. Short tandem repeat (STR) detection system is not sensitive enough to detect trace amounts of minor components in unbalanced mixed DNA. We developed a system using droplet digital polymerase chain reaction (ddPCR) capable of discovering trace components and accurately determining the ratio of mixed DNA in extremely unbalanced mixtures. The non-recombining regions of the X chromosome and Y chromosome were quantified in the DNA of male and female mixtures using duplex ddPCR. Absolute quantification of low-abundance portions of trace samples and unbalanced mixtures was done using different mixing ratios. The ddPCR system could be used to detect low-abundance samples with < 5 copies of DNA components in an extremely unbalanced mixture at a mixing ratio of 10000:1. The high sensitivity and specificity of the system could identify the mixing ratio of mixed DNA accurately. A ddPCR system was developed for evaluation of mixed samples of male DNA and female DNA. Our system could detect DNA quantities as low as 5 copies in extremely unbalanced mixed samples with good specificity and applicability. This method could assist forensic investigators in avoiding the omission of important physical evidence, and evaluating the ratio of mixed male/female trace samples.

Bedside-focused transthoracic echocardiography in acute atraumatic thoracic aortic syndrome: a systematic review and meta-analysis of diagnostic accuracy.

The objective of this review is to assess the diagnostic accuracy of bedside-focused transthoracic echocardiography (TTE) in acute atraumatic thoracic aortic syndrome in adults. We performed a systematic review and meta-analysis of publications that described the use of bedside-focused TTE on adults presenting to the emergency care setting with suspected atraumatic thoracic aortic syndrome. Studies were identified using keyword and Medical Subject Heading searches on databases and grey literature, followed by abstract screening and study selection by two independent reviewers. Sixteen studies over six decades were included in the meta-analysis (n = 4569 patients). The prevalence of Type A thoracic aortic dissection was 11% (range 1.4-45.7%) and Type B dissection was 7% (range 1.8-30.55%). Type A dissection through direct visualisation of an intimal flap on TTE (i.e. direct sign) pooled sensitivity and specificity were 89% [95% confidence interval (CI), 82-94%] and 92% (95% CI, 88-95%) respectively. For Type B dissection, the pooled sensitivity was 65% (95% CI, 45-80%) and specificity was 100% (95% CI, 0.69-100%). TTE indirect signs for dissection showed a pooled sensitivity of 64% (95% CI, 5.2-98.2%) and specificity of 94% (95% CI, 92-96.1%) for aortic valve regurgitation, a pooled sensitivity of 92% (95% CI 54-99.2%) and specificity of 87% (95% CI, 62-97%) for thoracic aortic aneurysm and a pooled sensitivity of 39% (95% CI 33.8-45%) and a specificity of 94% (95% CI, 92-95%) for pericardial effusion. In this systematic review and meta-analysis, bedside-focused TTE has a good specificity for Type A and B dissection, but poor sensitivity for Type B, and unclear for intramural haematoma and penetrating aortic ulcer.

Establishment of ELISA method for canine adenovirus type 1.

Canine adenovirus (CAdV) had a high prevalence in fox populations and induced fox encephalitis. No ELISA kits specifically for CAdV-1 antigen had been commercialized for foxes in China. It is crucial to develop a rapid and accurate ELISA method for detecting of CAdV-1. The monoclonal antibodies (mAbs, IgG1A) and HRP-labeled polyclonal antibodies (pAbs) were used to establish the ELISA method in this experiment. The results showed that the optimal concentration and coating time for the mAbs (IgG1A) were 2.15 μg/mL and overnight at 4°C, respectively. The dilution ratio of the HRP-labeled pAbs was 1:2000. Five percent skimmed milk was selected as the blocking agent. The optimal incubation times for blocking, CAdV-1, and HRP-labeled pAbs were all 1 h. The cut-off value for negative rectal swab was determined to be 0.366 ± 0.032. The maximum dilution ratio was 100 TCID50/mL. The ELISA method was positive to CAdV-1, and that was negative to CAdV-2, Canine Parvovirus (CPV) and Canine Distempervirus (CDV). The ELISA method showed good repeatability, sensitivity, and specificity. Compared with RT-PCR, the sensitivity, specificity, and coincidence rates of the ELISA method were 93.75, 90.9, and 92.86%, respectively. These results indicate that the established ELISA method can be used for the large-scale screening and epidemiology surveillance of CAdV-1 in foxes.

Confinement Effect Enhanced Bipolar Electrochemistry: Structural Color Coding Coupled with Wireless Electrochemiluminescence Imaging Technology.

In this work, SiO2/CNTs photonic crystal beads were constructed by doping CNTs into SiO2 photonic crystals, which have an angle-independent responsive structural color and can be used as bipolar electrodes due to their good electrical conductivity. In addition, the bipolar electrode-electrochemiluminescence (BPE-ECL) experiments and finite element simulation prove that the low driving voltage can trigger the bipolar electrode electrochemical reactions by confinement effect. Inspired by this, it is the first to combine the SiO2/CNTs structural color coding scheme with low-drive voltage induced wireless BPE-ECL imaging based on the confinement effect of microchannels to achieve simultaneous immune detection of ovarian cancer biomarkers (CA125, CEA, AFP). The detection limits of successfully constructed high-throughput BPE-ECL biosensor for AFP, CEA, and CA125 are 0.72 ng/mL, 0.95 ng/mL, and 1.03 U/mL, respectively, and have good stability and specificity, which expands the application of electrochemiluminescence and lays a foundation for the development of electrochemiluminescence coding technology.

Research on injury risk of elite male athletes in racing ice sports based on blood indexes.

This study aims to explore the relationship between blood biochemical indexes and injury risk of elite male athletes in racing ice sports. The male athletes compared the demographic indexes, monthly injuries, and longitudinal tracking data. The non-linear relationship was analyzed using an unrestricted cubic spline. Generalized estimating equations estimated the relative risk (OR) of injury occurrence. Receiver operating characteristics and the area under the curve determined diagnostic accuracy. In the snow sledding group, when creatine kinase rises to 489.46 u/L or Testosterone decreases to 41.32 ng/ml, the risk increases by 1.70 times (OR=1.70, p<0.001) and 1.69 times(OR=1.69, p<0.001) with statistical significance. the Creatine kinase (OR=1.01, P=0.007) and Testosterone (OR=1.00, P＜0.001) were included in the injury prediction model. The model exhibits excellent discrimination, with sensitivity and specificity of 82.8% and 86.5%, respectively. In the ice skating group, when Creatine kinase rise to 467.00 u/L, the risk increases by 2.56 times with statistical significance (OR=2.56, p<0.001). Creatine kinase (OR=1.01, P＜0.001) was included in the predictive model. The model demonstrates good discrimination, with sensitivity and specificity of 90.5% and 66.7%, respectively. Creatine kinase and Testosterone are the risk predictors of injury in elite snowmobile male athletes. Creatine kinase is an independent risk factor for injury in elite speed skaters.

Could CT Radiomic Analysis of Benign Adrenal Incidentalomas Suggest the Need for Further Endocrinological Evaluation?

We studied the application of CT texture analysis in adrenal incidentalomas with baseline characteristics of benignity that are highly suggestive of adenoma to find whether there is a correlation between the extracted features and clinical data. Patients with hormonal hypersecretion may require medical attention, even if it does not cause any symptoms. A total of 206 patients affected by adrenal incidentaloma were retrospectively enrolled and divided into non-functioning adrenal adenomas (NFAIs, n = 115) and mild autonomous cortisol secretion (MACS, n = 91). A total of 136 texture parameters were extracted in the unenhanced phase for each volume of interest (VOI). Random Forest was used in the training and validation cohorts to test the accuracy of CT textural features and cortisol-related comorbidities in identifying MACS patients. Twelve parameters were retained in the Random Forest radiomic model, and in the validation cohort, a high specificity (81%) and positive predictive value (74%) were achieved. Notably, if the clinical data were added to the model, the results did not differ. Radiomic analysis of adrenal incidentalomas, in unenhanced CT scans, could screen with a good specificity those patients who will need a further endocrinological evaluation for mild autonomous cortisol secretion, regardless of the clinical information about the cortisol-related comorbidities.

Development and validation of a perivascular space segmentation method in multi-center datasets

BackgroundPerivascular spaces (PVS) visible on magnetic resonance imaging (MRI) are significant markers associated with various neurological diseases. Although quantitative analysis of PVS may enhance sensitivity and improve consistency across studies, the field lacks a universally validated method for analyzing images from multi-center studies. MethodsWe annotated PVS on multi-center 3D T1-weighted (T1w) images acquired using scanners from three major vendors (Siemens, General Electric, and Philips). A neural network, mcPVS-Net (multi-center PVS segmentation network), was trained using data from 40 subjects and then tested in a separate cohort of 15 subjects. We assessed segmentation accuracy against ground truth masks tailored for each scanner vendor. Additionally, we evaluated the agreement between segmented PVS volumes and visual scores for each scanner. We also explored correlations between PVS volumes and various clinical factors such as age, hypertension, and white matter hyperintensities (WMH) in a larger sample of 1020 subjects. Furthermore, mcPVS-Net was applied to a new dataset comprising both T1w and T2-weighted (T2w) images from a United Imaging scanner to investigate if PVS volumes could discriminate between subjects with differing visual scores. We also compared the mcPVS-Net with a previously published method that segments PVS from T1 images. ResultsIn the test dataset, mcPVS-Net achieved a mean DICE coefficient of 0.80, with an average Precision of 0.81 and Recall of 0.79, indicating good specificity and sensitivity. The segmented PVS volumes were significantly associated with visual scores in both the basal ganglia (r = 0.541, p < 0.001) and white matter regions (r = 0.706, p < 0.001), and PVS volumes were significantly different among subjects with varying visual scores. Segmentation performance was consistent across different scanner vendors. PVS volumes exhibited significant associations with age, hypertension, and WMH. In the United Imaging scanner dataset, PVS volumes showed good associations with PVS visual scores evaluated on either T1w or T2w images. Compared to a previously published method, mcPVS-Net showed a higher accuracy and improved PVS segmentation in the basal ganglia region. ConclusionThe mcPVS-Net demonstrated good accuracy for segmenting PVS from 3D T1w images. It may serve as a useful tool for future PVS research.

Echocardiographic image quality deteriorates with the severity of cardiogenic shock

BackgroundTransthoracic echocardiography (TTE) is the primary tool for assessing left ventricular (LV) function in cardiogenic shock (CS). However, inadequate image quality often hinders it. In this retrospective study, we investigated factors associated with LV image quality in patients admitted to the intensive care unit (ICU) with ischemic CS.ResultsTwo critical care physicians accredited in echocardiography independently reviewed the TTEs of 100 patients admitted to our tertiary cardiac ICU with ST-elevation myocardial infarction complicated by CS between October 2016 and September 2019. Endocardial border definition (EBD) was graded for each myocardial segment of the apical 4-chamber and 2-chamber views using a conventional scoring system (1 = good, 2 = suboptimal, 3 = poor, and 4 = not possible). The biplane EBD index (EBDi) was calculated by averaging all segments from both views. An average EBDi of both observers was correlated with clinical and echocardiographic parameters. The median age was 62 years [54, 73], and 78% were males. LV ejection fraction and cardiac index (CI) medians were 29% [20, 35] and 1.93 l/min/m2 [1.40, 2.51], respectively. The median biplane EBDi was nearly suboptimal (1.833 [1.542, 2.083]). There was no correlation between EBDi and age, sex, or body mass index. However, biplane EBDi demonstrated statistically significant correlations with PaO2 (r2 = 0.066, p = 0.01), mean arterial pressure (MAP, r2 = 0.055, p = 0.03), CI (r2 = 0.105, p < 0.01), tricuspid annulus systolic velocity (RV S’, r2 = 0.092, p = 0.01), and tricuspid regurge maximum velocity (TR Vmax, r2 = 0.067, p = 0.01). In a multivariate model, only CI correlated independently with EBDi (r2 = 0.105, p < 0.01). The biplane EBDi predicted CI (area under the curve (AUC) 0.70, p = 0.001) with good sensitivity (71%) and reasonable specificity (61%).ConclusionsThe study suggests that in patients admitted to the ICU with ischemic CS, LV image quality by TTE deteriorates with the severity of shock, as indicated by CI.