Test Pattern Research Articles

A comparison of healthcare utilization and outcomes following skin vs. serum-specific IgE allergy testing

Objective To compare the cost, healthcare utilization, and outcomes between skin and serum-specific IgE (sIgE) allergy testing. Methods This retrospective cohort study used IBM® MarketScan claims data, from which commercially insured individuals who initiated allergy testing between January 1 and December 31, 2018 with at least 12 months of enrollment data before and after index testing date were included. Cost of allergy testing per patient was estimated by testing pattern: skin only, sIgE only, or both. Multivariable linear regression was used to compare healthcare utilization and outcomes, including office visits, allergy and asthma-related prescriptions, and emergency department (ED) and urgent care (UC) visits between skin and sIgE testing at 1-year post testing (α = 0.05). Results The cohort included 168,862 patients, with a mean (SD) age of 30.8 (19.5) years; 100,666 (59.7%) were female. Over half of patients (56.4%, n = 95,179) had skin only testing, followed by 57,291 patients with sIgE only testing and 16,212 patients with both testing. The average cost of allergy testing per person in the first year was $430 (95% CI $426–433) in patients with skin only testing, $187 (95% CI $183–190) in patients with sIgE only testing, and $532 (95% CI $522–542) in patients with both testing. At 1-year follow-up post testing, there were slight increases in allergy and asthma-related prescriptions, and notable decreases in ED visits by 17.0–17.4% and in UC visits by 10.9–12.6% for all groups (all p < 0.01). Patients with sIgE-only testing had 3.2 fewer allergist/immunologist visits than patients with skin-only testing at 1-year follow-up (p < 0.001). Their healthcare utilization and outcomes were otherwise comparable. Conclusions Allergy testing, regardless of the testing method used, is associated with decreases in ED and UC visits at 1-year follow-up. sIgE allergy testing is associated with lower testing cost and fewer allergist/immunologist visits, compared to skin testing.

Abstract PO4-08-05: Disparities in Genetic Testing Patterns and Positivity Among Patients with Breast Cancer in the CancerLINQ Real-World Oncology Database

Abstract Introduction: Indications for hereditary genetic testing (GT) continue to expand among breast cancer patients (pts), with some guidelines suggesting offering germline GT to all pts diagnosed with breast cancer. The objective of this study was to explore patterns of germline GT and prevalence of pathogenic and likely pathogenic variant (PV) frequency by age, sex, race and ethnicity, and stage at diagnosis within a large, real world oncology database. Methods: The American Clinical Society for Oncology CancerLINQ Discovery breast dataset was used to identify pts with a stage 0-III breast cancer diagnosis who underwent breast surgery at initial diagnosis from 1990-2022. Genetic testing was identified as an available test result from at least one of the following genes: BRCA1/2, ATM, CHEK2, PALB2, TP53, BARD1, BRIP1, CDH1, MHL1, MSH2, MSH6, NF1, RAD51C, or RAD51D. Descriptive statistics were used for comparisons, and adjusted multivariable regression predicting receipt of GT was performed. Results: Overall, 76,978 pts with breast cancer were identified. Of these, 16,284 (21.1%) underwent GT. There were differences in the proportion of pts that underwent GT by age, sex, self-reported race and ethnicity, and stage at diagnosis (Table). Genetic testing decreased with increasing age (59.2% in &amp;lt; 40 vs 7.5% in &amp;gt;=70, p&amp;lt; 0.001) and was more common in men (45.9% vs 21.1% of women, p&amp;lt; 0.001). Genetic testing rates ranged from 18.1-27.7% by race and ethnicity (p&amp;lt; 0.001), with the lowest rates in Non-Hispanic Black (18.1%) and American Indian/Alaskan Native pts (18.2%) and the highest rate in Hispanic pts (27.7%). Genetic testing also differed by stage at diagnosis, with 19.3% of stage I pts vs 25.7% of stage III pts having genetic testing (p&amp;lt; 0.001). On multivariable analysis adjusted for age, sex, race and ethnicity, and stage, male sex was associated with increased likelihood of GT (OR 5.12, 95% CI 4.04-6.49 compared to female sex, p&amp;lt; 0.001) while increasing age (OR 0.05, 95% CI 0.04-0.06 in age &amp;gt;=70 compared to age &amp;lt; 40, p&amp;lt; 0.001) and Non-Hispanic Black or American Indian/Alaskan Native race and ethnicity were associated with decreased likelihood of GT (OR 0.69, 95% CI 0.65-0.73 for Non-Hispanic Black and OR 0.71, 95% CI 0.50-1.00 for American Indian/Alaskan Native pts, compared to Non-Hispanic White pts, p&amp;lt; 0.001); stage was not independently associated with GT. Among those that had GT, PVs were detected in 2,974 (18.3%) pts. PVs were more common in pts &amp;lt; 40 years (27.3% vs 15.0-17.6% in pts &amp;gt;=40, p&amp;lt; 0.001) and in men (26.4% vs 18.2% in women, p&amp;lt; 0.001). Compared by race and ethnicity, PVs were highest among American Indian/Alaskan Native patients (30.2%) and lowest in Non-Hispanic White and Asian/Pacific Islander patients (18.6% and 17.0%, respectively, p&amp;lt; 0.001). There was also a higher prevalence PVs with increasing stage (16.5% for stage 0 and 23.8% for stage III, p&amp;lt; 0.001). Among those with PVs, the distribution was as follows: BRCA1 n=937 (31.5%), BRCA2 n=1176 (39.5%), TP53 n=315 (10.6%), CHEK2 n=238 (8.0%), ATM n=214 (7.2%), and PALB2 n=200 (6.7%). Conclusions: Differences in patterns of GT and PV frequency by age, sex, race and ethnicity, and stage were prevalent. Importantly, despite lower rates of GT, PV frequencies were similar or higher among minority patients and similar among all pts aged 40 and older. Inclusive testing practices and expansion of genetic testing coverage are needed to work towards equitable access to and acceptance of genetic testing. Table. Genetic Testing And Positivity Rates Citation Format: Olga Kantor, Alyssa Jones, Brittany Bychkovsky, Alison Laws, Anna Weiss, Huma Rana, Judy Garber, Rochelle Scheib, Marianna Chavez, Erica Mayer, Tari King, Elizabeth Mittendorf. Disparities in Genetic Testing Patterns and Positivity Among Patients with Breast Cancer in the CancerLINQ Real-World Oncology Database [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-08-05.

Abstract PS04-02: BRCA testing and PARP inhibitor utilization in real-world HER2-negative metastatic breast cancer

Abstract Background: PARP inhibitors (PARPi) have demonstrated progression-free survival benefits vs. chemotherapy in patients (pts) with metastatic breast cancer (mBC) and germline BRCA mutations (gBRCAm). NCCN guidelines recommend that all pts with mBC are offered gBRCAm testing to aid in systemic treatment decisions with PARPi. Understanding real-world gBRCAm testing patterns and PARPi use would be beneficial for improving clinical outcomes of pts with gBRCAm mBC. Methods: This retrospective cohort study identified pts ≥ 18 years old with HER2-negative mBC, diagnosed from 2014 to 2022 (US Flatiron Electronic Health Record database). gBRCAm testing patterns in mBC over time were examined by BC subtype (hormone receptor-positive [HR+] or triple-negative breast cancer [TNBC]) and disease stage at diagnosis [de novo or recurrent]). Timing of gBRCAm testing and subsequent initiation of first-line or later PARPi in pts with gBRCAm HR+ and TNBC mBC was assessed in pts diagnosed after 2018 when PARPi were approved in mBC. Prevalence of gBRCAm was calculated overall and by mBC subtype. Demographic and clinical characteristics were described by gBRCAm testing and PARPi initiation (yes/no). Real-world overall survival (OS) by PARPi use since mBC diagnosis was estimated using the Kaplan-Meier method and a log-rank test. Results: Of 15,006 total pts, 4654 (31.0%) had a gBRCAm test. Compared with pts who were not tested, gBRCAm-tested pts were younger at initial mBC diagnosis (median age: 53.5 vs. 62.0 years), had a shorter median disease-free interval before mBC diagnosis (821 vs. 959 days), and were less likely to have de novo mBC (28.0% vs. 31.2%). gBRCAm testing prevalence was 6.1% in the HR+ group (n=11,945) and 8.9% in the TNBC group (n=2430). gBRCAm testing rates mostly increased from 2014 to 2022 and were lowest in HR+ tumor subtypes; &amp;lt; 2/3 of all pts had a gBRCAm test from 2020 onwards (Table). Most pts with recurrent mBC (HR+: 68.3%; TNBC: 76.1%) were gBRCAm tested before diagnosis, whereas pts with de novo mBC were tested at a later timepoint ( &amp;gt; 60 days after mBC diagnosis – HR+: 48.3%; TNBC: 38.4%). Of all pts with gBRCAm diagnosed from 2018 onwards (n=187), 44.4% initiated PARPi. A higher proportion of pts with gBRCAm in the TNBC group initiated PARPi (52.9%) than in the HR+ group (42.4%). Pts with gBRCAm in the TNBC group received PARPi earlier than pts with gBRCAm in the HR+ group (mean days from mBC diagnosis to first PARPi use: 173 and 411 days, respectively). Fewer pts with de novo mBC (35.7%) initiated PARPi than pts with recurrent mBC (50.8%). With a median follow-up of 15.3 months, pts with gBRCAm initiated on PARPi had numerically longer median OS (32.3 months [95% CI: 24.2–47.4]) than PARPi non-initiators (21.4 months [95% CI:18.4–43.5]). OS results should be regarded with caution due to the small sample size (n=187). Conclusions: Despite NCCN guideline gBRCAm-testing recommendations, &amp;lt; 2/3 of pts with HER2-negative mBC in our study were gBRCAm tested from 2020 onwards. gBRCAm testing was lower in pts with HR+ disease and was performed at a later timepoint for pts with de novo disease. Wider and timelier implementation of gBRCAm testing to identify pts that could benefit from PARPi is warranted. Fewer pts with gBRCAm who had HR+ tumors or de novo disease received PARPi than pts with TNBC. Our data suggest that pts who initiated PARPi had numerically longer OS than PARPi non-initiators; further research into OS trends and PARPi use in gBRCAm mBC would be of interest. Editorial acknowledgment: Medical writing assistance was provided by Leigh-Ann Booth, Ph.D. from BOLDSCIENCE Inc., funded by AstraZeneca and Merck Sharp &amp; Dohme LLC, a subsidiary of Merck &amp; Co., Inc., Rahway, NJ, US Legal entity responsible for the study: AstraZeneca. Funding: This study was supported by AstraZeneca and Merck Sharp &amp; Dohme LLC, a subsidiary of Merck &amp; Co., Inc., Rahway, NJ, US, who are codeveloping olaparib. Table. gBRCAm testing rates over time in pts with HER2-negative mBC HER2-negative mBC is defined as IHC 0, or 1-positive, or IHC2-positive/ISH-negative. *Olaparib approved in mBC; †Olaparib approved in eBC. eBC, early breast cancer; gBRCAm, germline breast cancer gene mutation; HER2, human epidermal growth factor receptor 2; HR, hormone receptor; IHC, immunohistochemistry; ISH, in situ hybridization; mBC, metastatic breast cancer; pt, patient; TNBC, triple-negative breast cancer. Citation Format: Siddhartha Yadav, Sam Hillman, Linlin Luo, Weiyan Li, Jagadeswara Earla, Xiaoqing Xu. BRCA testing and PARP inhibitor utilization in real-world HER2-negative metastatic breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS04-02.

Pattern of drug abuse testing and association with medical complications: A single tertiary care experience

Pattern of drug abuse testing and association with medical complications: A single tertiary care experience

Trends in RSV testing patterns among infants presenting with bronchiolitis: Results from four United States health systems, 2015-2023

BackgroundBronchiolitis due to respiratory syncytial virus (RSV) is the leading cause of hospitalization among American infants. The overall burden of RSV among infants has been historically under-estimated due to variable testing practices, particularly in the outpatient setting. Universal masking and social distancing implemented during the coronavirus disease 2019 (COVID-19) pandemic altered RSV seasonality, however potential consequences on RSV testing practices across different healthcare settings and sociodemographic groups have not been described. Variable testing practices could also affect accurate assessment of the effects of two recently approved RSV preventative agents targeting infants. MethodsUtilizing real-time clinical and viral surveillance, we examined RSV testing practices among infants with bronchiolitis within four United States healthcare systems across different healthcare settings and sociodemographic groups pre- and post-COVID-19. ResultsRSV testing among infants with bronchiolitis increased since 2015 within each healthcare system across all healthcare settings and sociodemographic groups, with a more dramatic increase since the COVID-19 pandemic. Outpatient testing remained disproportionately low compared to hospital-based testing, although there were no major differences in testing frequency among sociodemographic groups in either setting. ConclusionsAlthough RSV testing increased among infants with bronchiolitis, relatively low outpatient testing rates remain a key barrier to accurate RSV surveillance.

Detection and antibiogram of bacterial contaminants in some commonly consumed indigenous street vended foods in Kasua Central Market in Kaduna North, Kaduna State, Nigeria

Some indigenous ready-to-eat foods, due to its affordability and availability serve as a major alternative to restaurants and high profiled eateries in developing countries. The hygiene standard of these foods is a critical point that needs to be considered due to microbial contamination by potential pathogens. A triplicate of three different food samples: Fura, Nunu, and Tuwo were collected and analysed to determine their microbiological safety. Bacterial isolates were identified using standard methods while antibiotic sensitivity test and multiple drug resistance pattern were carried out. The isolated bacteria: Escherichia coli, Klebsiella pneumoniae, Salmonella 100yphi, Staphylococcus aureus, and Enterobacter sp. While fungal isolates include: Aspergillus niger, Aspergillus flavus, Rhizopus. oryzae and Penicillium sp. Salmonella sp. was observed to be resistant to 70% of the antibiotics while both Klebsiella sp. And Enterobacter sp. exhibited resistance to 60% of the tested antibiotics. S. aureus had the least resistance to about 30% of the tested Gram-positive antibiotics. Out of all the tested antibiotics, only Tarivid was observed to be effective against all the Gram-negative bacterial isolates, while Reflacine and Ciprofloxacine were effective against 80% of them. The presence of coliform bacteria in the sampled foods raise a great concern about the safety of the street vended foods in the sampled region in Nigeria. The microbiologically low quality of the vended ready-to-eat foods assayed in this study might have resulted from a relatively low level of hygiene observed by the vendors, as well as absence of regulatory body or hygiene codes to guide the street food vendors. From the results of this study, efforts should be intensified by all concerned to make sure that the safety of people remains paramount in the ways the vended foods are produced and distributed.

Molecular Diagnostics and Treatment Patterns in Metastatic Non-small Cell Lung Cancer Patients: Real World Evidence from Greece: LACHESIS Study.

Lung cancer, primarily non-small cell lung cancer (NSCLC), is the leading cause of cancer deaths globally. In Greece in 2020, 8,960 new cases were reported. NSCLC's 5-year survival rates range from 54% (stage I) to less than 2% (stage IV); however, innovative therapies like immune check points inhibitors (ICIs) and targeted treatments have notably enhanced outcomes. The aim of this study was to assess the 1st and 2nd line treatment patterns with the introduction of new treatment modalities. Additionally, we evaluated biomarker testing approaches in NSCLC. LACHESIS was a retrospective multinational study, collecting and analyzing data from adult patients from Russia, Bulgaria, and Greece with metastatic NSCLC either newly diagnosed or relapsed from earlier stages, who had the option to undergo biomarker testing (genetic alterations/programmed death-ligand 1 protein expression levels, PD-L1), and who received 1st line treatment for squamous (SQ) or non-squamous (N-SQ) NSCLC. Subsequent lines of therapy were also reported. The Greek site registered retrospective data from 250 NSCLC patients, of whom 206 were newly diagnosed (ND) metastatic NSCLC patients and 44 were patients relapsed from earlier stages. Seventy-two had SQ NSCLC and 169 had N-SQ NSCLC. For these patients, treatment patterns including immunotherapy±chemotherapy combinations were recorded. Biomarker testing patterns, including genetic alterations and PD-L1 expression levels were also documented. LACHESIS provides treatment patterns and biomarker testing data. Greek patients were treated according to international guidelines, with immunotherapy as a viable option, particularly for PD-L1 levels over 50%. Biomarker testing, crucial for non-squamous (N-SQ) cases, should yield timely results for driver mutations, prioritizing patient benefits.

Translating Test Responses to Images for Test-termination Prediction via Multiple Machine Learning Strategies

Failure diagnosis is a software-based data-driven procedure. Collecting an excessive amount of fail data not only increases the overall test cost but can also potentially reduce diagnostic resolution. Test-termination prediction is thus proposed to dynamically determine which failing test pattern to terminate testing, producing an amount of test data that is sufficient for an accurate diagnosis analysis. In this work, we describe a set of novel methods utilizing advanced machine learning techniques for efficient test-termination prediction. To implement this approach, we first generate images representing failing test responses from failure-log files. These images are then used to train a multi-layer convolutional neural network (CNN) incorporating a residual block. The trained CNN model leverages the images and known diagnostic results to determine the optimal test-termination strategy within the testing process, ensuring efficient and high-quality diagnosis. In addition to the integration of test response-to-image translation, our approach harnesses two cutting-edge learning strategies to enhance fail data and boost performance in subsequent tasks. The first strategy is transfer learning, which utilizes sample-label information from one circuit to guide the decision of whether to continue or stop testing for another circuit lacking labels. The second strategy involves the use of a generative deep model to generate fail data in the form of synthetic images. This technique increases the modeling effectiveness by expanding the volume of training samples. Experimental results conducted on actual failing chips and standard benchmarks validate that our proposed method surpasses existing approaches. Our method creates opportunities to harness the power of recent advances in machine learning for improving test and diagnosis efficiency.

Changing patterns of routine laboratory testing over time at children's hospitals.

Research into low-value routine testing at children's hospitals has not consistently evaluated changing patterns of testing over time. To identify changes in routine laboratory testing rates at children's hospitals over ten years and the association with patient outcomes. We performed a multi-center, retrospective cohort study of children aged 0-18 hospitalized with common, lower-severity diagnoses at 28 children's hospitals in the Pediatric Health Information Systems database. We calculated average annual testing rates for complete blood counts, electrolytes, and inflammatory markers between 2010 and 2019 for each hospital. A > 2% average testing rate change per year was defined as clinically meaningful and used to separate hospitals into groups: increasing, decreasing, and unchanged testing rates. Groups were compared for differences in length of stay, cost, and 30-day readmission or ED revisit, adjusted for demographics and case mix index. Our study included 576,572 encounters for common, low-severity diagnoses. Individual hospital testing rates in each year of the study varied from 0.3 to 1.4 tests per patient day. The average yearly change in hospital-specific testing rates ranged from -6% to +7%. Four hospitals remained in the lowest quartile of testing and two in the highest quartile throughout all ten years of the study. We grouped hospitals with increasing (8), decreasing (n = 5), and unchanged (n = 15) testing rates. No difference was found across subgroups in costs, length of stay, 30-day ED revisit, or readmission rates. Comparing resource utilization trends over time provides important insights into achievable rates of testing reduction.

Advanced tensile fracture analysis of alumina ceramics: Integrating hybrid finite-discrete element modeling with experimental insights

This study offers novel insights into the Mode I tensile response of an alumina ceramic through the use of computational modeling and the flattened Brazilian disk (FBD) experiments. A modified hybrid finite-discrete element method (HFDEM) is developed, integrating a coupled damage and friction cohesive model and a microscopic stochastic fracture model with a Weibull strength distribution by Monte Carlo simulation. The model is used to simulate direct tensile failure processes under quasi-static loading conditions, providing qualitative and quantitative predictions of direct tensile failure processes of an alumina ceramic. Concurrently, quasi-static flattened Brazilian disk tests (indirect tensile tests) are performed on a standard MTS machine coupled with a high-speed camera. The modified HFDEM model is also applied to reproduce the FBD experiments, and our simulated tensile strength is consistent with the experimental results. The results of the modified HFDEM model show three kinds of phenomena (i.e., “underestimation”, “reasonable estimation”, and “overestimation” of the indirect tensile strength) and four different types of associated fracture and fragment patterns of FBD testing. The integration of simulation and experimental results reveal relationships between fracture patterns, fragment geometry, tensile strength, and indirect tensile strength. The fracture and fragmentation patterns derived from our modified HFDEM model can be utilized to analyze the “tensile strength” measured in BD testing. Overall, this research offers important insights and direction for future Brazilian disk experiments and tensile strength assessments, enhancing our comprehension of ceramic failure mechanisms under tensile loadings.

Applying Genetic Algorithm for test pattern generation process optimization

Applying Genetic Algorithm for test pattern generation process optimization

A novel dynamic/adaptive K-nearest neighbor model for the prediction of solar photovoltaic systems’ performance

The inherent variability in solar Photovoltaic (PV) systems motivates developing dynamic and adaptive data-driven models capable of accurately predicting the systems’ performance. A dynamic/adaptive K-Nearest Neighbor (K-NN) model to estimate the conversion efficiency of a solar PV system is proposed in this work. The proposed model estimates the conversion efficiency of a test pattern based on three steps: (i) identifying the similar historical operational conditions experienced by the system, (ii) assigning a weight to each condition based on its similarity to the test pattern at hand, and (iii) computing the weighted average conversion efficiency of the test pattern. Thus, the proposed model is adaptive and dynamic as the nearest neighbors and the associated weights vary from one test pattern to another. The proposed model is applied to a 7.98 kWp rooftop grid-connected solar PV system at the Hashemite University in Jordan. Its effectiveness is evaluated by resorting to the Mean Square Error (MSE), Accuracy, Coefficient of Determination (R2), and Adjusted R2 (R2adjusted), and comparing the results with the traditional K-NN and other techniques adequately developed in the same context, such as Artificial Neural Network (ANN), Extreme Learning Machine (ELM), and Multiple Linear Regression (MLR). Results show that the proposed model exhibited superior performance across all metrics, with a performance gain reaching up to 45.2 % and 6.8 % for the MSE and R2adjusted, respectively, compared to the base MLR. Further, the simplicity and computational efficiency of the proposed model validate its practical deployment in predicting PV system performance.

Cohort profile: A population-based record linkage platform to address critical epidemiological evidence gaps in respiratory syncytial virus and other respiratory infections

IntroductionThe Western Australia (WA) Respiratory Infections Linked Data Platform is a population-based cohort established to investigate the epidemiology of RSV and other respiratory infections in children aged 0-10 years, incorporating microbiological testing patterns, hospital admissions, emergency department presentations, and socio-demographic data. MethodsThe cohort was formed through individual linkages between datasets from the WA Department of Health including the Birth and Death Registry, Midwives Notification System (MNS), Hospital Morbidity Data Collection, Emergency Department Data Collection, WA Notifiable Diseases Database, WA Register of Developmental Anomalies, WA Cerebral Palsy Register, WA Antenatal Vaccination Database, WA Family Connections, and PathWest Respiratory Virus Surveillance Data. Hospitalisations and emergency department presentations were temporally linked to routine respiratory viral surveillance data. ResultsThe cohort consists of 368,830 WA births between 1 January 2010 and 31 December 2020 with accompanying perinatal and demographic data, and with secondary care follow-up to 30 June 2022. Of these births, 24,660 (6.7%) identify as Aboriginal. A total of 4,077 (1.1%) children died from all causes during the study period (2010-2020), and 9.2% (33,818) of children were born preterm (&lt;37 weeks). ConclusionThe Respiratory Infections Linked Data Platform enables epidemiological investigations, identifying virus-specific risk groups, risk factors, clinical presentation, viral testing patterns, long-term impacts and accurate measures of viral incidence rates in risk and population sub-groups This will not only aid in the calculation of cost-effectiveness estimates of interventions such as immunisations, but also provide guidance for design and implementation of such programs to priority groups. The Respiratory Infections Linked Data Platform will also enable evaluation of the direct and indirect effects of maternal and infant vaccines and new therapeutics. Analyses using this platform will also generate epidemiological data needed for other respiratory viruses on the vaccine pipeline such as parainfluenza virus and human metapneumovirus.

Repeat Next-Generation Sequencing Testing on Progression in Men With Metastatic Prostate Cancer Can Identify New Actionable Alterations.

There are limited data available on the real-world patterns of molecular testing in men with advanced prostate cancer. We thus sought to evaluate next-generation sequencing (NGS) testing in the United States, focused on single versus serial NGS testing, the different disease states of testing (hormone-sensitive v castration-resistant, metastatic vs nonmetastatic), tissue versus plasma circulating tumor DNA (ctDNA) assays, and how often actionable data were found on each NGS test. The Prostate Cancer Precision Medicine Multi-Institutional Collaborative Effort clinical-genomic database was used for this retrospective analysis, including 1,597 patients across 15 institutions. Actionable NGS data were defined as including somatic alterations in homologous recombination repair genes, mismatch repair deficiency, microsatellite instability (MSI-high), or a high tumor mutational burden ≥10 mut/MB. Serial NGS testing (two or more NGS tests with specimens collected more than 60 days apart) was performed in 9% (n = 144) of patients with a median of 182 days in between test results. For the second NGS test and beyond, 82.1% (225 of 274) of tests were from ctDNA assays and 76.1% (217 of 285) were collected in the metastatic castration-resistant setting. New actionable data were found on 11.1% (16 of 144) of second NGS tests, with 3.5% (5 of 144) of tests detecting a new BRCA2 alteration or MSI-high. A targeted therapy (poly (ADP-ribose) polymerase inhibitor or immunotherapy) was given after an actionable result on the second NGS test in 31.3% (5 of 16) of patients. Repeat somatic NGS testing in men with prostate cancer is infrequently performed in practice and can identify new actionable alterations not present with initial testing, suggesting the utility of repeat molecular profiling with tissue or blood of men with metastatic castration-resistant prostate cancer to guide therapy choices.

Improving soft X-ray imaging contrast uniformity of 50nm Au zone plate by optimizing pulse plating

The Fresnel zone plate plays a pivotal role in X-ray imaging systems, directly influencing the uniformity of imaging contrast. Achieving uniform imaging contrast imposes stringent requirements on the linewidth and height uniformity of the zone plate. The current mainstream method for zone plate fabrication involves utilizing electron beam lithography in conjunction with electroplating. However, in structures with large aspect ratios, precise deposition of gold to the bottom of the trench through electroplating becomes increasingly challenging to control. In this study, we employed a pulse plating process to enhance the uniformity of the plating height. Detailed investigations were conducted to analyze the effects of pulse current density, pulse duty cycle, and pulse frequency on plating height. Utilizing pulse plating, we successfully fabricated a zone plate with an outermost width of 50 nm and a thickness of approximately 245 nm. Structural analysis showed that the plating height uniformity is improved to better than 5%. The high uniformity imaging pattern was obtained by using the Siemens star test pattern at the soft x-ray imaging station at NSRL. The spatial resolution was down to 50 nm.

Retrospective Analysis of Antimicrobial Susceptibility Pattern of Pseudomonas aeruginosa from Clinical Samples of Dogs in Grenada, West Indies

Background: Clinical infections caused by multidrug-resistant pathogenic bacteria are associated with increased morbidity and mortality, imposing a severe economic burden. Pseudomonas aeruginosa, a gram-negative bacterium, had demonstrated a prominent level of acquired antimicrobial resistance to its selective antimicrobials. Currently, there is no updated information about the antimicrobial susceptibility pattern of Pseudomonas aeruginosa in Grenada. Hence, the present study aimed to determine the antimicrobial susceptibility pattern of P. aeruginosa from the clinical isolates of dogs in Grenada. Methods: This retrospective study used the diagnostic reports from January 2015 to December 2022. The diagnostic microbiology laboratory reports of canine patients at the Small Animal Clinic of St. George’s University in Grenada were analyzed to study the antimicrobial susceptibility pattern of P. aeruginosa. Result: Among the various bacterial clinical isolates, ninety-one clinical samples were positive for P. aeruginosa. The antimicrobial susceptibility test pattern of these isolates revealed susceptibility to gentamicin (95.6 %), ceftazidime (96.7%), imipenem (97.7%) and ciprofloxacin (97.8%). The result of the present retrospective study illustrates that P. aeruginosa isolates from canine patients in Grenada are susceptible to the recommended antimicrobial drugs. However, this study also revealed the recent development of progressive antimicrobial resistance. This mandates the judicious use of antibacterial drugs against bacterial infections in Grenada.

Memristive Explainable Artificial Intelligence Hardware.

Artificial intelligence (AI) is often considered a black box because it provides optimal answers without clear insight into its decision-making process. To address this black box problem, explainable artificial intelligence (XAI) has emerged, which provides an explanation and interpretation of its decisions, thereby promoting the trustworthiness of AI systems. Here, a memristive XAI hardware framework is presented. This framework incorporates three distinct types of memristors (Mott memristor, valence change memristor, and charge trap memristor), each responsible for performing three essential functions (perturbation, analog multiplication, and integration) required for the XAI hardware implementation. Three memristor arrays with high robustness are fabricated and the image recognition of 3 × 3 testing patterns and their explanation map generation are experimentally demonstrated. Then, a software-based extended system based on the characteristics of this hardware is built, simulating a large-scale image recognition task. The proposed system can perform the XAI operations with only 4.32% of the energy compared to conventional digital systems, enlightening its strong potential for the XAI accelerator.

Antifungal susceptibility profile of Candida species isolated from women with vulvovaginal candidiasis

Objectives: The objective of this study was to study the occurrence of vulvovaginal candidiasis (VVC) among women with vaginitis and to determine the antifungal susceptibility testing (AFST) pattern of Candida spp. isolated. Materials and Methods: A prospective study was conducted in a tertiary care setting. The two high vaginal swabs were collected and subjected to Gram’s stain, wet mount examination, and cultured on blood agar and sabouraud dextrose agar with chloramphenicol. The cultures were incubated at 37°C for 18–24 h. The Candida spp. was identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS), and AFST was performed according to the Clinical and Laboratory Standards Institute guidelines M27-A3. Statistical Analysis: The data was collected in excel sheet. The qualitative variables are presented as frequencies and percentages. The quantitative variables are presented as mean with SD and median. p value of less than 0.05 was considered statistically significant. Analysis will be done by using Epi InfoTM statistical software. Results: A total of 961 women with symptoms of vaginitis were screened. Candida spp. was isolated in 108 (11.2%) patients. The median age of affected women was 29 years, and the majority belonged to 20–30 years (60.2%). Age &lt;40 years was the significant risk factor (P = 0.016). Vaginal discharge was the most common complaint (82.4%),followed by itching (55.6%), vulvar edema, dyspareunia, and dysuria. Candida albicans was the predominant species (46.3%),followed by Candida glabrata (36.1%), Candida krusei (6.5%), and Candida tropicalis (6.5%). Ninety-six percentages of C. albicans were sensitive to fluconazole, while only 22.4% of non-albicans Candida spp (NAC) were susceptible. C. albicans showed 8% resistance to itraconazole and 8% intermediate resistance to caspofungin, whereas C. glabrata showed resistance to fluconazole, itraconazole, and caspofungin. Conclusions: The study showed a higher incidence of NAC and higher antifungal resistance leading to treatment failure. It is, hence, crucial to send fungal cultures, speciate, and perform AFST for all symptomatic patients of vulvo-vaginal candidiasis (VVC).

Comparative diagnostic utility of SARS-CoV-2 rapid antigen and molecular testing in a community setting.

SARS-CoV-2 antigen-detection rapid diagnostic tests (Ag-RDTs) have become widely utilized but longitudinal characterization of their community-based performance remains incompletely understood. This prospective longitudinal study at a large public university in Seattle, WA utilized remote enrollment, online surveys, and self-collected nasal swab specimens to evaluate Ag-RDT performance against real-time reverse transcription polymerase chain reaction (rRT-PCR) in the context of SARS-CoV-2 Omicron. Ag-RDT sensitivity and specificity within 1 day of rRT-PCR were evaluated by symptom status throughout the illness episode and Orf1b cycle threshold (Ct). From February to December 2022, 5,757 participants reported 17,572 Ag-RDT results and completed 12,674 rRT-PCR tests, of which 995 (7.9%) were rRT-PCR-positive. Overall sensitivity and specificity were 53.0% (95% CI: 49.6-56.4%) and 98.8% (98.5-99.0%), respectively. Sensitivity was comparatively higher for Ag-RDTs used 1 day after rRT-PCR (69.0%), 4 to 7 days post-symptom onset (70.1%), and Orf1b Ct ≤20 (82.7%). Serial Ag-RDT sensitivity increased with repeat testing ≥2 (68.5%) and ≥4 (75.8%) days after an initial Ag-RDT-negative result. Ag-RDT performance varied by clinical characteristics and temporal testing patterns. Our findings support recommendations for serial testing following an initial Ag-RDT-negative result, especially among recently symptomatic persons or those at high-risk for SARS-CoV-2 infection.

[Association between abnormal oral glucose tolerance test patterns in the second trimester and large for gestational age newborns].

Objective: To investigate the impact of abnormal patterns of 75 g oral glucose tolerance test (OGTT) in the second trimester on the risk of large for gestational age (LGA) newborn deliveries. Methods: General clinical data and OGTT results of 66 290 pregnant women who received regular prenatal care and delivered in Guangdong Maternal and Child Health Hospital from December 24, 2016 to July 26, 2022 were collected. According to the results of OGTT, the pregnant women were divided into 8 groups: normal blood glucose group (normal fasting blood glucose, 1-hour and 2-hour after oral glucose, 54 518 cases), gestational diabetes mellitus (GDM) 0 group (only abnormal fasting blood glucose, 1 430 cases), GDM 1 group (only abnormal blood glucose at 1-hour after oral glucose, 2 150 cases), GDM 2 group (only abnormal blood glucose at 2-hour after oral glucose, 3 736 cases), GDM 0+1 group (both fasting blood glucose and 1-hour after oral glucose were abnormal, 371 cases), GDM 0+2 group (both fasting blood glucose and 2-hour after oral glucose were abnormal, 280 cases), GDM 1+2 group (abnormal blood glucose at 1-hour and 2-hour after oral glucose, 2 981 cases) and GDM 0+1+2 group (abnormal fasting blood glucose, 1-hour and 2-hour after oral glucose, 824 cases). Multivariate logistic regression was used to analyze the effects of different abnormal OGTT patterns on LGA. In addition, the blood glucose measurements at the three time points of OGTT were combined and used as continuous variables in the receiver operating characteristic (ROC) curve to evaluate the predictive value of each blood glucose measurement mode for LGA and the area under the curve (AUC) was compared. Results: (1) Multivariate logistic regression analysis showed that the risks of LGA were significantly increased in GDM 0 group (OR=1.76, 95%CI: 1.50-2.08; P<0.001), GDM 0+1 group (OR=2.29, 95%CI: 1.72-3.04; P<0.001), and GDM 0+1+2 group (OR=1.98, 95%CI: 1.61-2.43; P<0.001). (2) ROC curve analysis showed that fasting blood glucose, 1-hour after oral glucose, 2-hour after oral glucose, fasting+1-hour after oral glucose, fasting+2-hour after oral glucose, 1-hour+2-hour after oral glucose, and fasting+1-hour+2-hour after oral glucose had certain predictive value for LGA (all P<0.001). The AUC of fasting blood glucose measurement was higher than that of 2-hour blood glucose measurement in predicting LGA, and the difference was statistically significant (P<0.05). There was no significant difference in the AUC between fasting blood glucose and other blood glucose measurement modes for predicting LGA (all P>0.05). Conclusions: In the abnormal OGTT patterns, pregnant women with abnormal fasting blood glucose, abnormal fasting+1-hour after oral glucose, and abnormal fasting+1-hour+2-hour after oral glucose have an increased risk of LGA. Fasting blood glucose measurement is of great significance for the prediction of LGA, and could be used as an optimal indicator to evaluate the risk of LGA in clinical practice.