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Development and evaluation of a one-pot RPA-Cas12a assay based on a primer-driven reverse screening strategy for preliminary screening of megalocytivirus-related viruses.

A primer-driven reverse-screening strategy was used to identify an RPA-Cas12a target suitable for the rapid preliminary screening of megalocytivirus-related viruses. The ISKNV reference genome NC_003494.1 was used as the initial template, and candidate amplification units were designed according to RPA primer-design requirements, primer physicochemical properties, and the availability of Cas12a protospacer-adjacent motif (PAM) sites and crRNA target sequences. Following preliminary amplification assessment, the retained candidate primers were aligned individually against 75 complete genome sequences of megalocytivirus-related viruses. Of these, 67 sequences met the predefined criteria for target-region integrity, primer-binding-site compatibility, and Cas12a recognition. Retrospective mapping to the reference genome located the candidate amplification region within ORF057L. Based on the resulting candidate detection unit, a one-pot RPA-Cas12a assay incorporating a commercially available lyophilized RPA amplification module was developed. Optimization showed that 400 nM reporter and 80 nM crRNA-1 provided relatively stable fluorescence output. A cut-off value of 1281.6 relative fluorescence units (RFU) was established as the mean plus three standard deviations of the endpoint fluorescence values obtained from 20 qPCR-negative samples. In analytical sensitivity testing, the assay generated fluorescence signals above the negative control at low plasmid copy numbers. However, because only a limited number of replicates were tested at these low template concentrations, these findings were not used to define a formal limit of detection. ISKNV, RSIV, and TRBIV samples tested positive, whereas the MRV sample produced an endpoint fluorescence value below the cut-off. Repeatability analysis of the same sample in six independent reactions yielded a coefficient of variation of 8.03%. Among the 39 samples examined, no discordant qualitative results were observed between the RPA-Cas12a assay and qPCR. These findings support the use of the ORF057L-targeted one-pot RPA-Cas12a assay as a rapid preliminary screening tool for megalocytivirus-related viruses. Nevertheless, its formal limit of detection, inter-batch stability, cross-reactivity with additional non-target pathogens, and clinical diagnostic performance require further evaluation.

Lyophilized RPA

Unoccluded bone conduction screening as an alternative to impedance screening.

The present study was undertaken to determine which intensity level of an unoccluded bone-conducted (BC) signal might be best suited for use as a supplemental procedure to an individual pure-tone air-conduction school screening program. Four intensity levels (0, 5, 10, 15 dB hearing level) of a 500 Hz BC tone were presented in ascending order to a public school population in addition to screening by impedance audiometry and pure-tone air conducted signals. Tetrachoric analysis using impedance screening results as a standard comparison revealed that a 10-dB unoccluded BC signal at 500 Hz provided an effective supplemental procedure for identifying conductive pathology in the population studied.

Audiometry

[Organization of mass-screening for early detection of cervical cancer and its precancerous conditions. I. report: Demonstration of a computer assisted mass-screening program (Model Rostock) (author's transl)].

Gynecological mass-screening leads to a decrease of prevalence and incidence of cervical cancer and precancerous conditions. In Rostock a program for early detection of cervical cancer was developed. Organization, application of computer in this model and the expenses of a computer assisted mass-screening-program are discussed. In order to facilitate comparison between various centers, a generally accepted classification and terminology of colposcopic, cytologic and histologic findings are essential. First epidemiological results of Rostock's women are demonstrated to characterize the screened population.

Costs and Cost Analysis

Comparison between the automated reagin test and reagin screen test methods of VDRL screening tests for syphilis in use in a routine laboratory.

A comparison is made between the automated reagin test (ART) using Technicon AutoAnalyzer equipment and the reagin screen test (RST) introduced by Lederle using a new antigen formulation. Treponemal haemagglutination tests (TPHA) were done simultaneously as second screen tests. The absorbed fluorescent treponemal antibody test (FTA-ABS) was used in all seropositive cases. Altogether 1154 sera were tested; 1028 were negative with all tests, 66 were positive with all tests, 42 were positive with TPHA and negative with ART and RST, and 16 were positive with TPHA and RST and negative with ART. It was concluded that the use of the RST and TPHA together would be the more sensitive screen test.

Antibodies, Bacterial

The worth of a screening program: an application of a statistical decision model for the benefit evaluation of screening projects.

A statistical decision model is applied to the benefit evaluation of screening projects to derive an expression which provides upper and lower limits for average benefits in terms of prevalance rates of screen positives and negatives, and the average cost of screening and referral. Possible applications of such a technique are discussed and a numerical example is given.

Bayes Theorem

[New intensifying screens in clinical radiology III: Screen-film combinations in mammography (author's transl)].

An industrial film was compared with four commercially available screen-film combinations with respect to dose, definition and signal to noise ratio. The demanded minimum resolving power requires definition of an object of 100 micrometer size. However, the defined minimum object sizes are approx. 180 micrometer with close-distance projection and approx. 240 micrometer with greater distance. In this study, therefore, the signal to noise ratios were measured at defined object sizes of 5 lp/mm and 2 lp/mm. The screen-film combinations have approximately the same values as the industrial film for a size of 250 micrometer (2 lp/mm) or are definitely higher. The signal to noise ratio of the Alpha M combination is superior by 50%, although the sensitivity of the combination is 4 to 6 times greater. The signal to noise ratio of the MinR system in 25% higher than that of the industrial film, the required dose being lower by a factor of 8. This results in skin doses of 0.7 rads instead of 6 rads with tissue layers of 4.8 cm thickness.

Female

[TSH-screening program for congenital hypothyroidism. Experiences with early thyrotropin (TSH) screening].

14,919 newborn infants were screened for congenital hypothyroidism within the last 5 years using a sensitive TSH method. 10 infants with congenital hypothyroidism were discovered thus presenting a frequency of 1:4500. Four of these infants showed abnormally high TSH levels and normal thyroxine levels. The determination of TSH in cord blood--or combined with the screening program for phenylketonuria--in eluate of dried filter paper specimens is the most sensitive test for primary hypothyroidism without false negative results and a low false positive recall rate of 0.16%. After initiation of therapy with thyroxine the TSH level falls unless therapy is delayed for longer. In the latter case TSH levels may remain elevated for several months despite therapy with thyroxine. We would suggest to start therapy with triiodothyronine for up to 14 days prior to initiation of the usual thyroxine therapy.

Congenital Hypothyroidism

Breast cancer screening. Benefit and risk for the first annual screening.

Of 96 cancers which have been detected as a result of the first annual screening of 10,470 volunteers, 46 have been clinically occult. Forty-one of these have been Stage 1 or less carcinoma, and 26 of these 41 have been minimal cancer. For the radiographic parameters used, the benefit of detecting these cancers vs. the risk of induced cancer is estimated as 103:1 and 65:1, respectively.

Adult

A new screening method for cystinuria. A simple and safe screening kit.

The new kit (Urocystin) presented here utilizes the dark brown coloration which a neutral aqueous solution of cystine develops rapidly upon addition of nickel ion and sodium hydrosulfite (Na2S2O4). What is needed is pouring 4 ml of the urine sample into the kit, and the kit is able to judge without fail any urine sample with a cystine concentration of 50 microgram/ml or more as positive. No pretreatment of the sample is necessary. The kit contains no hazardous reagents at all. The kit has thus turned screening of cystinuria into an extremely simple affair.

Cystinuria

Office screening for asymptomatic urinary tract infections. The evaluation of a practical, economic and reliable method screening the urines of asymptomatic girls in a busy pediatric office.

The urines of 3,270 asymptomatic girls were screened at annual physical examinations. The urines were collected in Dixie Cups without prior preparation of the perineum and cultured on 5% sheep cell agar. Less than 2 per cent of the specimens showed significant growth, thus requiring no follow-up visits by 98 per cent of the patients. Slightly less that 1/2 of one per cent were found to have asymptomatic urinary tract infections. The procedure was found to be practical, economically feasible and reliable, and was well accepted by both the parents and patients.

Economics, Medical

Screening for toxoplasmosis in pregnant women: presentation of a screening programme in the former "East"-Germany, and the present status in Germany.

The results of the screening programme (including the examination of fetal IgM) in East-Germany, related to the efficiency of therapy (pyrimethamine/sulfonamid) of the fetal infection risk are presented. For comparison the results of a prospective study of toxoplasmosis in pregnancy (n = 1697) without therapy, and follow up of the connatal infected infants to the age of 9/10 years old are shown. Recommendations for the diagnostic and therapeutical management in Germany for the future are presented.

Drug Therapy, Combination

[Organization of mass-screening for early detection of cervical cancer and its precancerous conditions. II. report: Practical experience with a computer assisted mass-screening program (Model Rostock) (author's transl)].

Two years experiences with a computerassisted program for early detection of prestages and early cervical cancer in Rostock-city are reported. From 43.000 women invited to take part in the examination, 27.028 = 65% finally cooperated. Pathological Pap-smears were found in 134 cases (= 0,52%). Histological examination in 51 cases (= 0,2%) showed 1 Erosio vera (false positive), 9 severe dysplasia, 30 carcinomata in situ, 3 early invasions (microinvasive cancer), 3 microcarcinoma and 5 macrocarcinoma. Accessory findings were seen in 10,2%. A good organized mass-screening-system with unique nomenclature, diagnostic and treatment of cervical cancer and its prestages gives the best supposition to cut down its rate of incidence.

Adult

[Programs of mass and selective screening of pregnant women in prenatal studies. Screening of alpha fetoprotein in the blood serum of the mother].

The total of 38479 echography studies and 25147 alpha-fetoprotein estimations in mother blood serum have been performed upon prenatal screening. 445 congenital developmental defects are revealed. AFP base and limiting values (2.5 MoM and 0.5 MoM) are found. AFP values and echocardiography results in the nor and in genetic syndromes of multiple congenital developmental defects are compared. It is found that AFP values are higher than MoM or only slightly higher than Me in the same syndromes. The different level of AFP for the same syndromes appeared to be associated with the phenomenon of overlapping due to the clinical polymorphism and type of injury of the nervous system and with the extent of changes in placenta, amniotic fluid and umbilical cord were revealed in 99% of syndromes. The increased AFP level can be considered as a marker to detect signs of the genetic syndromes. Low AFP level peculiar to aneuploidy appeared to be normal or increased. The AFP test can be used as a marker of changed embryogenesis.

Amniotic Fluid