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reverse algorithm for screening of syphilis and trends in prevalence among blood donors in Coastal Karnataka

TRANSFUSION CLINIQUE ET BIOLOGIQUE 2022年第3期29卷 219-223页

作者： Sangthang, S. Raturi, M. Kandsamy, D. Chenna, D. Shastry, S. Manipal Manipal Acad Higher Educ Kasturba Med Coll Dept Immunohematol & Blood Transfus Manipal Karnataka India Swami Rama Himalayan Univ Himalayan Inst Med Sci Dept Immunohematol & Blood Transfus Dehra Dun Uttarakhand India

Background: Transfusion transmissible syphilis is caused by Treponema pallidum;blood donors are traditionally screened with non-treponemal antibody tests to ensure transfusion safety. Detection of specific antibodies against T. pallidum is employed in reverse algorithm screening. We aim to analyze the utility of the reverse algorithm screening strategy for T. pallidum and to determine the prevalence trends among blood donors in our centre. Material and methods: The study was conducted in a Transfusion Centre catering to the 2030 bedded Tertiary Care Centre in coastal Karnataka in two timelines from 2012 to 2014, and 2019 to 2020, respectively. A fully automated Enzyme-Linked Immunosorbent Assay and Enhanced Chemiluminescence Immunoassay, which detect both IgM and IgG antibodies against *** were used in the study. Blood donor data from 2008 to 2020 were also analyzed to observe the trend in prevalence rate of syphilis among blood donors. Results: Among 26329 and 388 blood donors screened with ELISA and ECI, 134 (0.51%) and 9 (2.3%) were reactive to T. pallidum antibodies respectively. TPHA confirmed that 104 and 9 donors were reactive from each of the ELISA and ECI reactive donor groups. The increase in the prevalence of syphilis was observed with the use of reverse algorithm compared to the traditional strategy. The prevalence of syphilis in the present study ranged from 0.02 to 0.28%. Conclusion: The reverse algorithm screening can give a better result with a positive predictive value of 77.61% and 88.9% for ELISA and ECI. respectively Our study found that the use of reverse algorithm might increase the blood discard rate slightly but adds on to safety of blood components. Copyright (C) 2022 Societe francaise de transfusion sanguine (SFTS). Published by Elsevier Masson SAS. All rights reserved.

关键词： Syphilis reverse algorithm Blood donation Transfusion transmitted infection

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British Columbia's Experience after Implementation of the Treponema pallidum reverse algorithm and PCR Detection, 2015 to 2020

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MICROBIOLOGY SPECTRUM 2022年第3期10卷 e0068622页

作者： Morshed, Muhammad Lee, Min-Kuang Laley, Jonathan Cook, Darrel Mak, Annie Chahil, Navdeep Ryan, Venessa Montgomery, Carolyn Makaroff, Sylvia Malleson, Sarah Arnold, Barbra Grennan, Troy Wong, Jason Krajden, Mel British Columbia Ctr Dis Control Publ Hlth Lab Vancouver BC Canada BC Ctr Dis Control Clin Prevent Serv Vancouver BC Canada Univ British Columbia Dept Pathol & Lab Med Vancouver BC Canada Univ British Columbia Dept Med Vancouver BC Canada

In this study, we summarize the performance characteristics of the algorithm, together with PCR direct detection and epidemiological analysis, and report on syphilis cases identified from 2015 to 2020. This allowed us to paint a complete picture of the outcome of the utilization of the reverse algorithm for diagnosing syphilis cases. British Columbia (BC) implemented the syphilis reverse screening algorithm and Treponema pallidum PCR testing in 2014. We summarize the performance characteristics of the algorithm, together with PCR direct detection, and report on syphilis cases identified from 2015 to 2020. Prior to 2015, samples for syphilis diagnosis were first screened by rapid plasma reagin (RPR). As of 2015, sera were screened by the Siemens Advia Centaur syphilis assay (enzyme immunoassay [EIA]). Positive and equivocal samples were reflex tested by a T. pallidum passive particle agglutination assay (TPPA) and RPR. We used T. pallidum DNA PCR on clinical samples and restriction fragment length polymorphism analysis to identify azithromycin resistance mutations. Case/epidemiological data were obtained from the BC surveillance system. Of 1,631,519 samples screened by the EIA, 72,492 (4.4%) were positive and 187 (<0.1%) were equivocal. Of EIA-positive/equivocal samples, 10.6% were false positive, and false positivity was higher at lower EIA indices. The reverse algorithm detected 4,693 late latent syphilis cases that likely would have been missed by RPR screening. PCR had a very high sensitivity of 100% versus 52.9% and 52.4% for dark-field (DF) and immunofluorescence (IF) microscopy, respectively. The azithromycin resistance mutation A2058G was identified in 96% of PCR-positive samples, and A2059G was identified in 4%. Annually, there were 944 to 1,467 syphilis cases, with 62% in men who reported male sexual partners. The reverse algorithm had a low false-positive rate and very few equivocal screening results but did identify previously undiagnosed late latent syph

关键词： PCR reverse algorithm screening syphilis

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reverse algorithm FOR DETERMINING THE NUMBER OF CUTTING PASSES AND CUTTING CONDITIONS IN AXIAL TURNING

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TEHNICKI VJESNIK-TECHNICAL GAZETTE 2016年第4期23卷 1139-1145页

作者： Tasic, Marina Cosic, Predrag Univ Zagreb Fac Mech Engn & Naval Architecture Ivana Lucica 5 Zagreb 10000 Croatia

To avoid production of low quality products and reduce unnecessary time wastage, algorithms for decision making are widely used in process planning. Usually decision of selecting cutting conditions (depth of cut, feed and cutting speed) is made by experience or using handbooks. Much effort during years was invested in finding optimizing algorithms for metal cutting processes. algorithm given by G. Halevi does not include specific tool or machine for machining process and that is why it is called reverse algorithm. Taking in consideration boundary values of cutting conditions and their effects on surface roughness, algorithm finds maximum values of cutting conditions, giving preference to the feed rate and thus minimizing the number of cutting passes. Proposed algorithm was explained by data flow implemented in software package MATLAB and tested on the example of axial turning. The obtained results were compared to recommendations retrieved from Iscar's catalog and show that algorithm is suitable for determining appropriate number of cutting passes and cutting conditions. This paper is a contribution to the automated algorithms for decision making in process planning.

关键词： reverse algorithm cutting conditions axial turning

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Determination of gradient residual stress for elastoplastic materials by nanoindentation

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JOURNAL OF MANUFACTURING PROCESSES 2024年 109卷 359-366页

作者： Shen, Ziyi Dong, Ruipeng Li, Jiao Su, Yutai Long, Xu Northwestern Polytech Univ Sch Mech Civil Engn & Architecture Xian Peoples R China

Residual stress is an important manufacture factor affecting the working life of components and structures. In this paper, a dimensionless method is proposed to determine the residual stress profile by using the nanoindentation technique. An exponential function is formulated in a generalized form to describe the residual stress profile in the elastoplastic substrate material. A finite element (FE) model is created to simulate the entire process including the loading stage with the indenter penetrating into the substrate up to the maximum depth and also the subsequent unloading stage. For elastoplastic substrate materials following the power-law constitutive model, a wide range of FE predictions are made by considering various gradient residual stresses of interest. The results show that the applied load-penetration depth curve is highly consistent with the variation of gradient residual stress. Based on FE simulations, dimensionless functions considering the residual stress is derived for both the applied load and the total work done. Thereafter, a reverse algorithm is proposed to elegantly predict the gradient residual stress in elastoplastic materials. With several work examples, the proposed reverse algorithm is confirmed to be excellent for determining residual stresses by comparing the existing experimental results. More importantly, the proposed reverse algorithm can effectively determine the type and trend of gradient residual stresses, which helps to guide the optimization of manufacturing process for critical components and structures.

关键词： Nanoindentation Dimensional analysis Gradient residual stress reverse algorithm Finite element simulation

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Relationship between DiaSorin Liaison Treponema pallidum antibody indices and confirmatory assay results in the reverse syphilis testing algorithm

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DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE 2021年第1期100卷 115303-115303页

作者： Prince, Harry E. Marlowe, Elizabeth M. Schwab, Dale A. Quest Diagnost Infect Dis San Juan Capistrano CA 92675 USA

Published studies show that >99% of sera reactive in the reverse syphilis testing algorithm (RSTA) screening assay with an index above an assay-specific threshold confirm as reactive, with either a rapid plasma reagin-reactive (RPRR) or RPR-nonreactive/Treponema pallidum particle agglutination-reactive (TPPA(R)) result. However, the relationship between screen indices and confirmatory patterns has not been characterized. We thus assessed confirmatory testing results for 577 sera submitted for RSTA testing and a screen-reactive result in the DiaSorin Liaison assay. The median screen index was significantly higher for RPRR samples than TPPA(R) samples (55.6 versus 10.4), and the proportion with indices >28.3 (median for all 577 samples) was significantly higher for RPRR versus TPPA(R) samples (82% versus 26%). However, RPRR titers did not significantly correlate with screen indices (R-2 = 0.02). These findings demonstrate a significant relationship between RSTA screen indices and confirmatory assay results. The clinical utility of this relationship requires further study. (C) 2020 Elsevier Inc. All rights reserved.

关键词： Syphilis reverse algorithm

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reverse analysis of constitutive properties of sintered silver particles from nanoindentations

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INTERNATIONAL JOURNAL OF SOLIDS AND STRUCTURES 2020年第0期191卷 351-362页

作者： Long, X. Jia, Q. P. Li, Z. Wen, S. X. Northwestern Polytech Univ Sch Mech Civil Engn & Architecture Xian 710072 Peoples R China

Nanoindentation technology is an effective and convenient method for evaluating the mechanical properties of materials at micro and nano scales. Since the complete nanoindentation process is a typical non-linear mechanical behavior and the material deformation varies with the indentation depth, it is difficult to analytically obtain plastic parameters of constitutive models which are however important to describe the material properties in finite element simulations. In this study, nanoindentation experiments are carried out on the sintered silver nanoparticle (AgNP) which is one of the advanced die-attach materials for high-power electronic devices working in harsh environment. In order to further stabilize and enhance the thermal conductivity, different weight contents of SiC microparticles are incorporated in the AgNP paste before the sintering process. Finite element simulations are used to simulate the deformation and load resistance of materials in nanoindentation process. Plastic properties of materials are analyzed by proposing a reverse algorithm based on the measurements of nanoindentation responses. Essentially, the proposed reverse algorithm couples the dimensional analysis and trial-and-error fitting technique. The complete constitutive relationship of sintered AgNP with different SiC contents is obtained accordingly after examining the loading and unloading stages of nanoindentation responses. The influence of SiC content on the mechanical properties of sintered AgNP is also discussed by considering the material microstructure observed using a scanning electron microscopy. Finally, the uniqueness of constitutive curve from the proposed reverse algorithm is confirmed by the agreement of predicted and measured load-displacement responses using independent spherical indentations. (C) 2020 Elsevier Ltd. All rights reserved.

关键词： Nanoindentation Constitutive model reverse algorithm Uniqueness issue Sintered silver nanoparticle

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Syphilis: Understanding Traditional and reverse Screening algorithms

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JNP-JOURNAL FOR NURSE PRACTITIONERS 2020年第5期16卷 359-362页

作者： Thomas, Jacqueline F. Catlin, Shayria Stacey, Jonathan A. Univ West Florida Sch Nursing Pensacola FL 32514 USA Family Hlth Mobile AL USA Univ West Florida Hlth Adm Pensacola FL USA

Interpreting syphilis screening tests can be a challenge for health care providers. Clinical laboratories primarily use the reverse algorithm to screen for syphilis;however, the Centers for Disease Control and Prevention recommend the traditional algorithm. Both algorithms require the interpretation of 2 different serologic assays for screening and confirmation. Serologic testing used in both algorithms is reviewed for nurse practitioners to correctly interpret test results to establish a timely diagnosis and provide stageappropriate treatment. (C) 2020 Elsevier Inc. All rights reserved.

关键词： nontreponemal reverse algorithm syphilis traditional algorithm treponemal

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Abbott ARCHITECT Syphilis TP Chemiluminescent Immunoassay Accurately Diagnoses Past or Current Syphilis in Pregnancy

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AMERICAN JOURNAL OF PERINATOLOGY 2020年第1期37卷 112-118页

作者： Adhikari, Emily H. Frame, Ithiel J. Hill, Emilie Fatabhoy, Rizwana Strickland, Amanda L. Cavuoti, Dominick McIntire, Donald D. Hollaway, Rita M. Univ Texas Southwestern Med Ctr Dallas Dept Obstet & Gynecol Dallas TX 75390 USA Univ Texas Southwestern Med Ctr Dallas Dept Pathol Dallas TX USA Parkland Hlth & Hosp Syst Dept Pathol Dallas TX USA

Objective We evaluate diagnostic accuracy of the ARCHITECT chemiluminescent immunoassay (CIA) screening test in pregnancy, and evaluate pregnancy outcomes among screen-positive women. Study Design Samples from routine prenatal rapid plasma reagin (RPR) tests were collected between June 22 and August 18, 2017 and frozen. Samples were batch-tested with the Abbott ARCHITECT syphilis TP immunoassay (CIA, index test). We calculated sensitivity, specificity, predictive value, and false positivity. We compared pregnancy and neonatal outcomes among screen-positive women. Results Of 1,602 specimens, 35 (2.2%) were RPR +;of those, 24 (69%) were CIA +/ Treponema pallidum particle agglutination assay (TPPA)+ and 11 (31%) were CIA-/TPPA-. Of 1,567 RPR- specimens, 14 (0.9%) were CIA +;of those, 13 (93%) were TPPA + , and one (7%) had a false positive CIA test. Sensitivity of the CIA (95% CI) was 100% (90.5-100%), specificity 99.9% (99.6-100%), positive predictive value 97.4% (86.2-99.9%), and false positive rate 0.06% (0.002-0.4%) for current or past syphilis. Among 37 CIA +/TPPA+ women, seven (19%) had RPR-negative status (Group 1), 11 (30%) had previously treated syphilis (Group 2), and 19 (51%) had active infection (Group 3). One stillbirth occurred in a woman with early, active syphilis identified at delivery;no adverse perinatal outcomes occurred among women in Groups 1 or 2. Conclusion The ARCHITECT syphilis TP immunoassay accurately diagnoses current or past syphilis in pregnancy. Clinical history and staging remain essential using a reverse algorithm.

关键词： chemiluminescent diagnostic accuracy immunoassay reverse algorithm syphilis screening syphilis in pregnancy treponemal

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reverse Analysis of Surface Strain in Elasto-Plastic Materials by Nanoindentation

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INTERNATIONAL JOURNAL OF APPLIED MECHANICS 2021年第9期13卷

作者： Long, Xu Shen, Ziyi Lu, Changhen Jia, Qipu Guan, Cao Chen, Chuantong Wang, Haodong Li, Ye Northwestern Polytech Univ Sch Mech Civil Engn & Architecture Xian 710072 Peoples R China Osaka Univ Flexible 3D Syst Integrat Lab Osaka 5670047 Japan Harbin Inst Technol Sch Civil & Environm Engn Shenzhen 518055 Peoples R China

In this study, nanoindentation technology is utilized to investigate the in situ mechanical behavior of small-sized packaging materials. Rather than the ideal cases with unprestressed materials which have been intensively studies, this paper focuses on the effect of surface stress by prestressing the materials to be indented by a Berkovich indenter. The loading process until the maximum penetration depth is simulated by finite element (FE) models. With elastoplastic materials as described by a power-law model, extensive FE predictions are performed with the wide ranges of Young's modulus, yield strength and hardening exponent with and without pre-strain. FE results show that with different prestress values, the applied load-penetration depth responses vary in a highly consistent manner. The residual indentation profiles are found to be closely related with the stress state due to the pre-strain values. On the basis of FE simulations, a dimensionless function is therefore derived and a reverse algorithm is proposed to estimate the constitutive parameters and also the surface stress of elastoplastic materials. With one of the most commercialized lead-free solder materials in electronic packaging structures, the proposed reverse algorithm is utilized to estimate the residual stress based on the nanoindentation response of solder samples with different annealing conditions.

关键词： Nanoindentation surface strain reverse algorithm dimensionless analysis

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Performance Characteristics of the reverse Syphilis Screening algorithm in a Population With a Moderately High Prevalence of Syphilis

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AMERICAN JOURNAL OF CLINICAL PATHOLOGY 2016年第5期146卷 572-577页

作者： Rourk, Angela R. Nolte, Frederick S. Litwin, Christine M. Med Univ South Carolina Dept Pathol & Lab Med 171 Ashley Ave Charleston SC 29425 USA

Objectives: With the recent introduction of automated treponemal tests, a new reverse syphilis algorithm has been proposed and now used by many clinical laboratories. We analyzed the impact of instituting the reverse screening syphilis algorithm in a laboratory that serves a geographic area with a moderately high prevalence of syphilis infection. Methods: Serum samples sent for syphilis testing were tested using a treponemal enzyme immunoassay (EIA) as the screening assay. EIA reactive samples were tested by rapid plasma reagin (RPR) and titered to end point if reactive. RPR nonreactive samples were analyzed by the Treponema pallidum particle agglutination test (TP-PA). Pertinent medical records were reviewed for false-reactive screens and samples with evidence of past syphilis infection. Results: Among 10,060 patients tested, 502 (5%) were reactive on the initial EIA screen. The RPR was reactive in 150 (1.5%). TP-PA testing determined that 103 (1.0%) were falsely reactive on initial EIA screen. The reverse screening algorithm, however, identified 242 (2.4%) with evidence of latent, secondary, or past syphilis, 21 of whom had no or unknown prior treatment with antibiotics. Conclusions: Despite a 1.0% false-reactive rate, the reverse syphilis algorithm detected 21 patients with possible latent syphilis that may have gone undetected by traditional syphilis screening.

关键词： Syphilis TP-PA RPR reverse algorithm Treponema pallidum

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