Clinical Evaluation of a Syphilis Treponemal Immunoassay for Use in United States Patient Populations

BACKGROUND: The clinical performance of the VITROS® Immunodiagnostic Products Syphilis Assay was evaluated by comparison with composite results obtained with widely used lipoidal antigen (nontreponemal) and T. pallidum (treponemal) tests. METHODS: Serum samples were tested from patients presenting for syphilis screening, and in relevant subpopulations including pregnant women, people living with HIV, known serologically positive for syphilis, and medically diagnosed with syphilis. Samples originated from 1710 and 113 patients in the United States and South America, respectively. Results were also compared for VITROS vs the Roche Elecsys® Syphilis immunoassay alone. RESULTS: Positive percentage agreement was ≥ 98.81% for VITROS and the comparator composite results within and across populations, with a 95% Wilson Score confidence interval of 98.01%-99.94% across the entire intended use population. Negative agreement was ≥ 90.63%, with 95% Wilson Score confidence interval of 96.93%-98.67% for the entire population. Method comparison between VITROS and Elecsys assays found 99.09% total agreement and a Cohen\u27s kappa coefficient of 0.97. In separate analyses, nonreactivity was observed for VITROS in 197 of 201 (98%) apparently healthy individuals, and positive reactivity was observed in 151/151 (100%) serum samples preselected from patients with medically diagnosed syphilis, indicating high clinical sensitivity of the VITROS Syphilis assay. In addition, specimens preselected as serologically positive showed 100% reactivity with VITROS. CONCLUSIONS: These findings support strong clinical performance of the VITROS Syphilis assay for aiding in diagnosis of syphilis, and excellent concordance with the well-established Elecsys Syphilis test

Lung ultrasound-guided decongestion in heart failure patients: A systematic review and meta-analysis of randomized controlled trials

Background Pulmonary congestion is a prognostic marker for heart failure (HF) morbidity and mortality; however, the current congestion evaluation depends on traditional physical examination, which lacks adequate sensitivity. Lung ultrasound (LUS) has been investigated as a more sensitive method to guide decongestion in decompensated HF. Methods A systematic review and meta-analysis synthesizing evidence from randomized controlled trials (RCTs) obtained from PubMed, CENTRAL, Scopus, and Web of Science until March 2025. Using Stata MP v. 17, we used the fixed-effects model to report dichotomous outcomes using the risk ratio (RR) and continuous outcomes using the standardized mean difference with a 95% confidence interval (CI). PROSPERO ID: CRD42024620337. Results Nine RCTs with 1095 patients were included. LUS-guided management significantly decreased the risk of HF hospitalization/all-cause mortality (RR: 0.72, [95% CI 0.56, 0.93], p = 0.01), HF hospitalization (RR: 0.65, [95% CI 0.48, 0.88], p = 0.01), and HF urgent visits (RR: 0.38, [95% CI 0.22, 0.66], p \u3c 0.0001). There was no significant difference between LUS-guided management and standard of care regarding the incidence of hypotension (RR: 1.87, [95% CI 0.56, 6.20], p = 0.31), hypokalemia (RR: 0.93, [95% CI 0.48, 1.82], p = 0.83), hyperkalemia (RR: 0.98, [95% CI 0.62, 1.53], p = 0.91), and acute kidney injury/impaired renal function (RR: 1.08, [95% CI 0.66, 1.77], p = 0.75). Conclusion LUS-guided decongestion was associated with a significant decrease in the risk of HF re-hospitalization and HF urgent visits, with a tolerable safety profile, compared to standard care, with similar rates of hypotension, hypokalemia, hyperkalemia, and AKI

Chronic alcohol exposure parametric effects on anxiety- and pain-related behaviors in adult rats

Many animal models of alcohol dependence utilize forced alcohol exposure, including chronic intermittent exposure to alcohol vapor, to induce high blood alcohol concentrations (BACs) and withdrawal-associated behaviors similar to those seen in clinical contexts. Chronic alcohol exposure and withdrawal are especially important in influencing the expression of negative symptoms (e.g., negative affect and pain), which, in turn, increase alcohol consumption. However, cessation of chronic alcohol vapor exposure does not always lead to those canonical withdrawal behaviors in rodents. Environmental and genetic factors may modulate alcohol effects on behavior during withdrawal. Here, we used retrospective data analysis to determine associations between alcohol vapor exposure parameters (e.g., BACs, duration of exposure) and anxiety- or pain-like behavior in adult male and female Wistar rats. Our results indicate that specific vapor exposure parameters are predictive of thermal hyperalgesia in Wistar rats but less so for anxiety-like behavior during alcohol withdrawal; collectively, these data may be helpful in informing experiments designed to investigate chronic alcohol effects on behavioral outcomes

Spatially distinct cellular and molecular landscapes define prognosis in triple-negative breast cancer

Triple-negative breast cancer (TNBC) is a prevalent breast cancer subtype with the lowest 5-year survival. Several factors influence outcomes, but their inherent molecular and cellular heterogeneity are increasingly acknowledged as crucial determinants. Here, we report on the spatio-molecular heterogeneity underlying TNBC tumors in a retrospective, treatment-naive cohort with differential prognoses (17 good prognoses [GPx] \u3e15-year survival and 15 poor prognoses [PPx] \u3c 3-year survival]) profiled using GeoMx Digital Spatial Profiler. Analyses reveal that epithelial and microenvironment (TME) states are transcriptionally distinct between groups. Invasive GPx epithelia show an increase in immune transcripts, with a more immune-rich TME (via IF). PPx epithelia, in contrast, are more metabolically and translationally active, with a mesenchymal/fibrotic TME. Pre-cancerous epithelia in PPx exhibit a presence of aggressiveness, marked by increased EMT signaling and complement activity. We identify distinct epithelial gene signatures for PPx and GPx that can accurately classify diagnostic samples and likely inform therapy

Prophylactic Intravenous Antibiotic Use in Thyroglossal Duct and Branchial Cleft Cyst Excision: A NSQIP-P Analysis

Objective: To identify patterns in prophylactic intravenous antibiotics (PIAB) usage for thyroglossal duct and branchial cleft cyst excisions, and to evaluate whether PIAB improve patient outcomes. Study Design: Retrospective cohort study. Setting: American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) Surgical Antibiotic Prophylaxis Database. Methods: The NSQIP-P database was queried for pediatric patients (≤18) from 2021 to 2023 who underwent thyroglossal duct or branchial cleft cyst excision. Multivariate regressions assessed associations between PIAB use and outcomes including surgical site infection, unplanned readmission, and reoperation while adjusting for clinicodemographic factors (age, sex, race/ethnicity, admission status, surgical specialty, ASA classification, and wound classification). Results: Of 2106 TGDC and 2837 BCC patients, 83.5% and 68.0% received PIAB, respectively. Hispanic ethnicity, postoperative admission, and clean-contaminated wound classification were associated with increased PIAB use in both groups. In BCC patients, younger age and treatment by non-otolaryngologists predicted decreased PIAB use. While univariate analysis in TGDC cases showed lower infection rates with PIAB (OR, 0.52; 95% CI, 0.30-0.95; P =.025), this was not significant on multivariate analysis (0.59, 0.34-1.08, P =.074). PIAB did not significantly affect infection, readmission, or reoperation rates in either cohort on multivariate analysis. Conclusion: PIAB use in pediatric TGDC and BCC excisions varies with clinicodemographic factors but did not consistently reduce adverse outcomes. These findings underscore the need to reevaluate the necessity of PIAB and encourage further investigations to develop evidence-based guidelines for pediatric neck mass surgery

Introduction to RefWorks (February 2026)

Learn the basics of RefWorks, a citation management software offered by LSU Health New Orleans Libraries. Recorded session from February 12, 2026

The Antithrombotic Potential of Sulfated-Polysaccharides from Red Seaweed Hypnea musciformis (Wulfen) J.V. Lamouroux: An In Vitro, In Silico and In Vivo Study

Thrombosis has emerged as a significant concern during the Coronavirus Disease 2019 (COVID-19) pandemic, with patients experiencing increased venous thromboembolism due to prolonged immobilization and inflammation. In Brazil, studies show a higher thrombosis risk among COVID-19 patients, emphasizing the need for effective thromboprophylaxis. Heparin (HEP), commonly used in hospitals, enhances antithrombin III (ATIII) activity to inhibit thrombin and factor Xa, thus reducing thrombosis risk. However, it can cause adverse effects like bleeding and HEP-induced thrombocytopenia, complicating its use and prompting the search for safer anticoagulant alternatives. This study aimed to evaluate the anticoagulant properties of sulfated polysaccharides (SP) derived from the red seaweed Hypnea musciformis, particularly their hydrolysates with different molecular weights. Additionally, computational analyses were conducted to investigate their interaction with ATIII, compared to HEP, to determine if the mechanism of action is similar. In vitro, the assays assessed the antithrombotic activity using activated partial thromboplastin time (APTT) and prothrombin time (PT) tests, with low-molecular-weight HEP CLEXANE (LMWH) as a positive control. Results showed that the intact polysaccharide and one hydrolysate (EX 5) prolonged activated partial thromboplastin time, while no samples affected prothrombin time. The in vivo bleeding time test revealed that these samples had a significantly lower hemorrhagic tendency than the positive control. Computational simulations indicated a stronger interaction between ATIII and the intact polysaccharide compared to its hydrolysate. These findings suggest that SP from H. musciformis could offer a promising anticoagulant therapy with reduced bleeding risk for clinical application in thrombotic conditions

CD73 blockade enhances antitumor efficacy of oHSV in solid tumors by increasing macrophage-mediated antigen presentation

BACKGROUND: Oncolytic herpes simplex virus (oHSV) therapy is a live virus-based immunotherapy that lyses tumor cells which release antigens and activate antitumor immunity. oHSV therapy has been shown to increase ATP production and release of extracellular ATP (eATP). In the extracellular tumor microenvironment, eATP functions as an immune-activating damage-associated molecular pattern but is hydrolyzed to extracellular adenosine (eADO), which can be immune-suppressive. eADO is generated by the sequential action of ectoenzymes CD39 and CD73 (NT5E). Here, we examined the role of immunosuppressive eADO signaling in regulating antitumor immune efficacy of oHSV. METHODS: We evaluated changes in eADO signaling in vitro and in patient specimens after virotherapy. A genetic CD73 knock-out mouse model and blocking antibodies were used to assess the impact of CD73 on virotherapy in two different solid tumor models. Single-cell RNA sequencing was employed to assess changes in immune cell infiltration and communication. Flow cytometric immunophenotyping and immunofluorescent imaging were utilized to confirm single-cell sequencing predicted changes in tumor microenvironment. RESULTS: Transcriptomic analysis of patient tumors pre-virotherapy and post-virotherapy with CAN-3110 revealed increased expression of the adenosine receptor gene ADORA2B after treatment. High NT5E gene expression, as well as gene signatures suggestive of adenosine signaling, correlated with a significantly worse prognosis for patients with solid tumors. Single-cell sequencing of immune cells recruited to tumor-bearing brain hemispheres in CD73 knockout mice revealed an increase in macrophage-mediated antigen presentation and CD4 T cell cross-communication. Intracranial tumor-bearing CD73 knock-out mice treated with oHSV showed significant therapeutic improvement as the result of oHSV compared with wild-type mice. Combination of virotherapy with CD73 antibody blockade also resulted in enhanced antitumor efficacy. CONCLUSIONS: Here, we identify that immunosuppressive eADO signaling in the TME is a major barrier to oHSV therapy and CD73 blockade prevents tumor immune escape. The combination of oHSV with CD73 blockade supports the development of an antitumor immune memory response in solid tumors. This study supports clinical development of this combination strategy

Immunogenicity and protection mediated by dmLT and alum adjuvants for an HIV-1 vaccine

The development of an effective HIV-1 vaccine is of paramount importance to global health. Here, we compared the influence of two adjuvants, Escherichia coli double-mutant heat-labile toxin (dmLT) and alum, on the protective immunity induced by a cyclically permuted trimeric HIV-1 envelope gp120 protein (CycP-gp120) boost. Two groups of rhesus macaques received two modified vaccinia Ankara (MVA)/SHIV C.1086 primes followed by a CycP-gp120 protein boost adjuvanted with either dmLT (n = 9) or alum (n = 10). A group of unvaccinated macaques (n = 8) served as controls. All animals were intrarectally challenged with heterologous SHIV.CH505.375H.dCT weekly for 7 weeks. Following the challenge, dmLT-adjuvanted animals showed significant protection with a vaccine efficacy of 60.8% per exposure (p = 0.0246). Alum-adjuvanted animals did not show significant protection (p = 0.1575). Both adjuvants induced comparable envelope-specific binding antibody in serum and rectal secretions with broad V1V2 scaffold-binding specificity. IL-6 plasma concentration correlated positively with V1V2 scaffold-binding and increased after vaccination with both adjuvants. With respect to CD4 T cells, dmLT induced higher frequencies of proliferating central memory (T) and ICOS cells in blood compared to alum. However, these proliferating CD4 T cells showed a decrease in the proportion of gut-homing receptor α4β7-expressing cells in the dmLT group compared to the alum group at week 2 post-protein boost. The V1V2 scaffold-specific IgG, proliferating T and ICOS CD4 T-cell frequencies, and plasma IL-6 concentration associated positively with protection. These data demonstrate that the vaccine adjuvants dmLT and alum differentially modulate protective helper T-cell responses induced by the CycP-gp120 protein, highlighting the importance of an appropriate adjuvant for eliciting a protective immune response against HIV-1

Down-Regulation of Acyloxyacyl Hydrolase Expression in Alzheimer\u27s Disease Impairs LPS Detoxification and Contributes to Brain Pro-Inflammatory Signaling

Lipopolysaccharides (LPSs) are potent pro-inflammatory neurotoxins abundant in the gut microbiome and originate primarily from Gram-negative bacteria, such as Escherichia coli. LPS levels increase with brain aging and accumulate around neurons in Alzheimer\u27s disease (AD) brains. Microbiome-generated LPS and other endotoxins cross gut barriers, enter systemic circulation, and translocate across the blood-brain barrier into vascularized brain regions. These processes are exacerbated by aging and neurovascular diseases. Although pro-homeostatic systems mitigate LPS effects, these defenses can fail. This study provides the first evidence that acyloxyacyl hydrolase (AOAH; EC 3.1.1.77), a microglia-enriched LPS detoxifying enzyme, shows reduced expression in AD brain tissue. Analysis of AD patient brains revealed reduced AOAH messenger RNA (mRNA) levels, accompanied by elevated expression of microRNA (hsa-miR-450b-5p), an inflammation regulator. Furthermore, luciferase reporter assays demonstrated that miR-450b-5p specifically targets the AOAH 3\u27-UTR, leading to a dose-dependent suppression of reporter activity. Also, in vitro experiments on human neuronal glial (HNG) cells further confirmed down-regulation of AOAH expression at protein levels by miR-450b-5p. These findings suggest miR-450b-5p-mediated AOAH deficiency drives LPS-associated neurotoxicity and inflammatory neurodegeneration in AD