Implementation of a National Reference Laboratory for Buruli Ulcer Disease in Togo

Background: In a previous study PCR analysis of clinical samples from suspected cases of Buruli ulcer disease (BUD) from Togo and external quality assurance (EQA) for local microscopy were conducted at an external reference laboratory in Germany. The relatively poor performance of local microscopy as well as effort and time associated with shipment of PCR samples necessitated the implementation of stringent EQA measures and availability of local laboratory capacity. This study describes the approach to implementation of a national BUD reference laboratory in Togo. Methodology: Large scale outreach activities accompanied by regular training programs for health care professionals were conducted in the regions "Maritime'' and "Central,'' standard operating procedures defined all processes in participating laboratories (regional, national and external reference laboratories) as well as the interaction between laboratories and partners in the field. Microscopy was conducted at regional level and slides were subjected to EQA at national and external reference laboratories. For PCR analysis, sample pairs were collected and subjected to a dry-reagent-based IS2404-PCR (DRB-PCR) at national level and standard IS2404 PCR followed by IS2404 qPCR analysis of negative samples at the external reference laboratory. Principal Findings: The inter-laboratory concordance rates for microscopy ranged from 89% to 94%; overall, microscopy confirmed 50% of all suspected BUD cases. The inter-laboratory concordance rate for PCR was 96% with an overall PCR case confirmation rate of 78%. Compared to a previous study, the rate of BUD patients with non-ulcerative lesions increased from 37% to 50%, the mean duration of disease before clinical diagnosis decreased significantly from 182.6 to 82.1 days among patients with ulcerative lesions, and the percentage of category III lesions decreased from 30.3% to 19.2%. Conclusions: High inter-laboratory concordance rates as well as case confirmation rates of 50% (microscopy), 71% (PCR at national level), and 78% (including qPCR confirmation at external reference laboratory) suggest high standards of BUD diagnostics. The increase of non-ulcerative lesions, as well as the decrease in diagnostic delay and category III lesions, prove the effect of comprehensive EQA and training measures involving also procedures outside the laboratory

Toward a Standardized Strategy of Clinical Metabolomics for the Advancement of Precision Medicine

Despite the tremendous success, pitfalls have been observed in every step of a clinical metabolomics workflow, which impedes the internal validity of the study. Furthermore, the demand for logistics, instrumentations, and computational resources for metabolic phenotyping studies has far exceeded our expectations. In this conceptual review, we will cover inclusive barriers of a metabolomics-based clinical study and suggest potential solutions in the hope of enhancing study robustness, usability, and transferability. The importance of quality assurance and quality control procedures is discussed, followed by a practical rule containing five phases, including two additional "pre-pre-" and "post-post-" analytical steps. Besides, we will elucidate the potential involvement of machine learning and demonstrate that the need for automated data mining algorithms to improve the quality of future research is undeniable. Consequently, we propose a comprehensive metabolomics framework, along with an appropriate checklist refined from current guidelines and our previously published assessment, in the attempt to accurately translate achievements in metabolomics into clinical and epidemiological research. Furthermore, the integration of multifaceted multi-omics approaches with metabolomics as the pillar member is in urgent need. When combining with other social or nutritional factors, we can gather complete omics profiles for a particular disease. Our discussion reflects the current obstacles and potential solutions toward the progressing trend of utilizing metabolomics in clinical research to create the next-generation healthcare system.11Ysciescopu

Innovation dynamics and the role of infrastructure

This report shows how the role of the infrastructure – standards, measurement, accreditation, design and intellectual property – can be integrated into a quantitative model of the innovation system and used to help explain levels and changes in labour productivity and growth in turnover and employment. The summary focuses on the new results from the project, set out in more detail in Sections 5 and 6. The first two sections of the report provide contextual material on the UK innovation system, the nature and content of the infrastructure knowledge and the institutions that provide it. Mixed modes of innovation, the typology of innovation practices developed and applied here, is constituted of six mixed modes, derived from many variables taken from the UK Innovation Survey. These are: Investing in intangibles Technology with IP innovating Using codified knowledge Wider (managerial) innovating Market-led innovating External process modernising. The composition of the innovation modes, and the approach used to compute them, is set out in more detail in Section 4. Modes can be thought of as the underlying process of innovation, a bundle of activities undertaken jointly by firms, and whose working out generates well known indicators such as new product innovations, R&D spending and accessing external information, that are the partial indicators gathered from the innovation survey itself

A radiocarbon database for Scottish archaeological samples

For the majority of dating laboratories and their respective user communities, the journal Radiocarbon is no longer regarded as the medium for primary publication of radiocarbon measurements. In compliance with editorial policy, the emphasis has long since moved towards the publication of research papers on technological enhancements and applications of C-14 as well as other cosmogenic isotopes and this has left a requirement for an alternative medium for the publication of date lists per se.In the late 1980s, an International Radiocarbon Data Base was proposed by Renee Kra (then the managing editor) but limitations in computer and communications technologies together with the inevitable financial implications meant that this timely concept could not be taken to completion. In the last year, we have taken advantage of the development of the worldwide web to compile a database of C-14 age measurements of a Scottish archaeological nature which can be found at the web address http://www.historic-scotland.gov.uk/