Development and validation of a model for predicting the risk of brain arteriovenous malformation rupture based on three-dimensional morphological features

ObjectiveBrain arteriovenous malformation (bAVM) is an important reason for intracranial hemorrhage. This study aimed at developing and validating a model for predicting bAVMs rupture by using three-dimensional (3D) morphological features extracted from Computed Tomography (CT) angiography.Materials and methodsThe prediction model was developed in a cohort consisting of 412 patients with bAVM between January 2010 and December 2020. All cases were partitioned into training and testing sets in the ratio of 7:3. Features were extracted from the 3D model built on CT angiography. Logistic regression was used to develop the model, with features selected using L1 Regularization, presented with a nomogram, and assessed with calibration curve, receiver operating characteristic (ROC) curve and decision curve analyze (DCA).ResultsSignificant variations in associated aneurysm, deep located, number of draining veins, type of venous drainage, deep drainage, drainage vein entrance diameter (Dv), type of feeding arteries, middle cerebral artery feeding, volume, Feret diameter, surface area, roundness, elongation, mean density (HU), and median density (HU) were found by univariate analysis (p < 0.05). The prediction model consisted of associated aneurysm, deep located, number of draining veins, deep drainage, Dv, volume, Feret diameter, surface area, mean density, and median density. The model showed good discrimination, with a C-index of 0.873 (95% CI, 0.791–0.931) in the training set and 0.754 (95% CI, 0.710–0.795) in the testing set.ConclusionsThis study presented 3D morphological features could be conveniently used to predict hemorrhage from unruptured bAVMs

Detection of Clonorchis sinensis circulating antigen in sera from Chinese patients by immunomagnetic bead ELISA based on IgY.

BACKGROUND: Clonorchiasis, caused by Clonorchis sinensis, is widely distributed in Southeast Asia including China. Clonorchiasis is included in control programs of neglected tropical diseases by World Health Organization (WHO) because it is one of the major health problems in most endemic areas. Diagnosis of clonorchiasis plays a key role in the control programs. However, so far, there is no satisfactory method for clonorchiasis because of low sensitivity, poor practicality and high false positivity of available diagnostic tools. METHODOLOGY/PRINCIPAL FINDINGS: We developed an immunomagnetic bead enzyme-linked immunosorbent assay (ELISA) based on IgY (egg yolk immunoglobulin) against cysteine proteinase of C. sinensis for detection of circulating antigen in serum samples of patients infected with C. sinensis. The polyclonal IgY, coated with magnetic beads, was used as a capture antibody and a monoclonal IgG labeled with horseradish peroxidase as a detection antibody in the IgY-based immunomagnetic bead ELISA system (IgY-IMB-ELISA). The results showed that the sensitivity of IgY-IMB-ELISA was 93.3% (14 of 15) in cases of heavy infection (5000 to 9999 eggs per gram feces, i.e, EPG 5000-9999), 86.7% (13 of 15) in cases of moderate infection (EPG 1000-4999) and 75.0% (9 of 12) in cases of light infection (EPG <1000) of clonorchiasis. Together 36 of total 42 (85.7%) serum samples of human clonorchiasis gave a positive reaction. There was a significant correlation between ELISA optical density and egg counts (EPG) with a correlation coefficient of 0.83 in total 42 patients. There were no positive results in patients with trichinosis (n = 10) or cysticercosis (n = 10). Cross-reactivity was 6.7% (2 of 30) with schistosomiasis japonica and 10.0% (3 of 30) with paragonimiasis, respectively. No positive reaction was found in 20 healthy persons. CONCLUSIONS: Our findings suggest that IgY-IMB-ELISA appears to be a sensitive and specific assay for detection of circulating antigen in human clonorchiasis

Relationship between rCsCP concentrations and OD values.

<p>Bovine serum slbumin (BSA) was used as a negative control. OD values of rCsCp are expressed as mean OD values measured with IgY-IMB-ELISA from two independent combined experiments.</p

Detection results in sera of human clonorchiasis with different egg per gram faces (EPG) by IgY-IMB-ELISA.

<p>Each sample had duplicate tubes and the experiment was repeated twice.</p><p>Detection results in sera of human clonorchiasis with different egg per gram faces (EPG) by IgY-IMB-ELISA.</p

Analysis of IgY by Western blot.

<p>M: Protein molecular weight standards marker; 1: rCsCP probed with purified IgY from immunized egg yolk; 2: rCsCP probed with purified IgY from non-immunized egg yolk.</p

Comparison of OD values obtained in IgY-IMB-ELISA for detection of serum circulating antigens from clonorchiasis patients with different infection intensity (egg per gram of feces, EPG).

<p>Comparison of OD values obtained in IgY-IMB-ELISA for detection of serum circulating antigens from clonorchiasis patients with different infection intensity (egg per gram of feces, EPG).</p

Analysis of IgY by 12% SDS-PAGE in non-reducing condition.

<p>4 µg of protein was loaded for each lane. M: Protein molecular weight standards marker; 1: IgY from immunized egg yolk; 2: IgY from non-immunized egg yolk.</p