Factors influencing PCR detection of viruses in cerebrospinal fluid of patients with suspected CNS infections

Background: Polymerase chain reaction (PCR) is used to detect viruses in the cerebrospinal fluid (CSF) of patients with neurological disease. However, data to assist its use or interpretation are limited. Objective: We investigated factors possibly influencing viral detection in CSF by PCR, which will also help clinicians interpret positive and negative results. Methods: CSF from patients with was tested for human herpesviruses types 1–6, JC virus, enteroviruses, and Toxoplasma gondii. The likelihood of central nervous system (CNS) infection was classified as likely, possible, or unlikely. PCR findings in these categories were compared using single variable and logistic regression analysis. Results: Of 787 samples tested, 97 (12%) were PCR positive for one or more viruses. Of episodes likely to be CNS viral infections, 30% were PCR positive compared to 5% categorised as unlikely. The most frequent positive findings were Epstein Barr virus (EBV), enteroviruses, and herpes simplex virus (HSV). Enteroviruses and HSV were found predominantly in the likely CNS viral infection group, whereas EBV was found mainly in the unlikely group. Positive PCR results were more likely when there were 3–14 days between symptom onset and lumbar puncture, and when CSF white cell count was abnormal, although a normal CSF did not exclude a viral infection. Conclusions: The diagnostic yield of PCR can be maximised by using sensitive assays to detect a range of pathogens in appropriately timed CSF samples. PCR results, in particular EBV, should be interpreted cautiously when symptoms cannot readily be attributed to the virus detected

Addressing the gap for racially diverse research involvement:The King's model for minority ethnic research participant recruitment

Objectives: Ethnic minorities (EM) are still underrepresented in research recruitment. Despite wide literature outlining the barriers, enablers and recommendations for driving inclusion and diversity in research, there is still little evidence for successful diversity in research participation, which has a direct impact on the quality of care provided to ethnically diverse individuals. A new, comprehensive approach to recruitment strategies is therefore necessary. Study design: service improvement initiative. Methods: In the light of the Covid-19 pandemic and the key public health need to address the disparity in care provided to non-white populations, we used a novel, comprehensive approach (The King's Model) comprising of local and community actions to promote inclusive research recruitment. We then compared rates of diverse recruitment in studies where the novel approach, was applied to studies which had been closed to recruitment at the time of analysis and where ethnicity data was available. Results: Our results demonstrate that following the introduction of the King's Model for diverse recruitment, commercial interventional study diverse recruitment increased from 6.4% to 16.1%, and for non-commercial studies, from 30.2% to 41.0% and 59.2% in the selected studies. Conclusions: King's Model is potentially a useful tool in enhancing non-Caucasian recruitment to clinical research. Enriched by additional recommendations based on our experiences during the Covid-19 research recruitment drive, we propose the King's Model is used to support ethnically diverse research recruitment. Further evidence is needed to replicate our findings, although this preliminary evidence provides granular details necessary to address the key unmet need of validating clinical research outcomes in non-white populations

AQP5 , a second gene at play with CFTR in aquagenic palmoplantar keratoderma

International audienc

American game fishes : their habits, habitat, and peculiarities; how, when, and where to angle for them

Cheney, A. N. Introduction.--Hallock, Charles. The Salmon.--Perry. W. A. The Pacific salmon.--Cheighton, J. G. A. The landlocked salmon.--Haldeman, W. N. The tarpon.--Endicott, Francis. The striped bass.--Henshall, J. A. The black bass.--Goode, G. B. The blue-fish.--Henshall, J. A. The mascalonge.--Mosher, A. A. The mascalonge in Wisconsin waters.--Thurston, F. H. The brook trout.--Murray, W. H. H. Trouting on the Nipigon.--Pardee, Luther. The lake trout.--Shields, G. O. The Rocky mountain trout.--Clarke, S. C. Sea bass, sea trout, Spanish mackerel...and other southern fishes.--Thurston, F. H. The grayling.--Tomlia, W. D. The pike.--Mosher, A. A. The wall-eyed pike.--Tomlin, W. D. The pickerel.--Mather, Fred. The white perch.--Jordan, D. S. The yellow bass, white bass, strawberry bass...--Harris, W. C. The senses of fishes.--Keene, J. H. Fishing tackle, and how to make it.--Milan, B. C. Reels, their use and abuse.--Shields, G. O. The angler's camp outfit.Mode of access: Internet