Correlation of Treponemal Chemiluminescent Microparticle Immunoassay Screening Test Signal Strength Values With Reactivity of Confirmatory Testing

Background Automated chemiluminescent microparticle immunoassays (CMIAs) are the most common first step at high-volume laboratories for syphilis screening. If the initial screening test is reactive, 1 more treponemal test is required, resulting in increased cost. In this multicenter study, we aimed to determine the correlation between the CMIA signal-to-cutoff ratio (S/Co) and the confirmatory tests to reduce unnecessary confirmatory testing. Methods Eight hospitals from 5 provinces participated in this study. All laboratories used Architect Syphilis TP CMIA (Abbott Diagnostics, Abbott Park, IL) for initial screening. Treponema pallidum hemagglutination (TPHA), rapid plasma reagin (RPR), and fluorescent treponemal antibody absorption (FTA-ABS) were used as confirmatory tests according to the reverse or European Centre for Disease Prevention and Control algorithms. A receiver operating characteristic analysis was used to determine the optimal S/Co ratio to predict the confirmation results. Results We evaluated 129,346 serum samples screened by CMIA between January 2018 and December 2020. A total of 2468 samples were reactive; 2247 (91%) of them were confirmed to be positive and 221 (9%) were negative. Of the 2468 reactive specimens, 1747 (70.8%) had an S/Co ratio >= 10.4. When the S/Co ratios were >= 7.2 and >= 10.4, the specificity values were determined to be 95% and 100%, respectively. In a subgroup of 75 CMIA-positive patients, FTA-ABS was performed and 62 were positive. Among these FTA-ABS-positive patients, 24 had an S/Co ratio = 10.4, obviating the need for secondary treponemal testing in about 71% of the screening-reactive samples. This would substantially reduce the confirmatory testing volume and laboratory expenses. However, in high-risk group patients with CMIA positive results, S/Co ratio <10.4, and negative TPHA and RPR, FTA-ABS may be used for confirmation

Biodiversity for Carrying Capacity Assessment

Determination of marine vessel carrying capacity (MVCC) of an area is rather a new and challenging concept not only in Turkey, but also throughout the world. Determination of MVCC is a site specific process, and management objectives also play an important role during this process. Thus, MVCC calculation depends on various datasets comprising physical, ecological, social, economical or political components of the area in consideration. Ecological components, such as important habitats of endangered species and facies formations are considered as reduction factors for calculating MVCC of an area. This paper introduces ecological components identified for Kas-Kekova Special Environmental Protection Area (SEPA), one of the four areas where carrying capacity assessments have been performed in Turkey. Seven flora species were observed in the study area, which contribute to facies formations. Among these, Posidonia oceanica, Zostera marina and Cystoseira sp. were taken as reduction factors because of the direct interaction with mooring and anchoring activities in the area. The habitat of critically endangered Mediterranean monk seal was taken into consideration as another reduction factor because of the probability of cave formation and adjacent area being a sheltering zone for this species. The area coverage of ecological components which were considered as reduction factor was calculated as 2.246 km(2) within the study area (in total 7.387 km(2))

Biodiversity Assessment: Preliminary Findings in Koycegiz-Dalyan SEPA

In Turkey, biodiversity assessments in Coastal-Marine Protected Areas (CMPA) were started with the Datca-Bozburun Special Environmental Protection Area (SEPA) Biodiversity Project by the Authority of Special Environmental Protection Agency in collaboration with the Oceanos Team of the Istanbul University in 2002. "Koycegiz-Dalyan SEPA Biodiversity Project" was the fourth one in this field performed in 2010, the "International Year of Biodiversity", with cooperation between the Underwater Research Society and Dokuz Eylul University. The coastal and marine sites of the SEPA, especially Iztuzu Beach is important for nesting and breeding of Caretta caretta. Under the scope of the project, the study was carried out only once in autumn within the 0-50 meter depth zone with both sampling methods and visual observations of marine flora and fauna. The study aimed to define biodiversity of the marine area including seabed habitats and facies formations. Seven facies formations and six different benthic habitat types were defined during the study. Determinations of 17 species under several categories of IUCN Red List and 10 exotic species were other important findings which should be considered as significance of threat upon the marine ecosystem of the Koycegiz-Dalyan SEPA

A Multi-Center Study on the Efficacy of Eltrombopag in Management of Refractory Chronic Immune Thrombocytopenia: A Real-Life Experience

Objective: The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP)

A Multi-Center Study on the Efficacy of Eltrombopag in Management of Refractory Chronic Immune Thrombocytopenia: A Real-Life Experience

Objective: The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP). Materials and Methods: A total of 285 chronic ITP patients (187 women, 65.6 \%; 98 men, 34.4\%) followed in 55 centers were enrolled in this retrospective cohort. Response to treatment was assessed according to platelet count (/mm(3)) and defined as complete (platelet count of >100,000/mm(3)), partial (30,000-100,000/mm(3) or doubling of platelet count after treatment), or unresponsive (<30,000/mm(3)). Clinical findings, descriptive features, response to treatment, and side effects were recorded. Correlations between descriptive, clinical, and hematological parameters were analyzed. Results: The median age at diagnosis was 43.9 +/- 20.6 (range: 3-95) years and the duration of follow-up was 18.0 +/- 6.4 (range: 6-28.2) months. Overall response rate was 86.7\% (n=247). Complete and partial responses were observed in 182 (63.8\%) and 65 (22.8\%) patients, respectively. Thirty-eight patients (13.4\%) did not respond to eltrombopag treatment. For patients above 60 years old (n=68), overall response rate was 89.7\% (n=61), and for those above 80 years old (n=12), overall response rate was 83\% (n=10). Considering thrombocyte count before treatment, eltrombopag significantly increased platelet count at the 1st, 2nd, 3rd, 4th, and 8th weeks of treatment. As the time required for partial or complete response increased, response to treatment was significantly reduced. The time to reach the maximum platelet levels after treatment was quite variable (1-202 weeks). Notably, the higher the maximum platelet count after eltrombopag treatment, the more likely that side effects would occur. The most common side effects were headache (21.6\%), weakness (13.7\%), hepatotoxicity (11.8\%), and thrombosis (5.9\%). Conclusion: Results of the current study imply that eltrombopag is an effective therapeutic option even in elderly patients with chronic ITP. However, patients must be closely monitored for response and side effects during treatment. Since both response and side effects may be variable throughout the follow-up period, patients should be evaluated dynamically, especially in terms of thrombotic risk factors

Large-scale cis- and trans-eQTL analyses identify thousands of genetic loci and polygenic scores that regulate blood gene expression

Abstract Trait-associated genetic variants affect complex phenotypes primarily via regulatory mechanisms on the transcriptome. To investigate the genetics of gene expression, we performed cis- and trans-expression quantitative trait locus (eQTL) analyses using blood-derived expression from 31,684 individuals through the eQTLGen Consortium. We detected cis-eQTL for 88% of genes, and these were replicable in numerous tissues. Distal trans-eQTL (detected for 37% of 10,317 trait-associated variants tested) showed lower replication rates, partially due to low replication power and confounding by cell type composition. However, replication analyses in single-cell RNA-seq data prioritized intracellular trans-eQTL. Trans-eQTL exerted their effects via several mechanisms, primarily through regulation by transcription factors. Expression of 13% of the genes correlated with polygenic scores for 1,263 phenotypes, pinpointing potential drivers for those traits. In summary, this work represents a large eQTL resource, and its results serve as a starting point for in-depth interpretation of complex phenotypes