Accuracy of LightCycler® SeptiFast for the detection and identification of pathogens in the blood of patients with suspected sepsis: a systematic review protocol

Background: There is growing interest in the potential utility of molecular diagnostics in improving the detection of life-threatening infection (sepsis). LightCycler® SeptiFast is a multipathogen probebased real-time PCR system targeting DNA sequences of bacteria and fungi present in blood samples within a few hours. We report here the protocol of the first systematic review of published clinical diagnostic accuracy studies of this technology when compared with blood culture in the setting of suspected sepsis. Methods/design: Data sources: the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects (DARE), the Health Technology Assessment Database (HTA), the NHS Economic Evaluation Database (NHSEED), The Cochrane Library, MEDLINE, EMBASE, ISI Web of Science, BIOSIS Previews, MEDION and the Aggressive Research Intelligence Facility Database (ARIF). Study selection: diagnostic accuracy studies that compare the real-time PCR technology with standard culture results performed on a patient's blood sample during the management of sepsis. Data extraction: three reviewers, working independently, will determine the level of evidence, methodological quality and a standard data set relating to demographics and diagnostic accuracy metrics for each study. Statistical analysis/data synthesis: heterogeneity of studies will be investigated using a coupled forest plot of sensitivity and specificity and a scatter plot in Receiver Operator Characteristic (ROC) space. Bivariate model method will be used to estimate summary sensitivity and specificity. The authors will investigate reporting biases using funnel plots based on effective sample size and regression tests of asymmetry. Subgroup analyses are planned for adults, children and infection setting (hospital vs community) if sufficient data are uncovered. Dissemination: Recommendations will be made to the Department of Health (as part of an open-access HTA report) as to whether the real-time PCR technology has sufficient clinical diagnostic accuracy potential to move forward to efficacy testing during the provision of routine clinical care.

False-positive PCR results linked to administration of seasonal influenza vaccine

False-positive PCR results usually occur as a consequence of specimen-to-specimen or amplicon-to-specimen contamination within the laboratory. Evidence of contamination at time of specimen collection linked to influenza vaccine administration in the same location as influenza sampling is described. Clinical, circumstantial and laboratory evidence was gathered for each of five cases of influenza-like illness (ILI) with unusual patterns of PCR reactivity for seasonal H1N1, H3N2, H1N1 (2009) and influenza B viruses. Two 2010 trivalent influenza vaccines and environmental swabs of a hospital influenza vaccination room were also tested for influenza RNA. Sequencing of influenza A matrix (M) gene amplicons from the five cases and vaccines was undertaken. Four 2009 general practitioner (GP) specimens were seasonal H1N1, H3N2 and influenza B PCR positive. One 2010 GP specimen was H1N1 (2009), H3N2 and influenza B positive. PCR of 2010 trivalent vaccines showed high loads of detectable influenza A and B RNA. Sequencing of the five specimens and vaccines showed greatest homology with the M gene sequence of Influenza A/Puerto Rico/8/1934 H1N1 virus (used in generation of influenza vaccine strains). Environmental swabs had detectable influenza A and B RNA. RNA detection studies demonstrated vaccine RNA still detectable for at least 66 days. Administration of influenza vaccines and clinical sampling in the same room resulted in the contamination with vaccine strains of surveillance swabs collected from patients with ILI. Vaccine contamination should therefore be considered, particularly where multiple influenza virus RNA PCR positive signals (e.g. H1N1, H3N2 and influenza B) are detected in the same specimen.

The Langmuir probe as a diagnostic of the electron component within low temperature laser ablated plasma plumes

A Langmuir probe has been used as a diagnostic of the temporally evolving electron component within a laser ablated Cu plasma expanding into vacuum, for an incident laser power density on target similar to that used for the pulsed laser deposition of thin films. Electron temperature data were obtained from the retarding region of the probe current/voltage (I/V) characteristic, which was also used to calculate an associated electron number density. Additionally, electron number density data were obtained from the saturation electron current region of the probe (I/V) characteristic. Electron number density data, extracted by the two different techniques, were observed to show the same temporal form, with measured absolute values agreeing to within a factor of 2. The Langmuir probe, in the saturation current region, has been shown for the first time to be a convenient diagnostic of the electron component within relatively low temperature laser ablated plasma plumes. (C) 1999 American Institute of Physics. [S0034-6748(99)01503-8].

EXPERIMENTAL STUDIES OF LINE INTENSITY RATIO AS A DIAGNOSTIC OF RECOMBINING PLASMAS

Double slits have been incorporated in a flat field spectrometer to record spatially resolved and integrated spectra simultaneously. Variation of the absorbed irradiance and ionisation stage along the fibre plasmas has been monitored. By comparison of the spatially resolved and integrated resonance line ratios, it is found that the spatially integrated values deviated significantly from the real experimental circumstances due to nonuniformity along the plasmas.

Diagnostic of laser contrast using target reflectivity

Using three different laser systems, we demonstrate a convenient and simple plasma based diagnostic of the contrast of high-power short-pulse lasers. The technique is based on measuring the specular reflectivity from a solid target. The reflectivity remains high even at relativistic intensities above 10(19) W/cm(2) in the case of a high-contrast prepulse-free laser. On the contrary, the specular reflectivity drops with increasing intensities in the case of systems with insufficient contrast due to beam breakup and increased absorption caused by preplasma.

Third harmonic order imaging as a focal spot diagnostic for high intensity laser-solid interactions

As the state of the art for high power laser systems increases from terawatt to petawatt level and beyond, a crucial parameter for routinely monitoring high intensity performance is laser spot size on a solid target during an intense interaction in the tight focus regime ( 10(19) Wcm(-2) is demonstrated experimentally and shown to provide the basis for an effective focus diagnostic. Importantly, this technique is also shown to allow in-situ diagnosis of focal spot quality achieved after reflection from a double plasma mirror setup for very intense high contrast interactions (> 10(20) Wcm(-2)) an important application for the field of high laser contrast interaction science.

Nuclear activation as a high dynamic range diagnostic of laser-plasma interactions

Proton imaging has become a common diagnostic technique for use in laser-plasma research experiments due to their ability to diagnose electric field effects and to resolve small density differences caused through shock effects. These interactions are highly dependent on the use of radiochromic film (RCF) as a detection system for the particle probe, and produces very high-resolution images. However, saturation effects, and in many cases, damage to the film limits the usefulness of this technique for high-flux particle probing. This paper outlines the use of a new technique using contact radiography of (p,n)-generated isotopes in activation samples to produce high dynamic range 2D images with high spatial resolution and extremely high dynamic range, whilst maintaining both energy resolution and absolute flux measurements. (C)007 Elsevier B.V. All rights reserved.

Detection of short lived radioisotopes as a fast diagnostic for intense laser-solid interactions

As a diagnostic of high-intensity laser interactions (> 10(19) W cm(-2)), the detection of radioactive isotopes is regularly used for the characterization of proton, neutron, ion, and photon beams. This involves sample removal from the interaction chamber and time consuming post shot analysis using NaI coincidence counting or Ge detectors. This letter describes the use of in situ detectors to measure laser-driven (p,n) reactions in Al-27 as an almost real-time diagnostic for proton acceleration. The produced Si-27 isotope decays with a 4.16 s half-life by the predominantly beta+ emission, producing a strong 511 keV annihilation peak. (c) 2006 American Institute of Physics.