Survival nomograms for vulvar squamous cell carcinoma based on the SEER database and a Chinese external validation cohort.

OBJECTIVE: The aim of study was to construct a nomogram to effectively predict the overall survival (OS) and cancer-specific survival (CSS) for patients with vulvar squamous cell carcinoma (VSCC). METHODS: The training cohort consisted of 5405 patients with VSCC, extracted from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. Eighty-four patients with VSCC were selected from the disease database of the Shengjing Hospital of China Medical University from 2014 to 2020, and enrolled as the external validation cohort. Significant independent prognostic factors were identified using Cox regression analysis and used to develop nomograms to predict 1-, 3-, and 5-year OS and CSS in patients with VSCC. RESULTS: The nomogram predicting OS was developed based on tumor size, histological grade, International Federation of Gynecology and Obstetrics (FIGO) stage, regional lymph node involvement, distant metastases, surgery, chemotherapy, age, and race. The nomogram for CSS was constructed using the similar factors, excluding race but including marital status. The nomogram for 1-, 3-, and 5-year OS demonstrated robust performance with receiver operating characteristic curves (AUCs) exceeding 80% (0.86, 0.84, and 0.82), outperforming the FIGO staging alone (0.77, 0.75, and 0.72). Similarly, for CSS, our nomograms achieved larger AUCs of 0.89, 0.88, and 0.86 compared with FIGO staging alone (0.81, 0.79, and 0.78). CONCLUSION: The nomograms more accurately predict prognosis than simple FIGO staging. Moreover, the nomograms developed in this study provide a convenient, operable, and reliable tool for individual assessment and clinical decision-making for patients with VSCC.

Zonotope-Based Distributed Set-Membership Fusion Estimation for Artificial Neural Networks Under the Dynamic Event-Triggered Mechanism.

This article is concerned with the distributed set-membership fusion estimation problem for a class of artificial neural networks (ANNs), where the dynamic event-triggered mechanism (ETM) is utilized to schedule the signal transmission from sensors to local estimators to save resource consumption and avoid data congestion. The main purpose of this article is to design a distributed set-membership fusion estimation algorithm that ensures the global estimation error resides in a zonotope at each time instant and, meanwhile, the radius of the zonotope is ultimately bounded. By means of the zonotope properties and the linear matrix inequality (LMI) technique, the zonotope restraining the prediction error is first calculated to improve the prediction accuracy and subsequently, the zonotope enclosing the local estimation error is derived to enhance the estimation performance. By taking into account the side-effect of the order reduction technique (utilized in designing the local estimation algorithm) of the zonotope, a sufficient condition is derived to guarantee the ultimate boundedness of the radius of the zonotope that encompasses the local estimation error. Furthermore, parameters of the local estimators are obtained via solutions to certain bilinear matrix inequalities. Moreover, the zonotope-based distributed fusion estimator is obtained through minimizing certain upper bound of the radius of the zonotope (that contains the global estimation error) according to the matrix-weighted fusion rule. Finally, the effectiveness of the proposed distributed fusion estimation method is illustrated via a numerical example.

Association of dietary patterns with general and central obesity among Chinese adults: a longitudinal population-based study.

BACKGROUND: Limited evidence exists for the association between dietary patterns and later obesity phenotypes among Chinese adults. This longitudinal study aimed to evaluate associations of dietary patterns with general and central obesity in Chinese adults. METHODS: Based on the China Health and Nutrition Survey (CHNS) waves 2004 and 2015, the study was conducted on 4207 adult men and women (age range: 18-65 years). Dietary intakes were assessed by three consecutive 24-h dietary recalls, and dietary patterns were identified using exploratory factor analysis. Longitudinal associations of dietary patterns with general and central obesity were evaluated using logistic regression analyses. RESULTS: The prevalence rates of general and central obesity were 14.2% and 42.1%, respectively. Factor analysis extracted three major dietary patterns: "traditional southern," "modern," and "traditional northern." After adjustment for potential confounders, adults in the highest quartile of the traditional southern dietary group were less likely to develop over 10 years general (odds ratio [OR] = 0.50, 95% confidence interval [95%CI]: 0.39, 0.65) and central (OR = 0.52, 95%CI: 0.43, 0.63) obesity compared to those in the lowest quartile group. The modern dietary pattern was not significantly associated with general and central obesity. Adherence to the traditional northern dietary pattern increased the chance of both general and central obesity (OR = 1.61, 95%CI: 1.23, 2.10; OR = 1.64, 95%CI: 1.36, 1.98) after 10 years. CONCLUSIONS: Our study provides longitudinal evidence for associations between dietary patterns and later obesity phenotypes among Chinese adults. Our findings may guide the development of evidence-based preventive nutrition interventions to control the obesity epidemic.

Cyclic amplification of intracellular ROS boosts enzymatic prodrug activation for enhanced chemo-immunotherapy.

Tumor-associated enzyme activated prodrug is a potential strategy to overcome the limitations of chemotherapeutic agents. However, the efficiency of enzymatic prodrug activation is limited by the inability to reach adequate enzyme levels in vivo. Herein, we report an intelligent nanoplatform with cyclic amplification of intracellular reactive oxygen species (ROS) that significantly up-regulates the expression of tumor-associated enzyme, NAD(P)H:quinone oxidoreductase 1 (NQO1), to efficiently activate the prodrug of doxorubicin (DOX) for enhanced chemo-immunotherapy. The nanoplatform termed as CF@NDOX was fabricated by self-assembly of the amphiphilic cinnamaldehyde (CA) containing poly(thioacetal) conjugated with ferrocene (Fc) and poly(ethylene glycol) (PEG) (TK-CA-Fc-PEG), which further encapsulated the NQO1 responsive prodrug of DOX (NDOX). After CF@NDOX accumulates in tumors, the TK-CA-Fc-PEG with ROS responsive thioacetal group responds to endogenous ROS in tumor to release CA, Fc or NDOX. CA induces mitochondria dysfunction and elevates the intracellular hydrogen peroxide (H2O2) levels, which react with Fc to generate highly oxidative hydroxyl radical (•OH) through Fenton reaction. The •OH not only promotes ROS cyclic amplification but also increase the expression of NQO1 through Keap1-Nrf2 pathway regulation, which further boost the prodrug activation of NDOX for enhanced chemo-immunotherapy. Overall, our well-designed intelligent nanoplatform provides a tactic to enhance the antitumor efficacy of tumor-associated enzyme activated prodrug. STATEMENT OF SIGNIFICANCE: In this work, a smart nanoplatform CF@NDOX with intracellular ROS cyclic amplification for continuous upregulation of NQO1 enzyme expression was innovatively designed. It could utilize Fenton reaction of Fc to increase the level of NQO1 enzyme and CA to increase the level of intracellular H2O2, thereby facilitating the continuous Fenton reaction. This design allowed for a sustained elevation of the NQO1 enzyme, and a more complete activation of the NQO1 enzyme in response to the prodrug NDOX. This smart nanoplatform can achieve a desirable anti-tumor effect with the combined therapy of chemotherapy and ICD effects.

ROS-responsive self-activatable photosensitizing agent for photodynamic-immunotherapy of cancer.

Photodynamic therapy (PDT), as a non-invasive and spatiotemporally controllable modality, exhibits great potential in cancer treatment. However, the efficiency of reactive oxygen species (ROS) production was restricted to the hydrophobic characteristics and aggregation-caused quenching (ACQ) of photosensitizers. Herein, we designed a ROS self-activatable nano system (denoted as PTKPa) based on poly(thioketal) conjugated with photosensitizers (PSs) pheophorbide A (Ppa) on the polymer side chains for suppressing ACQ and enhancing PDT. The process of self-activation is that ROS, which is derived from laser irradiated PTKPa, as an activating agent accelerates poly(thioketal) cleavage with the release of Ppa from PTKPa. This in turn generates abundant ROS, accelerates degradation of the remaining PTKPa and amplifies the efficacy of PDT with more tremendous ROS generated. Moreover, these abundant ROS can amplify PDT-induced oxidative stress, cause irreversible damage to tumor cells and achieve immunogenic cell death (ICD), thereby boosting the efficacy of photodynamic-immunotherapy. These findings provide new insights into ROS self-activatable strategy for enhancing cancer photodynamic- immunotherapy. STATEMENT OF SIGNIFICANCE: This work described an approach to utilize ROS-responsive self-activatable poly(thioketal) conjugated with pheophorbide A (Ppa) for suppressing aggregation-caused quenching (ACQ) and enhancing photodynamic-immunotherapy. The ROS, generated from the conjugated Ppa upon 660nm laser irradiation, as a triggering agent which initiates the release of Ppa with poly(thioketal) degradation. That in turn generates abundant ROS and facilitates degradation of the remaining PTKPa, resulting in oxidative stress to tumor cells and achieving immunogenic cell death (ICD). This work provides a promising solution to improve tumor photodynamic therapeutic effects.

Activatable fluorescent probes for real-time imaging-guided tumor therapy.

Surgery and drug therapy are the two principal options for cancer treatment. However, their clinical benefits are hindered by the difficulty of accurate location of the tumors and timely monitoring of the treatment efficacy of drugs, respectively. Rapid development of imaging techniques provides promising tools to address these challenges. Compared with conventional imaging techniques such as magnetic resonance imaging and computed tomography etc., fluorescence imaging exhibits high spatial resolution, real-time imaging capability, and relatively low costs devices. The advancements in fluorescent probes further accelerate the implementation of fluorescence imaging in tumor diagnosis and treatment monitoring. In particular, the emergence of site-specifically activatable fluorescent probes fits the demands of tumor delineation and real-time feedback of the treatment efficacy. A variety of small molecule probes or nanoparticle-based probes have been developed and explored for the above-mentioned applications. This review will discuss recent advances in fluorescent probes with a special focus on activatable nanoprobes and highlight the potential implementation of activatable nanoprobes in fluorescence imaging-guided surgery as well as imaging-guided drug therapy.

Dual stimulus-triggered bioorthogonal nanosystem for spatiotemporally controlled prodrug activation and near-infrared fluorescence imaging.

In this study, we combined low pH and cathepsin B dual-stimulus-triggered delivery carriers with a bioorthogonal reaction-activated prodrug to achieve regulated activation of the prodrug. A workable method for precise tumor therapy and imaging is provided by the bioorthogonal reaction, which activates the prodrug and fluorescent probe.

PPARγ/Adiponectin axis attenuates methamphetamine-induced conditional place preference via the hippocampal AdipoR1 signaling pathway.

Methamphetamine (METH) is a highly addictive psychostimulant. The adipocyte-derived hormone adiponectin has a broad spectrum of functions in the brain. However, limited research has been conducted on the effect of adiponectin signaling on METH-induced conditioned place preference (CPP) and knowledge of the underlying neural mechanisms is scarce. The METH induced adult male C57/BL6J mice model were used for testing the therapeutic activities of intraperitoneal injection of AdipoR agonist AdipoRon and peroxisome proliferator-activated receptor gamma (PPARγ)-selective agonist rosiglitazone, adiponectin receptor 1 (AdipoR1) overexpression in hippocampal dentate gyrus (DG), and chemogenetic inhibiting the neural activity of DG, and the changes of neurotrophic factors, synaptic molecules, glutamate receptors, and inflammatory cytokines were also measured. We found that adiponectin expression was significantly reduced in METH addicted patients and mice. Our findings also showed that injection of AdipoRon or rosiglitazone alleviated the METH-induced CPP behavior. Moreover, the expression of AdipoR1 in the hippocampus was also reduced, and AdipoR1 overexpression blocked the development of METH-induced CPP behavior through regulatory effects on neurotrophic factors, synaptic molecules, and glutamate receptors. The observed inhibitory neural activity of the hippocampal dentate gyrus (DG) induced via a chemogenetic approach produced a therapeutic effect on the METH-induced CPP behavior. Finally, we identified an abnormal expression of some key inflammatory cytokines through the PPARγ/Adiponectin/AdipoR1 axis. This study demonstrates that adiponectin signaling is a promising diagnostic and therapeutic target for METH addiction.

A dual-amplified ROS-responsive nanosystem with self-accelerating drug release for synergistic chemotherapy.

In this work, we have developed a tumor-specific self-accelerating prodrug activation nanosystem consisting of self-amplifying degradable polyprodrug PEG-TA-CA-DOX and encapsulated fluorescent prodrug BCyNH2, equipped with a reactive oxygen species dual-cycle amplification effect. Furthermore, activated CyNH2 is a therapeutic agent with potential to synergistically improve chemotherapy.

Sequential Fusion Estimation for Multirate Complex Networks With Uniform Quantization: A Zonotopic Set-Membership Approach.

In this article, the sequential fusion estimation problem is investigated for multirate complex networks (MRCNs) with uniformly quantized measurements. The process and measurement noises, which are unknown-yet-bounded (UYB), are restrained into a family of zonotopes, and the multiple sensors are allowed to have different sampling periods. To facilitate digital transmissions, the sensor measurements are uniformly quantized before being sent to the remote estimator. The purpose of this article is to design a sequential set-membership estimator such that, in the simultaneous presence of UYB noises, multirate samplings, and uniform quantization effects, the estimation error (after each measurement update) is confined to a zonotope with minimum F -radius at each time instant. By introducing certain virtual measurements, the MRCNs are first transformed into single-rate ones exhibiting a switching phenomenon. Then, by utilizing the properties of zonotopes, the desired zonotopes are derived, which contain the estimation error dynamics after each measurement update. Subsequently, the gain matrices of the sequential estimator are derived by minimizing the F -radii of these zonotopes, and the uniform boundedness is analyzed for the F -radius of the zonotope containing the estimation error after all measurement updates. Furthermore, sufficient conditions are derived to ensure the existence of the desired uniform upper/lower bounds. Finally, an illustrated example is proposed to show the effectiveness of the proposed sequential fusion estimation method.

Mechanisms of Action of the Antimicrobial Peptide Cecropin in the Killing of Candida albicans.

The development of drug resistance has caused fungal infections to become a global health concern. Antimicrobial peptides (AMPs) offer a viable solution to these pathogens due to their resistance to drug resistance and their diverse mechanisms of actions, which include direct killing and immunomodulatory properties. The peptide Cecropin, which is expressed by genetically engineered bacteria, has antifungal effects on Candida albicans. The minimal inhibitory concentration (MIC) and the minimal fungicidal concentration (MFC) of Candida albicans were 0.9 µg/mL and 1.8 µg/mL, respectively, detected by the micro-broth dilution method. According to the killing kinetics, the MFC of Cecropin could kill Candida albicans in 40 min. The electron microscope indicated that Cecropin could cause the cell wall to become rough and nicked, eventually killing Candida albicans. The effects of Cecropin on the cell membrane of treated C. albicans, using the 1,6-diphenyl-1,3,5-hexatriene and propidium iodide protocol, showed that they could change the permeability and fluidity, destroy it, and lead to cell necrosis. In addition, Cecropin can also induce cells to produce excessive reactive oxygen species, causing changes in the mitochondrial membrane potential. Therefore, this study provides a certain theoretical basis for the antifungal infection of new antifungal agents.

Quantized recursive filtering for networked systems with stochastic transmission delays.

This paper investigates the recursive filtering problem for a class of networked systems subject to the uniform quantization effects and stochastic transmission delays. The system output is quantized according to a uniform quantization mechanism, and then sent to the remote filter via a communication network undergoing stochastic transmission delays (which are modeled by a sequence of independent and identically distributed variables). To deal with the stochastic transmission delays, an indicator function is delicately designed to ensure that the filtering process is implemented based on the quantized measurement with the newest timestamp available for the filter. With the aid of the indicator function, a free-delay system is obtained by using the augmented system method. The aim of this paper is to design a Kalman-type filter for the augmented system such that an upper bound of the filtering error covariance is guaranteed and minimized. With the aid of the stochastic analysis method, the desired upper bound of the filtering error covariance is derived by recursively solving two Riccati-like difference equations. Then, the upper bound is minimized by properly selecting the filter parameters. Finally, a numerical example is provided to illustrate the validity of the developed filtering scheme.

Research on Protection Performance of Surge Protective Devices against Electromagnetic Pulse.

To evaluate the protection performance of SPD (surge protective device) against electromagnetic pulse, the response ability of several typical surge protective devices to wide and narrow electromagnetic pulses was tested by using a SPD response ability test system. The results showed that SPD commonly used in lightning surge protection had certain ability to suppress electromagnetic pulse conduction disturbance. Gas discharge tubes presented typical clamping characteristics for wide pulses. MOV and TVS had obvious clamping effect on wide pulses, while had no clamping effect on narrow pulses, but could obviously reduce its peak value. Zener diodes had obvious clamping effect on narrow pulses, and the clamping voltage control accuracy was high.

Self-catalyzed tumor ferroptosis based on ferrocene conjugated reactive oxygen species generation and a responsive polymer.

In this work, we developed a ferroptosis self-catalyst, PTAF, exhibiting self-catalyzed ferroptosis for enhanced cancer therapy. Briefly, synergistic actions of self-catalyzed ˙OH accumulation and GPX4 indirect inactivation based on the establishment of the ROS self-catalytic loop effectively induced tumor ferroptosis, which provided a novel approach for enhanced tumor therapy.

Serum galectin-3BP as a novel marker of obesity and metabolic syndrome in Chinese adolescents.

INTRODUCTION: Childhood obesity (OB) and metabolic syndrome (MetS) have become a worldwide health problem. Comparative proteomic approaches are widely used in human OB to analyze protein changes in blood plasma. The present study determined the galectin-3 binding protein (galectin-3BP) expression level in different weight categories and assessed the associations between galectin-3BP and OB and MetS. RESEARCH DESIGN AND METHODS: The current study included 932 Chinese adolescents 13-18 years of age. The biochemical and anthropometric variables of all the subjects were evaluated using standardized procedures. The differentially expressed proteins (DEPs) were investigated among 60 adolescents (20 normal weight, 20 overweight and 20 obese) using tandem mass tag (TMT) quantitative proteomics. The serum galectin-3BP level was measured using ELISA. The associations between galectin-3BP and OB and MetS were analyzed in 932 adolescents using multiple logistic regression analyses. RESULTS: A significant DEP, galectin-3BP, can effectively separate the obese from the normal weight group using TMT. Adolescents in tertile 3 of galectin-3BP, when compared with adolescents in the tertile 1, were positively associated with OB (OR=3.32, 95% CI 1.79 to 6.16) and MetS (OR=3.28, 95% CI 1.30 to 8.26). The receiver operating characteristic curve for galectin-3BP in subjects with MetS indicated that the area under the curve was 0.85 (95% CI 0.79 to 0.91). CONCLUSIONS: This study confirmed an association between galectin-3BP and OB in Chinese adolescents, and galectin-3BP was also positively associated with MetS, and thus might be useful for identifying adolescents with MetS.

Relationships between IL-1ß, TNF-α genetic polymorphisms and HBV infection: A meta-analytical study.

BACKGROUND: IL-1ß and TNF-α have been demonstrated as pro-inflammatory cytokines to participate in the innate immune response and suppression of HBV infection. However, the exact relationship between IL-1ß, TNF-α gene polymorphisms and HBV infection remains unknown. Our study aims to assess the associations between IL-1ß, TNF-α gene polymorphisms and HBV infection. METHODS: A systematic literature search of PubMed and Embase databases was conducted through February 2020, and studies that were included in the present meta-analysis should fulfil the following conditions: (1) case-control studies focusing on the associations between IL-1ß, TNF-α polymorphisms and HBV infection; (2) patients in the case group should be tested positive for the HBsAg and/or HBV-DNA without liver cirrhosis or hepatocellular carcinoma; (3) the control group including healthy population or HBV spontaneous clearance population; (4) odds ratios (ORs) and their 95% confidence intervals (CIs) could be calculated based on the allele and genotype frequencies provided in articles. The quality of included studies was assessed according to the Newcastle-Ottawa scale (NOS) assessment system. Pooled ORs and 95% CIs were used to analyze the strength of associations. Subgroup analysis was performed according to ethnicity and control type. RESULTS: In the present meta-analysis, 49 articles including 10,218 cases and 9,557 controls were enrolled and seven polymorphisms (IL-1ß rs16944, rs1143634, TNF-α rs1799724, rs1799964, rs1800629, rs1800630, rs361525) were studied. In overall meta-analysis, significant associations were found in IL-1ß rs1143634, TNF-α rs1799724 and TNF-α rs1799964. For subgroup analysis under ethnicity, TNF-α rs1799724 and rs1800630 were markedly related to HBV infection in both Asian and Caucasian populations. In terms of control type subgroup, TNF-α rs1799724, rs1799964, rs1800630 were significantly associated with HBV persistence in HBV spontaneous clearance group. CONCLUSION: In the present study, we identified that three polymorphisms (IL-1ß rs1143634, TNF-α rs1799724, rs1799964) might serve as potential genetic biomarkers in HBV infection.

Epidemiology of norovirus gastroenteritis in hospitalized children under five years old in western China, 2015-2019.

OBJECTIVES: Norovirus is associated with one-fifth of all gastroenteritis cases, but basic epidemiological data is lacking, especially in developing countries. As long-term surveillance on norovirus gastroenteritis is scarce in western China, this study aims to update the epidemiological knowledge of norovirus gastroenteritis and to characterize the genotypes of norovirus strains. METHODS: Stool samples were collected from hospitalized children under 5 years old with gastroenteritis in Chengdu, China. All samples were tested for norovirus as well as rotavirus, sapovirus, enteric adenovirus, and astrovirus by real-time RT-PCR. RdRp and VP1 genes were sequenced in norovirus-positive samples to investigate viral phylogenies. RESULTS: Of the 1181 samples collected from 2015 to 2019, 242 (20.5%) were positive for norovirus. Among norovirus-positive cases, 65 cases had co-infection with another virus; norovirus/enteric adenovirus was most frequently detected (50.8%, 33/65). The highest positive rate was observed in children aged 13-18 months (23.7%, 68/287). Norovirus infection peaked in autumn (36.6%, 91/249), followed by summer (20.3%, 70/345). Pearson correlation analysis showed significant correlation between the norovirus-positive rate and humidity (r = 0.773, P < 0.05). GII.4 Sydney 2012 [P31] (48.5%, 79/163) and GII.3 [P12] (35.6%, 58/163) were the dominant norovirus strains. CONCLUSIONS: Norovirus has become one of the most common causes of viral gastroenteritis in children under 5 years old in western China. Continuous monitoring is imperative for predicting the emergence of new epidemic strains and for current vaccine development.

An enlightening role for cytokine storm in coronavirus infection.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in Wuhan, China has dispersed rapidly worldwide. Although most patients present with mild fever, cough with varying pulmonary shadows, a significant portion still develops severe respiratory dysfunction. And these severe cases are often associated with manifestations outside the respiratory tract. Currently, it is not difficult to find inflammatory cytokines upregulated in the blood of infected patients. However, some complications in addition to respiratory system with the coronavirus disease 2019 (COVID-19) are impossible to explain or cannot be attributed to virus itself. Thus excessive cytokines and their potentially fatal adverse effects are probably the answer to the multiple organ dysfunctions and growing mortality. This review provides a comprehensive overview of the mechanisms underlying cytokine storm, summarizes its pathophysiology and improves understanding of cytokine storm associated with coronavirus infections by comparing SARS-CoV-2 with severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV).

Complement C1q as a Potential Biomarker for Obesity and Metabolic Syndrome in Chinese Adolescents.

Background: Complement C1q (C1q) has been confirmed to be related to obesity, metabolic syndrome (MetS), and its components. However, human data regarding the associations are relatively scarce. This study aimed to investigate associations of C1q with obesity as well as MetS in Chinese adolescents. Methods: A total of 1,191 Chinese adolescents aged 13-18 years were enrolled in this study. The biochemical and anthropometric variables of all the subjects were evaluated using standardized procedures. C1q was measured using the immunoturbidometric assay. The relationship between C1q and obesity or MetS was analyzed using multiple regression analyses. Results: Obesity was more prevalent among participants in the highest tertile than in the lowest tertile of C1q levels. The highest tertile of C1q was related to a greater effect on the risk of MetS, and its trend test was statistically significant. Except for hyperglycemia, the prevalence of other components of MetS significantly increased relative to an increase in C1q tertile. Receiver operating characteristic (ROC) curve analysis of C1q for predicting adolescents with MetS illustrated that the area under the curve (AUC) was 0.82 [95% confidence interval (CI): 0.76, 0.88; P<0.001] in the total population after adjusting for confounders. Conclusions: This study observed a significantly higher prevalence of obesity and MetS features in adolescents with high C1q. The findings of the current study also reported a significant relationship between C1q levels and MetS components [except for fasting plasma glucose (FPG)] in Chinese adolescents. C1q may represent a biomarker for predicting obesity or MetS in adolescents.

The evaluation of low cut-off index values of Elecsys® HIV combi PT assay in predicting false-positive results.

OBJECTIVE: To analyze the results of different cut-off index (COI) values of Elecsys® HIV combi PT assay and to assess the role of COI in reducing the frequency of false-positive results. METHODS: We conducted a retrospective study of samples analyzed by Elecsys® HIV combi PT assay, a 4th-generation ECLIA, between 2016 and 2017. A total amount of 379 122 samples were collected for HIV (Human Immunodeficiency Virus) screening. RESULTS: A total of 379 122 samples were analyzed. 2528 (0.67%) were positive by Elecsys® HIV combi PT. Of these, 468 were false-positive results, and most of them (94.87%) were in samples with 1 < COI < 15. The false-positive rate was 0.12%. Patients with false-positive samples were more distributed in elder (P < .001) and female (P < .001) than true-positive specimens. The median COI in true-positive specimens was (385.20), which is significantly higher than false-positive specimens (2.08). The consistency between Elecsys® HIV combi PT assay and 3rd-generation and positive predictive value (PPV) increased with higher COI values. Cancer, infection, and neurological diseases were considered the potential confounding factors of HIV false-positive results (19.44%, 11.11%, and 6.62%, respectively). CONCLUSION: Samples with low COI values, especially those contain confounding factors, need to be further scrutinized to determine whether the confounding factors may cause false-positive problem. In addition, the hypothesis that low COI values may predict false-positive results is valid.