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Article ; Online: Clinical testing of pediatric mpox specimens: Unique features and challenges in a low prevalence population.

Ma, Angela / Bradley, Benjamin T

Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology

2023 Volume 163, Page(s) 105447

Abstract: Background: Pediatric mpox cases comprise less than 0.3% of the total cases reported in the United States during the global 2022 outbreak. As a result, relatively little is known about the epidemiology or performance characteristics of clinical testing ... ...

Abstract	Background: Pediatric mpox cases comprise less than 0.3% of the total cases reported in the United States during the global 2022 outbreak. As a result, relatively little is known about the epidemiology or performance characteristics of clinical testing in this group. Methods: We retrospectively extracted and analyzed results for pediatric mpox specimens tested at a national reference laboratory from July to December 2022. Results: During our study period 13.4% (2,063/15,385) of specimens were from individuals <18 years of age. The positivity rate of pediatric specimens was significantly lower than in adults (1.3% vs 22.3%). The pediatric cohort also consisted of a higher percentage of females (42.7% vs 31.0%) and lower percentage of specimens from genital sources (9.0% vs 19.7%) as compared to adults. In children, specimens were most frequently collected from 1-year-olds (10.1%) and least frequently from 11-year-olds (3.5%). Positivity rates were disproportionately elevated in the less than 1-year-old and 17-year-old age groups (7.8% and 6.4%, respectively). Ct values of positive cases were not statistically different between pediatric and adult cohorts (25.2 vs 22.2, p>0.05). When all pediatric cases with an initial positive mpox result were examined, 5/26 were classified as inconclusive and 2/26 were determined to be false positives. The positive predictive value of monkeypox virus detection was 90.5% (95% CI: 70.4-97.4%) in children. Conclusion: These results highlight important differences between pediatric and adult mpox populations and reinforce the need for clinical correlation when reporting positive results from a low prevalence population.
MeSH term(s)	Adult ; Female ; Humans ; Child ; Infant ; Mpox (monkeypox) ; Prevalence ; Retrospective Studies ; Disease Outbreaks
Language	English
Publishing date	2023-04-12
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1446080-4
ISSN	1873-5967 ; 1386-6532
ISSN (online)	1873-5967
ISSN	1386-6532
DOI	10.1016/j.jcv.2023.105447
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Zs.A 3790: Show issues

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Article ; Online: Review of the Clinical Presentation, Pathology, Diagnosis, and Treatment of Leishmaniasis.

Mathison, Blaine A / Bradley, Benjamin T

Laboratory medicine

2022 Volume 54, Issue 4, Page(s) 363–371

Abstract: Leishmaniasis is a vector-borne infection caused by kinetoplastid protozoans in the genera Leishmania and Endotrypanum. The disease occurs worldwide in the tropics and subtropics and can be particularly burdensome in resource-limited settings. Diseases ... ...

Abstract	Leishmaniasis is a vector-borne infection caused by kinetoplastid protozoans in the genera Leishmania and Endotrypanum. The disease occurs worldwide in the tropics and subtropics and can be particularly burdensome in resource-limited settings. Diseases caused by leishmaniasis range in severity from mild cutaneous lesions to life-threatening visceral and disfiguring mucocutaneous illnesses. Rapid and accurate diagnosis is needed to ensure proper clinical management of patients afflicted with this disease. Complicating matters of diagnosis and treatment are the diversity of species within these 2 genera and the variable specificity of diagnostic assays. This mini-review provides laboratory professionals with an overview of Leishmania epidemiology, biology, pathogenesis, clinical presentations, and treatments with additional emphasis placed on the nuances involved in diagnosis.
MeSH term(s)	Humans ; Leishmaniasis, Cutaneous/diagnosis ; Leishmaniasis, Cutaneous/drug therapy ; Leishmaniasis, Cutaneous/epidemiology ; Leishmania ; Laboratories
Language	English
Publishing date	2022-12-05
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	391758-7
ISSN	1943-7730 ; 0007-5027
ISSN (online)	1943-7730
ISSN	0007-5027
DOI	10.1093/labmed/lmac134
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Article ; Online: Repeat testing of mpox specimens with late CTs improves detection of potential false positive cases.

Shean, Ryan C / Hymas, Weston C / Klein, Jeremy / Pyne, Michael / Hillyard, David R / Bradley, Benjamin T

Journal of clinical microbiology

2024 Volume 62, Issue 2, Page(s) e0127523

Abstract: The mpox pandemic necessitated the rapid development of clinical assays for monkeypox virus detection. While the majority of mpox specimens have high viral loads with corresponding early cycle threshold (CT) values, reports have indicated some specimens ... ...

Abstract	The mpox pandemic necessitated the rapid development of clinical assays for monkeypox virus detection. While the majority of mpox specimens have high viral loads with corresponding early cycle threshold (CT) values, reports have indicated some specimens with late CT values can represent false positive results. To mitigate this risk, the Centers for Disease Control and Prevention (CDC) published an advisory recommending repeat testing of all specimens with CT values ≥34. However, limited experimental data were available to support this specific cutoff. In this study, we examine whether a more conservative approach in which all specimens with CT values ≥29 are repeated would improve the detection of potential false positive results. Compared to the CDC algorithm, our approach identified an additional 20% (5/25) of potential false positive results. To assess the impact of this cutoff on laboratory workload, we modeled the expected increase in test volume and turnaround time (TAT) relative to the CDC method. Using a lower repeat threshold, test volume increased by 0.7% while mean TAT increased by less than 15 minutes. Overall, a lower threshold than recommended by the CDC for repeating late CT mpox specimens may reduce the number of false positives reported while minimally impacting testing volume and TAT.
MeSH term(s)	United States ; Humans ; Mpox (monkeypox) ; Algorithms ; Biological Assay ; Centers for Disease Control and Prevention, U.S. ; Laboratories
Language	English
Publishing date	2024-01-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	390499-4
ISSN	1098-660X ; 0095-1137
ISSN (online)	1098-660X
ISSN	0095-1137
DOI	10.1128/jcm.01275-23
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Article ; Online: Chemotherapy to Spare Cognition.

Cooper, Benjamin T / Bradley, Julie A

International journal of radiation oncology, biology, physics

2019 Volume 103, Issue 3, Page(s) 544–545

MeSH term(s)	Cognition ; Ependymoma ; Female ; Humans ; Infant ; Skull
Language	English
Publishing date	2019-02-05
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	197614-x
ISSN	1879-355X ; 0360-3016
ISSN (online)	1879-355X
ISSN	0360-3016
DOI	10.1016/j.ijrobp.2018.10.040
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Zs.A 1218: Show issues

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Article ; Online: Relationship between medical programme progress test performance and surgical clinical attachment timing and performance.

Wearn, Andy / Bindra, Vanshay / Patten, Bradley / Loveday, Benjamin P T

Medical teacher

2023 Volume 45, Issue 8, Page(s) 877–884

Abstract: Purpose: Progress tests (PTs) assess applied knowledge, promote knowledge integration, and facilitate retention. Clinical attachments catalyse learning through an appropriate learning context. The relationship between PT results and clinical attachment ... ...

Abstract	Purpose: Progress tests (PTs) assess applied knowledge, promote knowledge integration, and facilitate retention. Clinical attachments catalyse learning through an appropriate learning context. The relationship between PT results and clinical attachment sequence and performance are under-explored. Aims: (1) Determine the effect of Year 4 general surgical attachment (GSA) completion and sequence on overall PT performance, and for surgically coded items; (2) Determine the association between PT results in the first 2 years and GSA assessment outcomes. Materials and methods: All students enrolled in the medical programme, who started Year 2 between January 2013 and January 2016, were included; with follow up until December 2018. A linear mixed model was applied to study the effect of undertaking a GSA on subsequent PT results. Logistic regressions were used to explore the effect of past PT performance on the likelihood of a student receiving a distinction grade in the GSA. Results: 965 students were included, representing 2191 PT items (363 surgical items). Sequenced exposure to the GSA in Year 4 was associated with increased performance on surgically coded PT items, but not overall performance on the PT, with the difference decreasing over the year. PT performance in Years 2-3 was associated with an increased likelihood of being awarded a GSA distinction grade (OR 1.62, Conclusions: Exposure to a surgical attachment improves PT results in surgically coded PT items, although with a diminishing effect over time, implying clinical exposure may accelerate subject specific learning. Timing of the GSA did not influence end of year performance in the PT. There is some evidence that students who perform well on PTs in preclinical years are more likely to receive a distinction grade in a surgical attachment than those with lower PT scores.
MeSH term(s)	Humans ; Educational Measurement/methods ; Learning ; Students ; Curriculum ; Education, Medical, Undergraduate/methods ; Students, Medical
Language	English
Publishing date	2023-03-11
Publishing country	England
Document type	Journal Article
ZDB-ID	424426-6
ISSN	1466-187X ; 0142-159X
ISSN (online)	1466-187X
ISSN	0142-159X
DOI	10.1080/0142159X.2023.2186205
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Article ; Online: Characterization of the Cytopathic Effects of Monkeypox Virus Isolated from Clinical Specimens and Differentiation from Common Viral Exanthems.

Ma, Angela / Langer, Janine / Hanson, Kimberly E / Bradley, Benjamin T

Journal of clinical microbiology

2022 , Page(s) e0133622

Abstract: While the practice of viral culture has largely been replaced by nucleic acid amplification tests, circumstances still exist in which the availability of viral culture will allow for the diagnosis of infections not included in a provider's differential ... ...

Abstract	While the practice of viral culture has largely been replaced by nucleic acid amplification tests, circumstances still exist in which the availability of viral culture will allow for the diagnosis of infections not included in a provider's differential diagnosis. Here, we examine the cytopathic effects (CPE) and clinical data associated with 18 cases of monkeypox virus (MPXV) isolated from 19 clinical samples submitted for viral culture. During the study period, a total of 3,468 viral cultures were performed with herpes simplex virus (HSV) most commonly isolated (646/3,468; 18.6%), followed by MPXV (19/3,468; 0.6%) and varicella-zoster virus (VZV) (12/3,468; 0.4%). Most MPXV-positive samples were obtained from males (14/19) and taken from genital (7/19) or rectal lesions (5/19). Cycle threshold values of tested samples ranged from 15.3 to 29.0. Growth of MPXV in cell culture was rapid, yielding detectable CPE at a median of 2 days (range: 1 to 4) often with >50% of the monolayer affected in RMK, BGM, A549, and MRC-5 cell lines. As clinical features of MPXV, HSV, and VZV lesions may overlap, CPE patterns were compared between viruses. HSV CPE developed in a similar time frame (median: 2 days, range: 1 to 7) but was more often negative in RMK cells relative to MPXV. VZV grew more slowly (median: 9 days, range: 5 to 11) and demonstrated CPE affecting ≤25% of cell monolayers when positive. Viral culture remains an important tool for the detection of rare or emerging viral pathogens, particularly when high viral load specimens are easily obtained.
Language	English
Publishing date	2022-11-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	390499-4
ISSN	1098-660X ; 0095-1137
ISSN (online)	1098-660X
ISSN	0095-1137
DOI	10.1128/jcm.01336-22
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Article ; Online: Mapping of uranium particles on J-type swipes with microextraction-ICP-MS.

Bradley, Veronica C / Burleson, Jacob / Andrews, Hunter B / Thompson, Cyril V / Spano, Tyler L / Dunlap, Daniel R / Zirakparvar, N Alex / Ticknor, Brian W / Hexel, Cole R / Manard, Benjamin T

The Analyst

2024 Volume 149, Issue 8, Page(s) 2244–2251

Abstract: A microextraction liquid sampling system coupled to a quadrupole inductively coupled plasma-mass spectrometer (ICP-MS) was utilized to spatially discern uranium particles, isotopically, on a cellulose-based swipe material ( ...

Abstract	A microextraction liquid sampling system coupled to a quadrupole inductively coupled plasma-mass spectrometer (ICP-MS) was utilized to spatially discern uranium particles, isotopically, on a cellulose-based swipe material (
Language	English
Publishing date	2024-04-15
Publishing country	England
Document type	Journal Article
ZDB-ID	210747-8
ISSN	1364-5528 ; 0003-2654
ISSN (online)	1364-5528
ISSN	0003-2654
DOI	10.1039/d3an02101g
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Article: Brain Vasculature Accumulates Tau and Is Spatially Related to Tau Tangle Pathology in Alzheimer's Disease.

Hoglund, Zachary / Ruiz-Uribe, Nancy / Del Sastre, Eric / Woost, Benjamin / Bailey, Joshua / Hyman, Bradley T / Zwang, Theodore / Bennett, Rachel E

bioRxiv : the preprint server for biology

2024

Abstract: Insoluble pathogenic proteins accumulate along blood vessels in conditions of cerebral amyloid angiopathy (CAA), exerting a toxic effect on vascular cells and impacting cerebral homeostasis. In this work we provide new evidence from three-dimensional ... ...

Abstract	Insoluble pathogenic proteins accumulate along blood vessels in conditions of cerebral amyloid angiopathy (CAA), exerting a toxic effect on vascular cells and impacting cerebral homeostasis. In this work we provide new evidence from three-dimensional human brain histology that tau protein, the main component of neurofibrillary tangles, can similarly accumulate along brain vascular segments. We quantitatively assessed n=6 Alzheimer's disease (AD), and n=6 normal aging control brains and saw that tau-positive blood vessel segments were present in all AD cases. Tau-positive vessels are enriched for tau at levels higher than the surrounding tissue and appear to affect arterioles across cortical layers (I-V). Further, vessels isolated from these AD tissues were enriched for N-terminal tau and tau phosphorylated at T181 and T217. Importantly, tau-positive vessels are associated with local areas of increased tau neurofibrillary tangles. This suggests that accumulation of tau around blood vessels may reflect a local clearance failure. In sum, these data indicate tau, like amyloid beta, accumulates along blood vessels and may exert a significant influence on vasculature in the setting of AD.
Language	English
Publishing date	2024-01-28
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.01.27.577088
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Article: Emerging respiratory infections: The infectious disease pathology of SARS, MERS, pandemic influenza, and Legionella.

Bradley, Benjamin T / Bryan, Andrew

Seminars in diagnostic pathology

2019 Volume 36, Issue 3, Page(s) 152–159

Abstract: Lower respiratory infections remain one of the top global causes of death and the emergence of new diseases continues to be a concern. In the first two decades of the 21st century, we have born witness to the emergence of newly recognized coronaviruses ... ...

Abstract	Lower respiratory infections remain one of the top global causes of death and the emergence of new diseases continues to be a concern. In the first two decades of the 21st century, we have born witness to the emergence of newly recognized coronaviruses that have rapidly spread around the globe, including severe acute respiratory syndrome virus (SARS) and Middle Eastern respiratory syndrome virus (MERS). We have also experienced the emergence of a novel H1N1 pandemic influenza strain in 2009 that caused substantial morbidity and mortality around the world and has transitioned into a seasonal strain. Although we perhaps most frequently think of viruses when discussing emerging respiratory infections, bacteria have not been left out of the mix, as we have witnessed an increase in the number of infections from Legionella spp. since the organisms' initial discovery in 1976. Here, we explore the basic epidemiology, clinical presentation, histopathology, and clinical laboratory diagnosis of these four pathogens and emphasize themes in humans' evolving relationship with our natural environment that have contributed to the infectious burden. Histology alone is rarely diagnostic for these infections, but has been crucial to bettering our understanding of these diseases. Together, we rely on the diagnostic acumen of pathologists to identify the clinicopathologic features that raise the suspicion of these diseases and lead to the early control of the spread in our populations.
MeSH term(s)	Coronavirus Infections/diagnosis ; Coronavirus Infections/pathology ; Humans ; Influenza, Human/diagnosis ; Influenza, Human/pathology ; Legionellosis/diagnosis ; Legionellosis/pathology ; Respiratory Tract Infections/diagnosis ; Respiratory Tract Infections/pathology ; Severe Acute Respiratory Syndrome/diagnosis ; Severe Acute Respiratory Syndrome/pathology
Keywords	covid19
Language	English
Publishing date	2019-04-17
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	605834-6
ISSN	1930-1111 ; 0740-2570
ISSN (online)	1930-1111
ISSN	0740-2570
DOI	10.1053/j.semdp.2019.04.006
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Zs.A 1988: Show issues

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Article ; Online: Microextraction-TQ-ICP-MS for the Direct Analysis of U and Pu from Cotton Swipes.

Bradley, Veronica C / Ticknor, Brian W / Dunlap, Daniel R / Zirakparvar, N Alex / Metzger, Shalina C / Hexel, Cole R / Manard, Benjamin T

Analytical chemistry

2023 Volume 95, Issue 43, Page(s) 15867–15874

Abstract: The microextraction sampling technique was integrated with triple quadrupole─inductively coupled plasma-mass spectrometry (TQ-ICP-MS) to directly sample and measure the isotopic compositions of uranium (U) and plutonium (Pu) from cotton swipes. Once ... ...

Abstract	The microextraction sampling technique was integrated with triple quadrupole─inductively coupled plasma-mass spectrometry (TQ-ICP-MS) to directly sample and measure the isotopic compositions of uranium (U) and plutonium (Pu) from cotton swipes. Once extracted, the U/Pu were directed into the TQ-ICP-MS instrument for isotopic determination. Carbon dioxide (CO
Language	English
Publishing date	2023-10-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1508-8
ISSN	1520-6882 ; 0003-2700
ISSN (online)	1520-6882
ISSN	0003-2700
DOI	10.1021/acs.analchem.3c01022
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