2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T4ff,Hypocellular bone marrow failure (BMF) may be acquired due to immune-mediated disease, the prototype being immune aplastic anemia (IAA), or inherited, due to germline defects in genes important for hematopoietic stem cells' function and maintenance (inherited bone marrow failure syndromes [IBMFS]). Proper diagnosis of the underlying etiology of hypocellular bone marrow failure, particularly distinguishing immune AA, myelodysplastic syndrome (MDS) (most relevant in this setting, hypoplastic MDS [MDS-h]), and the IBMFS, is important given the differences in clinical management. Clonal hematopoiesis (CH), in this context comprising somatic mutations or chromosomal abnormalities, is incorporated into standard algorithms for classification, risk stratification, and treatment decisions for hematologic malignancies, but the clinical significance in BMF is not well established. Disease-specific clonal signatures have been reported across the BMF spectrum, and here we show how distinct patterns of CH can aid in distinguishing different etiologies of hypocellular BMF. Additionally, detection of somatic alterations in many BMF disorders can estimate risk for secondary myeloid neoplasms, guide surveillance and, in some instances, allow for early therapeutic intervention.31:T510,Hypocellular bone marrow failure (BMF) may be acquired due to immune-mediated disease, the prototype being immune aplastic anemia (IAA), or inherited, due to germline defects in genes important for hematopoietic stem cells' function and maintenance (inherited bone marrow failure syndromes [IBMFS]). Proper diagnosis of the underlying etiology of hypocellular bone marrow failure, particularly distinguishing immune AA, myelodysplastic syndrome (MDS) (most relevant in this setting, hypoplastic MDS [MDS-h]), and the IBMFS, is important given the differences in clinical management. Clonal hematopoiesis (CH), in this context comprising somatic mutations or chromosomal abnormalities, is incorporated into standard algorithms for classification, risk stratification, and treatment decisions for hematologic malignancies, but the clinical significance in BMF is not well established. Disease-specific clonal signatures have been reported across the BMF spectrum, and here we show how distinct patterns of CH can aid in distinguishing different etiologies of hypocellular BMF. Additionally, detection of somatic alterations in many BMF disorders can estimate risk for secondary myeloid neoplasms, guide surveillance and, in some instances, allow for early therapeutic intervention.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Molecular Diagnostics: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Molecular Diagnostics (modality). Clinician-written summaries and actionable practice insights. 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The majority of tumors harbored SS18::SSX2 fusions (n=19), followed by SS18::SSX1 (n=6), and one rare SS18::NEDD4 fusion. Mean tumor size was 11.6 cm; 28.8% showed poorly differentiated or round cell features.","limitations":"Retrospective multi-institutional design with variable follow-up (range 2–129 months); molecular fusion data available in only a subset of cases; no standardized treatment data reported.","practice_takeaway":"Given high rates of metastasis and death, early and accurate diagnosis using molecular testing for SS18::SSX fusions is critical. Clinicians should not rely on morphology or immunohistochemistry alone, as overlap with other renal neoplasms is significant."}},{"doi":"10.1097/qco.0000000000001217","pmid":"42592788","title":"Recent advances in Strongyloides screening, diagnostics, therapeutics, and management","journal_title":"Current Opinion in Infectious Diseases","journal_issn":"0951-7375","published_at":"2026-08-13T00:00:00.000Z","url":"https://doi.org/10.1097/qco.0000000000001217","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-22T06:53:32.090Z","updated_at":"2026-08-22T06:53:32.090Z","tags":[{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"condition","value":"Strongyloidiasis","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"generic","value":"emodepside","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"generic","value":"ivermectin","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"generic","value":"moxidectin","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"modality","value":"Anthelmintic","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"modality","value":"Mass Drug Administration","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"modality","value":"Rapid Diagnostic Test","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"warning","value":"Emodepside cure rates described as 'predicted' from early trials — clinical applicability may be premature.","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"warning","value":"No primary trial data are presented; this is a narrative review summarizing advances, so cure rate figures (93–94% for moxidectin, 80–90% for emodepside) are drawn from referenced studies rather than original data in this paper.","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001217","tag_type":"warning","value":"Sample size tag omitted as no single study population is defined in this review article.","value_numeric":null}],"summaries":{"what_studied":"This review evaluates recent advances in Strongyloides stercoralis screening, diagnostics, therapeutics, and management, with focus on novel molecular and serologic tools, updated WHO treatment guidelines, and emerging anthelmintics (moxidectin, emodepside) across general and immunocompromised populations.","key_result":"Moxidectin is noninferior to ivermectin with 93–94% cure rates and a longer half-life; emodepside shows 80–90% predicted cure rates in early trials. New IgG/IgG4 rapid diagnostic tests using recombinant NIE and SsIR antigens enable point-of-care serologic screening, and WHO now conditionally recommends community-wide ivermectin mass drug administration in highly endemic settings.","limitations":"Data on treatment efficacy in severe disease (hyperinfection) and special populations remain limited; no prospective studies in high-risk groups are yet available; screening algorithms lack harmonization across settings.","practice_takeaway":"Screen immunocompromised patients at risk for hyperinfection using available IgG/IgG4 rapid tests or nucleic acid amplification where feasible. Moxidectin is a viable ivermectin alternative with comparable cure rates, and emodepside may offer a mechanistically distinct option for difficult cases."}},{"doi":"10.1111/ijd.70610","pmid":"42545806","title":"The Biological Basis of the Merlin\n CP\n ‐\n GEP\n Assay: Integrin Signaling and Early Metastatic Competence in Cutaneous Melanoma","journal_title":"International Journal of Dermatology","journal_issn":"0011-9059","published_at":"2026-08-03T00:00:00.000Z","url":"https://doi.org/10.1111/ijd.70610","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-06T13:22:10.472Z","updated_at":"2026-08-06T13:22:10.472Z","tags":[{"paper_doi":"10.1111/ijd.70610","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/ijd.70610","tag_type":"brand","value":"Merlin CP-GEP","value_numeric":null},{"paper_doi":"10.1111/ijd.70610","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1111/ijd.70610","tag_type":"condition","value":"Cutaneous Melanoma","value_numeric":null},{"paper_doi":"10.1111/ijd.70610","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/ijd.70610","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1111/ijd.70610","tag_type":"modality","value":"Gene Expression Profiling","value_numeric":null},{"paper_doi":"10.1111/ijd.70610","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1111/ijd.70610","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1111/ijd.70610","tag_type":"warning","value":"Age group defaulted to 'adult' as no specific population demographics are reported in this review.","value_numeric":null},{"paper_doi":"10.1111/ijd.70610","tag_type":"warning","value":"Impact flag 'practice_changing' is applied based on the stated NCCN Guideline inclusion, not on novel trial data presented within this paper.","value_numeric":null},{"paper_doi":"10.1111/ijd.70610","tag_type":"warning","value":"No original patient data is presented; this is a biological rationale review and does not report sensitivity, specificity, or AUC for the CP-GEP assay.","value_numeric":null}],"summaries":{"what_studied":"This review examines the biological rationale behind the Merlin CP-GEP assay — a clinicopathologic-gene expression profile test for cutaneous melanoma — focusing on how integrin signaling, focal adhesion dynamics, ECM remodeling, and TGF-β pathways underpin its ability to predict sentinel lymph node (SLN) metastasis risk in primary tumors.","key_result":"The CP-GEP assay captures a dissemination-competent phenotype via a core gene set (ITGB3, TGFBR1, PLAT, SERPINE2, LOXL4, CXCL8, GDF15, MLANA) detectable in primary tumors before clinically apparent metastasis; the assay is now included in NCCN Melanoma Guidelines for SLN metastasis risk prediction.","limitations":"This is a narrative review — no original clinical data or validation cohort is presented, so effect sizes and predictive performance metrics are not reported here. The review does not directly compare CP-GEP performance to other GEP assays in head-to-head data.","practice_takeaway":"Clinicians managing cutaneous melanoma can now apply the NCCN-endorsed Merlin CP-GEP assay to primary tumors to stratify SLN metastasis risk at a molecular level, potentially guiding sentinel lymph node biopsy decisions. The integrin/TGF-β biological framework suggests this assay identifies truly early metastatic biology rather than generic prognostic risk."}},{"doi":"10.1097/dad.0000000000003390","pmid":"42492940","title":"Morphologic and Molecular Differences of BAP1 Melanocytomas and BAP1 Inactivated Melanomas","journal_title":"The American Journal of Dermatopathology","journal_issn":"0193-1091","published_at":"2026-07-23T00:00:00.000Z","url":"https://doi.org/10.1097/dad.0000000000003390","source_score":1,"is_retracted":false,"is_open_access":null,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":false},"created_at":"2026-07-29T13:31:14.227Z","updated_at":"2026-07-29T13:31:14.227Z","tags":[{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"condition","value":"BAP1-Inactivated Melanocytoma","value_numeric":null},{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"condition","value":"BAP1-Inactivated Melanoma","value_numeric":null},{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"condition","value":"Melanocytic Tumor","value_numeric":null},{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"modality","value":"Dermatopathology","value_numeric":null},{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"sample_size","value":"n=43","value_numeric":43},{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"study_design","value":"Retrospective Comparative Case Series","value_numeric":null},{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"warning","value":"No survival or recurrence rates are quoted in the abstract despite clinical follow-up being noted; key_result reflects only the diagnostic/molecular findings available.","value_numeric":null},{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"warning","value":"Sex of study participants was not reported in the abstract; sex tag omitted.","value_numeric":null},{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"warning","value":"Study design is retrospective with a small combined sample (n=43); findings should be interpreted cautiously until validated in larger cohorts.","value_numeric":null},{"paper_doi":"10.1097/dad.0000000000003390","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the scarcity of outcomes-based diagnostic criteria in this specific entity; the evidence base remains limited by sample size.","value_numeric":null}],"summaries":{"what_studied":"This retrospective series compared morphologic and molecular features of 20 BAP1-inactivated melanomas (with clinical follow-up in 17) versus 23 BAP1-inactivated melanocytomas, to identify high-specificity diagnostic criteria that distinguish malignant from intermediate-grade lesions.","key_result":"Features exclusive to BAP1-inactivated melanomas included ulceration, tumor necrosis, subcutaneous invasion, and mitotic rate ≥4/mm². Melanomas also had significantly more pathogenic variants (mean 6.6 vs. 2.4; P=0.0001) and higher tumor mutational burden (TMB 31.2 vs. 7.8 mut/Mb; P=0.0071). Variants in TERT-promoter, CDKN2A, CDK4, MYC, SWI/SNF complex, and PI3K-AKT pathway were found only in melanomas.","limitations":"Small sample size (n=43 total) limits statistical power and generalizability. Retrospective design with incomplete follow-up (only 17 of 20 melanomas had clinical data) introduces selection bias. BAP1-inactivated melanomas are rare, so referral center case accrual may not reflect true population prevalence or spectrum.","practice_takeaway":"When evaluating a BAP1-inactivated melanocytic tumor, the presence of ulceration, necrosis, subcutaneous invasion, or mitotic rate ≥4/mm² should raise strong suspicion for melanoma rather than melanocytoma. Molecular testing showing TERT-promoter, CDKN2A, CDK4, or PI3K-AKT pathway mutations, or elevated TMB, further supports a diagnosis of BAP1-inactivated melanoma."}},{"doi":"10.1016/j.lungcan.2026.109514","pmid":"42385495","title":"Prevalence and characteristics of NTRK fusions in 25,946 patients with non-small cell lung cancer","journal_title":"Lung Cancer","journal_issn":"0169-5002","published_at":"2026-06-28T00:00:00.000Z","url":"https://doi.org/10.1016/j.lungcan.2026.109514","source_score":10,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-04T13:26:26.798Z","updated_at":"2026-07-04T13:26:26.798Z","tags":[{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"condition","value":"Non-Small Cell Lung Cancer","value_numeric":null},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"generic","value":"pan-TRK immunohistochemistry (EPR17341)","value_numeric":null},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"modality","value":"Immunohistochemistry","value_numeric":null},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"modality","value":"Next-Generation Sequencing","value_numeric":null},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"modality","value":"TRK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"sample_size","value":"n=25946","value_numeric":25946},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"study_design","value":"Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"warning","value":"Sex distribution across cohorts is not explicitly reported in the abstract; 'mixed' is assumed based on standard NSCLC population demographics.","value_numeric":null},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"warning","value":"The 'practice_changing' impact flag is applied because the findings directly challenge IHC-first screening strategies in NSCLC, but the rarity of the target alteration (0.03%) means clinical impact may be narrow.","value_numeric":null},{"paper_doi":"10.1016/j.lungcan.2026.109514","tag_type":"warning","value":"The study design combines two distinct cohorts with different primary screening methods (IHC vs. NGS), which limits direct cross-cohort comparison of test performance metrics.","value_numeric":null}],"summaries":{"what_studied":"This study assessed the prevalence and characteristics of NTRK1/2/3 fusions in 25,946 NSCLC patients across two cohorts: a tissue microarray cohort (n=1,703) screened by pan-TRK IHC with NGS confirmation, and an NGS cohort (n=24,243) with IHC retesting of positive cases.","key_result":"Functional NTRK fusions were detected in only 8 of 24,243 NGS-screened patients (0.03%). Pan-TRK IHC had a ~4% false-positive rate, predominantly in squamous cell carcinomas (60 of 69 IHC-positive cases), with NGS confirming zero functional fusions in the IHC-screened cohort.","limitations":"- IHC confirmatory NGS was only performed in 65 of 69 IHC-positive cases, leaving a small gap.\n- The Lungscape Cohort included only resected stage I–III NSCLC, limiting generalizability to advanced/metastatic disease.\n- Only 5 of 11 NGS-detected fusions were retested by IHC, so IHC sensitivity data are based on a small subset.","practice_takeaway":"Do not rely on pan-TRK IHC alone to identify NTRK fusion candidates in NSCLC — its ~4% false-positive rate, especially in squamous cell carcinoma, mandates confirmatory NGS. Functional NTRK fusions are exceedingly rare in NSCLC (0.03%), so reflex NGS-based testing is the appropriate strategy to avoid misidentification."}},{"doi":"10.1002/art.70257","pmid":"42328836","title":"From Interferon Signature to the Clinical Landscape: Type I Interferonopathies","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2026-06-22T00:00:00.000Z","url":"https://doi.org/10.1002/art.70257","source_score":5,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-27T13:27:35.341Z","updated_at":"2026-06-27T13:27:35.341Z","tags":[{"paper_doi":"10.1002/art.70257","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/art.70257","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.70257","tag_type":"condition","value":"Type I Interferonopathy","value_numeric":null},{"paper_doi":"10.1002/art.70257","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/art.70257","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1002/art.70257","tag_type":"modality","value":"Genetic Testing","value_numeric":null},{"paper_doi":"10.1002/art.70257","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1002/art.70257","tag_type":"sample_size","value":"n=46","value_numeric":46},{"paper_doi":"10.1002/art.70257","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/art.70257","tag_type":"study_design","value":"Observational Cohort Study","value_numeric":null},{"paper_doi":"10.1002/art.70257","tag_type":"warning","value":"Age group breakdown is not specified in the abstract — 'mixed' is assumed but pediatric vs. adult distribution is unclear.","value_numeric":null},{"paper_doi":"10.1002/art.70257","tag_type":"warning","value":"Antiviral activity findings are exploratory only (n=5); results should not be used to guide clinical decisions.","value_numeric":null},{"paper_doi":"10.1002/art.70257","tag_type":"warning","value":"Study design is cross-sectional/observational; no control group details or diagnostic cut-off values for IFN score or CXCL10 are reported in the abstract, limiting direct clinical application of thresholds.","value_numeric":null}],"summaries":{"what_studied":"A cohort of 46 patients with suspected type I interferonopathies was evaluated for clinical, immunological, genetic, and molecular profiles; the diagnostic utility of IFN signature (RT-qPCR), serum CXCL10/CXCL9 (ELISA), and antiviral activity (rVSV-GFP assay) were assessed alongside whole-exome sequencing (WES).","key_result":"Molecular diagnosis was confirmed in 37/46 patients (80%); IFN signature was positive in 31/34 evaluable patients (91%), with median IFN score significantly higher than controls (p<0.0001); serum CXCL10 correlated with IFN scores (rs=0.4994, p=0.0026); autoantibodies were detected in 67% of patients; antiviral activity varied by phenotype.","limitations":"Small sample size (n=46) limits generalizability; antiviral activity was assessed in only 5 patients; no longitudinal follow-up data reported to confirm diagnostic thresholds over time.","practice_takeaway":"Consider adding serum CXCL10 measurement alongside the IFN signature in the workup for suspected type I interferonopathies — both showed strong discriminative capacity and CXCL10 is a simpler, widely available assay. Patients with a clear interferon signature but no genetic diagnosis may represent a distinct 'undifferentiated interferonopathy' group worth tracking separately."}},{"doi":"10.1111/zph.70073","pmid":"42324577","title":"Serological and Molecular Surveillance of Influenza A Virus in Dogs and Cats in Central Chile","journal_title":"Zoonoses and Public Health","journal_issn":"1863-1959","published_at":"2026-06-21T00:00:00.000Z","url":"https://doi.org/10.1111/zph.70073","source_score":11,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-26T13:25:31.981Z","updated_at":"2026-06-26T13:25:31.981Z","tags":[{"paper_doi":"10.1111/zph.70073","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/zph.70073","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1111/zph.70073","tag_type":"condition","value":"Influenza A","value_numeric":null},{"paper_doi":"10.1111/zph.70073","tag_type":"condition","value":"Zoonotic Infection","value_numeric":null},{"paper_doi":"10.1111/zph.70073","tag_type":"generic","value":"influenza A virus","value_numeric":null},{"paper_doi":"10.1111/zph.70073","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/zph.70073","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1111/zph.70073","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1111/zph.70073","tag_type":"modality","value":"Serology","value_numeric":null},{"paper_doi":"10.1111/zph.70073","tag_type":"sample_size","value":"n=411","value_numeric":411},{"paper_doi":"10.1111/zph.70073","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/zph.70073","tag_type":"study_design","value":"Cross-Sectional Surveillance Study","value_numeric":null},{"paper_doi":"10.1111/zph.70073","tag_type":"warning","value":"No viral genetic sequencing was performed, so subtypes detected by RT-qPCR are not fully characterized — zoonotic potential of circulating strains cannot be determined from this data alone.","value_numeric":null},{"paper_doi":"10.1111/zph.70073","tag_type":"warning","value":"Sample size for cat serology was very small (n=20), making seroprevalence estimates in cats (50%) highly uncertain despite wide CIs reported. Findings in cats should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1111/zph.70073","tag_type":"warning","value":"Study period (June–November 2020) overlaps with COVID-19 pandemic restrictions, which may have affected animal movement, human-animal contact patterns, and sampling logistics in ways not discussed by the authors.","value_numeric":null},{"paper_doi":"10.1111/zph.70073","tag_type":"warning","value":"Total sample size of n=411 refers to combined oropharyngeal swab samples (342 dogs + 69 cats); serological sample sizes are smaller and different (173 dogs + 20 cats).","value_numeric":null}],"summaries":{"what_studied":"This cross-sectional surveillance study evaluated molecular (RT-qPCR) and serological (NP-ELISA, hemagglutination inhibition) evidence of Influenza A virus (IAV) in dogs (n=342 swabs, n=173 sera) and cats (n=69 swabs, n=20 sera) from shelters and multi-pet households in central Chile, collected June–November 2020.","key_result":"Active IAV was detected in 3.2% of dogs (11/342) and 5.8% of cats (4/69) by RT-qPCR. Seropositivity was high: 55.5% of dogs (96/173) and 50.0% of cats (10/20). Among NP-ELISA-positive animals, 25.7% (26/101) had pdmH1N1 antibodies, with cats showing higher median titres (160) than dogs (20). No associations were found between seropositivity and age, sex, origin, or area.","limitations":"Sampling was limited to a single geographic region (central Chile) and a narrow 6-month window, limiting generalizability. No genetic characterization of circulating strains was performed, so zoonotic risk cannot be fully assessed. Serological sample sizes — especially for cats (n=20) — were small, widening confidence intervals.","practice_takeaway":"Companion animals in Chile show substantial IAV exposure, including to pandemic H1N1, and should be included in One Health surveillance programs. Clinicians treating pets with respiratory illness should consider IAV and apply appropriate zoonotic precautions, particularly in households with immunocompromised individuals."}},{"doi":"10.3201/eid3207.251567","pmid":null,"title":"Nipah Virus Shedding in Urine from Fruit Bats, Sri Lanka, 2018–2019","journal_title":"Emerging Infectious Diseases","journal_issn":"1080-6040","published_at":"2026-06-17T00:00:00.000Z","url":"https://doi.org/10.3201/eid3207.251567","source_score":5,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-06-28T13:27:23.169Z","updated_at":"2026-06-28T13:27:23.169Z","tags":[{"paper_doi":"10.3201/eid3207.251567","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.3201/eid3207.251567","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.3201/eid3207.251567","tag_type":"condition","value":"Henipavirus Infection","value_numeric":null},{"paper_doi":"10.3201/eid3207.251567","tag_type":"condition","value":"Nipah Virus Infection","value_numeric":null},{"paper_doi":"10.3201/eid3207.251567","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.3201/eid3207.251567","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.3201/eid3207.251567","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.3201/eid3207.251567","tag_type":"sample_size","value":"n=2218","value_numeric":2218},{"paper_doi":"10.3201/eid3207.251567","tag_type":"study_design","value":"Cross-Sectional Surveillance Study","value_numeric":null},{"paper_doi":"10.3201/eid3207.251567","tag_type":"warning","value":"Phylogenetic clustering with human-pathogenic Kerala strains is notable, but the study cannot establish transmissibility or spillover risk to humans in Sri Lanka directly.","value_numeric":null},{"paper_doi":"10.3201/eid3207.251567","tag_type":"warning","value":"Sample size tag reflects total individual urine drops collected (2,218); only 32 pools were tested by PCR, which limits prevalence estimation. Both figures are reported in the paper.","value_numeric":null},{"paper_doi":"10.3201/eid3207.251567","tag_type":"warning","value":"The study design is observational environmental surveillance — no human subjects were enrolled, so age/sex tags are not applicable and were omitted.","value_numeric":null}],"summaries":{"what_studied":"Urine samples from *Pteropus medius* fruit bat colonies across four sites in Sri Lanka (Colombo, Mannar, Anuradhapura, Badulla) were screened for Nipah virus (NiV) using qPCR and whole-genome sequencing over March 2018–June 2019.","key_result":"NiV RNA was detected in 2 of 32 urine pools (collected in Colombo); both pools were confirmed by two independent qPCRs (phosphoprotein and nucleocapsid gene targets) and near-complete genome sequencing (93% and 98% genome coverage). The Sri Lanka strains share 98% nucleotide identity with the 2018 Kerala, India human outbreak strain and cluster phylogenetically with Kerala strains from 2007–2023.","limitations":"- Only 32 pooled samples (from 2,218 individual urine drops) were sequenced; pooling may obscure prevalence estimates.\n- Detection of NiV RNA in bats does not confirm active human spillover risk or viable virus.\n- Sampling was limited to four sites over ~15 months; seasonal shedding pulses may have been missed.","practice_takeaway":"Clinicians in Sri Lanka and southern India should maintain heightened awareness of NiV as a cause of acute encephalitis or severe respiratory illness, given confirmed bat reservoir presence within the region. Early diagnostic capacity for NiV RNA in clinical specimens and clear public messaging about avoiding bat urine exposure (e.g., raw palm sap, roosting trees) are warranted."}},{"doi":"10.1093/cid/ciag356","pmid":"42272071","title":"Oral Wash PCR Improves the Diagnosis of Pneumocystis Pneumonia in Immunocompromised Patients Without HIV: A Prospective Multicenter Study","journal_title":"Clinical Infectious Diseases","journal_issn":"1058-4838","published_at":"2026-06-11T00:00:00.000Z","url":"https://doi.org/10.1093/cid/ciag356","source_score":20,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-24T13:21:40.343Z","updated_at":"2026-06-24T13:21:40.343Z","tags":[{"paper_doi":"10.1093/cid/ciag356","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/cid/ciag356","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1093/cid/ciag356","tag_type":"condition","value":"Pneumocystis Pneumonia","value_numeric":null},{"paper_doi":"10.1093/cid/ciag356","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/cid/ciag356","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1093/cid/ciag356","tag_type":"modality","value":"Fungal Biomarker Testing","value_numeric":null},{"paper_doi":"10.1093/cid/ciag356","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1093/cid/ciag356","tag_type":"sample_size","value":"n=369","value_numeric":369},{"paper_doi":"10.1093/cid/ciag356","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/cid/ciag356","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1093/cid/ciag356","tag_type":"warning","value":"24 of 369 patients (6.5%) were classified as 'possible PCP' by the multidisciplinary committee; the basis for this classification is not fully detailed in the abstract, which may introduce spectrum bias.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag356","tag_type":"warning","value":"No brand or generic drug tags applied — the interventions are diagnostic tests, not therapeutics.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag356","tag_type":"warning","value":"The study population is HIV-negative immunocompromised patients only — results may not generalize to HIV-positive patients, who typically have higher fungal burdens and different OW PCR performance characteristics.","value_numeric":null}],"summaries":{"what_studied":"This prospective multicenter cohort study evaluated the diagnostic accuracy of oropharyngeal wash (OW) PCR — compared to bronchoalveolar lavage (BAL) PCR and serum beta-1,3-D-glucan (BDG) — for *Pneumocystis* pneumonia (PCP) in 369 HIV-negative immunocompromised patients with respiratory symptoms.","key_result":"OW PCR was positive in 81.6% of definite PCP cases vs. 0% in those without *Pneumocystis*; PPV was 78.5% and NPV 73.1%. A load threshold of ≥7 copies/mL raised PPV to 90% (sensitivity 73.5%). Combining OW PCR+ with BDG+ reached a PPV of 92%. Mean fungal load was markedly higher in PCP vs. colonization (4,251 vs. 3 copies/mL, p<0.0001).","limitations":"- ~15% of patients were classified as 'possible PCP,' creating diagnostic uncertainty that may affect performance estimates.\n- OW PCR alone has a NPV of only 73.1%, meaning a negative result does not reliably exclude PCP in high-risk patients.\n- BDG and OW PCR agreement was poor (κ<0.4), limiting interpretability of the combination strategy without further validation.","practice_takeaway":"In HIV-negative immunocompromised patients who cannot safely tolerate BAL, OW PCR with a threshold of ≥7 copies/mL offers a PPV of ~90% for PCP. Combining a positive OW PCR with a positive BDG further raises PPV to 92%, making this non-invasive paired approach a practical frontline diagnostic strategy."}},{"doi":"10.1002/ijc.70534","pmid":"42252568","title":"Clinical Validation of Four Point‐of‐Care High‐Risk\n HPV\n Assays, Including Two Reduced‐Valency Assays, for Cervical Cancer Screening in Low‐Resource Settings","journal_title":"International Journal of Cancer","journal_issn":"0020-7136","published_at":"2026-06-07T00:00:00.000Z","url":"https://doi.org/10.1002/ijc.70534","source_score":33,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-10T14:23:54.974Z","updated_at":"2026-06-10T14:23:54.974Z","tags":[{"paper_doi":"10.1002/ijc.70534","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"brand","value":"Allplex-HPV-HR","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"brand","value":"Cobas-4800","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"brand","value":"HPV-Q","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"brand","value":"PathoDetect-HPV-14","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"brand","value":"PathoDetect-HPV-7","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"brand","value":"Truenat-HR-HPV-Plus","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"condition","value":"Cervical Cancer","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"condition","value":"Cervical Intraepithelial Neoplasia","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"condition","value":"Human Papillomavirus Infection","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"generic","value":"HPV nucleic acid amplification test","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"modality","value":"Point-of-Care Testing","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"sample_size","value":"n=1159","value_numeric":1159},{"paper_doi":"10.1002/ijc.70534","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"study_design","value":"Diagnostic Accuracy Study","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"warning","value":"CIN2 is an imperfect histological endpoint with known reproducibility issues; the study included only 19 CIN2 cases among the 97 CIN2+ cases.","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied to Truenat-HR-HPV-Plus specifically, not all four assays evaluated.","value_numeric":null},{"paper_doi":"10.1002/ijc.70534","tag_type":"warning","value":"The VALGENT framework validation used samples from Argentina and Costa Rica only; generalizability to sub-Saharan Africa or South/Southeast Asia — the highest-burden low-resource regions — is uncertain.","value_numeric":null}],"summaries":{"what_studied":"Four point-of-care HR-HPV assays (PathoDetect-HPV-14, HPV-Q, Truenat-HR-HPV-Plus [8-type], and PathoDetect-HPV-7 [7-type]) were evaluated for clinical accuracy and reproducibility in cervical cancer screening using 1,159 cervical samples from the ESTAMPA study (Argentina and Costa Rica), compared against reference assays (Cobas-4800 and Allplex-HPV-HR) via the VALGENT framework.","key_result":"Truenat-HR-HPV-Plus met IARC validation criteria with 80.4% sensitivity (95% CI: 71.1–87.8) and 91.5% specificity (95% CI: 89.5–93.2) for CIN2+, non-inferior to Allplex-HPV-HR-8, and repeatability of 93.3% (κ=0.79); PathoDetect-HPV-7 showed lower sensitivity (68.1%); HPV-Q and PathoDetect-HPV-14 did not meet validation criteria.","limitations":"Samples were derived from a single multi-country study (Argentina and Costa Rica), which may limit generalizability to other low-resource settings; the CIN2+ case count was modest (n=97, including only 6 cancers), which constrains precision of estimates at the cancer endpoint.","practice_takeaway":"Truenat-HR-HPV-Plus (8-type) is a validated point-of-care option for cervical cancer screening in low-resource settings, offering higher specificity than 14-valent assays and potentially reducing unnecessary referrals. PathoDetect-HPV-7 and the two 14-type assays should not be used as primary screening tools until further validation is completed."}},{"doi":"10.1016/s2352-3026(26)00098-0","pmid":"42242260","title":"Diagnosis of primary CNS lymphoma through molecular and immune biomarkers in cerebrospinal fluid (PRICELUS): a multicentre, prospective, cohort study","journal_title":"The Lancet Haematology","journal_issn":"2352-3026","published_at":"2026-06-04T00:00:00.000Z","url":"https://doi.org/10.1016/s2352-3026(26)00098-0","source_score":12,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-11T13:42:46.582Z","updated_at":"2026-06-11T13:42:46.582Z","tags":[{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"condition","value":"Primary CNS Lymphoma","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"condition","value":"Secondary CNS Lymphoma","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"generic","value":"CXCL13","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"generic","value":"interleukin-10","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"generic","value":"MYD88 L265P mutation","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"modality","value":"CSF Biomarker","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"sample_size","value":"n=255","value_numeric":255},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"warning","value":"Six of 50 CNS lymphoma cases were secondary (not primary) CNS lymphoma; subgroup-specific performance data are not fully disaggregated.","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"warning","value":"The diagnostic algorithm was derived and internally validated within the same 255-patient cohort — no external validation set was used, so performance metrics may be optimistic.","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00098-0","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — authors themselves state further external validation is needed before routine clinical adoption.","value_numeric":null}],"summaries":{"what_studied":"This prospective multicentre cohort study (n=255 adults with suspected primary CNS lymphoma, 5 Dutch hospitals, 2021–2025) evaluated the diagnostic accuracy of CSF biomarkers — MYD88 L265P mutation, IL-10, and CXCL13 — as an alternative or adjunct to brain biopsy.","key_result":"MYD88 alone had 56% sensitivity and 98.5% specificity for CNS lymphoma. Combining MYD88 positivity with elevated IL-10 or CXCL13 reached 54% sensitivity and 100% specificity. Crucially, a triple-negative result (MYD88, IL-10, and CXCL13 all negative) gave a negative predictive value of 99.4% (162/163), making it a strong rule-out tool.","limitations":"The diagnostic algorithm and decision tree were derived and validated within the same cohort (no external validation). Only 20% of patients had CNS lymphoma, and secondary CNS lymphoma cases (n=6) were included alongside primary, which may affect generalizability.","practice_takeaway":"When all three CSF biomarkers (MYD88, IL-10, CXCL13) are negative, CNS lymphoma is highly unlikely (NPV 99.4%), potentially sparing patients a brain biopsy. A positive MYD88 plus elevated IL-10 or CXCL13 is essentially diagnostic (100% specificity), but sensitivity is only ~54%, so a positive result is actionable while a negative result still requires clinical judgment."}},{"doi":"10.1093/neuonc/noag122","pmid":"42203756","title":"Updates in molecular risk stratification of IDH-mutant astrocytoma","journal_title":"Neuro-Oncology","journal_issn":"1522-8517","published_at":"2026-05-27T00:00:00.000Z","url":"https://doi.org/10.1093/neuonc/noag122","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-08T13:46:41.058Z","updated_at":"2026-06-08T13:46:41.058Z","tags":[{"paper_doi":"10.1093/neuonc/noag122","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/neuonc/noag122","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1093/neuonc/noag122","tag_type":"condition","value":"Glioma","value_numeric":null},{"paper_doi":"10.1093/neuonc/noag122","tag_type":"condition","value":"IDH-Mutant Astrocytoma","value_numeric":null},{"paper_doi":"10.1093/neuonc/noag122","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/neuonc/noag122","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1093/neuonc/noag122","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1093/neuonc/noag122","tag_type":"study_design","value":"Review","value_numeric":null},{"paper_doi":"10.1093/neuonc/noag122","tag_type":"warning","value":"Full text of this paper was not provided — all structured fields are inferred from the title and journal metadata only. Key results, sample size, specific biomarkers discussed, and conclusions could not be extracted or verified. Treat all summary content as provisional.","value_numeric":null},{"paper_doi":"10.1093/neuonc/noag122","tag_type":"warning","value":"Publication date (2026-05-27) is recent; this paper may represent cutting-edge or pre-guideline content not yet reflected in standard practice.","value_numeric":null},{"paper_doi":"10.1093/neuonc/noag122","tag_type":"warning","value":"The impact_flag 'practice_changing' is speculative given the review-level study design and lack of full text access.","value_numeric":null}],"summaries":{"what_studied":"This paper reviews updates in molecular risk stratification of IDH-mutant astrocytoma, evaluating emerging biomarkers and genomic features used to classify tumor grade and predict outcomes.","limitations":"No full text was provided; summary is based on title, journal, and DOI metadata only — specific findings, cohort sizes, and conclusions cannot be verified.","practice_takeaway":"Clinicians managing IDH-mutant astrocytoma should monitor updates to molecular grading criteria, as evolving biomarkers may refine prognostication and guide treatment decisions beyond current WHO classification."}},{"doi":"10.1016/j.anai.2026.04.025","pmid":"42134747","title":"Precision medicine in eosinophilic esophagitis","journal_title":"Annals of Allergy, Asthma & Immunology","journal_issn":"1081-1206","published_at":"2026-05-14T00:00:00.000Z","url":"https://doi.org/10.1016/j.anai.2026.04.025","source_score":3,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-18T13:25:30.795Z","updated_at":"2026-05-18T13:25:30.795Z","tags":[{"paper_doi":"10.1016/j.anai.2026.04.025","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.025","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.025","tag_type":"condition","value":"Eosinophilic Esophagitis","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.025","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.025","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.025","tag_type":"modality","value":"Biologic Therapy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.025","tag_type":"modality","value":"Dietary Elimination Therapy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.025","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.025","tag_type":"modality","value":"Polygenic Risk Scoring","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.025","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.025","tag_type":"warning","value":"No specific patient cohort or sample size is reported — this is a review article, so sample_size tag is omitted.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.025","tag_type":"warning","value":"Published date (2026-05-14) is in the future relative to most training data — content reflects emerging/anticipated evidence.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.025","tag_type":"warning","value":"Sex breakdown of the EoE population is not specified in the abstract; sex tag omitted.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.025","tag_type":"warning","value":"The 'impact_flag' of practice_changing reflects the review's forward-looking framing around precision medicine transformation of EoE care, but most tools discussed are still investigational.","value_numeric":null}],"summaries":{"what_studied":"This review examines how precision medicine strategies — including polygenic risk scores, molecular endotyping, and minimally invasive biomarkers — can be integrated across the EoE disease continuum, from risk identification and diagnosis to treatment selection, food trigger identification, and noninvasive monitoring.","key_result":"EoE affects ~1 in 700 individuals in the US; current management is largely empiric and invasive, with patients facing diagnostic delays, repeated endoscopies, and trial-and-error therapy. Emerging tools may improve risk stratification, reduce endoscopy burden, and better match therapy to underlying disease biology.","limitations":"This is a narrative review without systematic search methodology or meta-analytic data, so conclusions reflect expert synthesis rather than pooled evidence. Most precision medicine tools discussed (e.g., polygenic risk scores, molecular endotyping) remain investigational and are not yet validated for routine clinical use.","practice_takeaway":"Current EoE treatment selection is guided by population-level response rates rather than individual disease biology — clinicians should watch for emerging noninvasive biomarkers and molecular endotyping tools that could soon reshape how therapy is chosen and monitored. Until these are validated, awareness of EoE heterogeneity should inform shared decision-making about sequencing therapies."}},{"doi":"10.1182/blood.2025029923","pmid":"42095935","title":"How I utilize somatic alterations in the diagnosis, risk stratification, and therapy of hypocellular bone marrow failure","journal_title":"Blood Journal","journal_issn":"0006-4971","published_at":"2026-05-07T00:00:00.000Z","url":"https://doi.org/10.1182/blood.2025029923","source_score":12,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-12","doi":"10.1182/blood.2025029923","days":"7","issn":"0006-4971","rank":"6","field":"Clinical Medicine","score":"12","category":"Hematology","categories":["Hematology"],"_categories":["Hematology"]},"pubmed":{"doi":"10.1182/blood.2025029923","title":"How I utilize somatic alterations in the diagnosis, risk stratification, and therapy of hypocellular bone marrow failure.","journal":"Blood","methods":"","results":"","abstract":"$30","keywords":[],"pubmed_id":"42095935","conclusions":"","publication_date":"2026-05-07T00:00:00"},"crossref":{"DOI":"10.1182/blood.2025029923","URL":"https://doi.org/10.1182/blood.2025029923","ISSN":["0006-4971","1528-0020"],"link":[{"URL":"https://ashpublications.org/blood/article-pdf/doi/10.1182/blood.2025029923/2517684/blood.2025029923.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https://ashpublications.org/blood/article-pdf/doi/10.1182/blood.2025029923/2517684/blood.2025029923.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["How I utilize somatic alterations in the diagnosis, risk stratification, and therapy of hypocellular bone marrow failure"],"author":[{"given":"Emma M","family":"Groarke","sequence":"first","affiliation":[{"name":"National Heart, Lung and Blood Institute, Bethesda, Maryland, United States"}]},{"given":"Fernanda","family":"Gutierrez-Rodrigues","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute (NHLBI)/NIH, Bethesda, Maryland, United States"}]},{"given":"Bhavisha A.","family":"Patel","sequence":"additional","affiliation":[{"name":"National Institute of Health, Bethesda, Maryland, United States"}]}],"issued":{"date-parts":[[2026,5,7]]},"member":"234","prefix":"10.1182","source":"Crossref","volume":null,"created":{"date-time":"2026-05-07T14:54:58Z","timestamp":1778165698000,"date-parts":[[2026,5,7]]},"indexed":{"date-time":"2026-05-07T15:19:13Z","timestamp":1778167153448,"date-parts":[[2026,5,7]]},"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://ashpublications.org/blood/article/doi/10.1182/blood.2025029923/568215/How-I-utilize-somatic-alterations-in-the-diagnosis"}},"subtitle":[],"deposited":{"date-time":"2026-05-07T14:54:59Z","timestamp":1778165699000,"date-parts":[[2026,5,7]]},"issn-type":[{"type":"print","value":"0006-4971"},{"type":"electronic","value":"1528-0020"}],"published":{"date-parts":[[2026,5,7]]},"publisher":"American Society of Hematology","reference":null,"short-title":[],"update-policy":"https://doi.org/10.1182/blood.2019cm0000","article-number":"blood.2025029923","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"original-title":[],"container-title":["Blood Journal"],"reference-count":0,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,5,7]]},"references-count":0,"short-container-title":[],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1182/blood.2025029923","is_oa":false,"title":"How I utilize somatic alterations in the diagnosis, risk stratification, and therapy of hypocellular bone marrow failure","updated":"2026-05-08T16:02:47+00:00","published_date":"2026-05-07","best_oa_location":null}},"created_at":"2026-05-14T13:22:58.577Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1182/blood.2025029923","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"condition","value":"Aplastic Anemia","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"condition","value":"Bone Marrow Failure","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"condition","value":"Clonal Hematopoiesis","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"condition","value":"Hypoplastic Myelodysplastic Syndrome","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"condition","value":"Inherited Bone Marrow Failure Syndromes","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"condition","value":"Myelodysplastic Syndromes","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"modality","value":"Cytogenetic Analysis","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"study_design","value":"Expert Opinion/Editorial","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"study_design","value":"Expert Review / Clinical Practice Narrative","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"warning","value":"Design appears to be an expert review; no primary data or numeric outcomes are provided in the abstract.","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"warning","value":"Population characteristics (age, sex) are not reported.","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"warning","value":"Published date (2026-05-07) is in the near future relative to today's date (2026-05-14); paper appears to be a very recent publication — findings may not yet have broad external validation.","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"warning","value":"Specific clonal signatures, thresholds, and management algorithms are not detailed in the provided text.","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"warning","value":"Study design classification as 'Expert Review' may overlap with 'Clinical Practice Guidelines'; level of evidence assigned as 5 (expert opinion) accordingly.","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"warning","value":"The authors explicitly note that clinical significance of clonal hematopoiesis in BMF is 'not well established,' limiting strength of recommendations.","value_numeric":null},{"paper_doi":"10.1182/blood.2025029923","tag_type":"warning","value":"This is a 'How I' expert narrative review, not a primary research study — no original patient cohort or statistical outcomes are reported.","value_numeric":null}],"summaries":{"key_result":"Disease-specific clonal hematopoiesis (CH) signatures differ across hypocellular BMF etiologies and can help distinguish IAA from MDS-h and IBMFS; somatic alterations also estimate risk for secondary myeloid neoplasms and may inform early therapeutic intervention.","what_studied":"A narrative review on how somatic alterations—clonal hematopoiesis from somatic mutations or chromosomal abnormalities—can aid diagnosis, risk stratification, and therapy decisions in hypocellular bone marrow failure, including immune aplastic anemia, hypoplastic MDS, and inherited bone marrow failure syndromes.","limitations":"This is an expert review without reported quantitative outcomes; the abstract does not specify mutation patterns, thresholds, or comparative performance metrics.","practice_takeaway":"In hypocellular marrow failure, incorporate testing for somatic mutations and cytogenetic changes to help distinguish immune AA, MDS-h, and IBMFS, estimate risk for secondary myeloid neoplasms, and guide surveillance; in select cases, results may support earlier therapy."}},{"doi":"10.1016/s1473-3099(26)00133-7","pmid":"42105779","title":"Expanding Xpert MTB/RIF Ultra and lateral flow urine lipoarabinomannan testing for diagnosis of tuberculosis among adults living with HIV admitted to hospitals in Tanzania and Mozambique (EXULTANT): a randomised controlled trial","journal_title":"The Lancet Infectious Diseases","journal_issn":"1473-3099","published_at":"2026-05-06T00:00:00.000Z","url":"https://doi.org/10.1016/s1473-3099(26)00133-7","source_score":17,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-11T13:20:55.962Z","updated_at":"2026-05-11T13:20:55.962Z","tags":[{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"brand","value":"Determine TB LAM Ag","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"brand","value":"Xpert MTB/RIF Ultra","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"condition","value":"HIV Infection","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"condition","value":"Tuberculosis","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"generic","value":"lipoarabinomannan urine assay","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"modality","value":"Lateral Flow Immunoassay","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"sample_size","value":"n=1172","value_numeric":1172},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"warning","value":"Sputum sample provision in the control arm was only 60.6% among eligible patients; this partial uptake of standard-of-care testing complicates interpretation of the between-group comparison.","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"warning","value":"The trial was conducted in Tanzania and Mozambique only; findings may not generalize to all high-burden TB/HIV settings with different healthcare infrastructure.","value_numeric":null},{"paper_doi":"10.1016/s1473-3099(26)00133-7","tag_type":"warning","value":"The very high 8-week mortality (>25%) in both arms suggests extreme disease severity at enrollment, which may have limited any diagnostic intervention's ability to reduce mortality — this ceiling effect is worth noting when interpreting null results.","value_numeric":null}],"summaries":{"what_studied":"This pragmatic RCT (EXULTANT) evaluated whether an expanded TB screening strategy — Xpert MTB/RIF Ultra from sputum, stool, and urine plus LF-LAM testing in all patients regardless of symptoms — improved outcomes vs. standard symptom-based WHO testing among adults living with HIV admitted to 11 hospitals in Tanzania and Mozambique (Sept 2022–Mar 2024).","key_result":"The expanded strategy did not improve the primary endpoint: 16.0% (93/582) in the intervention group vs. 15.3% (90/590) in the control group had microbiologically confirmed TB and started treatment within 72 h (difference 0.7%, 95% CI −3.4 to 4.8, p=0.73). 8-week all-cause mortality was 25.8% vs. 28.8% (HR 0.86, 95% CI 0.69–1.07, p=0.18), a non-significant difference.","limitations":"- Only 60.6% of eligible control participants provided a sputum sample, which may reflect real-world feasibility but also limits the counterfactual comparison.\n- High baseline mortality (>25% at 8 weeks) suggests advanced disease on admission may have limited the impact of any diagnostic strategy.\n- Trial conducted in two countries; generalizability to other high-burden settings may vary.","practice_takeaway":"Routinely expanding TB testing to stool and urine with Xpert Ultra and LF-LAM (beyond symptoms) did not translate to faster treatment or lower mortality for hospitalized PLHIV in this setting. Clinicians should not expect a universal multi-sample screening approach alone to change patient outcomes without addressing broader barriers such as treatment delays and late presentation."}},{"doi":"10.1016/s2213-2600(26)00049-4","pmid":"42097153","title":"Respiratory infections due to human common cold coronaviruses, SARS-CoV, MERS-CoV, and SARS-CoV-2: epidemiology, pathogenesis, clinical features, diagnostics, therapeutics, and vaccine landscapes","journal_title":"The Lancet Respiratory Medicine","journal_issn":"2213-2600","published_at":"2026-05-04T00:00:00.000Z","url":"https://doi.org/10.1016/s2213-2600(26)00049-4","source_score":4,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-09T13:22:25.803Z","updated_at":"2026-05-09T13:22:25.803Z","tags":[{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"condition","value":"Common Cold Coronavirus Infection","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"condition","value":"COVID-19","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"condition","value":"Long COVID","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"condition","value":"MERS-CoV","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"condition","value":"SARS-CoV","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"condition","value":"SARS-CoV-2","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"modality","value":"Antiviral","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"modality","value":"Immunomodulator","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"modality","value":"Vaccine","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"warning","value":"No sample size is applicable as this is a narrative review, not a primary study.","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"warning","value":"Rapidly evolving SARS-CoV-2 variant and therapeutic landscape (as of May 2026) may mean some specific recommendations have been updated since manuscript acceptance.","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00049-4","tag_type":"warning","value":"The 'practice_changing' impact flag is applied conservatively here given the broad, synthesis-level scope of the review rather than a single landmark trial result.","value_numeric":null}],"summaries":{"what_studied":"This comprehensive review evaluates the epidemiology, pathogenesis, clinical features, diagnostics, therapeutics, and vaccines for all human coronaviruses — including common cold coronaviruses, SARS-CoV, MERS-CoV, and SARS-CoV-2 — drawing on 25 years of epidemic outbreak data.","key_result":"The review synthesizes shared and divergent features across three zoonotic coronaviruses (SARS-CoV, MERS-CoV, SARS-CoV-2), covering the full clinical spectrum from asymptomatic to severe multisystem disease, long-term sequelae, case-fatality profiles, and the current evidence base for diagnostics, antivirals, immunomodulators, and vaccines.","limitations":"As a narrative review, it does not perform systematic searches or meta-analyses, which limits quantitative pooling of outcomes. The scope is broad, meaning depth on any single topic may be limited. Rapidly evolving SARS-CoV-2 variant data may have outpaced publication.","practice_takeaway":"Clinicians should maintain a high index of suspicion for atypical coronavirus presentations — especially in high-risk and resource-limited settings — and promptly report suspected cases to enable rapid infection control. Integrating One Health frameworks and multinational trial capacity are highlighted as key preparedness strategies for future outbreaks."}},{"doi":"10.1681/asn.0000001107","pmid":"42024462","title":"Normalization of nCounter Gene Expression Data Alters Molecular Diagnostics in Kidney Transplantation","journal_title":"Journal of the American Society of Nephrology","journal_issn":"1046-6673","published_at":"2026-04-23T00:00:00.000Z","url":"https://doi.org/10.1681/asn.0000001107","source_score":39,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-18T13:25:43.324Z","updated_at":"2026-05-18T13:25:43.324Z","tags":[{"paper_doi":"10.1681/asn.0000001107","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1681/asn.0000001107","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1681/asn.0000001107","tag_type":"condition","value":"Antibody-Mediated Rejection","value_numeric":null},{"paper_doi":"10.1681/asn.0000001107","tag_type":"condition","value":"Kidney Transplant Rejection","value_numeric":null},{"paper_doi":"10.1681/asn.0000001107","tag_type":"condition","value":"T Cell-Mediated Rejection","value_numeric":null},{"paper_doi":"10.1681/asn.0000001107","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1681/asn.0000001107","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1681/asn.0000001107","tag_type":"modality","value":"Gene Expression Profiling","value_numeric":null},{"paper_doi":"10.1681/asn.0000001107","tag_type":"modality","value":"Molecular Diagnostics","value_numeric":null},{"paper_doi":"10.1681/asn.0000001107","tag_type":"sample_size","value":"n=868","value_numeric":868},{"paper_doi":"10.1681/asn.0000001107","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1681/asn.0000001107","tag_type":"study_design","value":"Multicenter Diagnostic Accuracy Study","value_numeric":null},{"paper_doi":"10.1681/asn.0000001107","tag_type":"warning","value":"Level of evidence assigned as 3 (diagnostic accuracy study with multicenter validation); exact hierarchy placement may vary by framework used.","value_numeric":null},{"paper_doi":"10.1681/asn.0000001107","tag_type":"warning","value":"The full text pages retrieved appear to be an ASN Media Kit (advertising rates/specifications) rather than the actual research article body. The abstract and results sections provided sufficient data for extraction, but methodology details (e.g., model types, specific gene counts, patient demographics) could not be verified from the full text. Study design tag is based on the multi-cohort diagnostic accuracy framework described in the abstract; no RCT design is present.","value_numeric":null}],"summaries":{"what_studied":"Ten normalization methods for nCounter gene expression data were evaluated across 868 kidney allograft biopsies from 9 European and North American centers (derivation n=441, internal validation n=186, external validation n=241), all Banff-graded and profiled using the B-HOT panel, to assess their impact on gene count stability, differential expression, RNA-seq concordance, and diagnostic performance for AMR and TCMR.","key_result":"In the combined validation cohort (n=427), nSolver-based approaches, nanostringr, NanoStringDiff, MetaNorm, and RCRNormFast achieved robust discrimination (AMR AUROC 0.88–0.91, AUPRC 0.86–0.89; TCMR AUROC 0.90–0.92, AUPRC 0.78–0.83). RCRNorm performed poorly (AMR AUROC/AUPRC 0.55/0.41; TCMR 0.53/0.18), and RUVSeq degraded TCMR performance (AUROC 0.84–0.85; AUPRC 0.64–0.65).","limitations":"- No single gold-standard normalization was pre-specified; comparisons are observational across methods.\n- External validation used a fixed cohort from 9 centers, so generalizability to all lab settings is uncertain.\n- Only nCounter platform was studied; findings may not extend to other gene-expression platforms.","practice_takeaway":"For B-HOT-based molecular rejection diagnostics, standard nSolver-based normalization and simpler methods are reliable and sufficient — avoid RCRNorm and, for TCMR, RUVSeq. Harmonizing normalization pipelines is a critical step before clinical implementation of gene-expression profiling in kidney transplant biopsies."}}],"initialOffset":17,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Molecular Diagnostics"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Molecular Diagnostics"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Molecular Diagnostics"}}}]]

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