Etiologic diagnoses of lower respiratory tract infections (LRTI) have been relying primarily on bacterial cultures that often fail to return useful results in time. Although DNA-based assays are more sensitive than bacterial cultures in detecting pathogens, the molecular results are often inconsistent and challenged by doubts on false positives, such as those due to system- and environment-derived contaminations. Here we report a nationwide cohort study on 2986 suspected LRTI patients across P. R. China. We compared the performance of a DNA-based assay qLAMP (quantitative Loop-mediated isothermal AMPlification) with that of standard bacterial cultures in detecting a panel of eight common respiratory bacterial pathogens from sputum samples. Our qLAMP assay detects the panel of pathogens in 1047(69.28%) patients from 1533 qualified patients at the end. We found that the bacterial titer quantified based on qLAMP is a predictor of probability that the bacterium in the sample can be detected in culture assay. The relatedness of the two assays fits a logistic regression curve. We used a piecewise linear function to define breakpoints where latent pathogen abruptly change its competitive relationship with others in the panel. These breakpoints, where pathogens start to propagate abnormally, are used as cutoffs to eliminate the influence of contaminations from normal flora. With help of the cutoffs derived from statistical analysis, we are able to identify causative pathogens in 750 (48.92%) patients from qualified patients. In conclusion, qLAMP is a reliable method in quantifying bacterial titer. Despite the fact that there are always latent bacteria contaminated in sputum samples, we can identify causative pathogens based on cutoffs derived from statistical analysis of competitive relationship.Trial RegistrationClinicalTrials.gov NCT00567827

BackgroundCopy number variation (CNV) is essential to understand the pathology of many complex diseases at the DNA level. Affymetrix SNP arrays, which are widely used for CNV studies, significantly depend on accurate copy number (CN) estimation. Nevertheless, CN estimation may be biased by several factors, including cross-hybridization and training sample batch, as well as genomic waves of intensities induced by sequence-dependent hybridization rate and amplification efficiency. Since many available algorithms only address one or two of the three factors, a high false discovery rate (FDR) often results when identifying CNV. Therefore, we have developed a new CNV detection pipeline which is based on hybridization and amplification rate correction (CNVhac).MethodsCNVhac first estimates the allelic concentrations (ACs) of target sequences by using the sample independent parameters trained through physicochemical hybridization law. Then the raw CN is estimated by taking the ratio of AC to the corresponding average AC from a reference sample set for one specific site. Finally, a hidden Markov model (HMM) segmentation process is implemented to detect CNV regions.ResultsBased on public HapMap data, the results show that CNVhac effectively smoothes the genomic waves and facilitates more accurate raw CN estimates compared to other methods. Moreover, CNVhac alleviates, to a certain extent, the sample dependence of inference and makes CNV calling with appreciable low FDRs.ConclusionCNVhac is an effective approach to address the common difficulties in SNP array analysis, and the working principles of CNVhac can be easily extended to other platforms.

Abstract. We find a two term asymptotic expansion for the optimal expected value of a sequentially selected monotone subsequence from a random permutation of length n. A striking feature of this expansion is that tells us that the expected value of optimal selection from a random permutation is quantifiably larger than optimal sequential selection from an independent sequences of uniformly distributed random variables; specifically, it is larger by at least (1/6) log n + O(1).

Lower respiratory tract infections (LRTIs) are well known for the lack of a good diagnostic method. The main difficulty lies in the fact that there are a variety of pathogens causing LRTIs, and their management and treatment are quite different. The development of quantitative real-time loop-mediated isothermal amplification (qrt-LAMP) made it possible to rapidly amplify and quantify multiple pathogens simultaneously. The question that remains to be answered is how accurate and reliable is this method? More importantly, how are qrt-LAMP measurements utilized to inform/suggest medical decisions? When does a pathogen start to grow out of control and cause infection? Answers to these questions are crucial to advise treatment guidance for LRTIs and also helpful to design phase I/II trials or adaptive treatment strategies. In this article, our main contributions include the following two aspects. First, we utilize zero-inflated mixture models to provide statistical evidence for the validity of qrt-LAMP being used in detecting pathogens for LRTIs without the presence of a gold standard test. Our results on qrt-LAMP suggest that it provides reliable measurements on pathogens of interest. Second, we propose a novel statistical approach to identify disease-causing pathogens, that is, distinguish the pathogens that colonize without causing problems from those that rapidly grow and cause infection. We achieve this by combining information from absolute quantities of pathogens and their symbiosis information to form G-scores. Change-point detection methods are utilized on these G-scores to detect the three phases of bacterial growth-lag phase, log phase, and stationary phase.

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