Real-world utility of serological tests in patients with suspected scrub typhus in the Republic of Korea:A single-center,retrospective,observational study

Objective:Serological tests are widely used for scrub typhus diagnosis;however,their limitations are evident.This study aims to assess their practical value in clinical settings.Methods:We analyzed the data of adult patients with suspected scrub typhus who visited a tertiary care hospital in the Republic of Korea from September to December from 2019 to 2021.The included patients had an acute fever and at least one of the following ten secondary findings:myalgia,skin rash,eschar,headache,thrombocytopenia,increased liver enzyme levels,lymphadenopathy,hepatomegaly,splenomegaly,and pleural effusion.The diagnoses were grouped as scrub typhus or other diseases by two infectious disease physicians.Results:Among 136 patients who met the eligibility criteria,109 had scrub typhus and 27 had different diseases.Single and paired total antibodies using immunofluorescence assay(IFA),and total antibodies using immunochromatography-based rapid diagnostic testing(ICT)were measured in 98%,22%,and 75%of all patients,respectively.Confirmation using paired samples for scrub typhus was established at a median of 11[interquartile range(IQR)10-16]days following the first visit.Among the 82 admitted patients,the median admission time was 9(IQR 7-13)days.According to IFA,58(55%)patients with scrub typhus had total immunoglobulin titers≥1:320,while 23(85%)patients with other disease had titers<1:320.Positive ICT results were observed in 64(74%)patients with scrub typhus and 10(67%)patients with other diseases showed negative ICT results.Conclusions:Serological testing for scrub typhus is currently insufficient for decision-making in clinical practice.

Serological surveillance for SARS-CoV-2 antibodies among students,faculty and staff within a large university system during the pandemic

BACKGROUND At the end of December 2019,the world faced severe acute respiratory syndrome-coronavirus 2(SARS-CoV-2),which led to the outbreak of coronavirus disease 2019(COVID-19),associated with respiratory issues.This virus has shown significant challenges,especially for senior citizens,patients with other underlying illnesses,or those with a sedentary lifestyle.Serological tests conducted early on have helped identify how the virus is transmitted and how to curb its spread.The study hypothesis was that the rapid serological test for SARS-CoV-2 antibodies could indicate the immunoreactive profile during the COVID-19 pandemic in a university population.AIM To conduct active surveillance for serological expression of anti-SARS-CoV-2 antibodies in individuals within a university setting during the COVID-19 pandemic.METHODS This sectional study by convenience sampling was conducted in a large university in Niteroi-RJ,Brazil,from March 2021 to July 2021.The study population consisted of students,faculty,and administrative staff employed by the university.A total of 3433 faculty members,60703 students,and 3812 administrative staff were invited to participate.Data were gathered through rapid serological tests to detect immunoglobulin(Ig)M and IgG against SARS-CoV-2.Theχ²or Fisher's exact test was used to conduct statistical analysis.A 0.20 significance level was adopted for variable selection in a multiple logistic regression model to evaluate associations.RESULTS A total of 1648 individuals were enrolled in the study.The proportion of COVID-19 positivity was 164/1648(9.8%).The adjusted logistic model indicate a positive association between the expression of IgM or IgG and age[odds ratio(OR)=1.16,95%CI:1.02-1.31](P<0.0024),individuals who had been in contact with a COVID-19-positive case(OR=3.49,95%CI:2.34-5.37)(P<0.001),those who had received the COVID-19 vaccine(OR=2.33,95%CI:1.61-3.35)(P<0.001)and social isolation(OR=0.59,95%CI:0.41-0.84)(P<0.004).The likelihood of showing a positive result increased by 16%with every ten-year increment.Conversely,adherence to social distancing measures decreased the likelihood by 41%.CONCLUSION These findings evidenced that the population became more exposed to the virus as individuals discontinued social distancing practices,thereby increasing the risk of infection for themselves.

Life-Cycle Bearing Capacity for Pre-Stressed T-beams Based on Full-Scale Destructive Test

To investigate the evolution of load-bearing characteristics of pre-stressed beams throughout their service life and to provide a basis for accurately assessing the actual working state of damaged pre-stressed concrete T-beams,destructive tests were conducted on full-scale pre-stressed concrete beams.Based on the measurement and ana-lysis of beam deflection,strain,and crack development under various loading levels during the research tests,combined with the verification coefficient indicators specified in the codes,the verification coefficients of bridges at different stages of damage can be examined.The results indicate that the T-beams experience complete,incom-plete linear,and non-linear stages during the destructive test process.In the complete linear elastic stage,both the deflection and bottom strain verification coefficients comply with the specifications,indicating a good structural load-bearing capacity no longer adheres to the code’s requirements.In the non-linear stage,both coefficients exhi-bit a sharp increase,resulting in a further decrease in the structure’s load-bearing capacity.According to the pro-visions of the current code,the beam can be in the incomplete linear stage when both values fall within the code’s specified range.The strain verification coefficient sourced from the compression zone at the bottom of theflange is not recommended for assessing the bridge’s load-bearing capacity.

Serological survey on canine coronavirus antibodies in giant pandas by virus neutralization test

In order to survey the infectious situation of canine coronavirus (CCV) in giant panda population, a virus neutralization test detecting specific antibodies against CCV in giant panda抯 sera was established by using two-fold dilutions of serum and 100 TCID50 of the virus. The 62 sera samples of giant pandas, which were gathered from zoos and reserve region of Sichuan Province, China were detected. The neutralization antibody titer of 1:4 was recognized as the positive criterion, 8 sera samples were detected to be positive, and the positive rate was 12.9%. The titers of neutralizing antibody ranged from 1:8 to 1:32. It was the first comprehensive investigation on neutralization antibodies against CCV in giant panda population in China. The results of study showed that the infection of CCV in giant panda population was universal, which has posed a threat to the health of giant panda. Therefore, it is incumbent on us to study safe and effective vaccines to protect giant panda against CCV infection.

Non-invasive diagnosis of H pylori infection: Evaluation of serological tests with and without current infection marker CIM

AIM:To evaluate the performance of commercially available immunochromatographic (ICT) and immunoblot tests covering the current infection marker CIM and conventional ELISA for the diagnosis of H pylori infection in adult dyspeptic patients. METHODS:Consecutive non-treated dyspeptic patients undergoing diagnostic endoscopy were tested for H pylori infection by culture, rapid urease test, and histology of gastric biopsy specimens. Serum from 61 H pylori infected and 21 non-infected patients were tested for anti-H pylori IgG antibodies by commercial ELISA (AccuBindTM ELISA, Monobind, USA), ICT (Assure H pylori Rapid Test, Genelabs Diagnostics, Singapore), and immunoblot (Helico Blot 2.1, Genelabs Diagnostics, Singapore) assays. ICT and immunoblot kits cover CIM among other parameters and their performance with and without CIM was evaluated separately. RESULTS:Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of ELISA were 96.7%, 42.8%, 83.1%, 81.8%, and 82.9%, of ICT were 90.1%, 80.9%, 93.2%, 73.9%, and 87.8%, of ICT with CIM were 88.5%, 90.4%, 96.4%, 73.0%, and 89.0%, of immunoblot were 98.3%, 80.9%, 93.7%, 94.4%, and 93.9%, and of immunoblot with CIM were 98.3%, 90.4%, 96.7%, 95.0%, and 96.3%, respectively. CONCLUSION:Immunoblot with CIM had the best performance. ICT with CIM was found to be more specific and accurate than the conventional ELISA and may be useful for non-invasive diagnosis of H pylori infection.

Role of serological rapid antibody test in the management of possible COVID-19 cases

Although the detection of viral particles by reverse transcription polymerase chain reaction(RT-PCR)is the gold standard diagnostic test for coronavirus disease 2019(COVID-19),the false-negative results constitute a big challenge.AIM To examine a group of patients diagnosed and treated as possible COVID-19 pneumonia whose multiple nasopharyngeal swab samples were negative for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)by RT-PCR but then serological immunoglobulin M/immunoglobulin G(IgM/IgG)antibody against SARS-CoV-2 were detected by rapid antibody test.METHODS Eighty possible COVID-19 patients who had at least two negative consecutive COVID-19 RT-PCR test and were subjected to serological rapid antibody test were evaluated in this study.RESULTS The specific serological total IgM/IgG antibody against SARS-CoV-2 was detected in twenty-two patients.The mean age of this patient group was 63.2±13.1-yearsold with a male/female ratio of 11/11.Cough was the most common symptom(90.9%).The most common presenting chest computed tomography findings were bilateral ground glass opacities(77.2%)and alveolar consolidations(50.1%).The mean duration of time from appearance of first symptoms to hospital admission,to hospital admission,to treatment duration and to serological positivity were 8.6 d,11.2 d,7.9 d,and 24 d,respectively.Compared with reference laboratory values,serologically positive patients have shown increased levels of acute phase reactants,such as C-reactive protein,ferritin,and procalcitonin and higher inflammatory markers,such as erythrocyte sedimentation rate,lactate dehydrogenase enzyme,and fibrin end-products,such as D-dimer.A left shift on white blood cell differential was observed with increased neutrophil counts and decreased lymphocytes.CONCLUSION Our study demonstrated the feasibility of a COVID-19 diagnosis based on rapid antibody test in the cases of patients whose RT-PCR samples were negative.Detection of antibodies against SARS-CoV-2 with rapid antibody test should be included in the diagnostic algorithm in patients with possible COVID-19 pneumonia.

Performance of a serological IgM and IgG qualitative test for COVID-19 diagnosis:An experimental study in Brazil

Qualitative antibody tests are an easy,point-of-care diagnostic method that is useful in diagnosing coronavirus disease 2019,especially in situations where reverse transcription-polymerase chain reaction is negative.However,some factors are able to affect its sensitivity and accuracy,which may contribute to these tests not being used as a first-line diagnostic tool.

昆明烟区土壤线虫数量与环境因子的Mantel Test分析

为进一步明确昆明烟区影响线虫的环境因素,于2022年采集云南昆明烟区8个县(市、区)64个乡镇的320个植烟土壤样品,调查与测定样品采集地的海拔、土壤线虫数量以及土壤理化性质(pH值及有机质、水解性氮、速效钾和有效磷含量),并探讨土壤线虫数量与植烟土壤环境因子之间的潜在关系。结果表明,昆明烟区土壤线虫数量一定程度上受到海拔及土壤理化性质的影响,海拔与有机质、水解性氮和速效钾呈显著正相关,pH值与有效磷呈极显著负相关,相关系数为-0.850;土壤线虫数量与土壤有效磷呈正相关,与海拔、pH值、有机质、水解性氮、速效钾呈负相关,其中与海拔、有机质和水解性氮的相关系数较大,分别为-0.751、-0.651和-0.568。通过Mantel test分析确定海拔、有机质和水解性氮含量是影响昆明烟区土壤线虫数量的重要因子。本结果可为有效防治土壤线虫提供科学依据。

Correction to“Performance of a serological IgM and IgG qualitative test for COVID-19 diagnosis:An experimental study in Brazil”

Correction to“Freire de Melo F,Martins Oliveira Diniz L,Nélio Januário J,Fernando Gonçalves Ferreira J,Dórea RSDM,de Brito BB,Marques HS,Lemos FFB,Silva Luz M,Rocha Pinheiro SL,de Magalhães Queiroz DM.Performance of a serological IgM and IgG qualitative test for COVID-19 diagnosis:An experimental study in Brazil.World J Exp Med 2022;12(5):100-103[PMID:36196438 DOI:10.5493/wjem.v12.i5.100]”.In this article,we identified an issue with the“Acknowledgments”section.Here,we then provide a recognition section for our supporting institutions.

Failure characterization of fully grouted rock bolts under triaxial testing

Confining stresses serve as a pivotal determinant in shaping the behavior of grouted rock bolts.Nonetheless,prior investigations have oversimplified the three-dimensional stress state,primarily assuming hydrostatic stress conditions.Under these conditions,it is assumed that the intermediate principal stress(σ_(2))equals the minimum principal stress(σ_(3)).This assumption overlooks the potential variations in magnitudes of in situ stress conditions along all three directions near an underground opening where a rock bolt is installed.In this study,a series of push tests was meticulously conducted under triaxial conditions.These tests involved applying non-uniform confining stresses(σ_(2)≠σ_(3))to cubic specimens,aiming to unveil the previously overlooked influence of intermediate principal stresses on the strength properties of rock bolts.The results show that as the confining stresses increase from zero to higher levels,the pre-failure behavior changes from linear to nonlinear forms,resulting in an increase in initial stiffness from 2.08 kN/mm to 32.51 kN/mm.The load-displacement curves further illuminate distinct post-failure behavior at elevated levels of confining stresses,characterized by enhanced stiffness.Notably,the peak load capacity ranged from 27.9 kN to 46.5 kN as confining stresses advanced from σ_(2)=σ_(3)=0 to σ_(2)=20 MPa and σ_(3)=10 MPa.Additionally,the outcomes highlight an influence of confining stress on the lateral deformation of samples.Lower levels of confinement prompt overall dilation in lateral deformation,while higher confinements maintain a state of shrinkage.Furthermore,diverse failure modes have been identified,intricately tied to the arrangement of confining stresses.Lower confinements tend to induce a splitting mode of failure,whereas higher loads bring about a shift towards a pure interfacial shear-off and shear-crushed failure mechanism.

Unbound^(28)O,the heaviest oxygen isotope observed:a cutting-edge probe for testing nuclear models

The beyond-dripline oxygen isotopes^(27,28)O were recently observed at RIKEN,and were found to be unbound decaying into^(24)O by emitting neutrons.The unbound feature of the heaviest oxygen isotope,^(28)O,provides an excellent test for stateof-the-art nuclear models.The atomic nucleus is a self-organized quantum manybody system comprising specific numbers of protons Z and neutrons N.

Electrochemical biosensors for point-of-care testing

Point-of-care testing(POCT)is the practice of diagnosing and monitoring diseases where the patient is located,as opposed to traditional treatment conducted solely in a medical laboratory or other clinical setting.POCT has been less common in the recent past due to a lack of portable medical devices capable of facilitating effective medical testing.However,recent growth has occurred in this field due to advances in diagnostic technologies,device miniaturization,and progress in wearable electronics.Among these developments,electrochemical sensors have attracted interest in the POCT field due to their high sensitivity,compact size,and affordability.They are used in various applications,from disease diagnosis to health status monitoring.In this paper we explore recent advancements in electrochemical sensors,the methods of fabricating them,and the various types of sensing mechanisms that can be used.Furthermore,we delve into methods for immobilizing specific biorecognition elements,including enzymes,antibodies,and aptamers,onto electrode surfaces and how these sensors are used in real-world POCT settings.

Aquifer Test求群孔抽水试验水文地质参数

在水文地质条件复杂的地区,往往采用大型的群孔抽水试验充分揭露含水层特征,获取水文地质参数。用Aquifer Test软件求解水文地质参数,则方便实用、简捷高效,可快速输出拟合图形和求参结果。Aquifer Test提供了丰富的求参方案,求参必须结合当地当时的水文地质条件实际情况考虑,选择适合的方案和时空数据求取水文地质参数。

Performance of Comparative Cervical Tuberculin Test and Serological Methods with Culturing of Nasal Swab in Diagnosis of Bovine Tuberculosis in Cross Breed Cattle Baghdad Iraq: A Comparative Evaluation

This study was designed to assess the diagnostic value of Rapid Antigen bovine TB antibody test kit (RAT) and any association with cervical comparative tuberculin test (CCTT), (iELISA) and nasal swabs culturing, among based detection of M. bovis infection. A herd of 21 animals aged 1 - 8 years cross bread cattle of college of veterinary medicine. 19 (90.47%) animals had good body condition scores, two bulls included, and 2 (9.52%) cows were fair. Serum samples were collected, analyzed for anti-bovine TB antibody using RAT and iELISA. Also the herd was screened by CCTT. The tests were carried out twice, more than ten month interval, and twelve nasal swabs were taken within second survey. The first survey results revealed prevalence rate: 4 (19.04%) animals considered positive results (one positive and 3 suspected results) for CCTT, while the prevalence rate according to RAT was 10 (47.61%). The difference between the two prevalence rate was significant (McNemar chi-statistic = 4.50, p-value = 0.03) Kappa = 0.215 95% confidence interval: from -0.128 to 0.558;the strength of agreement is considered to be “fair”. The study interprets: sensitivity 30%;specificity 99%. The second survey results revealed prevalence rate according to CCTT was 4 (36.36%), while prevalence rate according to RAT was 5 (45.45%). The difference between the two prevalence was not significant (McNemar chi-statistic = 0.33, p-value = 0.56). Kappa = 0.441 95% confidence interval: from -0.087 to 0.968;the strength of agreement is considered to be “moderate”;sensitivity: 60%;specificity: 83%. All serum samples and nasal swabs gave negative results for iELISA and culturing respectively. The study concluded that RAT was highly specific, easy, labor and time saving, suggesting its use as screening test in bovine tuberculosis, and CCTT could be used to confirm positive animals screened by RAT, while there was no association between RAT, CCTT with body condition scores, iELISA and nasal swabs culture results.

Micromechanical testing and property upscaling of planetary rocks:A critical review

Knowledge of the mechanical behavior of planetary rocks is indispensable for space explorations.The scarcity of pristine samples and the irregular shapes of planetary meteorites make it difficult to obtain representative samples for conventional macroscale rock mechanics experiments(macro-RMEs).This critical review discusses recent advances in microscale RMEs(micro-RMEs)techniques and the upscaling methods for extracting mechanical parameters.Methods of mineralogical and microstructural analyses,along with non-destructive mechanical techniques,have provided new opportunities for studying planetary rocks with unprecedented precision and capabilities.First,we summarize several mainstream methods for obtaining the mineralogy and microstructure of planetary rocks.Then,nondestructive micromechanical testing methods,nanoindentation and atomic force microscopy(AFM),are detailed reviewed,illustrating the principles,advantages,influencing factors,and available testing results from literature.Subsequently,several feasible upscaling methods that bridge the micro-measurements of meteorite pieces to the strength of the intact body are introduced.Finally,the potential applications of planetary rock mechanics research to guiding the design and execution of space missions are environed,ranging from sample return missions and planetary defense to extraterrestrial construction.These discussions are expected to broaden the understanding of the microscale mechanical properties of planetary rocks and their significant role in deep space exploration.

Serological Investigation into the Infected Genotypes of Patients with Japanese Encephalitis in the Coastal Provinces of China

Objective Genotypes(G)1,3,and 5 of the Japanese encephalitis virus(JEV)have been isolated in China,but the dominant genotype circulating in Chinese coastal areas remains unknown.We searched for G5 JEV-infected cases and attempted to elucidate which JEV genotype was most closely related to human Japanese encephalitis(JE)in the coastal provinces of China.Methods In this study,we collected serum specimens from patients with JE in three coastal provinces of China(Guangdong,Zhejiang,and Shandong)from 2018 to 2020 and conducted JEV cross-neutralization tests against G1,G3,and G5.Results Acute serum specimens from clinically reported JE cases were obtained for laboratory confirmation from hospitals in Shandong(92 patients),Zhejiang(192 patients),and Guangdong(77 patients),China,from 2018 to 2020.Seventy of the 361 serum specimens were laboratory-confirmed to be infected with JEV.Two cases were confirmed to be infected with G1 JEV,32 with G3 JEV,and two with G5 JEV.Conclusion G3 was the primary infection genotype among JE cases with a definite infection genotype,and the infection caused by G5 JEV was confirmed serologically in China.

Multiplex Rapid Test with Acceptable Diagnosis Performance as a Solution to Increase Diagnosis of Hepatitis B and C Viruses in Pregnant Women in an Area of High Prevalence of Both Hepatitis Viruses Associated with HIV

Background and Objective: HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are very widespread in the world, however, less than 20% of the people affected are diagnosed and treated. This study aimed to determine the prevalence of HIV, HCV and HBV co-infections in pregnant women at Bangui Community University Hospital and the cost of screening. Methods: A cross-sectional study involving consenting pregnant women who came for antenatal care was performed. HIV, HCV antibodies and HBV antigens were detected using Exacto Triplex? HIV/HCV/HBsAg rapid test, cross-validated by ELISA tests. Sociodemographic and professional data, the modes of transmission and prevention of HIV and both hepatitis viruses were collected in a standard sheet and analyzed using the Epi-Info software version 7. Results: Pregnant women aged 15 to 24 were the most affected (45.3%);high school girls (46.0%), and pregnant women living in cohabitation (65.3%) were the most represented. Twenty-five (16.7%) worked in the formal sector, 12.7% were unemployed housewives and the remainder in the informal sector. The prevalence of HIV, HBV, and HCV viruses was 11.8%, 21.9% and 22.2%, respectively. The prevalence of co-infections was 8.6% for HIV-HBV, 10.2% for HIV-HCV, 14.7% for HBV-HCV and 6.5% for HIV-HBV-HCV. All positive results and 10% of negative results by the rapid test were confirmed by ELISA tests. The serology of the three viruses costs 39,000 FCFA (60 Euros) by ELISA compared to 10,000 FCFA (15.00 Euros) with Exacto Triplex? HIV/HCV/AgHBs (BioSynex, Strasbourg, France). Conclusion: The low level of education and awareness of hepatitis are barriers to development and indicate the importance of improving the literacy rate of women in the Central African Republic (CAR). Likewise, the high prevalence of the three viruses shows the need for the urgent establishment of a national program to combat viral hepatitis in the CAR.

Seismic performance evaluation of water supply pipes installed in a full-scale RC frame structure based on a shaking table test

As an important part of nonstructural components,the seismic response of indoor water supply pipes deserves much attention.This paper presents shaking table test research on water supply pipes installed in a full-scale reinforced concrete(RC)frame structure.Different material pipes and different methods for penetrating the reinforced concrete floors are combined to evaluate the difference in seismic performance.Floor response spectra and pipe acceleration amplification factors based on test data are discussed and compared with code provisions.A seismic fragility study of displacement demand is conducted based on numerical simulation.The acceleration response and displacement response of different combinations are compared.The results show that the combination of different pipe materials and different passing-through methods can cause obvious differences in the seismic response of indoor riser pipes.

Diagnosis of Helicobacter pylori Infection in Low Out-Outcome Country: Rapid Urease Test, Serological Test, versus Direct Microbiological Examination with Gram Stain

Introduction: Helicobacter pylori is a gram-negative bacillus responsible for numerous gastroduodenal pathologies, and this infection is a public health problem. The prevalence of infection with this bacterium remains high in countries with limited resources. Diagnosis relies mainly on numerous invasive and noninvasive methods. The aim of this work was to evaluate the different indirect diagnostic methods using bacterial cultures. Methods: We conducted a cross-sectional and analytical study from January to May 2022 in the gastroenterology departments of Douala General Hospital and Douala Military Hospital. All patients aged 18 years and older who were in the gastroenterology consultation and agreed to participate were included in our study. Sociodemographic, clinical, and paraclinical data were collected. Urease, liquid urea, and culture tests were performed from the specimens obtained by fibroscopy. Serological tests were performed on the blood sample. Results: 101 patients were included, 58 were female and 43 were male, for a sex ratio of 1.3. The mean age was 44.2 ± 16 years. The prevalence of infection was 90.5%, 44.1%, 40.6% and 21.8% for serology, direct microbiological examination, RUT (rapid urea test) and culture, respectively. Comparison of the different tests showed sensitivity and specificity of 67.1% and 64%, respectively, for RUT, 100% and 73.7%, respectively, for direct microbiological examination, and 100% and 14.8%, respectively, for serology. The positive and negative predictive values were 39.5% and 100% for serology, 39% and 85% for RUT, and 55.6% and 100% for direct microbiological examination, respectively. Conclusion: The prevalence of Helicobacter pylori infection depends on the type of test used. Direct examination is more reliable than RUT and serology.

Study on the Application Value of Liver Function and Serological Index Levels in the Diagnosis of Fatty Liver

Objective:To explore the application value of liver function and serological index detection in diagnosing fatty liver.Methods:Ninety patients with fatty liver disease(disease group)and ninety healthy subjects(healthy group)were selected as the subjects of this study.They all underwent liver function index testing and serological index testing.Test results were compared,and the diagnostic accuracy of single and combined tests was evaluated.Results:Liver function indicators of patients in the disease group were higher than those in the healthy group,with severe patients exhibiting higher levels than moderate patients and mild patients(P<0.05).Serological indicators in patients in the disease group were higher than those in the healthy group,with severe patients showing higher levels than moderate patients and mild patients(P<0.05).The diagnostic accuracy of liver function index testing was higher than that of serological index testing,and the accuracy of combined testing was higher than that of single testing(P<0.05).Conclusion:In diagnosing fatty liver,combining liver function testing and serological testing enables the initial diagnosis of the disease and facilitates the accurate assessment of its severity.