Publications by authors named "James Wacker"
Background: Risk stratification of emergency department patients with suspected acute infections and/or suspected sepsis remains challenging. We prospectively validated a 29-messenger RNA host response classifier for predicting severity in these patients. Methods: We enrolled adults presenting with suspected acute infections and at least one vital sign abnormality to six emergency departments in Greece.
View Article and Find Full Text PDFImportance: Rapid and accurate discrimination of sepsis and its potential severity currently require multiple assays with slow processing times that are often inconclusive in discerning sepsis from sterile inflammation.
Objective: To analyze a whole-blood, multivalent, host-messenger RNA expression metric for estimating the likelihood of bacterial infection and 30-day mortality and compare performance of the metric with that of other diagnostic and prognostic biomarkers and clinical parameters.
Design, Setting, And Participants: This prospective diagnostic and prognostic study was performed in the surgical intensive care unit (ICU) of a single, academic health science center.
Background And Importance: mRNA-based host response signatures have been reported to improve sepsis diagnostics. Meanwhile, prognostic markers for the rapid and accurate prediction of severity in patients with suspected acute infections and sepsis remain an unmet need. IMX-SEV-2 is a 29-host-mRNA classifier designed to predict disease severity in patients with acute infection or sepsis.
View Article and Find Full Text PDFPredicting the severity of COVID-19 remains an unmet medical need. Our objective was to develop a blood-based host-gene-expression classifier for the severity of viral infections and validate it in independent data, including COVID-19. We developed a logistic regression-based classifier for the severity of viral infections and validated it in multiple viral infection settings including COVID-19.
View Article and Find Full Text PDFObjectives: Clinically deployable methods for the rapid and accurate prediction of sepsis severity that could elicit a meaningful change in clinical practice are currently lacking. We evaluated a whole-blood, multiplex host-messenger RNA expression metric, Inflammatix-Severity-2, for identifying septic, hospitalized patients' likelihood of 30-day mortality, development of chronic critical illness, discharge disposition, and/or secondary infections.
Design: Retrospective, validation cohort analysis.
Objectives: The rapid diagnosis of acute infections and sepsis remains a serious challenge. As a result of limitations in current diagnostics, guidelines recommend early antimicrobials for suspected sepsis patients to improve outcomes at a cost to antimicrobial stewardship. We aimed to develop and prospectively validate a new, 29-messenger RNA blood-based host-response classifier Inflammatix Bacterial Viral Non-Infected version 2 (IMX-BVN-2) to determine the likelihood of bacterial and viral infections.
View Article and Find Full Text PDFArticle Synopsis
- Pulmonary embolism (PE) is a serious condition affecting many individuals and can lead to chronic pulmonary hypertension, which is expensive to treat, costing between $98,000 and $117,000.
- A study reviewed records of 341 patients treated for massive or submassive PE using either systemic heparin or catheter-directed thrombolysis (CDT), examining short-term costs and long-term outcomes.
- Results showed that CDT had fewer complications, shorter hospital stays, and lower rates of chronic pulmonary hypertension compared to heparin, though it initially cost more; however, over time, CDT was associated with greater overall cost savings and better patient outcomes.
Background: Whether or not to administer antibiotics is a common and challenging clinical decision in patients with suspected infections presenting to the emergency department (ED). We prospectively validate InSep, a 29-mRNA blood-based host response test for the prediction of bacterial and viral infections.
Methods: The PROMPT trial is a prospective, non-interventional, multi-center clinical study that enrolled 397 adult patients presenting to the ED with signs of acute infection and at least one vital sign change.
Background: Fever-7 is a test evaluating host mRNA expression levels of IFI27, JUP, LAX, HK3, TNIP1, GPAA1 and CTSB in blood able to detect viral infections. This test has been validated mostly in hospital settings. Here we have evaluated Fever-7 to identify the presence of respiratory viral infections in a Community Health Center.
View Article and Find Full Text PDFObjectives: Complex critical syndromes like sepsis and coronavirus disease 2019 may be composed of underling "endotypes," which may respond differently to treatment. The aim of this study was to test whether a previously defined bacterial sepsis endotypes classifier recapitulates the same clinical and immunological endotypes in coronavirus disease 2019.
Design: Prospective single-center observational cohort study.
Improved identification of bacterial and viral infections would reduce morbidity from sepsis, reduce antibiotic overuse, and lower healthcare costs. Here, we develop a generalizable host-gene-expression-based classifier for acute bacterial and viral infections. We use training data (N = 1069) from 18 retrospective transcriptomic studies.
View Article and Find Full Text PDFBackground: To ensure the safety of trees, two NDT (nondestructive testing) techniques, electric resistance tomography and stress wave tomography, were employed to quantitatively detect and characterize the internal decay of standing trees. Comparisons between those two techniques were done to make full use of the individual capability for decay detection.
Methods: Eighty trees (40 and 40 ) were detected, then wood increment cores were obtained from each cross disc trial.