Laboratory diagnosis of COVID-19 in China: A review of challenging cases and analysis

Since the early emergence of coronavirus disease in 2019 (COVID-19) in Wuhan, Hubei province, China, the rapid spread of the disease occurs throughout the world, rose to international global health concern at the level of a pandemic. In the face of these medical challenges threaten humans, the development of fast and accurate method for early screening and diagnosis COVID-19 be important to contain the emerging public health threats, and prevent further spread in the population.

Despite the large number COVID 19 confirmed cases in China, some problematic cases with laboratory test results are not consistent, it was reported. In particular, the rate of false-negative high of 41% in the second acute respiratory syndrome coronavirus (SARS-CoV-2) detection by a chain reaction of reverse transcription-polymerase (qRT-PCR) assay real-time observed in China. Although serological testing has been implemented worldwide as a complementary method to help identify the SARS-CoV-2, some limitations on its use have been reported in China. Therefore, the use of the qRT-PCR and blood tests in the diagnosis COVID-19 in China and elsewhere, presented a considerable challenge, but when used in combination, can be a valuable tool in the fight against COVID-19.

In this review, we provide an overview of the advantages and disadvantages of molecular techniques different for SARS-CoV-2 detection currently used in several laboratories, including qRT-PCR, gene sequencing, loop-mediated isothermal amplification (LAMP), nucleic spectrometry acid mass (MS), and gene editing technique based clustered regularly interspaced short palindromic repeats (CRISPR / Cas13) systems. Then we mainly review and analyze some of the causes of false negative results of qRT-PCR, and how to resolve some of the diagnostic dilemma.

Advances in Personalized Medicine and Non-Invasive Diagnostics in Solid Organ Transplantation

personalized medicine has become a mainstay and in practice in transplantation pharmacotherapy since the emergence of the field. Decisions relating to the diagnosis, selection, and monitoring of pharmacotherapy directed against individual transplantation, allograft and immunological needs of all patients. recent advances in pharmacogenomics, non-invasive biomarkers and artificial intelligence technology has the promise to change the way we individualize treatment and monitoring allograft function.

Pharmacogenomic testing can provide physicians with additional data to minimize toxicity and maximize the therapeutic dose in patients at high risk, causing more informed decisions that can lower the risk of rejection and adverse outcomes associated with immunosuppressive therapy. Development of non-invasive strategy for monitoring allograft function may offer a safer method and more convenient for detecting allograft injury. Cell-free DNA and gene expression profiles offer the potential to serve as a “liquid biopsy” minimize the risks for patients and provide clinicians with a useful molecular data that can help individualize immunosuppression and treatment of rejection.

The use of big data in transplantation and new artificial intelligence platform, such as iBox, hold tremendous promise in giving the doctor a “glimpse into the future” so as to allow for a more individualized approach to immunosuppressive therapy which may minimize future adverse outcome. Advances in diagnostic, laboratory science, and artificial intelligence have been made more even application of personalized medicine tailored for solid organ transplant recipients. In this perspective, we summarize current and emerging tools are available, supporting the use of literature, and to personalize the future horizon transplant.

 Laboratory diagnosis of COVID-19 in China: A review of challenging cases and analysis
Laboratory diagnosis of COVID-19 in China: A review of challenging cases and analysis

Prospective Evaluation of Single Nucleotide Variants by Two Different Technologies in Paraffin Sample Non-Small Cell Advanced Lung Cancer Patients

targeted therapy is a new paradigm in the management of lung cancer. Next-generation sequencing (NGS) technique has allowed for the simultaneous testing of multiple genes in a way that is fast and efficient; However, there are other molecular diagnostic tools such as 3D Vantage nCounter® single nucleotide variants (SNVs) solid tumor panel that also offers important benefits of the input sample and the time-to-response, making them highly attractive for everyday clinical use.

This study aims to examine the performance of the panel Vantage in a routine inspection of non-squamous non-small lung cancer cells more (NSCLC) patients and to validate and compare the output with Solid Tumors (OST) DNA kit panel Oncomine, which is a standard technique in our institution , Two parallel multiplexing approach is based on DNA NGS and direct digital detection of DNA technology to evaluate SNVs nCounter®. A total of 42 advanced non-squamous NSCLC patients were prospectively included in this study.

ELISA kit for Human Entamoeba Histolytica

KTE63027-5platesof96wells 5 plates of 96 wells
EUR 2702.4
Description: Quantitative sandwich ELISA for measuring Human Entamoeba Histolytica in samples from cell culture supernatants, serum, whole blood, plasma and other biological fluids.

ELISA kit for Human Entamoeba Histolytica

KTE63027-96T 96T
EUR 686.4
Description: Quantitative sandwich ELISA for measuring Human Entamoeba Histolytica in samples from cell culture supernatants, serum, whole blood, plasma and other biological fluids.

Entamoeba histolytica IgG

DEENTG0140 96
EUR 122

Entamoeba histolytica Antibody

abx021709-1ml 1 ml
EUR 1053.6

Entamoeba histolytica Antibody

GWB-424127 1 ml Ask for price

Entamoeba histolytica PCR kit

PCR-H670-48D 50T
EUR 543.6

Entamoeba histolytica PCR kit

PCR-H670-96D 100T
EUR 686.4

Entamoeba histolytica Calreticulin

1-CSB-EP004458EKM
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  • 100ug
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  • 1MG
  • 200ug
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Description: Recombinant Entamoeba histolytica Calreticulin expressed in E.coli

Entamoeba histolytica RT PCR kit

RTq-H670-100D 100T
EUR 860.4

Entamoeba histolytica RT PCR kit

RTq-H670-150D 150T
EUR 969.6

Entamoeba histolytica RT PCR kit

RTq-H670-50D 50T
EUR 717.6

Entamoeba histolytica IgG (Amebiasis)

GWB-BE1540 1x96 Assays Ask for price

Entamoeba histolytica Ag ELISA Kit

DEIA2309PY 96T
EUR 931.2
Description: The Entamoeba histolytica Ag ELISA is a device for direct detection of Entamoeba histolytica specific antigen in faecal samples.

Entamoeba histolytica One-Step PCR kit

Oneq-H670-100D 100T
EUR 1039.2

Entamoeba histolytica One-Step PCR kit

Oneq-H670-150D 150T
EUR 1177.2

Entamoeba histolytica One-Step PCR kit

Oneq-H670-50D 50T
EUR 861.6

Human Entamoeba Histolytica IgG ELISA Kit

abx055727-100g 100 µg Ask for price

Human Entamoeba Histolytica IgG ELISA Kit

abx055727-10g 10 µg
EUR 493.75

Human Entamoeba Histolytica IgG ELISA Kit

abx055727-50g 50 µg Ask for price

Recombinant Entamoeba histolytica Calreticulin

AP74227 1mg
EUR 2826

Recombinant Entamoeba histolytica Calreticulin

CSB-EP004458EKM 716 mg Ask for price

Recombinant Entamoeba histolytica protein [His]

DAGF-207 100ug
EUR 1020

Rat Entamoeba histolytica Antigen ELISA Kit

ERE0168 96Tests
EUR 625.2

Goat Entamoeba histolytica Antigen ELISA Kit

EGTE0168 96Tests
EUR 625.2

OAEF00662-1MG - Entamoeba histolytica Antibody

OAEF00662-1MG 1mg
EUR 635

Human Entamoeba Histolytica Antigen ELISA Kit

abx053908-96tests 96 tests
EUR 801.6

Human Entamoeba histolytica Antigen ELISA Kit

201-12-1812 96 tests
EUR 528
Description: A quantitative ELISA kit for measuring Human in samples from biological fluids.

Human Entamoeba histolytica Antigen ELISA Kit

EHE0168 96Tests
EUR 625.2

Human Entamoeba histolytica Antigen ELISA Kit

GA-E1828HM-48T 48T
EUR 346.8

Human Entamoeba histolytica Antigen ELISA Kit

GA-E1828HM-96T 96T
EUR 559.2

Mouse Entamoeba histolytica Antigen ELISA Kit

EME0168 96Tests
EUR 625.2

Human Entamoeba histolytica Antigen ELISA Kit

QY-E02359 96T
EUR 433.2

Human Entamoeba Histolytica Antigen ELISA Kit

abx053908-100g 100 µg Ask for price

Human Entamoeba Histolytica Antigen ELISA Kit

abx053908-10g 10 µg
EUR 493.75

Human Entamoeba Histolytica Antigen ELISA Kit

abx053908-50g 50 µg Ask for price

Bovine Entamoeba histolytica Antigen ELISA Kit

EBE0168 96Tests
EUR 625.2

Canine Entamoeba histolytica Antigen ELISA Kit

ECE0168 96Tests
EUR 625.2

Rabbit Entamoeba histolytica Antigen ELISA Kit

ERTE0168 96Tests
EUR 625.2

Canine Entamoeba histolytica Antigen ELISA KIT

QY-E70153 96T
EUR 511.2

Human Entamoeba histolytica antibody ELISA Kit

SL2641Hu 96 Tests
EUR 468

Porcine Entamoeba histolytica Antigen ELISA Kit

EPE0168 96Tests
EUR 625.2

Anserini Entamoeba histolytica Antigen ELISA Kit

EAE0168 96Tests
EUR 625.2

ViPrimePLUS Entamoeba histolytica qPCR Kit, 150rxns

QM1004 each Ask for price

Human Entamoeba histolytica Antigen (EH)ELISA Kit

SL0654Hu 96 Tests
EUR 468

Rat Entamoeba histolytica Antigen(EH Ag) ELISA Kit

NSL1072r 96 Tests
EUR 498

Human Entamoeba Histolytica Antibody IgG ELISA Kit

abx055727-96tests 96 tests
EUR 801.6

Guinea Pig Entamoeba histolytica Antigen ELISA Kit

EGE0168 96Tests
EUR 625.2

Human Entamoeba histolytica IgA (EH-IgA) ELISA Kit

SL3659Hu 96 Tests
EUR 468

Human Entamoeba histolytica IgG (EH-IgG) ELISA Kit

SL3660Hu 96 Tests
EUR 468

Human Entamoeba histolytica IgM (EH-IgM) ELISA Kit

SL3661Hu 96 Tests
EUR 468

Human Entamoeba histolytica Antigen(EH Ag) ELISA Kit

NSL1314Hu 96 wells
EUR 468

Canine Entamoeba Histolytica Antigen(EH Ag)ELISA Kit

NSL1890Ca 1985 wells
EUR 528

GWB-BE1540-96W - Entamoeba histolytica IgG (Amebiasis)

GWB-BE1540-96W 96Wells
EUR 329

Bovine Entamoeba histolytica Anti-gen(EH Ag) ELISA Kit

NSL1263Bo 96 T
EUR 528

Guinea pig Entamoeba histolytica Antigen (EH Ag) ELISA Kit

NSL0072Gp 96T
EUR 528

Entamoeba histolytica Multidrug resistance protein 1 (MDR1)

1-CSB-YP001046EKM
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  • 100ug
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  • 1MG
  • 200ug
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Description: Recombinant Entamoeba histolytica Multidrug resistance protein 1(MDR1) expressed in Yeast

Recombinant Entamoeba histolytica Multidrug resistance protein 1 (MDR1)

CSB-YP001046EKM 5438 mg Ask for price

Recombinant Entamoeba histolytica Multidrug resistance protein 1(MDR1)

AP72404 1mg
EUR 3389

Entamoeba histolytica HK-9 mouse monoclonal antibody, clone 5001, Ascites

BM3307 1 ml Ask for price

Recombinant Entamoeba histolytica Pyruvate, phosphate dikinase (PPDK),partial

CSB-EP336270EKM 3045 mg Ask for price

Recombinant Entamoeba histolytica Pyruvate, phosphate dikinase (PPDK) ,partial

RPC22574-100ug 100ug
EUR 721.6

Recombinant Entamoeba histolytica Pyruvate, phosphate dikinase (PPDK) ,partial

RPC22574-1mg 1mg
EUR 2884.7

Recombinant Entamoeba histolytica Pyruvate, phosphate dikinase (PPDK) ,partial

RPC22574-20ug 20ug
EUR 448.1

Entamoeba histolytice and Entamoeba dispar Antibody

abx024083-1mg 1 mg
EUR 1412.4

Entamoeba histolytice and Entamoeba dispar Antibody

abx024084-1mg 1 mg
EUR 1412.4

Entamoeba Histolytice and Entamoeba dispar Antibody

abx024085-1mg 1 mg
EUR 1395.6

Entamoeba histolytice and Entamoeba dispar Antibody

abx024083-400l 400 µl Ask for price

Entamoeba histolytice and Entamoeba dispar Antibody

abx024083-80l 80 µl
EUR 1200

Entamoeba histolytice and Entamoeba dispar Antibody

abx024084-400l 400 µl Ask for price

Entamoeba histolytice and Entamoeba dispar Antibody

abx024084-80l 80 µl
EUR 1200

Entamoeba Histolytice and Entamoeba dispar Antibody

abx024085-400l 400 µl Ask for price

Entamoeba Histolytice and Entamoeba dispar Antibody

abx024085-80l 80 µl
EUR 1200

Entamoeba Histolytice Antibody

abx024082-1mg 1 mg
EUR 1395.6

Entamoeba Histolytice Antibody

abx024082-400l 400 µl Ask for price

Entamoeba Histolytice Antibody

abx024082-80l 80 µl
EUR 1200

Anti-Entamoeba histolytica Antibody

15000 100ug
EUR 230

Anti-Entamoeba histolytica Antibody

15000-100 100ug
EUR 230

Anti-Entamoeba histolytica Antibody

15000-1000 1mg
EUR 903

Anti-Entamoeba histolytica Antibody

15000-500 500ug
EUR 460

Anti-Entamoeba histolytica Antibody

15001 100ug
EUR 230

Anti-Entamoeba histolytica Antibody

15001-100 100ug
EUR 230

Anti-Entamoeba histolytica Antibody

15001-1000 1mg
EUR 903

Anti-Entamoeba histolytica Antibody

15001-500 500ug
EUR 460

Anti-Entamoeba histolytica Antibody

15010 100ug
EUR 230

Anti-Entamoeba histolytica Antibody

15010-100 100ug
EUR 230

Anti-Entamoeba histolytica Antibody

15010-1000 1mg
EUR 903

Anti-Entamoeba histolytica Antibody

15010-500 500ug
EUR 460

Anti-Entamoeba histolytica Antibody

15020 100ug
EUR 230

Anti-Entamoeba histolytica Antibody

15020-100 100ug
EUR 230

Anti-Entamoeba histolytica Antibody

15020-1000 1mg
EUR 903

Anti-Entamoeba histolytica Antibody

15020-500 500ug
EUR 460

Anti-Entamoeba histolytica Antibody

15030 100ug
EUR 230

Anti-Entamoeba histolytica Antibody

15030-100 100ug
EUR 230

Anti-Entamoeba histolytica Antibody

15030-1000 1mg
EUR 903

Anti-Entamoeba histolytica Antibody

15030-500 500ug
EUR 460

Anti-Entamoeba histolytica Mouse Monoclonal Antibody

150101 5 x 100ug
EUR 664

Robinson Medium for Entamoeba (Twin

M459-500G 1 unit
EUR 45.2
Description: Robinson Medium for Entamoeba (Twin

genesig Easy kit for all Entamoeba species

Z-Path-Entamoeba_spp-EASY 50 tests
EUR 410
Description: Entamoeba_spp

E. histolytica Protein

abx061528-100ug 100 ug
EUR 1212

E. histolytica Protein

abx061528-100g 100 µg Ask for price

E. histolytica Protein

abx061528-10g 10 µg
EUR 1112.5

E. histolytica Protein

abx061528-50g 50 µg Ask for price

E. histolytica Antibody

GWB-6D884C 0.1 mg Ask for price

genesig Real-time PCR detection kit for Entamoeba sp

Z-Path-Entamoeba-spp 150 tests
EUR 808
Description: Entamoeba_spp

E. histolytica & dispar Antibody

abx024018-1mg 1 mg
EUR 1212

E. histolytica & dispar Antibody

abx024018-400l 400 µl Ask for price

E. histolytica & dispar Antibody

abx024018-80l 80 µl
EUR 1112.5

genesig Std Real-time PCR detection kit for Entamoeba sp

Z-Path-Entamoeba_spp-std 150 tests
EUR 602
Description: Entamoeba_spp

genesig Std Real-time PCR detection kit for Entamoeba sp

Z-Path-Entamoeba-spp-std 150 tests
EUR 602
Description: Entamoeba_spp

OPEF01694-100UG - Recombinant Entamoeba histoytica Antigen

OPEF01694-100UG 100ug
EUR 635

Black PU stool tyre casters foot control - EACH

FUR5310 EACH
EUR 796.09

Entamoeba muris

Oneq-V355-OneqV355100D Oneq-V355-100D
EUR 515

Entamoeba muris

Oneq-V355-OneqV355150D Oneq-V355-150D
EUR 594

Entamoeba muris

Oneq-V355-OneqV35550D Oneq-V355-50D
EUR 413

Entamoeba muris

PCR-V355-PCRV35548D PCR-V355-48D
EUR 230

Entamoeba muris

PCR-V355-PCRV35596D PCR-V355-96D
EUR 312

Entamoeba Medium

M077-500G 1 unit
EUR 49.05
Description: Entamoeba Medium

genesig Real-time PCR detection kit for E.histolytica

Z-Path-E-histolytica 150 tests
EUR 808
Description: E.histolytica

Entamoeba PCR kit

PCR-H683-48D 50T
EUR 543.6

Entamoeba PCR kit

PCR-H683-96D 100T
EUR 686.4

genesig Std Real-time PCR detection kit for E.histolytica

Z-Path-E-histolytica-std 150 tests
EUR 602
Description: E.histolytica

Entamoeba HiVeg Medium

MV077-500G 1 unit
EUR 49.05
Description: Entamoeba HiVeg Medium

Entamoeba RT PCR kit

RTq-H683-100D 100T
EUR 860.4

Entamoeba RT PCR kit

RTq-H683-150D 150T
EUR 969.6

Entamoeba RT PCR kit

RTq-H683-50D 50T
EUR 717.6

Entamoeba muris PCR kit

PCR-V355-48D 50T
EUR 543.6

Entamoeba muris PCR kit

PCR-V355-96D 100T
EUR 686.4

Entamoeba muris RT PCR kit

RTq-V355-100D 100T
EUR 860.4

Entamoeba muris RT PCR kit

RTq-V355-150D 150T
EUR 969.6

Entamoeba muris RT PCR kit

RTq-V355-50D 50T
EUR 717.6

Entamoeba One-Step PCR kit

Oneq-H683-100D 100T
EUR 1039.2

Entamoeba One-Step PCR kit

Oneq-H683-150D 150T
EUR 1177.2

Entamoeba One-Step PCR kit

Oneq-H683-50D 50T
EUR 861.6

Human recombinant purified matrilysin/MMP7 (matrix metalloproteinase 7) protein control for WB

MMP71-C 100 ul
EUR 343.2

QPCR Kit DNA Entamoeba h - EACH

MOL6874 EACH
EUR 1176.51

OAEF00809-1MG - Entamoeba Antibody

OAEF00809-1MG 1mg
EUR 635

OAEF00810-1MG - Entamoeba Antibody

OAEF00810-1MG 1mg
EUR 635

Entamoeba muris One-Step PCR kit

Oneq-V355-100D 100T
EUR 1039.2

Entamoeba muris One-Step PCR kit

Oneq-V355-150D 150T
EUR 1177.2

Entamoeba muris One-Step PCR kit

Oneq-V355-50D 50T
EUR 861.6

NATtrol Rotavirus (Stool Matrix) (0.5 mL)

NATROTA-GP 0.5 mL
EUR 55

ViPrimePLUS Entamoeba qPCR Kit, 150rxns

QM1003 each Ask for price

QPCR Kit DNA Entamoeba h Mmix - EACH

MOL6876 EACH
EUR 1499.64

Entamoeba dispar outer membrane Protein

abx061530-100ug 100 ug
EUR 1212

Entamoeba dispar outer membrane Protein

abx061530-100g 100 µg Ask for price

Entamoeba dispar outer membrane Protein

abx061530-10g 10 µg
EUR 1112.5

Entamoeba dispar outer membrane Protein

abx061530-50g 50 µg Ask for price

Core Panel Multi-Tumor control slides, set of 5

TS900 Set of 5
EUR 145
Description: Core Panel Multi-Tumor control slides, set of 5

Core Panel Multi-Tumor control slides, set of 25

TS900-25 Set of 25
EUR 425
Description: Core Panel Multi-Tumor control slides, set of 25

NATtrol Shigella sonnei (Stool Matrix) (0.5 mL)

NATSSO-GP 0.5 mL
EUR 55

Recombinant (E. Coli) Vesicular Stomatitis Virus Matrix Protein, Indiana (VSV-I M) Protein Control for Western Blot

VSIM12-C 100 ul
EUR 343.2

NATtrol Escherichia coli (Stool Matrix) (0.5 mL)

NATECO(933)-GP 0.5 mL
EUR 55

NATtrol Escherichia coli (Stool Matrix) (0.5 mL)

NATECO(ETEC)-GP 0.5 mL
EUR 55

Breast Panel Multi-Tumor control slides, set of 5

TS901 Set of 5
EUR 145
Description: Breast Panel Multi-Tumor control slides, set of 5

Breast Panel Multi-Tumor control slides, set of 25

TS901-25 Set of 25
EUR 395
Description: Breast Panel Multi-Tumor control slides, set of 25

Casein, for Molecular Biology

MB279-100G 1 unit
EUR 110.77
Description: Casein, for Molecular Biology

Casein, for Molecular Biology

MB279-500G 1 unit
EUR 387.65
Description: Casein, for Molecular Biology

NATtrol Campylobacter jejuni (Stool Matrix) (0.5 mL)

NATCJE-GP 0.5 mL
EUR 55

NATtrol Clostridium difficile (Stool Matrix) (0.5 mL)

NATCDI-GP 0.5 mL
EUR 55

NATtrol Adenovirus Type 40 (Stool Matrix) (0.5 mL)

NATADV40-GP 0.5 mL
EUR 55

NATtrol Adenovirus Type 41 (Stool Matrix) (0.5 mL)

NATADV41-GP 0.5 mL
EUR 55

NATtrol Salmonella typhimurium (Stool Matrix) (0.5 mL)

NATSTY-GP 0.5 mL
EUR 55

Control Animal Genomic DNA Panel, Set of any 5 species

G-005 5X0.025mg
EUR 720

Control Animal Genomic DNA Panel, Set of any 10 species

G-010 10x0.025mg
EUR 1193

Control/Blocking peptide for Mouse Histone deacetylase 1

HDAC111-P 100 ug
EUR 196.8

D-(+)-Glucose, anhydrous ?For Molecular

MB037-100G 1 unit
EUR 17.24
Description: D-(+)-Glucose, anhydrous ?For Molecular

D-(+)-Glucose, anhydrous ?For Molecular

MB037-500G 1 unit
EUR 83.6
Description: D-(+)-Glucose, anhydrous ?For Molecular

Urea, suitable for molecular biology

GE1210-1 1
EUR 58

Urea, suitable for molecular biology

GE1210-1KG 1 kg
EUR 106.8

Urea, suitable for molecular biology

GE1210-500 500
EUR 33.1

Urea, suitable for molecular biology

GE1210-500G 500 g
EUR 76.8

OPEF01693-100UG - Recombinant Entamoeba dispar OMP Antigen

OPEF01693-100UG 100ug
EUR 635

D(+)-Lactose monohydrate ?For Molecular

MB062-500G 1 unit Ask for price
Description: D(+)-Lactose monohydrate ?For Molecular

D(+)-Lactose monohydrate ?For Molecular

MB062-5KG 1 unit Ask for price
Description: D(+)-Lactose monohydrate ?For Molecular

Matrix Dissociation Buffer (EDTA-based), Sterile-Filtered, Molecular Grade

M1090-100 each
EUR 222

Pyridine, GlenBiol™, suitable for molecular biology with molecular sieve

GS8780-2500 2500
EUR 249.8

NATtrol Norovirus Group I (Recombinant) (Stool Matrix) (0.5 mL)

NATNOVI-GP 0.5 mL
EUR 55

NATtrol Norovirus Group II (Recombinant) (Stool Matrix) (0.5 mL)

NATNOVII-GP 0.5 mL
EUR 55

Guanidine hydrochloride ?For Molecular B

MB014-100G 1 unit
EUR 72.26
Description: Guanidine hydrochloride ?For Molecular B

Overall, 95% of the sample was marked with both technologies. Vantage panels accounted for 95% sensitivity and 82% specificity. In terms of predictive values, the probability of actually variants SNV when detected by Ncounter panel was 82%, whereas the probability of not variants SNV if not detected by the platform is 95%. Finally, Cohen’s Kappa coefficient was 0.76, indicating a substantial class correlation between OST and the Vantage panel. Our results make Ncounter a practical and cost-effective means of analytical sensitivity.

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