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Ventriculoperitoneal shunting (VPS) is the surgical technique of choice to manage pediatric hydrocephalus. Despite having good results, it is prone to complications, some of which are rare. This is the case report of a 2-year-old male, with an uncomplicated VPS done at 6 months of age, presenting with vomiting, irritability, anorexia, and drooling. There was an oral protrusion of a tube dripping clear fluid. Imaging studies demonstrated evidence of gastric perforation with a cephalic migration and transoral protrusion of the distal end of the shunt tubing. A gastroplasty, and immediate revision of the distal shunt were done free of any complications. This case report underlines the importance of recognizing and managing trans-oral protrusion of the distal end of VPS system in a timely manner, and raises awareness of this uncommon complication and its potential influence on patient health and survival, given ventriculitis' high lethality., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Produced water, a major by-product of oil and gas production, represents the most significant amount of waste by volume in the oil and gas industry. Focusing on the hydrocarbon's lifecycle, this review delves into the composition and global variations of produced water. It assesses the current treatment methods for their effectiveness and their potential for reuse in sectors beyond oil and gas, such as agriculture. The review highlights the environmental trade-offs in maximising energy production, analysing the ecological implications of produced water disposal in marine environments and the potential risks to marine biodiversity. Regional regulatory frameworks and their role in mitigating these environmental impacts are examined, alongside the challenges faced in standardising treatment solutions due to the complex nature of produced water. The conclusion underscores the need for continuous research to develop innovative and effective treatment technologies and advocates for a balanced approach to energy production that prioritises environmental stewardship., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: To evaluate the clinical performance of the novel PivNG primers and probes set (PivNG test) used in the cobas omni Utility Channel for supplemental testing of Neisseria gonorrhoeae (NG)., Methods: Oropharyngeal, urogenital and rectal samples were self-collected during routine testing at Barts Health sexual health clinics, London, UK. Samples were tested by the cobas CT/NG test and PivNG cobas omni Utility Channel test on cobas 6800/8800 Systems. Supplemental testing was carried out with the Xpert CT/NG test. PivNG overall percent agreements, positive percent agreements (PPAs)/negative percent agreements (NPAs) and positive/negative predictive values were calculated for each sample type. Microscopy and/or culture data were included for a randomised subset of concordant/discordant results, and a composite reference standard (cobas CT/NG, Xpert CT/NG and culture results) adjusted for partial verification bias was used to determine PivNG PPA and NPA., Results: Of 447 evaluable samples with valid results from all three assays (cobas CT/NG, PivNG and Xpert CT/NG), 288 (64.4%) were NG-positive by both PivNG and cobas CT/NG; 117 (26.2%) were NG-negative in both tests; and 42 (9.4%) had discordant results (with NG-negative supplementary Xpert) CT/NG results in 40/42 instances). Of 19 PivNG/Xpert CT/NG-discordant samples, 11 were confirmed NG-positive by microscopy and/or culture results. PivNG PPA and NPA were 100% and 91% for oropharyngeal swabs, 100% and 100% for vaginal swabs, 100% and 100% for male urine samples, and 100% and 97% for rectal swabs, respectively, compared with the partially adjusted composite reference standard., Conclusions: PivNG is a reliable supplementary test with high sensitivity for confirming NG infection when used in conjunction with the cobas CT/NG test and samples collected in cobas PCR Media. Moreover, the PivNG test offers a convenient, high-throughput solution for supplemental NG testing of various sample types, with the potential to reduce the number of indeterminate reports., Competing Interests: Competing interests: MH received support from Roche Molecular Systems for study protocol costs and is a member of the speaker's bureau of Roche Molecular Systems. XCP received support from Roche Diagnostics to attend past meetings not related to this study. DP, RS and SS have nothing to disclose. RA, ML and AH are employees of Roche Molecular Systems and report receiving stocks and stock options from Roche. MN is an employee of Roche Molecular Systems., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Mycoplasma genitalium (MG) and Trichomonas vaginalis (TV) can lead to long-term sequelae in males and females; however, global prevalence data vary between geographical regions, as these sexually transmitted infections are not included in routine screening. The objective of this study was to use the cobas ® TV/MG assay to assess the point prevalence of TV and MG in specimens from men and women over a broad European geographical area. Urine, vaginal, endocervical, and rectal samples were collected from patients aged ≥ 18 years receiving Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (NG) screening as per local standard of care at sites in Belgium, Germany, Spain, and the UK (Wales). Remnant samples were assessed using the cobas TV/MG assay. Analysis of 2795 samples showed that MG prevalence varied slightly across female sample types (range: 1.7-5.8%; p = 0.0042). MG prevalence was higher in male rectal samples (12.5%) than in male urine samples (3.9%; p < 0.0001). TV prevalence was low in male (0.8%; 12/1535) and female (1.3%; 16/1260) samples across all sites. Co-infection of TV/MG with CT or NG was 10.0% (19/190) and 9.6% (7/73), respectively, in both male and female samples. MG and TV prevalence rates were comparable to the published literature in Europe. MG prevalence was highest in male rectal samples; as rectal testing is an off-label use of the cobas TV/MG assay, the clinical utility of this assay for rectal testing should be further investigated., (© 2022. The Author(s).)

Background: HIV-1 viral load assays are essential tools for clinical management of people living with HIV-1., Objectives and Study Design: We evaluated concordance between three assays: the cobas® HIV-1 test for use on the cobas® 6800 and cobas® 8800 systems (cobas HIV-1); the COBAS® TaqMan® HIV-1 Test, v2.0 for use with the High Pure System and the COBAS® AmpliPrep/COBAS® TaqMan® HIV-1 test, v2.0. Analytical sensitivity, precision and accuracy of all three methods were assessed using the WHO 2nd International Standard for HIV-1, with concentrations from 5 to 1000 copies/mL. Accuracy and concordance were evaluated using 212 clinical specimens. Overall percent agreement (OPA) was determined using three different thresholds used as medical decision points., Results: The limit of detection was below 20 copies/mL for each assay. The hit rate for each assay was 100 % for concentrations ≥ 50 copies/mL. Only the cobas HIV-1 test generated quantifiable data for all replicates at 50 copies/mL. Between 50 and 400 copies/mL, results for all assays were accurate within 0.09 log 10 copies/mL, with standard deviation less than 0.14 log 10 copies/mL. The mean difference between paired results in clinical specimens ranged from -0.050 to 0.107 log 10 copies/mL across all assay comparisons. The OPA between pairs of assays ranged from 94.8 to 98.1% at the 50 copies/mL cutoff, and improved to a range of 97.6-99.0% at the 200 copies/mL cutoff. At the 1000 copies/mL cutoff, OPA between assays was 98.5-99.0%., Conclusions: The cobas HIV-1 assay is highly sensitive, accurate and suitable for use in clinical practice., (Copyright © 2021. Published by Elsevier B.V.)