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Objectives: To elicit the relative importance of the benefits and harms of colorectal cancer (CRC) screening among potential screening participants in the Dutch population. Methods: In a consensus meeting with 11 experts, risk reduction of CRC and CRC deaths (benefits) and complications from colonoscopy, stress of receiving positive fecal immunological test (FIT) results, as well as false-positive and false-negative FIT results (harms) were selected as determinant end points to consider during decision making. We conducted an online best-worst scaling survey among adults aged 55 to 75 years from the Dutch Health Care Consumer Panel of The Netherlands Institute for Health Services Research to elicit preference values for these outcomes. The preference values were estimated using conditional logit regression. Results: Of 265 participants, 234 (89%) had ever participated in CRC screening. Compared with the stress of receiving a positive FIT result, the outcome perceived most important was the risk of CRC death (odds ratio [OR] 4.5; 95% confidence interval [CI] 3.9-5.1), followed by risk of CRC (OR 4.1; 95% CI 3.6-4.7), a false-negative FIT result (OR 3.1; 95% CI 2.7-3.5), colonoscopy complications (OR 1.6; 95% CI 1.4-1.8), and a false-positive FIT result (OR 1.4; 95% CI 1.3-1.6). The magnitude of these differences in perceived importance varied according to age, educational level, ethnic background, and whether the individual had previously participated in CRC screening. Conclusion: Dutch men and women eligible for FIT-based CRC screening perceive the benefits of screening to be more important than the harms.

A large proportion of the insects which have invaded new regions and countries are emerging species, being found for the first time outside their native range. Being able to detect such species upon arrival at ports of entry before they establish in non-native countries is an urgent challenge. The deployment of traps baited with broad-spectrum semiochemical lures at ports-of-entry and other high-risk sites could be one such early detection tool. Rapid progress in the identification of semiochemicals for cerambycid beetles during the last 15 years has revealed that aggregation-sex pheromones and sex pheromones are often conserved at global levels for genera, tribes or subfamilies of the Cerambycidae. This possibly allows the development of generic attractants which attract multiple species simultaneously, especially when such pheromones are combined into blends. Here, we present the results of a worldwide field trial programme conducted during 2018–2021, using traps baited with a standardised 8-pheromone blend, usually complemented with plant volatiles. A total of 1308 traps were deployed at 302 sites covering simultaneously or sequentially 13 European countries, 10 Chinese provinces and some regions of the USA, Canada, Australia, Russia (Siberia) and the Caribbean (Martinique). We intended to test the following hypotheses: 1) if a species is regularly trapped in significant numbers by the blend on a continent, it increases the probability that it can be detected when it arrives in other countries/continents and 2) if the blend exerts an effective, generic attraction to multiple species, it is likely that previously unknown and unexpected species can be captured due to the high degree of conservation of pheromone structures within related taxa. A total of 78,321 longhorned beetles were trapped, representing 376 species from eight subfamilies, with 84 species captured in numbers greater than 50 individuals. Captures comprised 60 tribes, with 10 tribes including more than nine species trapped on different continents. Some invasive species were captured in both the native and invaded continents. This demonstrates the potential of multipheromone lures as effective tools for the detection of ‘unexpected’ cerambycid invaders, accidentally translocated outside their native ranges. Adding new pheromones with analogous well-conserved motifs is discussed, as well as the limitations of using such blends, especially for some cerambycid taxa which may be more attracted by the trap colour or other characteristics rather than to the chemical blend.

The Covid-19 pandemic has an impact on every aspect of human life, one of which is the mental health of the children. There are drastic changes in the child's life cycle and activities that cause mood fluctuations, feelings of sadness, fear, that cause excessive stress reactions. The Covid-19 pandemic is a difficult situation for children, even the impact affects their future. Therefore, there is a need for early detection to track children's mental health. This research aimed to inform teachers' in Bekasi city of their understanding of children's mental health conditions during the Covid-19 pandemic. The purpose of this research is that teachers will have skills in early detection of mental health in children. The method employed descriptive analysis and used survey methods, and questionnaires in collecting the data. The results of this study reveal that early detection knowledge is very important to be understood by teachers as a preventive step in preventing young children's mental health disorders in the future, so that children can be productive and active again to live their lives

Item does not contain fulltext The purpose of this study was to describe the development and preliminary testing of a new scale assessing knowledge about melanoma risk factors and early detection/secondary prevention. Data was drawn from a longitudinal study assessing barriers and facilitators of skin self- examination among patients diagnosed with melanoma. For the current analysis, 191 patients who completed the new 9-item Knowledge About Melanoma Early Detection Scale and other study measures were included. Exploratory factor analysis with were conducted, which identified a robust scale comprised of 6 items with factor loadings ranging from .56 to .81. Higher scores on the Knowledge About Melanoma Early Detection Scale were associated with younger age and more positive attitudes about melanoma prevention, but not with biological sex, education, melanoma stage, or past self-administered and physician-provided skin checks. Further studies are needed to replicate these findings and to further establish the predictive validity of this scale and its usefulness for health research. 9 p.

El propósito de este trabajo es explorar una tensión y un deseo. La tensión es la que encontramos entre nuestra capacidad para cambiar de opinión, componente crucial casi de cualquier interpretación del progreso, y la tendencia que parecemos exhibir a atrincherarnos en las creencias que están en el centro de la identidad política con la que nos identificamos en un contexto determinado. Nos gustaría ser capaces de detectar y jubilar nuestros prejuicios, de avanzar hacia posiciones más inclusivas y que nos hicieran mejores ciudadanos. Y, sin embargo, nos vemos arrastrados, en ocasiones contra nuestro mejor juicio, hacia posiciones que heredamos de las personas con las que compartimos las cosas que nos importan. A lo largo de este trabajo nos preguntaremos cómo es posible intervenir sobre esta tensión para retener aspectos necesarios de ambas tendencias. En concreto, pensaremos cómo es posible intervenir en este aparente problema cumpliendo un deseo: queremos combatir el mal discurso con más discurso. Las estrategias de intervención destinadas a contrarrestar los efectos negativos de la polarización que desarrollaremos tendrán como objetivo mejorar la calidad de la deliberación democrática. El diálogo con aquellas personas con quienes estamos en desacuerdo nos parece un ideal democrático irrenunciable. No hay, en este sentido, progreso sin desacuerdo., The purpose of this paper is to explore a tension and a desire. The tension is the one we find between our ability to change our mind, a crucial component of almost any conception of progress, and the tendency we apparently show to cling to the core beliefs of the political identity we identify with in a particular context. In order to adopt more inclusive positions and become better citizens, we would like to be able to detect and replace our prejudices. And yet, we are dragged, sometimes against our better judgment, toward positions that we inherited from those with whom we share the things we care about. Throughout this paper we wonder how it is possible to intervene on this tension in order to retain necessary aspects for both tendencies. In particular, we explore how it is possible to intervene on this apparent problem by fulfilling a desire: we want to combat bad discourse with more discourse. The intervention strategies devised to counteract the negative effects of the rise of polarization that we develop are aimed at improving the quality of democratic deliberation. Deliberating with those whom we disagree with seems to us to be an essential democratic ideal. In this sense, there is no progress without disagreement.

Funding: The LUNGSCOT study is funded by the Chief Scientists Office of the Scottish Government, reference HIPS/19/52. Introduction Targeted lung cancer screening is effective in reducing lung cancer and all-cause mortality according to major trials in the United Kingdom and Europe. However, the best ways of implementing screening in local communities requires an understanding of the population the programme will serve. We undertook a study to explore the views of those potentially eligible for, and to identify potential barriers and facilitators to taking part in, lung screening, to inform the development of a feasibility study. Methods Men and women aged 45–70, living in urban and rural Scotland, and either self-reported people who smoke or who recently quit, were invited to take part in the study via research agency Taylor McKenzie. Eleven men and 14 women took part in three virtual focus groups exploring their views on lung screening. Focus group transcripts were transcribed and analysed using thematic analysis, assisted by QSR NVivo. Findings Three overarching themes were identified: (1) Knowledge, awareness and acceptability of lung screening, (2) Barriers and facilitators to screening and (3) Promoting screening and implementation ideas. Participants were largely supportive of lung screening in principle and described the importance of the early detection of cancer. Emotional and psychological concerns as well as system-level and practical issues were discussed as posing barriers and facilitators to lung screening. Conclusions Understanding the views of people potentially eligible for a lung health check can usefully inform the development of a further study to test the feasibility and acceptability of lung screening in Scotland. Patient or Public Contribution The LUNGSCOT study has convened a patient advisory group to advise on all aspects of study development and implementation. Patient representatives commented on the focus group study design, study materials and ethics application, and two representatives read the focus group transcripts. Publisher PDF

Giant splenic artery aneurysms are rare and associated with high morbidity and mortality. Early detection is the key to decreasing morbidity and mortality. We present a giant splenic artery aneurysm which was managed by en bloc resection of the spleen, distal pancreas.

The Asian walnut moth, Garella musculana (Erschov, 1874) (Lepidoptera, Nolidae) is an alien pest originating from Central Asia and is now spreading in Europe, attacking walnut trees. In this study, we updated the current distribution of G. musculana, focusing on the Italian range, where it was reported for the first time in 2021. Field surveys showed an extensive distribution of G. musculana in northern Italy, particularly in the Veneto Region. In this area, the Asian walnut moth developed on English and black walnut, attacking almost exclusively tree shoots. Based on current distribution data, further investigations are required in the nearby regions as well as in those that were less surveyed. Lastly, it is imperative to conduct more studies on insect biology and the impact on walnut production.

Early detection is important for the management of invasive alien species. In the last decade citizen science has become an important source of such data. Here, we used opportunistic records from the “LIFE ARTEMIS” citizen science project, in which people submitted records from places where they observed tree pests, to understand the distribution of a rapidly-spreading forest pest: the oak lace bug (Corythucha arcuata) in Slovenia. These citizen science records were not distributed randomly. We constructed a species distribution model for C. arcuata that accounted for the biased distribution of citizen science by using the records of other tree pests and diseases from the same project as pseudo-absences (so-called constrained pseudo-absences), and compared this to a model with pseudo-absences selected randomly from across Slovenia. We found that the constrained pseudo-absence model showed that C. arcuata was more likely to be found in east, in places with more oak trees and at lower elevations, and also closer to highways and railways, indicating introduction and dispersal by accidental human transport. The outputs from the model with random pseudo-absences were broadly similar, although estimates from this model tended to be higher and less precise, and some factors that were significant (proximity to minor roads and human settlements) were artefacts of recorder bias, showing the importance of taking the distribution of recording into account wherever possible. The finding that C. arcuata is more likely to be found near highways allows us to design advice for where future citizen science should be directed for efficient early detection.

This community service is carried out in Sugio Lamongan. Sugio village consists of five hamlets, namely Caron, Bulus, Gondangwaruk, Pandanan, and Sugio hamlets. To find out whether there are growth and development problems, it is necessary to detect early growth and development of preschool children and one way so that preschool children get early detection of growth and development is to empower the community in this case by involving PAUD teachers. PAUD teachers can carry out early detection of growth and development continuously or continuously at the end of the semester, media or tools in the form of applications are needed so that PAUD teachers can carry out early detection of electronic-based growth and development. With the increase in science and technology, the internet can be reached to villages including Sugio village. The community service method is carried out with ELENCODE socialization lectures and assistance in implementing early detection of growth and development of preschool children with ELENCODE so that there is an increase in PAUD teacher knowledge about early detection of growth and development and improvement of electronic-based early detection skills of growth and development using ELENCODE., This community service is carried out in Sugio Lamongan. Sugio village consists of five hamlets, namely Caron, Bulus, Gondangwaruk, Pandanan, and Sugio hamlets. To find out whether there are growth and development problems, it is necessary to detect early growth and development of preschool children, and one way so that preschool children get early detection of growth and development is to empower the community in this case by involving PAUD teachers. PAUD teachers can carry out early detection of growth and development continuously or continuously at the end of the semester, media or tools in the form of applications are needed so that PAUD teachers can carry out early detection of electronic-based growth and development. With the increase in science and technology, the internet can be reached in villages including Sugio village. The community service method is carried out with ELENCODE socialization lectures and assistance in implementing early detection of growth and development of preschool children with ELENCODE so that there is an increase in PAUD teacher knowledge about early detection of growth and development and improvement of electronic-based early detection skills of growth and development using ELENCODE.

Anterior tibiofemoral dislocation after total knee arthroplasty is an extremely rare and serious event. Amongst English-published papers, we found only 15 cases, 3 of which presented vascular complications. This manuscript aims to present a 77-year-old woman with a TC-Plus (Smith & Nephew) cruciate-retaining type in first time of knee prosthesis, who suffered an anterior tibiofemoral dislocation and were admitted to our hospital. The clinical management and outcome were evaluated. Furthermore, a review of literature was performed. We concluded that early detection and surgical intervention of the vascular injury is the key in the survival of the limbs. If there is still knee instability after acute recovery, it seems that revision surgery with constrained total knee arthroplasty can bring about good clinical and functional results.

Malware applications are one of the major threats that computing systems face today. While security researchers develop new defense mechanisms to detect malware, attackers continue to release new malware families that evade detection. New defense mechanisms must therefore be developed to effectively counter malware. Hardware Performance Counters (HPCs) have been recently proposed as a means to detect malware. However, recent work has also shown that malware detection is not effective when performance counters are sampled in realistic scenarios. We show how proper data pre-processing and the use of the XGBoost classifier can be used to improve the performance of malware detection using HPCs by at least 15%. We also show that the proposed method can detect malware early (shortly after its launch) by classifying HPC datastreams at short time intervals. In addition, we propose a multi-temporal classification model that ensures the early detection of a high percentage of malware while maintaining overall low false positive rates. Finally, we show that through robust training, the XGBoost classifier shows up to 50x less vulnerability to adversarial attacks that are intended to undermine its malware detection performance.

Reducing the age of first autism diagnosis facilitates access to critical early intervention services. A current "waitlist crisis" for autism diagnostic evaluation thus demands that we consider novel use of available clinical resources. Previous work has found that expert autism clinicians can identify autism in young children with high specificity after only a brief observation; rapid identification by non-experts remains untested. In the current study, 252 children ages 12-53 months presented for a comprehensive autism diagnostic evaluation. We found that junior clinicians in training to become autism specialists (n = 29) accurately determined whether or not a young child would be diagnosed with autism in the first five minutes of the clinic visit in 75% of cases. Specificity of brief observations was high (0.92), suggesting that brief observations may be an effective tool for triaging young children toward autism-specific interventions. In contrast, the lower negative predictive value (0.71) of brief observations, suggest that they should not be used to rule out autism. When trainees expressed more confidence in their initial impression, their impression was more likely to match the final diagnosis. These findings add to a body of literature showing that clinical observations of suspected autism should be taken seriously, but lack of clinician concern should not be used to rule out autism or overrule other indicators of likely autism, such as parent concern or a positive screening result.

Objective: Globally, cardiovascular diseases (CVDs) are one of the most leading causes of death. In medical screening and diagnostic procedures of CVDs, electrocardiogram (ECG) signals are widely used. Early detection of CVDs requires acquisition of longer ECG signals. It has triggered the development of personal healthcare systems which can be used by cardio-patients to manage the disease. These healthcare systems continuously record, store, and transmit the ECG data via wired/wireless communication channels. There are many issues with these systems such as data storage limitation, bandwidth limitation and limited battery life. Involvement of ECG data compression techniques can resolve all these issues. Method: In the past, numerous ECG data compression techniques have been proposed. This paper presents a methodological review of different ECG data compression techniques based on their experimental performance on ECG records of the Massachusetts Institute of Technology-Beth Israel Hospital (MIT-BIH) arrhythmia database. Results: It is observed that experimental performance of different compression techniques depends on several parameters. The existing compression techniques are validated using different distortion measures. Conclusion: This study elaborates advantages and disadvantages of different ECG data compression techniques. It also includes different validation methods of ECG compression techniques. Although compression techniques have been developed very widely but the validation of compression methods is still a prospective research area to accomplish an efficient and reliable performance.

The most effective treatment for lung cancer is complete lung resection, although recurrences reach up to 10% and the appearance of second neoplasms, up to 6%. Therefore, the follow-up of these patients will be essential for the early detection and treatment of these events; however, there is no definition of the form, time and cadence of these follow-ups. In this consensus document, we try to define them based on the available scientific evidence. A critical review of the literature is carried out (meta-analysis, systematic reviews, reviews, consensus recommendations of scientific societies, randomized controlled studies, non-randomized controlled studies, observational studies and case series studies) and communications to the main congresses on oncology and thoracic surgery in Spanish, English and French. The evidences found are classified following the GRADE system. It is defined according to the existing evidence that the patient resected for lung cancer should be followed up, as well as that this follow-up should be close during the first years and with CT (not being necessary to follow up with PET-CT, biomarkers or bronchoscopy). Cessation of smoking is also recommended in this follow-up.

Digital technology is now an integral part of medicine. Tools for detecting, screening, diagnosis, and monitoring health-related parameters have improved patient care and enabled individuals to identify issues leading to better management of their own health. Wearable technologies have integrated sensors and can measure physical activity, heart rate and rhythm, and glucose and electrolytes. For individuals at risk, wearables or other devices may be useful for early detection of atrial fibrillation or sub-clinical states of cardiovascular disease, disease management of cardiovascular diseases such as hypertension and heart failure, and lifestyle modification. Health data are available from a multitude of sources, namely clinical, laboratory and imaging data, genetic profiles, wearables, implantable devices, patient-generated measurements, and social and environmental data. Artificial intelligence is needed to efficiently extract value from this constantly increasing volume and variety of data and to help in its interpretation. Indeed, it is not the acquisition of digital information, but rather the smart handling and analysis that is challenging. There are multiple stakeholder groups involved in the development and effective implementation of digital tools. While the needs of these groups may vary, they also have many commonalities, including the following: a desire for data privacy and security; the need for understandable, trustworthy, and transparent systems; standardized processes for regulatory and reimbursement assessments; and better ways of rapidly assessing value.

For early detection of surgical site infection (SSI) following spinal decompression surgery, we compared temporal changes in the values of laboratory markers that are not affected by operative parameters.The study included 302 patients, which were divided into an SSI group (patients who developed deep SSI) and a non-SSI group for analysis. We reviewed data on C-reactive protein level, total white blood cell (WBC) count, and WBC differential percentage and count before spinal decompression, on postoperative day 1, and on postoperative day 4. We identified laboratory markers that are not affected by operative parameters (operating time, intraoperative blood loss, and number of operative segments). Laboratory markers with a significant difference observed between the peak or nadir value and the value in the subsequent survey day were considered as an indicator of SSI. We examined the utility of each indicator by calculating sensitivity and specificity. Furthermore, we investigated the utility of the combination of all five indicators (wherein the recognition of one marker was considered positive).Temporal changes in five laboratory markers were considered indicators of SSI. The changes from postoperative day 1 to postoperative day 4 were as follows: (1) increased WBC count (42% sensitivity, 88% specificity), (2) increased neutrophil percentage (25% sensitivity, 96% specificity), (3) increased neutrophil count (25% sensitivity, 94% specificity), (4) decreased lymphocyte percentage (25% sensitivity, 95% specificity), and (5) decreased lymphocyte count (25% sensitivity, 85% specificity). The combination of these five markers showed a 50% sensitivity, 81% specificity, and 0.65 AUC.Five markers were found to be reliable indicators of SSI following spinal decompression surgery because they were not affected by operative parameters. The combination of all five indicators had moderate sensitivity and high specificity. Therefore, this may be reliable and useful for the early detection of SSI.

Los problemas en salud mental infantil son frecuentes, complejos y pueden conllevar un riesgo en el desarrollo. La prevención en salud mental es un compromiso colectivo, especialmente por parte de las instituciones que atienden la primera infancia: la escuela y la consulta pediátrica. El objetivo de esta investigación es validar un instrumento diseñado ad hoc de detección precoz en salud mental para la primera infancia. En el diseño del instrumento, denominado Detectar para Prevenir-Salud Mental Infantil-25 (DxP-SMI-25), se tuvo en cuenta la literatura previa y las limitaciones actuales en la detección precoz en salud mental. El contenido del cuestionario se validó mediante un juicio de expertos y se aplicó el cuestionario, junto al Ages & Statges Questionnaires: Social-Emotional-2, con el fin de obtener la validez de criterio. El instrumento diseñado muestra una buena predisposición y permite una evaluación global del desarrollo. Child mental health problems are frequent, complex and can lead to developmental risk. Prevention in mental health is a collective commitment, especially on the part of the institutions that care for early childhood: the school and the pediatric office. The aim of this paper is to validate an ad hoc instrument designed for early mental health screening in early childhood. The design of the instrument, called Detectar para Prevenir- Salud Mental Infantil-25 (DxP-SMI-25, Detect to Prevent- Children’s Mental Health-25), took into account previous literature and current limitations in early mental health screening. The content of the questionnaire was validated by means of expert judgment and the questionnaire was applied, together with the Ages & Statges Questionnaires: Social-Emotional-2, in order to obtain criterion validity. The designed instrument shows a good predisposition and allows a global assessment of development.

BACKGROUND: Autistic Spectrum Disorder (ASD) is a neurodevelopment condition that is normally linked with substantial healthcare costs. Typical ASD screening techniques are time consuming, so the early detection of ASD could reduce such costs and help limit the development of the condition. OBJECTIVE: We propose an automated approach to detect autistic traits that replaces the scoring function used in current ASD screening with a more intelligent and less subjective approach. METHODS: The proposed approach employs deep neural networks (DNNs) to detect hidden patterns from previously labelled cases and controls, then applies the knowledge derived to classify the individual being screened. Specificity, sensitivity, and accuracy of the proposed approach are evaluated using ten-fold cross-validation. A comparative analysis has also been conducted to compare the DNNs’ performance with other prominent machine learning algorithms. RESULTS: Results indicate that deep learning technologies can be embedded within existing ASD screening to assist the stakeholders in the early identification of ASD traits. CONCLUSION: The proposed system will facilitate access to needed support for the social, physical, and educational well-being of the patient and family by making ASD screening more intelligent and accurate.

Non-motor manifestations of Parkinson’s disease (PD) appear early and have a significant impact on the quality of life of patients, but few studies have evaluated their predictive potential with machine learning algorithms. We evaluated 9 algorithms for discriminating PD patients from controls using a wide collection of non-motor clinical PD features from two databases: Biocruces (96 subjects) and PPMI (687 subjects). In addition, we evaluated whether the combination of both databases could improve the individual results. For each database 2 versions with different granularity were created and a feature selection process was performed. We observed that most of the algorithms were able to detect PD patients with high accuracy (>80%). Support Vector Machine and Multi-Layer Perceptron obtained the best performance, with an accuracy of 86.3% and 84.7%, respectively. Likewise, feature selection led to a significant reduction in the number of variables and to better performance. Besides, the enrichment of Biocruces database with data from PPMI moderately benefited the performance of the classification algorithms, especially the recall and to a lesser extent the accuracy, while the precision worsened slightly. The use of interpretable rules obtained by the RIPPER algorithm showed that simply using two variables (autonomic manifestations and olfactory dysfunction), it was possible to achieve an accuracy of 84.4%. Our study demonstrates that the analysis of non-motor parameters of PD through machine learning techniques can detect PD patients with high accuracy and recall, and allows us to select the most discriminative non-motor variables to create potential tools for PD screening. Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. This work was partially funded by the Department of Education, Universities and Research of the Basque Government (ADIAN, IT-980-16); by the Spanish Ministry of Science, Innovation and Universities - National Research Agency and the European Regional Development Fund - ERDF (PhysComp, TIN2017-85409-P), and from the State Research Agency (AEI, Spain) under grant agreement No RED2018-102312-T (IA-Biomed); by Michael J. Fox Foundation [RRIA 2014 (Rapid Response Innovation Awards) Program (Grant ID: 10189)]; by the Instituto de Salud Carlos III through the project “PI14/00679” and “PI16/00005”, the Juan Rodes grant “JR15/00008” (IG) (Co-funded by European Regional Development Fund/European Social Fund - “Investing in your future”); and by the Department of Health of the Basque Government through the projects “2016111009” and “2019111100”.

Crypto ransomware is a type of malware that locks its victim’s file for ransom using an encryption algorithm. Its popularity has risen at an alarming rate among the cyber security community due to several successful worldwide attacks. The encryption employed had caused irreversible damage to the victim’s digital files, even when the victim chooses to pay the ransom. Therefore, this research proposes the Pre-Encryption Detection Algorithm (PEDA) that can detect crypto-ransomware at the pre-encryption stage, when no encryption has been done. PEDA provides two levels of detection; the first level of detection was before the ransomware can be activated using a signature comparison with a known crypto-ransomware’s signature. The signature was generated using SHA-256 (Secure Hashing Algorithm) that allowed fast and accurate comparison of the file content. The second level of detection used Learning Algorithm (LA) that can detect crypto-ransomware based on pre-encryption application program interface (API). The LA produced a 100% recall rate based on 80:20 ratios of training and testing, and 99.9% recall rate with a 10-fold cross-verification test. In addition, this research had also successfully identified fourteen important APIs that can differentiate between ransomware and goodware. Three APIs were present in most ransomware, but less in goodware; these APIs were NtProtectVirtualMemory, NtResumeThread, and NtTerminateProcess. Eleven APIs, on the other hand, were mostly present in goodware, but less in ransomware; these APIs were NtWriteVirtualMemory, UuidCreate, NtDelayExecution, NtSetInformationFile, NtWriteFile, CreateThread, NtReadVirtualMemory, VirtualFreeEx, CreateDirectoryW, VirtualProtectEx, and SetFilePointer.

Resumo Introducao: A insuficiencia cardiaca (IC) descompensada esta associada a mau prognostico a curto e longo prazo. A monitorizacao remota invasiva da pressao na arteria pulmonar (PAP) possibilita a detecao precoce da descompensacao da IC, previamente ao inicio dos sintomas, podendo melhorar os resultados clinicos. Descrevemos a experiencia inicial com a utilizacao do sistema de monitorizacao remota CardioMEMS™ em doentes com IC, incluindo a sua seguranca e eficacia. Metodos e resultados: Foram incluidos prospectivamente, 5 doentes com IC em classe III da New York Heart Association, com pelo menos uma hospitalizacao por IC descompensada nos ultimos 12 meses, submetidos a implantacao de sistema de monitorizacao remota invasiva da PAP. A mediana de idades foi de 66.0 anos (intervalo interquartil [IIQ] 50.5–77.5 anos), 80.0% eram do sexo masculino e todos apresentavam IC com fracao de ejecao reduzida. O sensor de PAP foi colocado num ramo da arteria pulmonar esquerda em todos os doentes, nao tendo ocorrido complicacoes major. Durante o follow-up mediano de 40 dias (IIQ 40-61 dias), foram transmitidas um total de 271 leituras, verificando-se uma adesao dos doentes de 100% e taxa de transmissao bem sucedida de 98.1%. A PAP manteve-se dentro do objetivo em tres doentes durante o follow-up. Apesar de continuarem assintomaticos, dois doentes apresentaram valores das PAP acima do alvo. Foi realizado ajuste dietetico e da dose de diuretico, sem necessidade de visitas clinicas presenciais, objetivando-se uma reducao efetiva das PAP. Durante o seguimento, nao se registaram hospitalizacoes por IC ou obitos. Conclusao: A monitorizacao da IC guiada pela hemodinâmica demonstrou ser segura e eficaz, podendo assumir-se como uma ferramenta util no manejo de doentes com IC, particularmente no contexto da pandemia COVID-19, quando e desejavel uma reducao do numero de consultas presenciais hospitalares. Background: Decompensated heart failure (HF) is associated with poor short- and long-term prognosis. Remote invasive monitoring of pulmonary artery pressures (PAP) enables early detection of HF decompensation, before symptoms occur, and may improve clinical outcomes. We aimed to describe our initial experience with the use of the CardioMEMS™ remote monitoring system in patients with HF, including its safety and effectiveness. Methods and results: Five patients with HF in New York Heart Association class III and at least one hospitalization due to decompensated HF in last 12 months, who underwent invasive remote monitoring of PAP, were included in this prospective registry. The median age was 66.0 years (interquartile range [IQR] 50.5–77.5 years), 80.0% were men and all had HF with reduced ejection fraction. The pulmonary artery (PA) sensor was placed in a left PA branch in all patients and no major procedural complications occurred. In median follow-up of 40 days (IQR 40–61 days), a total of 271 pressure readings were transmitted, patient compliance was 100% and freedom from sensor failure 98.1%. In three patients, PAP remained within the goal during follow-up. Two patients presented an increase in PAP to values above the targets, despite the absence of symptoms worsening. These required dietary and diuretic dose adjustment, without the need for outpatient clinic visits, which reduced PAP. No hospitalizations for HF or deaths occurred during follow-up. Conclusion: Hemodynamic-guided HF monitoring was safe and effective and may be a useful adjunctive tool to the standard-of-care management in selected HF patients, particularly in the context of the COVID-19 pandemic, where a reduction in the number of health care visits may be desirable.

Blast furnaces are the most crucial equipment in ironmaking processes. Stable operation of the blast furnace is a prerequisite for personnel safety and production efficiency. Therefore, early detection of abnormalities in blast furnaces is an important task for ironmaking processes. However, owing to the large fluctuations in the quality of raw materials, dynamic operating conditions, as well as the impact of the hot blast stoves switches, the measurements of blast furnace show severe nonstationary characteristics. All these factors make monitoring the blast furnace a challenging task. In this article, a nonstationary process monitoring method called consistent trend feature analysis (CTFA) is proposed, which can extract the trend-related features and discard perturbations in process data. The directions and amplitudes of the extracted trends are used for abnormality detection, and a local-learning-based method is proposed for determining a time-varying control limit. The detection performance of the proposed method is analyzed, with a sufficient condition and a necessary condition for the detectability given. The effectiveness of the proposed method is validated by the practical data collected from a large-scale blast furnace located in Liuzhou, China.

Increasing evidence has linked the humoral immune response with the development of various cancers. Therefore, there is growing interest in investigating the predictive value of antibodies to assess overall and tissue site-specific cancer risk. Given the large amount of antibody types and the broad scope of the search (i.e. cancer risk), the primary aim of this systematic review was to present an overview of the most researched antibodies (i.e. immunoglobulin (Ig) isotypes (IgG, IgM, IgA, and IgE), tumour and self-antigen-reactive antibodies, infection-related antibodies) in relation to overall and site-specific cancer risk. We identified various antibody types that have been associated with the risk of cancer. While no significant associations were found for IgM serum levels, studies found an inconsistent association among IgE, IgA, and IgG serum levels in relation to cancer risk. When evaluating antibodies against infectious agents, most studies reported a positive link with specific cancers known to be associated with the specific agent recognized by serum antibodies (i.e. helicobacter pylori and gastric cancer, hepatitis B virus and hepatocellular carcinoma, and human papillomavirus and cervical cancer). Several reports identified autoantibodies, as single biomarkers (e.g. anti-p53, anti-MUC1, and anti-CA125) but especially in panels of multiple autoantibodies, to have potential as diagnostic biomarkers for specific cancer types. Overall, there is emerging evidence associating certain antibodies to cancer risk, especially immunoglobulin isotypes, tumour-associated antigen-specific, and self-reactive antibodies. Further experimental studies are necessary to assess the efficacy of specific antibodies as markers for the early diagnosis of cancer.

Aim of the work: Measuring serum endocan level to determine its potential role in detecting subclinical cardiovascular involvement in psoriatic patients with or without arthritis. Patients and methods: This work included 14 psoriatic arthritis (PsA) patients, 14 psoriasis only (PsO) patients, and 14 age and sex matched controls. The psoriasis area severity index was evaluated. Serum endocan level was measured, subclinical atherosclerosis was assessed using brachial artery flow-mediated vasodilation (FMD), and echocardiography: standard and tissue Doppler imaging (TDI) was performed. Results: The mean age of PsA patients was 38.3 ± 9.9 years and for PsO was 37.9 ± 8 years. They were 3 males and 11 females in both groups with a comparable psoriasis duration (11 ± 4.9 vs 8 ± 6.3 years; p = 0.17). PsA patients had significantly increased endocan level (618 ± 227.8 ng/L) compared to those with PsO or controls (359 ± 185.7 and 130.6 ± 38.2 ng/L respectively; p

During the past few years, the traffic volume of legitimate traffic and attack traffic has increased manifolds up to Terabytes per second (Tbps). Because of the processing of such a huge traffic volume, it has become implausible to detect high rate attacks in time using conventional DDoS defense architectures. At present, the majority of the DDoS defense systems are deployed predominantly at the victim-end domain But these victim-end defense systems themselves are vulnerable to HR-DDoS attacks as the mammoth volume of attack traffic is generated by such type of attacks. The insufficient computational resources further make the problem more crucial at the victim-end. This paper proposed a distributed and collaborative architecture called E-Had that is capable of efficiently processing a large amount of data by distributing it among a number of mappers and reducers in a Hadoop based cluster. The proposed E-Had system has been comprehensively validated using various publicly available benchmarked datasets and real datasets generated in HA-DDoS testbed in terms of various detection system evaluation metrics. The experimental results clearly show that the proposed detection system is capable of early detection of different scenarios of DDoS attacks along with differentiating them from flash crowds.

The massive and growing burden imposed on modern society by depression has motivated investigations into early detection through automated, scalable and non-invasive methods, including those based on speech. However, speech-based methods that capture articulatory information effectively across different recording devices and in naturalistic environments are still needed. This article proposes two feature sets associated with speech articulation events based on counts and durations of sequential landmark groups or n-grams. Statistical analysis of the duration-based features reveals that durations from several consecutive landmark bigrams and onset-offset landmark pairs are significant in discriminating depressed from non-depressed speakers. In addition to investigating different normalization approaches and values of n for landmark n-gram features, experiments across different elicitation tasks suggest that the features can be tailored to capture different articulatory aspects of depressed voices. Evaluations of both landmark duration features and landmark n-gram features on the DAIC-WOZ and SH2 datasets show that they are highly effective, either alone or fused, relative to existing approaches.

Dermatologists often diagnose or rule out early melanoma by evaluating the follow-up dermoscopic images of skin lesions. However, existing algorithms for early melanoma diagnosis are developed using single time-point images of lesions. Ignoring the temporal, morphological changes of lesions can lead to misdiagnosis in borderline cases. In this study, we propose a framework for automated early melanoma diagnosis using sequential dermoscopic images. To this end, we construct our method in three steps. First, we align sequential dermoscopic images of skin lesions using estimated Euclidean transformations, extract the lesion growth region by computing image differences among the consecutive images, and then propose a spatio-temporal network to capture the dermoscopic changes from aligned lesion images and the corresponding difference images. Finally, we develop an early diagnosis module to compute probability scores of malignancy for lesion images over time. We collected 179 serial dermoscopic imaging data from 122 patients to verify our method. Extensive experiments show that the proposed model outperforms other commonly used sequence models. We also compared the diagnostic results of our model with those of seven experienced dermatologists and five registrars. Our model achieved higher diagnostic accuracy than clinicians (63.69% vs. 54.33%, respectively) and provided an earlier diagnosis of melanoma (60.7% vs. 32.7% of melanoma correctly diagnosed on the first follow-up images). These results demonstrate that our model can be used to identify melanocytic lesions that are at high-risk of malignant transformation earlier in the disease process and thereby redefine what is possible in the early detection of melanoma.

Background: Alzheimer’s Disease (AD) is the most common cause of dementia. Genetics, excessive exposure to environmental pollutants, as well as unhealthy lifestyle practices are often linked to the development of AD. No therapeutic approach has achieved complete success in treating AD; however, early detection and management with appropriate drugs are key to improving prognosis. Interventions: The pathogenesis of AD was extensively discussed in order to understand the reasons for the interventions suggested. The interventions reviewed include the use of different therapeutic agents and approaches, gene therapy, adherence to healthy dietary plans (Mediterranean diet, Okinawan diet and MIND diet), as well as the use of medicinal plants. The potential of nanotechnology as a multidisciplinary and interdisciplinary approach in the design of nano-formulations of AD drugs and the use of Superparamagnetic Iron Oxide Nanoparticles (SPIONs) as theranostic tools for early detection of Alzheimer’s disease were also discussed.

Background: The purpose of this study was to investigate the feasibility and effectiveness of an innovative telemedicine community-based intervention to increase detection of previously undiagnosed...

Objectives We propose a risk-tailored approach for management of lung cancer screening results. This approach incorporates individual risk factors and low-dose computed tomography (LDCT) image features into calculations of immediate and next-screen (1-y) risks of lung cancer detection, which in turn can recommend short-interval imaging or 1-year or 2-year screening intervals. Methods We first extended the "LCRAT+CT" individualized risk calculator to predict lung cancer risk after either a negative or abnormal LDCT screen result. To develop the abnormal screen portion, we analyzed 18,129 abnormal LDCT results in the National Lung Screening Trial (NLST), including lung cancers detected immediately (n = 649) or at the next screen (n = 235). We estimated the potential impact of this approach among NLST participants with any screen result (negative or abnormal). Results Applying the draft National Health Service (NHS) England protocol for lung screening to NLST participants referred 76% of participants to a 2-year interval, but delayed diagnosis for 40% of detectable cancers. The Lung Cancer Risk Assessment Tool+Computed Tomography (LCRAT+CT) risk model, with a threshold of less than 0.95% cumulative lung cancer risk, would also refer 76% of participants to a 2-year interval, but would delay diagnosis for only 30% of cancers, a 25% reduction versus the NHS protocol. Alternatively, LCRAT+CT, with a threshold of less than 1.7% cumulative lung cancer risk, would also delay diagnosis for 40% of cancers, but would refer 85% of participants for a 2-year interval, a 38% further reduction in the number of required 1-year screens beyond the NHS protocol. Conclusions Using individualized risk models to determine management in lung cancer screening could substantially reduce the number of screens or increase early detection.

We examined whether the magnitude of muscle damage indicated by changes in maximal voluntary isometric contraction (MVIC) strength 1 to 3 d after unaccustomed eccentric exercise (ECC) was correlated with changes in central and peripheral neuromuscular parameters immediately post-ECC.Twenty participants (19-36 yr) performed six sets of eight eccentric contractions of the knee extensors. Rate of force development (RFD) during knee extensor MVIC, twitch force, rate of force development (RFDRT) and rate of relaxation (RRRT) of the resting twitch, maximal M-wave (MMAX), voluntary activation, silent period duration, motor-evoked potentials (MEP) and short-interval intracortical inhibition were assessed before, immediately after, and 1 to 3 d post-ECC. Relationships between changes in these variables immediately post-ECC and changes in MVIC strength at 1 to 3 d post-ECC were examined by Pearson product-moment (r) or Spearman correlations.Maximal voluntary isometric contraction strength decreased (-22.2% ± 18.4%) immediately postexercise, and remained below baseline at 1 (-16.3% ± 15.2%), 2 (-14.7% ± 13.2%) and 3 d post-ECC (-8.6% ± 15.7%). Immediately post-ECC, RFD (0-30-ms: -38.3% ± 31.4%), twitch force (-45.9% ± 22.4%), RFDRT (-32.5% ± 40.7%), RRRT (-38.0% ± 39.7%), voluntary activation (-21.4% ± 16.5%) and MEP/MMAX at rest (-42.5% ± 23.3%) also decreased, whereas the silent period duration at 10%-MVIC increased by 26.0% ± 12.2% (P0.05). Decreases in RFD at 0 to 30 ms, 0 to 50 ms, and 0 to 100 ms immediately post-ECC were correlated (P0.05) with changes in MVIC strength at 1 d (r = 0.56-0.60) and 2 d post-ECC (r = 0.53-0.63). Changes in MEP/MMAX at 10%-MVIC immediately post-ECC were correlated with changes in MVIC strength at 1 d (r = -0.53) and 2 d (r = -0.54) post-ECC (P0.05).The magnitude of decrease in MVIC strength at 1 to 3 d after ECC was associated with the magnitude of changes in RFD and MEP/MMAX immediately post-ECC. However, based on individual data, these markers were not sensitive for the practical detection of muscle damage.

Head and neck reconstructive surgical techniques are complex; now the microvascular free tissue transfer is the most frequently used. The postreconstruction imaging interpretation is challenging due to the altered anatomy and flap variability. We aim to improve radiologists' knowledge with diverse methods of flap reconstruction for an accurate appreciation of their expected cross-sectional imaging appearance and early detection of tumor recurrence and other complication.

Cardiac implantable electronic devices establish proper therapy for the prevention of sudden cardiac death, significantly reducing the morbidity and mortality of patients with arrhythmias and heart failure. It is well-known that the number of electrodes increases the risk of complications. To preserve the benefit of atrial sensing without the need to implant an additional lead, a single-lead ICD system with a floating atrial dipole (DX ICD lead) has been developed. Besides all of the potential benefits, the necessity of a reliable and stable atrial sensing via the floating dipole could be the main concern against the use of this lead type. In the current generation of DX devices, the specially filtered atrial signal seems to be high enough and stable over time, which is crucial in the early detection of atrial arrhythmias, discrimination between different forms of tachycardias in order to prevent inappropriate ICD therapy, and achieving an optimal atrioventricular and interventricular synchrony in patients with a two-lead CRT-DX system. The present review summarizes the benefits and potential drawbacks of the DX ICD systems based on the available literature, furthermore, proposes an evidence-based algorithm of ICD type selection.

INTRODUCTION Routine HIV testing is expected to facilitate early diagnosis and treatment. Nevertheless, to date, limited data are available on the presumed benefit of early detection with improved outcomes through routine HIV testing. METHODS This study was based on the Taiwan national HIV/AIDS registry, with follow-up data validated through December 31, 2014. Outcomes of people diagnosed with HIV infection through the routine (routinely offered in specific settings, opt-out) versus through nonroutine (individual risk-based) testing were compared. The main outcomes of the study were late diagnosis, HIV-related mortality, and all-cause mortality. Individuals were matched by year of HIV diagnosis and adjusted for age, sex, transmission routes, and SES. Analyses were conducted in 2019-2020. RESULTS This study included all 28,674 people diagnosed with HIV infection during 1986-2014 (8,431 [29%] by routine testing, 18,305 [64%] by individual risk-based testing) with a mean follow-up time of 6.2 years. Routine testing was associated with an 80% lower likelihood of late HIV diagnosis (AOR=0.20, 95% CI=0.18, 0.23, p

Nano-enabled agriculture is an emerging hot topic. To facilitate the development of nano-enabled agriculture, reviews addressing or discussing the applications, knowledge gap, future research needs, and possible new research field of plant nanobiotechnology in agricultural production are encouraged. Here we review the following topics in plant nanobiotechnology for agriculture: 1) improving stress tolerance, 2) stress sensing and early detection, 3) targeted delivery and controlled release of agrochemicals, 4) transgenic events in non-model crop species, and 5) seed nanopriming. We discuss the knowledge gaps in these topics. Besides the use of nanomaterials for harvesting more electrons to improve photosynthetic performance, they could be used to convert nIR and UV to visible light to expand the light spectrum for photosynthesis. We discuss this approach to maintaining plant photosynthesis under light-insufficient conditions. Our aim in this review is to aid researchers to learn quickly how to use plant nanobiotechnology for improving agricultural production.

This paper describes a wearable, open-source wrist temperature monitoring system that enables the reliable identification of slowly-varying skin temperature patterns that may be indicative of infections. The hardware platform uses a Bluetooth Low Energy (BLE) wireless interface and includes three skin temperature sensors, a thermally-isolated ambient temperature sensor, an inertial measurement unit (IMU), and a Galvanic skin response (GSR) sensor. A template-matching algorithm is used to detect weak but long-lived anomalous temperature patterns that deviate from the normal circadian rhythm are thus may be driven by infections. Experimental and simulation results confirm that small temperature anomalies (peak value < 0.4°C) extending over 2-3 weeks can be detected with a total error rate < 10%.

The article deals with a review of scientific works on the issue of hepatic steatosis verification. Nowadays, the problem of timely detection and treatment of chronic diffuse liver diseases, in the pathogenesis of which fibrosis and hepatic steatosis play key role, becomes more and more important. It is recognized that hepatic steatosis is characterized by the accumulation of lipids in hepatocytes exceeding 5 % of the liver mass. In recent years, special attention is paid to the methods for verification of hepatic steatosis, which can be divided into invasive, minimally invasive and non-invasive. Invasive methods are still relevant, they include liver core needle biopsy — the gold standard. Minimally invasive methods for hepatic steatosis verification are based on the biochemical study of venous blood. Minimally invasive methods can be conditionally divided into routine — triglycerides, total cholesterol, high density lipoproteins etc., and calculated coefficients: SteatoTest and others. Their results are calculated on the basis of several indicators. Non-invasive methods of verification include: ultrasound, computed tomography, magnetic resonance imaging, elastometry with CAP™function (Fibroscan, model 502). In our opinion, for verification of hepatic steatosis, it is promising to use the ultrasound with the option of measuring the parameters of arterial stiffness in the WТrack mode. Among the non-invasive methods of hepatic steatosis verification, liver elastometry using FibroScan-502-touch device with CAP™ function made a breakthrough in some specific sense. Opening possibilities for early detection of hepatic steatosis enable to place on timely preventive and therapeutic measures and to create the conditions for stopping the progression, and possibly for the regression of hepatic steatosis., Статья посвящена обзору научных публикаций, посвященных проблеме верификации стеатоза печени. Сегодня все большее значение приобретает проблема своевременного выявления и лечения хронических диффузных заболеваний печени, в патогенезе которых ключевую роль играют фиброз и стеатоз печени. Считается, что стеатоз печени характеризуется накоплением липидов в гепатоцитах, превышающим 5 % массы печени. В последнее время особое внимание уделяется методам верификации стеатоза печени, которые можно разделить на инвазивные, малоинвазивные и неинвазивные. Не утратили актуальности инвазивные методы, к которым относится трепанбиопсия печени — золотой стандарт. Малоинвазивные методы верификации стеатоза печени основаны на биохимическом исследовании венозной крови. Малоинвазивные методы условно можно разделить на рутинные — триглицериды, общий холестерол, липопротеиды высокой плотности и др. — и расчетных коэффициентов: стеатотест и др., результат которых рассчитывается на основании нескольких показателей. К неинвазивным методам верификации относятся: УЗИ, КТ, МРТ, эластометрия с САРТМ-функцией (Фиброскан, модель 502). На наш взгляд, перспективным для верификации стеатоза печени является использование УЗИ с опцией измерения параметров жесткости артерий в режиме WТrack. Из неинвазивных методов верификации стеатоза печени в определенном смысле революцию произвела эластометрия печени при помощи аппарата FibroScan-502-touch с CAP™-функцией. Открывающиеся возможности ранней верификации стеатоза печени позволяют своевременно назначать комплекс лечебно-профилактических мероприятий и создавать предпосылки для остановки прогрессирования, а возможно, и для регресса стеатоза печени., Стаття присвячена огляду наукових публікацій, присвячених проблемі верифікації стеатозу печінки. Сьогодні все більшого значення набуває проблема своєчасного виявлення та лікування хронічних дифузних захворювань печінки, в патогенезі яких ключову роль виконують фіброз і стеатоз печінки. Вважається, що стеатоз печінки характеризується накопиченням ліпідів у гепатоцитах, що перевищує 5 % маси печінки. Останнім часом особлива увага приділяється методам верифікації стеатозу печінки, які можна розділити на інвазивні, малоінвазивні і неінвазивні. Не втратили актуальності інвазивні методи, до яких відноситься трепан-біопсія печінки — золотий стандарт. Малоінвазивні методи верифікації стеатозу печінки засновані на біохімічному дослідженні венозної крові. Малоінвазивні методи умовно можна розділити на рутинні — тригліцериди, загальний холестерол, ліпопротеїди високої щільності та ін. — та розрахункових коефіцієнтів — стеатотест та ін., результат яких розраховується на підставі декількох показників. К неінвазивним методам верифікації відносяться: УЗД, КТ, МРТ, еластометрія з САРТМ-функцією (Фіброскан, модель 502). На наш погляд, перспективним для верифікації стеатозу печінки є використання УЗД з опцією вимірювання параметрів жорсткості артерій у режимі WТrack. Із неінвазивних методів верифікації стеатозу печінки в певному сенсі революцію справила еластометрія печінки за допомогою апарату FibroScan-502-touch з CAP™-функцією. Відкриваються можливості ранньої верифікації стеатозу печінки, які дозволяють своєчасно призначати комплекс лікувально-профілактичних заходів і створювати передумови для зупинки прогресування, а можливо, і для регресу стеатозу печінки.

Background. Nasopharyngeal carcinoma is a malignant tumor that grows in the nasopharyngeal area with predilection in the fossa Rossenmuller and the nasopharyngeal roof adjacent to the Eustachian tube, so one of NPC’s early symptoms is ear symptoms. Hearing loss is a common symptom found in people with NPC due to dysfunction of the Eustachian tube, a continuing middle ear disorder that can result in conductive hearing loss.This study aims to find out the relationship between primary tumor of NPC and the degree of conductive hearing loss at dr. Mohammad Hoesin Hospital Palembang. Methods. This is a cross sectional study that obtained 42 samples from the medical records at Dr. Mohammad Hoesin Hospital Palembang that met the inclusion and exclusion criteria. The study subjects collected in total sampling have been conducted audiometry examinations at the ORLHNS clinic of Dr. Mohammad Hoesin Hospital Palembang during the period January 2019 - April 2021. Results. The proportion of hearing loss in NPC patients in this study was 30 subjects (71.4%) with the highest proportion of hearing loss complaints being 33.3%. The proportion of conductive hearing loss of nasopharyngeal carcinoma patients in the study was 33 subjects (78.5%) right ear and 28 subjects (66.7%) left ear. There was a significant association between the degree of the NPC primary tumor and the incidence of conductive deafness of the left ear, but there was no significant association in the right ear. There is a significant correlation between NPC primary tumors and left ear hearing thresholds at frequencies of 500 Hz and 4000 Hz, but there is no significant association between the degree of NPC primary tumor and right ear hearing loss. Conclusions. There is significant correlation between the primary tumor of NPC and the hearing threshold of the left ear but there was no significant association in the right ear.

The target number of children in early detection of child development and development in the working area of ??Puskesmas Karangrejo is 1,037 children, with details of 133 infants from 0 - 11 months and 904 children aged 12 - 72 months. Of these, the coverage for early detection until February 2020 is still low, namely at 6.7%. The purpose of the Community Service is to empower families in conducting early detection of toddler growth and development in the Karangrejo Health Center area. The method of activity is health education and empowerment of “active participation” of mothers toddler in stimulating and detecting the growth and development of their children. The result of mentoring was that there was progress in the developmental ability of 1 child who had not been able to walk at the age of 19 months, showing an increase in walking ability after 2 weeks of assistance. There was an increase in the knowledge of mothers / families about growth and development by 12.68 points. There was an increase in the frequency of implementing stimulation for child growth and development by mothers of under-five from 88.2% of mothers who had stimulated to 98.6% after mentoring. Continuity of family empowerment is needed regarding early detection of growth and development and not only involving mothers / families but also involving cadres.

In general, family planning can be defined as an effort to regulate the number of pregnancies in such a way that it will have a positive impact on the mother, baby, father and family concerned and will not cause harm as a direct result of the pregnancy. Family planning is an attempt to regulate the population or the use of methods to regulate fertilization to help a person or family achieve certain goals. The purpose referred to here is an intentional arrangement of pregnancy by the family, which is not against the applicable laws or regulations and also the morals of Pancasila and for the welfare of the family. Giving understanding to couples of childbearing age that there are various kinds of contraceptives and their benefits, so that people can choose any contraceptive that suits the individual. With more benefits than side effects, especially to keep the pregnancy distance, and a prosperous family can be achieved. It is hoped that with careful family planning, pregnancy is something that is really expected so that it will avoid the act of terminating a pregnancy with abortion. Ciamis Regency is in the province of West Java, where the area is directly adjacent to two regencies, namely Banjar and Tasikmalaya. Its location in the center of the city makes the Benteng village not like a village in general.

Children are the nation's most valuable asset in the future, monitoring and stimulation of growth and development is one way for children to achieve optimal growth and development. Every child needs to be stimulated and monitored regularly as early as possible appropriately and continuously, both in the family and at school. Monitoring growth and development is carried out to find out whether children grow and develop according to their age and stage of development and can detect deviations in child growth and development. The purpose of this community service is to increase knowledge and provide training to early childhood teachers regarding early detection of child growth and development. This community service method is to conduct counseling about growth and development and early detection, followed by training for early detection of growth and development. Community service results: Pretest results show that of the 35 early childhood teachers who participated in the activity, 13 teachers had poor knowledge, and 12 teachers had sufficient knowledge, and 10 teachers had good knowledge. The results of the posttest after the counseling were 35 early childhood teachers who had good knowledge. The conclusion of community service is: There is an increase in knowledge after counseling on growth and development and early detection.

Background:This research aimed to determine whether patterns of temporal changes in activity levels can indicate postoperative complications following hepatectomy., Methods:Between December 2016 and December 2019, 147 patients wore an accelerometer to measure their physical activity levels after hepatectomy until postoperative day 7. Patterns of changes in activity levels were categorized as follows: upward slope type (n = 88), wherein activity levels gradually increased; bell curve type (n = 13), wherein activity levels initially increased but subsequently decreased; and flat type (n = 46), wherein there was no apparent increase in activity levels. Patient characteristics and postoperative complications were compared for each group., Results:Postoperative complications occurred in 4.5% of patients in the upward slope group, in 76.9% in the bell curve group, and in 65.2% in the flat group (p < 0.001). Surgical site infections (SSI), refractory pleural effusion, and ascites were more common in the bell curve group, while pneumonia was only observed in the flat group., Conclusion:SSI, pleural effusion, and ascites should be considered when previously increasing activity levels decline during the postoperative period. In addition, there is a high risk of SSI and pneumonia when activity levels do not increase at all after surgery.

Introduction Delirium is the most frequent manifestation of central nervous system dysfunction, a fluctuating and acute cognitive alteration in the critically ill patient. Objective To analyse the scientific production about delirium in paediatric patients in the Intensive Care Unit on early detection, diagnosis, and nursing care. Methodology An integrative review of primary studies was conducted in three databases PubMed, Web of Science, SCOPUS, with the search strategy (Intensive Care Units, Paediatric) and (Delirium) and (Nursing Care), criteria of inclusion of primary studies published between 2011 and 2019, in English and Spanish available in full text. Results After analytical reading, 15 primary studies were selected, our results contribute to early detection, validated evaluation methods to diagnose delirium in Spanish-speaking paediatric patients such as PsCAM-ICU, PCAM-ICU and Cornell as well as nursing in the care of critical paediatric patients with the presence of delirium. Conclusions Cognitive assessment using validated scales in the paediatric patient allows the practice of the nursing professional in the paediatric unit to go beyond a series of instrumental tasks in the PICU and allows prevention to follow-up and control of cases in the delirious patient.

The mild symptoms in Mild Cognitive Impairment (MCI), a precursor of dementia, often go unnoticed and are assumed as normal aging signs. Such negligence result in late visits which consequently, lead to the diagnosis and progression of dementia. An instrumented gait assessment in home settings may facilitate the detection of subtle MCI-related motor deficits thus, allowing early diagnosis and intervention. This paper investigates potential gait biomarkers derived from shank mounted inertial sensors signals under normal and dual-task walking conditions using data collected from thirty MCI and thirty cognitively normal (CN) subjects. To identify potential gait biomarkers for MCI screening, we assess the variance and predictive power of each feature. Moreover, multiple classification models using different machine learning and feature selection techniques are built to automate MCI detection by leveraging the gait biomarkers. Statistical analysis reveal multiple gait parameters that are significantly different under both single and dual-task settings. However, we show that dual-task walking provides better distinction between MCI and CN subjects. The machine learning model employed for MCI pre-screening based on the inertial sensor-derived gait biomarkers achieves accuracy and sensitivity of 71.67% and 83.33%, respectively.

Currently, early detection of lung cancer relies on the characterisation of images generated from computed tomography (CT). However, lung tissue biopsy, a highly invasive surgical procedure, is required to confirm CT-derived diagnostic results with very high false-positive rates. Hence, a non-invasive or minimally invasive biomarkers is essential to complement the existing low-dose CT (LDCT) for early detection, improve responses to a certain treatment, predict cancer recurrence, and to evaluate prognosis. In the past decade, liquid biopsies (e.g., blood) have been demonstrated to be highly effective for lung cancer biomarker discovery. In this review, the roles of emerging liquid biopsy-derived biomarkers such as circulating nucleic acids, circulating tumour cells (CTCs), long non-coding RNA (lncRNA), and microRNA (miRNA), as well as exosomes, have been highlighted. The advantages and limitations of these blood-based minimally invasive biomarkers have been discussed. Furthermore, the current progress of the identified biomarkers for clinical management of lung cancer has been summarised. Finally, a potential strategy for the early detection of lung cancer, using a combination of LDCT scans and well-validated biomarkers, has been discussed.

Merkel cell carcinoma (MCC) is a primary neuroendocrine skin cancer that recurs in ~40% of cases. Merkel cell polyomavirus (MCPyV) and ultraviolet (UV)-induced mutations are two major causative factors of MCC. Virus-positive MCCs express polyomavirus oncoproteins that are highly immunogenic yet are required for ongoing tumor growth. Virus-negative MCCs have a high burden of UV-DNA mutations that encode tumor-specific UV-neoantigens. Thus, both UV- and virus-induced MCCs are highly immunogenic, enabling diverse T-cell targeted therapies. Optimal MCC management is challenging given its rarity, aggressive nature, rapidly evolving care guidelines, and fundamental differences in management compared to other skin cancers. MCC is often managed aggressively with extensive surgery, radiotherapy or systemic therapy, frequently leading to toxicities that might have been avoidable while still achieving optimal disease control. Thus, multi-disciplinary care is crucial for providing patients with the best possible outcomes. The outlook for many patients with advanced MCC has progressed remarkably over the past decade due to PD-1 pathway blocking agents that provide durable benefit for a substantial subset of MCC patients. The management of early-stage MCC has also improved due to better approaches to integrate surgery and radiotherapy. Prognostic accuracy and ongoing surveillance have advanced due to stage-specific recurrence data and sophisticated "liquid biopsies" that allow early detection of disease recurrence. Here we summarize both recent striking progress and pressing challenges such as PD-(L)1-refractory MCC, and management of MCC patients with immune dysfunction. We also highlight diverse resources to allow providers to take advantage of recent progress in this fast-moving field.