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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.

Background Workplace absenteeism increases significantly during influenza epidemics. Sick leave records may facilitate more timely detection of influenza outbreaks, as trends in increased sick leave may precede alerts issued by sentinel surveillance systems by days or weeks. Sick leave data have not been comprehensively evaluated in comparison to traditional surveillance methods. The aim of this paper is to study the performance and the feasibility of using a detection system based on sick leave data to detect influenza outbreaks. Methods Sick leave records were extracted from private French health insurance data, covering on average 209,932 companies per year across a wide range of sizes and sectors. We used linear regression to estimate the weekly number of new sick leave spells between 2016 and 2017 in 12 French regions, adjusting for trend, seasonality and worker leaves on historical data from 2010 to 2015. Outbreaks were detected using a 95%-prediction interval. This method was compared to results from the French Sentinelles network, a gold-standard primary care surveillance system currently in place. Results Using sick leave data, we detected 92% of reported influenza outbreaks between 2016 and 2017, on average 5.88 weeks prior to outbreak peaks. Compared to the existing Sentinelles model, our method had high sensitivity (89%) and positive predictive value (86%), and detected outbreaks on average 2.5 weeks earlier. Conclusion Sick leave surveillance could be a sensitive, specific and timely tool for detection of influenza outbreaks.

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.

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.

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.

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.

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.

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

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.

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: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.

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.

Individuals with a genetic susceptibility to pancreatic ductal adenocarcinoma (PDAC) may benefit from surveillance to increase the likelihood of early detection. Currently, candidates for surveillance are identified based on genetic test results and family history of PDAC, and surveillance is accomplished through imaging of the pancreas (endoscopic ultrasound or MRI). Novel methods that incorporate personalized risk, biomarkers, and radiomics are being investigated in an attempt to improve identification of at-risk individuals and to increase detection of precursor and early-stage lesions.

Early detection and accurate monitoring are two critical factors affecting the outcome of anticancer therapy. However, both these factors are affected by the limitations of conventional approaches of diagnosis and treatment. Nanomedicine has progressively offered a scientific solution in improved delivery and better diagnosis of various cancers, thus providing a targeted treatment approach. With the advances in the field, simultaneous delivery and diagnosis are becoming a reality. The present manuscript discusses various drug delivery challenges, provides the scope for theranostic nanomaterials in the diagnosis and treatment of cancer. The clinical and translational potential of theranostic nanomedicine and the future directions for further research are also presented in the manuscript.

Contains fulltext : 244756.pdf (Publisher’s version ) (Open Access) In Western populations, the incidence of oesophageal squamous cell carcinoma (OSCC) has been declining, whereas the incidence of oesophageal adenocarcinoma (OAC) has been increasing. Our study examines temporal trends in the incidence of oesophageal cancer in the Netherlands between 1989 and 2016, in addition to predicting future trends through 2041. Data from the Netherlands Cancer Registry and Statistics Netherlands were collected to obtain incidence trends of OSCC and OAC for the period 1989 to 2016. Age-period-cohort (APC) modelling was used to estimate the contribution of age, calendar period and birth cohort on the observed incidence trends. To predict the future numbers of new cases of both OSCC and OAC from 2017 to 2041, log-linear APC models were fitted to the trends of 1989 to 2016. The age-standardised incidence rates of OSCC have decreased slightly for men and increased slightly for women. In contrast, a marked increase in the incidence of OAC was observed, ranging from 2.8 per 100 000 persons in 1989 to 10.1 in 2016. This increase in OAC incidence was more prominent in men, and it will result in an increased risk of OAC for successive generations. Future projections indicate that the incidence of OAC will further increase to 13.1 per 100 000 persons in 2037 to 2041, meaning that there will be 13 259 cases of OAC in 2037 to 2041, as compared to 9386 diagnoses in 2017 to 2021. The changing epidemiologic trends in oesophageal cancer in the Netherlands should be reflected in the development of prevention, early detection and treatment strategies.

The conventional diagnostic process and tools of cardiovascular autonomic neuropathy (CAN) can easily identify the two main categories of the condition: severe/definite CAN and normal/healthy without CAN. Conventional techniques encounter significant challenges when identifying CAN in its early or atypical stages due to the inherent imbalanced and incompleteness condition in the collected clinical multimodal data, including electrocardiogram (ECG) data from ECG sensors, blood chemistry, podiatry, and endocrinology features. Therefore, most detection tools and techniques are limited to binary CAN classification. However, early diagnosis of CAN or diagnosis of the atypical stages of CAN is more important than the diagnosis of severe CAN, which, in fact, is easily identifiable with a few diagnostic reports. In this paper, we propose a novel multi-class classification approach for timely CAN detection. The proposed classification algorithm develops a multistage fusion model by combining feature selection and multimodal feature fusion techniques. The proposed method develops a performance criterion-based feature selection technique to guarantee highly significant features. A multimodal feature fusion technique was developed using deep learning feature fusion and selected original features. The experimental results obtained from testing with a large CAN dataset indicate that the proposed algorithm significantly improved the diagnostic accuracy of CAN compared to conventional Ewing battery features. The algorithm also identified the early or atypical stages of CAN with an AUC score of 0.931 using leave-one-out cross-validation.

Most scientific contributions addressing cyber-security issues in water distribution networks present proposals of detection systems and very few propose location systems. A novel methodology for detection and location of cyber-attacks in water distribution networks (WDNs) is proposed in this paper. Structural analysis and autoencoder neural networks are effectively combined with a the control chart Adaptive Exponentially Weighted Moving Average (AEWMA). In the training phase, the proposed detection and location framework only requires data from normal operating conditions and knowledge about the behavioral model of the system which represents an advantage over previous works that demand for additional data of cyber-attacks. Among other advantages of the proposed methodology are the high performance in the effective, robust and early detection and the effectiveness of the location strategy. The proposal was evaluated with the known case study BATADAL.

Antecedentes y Objetivo El objetivo fue describir las características clínicas y el pronóstico de los pacientes con infección nosocomial por SARS-CoV-2. Métodos Se realizó un estudio observacional y prospectivo en un hospital de referencia. Se incluyeron todos los pacientes adultos diagnosticados de infección por SARS-CoV-2 nosocomial en octubre de 2020, definida como una PCR para SARS-CoV-2 negativa al ingreso y positiva a partir de los siete días de hospitalización. Resultados Se diagnosticaron 66 casos de infección por SARS-CoV-2 nosocomial: 39 (59%) hombres, edad mediana al diagnóstico de 74,5 años (RIC 56,8-83,1) y mediana del índice de comorbilidad de Charlson de 3 puntos (RIC 1-5). Veintisiete (41%) presentaron neumonía y 13 (20%) fallecieron durante el ingreso. La mortalidad a los 28 días fue del 33% (22 pacientes). La mortalidad a los 28 días en los 242 pacientes con infección por SARS-CoV-2 adquirida en la comunidad y hospitalizados durante el mismo periodo fue del 10%. Conclusiones Se deben extremar las medidas de prevención y detección precoz de brotes nosocomiales de COVID-19 para minimizar el impacto negativo de esta infección.

WT1 overexpression is frequently identified in acute myeloid leukemia (AML) and has been reported to be a potential marker for monitoring measurable residual disease (MRD). We evaluated the use of postinduction WT1 MRD level as a prognostic factor, as well as the interaction between postinduction WT1 MRD response and the effect of allogeneic stem cell transplantation (allo-SCT) in the first complete remission (CR). In the ALFA-0702 trial, patients with AML, aged 18 to 59, had a prospective quantification of WT1 MRD. The occurrence of a WT1 MRD ratio >2.5% in bone marrow or >0.5% in peripheral blood was defined as MRDhigh, and ratios below these thresholds were defined as MRDlow. The prognostic value of MRD after induction chemotherapy was assessed in 314 patients in first CR by comparing the risk of relapse, the relapse-free survival (RFS), and the overall survival (OS). Interaction between MRD response and the allo-SCT effect was evaluated in patients by comparing the influence of allo-SCT on the outcomes of patients with MRDhigh with those with MRDlow. The results showed that patients with MRDhigh after induction had a higher risk of relapse and a shorter RFS and OS. The MRD response remained of strong prognostic value in the subset of 225 patients with intermediate-/unfavorable-risk AML who were eligible for allo-SCT, because patients with MRDhigh had a significantly higher risk of relapse resulting in worse RFS and OS. The effect of allo-SCT was higher in patients with MRDlow than in those with MRDhigh, but not significantly different. The early WT1 MRD response highlights a population of high-risk patients in need of additional therapy.

Declining cervical cancer rates in the United States highlights the value of prevention and early detection of premalignant cervical disease afforded by the human papillomavirus vaccine and Pap smear. The availability of in-office loop electrosurgical excision procedure affords clinicians with a cost-effective and preferred tool for the excision of high-grade lesions of the cervix with minimal risk for severe adverse outcomes. The most recent American Society for Colposcopy and Cervical Pathology guidelines recommend a risk-based approach for the detection, treatment, and surveillance of cervical disease and specifically focus on the risk of developing cervical intraepithelial neoplasia 3 or worse histology.

PURPOSE Genomic cancer risk assessment (GCRA) is standard-of-care practice that uses genomic tools to identify individuals with increased cancer risk, enabling screening for early detection and cancer prevention interventions. GCRA is not available in most of Mexico, where breast cancer (BC) is the leading cause of cancer death and ovarian cancer has a high mortality rate. METHODS Guided by an implementation science framework, we piloted the Genomic Risk Assessment for Cancer Implementation and Sustainment (GRACIAS) intervention, combining GCRA training, practice support, and low-cost BRCA1/ 2 ( BRCA) gene testing at four centers in Mexico. The RE-AIM model was adapted to evaluate GRACIAS intervention outcomes, including reach, the proportion of new patients meeting adapted National Comprehensive Cancer Network criteria who participated in GCRA. Barriers to GCRA were identified through roundtable sessions and semistructured interviews. RESULTS Eleven clinicians were trained across four sites. Mean pre-post knowledge score increased from 60% to 67.2% (range 53%-86%). GCRA self-efficacy scores increased by 31% (95% CI, 6.47 to 55.54; P = .02). Participant feedback recommended Spanish content to improve learning. GRACIAS promoted reach at all sites: 77% in Universidad de Guadalajara, 86% in Instituto Nacional de Cancerología, 90% in Tecnológico de Monterrey, and 77% in Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Overall, a pathogenic BRCA variant was identified in 15.6% (195 of 1,253) of patients. All trainees continue to provide GCRA and address barriers to care. CONCLUSION We describe the first project to use implementation science methods to develop and deliver an innovative multicomponent implementation intervention, combining low-cost BRCA testing, comprehensive GCRA training, and practice support in Mexico. Scale-up of the GRACIAS intervention will promote risk-appropriate care, cancer prevention, and reduction in related mortality.

Newborn screening is necessary for early detection of rare diseases, however, venipuncture and heel lance are painful for newborn infants. There are however effective evidence-based pain management strategies include breastfeeding or skin-to-skin care or giving a small volume of sweet solution. These strategies are demonstrated in a parent-targeted publicly accessible video titled Be Sweet to Babies, which has been produced and disseminated in multiple languages, including Farsi. We aimed to evaluate (1) the dissemination and reach of the Farsi video (using video analytics); and (2) viewers’ i) baseline knowledge and previous use of these pain management strategies; ii) intention to advocate for/recommend these strategies (using an online survey accessed from the video). Eight months after the release date, the video had 618,685 views and 202 viewers completed the survey. Almost half the participants knew about or used breastfeeding (n = 81, 40%), skin-to-skin care (n = 106, 53%) or sucrose (82, 41%) before viewing the video. After viewing the video, almost all participants (n = 195, 96%) intended to advocate for use or recommend these strategies to others. This study showed the acceptability, reach, and feasibility of the “Be Sweet to Babies” video, translated and voiced over in Farsi, as a parent-targeted and mediated knowledge translation tool.

Summary Background & aims Monitoring growth and body composition in childhood is vital for early detection of health and nutrition problems during child development. The bioelectrical impedance vector analysis (BIVA) revealed its effectiveness as an indicator of nutritional status. This study aimed to measure the bioimpedance vectors of a sample of multiethnic children and evaluate the utility of BIVA for the classification of the nutritional status in a group of children with greater vulnerability, including in the presence of obesity. Methods This is a cross-sectional study that analyzed the bioelectrical impedance of a sample of 321 children from public daycare centers, aged 1–4 years, using the RXc graph method (tetrapolar analysis at 50 kHz frequency). The 95%, 75%, and 50% tolerance ellipses were plotted by age group. The Z-scores of bioimpedance parameters (Xc/H-Z and R/H-Z) were calculated regarding age, which were used to build reference tolerance ellipses for a single group, regardless of age. Such ellipses were evaluated for their ability to recognize the pattern and classify the deviations, using individual vectors of obese children. Results The mean impedance vectors showed progressively higher reactances and lower resistances with age. In the group of obese children, the individual vectors located outside the 95% baseline tolerance ellipse were 12.5%, 18.75%, and 11.1% of the cases for the WHZ, WAZ, and BMIZ criteria, respectively, all above the expected 5%, but much below expectations. This may be a problem with the obesity criteria used, as WHZ, WAZ, and BMIZ do not differentiate fat from lean mass. Conclusion Bioimpedance vector analysis reflects differences in the bioelectric patterns of children classified as obese. Provided the obesity criteria are constructed based on fat measurements, rather than lean mass, the use of tolerance ellipses in the BIVA chart is promising as a tool for monitoring nutritional status where measuring body composition is difficult, because constant tissue hydration cannot be assumed.

Gynecologic cancers contribute to a significant portion of cancer morbidity and mortality among women in the United States and across the globe. This article provides a comprehensive review of current screening guidelines and novel techniques that have promise in the prevention and early detection of gynecologic cancers in the future. The authors anticipate a move toward less invasive testing modalities, use of cancer biomarkers, and the prevention and treatment of high-risk factors such as human papilloma virus infection and obesity.

Studies have suggested that qSOFA can be used for early detection of sepsis immediately upon arrival at the emergency department (ED). Despite this, little is known about the risk factors associated with the subsequent diagnosis of sepsis among patients with qSOFA2 in the ED.This is a retrospective cohort study using ED data from a large tertiary medical center in Japan, 2018-2020. We included adult patients (aged ≥18 years) presenting to the ED with suspected infection (e.g., having a fever) and qSOFA2. We identified patients who developed sepsis based on the Sepsis-3 criteria, and compared patient characteristics (e.g., demographics, vital signs upon the initial triage, chief complaint, and comorbidities) between patients who developed sepsis or not. Additionally, we identified the potential risk factors of sepsis among patients with qSOFA2 using a multivariable logistic regression model.We identified 151 (7%) patients who developed sepsis among 2025 adult patients with suspected infection and qSOFA2. Compared with patients who did not develop sepsis, patients who developed sepsis were likely to be older and have vital signs suggestive of imminent sepsis (e.g., high respiratory rate). In the multivariable logistic regression model, the potential risk factors of sepsis among patients with qSOFA2 were older age (adjusted OR, 1.92 [95%CI 1.19-3.19]), vital signs suggestive of imminent sepsis (e.g., adjusted OR of altered mental status, 3.50 [95%CI 2.25-5.50]), receipt of oxygen therapy upon arrival at the ED (adjusted OR, 1.91 [95%CI 1.38-2.26]), chief complaint of sore throat (adjusted OR, 2.15 [95%CI 1.08-4.13]), and the presence of comorbid diabetes mellitus, ischemic heart disease, and chronic kidney disease (e.g., adjusted OR of diabetes mellitus, 1.47 [95%CI 1.10-1.96]). On the contrary, chief complaint of abdominal and chest pain were associated with a lower risk of sepsis (e.g., adjusted OR of abdominal pain, 0.26 [95%CI 0.14-0.45]).We found that older age, vital signs prognosticating sepsis, and the presence of some comorbidities were the potential risk factors of sepsis in patients with qSOFA2. These potential risk factors could be useful to efficiently recognize patients who might develop sepsis in the ED.

The burden of breast and cervical cancer in terms of incidence and mortality in low- and mid-income countries is increasing daily due to late diagnosis, unhealthy lifestyle choices, late presentation, and poor attitude to screening. Early detection increases the chances of survival. This present study assessed Assam women’s breast and cervical cancer screening (CCS) awareness, the practice of breast self-examination (BSE), and uptake of human papillomavirus vaccines. An internet-based cross-sectional questionnaire was utilized to obtain 251 consenting respondents. The mean age of respondents was 27.8 ± 6.91. Only 205 (81.7%) and 110 (43.8%) respondents have satisfactory levels of BCS, and CCS knowledge, respectively. While only 76 (30.3%) respondents had satisfactory BSE practice. Age range (26 – 32 years), tertiary education, and being single were demographic characteristics that influenced knowledge and practice. Though the respondents had a satisfactory knowledge level, screening uptake among respondents is very poor as only 32 (12.7 %) had ever been screened and only 19 (7.6 %) ever been vaccinated. The major reasons for poor screening uptake were “no symptoms” and “not aware of screening location”. Most respondents (227, 90.4 %) are willing to go for screening if well oriented. This presents an opportunity to enhance awareness about screening and vaccination among Assam women. The media/internet and health practitioners can be leveraged to promote the uptake and utilization of screening services and BSE practice. Doi: 10.28991/SciMedJ-2021-0304-5 Full Text: PDF

Background Early detection of depression is very important for the treatment of patients. In view of the current inefficient screening methods for depression, the research of depression identification technology is a complex problem with application value. Methods Our research propose a new experimental method for depression detection based on audio and text. 160 Chinese subjects are investigated in this study. It is worth noting that we propose a text reading experiment to make subjects emotions change rapidly. It will be called Segmental Emotional Speech Experiment (SESE) below. We extract 384-dimensional Low-level audio features to find the differences of different emotional change in SESE. At the same time, our research propose a multi-modal fusion method based on DeepSpectrum features and word vector features to detect depression by using deep learning. Results Our experiment proved that SESE can improve the recognition accuracy of depression and found differences in Low-level audio features. Case group and Control group, gender and age are grouped for verification. It is also satisfactory that the multi-modal fusion model achieves accuracy of 0.912 and F1 score of 0.906. Conclusions Our contribution is twofold. First, we propose and verify SESE, which can provide a new experimental idea for the follow-up researchers. Secondly, a new efficient multi-modal depression recognition model is proposed.

Introduction: Early detection of large vessel occlusion (LVO) is essential to facilitate fast endovascular treatment. CT angiography (CTA) is used to detect LVO in suspected stroke patients. We aimed to assess the accuracy of CTA evaluations in daily clinical practice in a large cohort of suspected stroke patients. Patients and methods: We used data from the PRESTO study, a multicenter prospective observational cohort study that included suspected stroke patients between August 2018 and September 2019. Baseline CTAs were re-evaluated by an imaging core laboratory and compared to the local assessment. LVO was defined as an occlusion of the intracranial internal carotid artery, M1 segment, or basilar artery. Medium vessel occlusion (MeVO) was defined as an A1, A2, or M2 occlusion. We calculated the accuracy, sensitivity, and specificity to detect LVO and LVO+MeVO, using the core laboratory evaluation as reference standard. Results: We included 656 patients. The core laboratory detected 89 LVOs and 74 MeVOs in 155 patients. Local observers missed 6 LVOs (7%) and 28 MeVOs (38%), of which 23 M2 occlusions. Accuracy of LVO detection was 99% (95% CI: 98–100%), sensitivity 93% (95% CI: 86–97%), and specificity 100% (95% CI: 99–100%). Accuracy of LVO+MeVO detection was 95% (95% CI: 93–96%), sensitivity 79% (95% CI: 72–85%), and specificity 99% (95% CI: 98–100%). Discussion and Conclusion: CTA evaluations in daily clinical practice are highly accurate and LVOs are adequately recognized. The detection of MeVOs seems more challenging. The evolving EVT possibilities emphasize the need to improve CTA evaluations in the acute setting.

PURPOSE Breast cancer risk prediction models are used to identify high-risk women for early detection, targeted interventions, and enrollment into prevention trials. We sought to develop and evaluate a risk prediction model for breast cancer in US Black women, suitable for use in primary care settings. METHODS Breast cancer relative risks and attributable risks were estimated using data from Black women in three US population-based case-control studies (3,468 breast cancer cases; 3,578 controls age 30-69 years) and combined with SEER age- and race-specific incidence rates, with incorporation of competing mortality, to develop an absolute risk model. The model was validated in prospective data among 51,798 participants of the Black Women's Health Study, including 1,515 who developed invasive breast cancer. A second risk prediction model was developed on the basis of estrogen receptor (ER)–specific relative risks and attributable risks. Model performance was assessed by calibration (expected/observed cases) and discriminatory accuracy (C-statistic). RESULTS The expected/observed ratio was 1.01 (95% CI, 0.95 to 1.07). Age-adjusted C-statistics were 0.58 (95% CI, 0.56 to 0.59) overall and 0.63 (95% CI, 0.58 to 0.68) among women younger than 40 years. These measures were almost identical in the model based on estrogen receptor–specific relative risks and attributable risks. CONCLUSION Discriminatory accuracy of the new model was similar to that of the most frequently used questionnaire-based breast cancer risk prediction models in White women, suggesting that effective risk stratification for Black women is now possible. This model may be especially valuable for risk stratification of young Black women, who are below the ages at which breast cancer screening is typically begun.

Cancer incidence is rising in low- and especially middle-income countries (MIC), driven primarily by four high-burden cancers (breast, cervix, lung, colorectal). By 2030, more than two-thirds of all cancer deaths will occur in MICs. Prevention and early detection are required alongside efforts to improve access to cancer treatment. Successful strategies for decreasing cancer mortality in high-income countries are not always effective, feasible or affordable in other countries. In this review, we evaluate strategies for prevention and early detection of breast, cervix, lung, and colorectal cancers, focusing on modifiable risk factors and high-risk subpopulations. Tobacco taxation, human papilloma virus vaccination, cervical cancer screen-and-treat strategies, and efforts to reduce patient and health system–related delays in the early detection of breast and colorectal cancer represent the highest yield strategies for advancing cancer control in many MICs. An initial focus on high-risk populations is appropriate, with increasing population coverage as resources allow. These strategies can deliver significant cancer mortality gains, and serve as a foundation from which countries can develop comprehensive cancer control programs. Investment in national cancer surveillance infrastructure is needed; the absence of national cancer data to identify at-risk groups remains a barrier to the development of context-specific cancer control strategies.

Diabetes is a disease that has no permanent cure; hence early detection is required. Data mining, machine learning (ML) algorithms, and Neural Network (NN) methods are used in diabetes prediction in our research. We used the Pima Indian Diabetes (PID) dataset for our research, collected from the UCI Machine Learning Repository. The dataset contains information about 768 patients and their corresponding nine unique attributes. We used seven ML algorithms on the dataset to predict diabetes. We found that the model with Logistic Regression (LR) and Support Vector Machine (SVM) works well on diabetes prediction. We built the NN model with a different hidden layer with various epochs and observed the NN with two hidden layers provided 88.6% accuracy.

Breast cancer normally occurs in the breast cells of both men and women, but is prominent in women. Computer aided detection increases the chance of early detection and diagnosis. This paper proposes a breast cancer detection method using Nuclear Atypia Scoring (NAS). The proposed cancer detection method works by converting each and every cancerous tissue into objects. Along with detecting the grade, proposed mechanism gives the count of the detected cells. This assists pathologists in identifying whether cells are cancerous or not along with the count of each type. Proposed model was evaluated on MITOS-ATYPIA-14 Challenge dataset. Accuracy of 0.89 and precision of 0.87 is obtained by the best method. Results indicate that the proposed machine learning technique has better performance as compared to existing methods and can aid pathologists in the detection process.

A major health consequence of climate change is an increased prevalence of vector-borne diseases due to changes in temperatures and the environments in which vectors can survive and carry out transmissible activity. Because of climate change, emerging health challenges related to the warming of the planet have led to an increase in vector-borne diseases in broadening geographic areas. Individuals affected with Lyme disease may present with a variety of symptoms, which highlights the importance of illness recognition to ensure that a patient can receive timely treatment and effective support. Despite the focus on early detection and treatment of acute Lyme disease, chronic health problems associated with Lyme disease are an emerging problem in the 21st century. This article focuses on the role of nurse practitioners and members of the health professional team in the recognition, clinical care, patient education, and management of increasing rates of chronic Lyme disease.

Background Early detection of lung cancer in asymptomatic patients remains challenging, especially for stage I. Considering the substantial interaction with tumor immunogenicity, we hypothesized that lung cancer-associated TCR (LC-aTCR) may serve as potential biomarker in early detection of stage I lung cancer. Methods Individuals who received low-dose computed tomography (LDCT) screening were enrolled in the study. Surgical tissues and peripheral blood specimens were collected and performed with DNA-based T cell repertoire (TCR) sequencing. The motif-based algorithm was used to deconstruct specific lung cancer-associated TCRs (LC-aTCRs). Results A total of 146 individuals participating in the real-world LDCT screening project were enrolled in this study, including 52 patients with pathologically-confirmed stage I lung cancer and 94 non-cancer controls. We developed a motif-based algorithm to define 80 LC-aTCRs in the training cohort. Moreover, in the validation cohort, high sensitivity and specificity was showed in stage I lung cancer with 72% and 91% respectively, and the AUC of the ROC curve was 0.91 (95% CI: 0.85 ∼ 0.96). Conclusion This work provides inspiration for stage I lung cancer detection by using blood TCR profiling data. The combination of TCR-based assay and routine screening deserves further testing in larger cohorts.

Circulating biomarkers of drug-induced liver injury (DILI) have been a focus of research in hepatology over the last decade, and several novel DILI biomarkers that hold promise for certain applications have been identified. For example, glutamate dehydrogenase holds promise as a specific biomarker of liver injury in patients with concomitant muscle damage. It may also be a specific indicator of mitochondrial damage. In addition, microRNA-122 is sensitive for early detection of liver injury in acetaminophen overdose patients. However, recent events in the field of DILI biomarker research have provided us with an opportunity to step back, consider how biomarker discovery has been done thus far, and determine how to move forward in a way that will optimize the discovery process. This is important because major challenges remain in the DILI field and related areas that could be overcome in part by new biomarkers. In this short review, we briefly describe recent progress in DILI biomarker discovery and development, identify current needs, and suggest a general approach to move forward.

AIM To determine the effectiveness of two instructional guides to obtain video recordings for the General Movements Assessment (GMA). METHODS A cross-sectional study of a community sample of family participants with low-risk term newborn infants recruited via social media and randomly allocated to receive one of two instructional guides (detailed or quick versions) to film their infant's movements at home. Participants returned videos via a secure Research Electronic Database Capture link and videos were scored for quality across 10 criteria, along with scoring the GMA. Participants were surveyed about their perceptions of the instructional guides and electronic file transmission. RESULTS Seventy-six parents of infants were enrolled and randomly allocated to receive detailed (n = 38) and quick (n = 38) instructions to film their infant for a GMA. Videos were returned by 87% (95% confidence interval (CI) 72%, 96%) of detailed instruction users and 84% (95% CI 69%, 94%) of quick instruction users. The GMA could be conducted on all returned videos. The mean score for video quality was 9.9/10 (standard deviation 0.4, 95% CI 9.7, 10.0) for detailed instructions and 9.7 (standard deviation 0.6, 95% CI 9.4, 9.9) for quick instructions. Overall, participants felt that either instructional guide was easy to use. Fifteen (20%) participants had difficulties with video file transmission, requiring additional support. CONCLUSIONS Parents can successfully use one of two different instructional guides for filming their infant's movements for GMA; however, support should be provided for safe and easy file transmission.