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Purpose: Despite the robust expansion of research surrounding artificial intelligence (AI) and machine learning (ML) and their applications to medicine, these methodologies often remain opaque and inaccessible to many otolaryngologists. Especially, with the increasing ubiquity of large-language models (LLMs), such as ChatGPT and their potential implementation in clinical practice, clinicians may benefit from a baseline understanding of some aspects of AI. In this narrative review, we seek to clarify underlying concepts, illustrate applications to otolaryngology, and highlight future directions and limitations of these tools. Methods: Recent literature regarding AI principles and otolaryngologic applications of ML and LLMs was reviewed via search in PubMed and Google Scholar. Results: Significant recent strides have been made in otolaryngology research utilizing AI and ML, across all subspecialties, including neurotology, head and neck oncology, laryngology, rhinology, and sleep surgery. Potential applications suggested by recent publications include screening and diagnosis, predictive tools, clinical decision support, and clinical workflow improvement via LLMs. Ongoing concerns regarding AI in medicine include ethical concerns around bias and data sharing, as well as the "black box" problem and limitations in explainability. Conclusions: Potential implementations of AI in otolaryngology are rapidly expanding. While implementation in clinical practice remains theoretical for most of these tools, their potential power to influence the practice of otolaryngology is substantial. Level of evidence: 4. [ABSTRACT FROM AUTHOR]

Background The 2023 Duke-ISCVID (International Society of Cardiovascular Infectious Diseases) classification is a new diagnostic tool for infective endocarditis, updating the 2000 modified Duke and the 2015 European Society for Cardiology (ESC) classifications. In comparison, its sensitivity is higher; however, its specificity remains to be evaluated and compared to that of the 2 other classifications in endocarditis suspected patients. Methods We retrospectively collected the characteristics of patients hospitalized in Bichat University's Hospital, Paris, in 2021, who had been evaluated for clinical suspicion of endocarditis, have had at least a transthoracic echocardiography, 2 pairs of blood cultures, 3-month follow-up and in whom endocarditis diagnosis was finally rejected. All patients were classified by 2000 modified Duke, 2015 ESC and 2023 Duke-ISCVID, as though the endocarditis diagnosis had not been rejected. Results In total, 130 patients' charts were analyzed. Mean age was 62 years, 84 (64.6%) were male, 39 (30.0%) had prosthetic cardiac valve or valve repair, 21 (16.2%) cardiac implanted electronic device, and 30 (23.1%) other cardiac conditions. Overall, 5, 2, and 5 patients were falsely classified as definite endocarditis with the 2000 modified Duke, 2015 ESC, and 2023 Duke-ISCVID classifications, respectively. The corresponding specificities were 96.2% (95% confidence interval [CI] [90.8%, 98.6%]), 98.5% (95% CI [93.9%, 99.7%]), and 96.2% (95% CI [90.8%, 98.6%]). The rates of possible endocarditis were of 38%, 35%, and 35% in the 3 classifications, respectively. Conclusions The 2023 Duke-ISCVID classification is highly specific for ruling out the diagnosis of definite infective endocarditis in patients who had been evaluated for IE. [ABSTRACT FROM AUTHOR]

Between 1 to 2 of every 1,000 children are born deaf or hard of hearing (DHH) and, of those, 30–50% have additional disabilities, including Autism Spectrum Disorder (ASD). Most measures assessing ASD characteristics rely on some degree of behavioral response to sound (e.g., responding to name, listening response), and may not be appropriate for use with children who are DHH. Further, ASD specific measures do not provide information on a child's functional abilities across developmental domains. We conducted a cross-sectional analysis comparing mean T-scores on a standardized multidimensional measure, the Behavior Assessment System for Children, Third Edition, Parent Rating Scale (BASC-3 PRS), across three groups matched for age and sex: children who are DHH and diagnosed with ASD (DHH + ASD; n = 16); children who are DHH without ASD (DHH-ASD; n = 16); and children who are typically hearing with ASD (H + ASD; n = 16). Analyses revealed statistically significant differences across scales of Attention Problems, Atypicality, Withdrawal, Behavioral Symptoms Index, Social Skills, Leadership, Functional Communication, Activities of Daily Living, Adaptive Skills, Autism Probability Indices, and Developmental Social Disorders. Pairwise comparisons showed DHH + ASD and H + ASD mean T-scores were statistically similar and distinct from DHH-ASD mean T-scores on all these scales except for Withdrawal, Leadership, Functional Communication, and Activities of Daily Living, where pairwise comparisons varied. The findings add to the literature on ASD and DHH children and call for further exploration of the BASC-3 as a tool for both evaluation of ASD and the development of individualized treatment plans in this unique population. [ABSTRACT FROM AUTHOR]

At an early stage, esophageal cancer can be removed surgically or endoscopically. T1a tumors are removed by endoscopic resection, whereas T1b tumors are preferably surgically removed (esophagectomy) due to possible lymph node involvement. However, the diagnostic tools (endoscopic ultrasonography (EUS) and CT/PET-CT) used to distinguish between T1a and T1b tumors and to detect malignant lymph nodes are imprecise. This study aimed to review the accuracy of preoperative locoregional staging in superficial esophageal cancer in a Danish setting. This was a retrospective, multicenter study including patients with a cT1 esophageal tumor, both adenocarcinoma and squamous cell carcinoma. Patients receiving neoadjuvant treatment were excluded. Results from the preoperative diagnostics tools were compared with the pathology report to determine the diagnostic accuracy. Sixty-eight patients were included, 34 patients underwent esophagectomy, and 34 patients underwent endoscopic resection. The positive predictive value (PPV) of PET-CT (or CT) (when staged as a T1 tumor) was 77% (95%CI: 0.59–0.88), and the PPV of EUS (when staged as a T1a or T1b tumor) was 52% (95%CI: 0.32–0.72) and 60% (95%CI: 0.36–0.82), respectively. Six patients had malignant lymph nodes in the surgical specimen; none of them was identified before surgery. In conclusion, neither CT/PET-CT nor EUS is a precise tool to distinguish mucosal from submucosal esophageal tumors. Furthermore, in superficial malignant lesions, lymph node involvement is rare, but when present, it is rarely detected before surgery. To improve staging accuracy, all patients with cT1 tumors could be referred for a diagnostic endoscopic resection prior to possible other treatments. [ABSTRACT FROM AUTHOR]

Introduction: Visual disturbances are the most common symptoms of migraine aura. These symptoms can be described systematically by subdividing them into elementary visual symptoms. Since visual symptoms of migraine aura are not easy to describe verbally, we developed a collection of images illustrating previously reported elementary visual symptoms. Objectives: To test a standardised visual migraine aura iconography in a large population of migraine with aura patients and to improve it based on the participants' feedback. Methods: We created a set of images representing 25 elementary visual symptoms and a web-based survey where participants could report whether they recognised these images as part of their visual aura. Elementary visual symptoms could also be recognised via a corresponding text description or described in a free text by participants. Individuals with migraine aura recruited from four tertiary headache centres (in Switzerland, Denmark, Norway and Italy) were invited to complete the survey. Results: Two hundred and fifteen participants completed the study (78.9% women, median age 36). They recognised a total of 1645 elementary visual symptoms from our predefined list. Of those, 1291 (78.4%) where recognised via standardised iconography images. A new type of elementary visual symptom was reported by one participant. Conclusion: Most elementary visual symptoms experienced by participants were recognised via the standardised iconography. This tool can be useful for clinical as well as research purposes. [ABSTRACT FROM AUTHOR]

Biomaterials embody a groundbreaking paradigm shift in the field of drug delivery and human applications. Their versatility and adaptability have not only enriched therapeutic outcomes but also significantly reduced the burden of adverse effects. This work serves as a comprehensive overview of biomaterials, with a particular emphasis on their pivotal role in drug delivery, classifying them in terms of their biobased, biodegradable, and biocompatible nature, and highlighting their characteristics and advantages. The examination also delves into the extensive array of applications for biomaterials in drug delivery, encompassing diverse medical fields such as cancer therapy, cardiovascular diseases, neurological disorders, and vaccination. This work also explores the actual challenges within this domain, including potential toxicity and the complexity of manufacturing processes. These challenges emphasize the necessity for thorough research and the continuous development of regulatory frameworks. The second aim of this review is to navigate through the compelling terrain of recent advances and prospects in biomaterials, envisioning a healthcare landscape where they empower precise, targeted, and personalized drug delivery. The potential for biomaterials to transform healthcare is staggering, as they promise treatments tailored to individual patient needs, offering hope for improved therapeutic efficacy, fewer side effects, and a brighter future for medical practice. [ABSTRACT FROM AUTHOR]

Gliomas, a prevalent category of primary malignant brain tumors, pose formidable clinical challenges due to their invasive nature and limited treatment options. The current therapeutic landscape for gliomas is constrained by a "one-size-fits-all" paradigm, significantly restricting treatment efficacy. Despite the implementation of multimodal therapeutic strategies, survival rates remain disheartening. The conventional treatment approach, involving surgical resection, radiation, and chemotherapy, grapples with substantial limitations, particularly in addressing the invasive nature of gliomas. Conventional diagnostic tools, including computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), play pivotal roles in outlining tumor characteristics. However, they face limitations, such as poor biological specificity and challenges in distinguishing active tumor regions. The ongoing development of diagnostic tools and therapeutic approaches represents a multifaceted and promising frontier in the battle against this challenging brain tumor. The aim of this comprehensive review is to address recent advances in diagnostic tools and therapeutic approaches for gliomas. These innovations aim to minimize invasiveness while enabling the precise, multimodal targeting of localized gliomas. Researchers are actively developing new diagnostic tools, such as colorimetric techniques, electrochemical biosensors, optical coherence tomography, reflectometric interference spectroscopy, surface-enhanced Raman spectroscopy, and optical biosensors. These tools aim to regulate tumor progression and develop precise treatment methods for gliomas. Recent technological advancements, coupled with bioelectronic sensors, open avenues for new therapeutic modalities, minimizing invasiveness and enabling multimodal targeting with unprecedented precision. The next generation of multimodal therapeutic strategies holds potential for precision medicine, aiding the early detection and effective management of solid brain tumors. These innovations offer promise in adopting precision medicine methodologies, enabling early disease detection, and improving solid brain tumor management. This review comprehensively recognizes the critical role of pioneering therapeutic interventions, holding significant potential to revolutionize brain tumor therapeutics. [ABSTRACT FROM AUTHOR]

Infertility affects a significant proportion of the reproductive‐aged population, with male‐associated factors contributing to over half of the cases. However, current diagnostic tools have limitations, leading to an underestimation of the true prevalence of male infertility. While traditional semen parameters provide some insights, they fail to determine the true fertility potential in a substantial number of instances. Therefore, it is crucial to investigate additional molecular targets responsible for male infertility to improve understanding and identification of such cases. Seminal plasma, the main carrier of molecules derived from male reproductive glands, plays a crucial role in reproduction. Amongst its multifarious functions, it regulates processes such as sperm capacitation, sperm protection and maturation, and even interaction with the egg's zona pellucida. Seminal plasma offers a non‐invasive sample for urogenital diagnostics and has shown promise in identifying biomarkers associated with male reproductive disorders. This review aims to provide an updated and comprehensive overview of seminal plasma in the diagnosis of male infertility, exploring its composition, function, methods used for analysis, and the application of emerging markers. Apart from the application, the potential challenges of seminal plasma analysis such as standardisation, marker interpretation and confounding factors have also been addressed. Moreover, we have also explored future avenues for enhancing its utility and its role in improving diagnostic strategies. Through comprehensive exploration of seminal plasma's diagnostic potential, the present analysis seeks to advance the understanding of male infertility and its effective management. [ABSTRACT FROM AUTHOR]

The objective of this bibliometric analysis was to investigate the citation pattern of studies that have developed a diagnostic tool to diagnose appendicitis. We investigated characteristics of citations, publication frequency, evolution of citations, and fluctuation of previously highly cited studies. We analyzed which studies had been cited in the method section and identified impactful studies in this research field by a network visualization. We analyzed the differences in citations between diagnostic tools requiring a doctor to be present against the diagnostic tools not requiring doctors to be present, English language studies against non-English studies, and identified diagnostic tools targeting children. There was an upward trend in publications in this research field, and between 1999-2021 the Alvarado score has been cited the most. In general, there was a high fluctuation, and 40 studies had been cited in the methods sections. There were significant differences in studies regarding diagnostic tools written in English compared to non-English studies, with more citations in the English-language studies. Furthermore, 22 studies had children as the target population. The Alvarado score was the highest cited study since 1999, with 1086 citations, making it the most impactful study in this research field of diagnostic tools to diagnose appendicitis. Due to the diversity of target populations and settings for which diagnostic tools are developed, there is a need to expand research on diagnostic tools for appendicitis. [ABSTRACT FROM AUTHOR]

A fundamental aspect of caring for neurocritical patients is interpreting and understanding their neurological signs and symptoms. This will be a helpful key to determining the brain injury or dysfunction's location, extent, and severity. The semiotics of the neurocritical patient encompasses various domains, including motor, sensory, cognitive, and autonomic functions. A comprehensive understanding of the semiotics of the neurocritical patient empowers clinicians to make timely and accurate diagnoses, predict outcomes, and implement targeted therapeutic interventions. It also enables effective communication among the interdisciplinary team members involved in the patient's care. This article review shows the importance of accurately recognizing and deciphering these signs to guide clinical decision-making. [ABSTRACT FROM AUTHOR]

The dynamic interplay between the immunome and microbiome in reproductive health is a complex and rapidly advancing research field, holding tremendously vast possibilities for the development of reproductive medicine. This immunome–microbiome relationship influences the innate and adaptive immune responses, thereby affecting the onset and progression of reproductive disorders. However, the mechanisms governing these interactions remain elusive and require innovative approaches to gather more understanding. This comprehensive review examines the current knowledge on reproductive microbiomes across various parts of female reproductive tract, with special consideration of bidirectional interactions between microbiomes and the immune system. Additionally, it explores innate and adaptive immunity, focusing on immunoglobulin (Ig) A and IgM antibodies, their regulation, self-antigen tolerance mechanisms, and their roles in immune homeostasis. This review also highlights ongoing technological innovations in microbiota research, emphasizing the need for standardized detection and analysis methods. For instance, we evaluate the clinical utility of innovative technologies such as Phage ImmunoPrecipitation Sequencing (PhIP-Seq) and Microbial Flow Cytometry coupled to Next-Generation Sequencing (mFLOW-Seq). Despite ongoing advancements, we emphasize the need for further exploration in this field, as a deeper understanding of immunome–microbiome interactions holds promise for innovative diagnostic and therapeutic strategies for reproductive health, like infertility treatment and management of pregnancy. [ABSTRACT FROM AUTHOR]

Create a language-independent, ecologically valid auditory processing assessment and evaluate relative stimuli intelligibility in native and non-native English speakers. The Language-Independent Speech in Noise and Reverberation Test (LISiNaR) targets comprised consonant-vowel (CVCV) pseudo-words. Distractors comprised CVCVCVCV pseudo-words. Stimuli were presented over headphones using an iPad either face-to-face or remotely. Scoring occurred adaptively to establish a participant's speech reception threshold in noise (SRT). The listening environment was simulated using reverberant and anechoic head-related transfer functions. In four test conditions, targets originated from 0°. Distractors originated from either ±90°, ±67.5° and ±45° (spatially separated) or 0° azimuth (co-located). Reverberation impact (RI) was calculated as the difference in SRTs between the anechoic and reverberant conditions and spatial advantage (SA) as the difference between the spatially separated and co-located conditions. Young adult native speakers of Australian (n = 24) and Canadian (25) and non-native English speakers (34). No significant effects of language occurred for the test conditions, RI or SA. A small but significant effect of delivery mode occurred for RI. Reverberation impacted SRT by 5 dB relative to anechoic conditions. Performance on LISiNaR is not affected by the native language or accent of groups tested in this study. [ABSTRACT FROM AUTHOR]

Aim of the study: Biliary atresia (BA) is a blockage in the tubes (ducts) that carry bile from the liver to the gallbladder. The aspartate aminotransferase to platelet ratio (APRI), and Fibrosis-4 (FIB-4) scores are commonly used compound surrogates for advanced fibrosis. However, the use of APRI and FIB-4 entails a risk of overestimating the fibrosis stage due to the impact of necroinflammatory activity on transaminases. So, we determined the optimal cutoff values of the APRI and FIB-4 indices in prediction of fibrosis in BA patients. The aim of the study was to evaluate the validity of the APRI and FIB-4 indices in prediction of fibrosis in patients with BA. Material and methods: A cross sectional hospital-based study was conducted on 121 children complaining of BA attending the National Liver Institute, Menoufia University, Shebin Elkom, Menoufia, Egypt, during the period from January 2022 to February 2023. Results: The APRI score was significantly higher among neglected BA than BA type II a, BA type III, type II b and type I (p = 0.001). Also FIB-4 was significantly higher among neglected BA than BA type II a, BA type II b, type III and type I (p = 0.001). Receiver operating characteristic (ROC) curve analysis showed that the cutoff point of the APRI score in prediction of fibrosis in patients with BA was 1.29, with sensitivity of 88.6% and specificity of 76.0%, while the cutoff point of FIB-4 in prediction of fibrosis in patients with BA was 9.82 with sensitivity of 89.0% and specificity of 70.0%. Conclusions: Our study confirms that FIB-4 and APRI scores are both able to predict severe fibrosis. APRI score and FIB-4 are good non-invasive alternatives to liver biopsy in the detection of liver fibrosis and its extent in patients with BA. [ABSTRACT FROM AUTHOR]

Aims. To evaluate scope of diagnosing tools-Alvarado score, CRP, USG, and CT in acute appendicitis. Method. Conducted observational study of 152 patients in Department of Emergency Medicine, Sri Ramachandra Medical College and Research Institute, Chennai, India between January to December 2022. The diagnostic tool’s (Alvarado score, CRP, USG, CT (abdomen), sensitivity, specificity, accuracy, and ROC were analyzed to diagnose acute appendicitis. Results. Among 152 study patients, males - 86, females - 66, higher number of age group was <30 years, abnormal variables in study patients are BP - 79%, HR - 80%, RFP pain - 57%, anoxia - 78%, nausea/ vomiting - 68%, RIF tenderness - 69%, rebound tenderness - 63.8%, elevated temperature - 62%, pain - 44.7%, leukocytosis - 70.7%, and left shift - 38.2%. In comparison, Alvarado scores-identified 98% patients, (<5 score - 8.2%, 5-6 score - 30.6%, >7-61.2%) (0.0271), CRP - identified 95.1% (<0.001), USG identified (group 1-33%, group 2-12.2%, group 3-11.3%, and group 4-43.5%, and CT identified 152/152 (100%) patients with acute appendicitis. The odds ratio/95% CI of diagnostic tools (USG - 0.878, 0.66, CRP - 7.337, 2.623, Alvarado score - 0.81, 0.687). Sensitivity (Alvarado's score - 84.74%, USG - 83.33%, CRP - 76.43%), and specificity was (Alvarado's score - 84.32, USG - 72.97%, CRP-83.86%. The PPV (Alvarado's score - 74.56%, USG - 75.5%, CRP - 33.16%), NPV (Alvarado's score - 32.5%, USG - 79.1%, CRP - 81.03%), and diagnostic accuracy (Alvarado's score - 72.01%, USG - 73.05%, CRP - 68.81%). ROC in individual tools-Alvarado score was specific than USG, and CRP. ROC in combination toolsAlvarado score and USG was specific than USG, and CRP. Conclusion. Among the diagnostic tools tested, as individual tool-Alvarado score was specific, in combination, and Alvarado score and USG were accurate, specific, sensitive, hence combination of tools will identify acute appendicitis early to reduce mortality by undiagnosed or late diagnosed. [ABSTRACT FROM AUTHOR]

This study aimed to analyse clinical and laboratory findings in primary care patients with respiratory tract infections to distinguish the group more likely to receive antibiotic treatment. The study group consisted of 631 patients (264 males; 367 females) with a median age of 48 years (IQR 36–63 years). Analysed groups included patients treated with antibiotics (n = 269 patients; 43%) and those who recovered without antibiotic treatment (n = 362 patients; 57%). Patients receiving antibiotics were older (median 51 vs. 47 years; p = 0.008) and more commonly developed fever (77% vs. 25%, p < 0.0001) and cough (63% vs. 30%; p = 0.0014). Moreover, they more frequently presented wheezing and crackles upon physical examination (28% vs. 4% and 9% vs. 0.3%; p < 0.0001 and p < 0.0001, respectively). They also had more comorbidities and came to more follow-up visits (median of 4 vs. 3 and 2 vs. 1, p < 0.0001 and p < 0.0001, respectively). Patients receiving symptomatic therapy more often had positive point-of-care tests (POCTS)—20% vs. 7%; p = <0.0001. Multivariate analysis in our cohort found comorbidities complexity (odds ratio—OR 2.62; 95% confidence interval—1.54–4.46), fever (OR 32.59; 95%CI 19.15–55.47), crackles (OR 26.35; 95%CI 2.77–250.81) and the number of visits (OR 4.15; 95%CI 2.39–7.20) as factors increasing the probability of antibiotic treatment. Positive influenza POCTS reduced the risk of antibiotic therapy (OR 0.0015; 95%CI 0.0001–0.0168). [ABSTRACT FROM AUTHOR]

Background: We aimed to provide an overview of all diagnostic tools developed to diagnose appendicitis with their reported accuracy and to further characterize these including their need for diagnostic equipment. Methods: This scoping review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews and a protocol was registered at Open Science Framework. We performed a systematic literature search in PubMed, Embase, China National Knowledge Infrastructure, Índice Bibliográfico Espanhol de Ciências da Saúde, and Latin American and Caribbean Health Sciences Literature. We included original articles of all languages with the purpose to derive an accessible diagnostic tool. We extracted data regarding study- and diagnostic tool characteristics, and the accuracy of each diagnostic tool. Results: The search led to 6419 records, where 74 studies were included, yielding 82 diagnostic tools reported in seven different languages. Among these tools, 35% included patient characteristics, 85% symptoms, 93% physical examinations, 37% vital signs, 78% laboratory values, and 16% imaging. Among the diagnostic tools, 35% relied on a medical doctor/surgeon with access to a laboratory, and six diagnostic tools did not require a bedside medical doctor/surgeon. The median positive predictive value, negative predictive value, sensitivity, and specificity across diagnostic tools were 91%, 94%, 89%, and 86%, respectively. Conclusions: We identified 82 diagnostic tools that most frequently were based on symptoms and physical examinations. Most diagnostic tools relied on a medical doctor/surgeon with access to laboratory values. The accuracy was high across the diagnostic tools. [ABSTRACT FROM AUTHOR]

Aim of the study: Biliary atresia (BA) is a blockage in the tubes (ducts) that carry bile from the liver to the gallbladder. The aspartate aminotransferase to platelet ratio (APRI), and Fibrosis-4 (FIB-4) scores are commonly used compound surrogates for advanced fibrosis. However, the use of APRI and FIB-4 entails a risk of overestimating the fibrosis stage due to the impact of necroinflammatory activity on transaminases. So, we determined the optimal cutoff values of the APRI and FIB-4 indices in prediction of fibrosis in BA patients. The aim of the study was to evaluate the validity of the APRI and FIB-4 indices in prediction of fibrosis in patients with BA. Material and methods: A cross sectional hospital-based study was conducted on 121 children complaining of BA attending the National Liver Institute, Menoufia University, Shebin Elkom, Menoufia, Egypt, during the period from January 2022 to February 2023. Results: The APRI score was significantly higher among neglected BA than BA type II a, BA type III, type II b and type I (p = 0.001). Also FIB-4 was significantly higher among neglected BA than BA type II a, BA type II b, type III and type I (p = 0.001). Receiver operating characteristic (ROC) curve analysis showed that the cutoff point of the APRI score in prediction of fibrosis in patients with BA was 1.29, with sensitivity of 88.6% and specificity of 76.0%, while the cutoff point of FIB-4 in prediction of fibrosis in patients with BA was 9.82 with sensitivity of 89.0% and specificity of 70.0%. Conclusions: Our study confirms that FIB-4 and APRI scores are both able to predict severe fibrosis. APRI score and FIB-4 are good non-invasive alternatives to liver biopsy in the detection of liver fibrosis and its extent in patients with BA. [ABSTRACT FROM AUTHOR]

Epidemics and pandemics have occurred since the beginning of time, resulting in millions of deaths. Many such disease outbreaks are caused by viruses. Some viruses, particularly RNA viruses, are characterized by their high genetic variability, and this can affect certain phenotypic features: tropism, antigenicity, and susceptibility to antiviral drugs, vaccines, and the host immune response. The best strategy to face the emergence of new infectious genomes is prompt identification. However, currently available diagnostic tests are often limited for detecting new agents. High-throughput next-generation sequencing technologies based on metagenomics may be the solution to detect new infectious genomes and properly diagnose certain diseases. Metagenomic techniques enable the identification and characterization of disease-causing agents, but they require a large amount of genetic material and involve complex bioinformatic analyses. A wide variety of analytical tools can be used in the quality control and pre-processing of metagenomic data, filtering of untargeted sequences, assembly and quality control of reads, and taxonomic profiling of sequences to identify new viruses and ones that have been sequenced and uploaded to dedicated databases. Although there have been huge advances in the field of metagenomics, there is still a lack of consensus about which of the various approaches should be used for specific data analysis tasks. In this review, we provide some background on the study of viral infections, describe the contribution of metagenomics to this field, and place special emphasis on the bioinformatic tools (with their capabilities and limitations) available for use in metagenomic analyses of viral pathogens. [ABSTRACT FROM AUTHOR]

Cryptococcus species are a major cause of life-threatening infections in immunocompromised and immunocompetent hosts. While most disease is caused by Cryptococcus neoformans, Cryptococcus gattii, a genotypically and phenotypically distinct species, is responsible for 11–33% of global cases of cryptococcosis. Despite best treatment, C. gattii infections are associated with early mortality rates of 10–25%. The World Health Organization's recently released Fungal Priority Pathogen List classified C. gattii as a medium-priority pathogen due to the lack of effective therapies and robust clinical and epidemiological data. This narrative review summarizes the latest research on the taxonomy, epidemiology, pathogenesis, laboratory testing, and management of C. gattii infections. [ABSTRACT FROM AUTHOR]

Insulin resistance (IR) is a defining feature of obesity, diabetes, and cardiovascular disease, and it contributes to many of the metabolic syndrome's abnormalities. Although our understanding of IR has vastly increased over time, several parts of its assessment continue to elude researchers and doctors. Although the quantitative assessment of insulin sensitivity is not regularly utilized in biochemical investigations for diagnostic purposes, the growing importance of IR has led to further research into its application. IR must be assessed in a number of clinical situations when insulin sensitivity is reduced. IR is being studied more and more in numerous disease states to help researchers better understand its pathophysiology, etiology, and implications. The gold standard approach for determining insulin sensitivity is the hyperinsulinemic euglycemic glucose clamp, although it is impractical due to its labor- and time-intensive nature. As a result, a variety of surrogate indices have been used to make determining IR easier and more accurate. The goal of this study is to highlight different elements and approaches for present and future insulin sensitivity/resistance measurements. Understanding and exploiting the condition will be aided by a thorough understanding of these signs. [ABSTRACT FROM AUTHOR]

Neurological disorders are a point of attraction these days due to their physical, mental, and genetic threat to human beings. The researchers are refining the therapeutics and striving to eradicate the life‐threatening burden of chronic diseases by upsurging and proposing advanced instrumentation. There are a number of neurological diseases that cause alterations in the genetic sequences due to pathogenic or self‐negligence. According to the WHO, stroke, septicemia, PD, epilepsy, and MS are found to be the deadliest and most invading among millions of people. Various diagnostic methods are employed for monitoring these disorders in the human body at an early stage, in process of cure. The current review highlights the strengths of several advanced detection devices, such as biosensors to identify and quantify biomarkers, some sensing gadgets, and other genetic tactics or innovations to ameliorate traditional protocols. Furthermore, the meticulous description of ongoing experiments with the help of relevant case studies of neurodegenerative disorders supports the impact and vitality of advanced equipment. Further, the necessity of biosensors in distinct disorders to aid in an early diagnosis, and the influence of nano‐based materials in preparation is emphasized. Finally, several issues that should be addressed in upcoming decades with the steep rise in analytical technology have been discussed. [ABSTRACT FROM AUTHOR]

Clinical predictive tools are a topic gaining interest. Many tools are developed each year to predict various outcomes in medicine and surgery. However, the proportion of predictive tools that are implemented in clinical practice is small in comparison to the total number of tools developed. This narrative review presents key principles to guide the translation of predictive tools from academic bodies of work into useful tools that complement clinical practice. Our review identified the following principles: (1) identifying a clinical gap, (2) selecting a target user or population, (3) optimizing predictive tool performance, (4) externally validating predictive tools, (5) marketing and disseminating the tool, (6) navigating the challenges of integrating a tool into existing healthcare systems, and (7) developing an ongoing monitoring and evaluation strategy. Although the review focuses on examples in orthopaedic surgery, the principles can be applied to other disciplines in medicine and surgery. [ABSTRACT FROM AUTHOR]

Halal authentication has become essential in the food industry to ensure food is free from any prohibited ingredients according to Islamic law. Diversification of food origin and adulteration issues have raised concerns among Muslim consumers. Therefore, verification of food constituents and their quality is paramount. From conventional methods based on physical and chemical properties, various diagnostic methods have emerged relying on protein or DNA measurements. Protein-based methods that have been used in halal detection including electrophoresis, chromatographic-based methods, molecular spectroscopy and immunoassays. Polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP) are DNA-based techniques that possess better accuracy and sensitivity. Biosensors are miniatured devices that operate by converting biochemical signals into a measurable quantity. CRISPR-Cas is one of the latest novel emerging nucleic acid detection tools in halal food analysis as well as quantification of stable isotopes method for identification of animal species. Within this context, this review provides an overview of the various techniques in halal detection along with their advantages and limitations. The future trend and growth of detection technologies are also discussed in this review. [ABSTRACT FROM AUTHOR]

Metal‐based compounds have been widely used for biomedical applications. Their unique characteristics make them attractive for both therapeutic and diagnostic purposes. However, numerous issues including toxicity, poor aqueous solubility, and unfavorable biodistribution hamper their widespread use. To overcome these drawbacks, the concept of metal‐based prodrugs emerged. This field is particularly developed for applications in oncology. More precisely, tumor‐associated stimuli (e.g., pH variation, redox activity, enzyme overexpression, etc.) have been exploited to trigger the selective delivery of active metal‐based drugs to the tumor site. The main advances in this area are discussed in this Review. [ABSTRACT FROM AUTHOR]

Metal‐based compounds have been widely used for biomedical applications. Their unique characteristics make them attractive for both therapeutic and diagnostic purposes. However, numerous issues including toxicity, poor aqueous solubility, and unfavorable biodistribution hamper their widespread use. To overcome these drawbacks, the concept of metal‐based prodrugs emerged. This field is particularly developed for applications in oncology. More precisely, tumor‐associated stimuli (e.g., pH variation, redox activity, enzyme overexpression, etc.) have been exploited to trigger the selective delivery of active metal‐based drugs to the tumor site. The main advances in this area are discussed in this Review. [ABSTRACT FROM AUTHOR]

Background: Neonatal sepsis is the third-leading cause of death and disability in the first month following delivery. Due to non-specific and inconclusive symptoms in early neonatal sepsis and bacterial culture (that is used as the gold standard) taking time, the diagnosis of early-onset sepsis (EOS) is challenging. Serum C-reactive protein (CRP) increase is a frequent inflammatory measure being studied for its diagnostic accuracy in neonatal sepsis. But challenges still exist, driven by various sensitivities and specificities determined by the kind of pathogen, reference values, and patient gestational and chronological age. Material and methods: Relevant retrospective clinical studies were carefully reviewed, and comprehensive analysis aimed to discern common ground and supporting ideas between them. The sequential CRP levels (each infant had at least 3 measurements) were recorded at different intervals after birth within the first 72 hours of age. The methodology and objectives of these studies were similar Results: The dynamics of C-reactive protein (CRP) levels were investigated in one of the studies involving 145 infants who met the inclusion criteria, 25% of whom were preterm. Particularly, at 12--24--36 and 48 hours, term babies had higher CRP levels than preterm babies. These levels peaked at 24 hours, then declined at 36 hours and settled by 48 hours. There was a substantial increase in the median CRP readings in the term group at all time points when compared to the preterm infants. Another study included 863 newborns, of which 179 term and 353 preterm babies met the inclusion criteria. In this study, preterm newborns had lower median CRP values in the group of EOS-positive (9 vs. 18.5 mg/L) and EOS negative infants (0.5 vs. 2 mg/L). Furthermore, it was noted that CRP levels were also increased in neonates with meconium aspiration syndrome (MAS) in term, severe respiratory distress syndrome, and the administration of surfactant in preterm newborns. We included another study to reiterate the above findings. In a retrospective cross-sectional study of 872 neonates, CRP levels higher than 8 mg/L were recorded when neonates were exposed to premature rupture of membrane (PROM), maternal autoimmune diseases, and MAS, and significantly lower when newborns were exposed to antenatal steroids, placenta previa, Intrahepatic cholestasis of pregnancy (ICP), and caesarean delivery. Conclusions: When comparing the median CRP values at different time intervals within the 72-hour period, we found that the median CRP values recorded in EOS-diagnosed preterm newborns were lower than those of EOS- diagnosed term newborns. Other non-infectious factors that contribute to elevated CRP levels include the administration of surfactant, MAS, PROM, and maternal autoimmune diseases. We now also know that, for instance, a caesarean delivery may show a lower-than-expected CRP level. This temporal profile reveals a unique CRP response in term and pre-term newborns, emphasizing the significance of taking these differences to heart while making clinical judgments. Ongoing efforts to refine gestational age-specific reference values for CRP are pivotal for enhancing its reliability in neonatal care. [ABSTRACT FROM AUTHOR]

This concise review provides the broad background and selection from the literature for a Keynote lecture at EHSF 2022 on state of the art technologies in inflammation research, with an emphasis on disease of the skin and the nervous system. The value of ex vivo skin explant models is discussed, as well as the innovative use of animal models, wherein the crucial roles of antigen experience and "wild" microbiota are emphasized. Spectral flow cytometry allowing large surface marker panels to be explored is touched upon, as well as multiplex technology for cytokines and other analytes important for inflammation and tissue damage. Single‐cell sequencing and in situ transcriptomics (spatial profiling) now provide exciting granular information on functional cell subsets, interactions and plasticity. A selection of novel research and diagnostic tools for antibodies against linear peptides or gangliosides is presented. Finally, the review discusses a new anti‐inflammatory strategy against skin inflammation with a panel of protease inhibitors derived from the protein fraction of industrial starch potatoes. [ABSTRACT FROM AUTHOR]

Simple Summary: Luteal deficiency is defined as reduced progesterone production by the corpus luteum, either in the amount or duration, or both. The clinical manifestations include primary infertility and pregnancy loss during the late embryonic/early fetal period (30–50 days post-AI). This work provides a clinical overview of the current understanding of luteal deficiency and its association with low fertility in dairy cows. Luteal deficiency is defined as reduced progesterone (P4) steroidogenesis by the corpus luteum (CL), either in the amount or duration, or both. This work provides a clinical overview of the current understanding of luteal deficiency and its association with low fertility in dairy cows. Low plasma P4 concentrations during the luteal phase post-artificial insemination (AI) are associated with lower conception rates. Treatments post-AI with P4, gonadotropin-releasing hormone (GnRH) or human chorionic gonadotropin (hCG) improve fertility in some conditions. Sub-luteal function during the late embryonic period (at pregnancy diagnosis, i.e., 28–34 days post-AI), is just one factor among other factors associated with pregnancy loss. Treatment with P4 in cows with one CL favors pregnancy maintenance, while GnRH treatment does the same in cows carrying twins. The diagnosis of sub-luteal function can be made clinically on the basis of plasma or milk P4 concentrations. Automated in-line milk P4 analysis systems to diagnose luteal activity emerge as a very interesting tool in dairy herds. Monitoring plasma or milk P4 concentrations with the help of Doppler ultrasonography to assess the CL function would allow individualizing the luteal phase support. [ABSTRACT FROM AUTHOR]

Skin cancer is a critical global public health concern, with melanoma being the deadliest variant, correlated to 80% of skin cancer-related deaths and a remarkable propensity to metastasize. Despite notable progress in skin cancer prevention and diagnosis, the limitations of existing methods accentuate the demand for precise diagnostic tools. Biosensors have emerged as valuable clinical tools, enabling rapid and reliable point-of-care (POC) testing of skin cancer. This review offers insights into skin cancer development, highlights essential cutaneous melanoma biomarkers, and assesses the current landscape of biosensing technologies for diagnosis. The comprehensive analysis in this review underscores the transformative potential of biosensors in revolutionizing melanoma skin cancer diagnosis, emphasizing their critical role in advancing patient outcomes and healthcare efficiency. The increasing availability of these approaches supports direct diagnosis and aims to reduce the reliance on biopsies, enhancing POC diagnosis. Recent advancements in biosensors for skin cancer diagnosis hold great promise, with their integration into healthcare expected to enhance early detection accuracy and reliability, thereby mitigating socioeconomic disparities. [ABSTRACT FROM AUTHOR]

The significance of muscle biopsy as a diagnostic tool in idiopathic inflammatory myopathies (IIM) remains elusive. We aimed to determine the diagnostic weight that has been given to muscle biopsy in patients with suspected IIM, particularly in terms of clinical diagnosis and therapeutic decisions. In this retrospective multicentric study, we analyzed muscle biopsy results of adult patients with suspected IIM referred to a tertiary center between January 1, 2007, and October 31, 2021. Information regarding referral department, suspected diagnosis, biopsy site, demographic, clinical, laboratory data, and imaging results were extracted. Statistical analyses included the level of agreement between suspected and histological diagnosis and calculation of diagnostic performance (positive and negative predictive values, positive and negative likelihood ratios, sensitivity, and specificity of muscle biopsy in relation to clinical diagnosis and/or treatment initiation). Performance was tested in different strata based on clinical pre-test probability. Among 758 muscle biopsies, IIM was histologically compatible in 357/758 (47.1%) cases. Proportion of IIM was higher if there was a solid clinical pre-test probability (64.3% vs. 42.4% vs. 48% for high, medium and low pre-test probability). Sensitivity and specificity of muscle biopsy were highest (82%) when the diagnosis by the clinician was used as outcome scenario. Negative predictive value was only moderate (between 63% and 80%) and lowest if autoantibodies were positive (35%). In patients with clinically suspected IIM, approximately 50% of biopsies revealed features indicative of IIM. Diagnostic performance of muscle biopsy was moderate to high depending on clinical pre-test probability. • In case of suspected IIM, muscle biopsy is a reliable tool for confirming diagnosis. • Symptoms, elevated CK-levels and changes in EMG are indicative for IIM in biopsy. • Detection of MAA or MSA are highly relevant to establish clinical diagnosis. [ABSTRACT FROM AUTHOR]

The article analyzes the problem of developing professional reflection in Ukrainian and foreign psycho-pedagogical literature. It shows that such definitions as "reflection", "professional reflection" and "teacher's professional reflection" are interconnected in the context of general, special and specific features. A detailed review of current neurocognitive approaches has made it possible to determine the main aspects of biological mechanisms of reflection. One can see that Ukrainian psycho-pedagogical discourse does not consider neurophysiological aspects of shaping and developing professional reflection. Given the views of Ukrainian researchers on the matter, teacher's professional reflection is seen as the correlation of their capabilities with the requirements of the teaching profession; a set of internal conditions for reaching a new level of professional performance; a certain technology of objective analysis and organization of one's experience, as well as understanding and use of others' experience. Together, they determine a values-based attitude towards the teaching profession. However, Ukrainian methodology employs diagnostic tools which partially rely on the lateral features of the actors in the educational process and, thus, neuroscientific insights. [ABSTRACT FROM AUTHOR]

Background: There have been few studies on the relationship between the neutrophil to lymphocyte ratio (NLR) and necrotizing enterocolitis (NEC). We conducted a retrospective case-control study to investigate this relationship in preterm neonates.Methods: A total of 199 preterm neonates diagnosed with NEC between January 2018 and January 2020 were included in this study. For each preterm infant with NEC that was admitted to the neonatal intensive care unit (NICU), controls were preterm neonates (matched for gestation and year of birth) who were not diagnosed with NEC. Exclusion criteria were post-maturity, small or large for gestational age (week of pregnancy), congenital major anomalies, and cyanotic congenital heart disease. Univariate and multivariate logistic regression analyses were used to identify the association between NLR and preterm NEC.Results: This study included 93 preterm neonates with NEC and 106 matched controls. There were no significant differences in gestational age (GA), birth weight (BW), age, sex, vaginal delivery (VD), chorioamnionitis (CA), and gestational diabetes mellitus (GDM) between the groups. Compared with the control group, the lower and higher NLR levels in the NEC group were statistically different. Following univariate analysis, NLR was a risk factor for NEC (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.00-1.90; P = 0.042), and according to multivariate analysis, risk factors for NEC were NLR ≥ 3.20 and NLR < 1.60, within 1 week before NEC diagnosis. Thus, NLR values of ≥ 1.60 and < 3.20 were determined as the predictive cut-off values for protecting preterm infants from NEC (Model I: OR, 0.20; 95% CI, 0.10-0.40; P < 0.001) and (Model II: OR, 0.10; 95% CI, 0.00-0.40; P < 0.001].Conclusions: NLR ≥ 1.60 and NLR < 3.20 were associated with a decreased risk of NEC in preterm infants. [ABSTRACT FROM AUTHOR]

Virus pandemics have happened, are happening and will happen again. In recent decades, the rate of zoonotic viral spillover into humans has accelerated, mirroring the expansion of our global footprint and travel network, including the expansion of viral vectors and the destruction of natural spaces, bringing humans closer to wild animals. Once viral cross-species transmission to humans occurs, transmission cannot be stopped by cement walls but by developing barriers based on knowledge that can prevent or reduce the effects of any pandemic. Controlling a local transmission affecting few individuals is more efficient that confronting a community outbreak in which infections cannot be traced. Genetic detection, identification, and characterization of infectious agents using next-generation sequencing (NGS) has been proven to be a powerful tool allowing for the development of fast PCR-based molecular assays, the rapid development of vaccines based on mRNA and DNA, the identification of outbreaks, transmission dynamics and spill-over events, the detection of new variants and treatment of vaccine resistance mutations, the development of direct-acting antiviral drugs, the discovery of relevant minority variants to improve knowledge of the viral life cycle, strengths and weaknesses, the potential for becoming dominant to take appropriate preventive measures, and the discovery of new routes of viral transmission. [ABSTRACT FROM AUTHOR]

To evaluate the performance of GeneXpert MTB/RIF (Xpert) for tuberculous meningitis (TBM) and to identify additional indicators to improve diagnostic accuracy. An accuracy study was conducted. During 2011-2019, 243 TBM with 140 non-TBM in three TB-designated facilities in China were enrolled. Microbiological evidence of M tuberculosis (Mtb) in CSF was used as the reference. Additional indicators were identified by Boosted-Classification and Regression Tree (CART), the improvement of diagnostic performance was evaluated by ROC. The diagnostic sensitivity of Xpert was 71.1 % for definite TBM, and 5.5 % for probable/possible TBM. The positive rate of Xpert was improved with cerebrospinal fluid (CSF) increasing volume and was associated with CSF color (yellow). The additional indicators obtained by CART were CSF lactate and glucose and increased the sensitivity to 96.1 % (definite TBM) and 84.6 % (probable/possible TBM). The diagnostic performance of Xpert was satisfactory in definite TBM and would significantly be improved by the additional use of CSF lactate and glucose. [ABSTRACT FROM AUTHOR]

Osteoporosis, a prevalent bone disorder influenced by genetic and environmental elements, significantly increases the likelihood of fractures and bone weakness, greatly affecting the lives of those afflicted. Yet, the exact epigenetic processes behind the onset of osteoporosis are still unclear. Growing research indicates that epigenetic changes could act as vital mediators that connect genetic tendencies and environmental influences, thereby increasing the risk of osteoporosis and bone fractures. Within these epigenetic factors, certain types of RNA, such as microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), have been recognized as key regulatory elements. These RNA types wield significant influence on gene expression through epigenetic regulation, directing various biological functions essential to bone metabolism. This extensive review compiles current research uncovering the complex ways in which miRNAs, lncRNAs, and circRNAs are involved in the development of osteoporosis, especially in osteoblasts and osteoclasts. Gaining a more profound understanding of the roles these three RNA classes play in osteoporosis could reveal new diagnostic methods and treatment approaches for this incapacitating condition. In conclusion, this review delves into the complex domain of epigenetic regulation via non-coding RNA in osteoporosis. It sheds light on the complex interactions and mechanisms involving miRNAs, lncRNAs, and circRNAs within osteoblasts and osteoclasts, offering an in-depth understanding of the less explored aspects of osteoporosis pathogenesis. These insights not only reveal the complexity of the disease but also offer significant potential for developing new diagnostic methods and targeted treatments. Therefore, this review marks a crucial step in deciphering the elusive complexities of osteoporosis, leading towards improved patient care and enhanced quality of life. [ABSTRACT FROM AUTHOR]

This study aimed to validate the Greek version of the Dissociative Experience Scale (DES). A sample of 340 psychiatric outpatients and controls was selected. Part of the sample went through a retest procedure after a two-week period. Due to the absence of equivalent tests, the Multiscale Dissociation Inventory (MDI), the Structured Clinical Interview for DSM-IV-Dissociative Disorders Revised (SCID-D-R), and the Zung Self-Rating Anxiety Scale were used. Explanatory factor analysis was performed, resulting in a 28-item scale; the analysis revealed four factors, explaining 61% of total variation: Depersonalization, Amnesia, Absorption, and Miscellaneous. Cronbach's alpha coefficient for the DES was 0.95. Intraclass correlation coefficient (ICC) of the total score between the first and second interview was 0.84. Concurrent and convergent validity, as assessed by correlations with clinical assessment used as a "gold standard," (0.77), MDI (0.96), and Zung scale (0.75) were satisfactory to excellent. The total score on the DES was significantly higher in the clinical sample than in the controls (17.8 ± 16.2 vs. 5.8 ± 7.2, p <.001), indicating high discriminant validity. After the ROC analysis was run, the best compromise between sensitivity/specificity was achieved at the value of 20. The Greek version of the DES is a reliable and valid tool suitable to assess dissociation in clinical and healthy populations. [ABSTRACT FROM AUTHOR]

The COVID-19 is a highly contagious disease represented with multiple non specific symptoms and caused by Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2). Despite its dissemination and worsening trends researchers are still searching for the best treatment option. Timely diagnosis is the key to get more appropriate treatment regimen. Several clinical trials are ongoing to determine the efficacy and safety of existing and new therapies against Coronavirus Disease -2019 (COVID-19). These include corticosteroids, antivirals, monoclonal antibodies, interferon Alpha 2b and other immune modulators. In addition to treatment, efficacious and safe vaccines are required to slow viral transmission and to prevent further morbidity and mortality. The vaccination is useful tool to get control over the virus. Although, mass immunisation campaigns are ongoing in many countries, global coverage is crucial for getting the pandemic under control. This descriptive review collated the information on current diagnostics tools for determination of COVID-19 infection and available preventive and therapeutic strategies based on the ongoing clinical trials data and published literature. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2). The disease was first identified in December 2019 in Wuhan, the capital of China's Hubei province, and has since spread globally, resulting in the ongoing 2019-20 coronavirus pandemic. The COVID-19 pandemic has placed incredible tension on healthcare systems around the globe. Common symptoms include fever, cough, and shortness of breath. Other symptoms may include muscle pain, diarrhea, sore throat, loss of smell, and abdominal pain. It is challenging for doctors and physicians to distinguish COVID-19 from other acute respiratory tract infections via clinical symptoms because those who are infected display a wide range of symptoms. An effective, point-of-care (POC) diagnostic tool could ease healthcare system strain, protect healthcare professionals, and support quarantine efforts. With a lack of effective medical treatments or vaccines for COVID-19, early identification and patient isolation has been the most effective means of disease management to slow the spread of the pandemic. COVID-19 testing involves analyzing samples to assess the current or past presence of SARS-CoV-2. The two main branches detect either the presence of the virus or of antibodies produced in response to infection. Test analysis is often performed in automated, high-throughput, medical laboratories by medical laboratory scientists. In this article, we have discussed the currently used diagnostic tests for detection of Coronavirus and COVID-19. [ABSTRACT FROM AUTHOR]

Developing optimal T-cell response assays to severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is critical for measuring the duration of immunity to this disease and assessing the efficacy of vaccine candidates. These assays need to target conserved regions of SARS-CoV-2 global variants and avoid cross-reactivity to seasonal human coronaviruses. To contribute to this effort, we employed an in silico immunoinformatics analysis pipeline to identify immunogenic peptides resulting from conserved and highly networked regions with topological importance from the SARS-CoV-2 nucleocapsid and spike proteins. A total of 57 highly networked T-cell epitopes that are conserved across geographic viral variants were identified from these viral proteins, with a binding potential to diverse HLA alleles and 80 to 100% global population coverage. Importantly, 18 of these T-cell epitope derived peptides had limited homology to seasonal human coronaviruses making them promising candidates for SARS-CoV-2-specific T-cell immunity assays. Moreover, two of the NC-derived peptides elicited effector/polyfunctional responses of CD8+ T cells derived from SARS-CoV-2 convalescent patients. [ABSTRACT FROM AUTHOR]

Magnetic levitation (MagLev) is a well-documented, robust technique for density measurements and separations. Although the potential of MagLev as an emerging tool in biotechnology has been recently investigated, the practical use of MagLev in diagnosis and disease detection merits further attention. This review highlights the diagnostic capacity of a simple and portable MagLev system and the possibilities and limitations of the MagLev technique for density-based separation, classification, and manipulation of soft matter and biological systems (e.g., cells, proteins), which in turn may pave the way for the discovery of disease-specific biomarkers. The magnetic levitation (MagLev) technique enables the separation, measurement, and analysis of a wide range of materials and biosystems. The simple, inexpensive, rapid, and energy-free MagLev technique can detect and separate useful biomarkers involved in disease progression from their complex environments, which has great potential in diagnostic and biomedical applications. MagLev can also rapidly identify and discriminate a variety of biomolecules as they experience various physiological conditions in a biological complex and consequently change density, including drug screening in personalized medicine. MagLev can furthermore detect changes in the density of biomolecules in certain diseases, creating a point-of-care device for diagnostic purposes. [ABSTRACT FROM AUTHOR]

Hantaviruses are enveloped negative (−) single‐stranded RNA viruses belongs to Hantaviridae family, hosted by small rodents and entering into the human body through inhalation, causing haemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS) also known as hantavirus cardiopulmonary syndrome (HCPS). Hantaviruses infect approximately more than 200 000 people annually all around the world and its mortality rate is about 35%–40%. Hantaviruses play significant role in affecting the target cells as these inhibit the apoptotic factor in these cells. These viruses impair the integrity of endothelial barrier due to an excessive innate immune response that is proposed to be central in the pathogenesis and is a hallmark of hantavirus disease. A wide range of different diagnostic tools including polymerase chain reaction (PCR), focus reduction neutralization test (FRNT), enzyme‐linked immunosorbent assay (ELISA), immunoblot assay (IBA), immunofluorescence assay (IFA), and other molecular techniques are used as detection tools for hantavirus in the human body. Now the availability of therapeutic modalities is the major challenge to control this deadly virus because still no FDA approved drug or vaccine is available. Antiviral agents, DNA‐based vaccines, polyclonal and monoclonal antibodies neutralized the viruses so these techniques are considered as the hope for the treatment of hantavirus disease. This review has been compiled to provide a comprehensive overview of hantaviruses disease, its pathophysiology, diagnostic tools and the treatment approaches to control the hantavirus infection. [ABSTRACT FROM AUTHOR]

For several years, poultry production in Egypt has been suffering from co‐circulation of multiple respiratory viruses including highly pathogenic avian influenza virus (HPAIV) H5N1 (clade 2.2.1.2) and low pathogenic H9N2 (clade G1‐B). Incursion of HPAIV H5N8 (clade 2.3.4.4b) to Egypt in November 2016 via wild birds followed by spread into commercial poultry flocks further complicated the situation. Current analyses focussed on 39 poultry farms suffering from respiratory manifestation and high mortality in six Egyptian governorates during 2017–2018. Real‐time RT‐PCR (RT‐qPCR) substantiated the co‐presence of at least two respiratory virus species in more than 80% of the investigated flocks. The percentage of HPAIV H5N1‐positive holdings was fairly stable in 2017 (12.8%) and 2018 (10.2%), while the percentage of HPAIV H5N8‐positive holdings increased from 23% in 2017 to 66.6% during 2018. The proportion of H9N2‐positive samples was constantly high (2017:100% and 2018:63%), and H9N2 co‐circulated with HPAIV H5N8 in 22 out of 39 (56.8%) flocks. Analyses of 26 H5, 18 H9 and 4 N2 new sequences confirmed continuous genetic diversification. In silico analysis revealed numerous amino acid substitutions in the HA and NA proteins suggestive of increased adaptation to mammalian hosts and putative antigenic variation. For sensitive detection of H9N2 viruses by RT‐qPCR, an update of primers and probe sequences was crucial. Reasons for the relative increase of HPAIV H5N8 infections versus H5N1 remained unclear, but lack of suitable vaccines against clade 2.3.4.4b cannot be excluded. A reconsideration of surveillance and control measures should include updating of diagnostic tools and vaccination strategies. [ABSTRACT FROM AUTHOR]

In autism spectrum disorders, diagnosing it is a matter of importance for two reasons: screening for reducing of expenses and diagnosing for well-timed and important intervening. Therefore; this study is a systematic review on autism spectrum disorders diagnostic tools emphasizing Iran's diagnostic system. Using systematic review study method, key words like screening tool autism and diagnostic tool on information sources like science direct, Springer, Scopus and Googlescholar and also using screeningand diagnostic tools of Autism on information sources like magiran and SID, this study was carried out and during 1980 until 2020, 144 essays were done and by using systematic sampling 58 of them were finally resulted. Results showed that among tools created for autism spectrum disorders, 6 screening tools, 8 diagnostic tools, 2 native Iranian tools and 34 tools connected with normalization results belonged to other countries and 10 papers on considered tools normalization were done in Iran. It seems that for applying useful and valid tools to diagnosing the Iranian autistic kid, normalizing more tests is required so that diagnosing process by valid tools can be made. [ABSTRACT FROM AUTHOR]

The assessment of the state of degradation of audio carriers is a crucial step in the preservation workflow. This requires targeted diagnostic tools, and a shared vocabulary to describe the symptomatology in an objective way. This article presents a framework for the evaluation of the symptoms and signs of degradation of audio media, with a comprehensive dictionary including 182 unique definitions, applied to eight different audio media types. A five stepped rating scale is associated to each item in the dictionary. Multimedia reference material is provided for comparative purposes. The article also includes a detailed description of the framework's implementation in a relational database, in the form of an independent module that can easily be integrated in existing information management systems. The possibility to develop the evaluation reference system into a collaborative 'hypermedia knowledge base' is built into the framework's design. The technology to start accumulating a critical mass of data is available and inexpensive, and it would help achieve much more consistent evaluations not just at collection level but across collections. [ABSTRACT FROM AUTHOR]

Objective: To create a language independent version of the Listening in Spatialised Noise – Sentences test (LiSN-S) and evaluate it in an English-speaking population. Design: Test development and normative data collection. LiSN-Universal (LiSN-U) targets consisted of CVCV pseudo-words (e.g. /mupa/). Two looped distracter tracks consisted of CVCVCVCV pseudo-words. The listener's task was to repeat back the target pseudo-words. Stimuli were presented over headphones using an iPad. Speech reception thresholds were measured adaptively. In the co-located condition all stimuli came from directly in front. In the spatially-separated condition the distracters emanated from +90° and −90° azimuth. Perceived location was manipulated using head-related transfer functions. Spatial advantage was calculated as the difference in dB between the co-located and spatially separated conditions. Study samples: Stimulus intelligibility data were collected from 20 adults. Normative data were collected from native English speakers (23 adults and 127 children). Results: Children's spatially separated, co-located, and spatial advantage results improved significantly with age. Spatial advantage was 4–6 dB larger in the LiSN-U than LiSN-S depending on age group. Conclusion: Whereas additional research in non-native English populations is required, the LiSN-U appears to be an effective tool for measuring spatial processing ability. [ABSTRACT FROM AUTHOR]

Muscle complaints are frequently reported symptoms which can occur in the context of numerous and not always primary muscle diseases. Further diagnostic steps are not always warranted. The presence of distinct warning symptoms represents the base for further decision making. Warning symptoms include among others myalgia/weakness/atrophy/hypertrophy of distinct muscle groups, fasciculations, dysphagia, bulbar signs, abnormal reflexes, signs for a systemic autoimmune disorder/connective tissue disease or a persisting CK elevation (>1000 U/l) even in asymptomatic patients. Depending on the indication important diagnostic steps include lab tests, MRI, E(N)MG, specific endurance tests, muscle biopsy or genetic tests. [ABSTRACT FROM AUTHOR]

The increased modularity in the total hip arthroplasty (THA) allows adapting the prosthesis to the specific anatomical characteristics of each patient. However, the advantages of the modular THA are shadowed by the increased number of prosthesis failures observed in patients. The presence of junction in modular THA may increase its risk of mechanical failure. Moreover, the micro movements between neck and stem could lead to the production of metallic debris which may cause tissue inflammation and unsealing of prosthesis due to osseous dissolution. It is necessary to understand the mechanism of dispersion of the metal particles from the prosthesis into the tissue. Techniques currently applied in hospitals, such as X-ray scans or optical tissue microscopies, are able to distinguish metal particles, but unable to identify their specific metallic origin. In this work, within the TissueMaps project, we have proved that Proton Induced X-ray Emission (PIXE) is able to provide the distribution and elemental composition of particles from the prosthesis into the pseudo capsular tissue samples (near the femoral head) and identify the features observed under optical microscopy, in a case of broken neck prosthesis. [ABSTRACT FROM AUTHOR]

Introduction: Acute kidney injury in pediatric patients (pAKI) is common in developing countries and leads to significant morbidity and mortality. Most nephrology services in developing countries are only in larger cities and for that reason many cases remain undiagnosed. We evaluated the performance of a saliva urea nitrogen (SUN) dipstick to diagnose pAKI in Sudan. Methods: We collected demographic and clinical information, serum creatinine (SCr), blood urea nitrogen (BUN), SUN, and urine output (UO) in children with pAKI. pAKI was diagnosed based on different criteria (Risk, Injury, Failure, Loss of kidney function, and end-stage kidney disease, Acute Kidney Injury Network and Kidney Disease Improving Global Outcomes). We also recorded hospital and 3-months' mortality and progression to chronic kidney disease (CKD) as outcomes. Results: We studied 81 patients (mean age 10.7 ± 7 years, 51.9% females) and divided them by age into (a) neonates (<120 days; n = 21; 25.9%); (b) -infants (120–365 days; n = 18; 25.9%); and (c) children (>365 days; n = 42; 53.1%). Diagnosis using different pAKI definitions resulted in differences in AKI staging. SUN reliably reflected BUN over the entire study period, regardless of treatment modality or pAKI severity. Neither pAKI staging, SUN, BUN, nor SCr were associated with mortality or progression to CKD. UO predicted all-cause mortality during the 3-months follow-up. Conclusion: Diagnosis of pAKI using different criteria differs in triage and staging. SUN reflects BUN particularly at higher BUN levels and allows monitoring of treatment responses. Despite the lack of predictive power of SUN to predict hard outcomes, measurement of SUN by dipstick can be used to identify, screen, and monitor pediatric patients with pAKI. [ABSTRACT FROM AUTHOR]

Idiosyncratic drug‐induced liver injury (DILI) is a challenging liver disorder because it can present with a range of phenotypes, mimicking almost every other hepatic disease, and lacks specific biomarkers for its diagnosis. Hence, a confident DILI diagnosis is seldom possible as it relies on the precise establishment of a temporal sequence between the exposure to a given prescription drug or sometimes hidden herbal product/over the counter medication as well as the exclusion of other aetiologies of liver disease. However, an accurate diagnosis is of most importance, as prompt withdrawal of the causative agent is essential in DILI management. Indeed, DILI can be severe and even fatal or in a fraction of cases evolve to chronic damage, but specific biomarkers for predicting mortality/liver transplantation or a chronic outcome in the very early phases of DILI are not yet available. In this article, we discuss the best diagnostic and prognostic approach of a DILI suspicion by judiciously choosing and interpreting the standard tests currently used in clinical practice. [ABSTRACT FROM AUTHOR]

• A framework for evaluating solar irradiance probabilistic forecasts is proposed. • The verification framework is based on visual diagnostic tools and a set of scores. • The verification metrics are applied to ensemble and quantile forecasts. • It is recommended to use a set of scores to assess the quality of the forecasts. We propose a framework for evaluating the quality of solar irradiance probabilistic forecasts. The verification framework is based on visual diagnostic tools and a set of scoring rules mostly originating from the weather forecast verification community. Two types of probabilistic forecasts are used as a basis to illustrate the application of these verification approaches. The first one consists in ensemble forecasts commonly provided by national or international meteorological centres. The second one originates from statistical methods and produces a set of discrete quantile forecasts, the nominal proportions of which span the unit interval. These probabilistic forecasts are evaluated for two selected sites that experience very different climatic conditions. The first site is located in the continental US while the second one is situated on La Réunion Island. Although visual diagnostic tools can help identify deficiencies in generated forecasts, it is recommended that a set of numerical scores be used to assess the quality of probabilistic forecasts. In particular, the Continuous Ranked Probability Score (CRPS) seems to have all the features needed to evaluate a probabilistic forecasting system and, as such, may become a standard for verifying solar irradiance probabilistic forecasts and by extension probabilistic forecasts of solar power generation. [ABSTRACT FROM AUTHOR]