Asymptomatic Individuals Research Articles

Reliability and concurrent validity of the bubble inclinometer for visual estimation of straight leg raise in asymptomatic individuals

IntroductionThe straight leg raise (SLR) test is commonly used to investigate neurodynamic problems or hamstring muscle length. Visual estimation can be used to identify the degrees of hip flexion during the SLR test. However, intra-tester and inter-tester reliability, as well as concurrent validity, await formal investigation.MethodsThis study was an experimental study. Two testers, a novice and an experienced physical therapist, measured hip flexion angles during the SLR test using visual estimation for two sessions and the bubble inclinometer method during the first session in 31 asymptomatic participants, in random order. Intra-tester reliability (intraclass correlation coefficient, ICC<sub>3,3</sub>), inter-tester reliability (ICC<sub>2,3</sub>), concurrent validity (Pearson correlation with bubble inclinometer), and measurement error was represented as standard error of measurement (SEM) and minimal detectable change (MDC), were calculated.ResultsThe concurrent validity and intra-tester reliability of visual estimation for both testers were good (ICC<sub>3,3</sub> = 0.885 with 95% confidence interval = 0.775–0.943, <i>p</i> < 0.001) and excellent (ICC<sub>3,3</sub> = 0.904 with 95% confidence interval = 0.810–0.952, <i>p</i> < 0.001), respectively. Inter-tester reliability of visual estimation was poor (ICC<sub>2,3</sub> = 0.373 with 95% confidence interval = 0.027–0.639, <i>p</i> = 0.018).ConclusionsAlthough the concurrent validity of visual estimation with the bubble inclinometer was good, and intra-tester reliability was excellent, the inter-tester reliability was poor. Therefore, caution should be exercised if more than one tester is involved in visual estimation.

The open Latarjet procedure does not affect scapulohumeral rhythm three months postoperatively

BackgroundAlthough it is considered a sensitive indicator of shoulder disabilities, the scapulohumeral rhythm has not been investigated after anterior glenohumeral stabilization with open Latarjet procedure. This study aimed to assess the short-term influence of glenohumeral stabilization on scapulohumeral rhythm in patients who underwent open Latarjet procedure compared to asymptomatic individuals. MethodsA group of male patients who underwent anterior glenohumeral stabilization by open Latarjet procedure and a healthy group were enrolled in this study. An electromagnetic device was used to record scapulothoracic and glenohumeral joint kinematics during dynamic arm elevation and depression in the scapular plane before and three months after surgery. Then, the three-dimensional dynamic scapulohumeral rhythm was computed bilaterally. SPM ANOVAs were used for statistical analysis. FindingsTwenty-two participants per group were included. The scapulohumeral rhythm of the two groups increased from 1.88 [mean] ± 0.79 [standard deviation] to 2.83 ± 1.52 during the ascending phase, while a decrease followed by a slight increase in the scapulohumeral rhythm were observed during the descending phase. The scapulohumeral rhythm did not significantly differ between the operated and non-operated sides or before and after surgery. When pooling the sides for each group, no significant differences were observed between the groups. InterpretationThe scapulohumeral rhythm in patients who underwent the Latarjet procedure is not modified three months after surgery and is similar to the scapulohumeral rhythm of asymptomatic individuals. These findings suggest that in addition to restoring glenohumeral stability, the open Latarjet procedure preserves shoulder joint coordination three months postoperatively.

Associations between Various Inflammatory Markers and Carotid Findings in a Voluntary Asymptomatic Population Sample.

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide, and atherosclerosis is the key factor promoting its development. Carotid intima-media thickening and the presence of carotid plaques are important indices of cardiovascular risk. In addition, inflammation is a major and complex factor in the development of atherosclerosis. The relationships between carotid atherosclerosis and certain inflammatory markers have rarely been studied in healthy individuals. Therefore, we aimed to investigate the associations between subclinical carotid atherosclerosis and various inflammatory biomarkers in a large Caucasian population free of evident CVD. In addition to recording study participants' demographic characteristics, anthropometric characteristics, and atherosclerotic risk factors, laboratory tests were performed to measure levels of hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein, and inflammatory cytokines/chemokines, including interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-18, IL-23, IL-33, interferon (IFN)-α2, IFN-γ, tumor necrosis factor-α, and monocyte chemoattractant protein (MCP)-1. This study included 264 asymptomatic individuals with a median age of 61.7 years (interquartile range, 54.5-67.5 years); 45.7% of participants were male. Participants were divided into two groups according to their carotid status: the normal carotid group, comprising 120 participants; and the pathological carotid group, comprising 144 participants. Compared with the normal carotid group, hypertension and diabetes mellitus were significantly more common and serum levels of HbA1c, IL-8, and MCP-1 were significantly higher in the pathological carotid group. Multivariate regression analysis revealed significant positive associations between pathological carotid findings and serum levels of IL-8 (highest tertile, OR: 2.4, p = 0.030) and MCP-1 (highest tertile, OR: 2.4, p = 0.040). Our results suggest that IL-8 and MCP-1 may serve as early indicators of subclinical atherosclerosis, thereby helping to identify individuals at increased risk of CVD before the onset of clinical symptoms.

Asymptomatic carriage of Plasmodium falciparum in children living in a hyperendemic area occurs independently of IgG responses but is associated with a balanced inflammatory cytokine ratio

BackgroundAsymptomatic carriage of infected red blood cells (iRBCs) can be prevalent in communities regardless of transmission patterns and can occur with infection of different Plasmodium species. Clinical immunity dampens the inflammatory responses leading to disease symptoms in malaria. The aim of this study was to define the immunological correlates of asymptomatic carriage of Plasmodium falciparum in a highly exposed population.Methods142 asymptomatic Plasmodium-infected individuals greater than 2 years of age without fever (body temperature <37.5 ℃) were followed weekly for 10 weeks before being treated with artemisinin-based combination therapy (ACT). Plasma levels of 38 cytokines were measured at baseline by Luminex and the quantity and growth inhibitory activities of circulating parasite-reactive antibodies measured. The Plasmodium antigen tested included P. falciparum merozoite extract (ME) and schizont extract (SE), and the recombinant proteins erythrocyte binding antigen 175 (EBA-175) and merozoite surface protein 1 (MSP-119).ResultsMedian levels of IgG against P. falciparum EBA-175 and MSP-119 at baseline were significantly higher in those older than 20 years of age compared with the younger age group and appeared to correlate with better parasite control. Amongst all participants there were no discernible changes in IgG levels over time. Parasite density was higher in the younger age group and associated with IL-10, TNF and MCP-1 levels. A balanced IL-10:TNF ratio was associated with asymptomatic malaria regardless of age, and balanced ratios of IL-10/TNF and IL-10/IFN-γ were the only significant correlate of maintenance of asymptomatic malaria over the course of the study in individuals 20 years of age and younger.ConclusionThe above findings indicate that asymptomatic carriage of P. falciparum in children living in a hyperendemic area occurs independently of IgG but is associated with a balanced inflammatory cytokine ratio.

Cardiovascular Aging and Risk Assessment: How Multimodality Imaging Can Help.

Aging affects the cardiovascular system, and this process may be accelerated in individuals with cardiovascular risk factors. The main vascular changes include arterial wall thickening, calcification, and stiffening, together with aortic dilatation and elongation. With aging, we can observe left ventricular hypertrophy with myocardial fibrosis and left atrial dilatation. These changes may lead to heart failure and atrial fibrillation. Using multimodality imaging, including ultrasound, computed tomography (CT), and magnetic resonance imaging, it is possible to detect these changes. Additionally, multimodality imaging, mainly via CT measurements of coronary artery calcium or ultrasound carotid intima-media thickness, enables advanced cardiovascular risk stratification and helps in decision-making about preventive strategies. The focus of this manuscript is to briefly review cardiovascular changes that occur with aging, as well as to describe how multimodality imaging may be used for the assessment of these changes and risk stratification of asymptomatic individuals.

Basal inferoseptal segment is highly susceptible to deformation in the clinical spectrum of transthyretin-derived amyloid cardiomyopathy.

While the prevalence of transthyretin-derived amyloid cardiomyopathy (ATTR-CM) is on the rise, detailed understanding of its morphological and functional characteristics within the left ventricle (LV) across heart failure (HF) remains limited. Utilizing two-dimensional (2D) speckle-tracking echocardiography, we assessed longitudinal strain (LS) in 63 histology-confirmed ATTR-CM patients. Additionally, cardiac magnetic resonance (CMR) images measured native T1 and extracellular volume (ECV), compared with LS across 18 LV segments. Patients were categorized into three groups based on HF status: Group 1 (no HF symptoms), Group 2 (HF with preserved LV ejection fraction), and Group 3 (HF with reduced LV ejection fraction). LS analysis unveiled susceptibility to deformation in the basal inferoseptal segment, persisting even in asymptomatic cases. CMR demonstrated increasing native T1 deviation, particularly evident in segments distant from the inferoseptal region. Contrastingly, maximal ECV was consistently observed in the basal and mid-ventricular inferior-septum, even in asymptomatic individuals. Segmental LS decline correlated with ECV expansion but not with native T1 values. Our findings suggest that the inferoseptal segment is highly susceptible to amyloid infiltration, and 2D speckle-tracking echocardiography and CMR may serve as a valuable tool for its early detection.

Prevalence of Hypertension among Asymptomatic Patients During Screening in the Primary Health Care Center, Riyadh, Saudi Arabia

Background: Hypertension is a significant public health problem globally, its prevalence and incidence are commonly seen in the Mideast countries, particularly in Saudi Arabia. It is a chronic disease that can harm many systems with its prevalence varying across different populations. The asymptomatic pattern of hypertension makes it a challenging disease. Screening for hypertension in asymptomatic individuals is crucial for early detection and management to prevent complications. Aim: we aim in our study to clarify prevalence of hypertension between asymptomatic patients during screening at primary health care centers in Saudi Arabia.Methods: In Riyadh, Saudi Arabia, Prince Sultan Medical City, observational research was carried out. Participants in the study were asymptomatic people getting regular checkups at primary health care centers. Blood pressure (BP) was taken using standardized protocols, with hypertension being defined as a systolic blood pressure (SBP) reading of at least 140 millimeters of mercury and/or a diastolic blood pressure (DBP) measurement of no fewer than 90 millimeters of mercury. Data were collected and analyzed to determine the prevalence of hypertension individuals in the study population. Results: A total of three hundred asymptomatic patients were incorporated into the study. The mean patient age was 41.22 years, with 25.7 % being male and 74.3 % female. The overall incidence of hypertension between asymptomatic patients during screening was found to be 20%. Subgroup analysis using age, sex, and other relevant factors will also be presented in the final report. Conclusion: Our study sheds light on the high incidence of hypertension among asymptomatic individuals during evaluation at primary health care centers in Prince Sultan Medical City, Saudi Arabia. The findings underline the importance of routine BP screening in the early identification and treatment of hypertension, which reduces the prevalence of cardiovascular disease in the general population.

Genetic analysis of asymptomatic antinuclear antibody production.

Antinuclear antibodies (ANA) are detected in up to 14% of the population and the majority of individuals with ANA are asymptomatic. The literature on the genetic contribution to asymptomatic ANA positivity in the population is limited. In this study, we aimed to perform a multi-ancestry genome-wide association study (GWAS) of asymptomatic ANA positivity. Asymptomatic ANA positive and negative individuals from the All of Us Research Program were included in this study, selecting those with an ANA test by immunofluorescence and no evidence of autoimmune disease. Imputation was performed and a multi-ancestry meta-analysis including approximately 6 million single-nucleotide polymorphisms (SNPs) was conducted. Genome-wide SNP based heritability was estimated using the GCTA software. A cumulative genetic risk score for lupus was constructed using previously reported genome-wide significant loci. 1,955 asymptomatic ANA positive and 3,634 asymptomatic ANA negative individuals were included across three genetic ancestries. The multi-ancestry meta-analysis revealed SNPs with a suggestive association (p-value < 1×10 -5 ) across 8 different loci, but no genome-wide significant loci were identified. A gene variant upstream of HLA-DQB1 (rs17211748, P = 1.4×10 -6 , OR = 0.82, 95% CI 0.76-0.89) showed the most significant association. The heritability of asymptomatic ANA positivity was estimated to be 24.9%. Asymptomatic ANA positive individuals did not exhibit increased cumulative genetic risk for lupus compared to ANA negative individuals. ANA production is not associated with significant genetic risk and is primarily determined by non-genetic, likely environmental, factors.

Revealing the unrevealed: echocardiography for non-ischemic scar tissue detection.

The detection of myocardial scar tissue profoundly influences athletes care and prognostic categorization. Athletes appear to be at risk of developing fatal arrhythmias when harboring a quiescent cardiac disorder. Early identification of disease in asymptomatic individuals through preparticipation screening is means to prevent these events. We presented a male marathon runner master athlete who came at our Department of Sports Medicine for a preparticipation screening. Baseline 12-lead standard electrocardiogram was normal. A maximal cycle ergometer exercise test revealed exercise-induced premature ventricular contractions (PVCs) with uncommon morphology. Echocardiography revealed an hyperechogenic zone at mid-basal posterior segments of the left ventricle. Twenty-four-hours ECG Holter monitoring, with training session, showed some isolated polymorphic PVCs even during training session. Cardiac magnetic resonance (CMR) confirmed the presence of a non-ischemic left ventricular scar (subepicardial) into the mid-basal segment of the posterior wall. Echocardiography is a first-line, economic, and accessible diagnostic test for athletes and it can be useful, when abnormalities are detected, to indicate further investigations, such as CMR. Although non-ischemic left ventricular scarring is difficult to detect on echocardiography, this event is sometimes possible and require further investigation when observed.

Clinical Implementation of Amyloid PET: Latest Findings and Practical Approaches in the Diagnosis and Treatment of Alzheimer's Disease

Amyloid PET plays a crucial role in the early diagnosis of Alzheimer's disease and the determination of the feasibility of disease-modifying therapies. It offers several advantages, including high sensitivity and specificity, minimal invasiveness, and the ability to provide spatial evaluation, all of which contribute to the optimization of dementia care. However, proper use and interpretation of the results require a thorough understanding of their limitations. Although careful consideration is necessary when using scans on asymptomatic individuals, clinical applications could broaden if preemptive treatments and high-precision individual risk assessments for the preclinical stage are developed.

557P Three-year update of real-world evaluation of ColonAiQ for colorectal cancer screening in asymptomatic individuals

557P Three-year update of real-world evaluation of ColonAiQ for colorectal cancer screening in asymptomatic individuals

Screening for Small Airway Obstruction in Garment Industry: A Pilot Study

Abstract Aim and Background: A noticeable gap in the literature is observed in factors associated with the occurrence of respiratory illness among people working in garment industries. This study aims to investigate whether spirometry screening is warranted for individuals employed within the garment industry. Subjects and Methods: This is an observational cross-sectional pilot study conducted in asymptomatic workers of various sectors in a garment industry using spirometry to check for the presence of small airway obstruction. Duration of work along with the nature of work was taken into consideration to see if any correlation exists with the small airway obstruction. Results: A random sample of 40 asymptomatic individuals was drawn consisting of 16 males and 24 females with 47.5% of them working for around 5–10 years. Ninety-five percentage showed no evidence of small airway obstruction and only 5% showed small airway obstruction showing that no correlation exists between the duration of work and the development of small airway obstruction in the garment industry. Conclusion: There appears to be no significant link between the duration of employment in the garment industry and the development of small airway obstruction as compared to the textile/cotton industry, yet annual screening could be integrated into routine health assessments.

Investigating seroprevalence of IgG antibodies against Monkeypox Virus (MPXV) in a cohort of people living with HIV (PLWH) in Rome, during the 2022 outbreak: Moving beyond traditional at-risk populations

BackgroundHigh incidence mpox rates suggest asymptomatic individuals may contribute to virus transmission. We undertook this study to assess the seroprevalence of IgG anti-MPXV in a cohort of asymptomatic PLWH, to analyze the size of the phenomenon of asymptomatic infections. Materials and methodsFrom October 2022 to March 2023 we serially collected serum samples from PLWH attending our Clinic. IgG against MPXV have been assessed on stored cryopreserved samples with an ELISA. Only people with no previous reported vaccine against smallpox or mpox nor previous clinical manifestations consistent with a mpox diagnosis were included. Results285 PLWH were included. Twenty-one participants tested positive for IgG anti MPXV (7.37 %, 95 % CI 4.62–11.0). Seropositivity was predominant in male (15/285, 71.4) with a small fraction of female (6/285,28.6 %) and PWID (1/285,4.8 %). ConclusionsOur findings suggest the possibility of an asymptomatic course of the mpox infection even in populations beyond traditional high-risk groups.

Coronary Microvascular Function in Asymptomatic Middle-Aged Individuals With Cardiometabolic Risk Factors.

In patients with ischemic heart disease, coronary microvascular dysfunction is associated with cardiovascular risk factors and poor prognosis; however, data from healthy individuals are scarce. The purpose of this study was to assess the impact of cardiovascular risk factors and subclinical atherosclerosis on coronary microvascular function in middle-aged asymptomatic individuals. Myocardial perfusion was measured at rest and under stress using cardiac magnetic resonance in 453 individuals and used to generate myocardial blood flow (MBF) maps and calculate myocardial perfusion reserve (MPR). Subclinical atherosclerosis was assessed using 3-dimensional vascular ultrasound of the carotid and femoral arteries and coronary artery calcium scoring at baseline and at 3-year follow-up. Median participant age was 52.6 years (range: 48.9-55.8 years), and 84.5% were male. After adjusting for age and sex, rest MBF was directly associated with the number of the metabolic syndrome components present (elevated waist circumference, systolic and diastolic blood pressure, fasting glucose, and triglycerides and low high-density lipoprotein cholesterol), insulin resistance (homeostatic model assessment for insulin resistance), and presence of diabetes. MPR was reduced in the presence of several metabolic syndrome components, elevated homeostatic model assessment for insulin resistance, and diabetes. Stress MBF was inversely associated with coronary artery calcium presence and with global plaque burden. Higher stress MBF and MPR were associated with less atherosclerosis progression (increase in plaque volume) at 3 years. In asymptomatic middle-aged individuals free of known cardiovascular disease, the presence of cardiometabolic risk factors and systemic (poly-vascular) subclinical atherosclerosis are associated with impaired coronary microvascular function. Better coronary microvascular function reduces atherosclerosis progression at follow-up. (Progression of Early Subclinical Atherosclerosis [PESA]; NCT01410318).

Assessing hip joint-related structure and patient-reported outcomes in people with Marfan syndrome.

People with Marfan syndrome (MFS) have clinical symptoms of hip pain, but to date, there is limited knowledge about hip-related structural abnormalities in these patients. Therefore, the purpose of this cross-sectional study was to assess hip-related structural abnormalities and patient-reported outcomes (PRO) in a cohort of patients with MFS compared to healthy controls. Nineteen individuals with MFS(17 females, 39.8±11.5 years) and 19 age, sex, and body mass index-matched healthy, asymptomatic individuals (17 females, 36.2±12.5 years)underwent radiographic imaging and unilateral hip MRI. The Scoring Osteoarthritis with MRI (SHOMRI) technique was used to assess hip-related morphological abnormalities between the MFS and control groups. All participants completed the Hip disability and Osteoarthritis Outcome Score (HOOS) to assess hip-related symptoms, pain, and function during activities of daily living (ADL) and quality of life (QOL). The MFS group exhibited higher lateral center edge angles (p < .001). Despite similar severity of femoral cartilage damage (p = 1.0), the MFS group exhibited a higher severity (p = 0.046)of acetabular cartilage degeneration (1.21±1.08) compared to the controls(0.53±1.02). There were no between-group differences in severity of labral pathology, subchondral cysts, or edema. Individuals with MFS also self-reported significantly lower HOOS symptoms (p = 0.003), pain (p = 0.014), ADL (p = 0.028), and QOL (p = 0.014) sub-scores, indicating worse hip-related PRO in MFS. Our study results suggest that individuals with MFS exhibit early signs of acetabular cartilage degeneration and poor hip-related clinical outcomes compared to healthy individuals. Future work should investigate the underlying biomechanical mechanisms associated with hip joint degeneration in the MFS population.

Myofascial release; a diagnostic tool for knee-abdomen and knee myofascial pain syndromes in knee osteoarthritic patients. An interventional based prevalence study

Background. Knee osteoarthritis (OA) is detected in all grades in imaging of asymptomatic individuals. Knee-abdomen syndrome (KAS) and knee myofascial pain syndrome (KMPS) are newly identified syndromes of knee pain originating from myofascial induced stress upon the knee’s capsule. Objective. To measure the prevalence of KAS and KMPS among knee OA patients and explore the concepts of the new syndromes. Methods. An intervention-based prevalence study was conducted with a representative sample of 61 knee OA patients who underwent one session of Myofascial release (MFR). Pain was evaluated and averaged pre- and post-MFR during standing, active knee flexion, extension, and squats. A pain reduction of 50% is considered diagnostic for KMPS and KAS. Pain reduction maintained for one week indicates KAS. Results. KAS and KMPS were reconstructed as part of the knee myofascial pain spectrum (KMPs). 13% of patients had KMPs with asymptomatic OA and 100% pain reduction post-MFR. 20% had symptomatic OA with no pain reduction. 67% of patients had KMPs with more than 20% pain reduction. Conclusion. KMPs was identified in the majority of knee OA patients. Asymptomatic OA was misdiagnosed as the source of pain in 13% of patients.

Comparative Effects of Neurodynamic Slider and Tensioner Mobilization Techniques on Sympathetic Nervous System Function: A Randomized Controlled Trial.

Objective: To investigate the effect of slider and tensioner neurodynamic techniques (NDTs) on the sympathetic nervous system (SNS) activity, aiming to identify which technique more effectively modulates autonomic responses in asymptomatic individuals. Materials and Methods: In this double-blind controlled trial, a total of 90 healthy participants were randomly allocated into three groups: slider, tensioner, and control. Skin conductance (SC) was continuously monitored throughout the entire 20 min experiment, while body temperature and blood pressure were measured pre- and post-intervention. Results: The SC levels significantly increased in both the slider and tensioner groups compared to the control group during the intervention and end rest period on the left leg (slider vs. control: p < 0.001, d = 1.20; tensioner vs. control: p < 0.001, d = 1.64) and on the right leg (slider vs. control: p < 0.001, d = 1.47; tensioner vs. control: p < 0.001, d = 0.73). There were no significant differences between the two NDTs on the left (p < 0.13, d = 0.89) and right legs (p < 1.00, d = 0.36). The body temperature of the slider group showed a significant increase compared to both the control group (p < 0.001, d = 0.95) and the tensioner group (p < 0.001, d = 1.48). There were no significant differences between the groups in systolic (p = 0.95) or diastolic blood pressure (p = 0.06). There were no side-specific effects on SNS activity between the left and right legs (p < 0.019) during all intervention phases. Conclusions: Significant sympathoexcitatory responses were elicited by both slider and tensioner NDTs in asymptomatic participants, demonstrating their efficacy in modulating the SNS. The differences between the two techniques were not statistically significant; however, the tensioner NDT showed a slightly more pronounced effect, suggesting that the tensioner NDT can be considered superior in terms of overall SNS effect. These findings indicate that both techniques may have the potential to enhance autonomic regulation in clinical practice; however, the tensioner NDT may be more effective. The consistent responses across participants highlight the systemic benefits of NDTs, providing a foundation for further research into their application in symptomatic populations. This study contributes to evidence-based practice by providing baseline data that support the development of theoretical frameworks and aid in clinical decision-making.

Development and Validation of Machine Learning Algorithms for Prediction of Colorectal Polyps Based on Electronic Health Records.

Colorectal Polyps are the main source of precancerous lesions in colorectal cancer. To increase the early diagnosis of tumors and improve their screening, we aimed to develop a simple and non-invasive diagnostic prediction model for colorectal polyps based on machine learning (ML) and using accessible health examination records. We conducted a single-center observational retrospective study in China. The derivation cohort, consisting of 5426 individuals who underwent colonoscopy screening from January 2021 to January 2024, was separated for training (cohort 1) and validation (cohort 2). The variables considered in this study included demographic data, vital signs, and laboratory results recorded by health examination records. With features selected by univariate analysis and Lasso regression analysis, nine machine learning methods were utilized to develop a colorectal polyp diagnostic model. Several evaluation indexes, including the area under the receiver-operating-characteristic curve (AUC), were used to compare the predictive performance. The SHapley additive explanation method (SHAP) was used to rank the feature importance and explain the final model. 14 independent predictors were identified as the most valuable features to establish the models. The adaptive boosting machine (AdaBoost) model exhibited the best performance among the 9 ML models in cohort 1, with accuracy, sensitivity, specificity, positive predictive value, negative predictive value, F1 score, and AUC (95% CI) of 0.632 (0.618-0.646), 0.635 (0.550-0.721), 0.674 (0.591-0.758), 0.593 (0.576-0.611), 0.673 (0.654-0.691), 0.608 (0.560-0.655) and 0.687 (0.626-0.749), respectively. The final model gave an AUC of 0.675 in cohort 2. Additionally, the precision recall (PR) curve for the AdaBoost model reached the highest AUPR of 0.648, positioning it nearest to the upper right corner. SHAP analysis provided visualized explanations, reaffirming the critical factors associated with the risk of colorectal polyps in the asymptomatic population. This study integrated the clinical and laboratory indicators with machine learning techniques to establish the predictive model for colorectal polyps, providing non-invasive, cost-effective screening strategies for asymptomatic individuals and guiding decisions for further examination and treatment.

Evaluation of the Factors Influencing the Occurrence of Varicocele in Males Aged 15-35 in Mogadishu, Somalia

Testicular varicoceles, a common condition characterized by the dilation and enlargement of veins within the scrotum, are predominantly found in the adolescent and young adult age group. This condition can adversely affect testicular function in various ways, including decreased sperm production, reduced sperm quality, and even testicular atrophy. The prevalence of varicoceles varies across different regions, with estimates ranging from 15-20% in Somalia and other parts of Africa, 10-15% in Asia, and 15-20% in the United States and other parts of America. In the small island nation of Erub, the incidence is relatively lower, at around 5-10% of the male population. The exact etiology of varicoceles is not fully understood, but it is believed to be related to a combination of factors, such as genetic predisposition, anatomical abnormalities, and environmental influences. Certain risk factors, including obesity, sedentary lifestyle, and exposure to high temperatures, have been associated with an increased risk of developing varicoceles. While varicoceles can adversely affect testicular function and fertility, it is important to note that not all individuals with varicoceles experience fertility-related problems. The management of varicoceles often involves a multidisciplinary approach, with close monitoring and periodic evaluation being the recommended approach for asymptomatic individuals. In cases where varicoceles are causing symptoms or affecting fertility, various treatment options, such as surgical repair (varicocelectomy) or percutaneous embolization techniques, may be considered. Understanding the prevalence, etiology, and management strategies of varicoceles is crucial for healthcare professionals to provide appropriate care and support for individuals affected by this condition.

Advances in Malaria Diagnostic Methods in Resource-Limited Settings: A Systematic Review.

Malaria continues to pose a health challenge globally, and its elimination has remained a major topic of public health discussions. A key factor in eliminating malaria is the early and accurate detection of the parasite, especially in asymptomatic individuals, and so the importance of enhanced diagnostic methods cannot be overemphasized. This paper reviewed the advances in malaria diagnostic tools and detection methods over recent years. The use of these advanced diagnostics in lower and lower-middle-income countries as compared to advanced economies has been highlighted. Scientific databases such as Google Scholar, PUBMED, and Multidisciplinary Digital Publishing Institute (MDPI), among others, were reviewed. The findings suggest important advancements in malaria detection, ranging from the use of rapid diagnostic tests (RDTs) and molecular-based technologies to advanced non-invasive detection methods and computerized technologies. Molecular tests, RDTs, and computerized tests were also seen to be in use in resource-limited settings. In all, only twenty-one out of a total of eighty (26%) low and lower-middle-income countries showed evidence of the use of modern malaria diagnostic methods. It is imperative for governments and other agencies to direct efforts toward malaria research to upscale progress towards malaria elimination globally, especially in endemic regions, which usually happen to be resource-limited regions.