Case Detection Rate Research Articles

Detection of Bovine Respiratory Syncytial Virus in Cattle: A Systematic Review and Meta-Analysis

Bovine respiratory syncytial virus (BRSV) is an economically important pathogen of cattle and contributes to the bovine respiratory disease complex (BRDC). Despite individual studies investigating BRSV prevalence, risk factors, and detection methodologies, a systematic review and meta-analysis have been lacking. The aim of the current study was to conduct a systematic review and meta-analysis to determine the prevalence and detection rate of BRSV and identify associated risk factors. Additionally, the study aimed to explore the variability in BRSV prevalence based on different detection methods and associated risk factors. Adhering to PRISMA guidelines, data from three databases—Web of Science, PubMed, and Scopus—were systematically retrieved, screened and extracted. Out of 2790 initial studies, 110 met the inclusion criteria. The study found that prevalence and detection rates varied based on the detection methods used (antibody, antigen, and nucleic acid), study populations, production systems, and geographic locations. Findings were reported as a pooled proportion. The pooled proportion, hereafter referred to as prevalence or detection rate, was determined by calculating the ratio of cattle that tested positive for BRSV to the total number of cattle tested. Key findings include a pooled prevalence of 0.62 for antibody-based methods, 0.05 for antigen-based methods, and 0.09 (adjusted to 0.03) for nucleic acid-based methods. Detection rates in BRDC cases also varied, with antibody methods showing a rate of 0.34, antigen methods 0.16, and nucleic acid methods 0.13. The certainty of evidence of the meta-analysis results, assessed using GRADE, was moderate for antibody detection methods and low for antigen and nucleic acid methods. The study identified significant risk factors and trends affecting BRSV prevalence, such as geographical location, herd size, age, and co-infections. The results of the current study showed the complexity of understanding BRSV prevalence in different settings. The variability in BRSV prevalence based on detection methods and associated risk factors, such as geographic location and herd size, highlights the need for tailored approaches to detect and manage BRSV accurately.

Comparative benefits of Ki and SUV images in lesion detection during PET/CT imaging

BackgroundClinical application of the tracer net influx rate (Ki) imaging in PET/CT remains limited, due to a lack of evidence demonstrating the superiority of Ki images in lesion detection, and guidelines on when to utilize Ki images. This study aims to compare the benefits of Ki and standardized uptake value (SUV) images in lesion detection during PET/CT imaging. By analyzing the performance of both techniques in identifying tumor lesions, the study seeks to provide guidance for the clinical application of Ki images.ResultsThis retrospective study included 134 patients with 244 pathologically confirmed lesions (200 malignant and 44 benign). Patients with a histopathological diagnosis received a weight-based 18F-FDG injection and underwent 60-min total-body PET/CT dynamic imaging. SUV images were reconstructed using data collected from the last 10 min of the scans. Ki images were generated using the Patlak methods with data from minutes 12–60. The background SUVmax, SUVmean, SUVSD, Kimax, Kimean, and KiSD values were recorded. The signal-to-noise ratios of the SUV (SUVSNR) and Ki (KiSNR) images were calculated. The lesion detection rate and sensitivity of the SUV and Ki images were evaluated. The lesion-detection rates were 97.7% (214/219) and 99.5% (218/219) for the SUV and Ki images, respectively (p = .22). Five false-negative lesions on the SUV images were true-positive on the Ki images (3 hepatic malignancies and 2 metastatic lymph nodes). The sensitivity (94.0% vs. 96.0%, p = .22), specificity (41.9% vs. 41.9%, p > .99), accuracy (84.4% vs. 86.1%, p = .61), positive predictive value (87.9% vs. 88.1%, p = .94), negative predictive value (60.0% vs. 69.2%, p = .47), and the area under the curve [0.68 (95% confidence interval, 0.61–0.73) vs. 0.69 (95% confidence interval, 0.62–0.74)] were similar in the SUV and Ki images (all p ≥ .10).ConclusionKi images exhibit benefits in lesion detection compared to SUV images, particularly in organs with high background such as liver. The enhanced contrast provided by Ki imaging is recommended to clinically improve detection rates in such cases.

Analysis of Tuberculosis Control (Case Study in The City of Mojokerto) Year 2024

This study aims to analyze the tuberculosis (TB) situation in Mojokerto City, focusing on the increase in cases among children and identifying effective countermeasures. TB, a preventable and curable infectious disease caused by Mycobacterium tuberculosis, is particularly problematic in developing countries like Indonesia due to high incidence and mortality rates, necessitating a comprehensive control strategy. Employing qualitative methods, this research delves into the practices, perceptions, and social dynamics affecting TB control efforts in Mojokerto, illuminated by the latest data showing a significant increase in pediatric TB cases and the public health situation. Findings reveal a TB incidence rate of 385 per 100,000 inhabitants, a case detection rate of 75%, and a notably high pediatric TB case proportion of 32%. The effectiveness of case tracking by health centers varies, with an average of only 54% receiving Tuberculosis Preventive Therapy (TPT). Major obstacles include limited access to radiology services, social stigma, and the need for adequate health facilities. Innovations such as the "Mbak Desi Fights TB" program and enhanced cross-sector cooperation are deemed crucial to strengthen control strategies. The study concludes that a multifaceted strategy is essential for combating TB in Mojokerto, which should include enhanced case detection, health system strengthening, and community integration in control efforts. Increased collaboration across sectors and advancements in research and development are expected to accelerate TB elimination. This research offers efficient recommendations to improve TB control strategies, based on an in-depth analysis of the current conditions and social dynamics in Mojokerto.

Trends in case detection rate for leprosy and factors associated with disability among registered patients in Zanzibar, 2018–2021

BackgroundLeprosy is still a disease of public health concern. Globally, 2–3 million people are thought to be affected by leprosy’s disease-related disabilities. Regarding leprosy status in Zanzibar, limited information is available. Determining changes in detection rates and factors associated with disability is crucial for treatment and preventative strategies for this debilitating disease. This study aimed to determine trends in case detection rate for leprosy and risk factors for disability among registered patients in Zanzibar, from 2018 to 2021. The study included all leprosy patients who received treatment in Zanzibar's 11 districts between 2018 and 2021. The study design used was an analytical cross-sectional. Prevalence and new case detection rate (NCDR) were calculated. Multivariable Poisson regression analyses were used to identify factors associated with leprosy disability. Crude and adjusted prevalence ratios (APR) and their respective 95% confidence intervals (CI) were reported. P-values ≤ 0.05 were considered significant.ResultsOf the 490 leprosy cases reported between 2018 and 2021, 469 (95.7%) were new patients, and 349 (71.2%) were multi-bacillary. The disease was found to be more common in males 296 (60.4%). The average prevalence was 7/100,000 population, while the average NCDR was 7/100,000 from 2018 to 2021. There was a significant decrease in disability grades from diagnosis to the end of treatment over 4 years (P < 0.001). Male sex (APR 1.55; 95% CI 1.18–2.04), advanced age (APR 5.01; 95% CI 1.91–13.17), multi-bacillary (APR 6.99; 95% CI 3.16–15.44) and HIV negative patients (APR 1.51; 95% CI 1.11–2.06) were more likely to develop physical disability.ConclusionThis study found that leprosy disability grades at diagnosis compared to the end of treatment declined during 4 years. There was no significant change in point prevalence and NCDR during the 4-year study period. Disability was associated with male sex, advanced age, multi-bacillary, and HIV-negative patients. To prevent leprosy-related disability and transmission, health education, early case detection, and adequate multidrug therapy should be prioritized.

S437 Ceiling Effect of CADe in Improving Detection Rates in FIT Positive Cases Among Gastroenterologists With High Baseline ADR

S437 Ceiling Effect of CADe in Improving Detection Rates in FIT Positive Cases Among Gastroenterologists With High Baseline ADR

Mastalgia and Why It Should Be Evaluated With Imaging in Areas Where Use of Breast Cancer Screening Services are Unsatisfactory.

Mastalgia or breast pain is a very common symptom in women attending breast clinic. The aim of this study was to evaluate whether imaging for mastalgia leads to cancer detection in an area where routine breast cancer screening services are underutilized. This prospective study was performed between 1st March 2021 to 31st January 2023 at a tertiary care academic institution of central India. All patients underwent through clinical examination by a surgeon. Then patients were referred for ultrasound and/or X-ray mammography (MMG) depending on age. Cancer detection rate was calculated. The final cohort consisted of 176 patients with mastalgia and without any abnormality on clinical breast examination. Sixteen patients had mass lesion on radiology and core needle biopsy resulted as infiltrating duct carcinoma in 7 patients and benign phylloides tumor in one patient. Overall case detection rate for cancer was 4%. The breast cancer detection rate in patients presenting with mastalgia was low. However, in the absence of routine mammographic screening in the Indian general population, these would have been missed. Hence, diagnostic assessment for mastalgia is an appropriate strategy in countries where routine screening MMG is lacking.

Using environmental DNA to assess the response of steelhead/Rainbow Trout and Coastrange Sculpin populations to postfire debris flows in coastal streams of Big Sur, California

AbstractObjectiveDebris flows are among the most extreme disturbances to streams and are predicted to become more frequent under climate change. We assessed the response of steelhead Oncorhynchus mykiss (anadromous Rainbow Trout)/Rainbow Trout (hereafter, collectively referred to as O. mykiss) and Coastrange Sculpin Cottus aleuticus populations to major postfire debris flows in two small coastal basins of California using noninvasive environmental DNA (eDNA) sampling.MethodsWe analyzed water samples from disturbed reaches for eDNA in the first two summers after debris flows. In Big Creek, all Coastrange Sculpin habitat was disturbed by debris flows, but a major tributary occupied by O. mykiss was not affected. In Mill Creek, all available habitat for both species was disturbed. We also sampled two unburned basins as undisturbed reference streams.ResultIn Big Creek, O. mykiss eDNA was detected in all water samples during both years, and concentrations in some samples approached the lowest concentrations in the reference streams. Coastrange Sculpin eDNA was detected only in a single water sample in the first year and was not detected in the second year. In Mill Creek, neither species was detected in the first year, but during the second year, O. mykiss eDNA was detected at very low concentrations in 40% of samples and Coastrange Sculpin eDNA was detected in a single sample.ConclusionOur results indicate that O. mykiss and Coastrange Sculpins either survived in or quickly reoccupied the disturbed reaches from within the basins. However, the detection rates for cases in which all habitat for a species in a basin was affected by debris flows indicate that abundances were very low, suggesting that persistence may be uncertain unless there is successful reproduction or immigration. Finally, eDNA appears to be effective for monitoring sensitive fish populations after a major disturbance; however, detection rates in individual samples may be low and require appropriate sampling designs to achieve the desired detection probability.

Glaucoma in general population and steroid users

In recent years, several surveys have reported on the prevalence of glaucoma worldwide. One study has shown that financial stability in population has affected glaucoma. However, there have been differences in the reported prevalence rates due to methodological variations. In the Eastern part of the world, 7.8 million people had primary open angle glaucoma (POAG) with prevalence of about 2.51%. To estimate the number of people with glaucoma or at risk of the disease, they age and gender occurrence estimates have been used, along with population estimates. East Asians have more chances to have PACG than POAG compared to western people. Their analysis shows that about 11.2 million people of the age 40 years and older with glaucoma in South East Asia, with POAG in 6.48 million people and PACG affecting 2.54 million. Additionally, any primary angle-closure disease could affect around 27.6 million people. The majority of glaucoma patients in South East Asia go undiagnosed, which makes it difficult to discover and treat the condition. We consider different strategies to raise case detection rates across the nation while taking into account the limited resources and personnel at our disposal. Aim of this study was to understand prevalence of glaucoma in general populations and steroid users.

Integrating SARS-CoV-2 rapid antigen testing in maternal, neonatal and child health, HIV, and TB clinics in Kenya and Cameroon: outcomes from the Catalysing COVID-19 Action Project

IntroductionEarly diagnosis of SARS-CoV-2 infection is key to preventing severe disease and poor outcomes in vulnerable populations, such as pregnant women and people living with HIV or diagnosed with tuberculosis...

Epidemiological characteristics of human respiratory syncytial virus in patients with severe acute respiratory infection in Tianjin City from 2015 to 2020

Objective: To investigate the epidemiological characteristics of human respiratory syncytial virus (HRSV) in patients with Severe Acute Respiratory Infection (SARI) in Tianjin from 2015 to 2020. Methods: The study data were obtained from the Third Center Hospital of Tianjin, a designated sentinel hospital, from 2015 to 2020, with 1 597 SARI patients enrolled in this study. The clinical specimens of the research participants were subjected to respiratory multi-pathogen testing. HRSV-positive specimens were subtyped to analyze the differences in HRSV detection rates among cases of different age groups and periods and their mixed infection situations. Results: A total of 1 597 nasopharyngeal swabs were collected, with an HRSV detection rate of 4.20%. Among 67 HRSV-positive specimens, there were 19 pure HRSV-A nucleic acid-positive specimens, 19 pure HRSV-B nucleic acid-positive specimens and 29 mixed HRSV-A and HRSV-B nucleic acid-positive specimens. The difference in HRSV detection rate among different age groups was statistically significant (P<0.05), and the HRSV detection rate in children under five years old was higher than that in other age groups. From 2016 to 2020, the detection rate of HRSV showed an increasing trend year by year. The HRSV detection rate of SARI cases was highest in the winter season, at 7.15%. There were 10 (14.93%) mixed positive cases for HRSV and other viruses, of which four were mixed positive for HRSV and influenza A. Conclusion: The incidence of HRSV in Tianjin exhibits an increasing trend from 2016 to 2020, peaking during the winter season, with children under five years old constituting a high-risk demographic for HRSV infection.

Empowerment Tuberculosis Cadres with Participatory Socialization as Effort to Improve The TB Suspect's Achievements at The Sempu’s Public Health Center

Background: Tuberculosis (TB) is an infectious disease with high mortality and morbidity rates in Indonesia, caused by the bacterium Mycobacterium tuberculosis. The Case Detection Rate (CDR) in Banyuwangi is still relatively low at 54% compared to the set target. In Banyuwangi, one of the Non-Governmental Organizations (NGOs), Yayasan Bhanu Yasa Sejahtera Yabhysa, supports the TB control program in the region. Since 2021, this community has collaborated with the Banyuwangi Health Department to implement community-based TB interventions in 28 Community Health Centers (Puskesmas) spread across 16 districts, with a total of 66 active TB cadres. The aim of this community service is to train Tuberculosis (TB) cadres through socialization to improve the performance of TB suspects in Sempu Banyuwangi Community Health Center. Methods: The analysis of knowledge improvement data used a paired T-test with a 95% Confidence Interval. The test was conducted to evaluate the difference in knowledge improvement before and after education. Results: From the results of this community service, there was an increase in knowledge before and after socialization by 0.06 or 6%. The formation of TB cadres through contact investigation simulation carried out in community service activities resulted in the formation of four cadres. Conclusion: Based on the pre-test and post-test results, respondents showed a 6% increase in knowledge. The hope of this community service is to improve the achievement of TB suspect cases and reduce TB cases in Sempu Community Health Center.

Performance analysis of mathematical methods used to forecast the 2022 New York City Mpox outbreak.

In mid-2022, New York City (NYC) became the epicenter of the US mpox outbreak. We provided real-time mpox case forecasts to the NYC Department of Health and Mental Hygiene to aid in outbreak response. Forecasting methodologies evolved as the epidemic progressed. Initially, lacking knowledge of at-risk population size, we used exponential growth models to forecast cases. Once exponential growth slowed, we used a Susceptible-Exposed-Infectious-Recovered (SEIR) model. Retrospectively, we explored if forecasts could have been improved using an SEIR model in place of our early exponential growth model, with or without knowing the case detection rate. Early forecasts from exponential growth models performed poorly, as 2-week mean absolute error (MAE) grew from 53 cases/week (July 1-14)to 457 cases/week (July 15-28).However, when exponential growth slowed, providing insight into susceptible population size, an SEIR model was able to accurately predict the remainder of the outbreak (7-week MAE: 13.4 cases/week). Retrospectively, we found there was not enough known about the epidemiological characteristics of the outbreak to parameterize an SEIR model early on. However, if the at-risk population and case detection rate were known, an SEIR model could have improved accuracy over exponential growth models early in the outbreak.

Molecular detection of emerging porcine circovirus in Taiwan

Porcine Circovirus type (PCV) 2 is an important pathogen that has been circulating worldwide and has cuased serious economic loss in pig industry. However, both PCV3 and PCV4 are newly emerging viruses. In Taiwan, PCV2 has been one of the critical pathogens in pig frams and PCV3 has been detected since 2016; however, the epidemiolog of PCV3 in Taiwan remains unclear and PCV4 has yet to be identified. Therefore, in order to detect the positive rate of PCV2, to investigate the epidemiolog of PCV3 in the pig farms, and to examine whether pigs were infected with PCV4 in Taiwan, a total of 128 samples from 46 clinical cases of pigs were collected from September 2020 to December 2021. The case detection rates were 54.3 % for PCV2, 43.5 % for PCV3, and 2.2 % for PCV4. The results suggested that the positivity rates for both PCV2 and PCV3 were still high in Taiwan. In addition, PCV3 was detected among cases from all 7 sampled counties and in 11 of the 16 sampling months, suggesting that PCV3 may lead to endemic pig disease in Taiwan. Surprisingly, the PCV4 was also detected, suggesting the first PCV4 case in Taiwan. The complete genomes derived from the identified PCV3 and PCV4 strains were subsequently sequenced followed by phylogenetic analysis. The results suggested that the 17 identified PCV3 strains could be divided into Taiwanese-like and Japanese-like strains. In addition, the amino acid residues at positions 27, 80, and 212 in the identified PCV4 cap protein were asparagine, isoleucine, and methionine, respectively, and thus the identified PCV4 was catalorized into clade PCV4b. Consequently, it is concluded that (i) the prevalence of PCV2 and PCV3 is still high in Taiwanese pigs, (ii) PCV3 has may be an endemic infection in Taiwan and can be classified into Japanese-like and Taiwanese-like strains, (iii) PCV4 was detected for the first time in Taiwanese pigs and can be classified into PCV4b. It remains unclear how PCV2, PCV3, and PCV4 were introduced to Taiwan, and thus continuous investigation of emerging pathogens in pigs is needed.

Recent Biochemical Advances in Antitubercular Drugs: Challenges and Future.

Tuberculosis (TB) is one of the leading causes of death world-wide after AIDS. It infects around one-third of global population and approximately two million people die annually from this disease because it is a very contagious disease spread by Mycobacterium tuberculosis. The increasing number of drug-resistant strains and the failure of conventional treatments against this strain are the challenges of the coming decades. New therapeutic techniques aim to confirm cure without deterioration, to reduce deaths, contagions and the formation of drug-resistant strains. A plethora of new diagnostic tests are available to diagnose the active tuberculosis, screen latent M. tuberculosis infection, and to identify drug-resistant strains of M. tuberculosis. When effective prevention strategies do not prevail, high rates of early case detection and successive cures to control TB emergence would not be possible. In this review, we discussed the structural features of M. tuberculosis, Multi drug resistance tuberculosis (MDR-TB), extremely drug-resistant tuberculosis (XDR-TB), the mechanism of M. tuberculosis infection, the mode of action of first and second-line antitubercular drugs, the mechanism of resistance to the existing drugs, compounds in preclinical and clinical trial and drugs presently available for the treatment of tuberculosis. Moreover, the new diagnostic techniques to detect M. tuberculosis are also discussed in this review.

A novel dual-target Septin9 methylation assay for improved detection of early-stage colorectal cancer and high-grade intraepithelial neoplasia

BackgroundColorectal cancer (CRC) ranks as the third most common malignancies in the world, and periodic examination of the patient is advantageous in reducing the mortality of CRC. The first blood-based Septin9 gene methylation assay which recognized by the US FDA for CRC examination was Epi proColon. However, this assay was not broadly applied in the current clinical guideline because of its relatively lower sensitivity in the detection of early-stage CRC.MethodsThis study aimed at developing a new multiplex Septin9 methylation assay (ColonUSK) which simultaneously evaluates two CpG-rich subregions in the promoter of the Septin9 gene and an internal control in a single reaction. ColonUSK proved increased sensitivity, with a detection limit as low as 12pg of the positive DNA compared with the Septin9 assay targeting one CpG-rich subregion. 1366 subjects were prospectively recruited from four comprehensive hospitals in China in an opportunistic screening study for assessing its value in CRC detection. Blind testing was developed to evaluate ColonUSK in comparison with clinical examination using clinical gold standard such as colonoscopy.ResultsThe assay demonstrates clinical sensitivity for diagnosing colorectal cancer (CRC) and advanced adenoma at rates of 77.34% and 25.26%, respectively. Furthermore, ColonUSK exhibits a high degree of specificity for non-CRC cases (95.95%) clinically. Significantly, the detection rate of cases in high-grade intraepithelial neoplasia increased to 54.29%. The value for the assay in the Kappa test was 0.76, showing a high degree of consistency between ColonUSK and clinical gold standard.ConclusionsColonUSK indicated moderate diagnostic value and could become a non-invasive detection way for CRC. The implementation of the ColonUSK assay has the capacity to markedly enhance CRC screening practices.

A novel approach to brain tumor detection using K-Means++, SGLDM, ResNet50, and synthetic data augmentation.

Introduction: Brain tumors are abnormal cell growths in the brain, posing significant treatment challenges. Accurate early detection using non-invasive methods is crucial for effective treatment. This research focuses on improving the early detection of brain tumors in MRI images through advanced deep-learning techniques. The primary goal is to identify the most effective deep-learning model for classifying brain tumors from MRI data, enhancing diagnostic accuracy and reliability. Methods: The proposed method for brain tumor classification integrates segmentation using K-means++, feature extraction from the Spatial Gray Level Dependence Matrix (SGLDM), and classification with ResNet50, along with synthetic data augmentation to enhance model robustness. Segmentation isolates tumor regions, while SGLDM captures critical texture information. The ResNet50 model then classifies the tumors accurately. To further improve the interpretability of the classification results, Grad-CAM is employed, providing visual explanations by highlighting influential regions in the MRI images. Result: In terms of accuracy, sensitivity, and specificity, the evaluation on the Br35H::BrainTumorDetection2020 dataset showed superior performance of the suggested method compared to existing state-of-the-art approaches. This indicates its effectiveness in achieving higher precision in identifying and classifying brain tumors from MRI data, showcasing advancements in diagnostic reliability and efficacy. Discussion: The superior performance of the suggested method indicates its robustness in accurately classifying brain tumors from MRI images, achieving higher accuracy, sensitivity, and specificity compared to existing methods. The method's enhanced sensitivity ensures a greater detection rate of true positive cases, while its improved specificity reduces false positives, thereby optimizing clinical decision-making and patient care in neuro-oncology.

Monitoring of Pesticide Residues in Chili Peppers Using International Pesticide Monitoring Data for Safety Management.

Repeated pesticide residue detection in chili peppers in the Republic of Korea has become a serious health concern. Thus, monitoring domestically grown and imported chili peppers for pesticide residues is of great significance. Here, we investigated pesticide residues detected in imported and domestically grown chili peppers using global pesticide residue monitoring data. Our analysis involved organizing inspection and detection data from different sources. Global pesticide residue monitoring data for chili peppers revealed 139 pesticide types, 43,532 inspections, and 3966 detections (detection rate, 9.11%). Peppers from Mexico were sampled the most (39,927 inspections) and showed the highest number of detected cases (2998 cases). Globally, the top 10 most frequently detected pesticides were clothianidin, imidacloprid, thiamethoxam, chlorpyrifos, thiacloprid, metalaxyl, myclobutanil, azoxystrobin, carbendazim, and cyhalothrin, with detection rates in the range of 10.52-28.66%. Furthermore, domestic chili pepper pesticide residue monitoring revealed 73 pesticide types, 3535 inspections, and 332 detected cases (detection rate, 9.39%), and the top 10 most frequently detected pesticides were chlorfenapyr, tebuconazole, flonicamid, dinotefuran, boscalid, pyraclostrobin, fluxametamide, thiamethoxam, pyridaben, and azoxystrobin, with detection rates in the range of 13.89-32.58%. These findings may serve as fundamental data for safety management related to chili pepper pesticide residues in the Republic of Korea.

Diagnostic Value of X-Map Images Reconstructed by Plain Dual-Energy Computed Tomography Scans in Acute Ischemic Stroke.

This study aimed to evaluate the diagnostic value of X-Map reconstruction based on Dual-Energy Computed Tomography (DECT) in acute ischemic stroke (AIS). Sixty-six cases of suspected AIS patients hospitalized from November, 2021 to April, 2022 were retrospectively selected. DECT, Computed Tomography Perfusion imaging (CTP), Computed Tomography Angiography (CTA), and MRI were all performed within 24 hours after symptom onset. As the gold standard for diagnosing AIS, a total of 53 patients were diagnosed with AIS based on the diffusion-weighted imaging positive results in MRI. The Chi-square test was used to evaluate the diagnostic efficacy of AIS among X-Map, CTP, and CTA. In the 53 patients with confirmed ASI, a total of 72 lesions were detected, including in the frontal lobes (n=33), parietal lobes (n=7), temporal lobes (n=12), basal ganglia regions (n=12), thalamus (n=3), and pons (n=5). The case detection rate of X-Map for AIS was similar to that of CTP (p=0.151) but was significantly higher than that of CTA (p<0.001). In terms of diagnostic efficacy, among the total 66 patients enrolled, X-Map achieved a higher diagnostic sensitivity (85%) than CTP and CTA. However, CTP achieved the best diagnostic specificity (84.6%) and diagnostic accuracy (77.4%) among the diagnostic tools used. X-Map provides a better or equal clinical value for the diagnosis of AIS as compared to CTA and CTP, respectively, highlighting its potential in clinical applications.

Epidemiological Study of Leprosy in Elqalaah Dermatology and Leprosy Clinic

Abstract Background Leprosy is a chronic, infectious disease caused by Mycobacterium leprae. It mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and the eyes. Nerve damage may result in lack of ability to feel pain, which can lead to loss of parts of a person's extremities from repeated injuries or infection due to unnoticed wounds. Egypt is one of the first countries in the region to achieve the elimination target at the national level as early as 1994, However Leprosy is still endemic in certain foci in Egypt. Thus, our study aims to evaluate the epidemiology of leprosy in Elqalaah leprosy clinic in Cairo over the last decade to support the current national control program of leprosy with updated data. Objective This study presents an analysis of pattern of new cases of leprosy detected annually from 2009 to 2020 in Elqalaah Dermatology and leprosy clinic in Cairo as the new-case detection rate is better than prevalence as an indicator of disease trends. Methods and Material Data about patients with newly diagnosed leprosy were collected from Elqalaah dermatology and leprosy clinic registry, the main referral center in Cairo governorate. Case detection rates (CDR) were calculated for each year by dividing the newly diagnosed cases by mid-year populations for the same year. Results 504 patients were newly diagnosed between 2009 and 2020. The mean age of patients at diagnosis was 38.16 years, 64.5% were males, and 5.4% were children below 14 years of age. The new case detection rate ranged from 0.66/100,000 population in 2009 to 0.12 /100,000 population in 2020. 82.5% were classified as multibacillary. 75.6% were detected by notification method, and 82.5% of patients completed their treatment course. Macules was the most common clinical finding and was found in 67.7% of patients. 18.5% of cases had previous history of contact with other leprosy patient. 13.1% and 2.4% suffered type one and type two leprae reactions respectively. 11.9% of cases had grade two hand disabilities, 6.7% had grade two feet disabilities and 1.8% had grade two eye disabilities. Conclusions The new case detection rate is acceptable compared to the global level and there was a decline in the number of cases throughout the years of the study, however community- based research should be encouraged and leprosy trends over years from different regions need to be reported to know the actual status of leprosy in different regions of country and continued surveillance of patients and their contacts is required to detect relapses and undiagnosed cases.

Targeted next-generation sequencing reveals the genetic mechanism of Chinese Marfan syndrome cohort with ocular manifestation.

Marfan syndrome (MFS) is a hereditary connective tissue disorder involving multiple systems, including ophthalmologic abnormalities. Most cases are due to heterozygous mutations in the fibrillin-1 gene (FBN1). Other associated genes include LTBP2, MYH11, MYLK, and SLC2A10. There is significant clinical overlap between MFS and other Marfan-like disorders. To expand the mutation spectrum of FBN1 gene and validate the pathogenicity of Marfan-related genes in patients with MFS and ocular manifestations. We recruited 318 participants (195 cases, 123 controls), including 59 sporadic cases and 88 families. All patients had comprehensive ophthalmic examinations showing ocular features of MFS and met Ghent criteria. Additionally, 754 cases with other eye diseases were recruited. Panel-based next-generation sequencing (NGS) screened mutations in 792 genes related to inherited eye diseases. We detected 181 mutations with an 84.7% detection rate in sporadic cases and 87.5% in familial cases. The overall detection rate was 86.4%, with FBN1 accounting for 74.8%. In cases without FBN1 mutations, 23 mutations from seven Marfan-related genes were identified, including four pathogenic or likely pathogenic mutations in LTBP2. The 181 mutations included 165 missenses, 10 splicings, three frameshifts, and three nonsenses. FBN1 accounted for 53.0% of mutations. The most prevalent pathogenic mutation was FBN1 c.4096G>A. Additionally, 94 novel mutations were detected, with 13 de novo mutations in 14 families. We expanded the mutation spectrum of the FBN1 gene and provided evidence for the pathogenicity of other Marfan-related genes. Variants in LTBP2 may contribute to the ocular manifestations in MFS, underscoring its role in phenotypic diversity.