Early Detection Measures Research Articles

Heart Failure Early Prediction Using Machine And Deep Learning Algorithm

In this article, we use machine learning approaches to give a thorough investigation into the prediction of cardiac illnesses and strokes. The Stroke Prediction Dataset and the Heart Failure Prediction Dataset are the two datasets that we use. Our objective is to maximize accuracy and minimize Mean Absolute Error (MAE) and Mean Squared Error (MSE) in order to enhance predictive performance. We use a variety of machine learning methods, such as Random Forests, Naive Bayes, Decision Trees, and k-Nearest Neighbors (KNN). We also use Artificial Neural Networks (ANN) and Multi-Layer Perceptrons (MLP) as deep learning models. We use oversampling approaches to rectify the imbalance in classes. For hyperparameter tweaking, we also use Grid Search and k-Fold Cross Validation. Our goal is to deliver valuable insights into early detection and preventive measures through comprehensive testing and assessment for prevention of strokes and heart diseases.

Karakteristik dan Analisis Risiko Kasus Tuberkulosis di Puskesmas Senen Jakarta Pusat tahun 2023

Indonesiaranks second globally with the highest number of Tuberculosis (TB) cases, following India. Consequently, TB remains a high-priority health issue requiring immediate attention. This study aims to describe the TB case characteristic and analyze the TB risk in each urban villages of Senen, Central Jakarta. This is a descriptive cross-sectional study. Data was obtained from medical records and the Tuberculosis Information System (SITB) at Senen Primary Health Care (PHC) during January – December2023. Demographic data, TB type, result of rapid molecular test, and comorbidities were presented in numbers and percentages. Total TB cases, incidence rate (IR), and standardized morbidity ratio (SMR) were calculated for each urban villages and the entire subdistrict. The distribution of the number of cases, IR, and SMR was displayed on a map. Overall, 300 TB cases were found among 3,421 suspected TB cases examined at the Senen PHC in 2023, with a positivity rate of 7.22% and an incidence rate of 240 per 100,000 population. The highest number of TB cases occurred in September 2023 with 52 cases (17.33%). Of the total TB cases in Senen, TB cases were commonly found in males (67.67%), the productive age group (15-59 years) accounted for73.33%,new TB cases accounted for 93.33%, 100% were pulmonary TB cases, 82.33% were bacteriologically confirmed with 93.36% of them being drug-sensitive TB (DS-TB), smokers (73.33%) and employed (72.67%). TB cases were spread across sixurban villages, with Kramat having the highest number of cases at 98 (32.67%), a TB IR of 78 per 100,000 population, and an SMR of 0.71. TB cases occurred throughout the year in the Senen Subdistrict. The characteristics of TB cases in Senen were dominated by males, productive age groups, pulmonary TB, new cases, bacteriologically confirmed cases, DS-TB, smokers, and employed individuals. The TB risk varied in each area, with the highest number of cases, IR, and SMR found in Kramat urban village A comprehensive strategy combining early detection, effective treatment, and preventive measures is essential to control the TB epidemic in the Senen Subdistrict.

Impacts of osteosarcopenia on musculoskeletal health, risks of falls and fractures, and activities of daily living among population aged 50 and above: an age- and sex-matched cross-sectional analysis

AimsWe conducted this study to investigate the impact of muscle loss on musculoskeletal health, fall and fracture risks, and activities of daily living (ADL) in elderly patients with osteoporosis.Materials and methodsThis age- and sex-matched cross-sectional study analyzed data from a medical center involving patients aged ≥ 50 from 2020 to 2022. The included participants were formed into three groups: 100 with osteoporosis only, 100 with osteosarcopenia, and 50 control individuals without osteoporosis and sarcopenia. We compared groups based on their baseline characteristics, bone and muscle health measurements, and the risks of falls and fractures using the STRATIFY scale and FRAX, respectively. Additionally, ADL was assessed using the Barthel Index. A multivariate analysis was performed to identify factors associated with declined ADL in osteosarcopenic patients.ResultsThe mean age was 76.17 years, and 82% were female. The osteosarcopenic group demonstrated poorer bone and muscle quality and quantity, with greater risks of major osteoporotic-related fractures, hip fractures, and falls, as well as significantly decreased ADL than other groups. When comparing sexes, females exhibited worse performance than males across groups. Slow gait speed and high STRATIFY score are independent predictors of declined ADL in osteosarcopenic patients.ConclusionSarcopenia exacerbates osteoporotic patients, particularly women, worsening bone deterioration, increasing fall and fracture risks, and significantly impairing daily activities. Enhancing walking speed and reducing fall risk can boost independence in individuals with osteosarcopenia. Early detection, proper management, and preventive measures are essential for mitigating these adverse outcomes in high-risk individuals.

Marine Invasive Algae's Bioactive Ingredients as a Sustainable Pathway in Cosmetics: The Azores Islands as a Case Study.

Marine invasive species pose significant ecological, economic, and social challenges, disrupting native ecosystems, outcompeting local species and altering biodiversity. The spread of these species is largely driven by global trade, shipping, and climate change, which allow non-native species to establish themselves in new environments. Current management strategies, including early detection, rapid response, and biosecurity measures, have had some success, but the complexity and scale of the problem require continuous monitoring. This review explores the possibility of using some marine invasive species as skincare ingredients and explores the Azorean islands as a case study for the valorization of biomass. Additionally, this review addresses legislative barriers that delay the development of sustainable cosmetic markets from invasive species, highlighting the regulatory landscape as a critical area. It concludes that marine invasive species present a regional and global problem that requires regional and global solutions. Such solutions strongly need to address environmental impacts and net socioeconomic benefits, but such solutions must also consider all regional differences, technical capacities and financial resources available. Thus, as a future perspective, strategies should emphasize the need for international collaboration and the development of more effective policies to prevent the spread of invasive species. There is still much work to be completed. By working together, the biodiversity for future generations will be better monitored and explored.

Meniscus Tears: Risk Factors, Physical Examination, and Preventive Approaches

Abstract. Meniscus injuries are among the most frequent knee issues, affecting individuals across a wide age range and often resulting from acute trauma or age-related degeneration. The meniscus, essential for knee stability, shock absorption, and joint lubrication, is particularly vulnerable to injury in sports involving twisting and pivoting motions. This review discusses the anatomy of the meniscus, various types of tearssuch as radial, horizontal, complex, and bucket-handle tearsand the primary risk factors, including sports activities and occupational stress. Diagnostic tools like the McMurray and Apley compression tests, along with MRI, are crucial in assessing the severity of the injury. Effective prevention strategies include strengthening exercises for the quadriceps and hamstrings, flexibility routines, proper movement techniques, and the use of protective gear like knee braces. Early detection and consistent preventive measures are critical in preserving knee function, minimizing the risk of re-injury, and preventing long-term complications such as osteoarthritis.

Interrelationships of stress, burnout, anxiety, depression, quality of life and suicidality among Chinese residents under Standardized Residency Training: a network analysis

Background Chinese resident physicians confront challenges such as staff shortages and heavy workloads, leading to a heightened prevalence of mental distress. This study aims to investigate the symptom network of stress, burnout, anxiety, depression (SBAD) and adverse personal outcomes in this cohort. Methods From October 2020 to April 2022, 994 physicians were recruited across China through snowball sampling. Stress, burnout, anxiety and depression were assessed using the 10-item Perceived Stress Scale, a two-item burnout questionnaire, Generalized Anxiety Disorder Scale-7 and the Patient Health Questionnaire-9, respectively. Data on adverse personal outcomes (low quality of life [QOL] and suicidal ideation) were collected. We constructed and visualized two networks, calculating expected influence (EI) and bridge EI indices to identify central and bridge symptoms. Results In the SBAD network, perceived helplessness was the most central and critical bridge symptom connecting stress and mental distress, with emotional exhaustion identified as the secondary bridge symptom. Perceived helplessness, perceived self-efficacy and emotional exhaustion exhibited the highest negative correlations with QOL. Worthless (PHQ6) and motor (PHQ8) symptoms were strongly correlated with suicidal ideation. The estimated SBAD network showed excellent stability and accuracy. Conclusions Our study emphasizes that perceived helplessness may be a high-priority target for preventing and intervening in mental distress and improving QOL among residents. Burnout transcends workplace problems and is widely connected to depression, anxiety and QOL. Implementing early detection and intervention measures at three levels—the individual physician, health system and professional colleges, and external regulators—is crucial for preventing and alleviating stress and mental distress among residents.

A Closed-Loop Ear-Worn Wearable EEG System with Real-Time Passive Electrode Skin Impedance Measurement for Early Autism Detection.

Autism spectrum disorder (ASD) is a chronic neurological disorder with the severity directly linked to the diagnosis age. The severity can be reduced if diagnosis and intervention are early (age < 2 years). This work presents a novel ear-worn wearable EEG system designed to aid in the early detection of ASD. Conventional EEG systems often suffer from bulky, wired electrodes, high power consumption, and a lack of real-time electrode-skin interface (ESI) impedance monitoring. To address these limitations, our system incorporates continuous, long-term EEG recording, on-chip machine learning for real-time ASD prediction, and a passive ESI evaluation system. The passive ESI methodology evaluates impedance using the root mean square voltage of the output signal, considering factors like pressure, electrode surface area, material, gel thickness, and duration. The on-chip machine learning processor, implemented in 180 nm CMOS, occupies a minimal 2.52 mm² of active area while consuming only 0.87 µJ of energy per classification. The performance of this ML processor is validated using the Old Dominion University ASD dataset.

Mathematical analysis with control of liver cirrhosis causing from HBV by taking early detection measures and chemotherapy treatment

Reformulating the physical processes associated with the evolution of different ailments in accordance with globally shared objectives is crucial for deeper comprehension. This study aims to investigate the mechanism by which the HB virus induces harmful inflammation of the liver, with a focus on early detection and therapy using corticosteroids or chemotherapy. Based on the developed hypothesis, a new mathematical model has been created for this purpose. The recently developed system for HBV is SEI1I2R\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$SEI_{1} I_{2}R$$\\end{document}, which is examined both quantitatively and qualitatively to determine its actual effect on stability. Reliable conclusions are ensured by examining the system’s boundedness, positivity, existence, uniqueness, and conducting local and global stability analysis-all crucial components of epidemic models. Global stability is tested using Lyapunov first derivative functions to assess the overall impact of asymptomatic persons and chemotherapy treatment. Additionally, the Lipschitz condition is used to confirm the unique solutions for the newly built HBV model using methods from fixed point theory, thus meeting the requirements for uniqueness and existence. Since the population must maintain this property, positivity is confirmed using global derivatives and Lipschitz criteria to calculate the rate of change in each sub-compartment. Applying the Mittag-Leffler kernel with a fractal-fractional operator to continuously monitor the HBV virus for liver cirrhosis infection yields dependable results. Furthermore, the current situation regarding the HBV outbreak pertaining to liver cirrhosis infection, along with the control measures implemented following early diagnosis through asymptomatic measures and chemotherapy treatment under constant observation, are established to prevent chronic stage infections. Simulations have been used to study the true behavior and impact of HBV in asymptomatic persons receiving chemotherapy for liver cirrhosis infection in the community. This research is essential for understanding the spread of viruses and developing control strategies based on our validated findings to mitigate the risk factors associated with liver cirrhosis.

Indications regarding early detection screening for genital tract neoplasms

Testicular tumors and penile cancer are rare but potentially life-threatening diseases. Testicular tumors primarily affect younger men, while penile cancer is more common in older men. Early detection can significantly improve survival rates. This article investigates the indications for early detection screenings for testicular tumors and penile cancer. Acomprehensive literature review was conducted to analyze current studies and guidelines. No general screening programs are recommended for either type of cancer. For testicular tumors, self-examination of the testes is recommended, while for penile carcinomas, education on risk factors such as human papillomavirus (HPV) infections or phimosis is emphasized. In both cases, medical examination is crucial. Education and awareness, especially among at-risk groups, are essential. Physicians play akey role in conducting and recommending early detection measures.

Association between complete blood-count-based inflammatory scores and hypertension in persons living with and without HIV in Zambia.

Hypertension is a risk factor for cardiovascular events. Inflammation plays an important role in the development of essential hypertension. Studies assessing the association between complete blood count-based inflammatory scores (CBCIS) and hypertension are scarce. Therefore, this study aimed to determine the relationship between CBCIS and hypertension among individuals with and without human immunodeficiency virus (HIV). This was a cross-sectional study among 344 participants at Serenje District Hospital and Serenje Urban Clinic. We used structured questionnaires to collect sociodemographic, clinical and laboratory characteristics. CBCIS included lymphocyte-monocyte ratio (LMR), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), derived neutrophil-lymphocyte ratio (d-NLR), and differential white blood cells. The primary outcome variable was hypertension defined as systolic and diastolic blood pressure higher than or equal to 140/90 mmHg. Logistic regression was used to estimate the association between hypertension and CBCIS in statistical package for social science (SPSS) version 22.0. The participants had a median age of 32 years (interquartile range (IQR) 24-42) and 65.1% (n = 224) were female. The prevalence of hypertension was 10.5% (n = 36). Among those with hypertension, 55.6% (n = 20) were female and 44.4% (n = 16) were male. The CBCIS significantly associated with hypertension in people living with HIV (PLWH) was PLR (adjusted odds ratio (AOR) 0.98; 95% confidence interval (CI) 0.97-0.99, p = 0.01) while in people without HIV, AMC (AOR 15.40 95%CI 3.75-63.26), ANC (AOR 1.88 95%CI 1.05-3.36), WBC (AOR 0.52 95%CI 0.31-0.87) and PLR (AOR 0.98 95%CI 0.97-0.99) were the factors associated with hypertension. Compared to people without HIV, only WBC, ANC, NLR, and d-NLR were good predictors of hypertension among PLWH. Our study indicates a notable HIV-status driven association between CBCIS and hypertension, suggesting the use of CBICS as potential biomarkers for hypertension risk with substantial implications for early detection and preventive measures.

Empowering diabetic foot ulcer prevention: A novel cloud-based plantar pressure monitoring system for enhanced self-care

Background This study was prompted by the crucial impact of abnormal plantar pressure on diabetic foot ulcer development and the notable lack of its monitoring in daily life. Our research introduces a cloud-based, user-friendly plantar pressure monitoring system designed for seamless integration into daily routines. Objective This innovative system aims to enable early ulcer prediction and proactive prevention, thereby substantially improving diabetic foot care through enhanced self-care and timely intervention. Methods A novel, user-centric plantar pressure monitoring system was developed, integrating a wearable device, mobile application, and cloud computing for instantaneous diabetic foot care. This configuration facilitates comprehensive monitoring at 64 underfoot points. It encourages user engagement in health management. The system wirelessly transmits data to the cloud, where insights are processed and made available on the app, fostering proactive self-care through immediate feedback. Tailored for daily use, our system streamlines home monitoring, enhancing early ulcer detection and preventative measures. Results A feasibility study validated our system's accuracy, demonstrating a relative error of approximately 4% compared to a commercial pressure sensing walkway. This precision affirms the system's efficacy for home-based monitoring and its potential in diabetic foot ulcer prevention, positioning it as a viable instrument for self-managed care. Conclusions The system dynamically captures and analyzes plantar pressure distribution and gait cycle details, highlighting its utility in early diabetic foot ulcer detection and management. Offering real-time, actionable data, it stands as a critical tool for individuals to actively participate in their foot health care, epitomizing the essence of self-managed healthcare practices.

Minimizing Acute Kidney Injury in Pediatric Cardiac Surgery: Incidence, Early Detection, and Preemptive Measures.

Background Acute kidney injury (AKI) poses a significant challenge in pediatric cardiac surgery, having a profound impact on patient morbidity and mortality. This study aims to determine the incidence of AKI, explore novel biomarkers for early detection,assess potential risk factors along with preemptive strategies to minimize its incidence and compare the results with similar studies that did not use these interventions. Methods This prospective observational cohort study, conducted from October 2022 to June 2024 at a tertiary care center, involved 44 pediatric patients, aged three months to 15 years, undergoing cardiac surgery. Kidney function was assessed through preoperative and postoperative measurements of serum creatinine, urine output, blood urea, and newer biomarkers such as cystatin C and urine neutrophil gelatinase-associated lipocalin (NGAL). AKI was defined and classified using the Acute Kidney Injury Network (AKIN) criteria, based on increases in serum creatinine or reductions in urine output within the first three days post surgery. To reduce the risk of AKI, a low-dose vasopressin infusion and blood transfusion were administered to maintain renal perfusion and optimal hematocrit levels. The incidence of AKI was calculated and compared with other studies that did not utilize these strategies Results AKI occurred in 31.8% (n=14) of the pediatric patients undergoing cardiac surgery. To reduce the risk of AKI, preemptive low-dose vasopressin was used as a preventive strategy. Patients who developed AKI exhibited significant elevations in serum creatinine, blood urea, and cystatin C, with postoperative NGAL levels exceeding 50 ng/ml. The study found a strong correlation between lower intraoperative hematocrit levels (<30%) and a higher incidence of AKI (100% vs. 6.2%, p<0.001). Conclusions Effective management of intraoperative hematocrit levels and the preemptive use of vasopressin are promising strategies for reducing AKI risk by optimizing renal perfusion and function during cardiac surgery.Early detection through biomarkers like cystatin C and NGAL offers the potential for timely intervention and better patient outcomes. These findings contribute to improving risk assessment and perioperative management in pediatric patients vulnerable to AKI.

Assessment of Refractive Errors, Dental Caries, and Scoliosis in School Children Aged 6-14 Years: A Study in Durrës Schools

This study aims to assess the prevalence of refractive errors, dental caries, and scoliosis in children aged 6-14 years across several primary and secondary schools in the city of Durrës. The sample includes 370 students from "Vincenc Prendushi", "Nënë Tereza", "Vasil Ziu", "Abedin Dino", and "Bajram Curri" schools. Each school was selected randomly. From each school we have selected different classes and students for further evaluation. Each student underwent a clinical examination to evaluate vision, oral health, and postural status. Refractive errors were assessed using Snellen chart table placed in 6 meters. Dental caries was evaluated through clinical inspection of the teeth, using the DMFT index (Decayed, Missing, and Filled Teeth). Scoliosis was diagnosed through physical examination and the Adams forward bend test, done in physiotherapy lab of Aleksander Moisiu University. The results provide insight into the risk factors and the need for early interventions to improve the overall health of children in this age group. Out of the 370 students, 28% (104 students) were found to have refractive errors, with myopia being the most common condition, affecting 17% (63 students), followed by hyperopia in 9% (33 students), and astigmatism in 2% (8 students). A total of 42% (155 students) exhibited signs of dental caries, with an average DMFT score of 2.8, indicating a moderate level of oral health concerns. Additionally, 12% (45 students) were diagnosed with scoliosis, with mild curvature observed in 8% (30 students) and moderate to severe curvature in 4% (15 students). These findings suggest a significant need for vision correction, oral health education, and orthopedic monitoring in the student population. Early detection and preventive measures in schools are crucial to addressing these health issues effectively and ensuring the well-being of children during their developmental years.

Dengue virus transmission during non-outbreak period in Dar Es Salaam, Tanzania: a cross-sectional survey

BackgroundTanzania has experienced multiple dengue outbreaks between 2010 and 2019, caused by various dengue virus (DENV) strains. In 2019, there were 6917 confirmed dengue cases and 13 deaths in Tanzania. Routine diagnosis of dengue fever is unfortunately excluded, particularly during non-outbreak periods, resulting in delayed outbreak detection and control. The aim of this study was to improve early detection and control measures for DENV by investigating its circulation in human and Aedes aegypti (A.aegypti) mosquitoes during the non-outbreak periods in Dar es Salaam, Tanzania, which is an area frequently affected by dengue outbreaks.MethodsFour hundred and fifteen (415) blood samples were collected from patients attending randomly selected health facilities in five wards; Azimio, Keko, Mtoni, Mbagala and Chamazi within Temeke district. The samples were tested for DENV NS1 antigen and anti-dengue IgM and IgG antibodies by rapid test. Then, 150 out of 415 blood samples were tested for the DENV by conventional Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). Two thousand two hundred and fifty (2,250) adult female A.aegypti mosquitoes were collected using a Prokopack aspirator and BG sentinel trap or obtained after rearing immature stages and tested, in pools of 15 for DENV by RT-PCR. Statistical Software, SPSS version 23, was used for data analysis.ResultsOf the tested blood samples, 17% (71/415) were positive by NS1 antigen, 0.5% (2/415) by IgM, 0.5% (2/415) by IgG antibodies, and 0.5% (2/415) by IgM and IgG. None of the samples tested positive by DENV RT-PCR. Moreover, 3.3% (5/150) of tested mosquito pools had DENV by RT-PCR. Individuals aged between 21 and 40 years of age had increased risk of testing positive for DENV NS1 antigen, followed by those aged 5–20 years old, particularly those residing from Azimio ward, Keko ward, Mtoni ward and Mbagala ward, p-value ≤ 0.05.ConclusionFindings from this study revealed evidence of DENV circulation during non-outbreak periods in Dar es Salaam, Tanzania. These findings underscore the importance of including testing for dengue infection in routine differential diagnoses of febrile cases, and also frequent dengue surveillance in mosquitos. This proactive approach will help early DENV outbreak detection and control in the country.

Prediction of the burden and characteristics of coronary plaques by cardiorespiratory fitness

Abstract Background Cardiorespiratory fitness (CRF) and coronary plaque burden are both important predictors of mortality. Although mortality of coronary heart disease (CHD) is reduced, prevalence remains high and there is a need to improve early detection and preventive measures. How CRF relates to coronary plaque burden and composition in the general population is largely unknown. Purpose The aim was to study the relationship between CRF and the total coronary plaque burden, including subgroups of coronary plaques, in subjects without known CHD. Methods A random sample of participants from a large population-based echocardiographic reference range study aged 55-70 at baseline was included. Coronary plaque burden was assessed, on average, 4.0 years after the baseline evaluation using coronary computed tomography angiography (CCTA). The burden and characteristics of the coronary plaques were evaluated using a validated, commercially available, semi-automatic software that assessed all coronary territories including the left main, left anterior descending, circumflex, and right arteries. Coronary plaques were classified as dense calcified plaques, plaques with necrotic core, fibrous, and fibrous-fatty plaques. Baseline measures included cardiovascular risk factor assessment and measurement of peak oxygen consumption (VO2peak) assessed by treadmill cardiopulmonary exercise testing. Linear regression models were used to assess the impact of VO2peak on coronary plaque burden. In Model 1, we adjusted for sex and age, while Model 2 also included adjustments for non-HDL cholesterol, HbA1c, systolic blood pressure, smoking status, and body mass index. Results Of 845 invited to undergo CCTA, 707 (51% females) underwent CT scanning. Of these, 699 scans had acceptable quality for further analyses. Table 1 shows baseline characteristics and Table 2 shows the associations of VO2peak with coronary plaque burden. In the fully adjusted Model 2, there was a significant negative association of VO2peak with total plaque burden (β -0.18, R2 15%, p&amp;lt;0.001), while the association was not significant in Model 1 (p=0.54). Similarly, higher VO2peak significantly predicted a lower burden of dense calcified plaques, plaques with necrotic core, and fibrofatty plaques in both models (R2 3-17%, p≤0.01). The results were consistent whether the coronary plaques were evaluated across the entire coronary arteries (down to a diameter of 1.5 mm) or solely in the proximal segments. However, the predictive power of the models was relatively low with R2 of maximum 17%. Conclusion In a population without known CHD, CRF explained a modest part of the variation in coronary plaque burden. Considering CRF in risk prediction may enhance coronary artery disease prevention beyond traditional risk factors.

Immune-checkpoint myocarditis phenotype when using systematic troponin surveillance in cancer patients.

Abstract Background ICI myocarditis, often described as potentially fulminant in registries from specialized centers, lacks sufficient data on its subclinical forms. ESC 2022 guidelines advocate systematic troponin measurements for early detection, resulting in numerous suspected cases of ICI myocarditis. Additionally, many patients receive other potentially cardiotoxic cancer drugs (e.g.,anthracyclines), adding complexity to the management. Purpose To identify factors associated with ICI-myocarditis diagnosis in a single-center unselected cohort referred for suspicion of CV immune-related adverse events(irAEs). Patients underwent standardized evaluation, including serum testing, ECG, echocardiogram, cardiac MRI(CMRi) and multidisciplinary team assessment including cardiology and internal medicine specialists. Coronary imaging and myocardial biopsy (EMB) were performed as needed. ICI-myocarditis diagnosis was adjudicated by expert panel (FC, MM, SH) based on Dallas, ESC, and IC-OS criteria. Results We enrolled 175 consecutive patients from March 2022 to October 2023; 40 (22.89%) were male, with a median age of 61 (IQR 48.0-72.0) years. 92(52.57%) were referred for lone asymptomatic troponin raise, 101 (57.7%) had breast cancer; 142 (81.11%) received other cardiotoxic drugs. We identified 95 (61.71%) patients with CV irAEs at referral (8 had &amp;gt;=2 CV irAEs) with a total of 108 CV irAEs after follow up, including 72 (41.14%) with ICI-myocarditis at referall. No CV deaths occurred within 30 days from referall. Characteristics and univariate analysis are depicted in the Table1. Reasons for referral in the ICI-myocarditis population are depicted in the Figure1. On multivariate regression analysis, prior CV disease history (OR 6.232 [CI 1.204-32.260], p=0.029), EMB (OR 24.969 [5.139-121.32], p=&amp;lt;.0001), IC-OS criteria fulfilled (OR 43.108 [9.222-201.510], p=&amp;lt;.0001), and positive Lake Louise criteria on CMRi (OR 6.583[1.416-30.610], p=0.0163) were associated with myocarditis. In a sub-analysis group of breast cancer patients (largely receiving anthracyclines), ICI-myocarditis was associated on multivariate regression with abnormal ECG (OR 14.227 [CI 1.632-124.040], p=&amp;lt; 0.0163) and EMB (OR 8.508 [CI 2.718-26.638], p=0.0002). The same characteristics were significantly associated with other CV irAEs in the group of breast cancer patients. In the group of patients with cancers other than breast, factors significantly associated with ICI myocarditis diagnosis were: EMB (OR 70.656 [CI 5.970-836.161], 0.0007), and no arterial hypertension (OR 9.554 [CI 1.792-50.940], p= 0.0082). Conclusions The FAST TRACK study highlights the high proportion of patients fulfilling ICI-myocarditis criteria despite no or mild symptoms, mainly referred for troponin elevation. However, subclinical ICI-myocarditis appears to bear good prognosis. Endomyocardial biopsy is key to increase the diagnosis rate of ICI-myocarditis across different cancer populations when mildly symptomatic.Table 1Figure 1

Effectiveness and Nephrotoxicity of Polymyxin B among Intensive Care Unit Patients: A Clinical Evaluation

Polymyxin B is a reserve antibiotic, but there has been an upsurge in its use due to a rise in multidrug-resistant gram-negative bacteria. However, nephrotoxicity and resistance concerns persist, with global resistance rates reaching 29%. Effectiveness of Polymyxin B (clinical and microbiological response) and the frequency of nephrotoxicity is not well documented in resource limited settings. Research is essential to guide optimization of Polymyxin B therapy and inform the adoption of measures for early detection of kidney injury to prevent damage. This study aimed to assess the effectiveness of Polymyxin B by evaluating clinical and microbiological responses and determining nephrotoxicity incidence using KDIGO criteria in ICU patients at Moi Teaching and Referral Hospital (MTRH). A prospective observational cohort study was conducted at MTRH ICUs between December 2021 and November 2022, on patients treated with Polymyxin B. Data on demographics, comorbidities, Polymyxin B dosage regimens, clinical responses, and microbiological results were collected. Descriptive statistics summarized patient characteristics, while associations between dosage regimens and outcomes were evaluated using Fisher's exact test and multivariate regression, with a p&lt;0.05 considered statistically significant. Forty-four patients with a mean age of 48 years were included; 66% were male, and cerebrovascular disease was the most common comorbidity. All patients had multidrug-resistant gram-negative infections qualifying for Polymyxin B therapy. Most (89%) received monotherapy, with 86% achieving a good clinical response, 7% experiencing treatment failure, and 7% dying. Doses of 20,000–25,000 IU/Kg/day were associated with microbiological eradication and good clinical response (p&lt;0.001), while 15,000 IU/Kg/day was associated with treatment failure. Acute kidney injury occurred in 48% of patients, with 68% developing hypomagnesemia. Polymyxin B at doses of between 20,000-25,000IU/Kg/day should be considered as a starting dose due to the association with good clinical response, with alternate-day monitoring of serum creatinine levels for early detection of nephrotoxicity.

Public Awareness of the Symptoms and Risk Factors of Thyroid Disease in Saudi Arabia.

Thyroid disorders are a common manifestation of hormonal disorders that result from either excessive or insufficient production of thyroid hormones and the swelling of the thyroid gland. A lack of information and awareness of the signs and risk factors of thyroid problems can lead to untreated patients, thereby harming public health. Observational cross-sectional research was conducted in the Al-Baha region of Saudi Arabia, with 531 residents selected from the general population. The data were analyzed using SPSS to derive significant insights, and questionnaires were used to collect the data. The results revealed that 79 (14.9%) of the participants had been diagnosed with thyroid disease. The risk factors for thyroid diseases reported were as follows: female gender (386, 72.7%); exposure to radiation (329, 62.0%); smoking (312, 58.8%); family history (300, 56.5%); and insufficient or excess intake of iodine (277, 52.2%).Only 110 (20.7%) of the participants knew that the use of amiodarone medication is a risk factor for thyroid diseases. The symptoms reported included fatigue (430, 81.0%), feeling cold, and weight gain (409, 77.0%); neck lump (379, 71.4%); depression (367, 69.1%); and hair loss (336, 63.3%). Early diagnosis (426, 80.2%), a well-exercised program (394, 74.2%), and a well-balanced diet (392, 73.8%) were the prevention methods reported by a majority of the participants. The study results revealed an average score of 13.57±2.11, with a minimum knowledge score of 0 and a maximum of 25. A statistically significant difference was observed in knowledge scores based on the participant's gender, age, education level, previous diagnosis with thyroid diseases, family history of thyroid diseases, and having performed thyroid gland investigation with p-values <0.05 (<0.001, 0.019, 0.027, <0.001, 0.023, and 0.031), respectively. Nearly half of the participants had low knowledge scores regarding the risk factors and clinical manifestations of thyroid diseases. Although a sizable proportion of participants demonstrated awareness of some clinical presentations and prevention methods, there are serious knowledge gaps regarding the risk factors and symptoms of thyroid disease among the general population in the Al-Baha region. There is a need for targeted health education programs to improve public awareness of risk factors and early detection and prevention measures of thyroid diseases to improve the quality of life among community members.

Climate change impacts on worldwide ecological niche and invasive potential of Sternochetus mangiferae.

Present climate studies on invasive species imply that climate change will alter the habitat suitability of invasive pests, especially given the projected rise in average global temperatures by the end of 2100. However, globally, limited information exists on the habitat suitability of the mango stone weevil, Sternochetus mangiferae Fabricius, which impedes the development of early detection and preventive measures. Herein, we used the MaxEnt model to estimate the potential global geographical distribution of S. mangiferae. Our results revealed that thermal conditions played a significant role in explaining the invasion risk of S. mangiferae. Habitat suitability was found in all continents, except Antarctica. Under the present condition, habitat suitability covered 5.67 × 107 km2. For ssp126, habitat suitability will decrease from the 2060s (5.58 × 107 km2) and 2080s (5.57 × 107 km2). Similarly, under ssp585, suitable areas will decrease from 5.62 × 107 to 5.51 × 107 km2 for the 2060s and 2080s, respectively. Our study has estimatedvariability in the habitat suitability of S. mangiferae which establishes a foundation for determining global riskassessment and response plans for the pest. This study also identifies areas where the pest is inherently more vulnerable to the impacts of changing climates and enables forecasting of its potential distribution in a dynamic world. © 2024 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Identifying food safety risks with a novel digitally-driven food safety early warning tool – A retrospective study on the pesticide ethylene oxide

Foodborne diseases present a major global health challenge, with 600 million annual cases and 420,000 deaths worldwide in 2023 reported by the World Health Organization, underscoring the critical need for early risk detection and swift measures. Novel solutions for early risk detection in food are emerging due to artificial intelligence-based data models. By applying diverse algorithms and ontologies in data processing, the continually expanding amount of available data can be harnessed in a precise manner. To assess the efficacy of such technologies in early risk detection, we evaluated whether the risk to exceed a legal limit for ethylene oxide – specifically in sesame seeds – could have been identified sooner with the assistance of a commercially available Artificial Intelligence (AI)-based platform. The non-compliance of sesame seeds led to various product recalls in the year 2020. The result of this retrospective case study shows that the first indirect indications of the issue started to emerge from the year 2018 with initial Rapid Alert System for Food and Feed (RASFF) notification of ethylene oxide limit value exceedances in black pepper powder. Based on these promising findings, the subsequent challenge is to develop a methodology for systematically categorizing and evaluating similar risks in the light of the exponentially growing volume of accessible data.