Early Detection Measures Research Articles

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<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 >=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=<.0001), IC-OS criteria fulfilled (OR 43.108 [9.222-201.510], p=<.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=< 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<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<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.

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.

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.

Modeling different strategies towards control of lung cancer: leveraging early detection and anti-cancer cell measures

The global population has encountered significant challenges throughout history due to infectious diseases. To comprehensively study these dynamics, a novel deterministic mathematical model, TCD I L 2 Z, is developed for the early detection and treatment of lung cancer. This model incorporates I L 2 cytokine and anti-PD-L1 inhibitors, enhancing the immune system’s anticancer response within five epidemiological compartments. The TCD I L 2 Z model is analyzed qualitatively and quantitatively, emphasizing local stability given the limited data-a critical component of epidemic modeling. The model is systematically validated by examining essential elements such as equilibrium points, the reproduction number ( R 0 ), stability, and sensitivity analysis. Next-generation techniques based on R 0 that track disease transmission rates across the sub-compartments are fed into the system. At the same time, sensitivity analysis helps model how a particular parameter affects the dynamics of the system. The stability on the global level of such therapy agents retrogrades individuals with immunosuppression or treated with I L 2 and anti-PD-L1 inhibitors admiring the Lyapunov functions’ applications. NSFD scheme based on the implicit method is used to find the exact value and is compared with Euler’s method and RK4, which guarantees accuracy. Thus, the simulations were conducted in the MATLAB environment. These simulations present the general symptomatic and asymptomatic consequences of lung cancer globally when detected in the middle and early stages, and measures of anticancer cells are implemented including boosting the immune system for low immune individuals. In addition, such a result provides knowledge about real-world control dynamics with I L 2 and anti-PD-L1 inhibitors. The studies will contribute to the understanding of disease spread patterns and will provide the basis for evidence-based intervention development that will be geared toward actual outcomes.

Assessing the Health Belief Model of Students with Regard to Breast Cancer: A Descriptive Study

Background: Breast cancer continues to be a substantial worldwide health issue, impacting millions of individuals and families annually. Gaining insight into individuals' perception and reaction to the risk of breast cancer is crucial for advancing early detection and successful prevention methods. The Health Belief Model (HBM) is a commonly utilised theoretical framework for examining health behaviours associated with breast cancer. According to the Health Belief Model (HBM), individuals are more inclined to take measures to prevent or manage a health threat if they believe that they are at risk of developing the condition, perceive the condition to have severe consequences, believe that taking action would be advantageous in reducing the threat, and perceive minimal obstacles to taking action. The study seeks to evaluate the Health Belief Model of students in relation to breast cancer. Methods: A descriptive research design was adopted. Self-administered semi-structured questionnaires were used to elicit information from 365 female participants. Purposive sampling approach was used to choose Tamale Girls and Ghana Senior High Schools from the Tamale Metropolis and simple random technique was used to identify the study respondents. Data was analysed using SPSS. Statistics like frequency and percentages were used to represent the findings. Results: The study revealed that students possessed a moderate-to-high level of information regarding the causes, effects, and preventions of breast cancer. This knowledge was mostly influenced by the type or category of learning. Overall, a minimal number of students participated in the screening process for breast cancer. Among the three techniques, breast self-examination was the most commonly utilised, followed by mammography and clinical breast examination. Factors such as age, family size, religion, and social class were found to be associated with breast cancer screening. Conclusion: Students generally exhibited a modest degree of perceived vulnerability to breast cancer. They also demonstrated a favourable disposition towards the advantages of breast cancer prevention and early detection measures.

Developing a Sustainable Education Protocol for Children with Attention Deficit Hyperactivity Disorder (adhd) in the Context of Developing Country

Abstract Attention Deficit Hyperactivity Disorder (adhd) is a neurodevelopmental disorder characterised by symptoms of inattention, hyperactivity, and impulsivity that may significantly impact children’s academic, social, and emotional health. This study has examined the most recent scholarly research on the influence of adhd on children’s academic performance as well inclusive education protocol in different country contexts. Legal and academic interventions for adhd are well-established in developed countries, but there is a significant gap in addressing the needs of children with adhd in developing countries. This research study aims to fill the gap by suggesting a sustainable formal education protocol designed to meet the specific problems and situations of developing countries. The proposed Strategies-Support Services-Collaboration (ssc) protocol is influenced by concepts of inclusion, equity, and sustainability, aiming to address the different challenges encountered by children with adhd in obtaining quality education. The protocol includes measures for early detection and assessment of adhd, customised academic accommodations and support services, teacher training and capacity-building programmes, and collaborations with community resources and healthcare professionals. This research intends to empower educators, policymakers, and communities by proposing a sustainable formal education protocol. The goal is to establish more inclusive and supportive learning settings for children with adhd, thereby enhancing their academic success and general well-being. Integrating children with adhd into formal school aligns with the Sustainable Development Goal (sdg) 4 which aims to offer inclusive and quality education for everyone.

Application of fecal immunochemical test in colorectal cancer screening: A community-based, cross-sectional study in average-risk individuals in Hainan.

The incidence of colorectal cancer (CRC) in China is steadily rising, with a high proportion of advanced-stage diagnoses. This highlights the significance of early detection and prevention measures to enhance survival rates. Fecal immunochemical testing (FIT) is a globally recommended CRC screening method; however, limited research has been conducted on its application in Hainan. To assess the efficacy and adherence of FIT screening among average-risk individuals in Hainan, while also examining the risk factors associated with positive FIT results. This population-based cross-sectional study implemented FIT screening for CRC in 2000 asymptomatic participants aged 40-75 years from five cities and 21 community health centers in Hainan Province. The study was conducted from August 2022 to April 2023, employing a stratified sampling method to select participants. Individuals with positive FIT results subsequently underwent colonoscopy. Positive predictive values for confirmed CRC and advanced adenoma were calculated, and the relationship between relevant variables and positive FIT results was analyzed using χ 2 tests and multivariate logistic regression. A total of 1788 participants completed the FIT screening, with a median age of 57 years (interquartile range: 40-75). Among them, 503 (28.1%) were males, and 1285 (71.9%) were females, resulting in an 89.4% compliance rate for FIT screening. The overall positivity rate of FIT was 4.4% [79 out of 1788; 95% confidence interval (CI): 3%-5%]. The specific positivity rates for Haikou, Sanya, Orient City, Qionghai City, and Wuzhishan City were 9.6% (45 of 468; 95%CI: 8%-11%), 1.3% (6 of 445; 95%CI: 0.1%-3.1%), 2.7% (8 of 293; 95%CI: 1.2%-4.3%), 3.3% (9 of 276; 95%CI: 1.0%-6.3%), and 4.2% (11 of 406; 95%CI: 1.2%-7.3%), respectively. Significant associations were found between age, dietary habits, and positive FIT results. Out of the 79 participants with positive FIT results, 55 underwent colonoscopy, demonstrating an 82.2% compliance rate. Among them, 10 had a clean gastrointestinal tract, 43 had polyps or adenomas, and 2 were confirmed to have CRC, yielding a positive predictive value of 3.6% (95%CI: 0.9%-4.2%). Among the 43 participants with polyps or adenomas, 8 were diagnosed with advanced adenomas, resulting in an advanced adenoma rate of 14.5% (95%CI: 10.1%-17.7%). In the Hainan region, FIT screening for CRC among asymptomatic individuals at average risk is feasible and well-received.

Comparison of the differential effect of participation in breast cancer screening program versus opportunistic screening or symptomatic detection on tumour characteristics.

The success of a breast cancer screening program is highly dependent on adherence. We aimed to compare the differential effect of participation in breast cancer screening program versus opportunistic screening or symptomatic detection on tumour characteristics. We included women referred to our Breast Centre in 2015-2021: 321 from the breast cancer screening group (group 1) and 422 through opportunistic screening or due to symptomatic detection (group 2). We compared data on sociodemographics, breast cancer detection, clinical features and tumour characteristics. A total of 10.6% of women in group 1 had breast symptoms and 63.8% had breast signs, with group 2 presenting higher proportions (57.6 and 77.8%, respectively, P < 0.001). The median tumour size in group 1 was smaller compared with group 2 (14 vs 17 mm, P < 0.001). A total of 8.7% of women in group 1 had nodal involvement whereas in group 2 the proportion corresponded to 19.0% (P < 0.001). No women in group 1 were diagnosed with metastasis, while metastases were found in 2.4% of those from group 2 (P = 0.005). There were no significant differences in molecular subtype of invasive tumours between the two groups. The tumour characteristics of women who participated in the breast cancer screening program showed in almost all characteristics more favourable results in comparison with the group who underwent opportunistic screening or sought care due to symptoms. The lower clinical stage observed in those referred from the organised program reaffirms that it is an effective measure for early detection, diagnosis, and treatment.

Burden of osteoarthritis in Indonesia: A Global Burden of Disease (GBD) study 2019.

Osteoarthritis (OA) is a complex and common condition, especially affecting the knees due to their weight-bearing role. Traditionally seen as a degenerative disease, OA is now understood to have both mechanical and inflammatory causes. Despite its increasing prevalence, there is limited data on OA in Indonesia, resulting in low awareness among clinicians and the public. The aim of this study was to describe the OA burden in Indonesia, focusing on its prevalence, incidence, and years lived with disability (YLD) from 1990 to 2019, using data from the Global Burden of Disease (GBD) study 2019. A descriptive cross-sectional study was conducted to examine the prevalence, incidence, and YLD of OA in Indonesia from the GBD study 2019. OA prevalence and YLD were compared to other countries according to similar social demographics and geographical proximity. OA YLD was also compared to the top causes of death and disability YLD in Indonesia. The study found that OA cases in Indonesia more than doubled from 1990 to 2019, with increases of 153.12% in males and 143.36% in females. Similar trends were observed for knee OA. The age-standardized prevalence rate in Indonesia increased by 11.03% in males and 8.42% in females, and these were higher compared to China, India, Singapore, and the global average. Younger people had a higher OA prevalence rate growth than older groups. The incidence rate for OA also rose significantly, with males seeing a 10.89% increase to 290 per 100,000 people and females with an 8.57% increase to 384 per 100,000 people. Despite lower overall burden rates compared to some countries, Indonesia experienced significant growth in YLD due to OA (12.16% in males and 9.65% in females) since 1990. Although OA was less burdensome than stroke, diabetes, low back pain, and chronic obstructive pulmonary disease (COPD), its YLD growth rate was higher. In conclusion, OA prevalence and incidence in Indonesia significantly increased from 1990 to 2019, with a notable rise among younger populations. OA had a higher YLD growth compared to several other major diseases in Indonesia, highlighting the need for early detection and preventive measures, particularly for the younger population.

Defining the Functional Sensitivity for the Siemens Atellica Calcitonin Assay: Insight From a Single-Center Study

BackgroundDetectable, and especially rising postthyroidectomy serum calcitonin and carcinoembryonic antigen levels, as per American Thyroid Association guidelines, indicate potential disease presence, requiring frequent calcitonin measurement or imaging for early detection of persistent or recurrent medullary thyroid carcinoma. Thus, defining the clinical cutoff value of detection of calcitonin assays relative to imaging and clinical status is crucial for patient care. This study aimed to evaluate postoperative calcitonin levels using the new Siemens Atellica assay system to determine the most appropriate levels for clinical decision-making. MethodsA retrospective analysis was conducted using Siemens Atellica for calcitonin testing on 56 samples from 40 patients between September 27, 2022 and August 11, 2023. Only calcitonin results performed at least 3 months post-total thyroidectomy were included. Imaging studies, within 6 months of the calcitonin report, were assessed. Carcinoembryonic antigen results were also reviewed. ResultsPrecision analysis at 2.94 and 5.24 pg/mL revealed coefficients of variation at 16.49% and 8.87%, respectively. For the evidence of post-total thyroidectomy persistent or recurrent medullary thyroid carcinoma confirmed by imaging, using a 1.89 pg/mL cutoff for calcitonin yielded 43% sensitivity and 67% specificity. Using a 5.00 pg/mL cutoff resulted in 0% sensitivity and 100% specificity. ConclusionsOur findings indicate the potential suitability of a 5 pg/mL calcitonin cutoff on the Siemens Atellica platform for evaluating tumor persistence or recurrence in post-thyroidectomy patients in our institution. However, individual laboratories should establish their own clinical cutoff value when evaluating calcitonin levels for monitoring tumor recurrence post-thyroidectomy.

Time trend analysis and impacts of the COVID-19 pandemic on mammography and Papanicolaou test coverage in Brazilian state capitals

BackgroundBreast and cervical cancer are major public health issues globally. The reduction in incidence and mortality rates of these cancers is linked to effective prevention, early detection, and appropriate treatment measures. This study aims to analyze the temporal trends in the prevalence of mammography and Papanicolaou test coverage among women living in Brazilian state capitals between 2007 and 2023, and to compare the coverage of these tests before and during the Covid-19 pandemic.MethodsA time series study was conducted using data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey from 2007 to 2023. The variables analyzed included mammography and Papanicolaou test coverage according to education level, age group, race/skin color, regions, and Brazilian capitals. The Prais-Winsten regression model was used to analyze the time series, and Student’s t-test was employed to compare the prevalence rates between 2019 and 2023.ResultsBetween 2007 and 2023, mammography coverage showed a stationary trend (71.1% in 2007 and 73.1% in 2023; p-value = 0.75) with a declining trend observed among women with 12 years or more of education (APC= -0.52% 95%CI -1.01%; -0.02%). Papanicolaou test coverage for all women aged between 25 and 64 exhibited a downward trend from 82% in 2007 to 76.8% in 2023 (APC= -0.45% 95%CI -0.76%; -0.13%). This decline was also noticed among those with 9 years or more of education; in the 25 to 44 age group; among women with white and mixed race; and in the Northeast, Central-West, Southeast, and South regions. When comparing coverage before and during Covid-19 pandemic, a reduction was noted for both tests.ConclusionsOver the years, there has been stability in mammography coverage and a decline in Papanicolaou test. The COVID-19 pandemic negatively impacted the number of these tests carried out among women, highlighting the importance of actions aimed at increasing coverage, especially among the most vulnerable groups.

The current landscape of cancer treatment scenario in Bangladesh

The current cancer scenario in Bangladesh presents a significant public health challenge. Cancer is the second leading cause of death in the country, with approximately 150,000 new cases diagnosed and 108,000 deaths annually. Bangladesh is facing several critical issues regarding cancer treatment like the lack of a national cancer control strategy and comprehensive cancer screening system, resulting in most patients being diagnosed at advanced stages, which reduces the chances of successful treatment. Early detection and prevention measures are crucial, but efforts in these areas remain inadequate in Bangladesh.

Robust Forest Fire Detection using Deep Convolutional Neural Networks

Forest fires pose significant threats to ecosystems, wildlife, and human lives, necessitating proactive measures for early detection and rapid response. This paper presents FireGuard, an efficient model for forest fire detection using deep convolutional neural networks (CNNs). Leveraging the power of deep learning and image processing techniques, FireGuard analyzes aerial imagery and satellite data to detect signs of smoke and fire outbreaks in forested areas. The model utilizes a lightweight CNN architecture optimized for real-time performance and resource-constrained environments, making it suitable for deployment on unmanned aerial vehicles (UAVs), surveillance cameras, and satellite platforms. Experimental results demonstrate the effectiveness of FireGuard in accurately identifying forest fires with high precision and recall, outperforming traditional methods and existing deep learning models. By providing early warnings of potential fire incidents, FireGuard enables timely intervention by fire fighting agencies, thereby mitigating the impact of forest fires and preserving natural habitats.

Glaucoma Severity Stage at First Visit at a University Eye Clinic in Congo.

Initial presentation of glaucoma at a major eye clinic mostly features advanced disease with a high proportion of blindness. This is likely a microcosm of a nationwide issue requiring concerted strategies to detect glaucoma early. To characterize the severity stage of new glaucoma patients and identify the predictors of late presentation in Congolese attending a university eye clinic. New glaucoma patients (n=118) were labelled as early or late presenters based visual field sensitivity in the worse eye. Predictors of late presentation were determined through logistic regression analytical models. Mean age was 58.9±15.7 years, 51.7% were males. Overall, the worse eye had advanced whereas the better eye had moderate glaucoma, with an asymmetry of -7.4dB (P<0.001). Blindness was present in 30.5% of worse and 5.1% of better eyes. Seventy-two patients (61.0%) were late presenters. Visual acuity was lower (P<0.001), intraocular pressure (IOP) higher (P=0.02), cup-to-disc ratio larger (P=0.011), and retinal nerve fiber layer thinner (P=0.001) in late presenters' worse than better eye. The worse and better eyes of late presenters had advanced glaucoma, with a -9.6dB interocular asymmetry (P<0.001); 40.3% and 8.3% were blind, respectively. In early presenters, the worse and better eye had moderate and early disease, respectively; the asymmetry was -3.2dB (P<0.001), and 15.2% were blind. Overall, 58.5% and 65.3% presented with advanced disease in the worse eye based on visual field and cup-to-disc ratio criteria of the Canadian Ophthalmological Society staging scale, respectively. Most new glaucoma patients had bilateral advanced but asymmetric disease. These findings call for the establishment of community-based measures for early detection of glaucoma and a referral network system connecting community healthcare to tertiary eye clinics.

Establishment and risk factor assessment of the abnormal body temperature probability prediction model (ABTP) for dairy cattle

The study aims to develop an abnormal body temperature probability (ABTP) model for dairy cattle, utilizing environmental and physiological data. This model is designed to enhance the management of heat stress impacts, providing an early warning system for farm managers to improve dairy cattle welfare and farm productivity in response to climate change. The study employs the Least Absolute Shrinkage and Selection Operator (LASSO) algorithm to analyze environmental and physiological data from 320 dairy cattle, identifying key factors influencing body temperature anomalies. This method supports the development of various models, including the Lyman Kutcher-Burman (LKB), Logistic, Schultheiss, and Poisson models, which are evaluated for their ability to predict abnormal body temperatures in dairy cattle effectively. The study successfully validated multiple models to predict abnormal body temperatures in dairy cattle, with a focus on the temperature-humidity index (THI) as a critical determinant. These models, including LKB, Logistic, Schultheiss, and Poisson, demonstrated high accuracy, as measured by the AUC and other performance metrics such as the Brier score and Hosmer–Lemeshow (HL) test. The results highlight the robustness of the models in capturing the nuances of heat stress impacts on dairy cattle. The research develops innovative models for managing heat stress in dairy cattle, effectively enhancing detection and intervention strategies. By integrating advanced technologies and novel predictive models, the study offers effective measures for early detection and management of abnormal body temperatures, improving cattle welfare and farm productivity in changing climatic conditions. This approach highlights the importance of using multiple models to accurately predict and address heat stress in livestock, making significant contributions to enhancing farm management practices.

Update on lacrimal apparatus dysfunction associated with differentiated thyroid cancer after I-131 therapy.

The most prevalent lacrimal apparatus dysfunctions associated with differentiated thyroid cancer(DTC) after I-131 therapy are dry eye and nasolacrimal duct obstruction(NLDO), leading to ocular discomfort and lower quality of life for patients. It is crucial to diagnose and manage lacrimal apparatus dysfunction associated with I-131 therapy for DTC. Therefore, this review aims to comprehensively summarize and analyze the advances in mechanisms and therapeutic options underlying lacrimal apparatus dysfunction induced by I-131 therapy for DTC. A comprehensive search of CNKI, PubMed, and Wed of Science was performed from the database to December of 2023. Key search terms were "Thyroid cancer", "I-131", "Complications", "Dry eye", "Epiphora", "Tear", "Nasolacrimal duct" and "NLDO". The research indicates that I-131 therapy for DTC causes damage to the lacrimal glands and nasolacrimal duct system, resulting in symptoms such as dry eye, epiphora, and mucoid secretions. Moreover, recent research has focused on exploring relevant risk factors of the condition and experimental and clinical treatments. However, there is some controversy regarding the mechanisms involved, whether it is due to the passive flow of I-131 in tears, active uptake of I-131 by the sodium-iodide symporter (NIS) in the lacrimal sac and nasolacrimal duct, or secondary metabolic and hormonal disturbances caused by I-131. It is crucial for early detection and preventive measures by ophthalmologists and the need for further studies to elucidate the mechanisms underlying the disease.