Early Diagnosis Research Articles

Predicting gestational diabetes mellitus risk at 11–13 weeks’ gestation: the role of extrachromosomal circular DNA

BackgroundGestational diabetes mellitus (GDM) significantly impacts maternal and infant health both immediately and over the long term, yet effective early diagnostic biomarkers are currently lacking. Thus, it is essential to identify early diagnostic biomarkers for GDM risk screening. Extrachromosomal circular DNA (eccDNA), being more stable than linear DNA and involved in disease pathologies, is a viable biomarker candidate for diverse conditions. In this study, eccDNA biomarkers identified for early diagnosis and assessment of GDM risk were explored.MethodsUsing Circle-seq, we identified plasma eccDNA profiles in five pregnant women who later developed GDM and five matched healthy controls at 11–13 weeks of gestation. These profiles were subsequently analyzed through bioinformatics and validated through outward PCR combined with Sanger sequencing. Furthermore, candidate eccDNA was validated by quantitative PCR (qPCR) in a larger cohort of 70 women who developed GDM and 70 normal glucose-tolerant (NGT) subjects. A ROC curve assessed the eccDNA’s diagnostic potential for GDM.Results2217 eccDNAs were differentially detected between future GDM patients and controls, with 1289 increased and 928 decreased in abundance. KEGG analysis linked eccDNA genes mainly to GDM-related pathways such as Rap1, MAPK, and PI3K-Akt, and Insulin resistance, among others. Validation confirmed a significant decrease in eccDNA PRDM16circle in the plasma of 70 women who developed GDM compared to 70 NGT women, consistent with the eccDNA-seq results. PRDM16circle showed significant diagnostic value in 11–13 weeks of gestation (AUC = 0.941, p < 0.001).ConclusionsOur study first demonstrats that eccDNAs are aberrantly produced in women who develop GDM, including PRDM16circle, which can predict GDM at an early stage of pregnancy, indicating its potential as a biomarker.Trial registration ChiCTR2300075971, http://www.chictr.org.cn. Registered 20 September 2023.

Potential-Resolved Ratio Electrochemiluminescence Biosensor Based on Perylene Diimide-MOF and DNA Nanoflowers-CdS Quantum Dots for Detection of Dual Targets.

BRCA1 gene and carcinoembryonic antigen (CEA) are important markers of breast cancer, so accurate detection of them is significant for early detection and diagnosis of breast cancer. In this study, a potential-resolved ratio electrochemiluminescence (ECL) biosensor using perylene diimide (PDI)-metal-organic framework and DNA nanoflowers (NFs)-CdS quantum dots (QDs) was constructed for detection of BRCA1 and CEA. Specifically, PDI-MOF and CdS QDs can generate potential-resolved intense ECL signals only using one coreactant, so the detection procedure can be effectively simplified. PDI-MOF was first attached to the electrode by graphene oxide, and the dopamine (DA) probe was linked to quench the ECL signal by DNA hybridization. In the presence of target BRCA1, it can form a bipedal DNA walker, so the quenching molecules (DA) were detached from the electrode via the walker amplification process aided by Mg2+, so that the PDI signal at -0.25 V was restored for the BRCA1 assay. Moreover, CdS QDs@DNA NFs as amplified signal probes were formed by self-assembly, and the target CEA-amplified product introduced the CdS QDs@DNA NFs to the electrode, so the QD ECL signal at -1.42 V was enhanced, while the ECL signal of PDI is unchanged; thus, CEA detection was achieved by the ratio value between them. Therefore, the detection accuracy is guaranteed by detection of two cancer markers and a ratio value. This biosensor has a great contribution to the development of new ECL materials and a novel ECL technique for fast and efficient multitarget assays, showing great significance for the early monitoring and diagnosis of breast cancer.

Two-Step Conservative Surgery for Complicated Forms of Diabetes-Related Foot Osteomyelitis.

Diabetes-related foot osteomyelitis (DFO) is a common yet complex condition, often complicated by concurrent soft tissue infections (STIs). This study evaluates the efficacy of a two-step conservative surgical approach, hypothesizing that it offers comparable outcomes to a one-step procedure. Conducted on a cohort of 93 patients with DFO, the study categorized cases into two types: OM1 (osteomyelitis without STI) and OM2 (osteomyelitis with STI). OM2 was further subdivided into OM2a (early diagnosis) and OM2b (late diagnosis), with OM2 patients undergoing initial soft tissue debridement followed by elective bone surgery. The results indicated no significant differences in infection recurrence or amputation rates between the two surgical approaches, with recurrence observed in 20.7% of cases and amputations in 10.8%. The two-step procedure was associated with higher inflammatory responses and greater need for antibiotics and hospital admissions. However, these factors did not translate into increased recurrence or amputation compared to the one-step procedure. The study supports the two-step approach as a safe and effective method for managing complicated DFO cases, providing a viable alternative to immediate amputation or single-stage surgery. Despite some limitations, including regional specificity and potential underdiagnosis in late-diagnosed cases, the findings offer valuable insights for clinical management and suggest further research to refine treatment protocols. The study's strengths include confirmed histopathological diagnoses and consistent follow-up, reinforcing the validity of the two-step surgical approach for complex DFO treatment.

Investigation of Metabolic Parameters of Women of Reproductive Age

Objective: Fertility rates are decreasing every year, mainly due to socioeconomic and medical reasons. In this study we aimed to investigate the incidence of metabolic disorders that may negatively affect reproduction. Methods: Glucose parameters of 5892 patients, lipid parameters of 2491 patients and thyroid function tests of 457 patients were retrospectively examined. Patients divided into two groups in terms of age. Each age groups were divided into subgroups as diabetic, prediabetic, non-diabetic and euthyroidism, overt hypothyroidism, subclinical hypothyroidism and hyperthyroidism. Results: The rate of Euthyroidism was 85.8%, overt hypothyroidism was 4.2%, subclinical hypothyroidism was 3.5%, and hyperthyroidism (subclinical+overt) was 6.5% in all ages. There was no significant difference in st3, st4 and TSH values according to age (p values p = 0.051, p = 0.195, p = 0.585, respectively). The rate of diabetes was 4.7%, non-diabetes 83.7% and prediabetes was 11.6%. There was a significant difference between diabetic, prediabetic, and non-diabetic according to age (p≤0.001). Conclusion: Thyroid dysfunction and glucose metabolism disorders are more common in our country due to genetic and environmental factors. Early diagnosis is very important to avoid the unwilling side effects of this condition. For this, new approaches are needed, such as close follow-up clinics aimed only at women of reproductive age.

The Promise of Artificial Intelligence in Neuroanesthesia: An Update

AbstractArtificial intelligence (AI) is poised to transform health care across medical specialties. Although the application of AI to neuroanesthesiology is just emerging, it will undoubtedly affect neuroanesthesiologists in foreseeable and unforeseeable ways, with potential roles in preoperative patient assessment, airway assessment, predicting intraoperative complications, and monitoring and interpreting vital signs. It will advance the diagnosis and treatment of neurological diseases due to improved risk identification, data integration, early diagnosis, image analysis, and pharmacological and surgical robotic assistance. Beyond direct medical care, AI could also automate many routine administrative tasks in health care, assist with teaching and training, and profoundly impact neuroscience research. This article introduces AI and its various approaches from a neuroanesthesiology perspective. A basic understanding of the computational underpinnings, advantages, limitations, and ethical implications is necessary for using AI tools in clinical practice and research. The update summarizes recent reports of AI applications relevant to neuroanesthesiology. Providing a holistic view of AI applications, this review shows how AI could usher in a new era in the specialty, significantly improving patient care and advancing neuroanesthesiology research.

Family Involvement During Comprehensive Developmental Evaluations: Perspectives of Diverse Mothers.

Early diagnosis and social support postdiagnosis (i.e., family involvement) can lead to improved outcomes for children with autism spectrum disorder (ASD) and other developmental disorders. Children of minority ethnic and racial groups are typically diagnosed later in childhood compared with White children, contributing to disparities in outcomes. Research has not yet explored family involvement during comprehensive developmental evaluations nor accounted for cross-cultural differences in family roles and involvement. This qualitative study sought to characterize the nature and impact of family involvement during the developmental evaluation process among racially and ethnically marginalized mothers of children with developmental delays and possible ASD. Mothers (N = 27) of children who had a positive autism screen during their 18- or 24-month well-child visit but did not receive an ASD diagnosis after comprehensive developmental evaluation participated in individual semi-structured interviews exploring experiences with developmental screening, related services, and family involvement/social support. Qualitative data were transcribed, coded, and analyzed using applied thematic analysis. Data were stratified by partner status (i.e., partnered vs. nonpartnered) to examine differences in support and family involvement across varying family compositions. Three qualitative themes emerged: (1) mothers sought family involvement when making decisions about pursuing developmental evaluations, (2) family involvement affected mothers' navigation of logistical challenges, and (3) mothers involved family members for emotional support. Differences by partner status emerged in themes 1 and 2. Findings highlight benefits of and potential approaches to harnessing family involvement to support parents' navigation of the developmental evaluation process and ultimately improve child outcomes.

Exosomal CircRNAs: A Future Star in Colorectal Cancer.

Colorectal cancer (CRC) is currently the third most common malignancy world-wide, with an increasing mortality rate and treatment resistance. Due to the lack of effective biomarkers and therapeutic targets, the early diagnosis and treatment of colorectal cancer re-main suboptimal. Circular RNAs (circRNAs) are a novel class of non-coding RNAs with co-valent closed-loop structures that are well stabilized and conserved and are involved in multi-ple pathological conditions in humans. CircRNAs have been identified to be enriched and sta-ble in exosomes. In addition, there is growing proof that exosomal circRNAs that have been identified as oncogenes or tumor suppressors regulate CRC growth, migration, and sensitivity to radiotherapy and chemotherapy. Exosomal circRNAs represent promising candidates as di-agnostic biomarkers and anti-tumor targets. In this article, we explore recent studies on exo-somal circRNAs in CRC and describe their biological functions in colorectal cancer develop-ment, illustrating their potential as biomarkers and targeted therapeutic capabilities.

Potentially avoidable mortality among adults with intellectual disability.

Persons with intellectual disabilities (ID) face pronounced health disparities. The aim of this study was to describe premature mortality by causes of death and avoidable mortality among persons with ID compared to the general Danish population. This study is based on a Danish nationwide cohort of adults (aged 18-74 years) with ID (n = 57663) and an age- and sex-matched reference cohort (n = 607 097) which was established by linkage between several registers. The cohorts were followed in the Register of Causes of Death between 2000 and 2020. Causes of death were categorized into preventable, treatable, or unavoidable deaths using the OECD/Eurostat classification and furthermore categorized into specific interventions. We compared the observed and expected number of deaths by calculating standardized mortality ratio (SMR). Among persons with ID the number of deaths was 9400 whereof 5437 (58%) were avoidable. SMR for preventable deaths, e.g. by reducing smoking and alcohol intake or by vaccination, was 2.62 (95% CI, 2.51-2.73), and SMR for treatable deaths, e.g. by earlier diagnosis and treatment, was 6.00 (5.72-6.29). Unavoidable mortality was also six-fold increased (SMR = 6.03; 5.84-6.22). Preventable deaths were higher for persons with mild ID compared to severe ID, while treatable and unavoidable mortality were highest for persons with severe ID. The study confirmed that persons with ID have an amplified risk of mortality across all categories. There is a need for competence development of social care and healthcare personnel and reasonable adjustment of health promotion programs and healthcare services for people with ID.

Patient factors that lead to presentation delay in breast cancer among Sri Lankan women: A cross-sectional study

Background: Breast cancer (BC) poses a significant public health concern as it is the most common cancer detected among women worldwide. Early detection and intervention are associated with better prognosis and survival. A primary reason for the rising mortality and morbidity in developing countries is the lack of patient education and practice early detection programs and presentation. Aims and Objectives: The main objective of this study is to evaluate the prevalence of delayed presentation and the factors lead to delay among BC patients in Sri Lanka. Materials and Methods: A descriptive cross-sectional study was conducted from January 01, 2023, to June 30, 2023 among women diagnosed with BC attending two selected state hospitals in Sri Lanka. All women with histological diagnosis of early, locally advanced, or metastatic BC attending for treatment were included and women with recurrent BC and concomitant other cancers were excluded. Presentation delay was defined as ≥3 months. The calculated sample size was 396. Results: About 47.5% of our study population (n=188) had a presentation delay of more than 3 months. The main reasons for the delay in presentation were, being unaware that BC is a major problem in Sri Lanka, difficulty in accessing healthcare, and not being able to find time due to family and social commitments. Women who had not been practicing self-breast examination had a significant association with presentation delay (OR=3.26, 95% CI - 0.090–0.362, P=0.001). The participants who were having a presentation delay were also more likely to be diagnosed with an advanced stage of cancer (OR=2.86, 95% CI - 2.573–3.153, P=0.000). Conclusion: Our study population depicts a good knowledge related to BC symptoms, risk factors, and early detection methods. However, very few are practicing them. There is also a significant delay of presentation due to various factors. Awareness and good practices would lead to early detection and diagnosis and improve overall survival.

A rapid LAMP assay for the diagnosis of oak wilt with the naked eye

BackgroundOak wilt disease, caused by Bretziella fagacearum is a significant threat to oak (Quercus spp.) tree health in the United States and Eastern Canada. The disease may cause dramatic damage to natural and urban ecosystems without management. Early and accurate diagnosis followed by timely treatment increases the level of disease control success.ResultsA rapid assay based on loop mediated isothermal amplification (LAMP) was first developed with fluorescence detection of B. fagacearum after 30-minute reaction time. Six different primers were designed to specifically bind and amplify the pathogen’s DNA. To simplify the use of this assay in the field, gold nanoparticles (AuNPs) were designed to bind to the DNA amplicon obtained from the LAMP reaction. Upon inducing precipitation, the AuNP-amplicons settle as a red pellet visible to the naked eye, indicative of pathogen presence. Both infected and healthy red oak samples were tested using this visualization method. The assay was found to have high diagnostic sensitivity and specificity for the B. fagacearum isolate studied. Moreover, the developed assay was able to detect the pathogen in crude DNA extracts of diseased oak wood samples, which further reduced the time required to process samples.ConclusionsIn summary, the LAMP assay coupled with oligonucleotide-conjugated gold nanoparticle visualization is a promising method for accurate and rapid molecular-based diagnosis of B. fagacearum in field settings. The new method can be adapted to other forest and plant diseases by simply designing new primers.

Genome-wide assessment of shared genetic landscape of idiopathic pulmonary fibrosis and its comorbidities.

Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease accompanied by both local and systemic comorbidities. Genetic factors play a role in the development of IPF and certain associated comorbidities. Nevertheless, it is uncertain whether there are shared genetic factors underlying IPF and these comorbidities. To bridge this knowledge gap, we conducted a systematic investigation into the shared genetic architecture between IPF and ten prevalent heritable comorbidities (i.e., body mass index [BMI], coronary artery disease [CAD], chronic obstructive pulmonary disease [COPD], gastroesophageal reflux disease, lung cancer, major depressive disorder [MDD], obstructive sleep apnoea, pulmonary hypertension [PH], stroke, and type 2 diabetes), by utilizing large-scale summary data from their respective genome-wide association studies and multi-omics studies. We revealed significant (false discovery rate [FDR] < 0.05) and moderate genetic correlations between IPF and seven comorbidities, excluding lung cancer, MDD and PH. Evidence suggested a partially putative causal effect of IPF on CAD. Notably, we observed FDR-significant genetic enrichments in lung for the cross-trait between IPF and CAD and in liver for the cross-trait between IPF and COPD. Additionally, we identified 65 FDR-significant genes over-represented in 20 biological pathways related to the etiology of IPF, BMI, and COPD, including inflammation-related mucin gene clusters. Several of these genes were associated with clinically relevant drugs for the treatment of IPF, CAD, and/or COPD. Our results underscore the pervasive shared genetic basis between IPF and its common comorbidities and hold future implications for early diagnosis of IPF-related comorbidities, drug repurposing, and the development of novel therapies for IPF.

Machine Learning-Driven Biomarker Discovery for Skeletal Complications in Type 1 Gaucher Disease Patients

Type 1 Gaucher disease (GD1) is a rare, autosomal recessive disorder caused by glucocerebrosidase deficiency. Skeletal manifestations represent one of the most debilitating and potentially irreversible complications of GD1. Although imaging studies are the gold standard, early diagnostic/prognostic tools, such as molecular biomarkers, are needed for the rapid management of skeletal complications. This study aimed to identify potential protein biomarkers capable of predicting the early diagnosis of bone skeletal complications in GD1 patients using artificial intelligence. An in silico study was performed using the novel Therapeutic Performance Mapping System methodology to construct mathematical models of GD1-associated complications at the protein level. Pathophysiological characterization was performed before modeling, and a data science strategy was applied to the predicted protein activity for each protein in the models to identify classifiers. Statistical criteria were used to prioritize the most promising candidates, and 18 candidates were identified. Among them, PDGFB, IL1R2, PTH and CCL3 (MIP-1α) were highlighted due to their ease of measurement in blood. This study proposes a validated novel tool to discover new protein biomarkers to support clinician decision-making in an area where medical needs have not yet been met. However, confirming the results using in vitro and/or in vivo studies is necessary.

Atendimento clínico felino eficiente para reduzir estresse e alterações em exames complementares

The feline species presents quite particular characteristics and has great sensitivity to olfactory, visual, tactile and auditory stimuli. Thus, when going to the veterinary environment, there are numerous factors that can cause stress. Therefore, cat-friendly management is essential in clinical routine to reduce alterations in complementary exams, as an animal in this state presents significant changes in its physiological parameters. By implementing positive strategies that respect the individualities of the patients, they feel calmer and more confident, which decreases the likelihood of developing stress-related pathologies. Additionally, it is a fact that cat-friendly hospital environments optimize recovery and preserve the emotional state of the animals. Therefore, this work reviews the main practices in clinical care that ensure greater well-being for cats, minimizing sources of stress and, consequently, alterations in complementary exams. With these measures, both animals and owners become more secure in making regular visits to the veterinarian, allowing for frequent monitoring of the animals' health, thus increasing the chances of early diagnoses.

Agreement between two real-time commercial PCR kits and an in-house real-time PCR for diagnosis of mucormycosis.

Early diagnosis of mucormycosis is crucial for initiating effective treatment. The detection of Mucorales DNA by PCR in serum has revolutionized the diagnosis of this infection. However, the use of in-house methods can be time consuming. The availability of a commercial kit eliminates the need for in-house assay development, reducing laboratory workload and ensuring consistent performance across different healthcare settings. Currently, there are several commercial assays available, but many have limited evaluation. In this study, we compared two commercial kits and found that the MycoGENIE Kit offers a promising alternative to the in-house method.

Evaluation of WHO catalog of mutations and five WGS analysis tools for drug resistance prediction of Mycobacterium tuberculosis isolates from China.

The continuous advancement of molecular diagnostic techniques, particularly whole-genome sequencing (WGS), has greatly facilitated the early diagnosis of drug-resistant tuberculosis patients. Nonetheless, the interpretation of results from various types of mutations in drug-resistant-associated genes has become the primary challenge in the field of molecular drug-resistance diagnostics. In this study, our primary objective is to evaluate the diagnosis accuracy of the World Health Organization (WHO) catalog of mutations and five WGS analysis tools (PhyResSE, Mykrobe, TB Profiler, Gen-TB, and SAM-TB) in drug resistance to 10 anti-Mycobacterium tuberculosis (MTB) drugs. We utilized the data of WGS collected between 2014 and 2017 in Zhejiang Province, consisting of 110 MTB isolates as detailed in our previous study. Based on phenotypic drug susceptibility testing (DST) results using the proportion method on Löwenstein-Jensen medium with antibiotics, we evaluated the predictive accuracy of genotypic DST obtained by these tools. The results revealed that the WHO catalog of mutations and five WGS analysis tools exhibit robust predictive capabilities concerning resistance to isoniazid, rifampicin, ethambutol, streptomycin, amikacin, kanamycin, and capreomycin. Notably, Mykrobe, SAM-TB, and TB Profiler demonstrate the most accurate predictions for resistance to pyrazinamide, prothionamide, and para-aminosalicylic acid, respectively. These findings are poised to significantly guide and influence future clinical treatment strategies and resistance monitoring protocols.IMPORTANCEWhole-genome sequencing (WGS) has the potential for the early diagnosis of drug-resistant tuberculosis. However, the interpretation of mutations of drug-resistant-associated genes represents a significant challenge as the amount and complexity of WGS data. We evaluated the accuracy of the World Health Organization catalog of mutations and five WGS analysis tools in predicting drug resistance to first-line and second-line anti-TB drugs. Our results offer clinicians guidance on selecting appropriate WGS analysis tools for predicting resistance to specific anti-TB drugs.

Recent Strategies for MicroRNA Detection: A Comprehensive Review of SERS-Based Nanobiosensors

With advances in technology, diagnostic techniques have become more sophisticated and efficient at detecting biomarkers rapidly. Biomarkers such as microRNA (miRNA), which exhibit exceptional specificity and sensitivity compared with other biomarkers, have garnered particular interest. Composed of 21–24 nucleotides, miRNAs constitute a noncoding RNA group that regulates gene expression, immune system activation, apoptosis, and other cellular processes; hence, they are frequently used as biomarkers for various diseases. This has sparked significant interest regarding the identification of the specific miRNAs implicated in many diseases. Presently, miRNA detection methods include northern blots, reverse transcription-quantitative polymerase chain reaction, and next-generation sequencing. While these methods are all sensitive, they are time-consuming, complex, and expensive, which renders them unsuitable for on-site detection. Surface-enhanced Raman scattering (SERS) can overcome these limitations to enable the sensitive and rapid detection of miRNA. This technique amplifies Raman signals, with signal enhancement levels changing sensitively depending on the distance between the target molecule and substrate. Therefore, this review covers the principle of SERS as a method for detecting miRNAs using nanomaterials, along with examples of nanomaterials and SERS applications. Based on the available literature, SERS is anticipated to enable the convenient, early diagnosis of various diseases, potentially lowering mortality rates. This review could therefore contribute significantly to the advancement of medical and diagnostic technologies.

Impedimetric identification of heteroMOFs modified porous nickel foam self-supports as robust electrodes for CA 19-9 pancreatic tumor marker in human serum

An impedance-based electrochemical immunosensor for direct and binder-free target recognition of carbohydrate antigen (CA 19-9) tumor biomarker for the early diagnosis of pancreatic cancer was reported. This study uses an in situ solvothermal process to develop a simple method for the one-pot construction of Ni-Fe heteroMOFs (HFNMOFs,) self-supported on conductive nickel foam (NicFm). Utilizing HFNMOFs@NicFm developed in this study, the electrochemical performance of the biosensor was studied for the first time. The as-prepared mixed MOFs decorated NicFm electrodes displayed potential electrochemical outputs. They demonstrated the potential for developing binder-free non-enzymatic immunosensors with wide linear limits, high selectivity, stability, and excellent sensitivity. The bifunctional MOFs exhibit improved electrochemical conductivity owing to the highly exposed metal sites and hierarchical porosity. The changes in the charge transfer resistance present a linear response against increasing target concentrations. The immunosensor developed in this study exhibited its detection limit of 2.56 U/mL. Further, the bioelectrodes produced were validated against real human spiked serum with good results of percentage recovery, indicating the immunosensor is well-suitable to be tested in real-time analysis.

Annual trends in atypical haemolytic uremic syndrome management in Japan and factors influencing early diagnosis and treatment: a retrospective study

Atypical haemolytic uremic syndrome (aHUS) is a rare disorder characterised by complement-mediated thrombotic microangiopathy (TMA). Despite clinical guidelines, the diagnosis and treatment of aHUS in its early stages remains challenging. This study examined the annual trends in aHUS clinical practices in Japan and explored factors influencing early diagnosis and treatment. Using data from the 2011–2020 Diagnosis Procedure Combination database, 3096 cases with the HUS disease code were identified, of which 217 were confirmed as aHUS and treated with eculizumab or plasma exchange. Early initiation, defined as starting eculizumab or plasma exchange within 7 days of admission, was the focus of the study. Our study revealed no significant changes over time in the number of aHUS diagnoses, cases treated with eculizumab, or early initiation cases. Early initiation cases underwent haemodialysis earlier and had ADAMTS13 activity measured earlier, shorter hospital stays, and lower hospitalisation costs than late initiation cases. In conclusion, we found no increase in the number of newly diagnosed aHUS cases or early treatment initiation over time. Early recognition of TMA and differentiation of the causative disease are crucial for identifying potential aHUS cases, which may lead to better patient prognoses.

The Dynamics of NS1 Antigen and Platelet Levels in the Acute Phase of Dengue Hemorrhagic Fever

Introduction: Dengue hemorrhagic fever (DHF) is a significant global health concern, particularly in tropical and subtropical regions. The early diagnosis and effective management of DHF are crucial to reduce morbidity and mortality. The NS1 antigen and platelet count are two key laboratory parameters used in the diagnosis and monitoring of DHF. This study aimed to investigate the dynamics of NS1 antigen and platelet levels during the acute phase of DHF and their correlation with disease severity. Methods: A prospective cohort study was conducted at a tertiary care hospital in Central Java, Indonesia. Patients presenting with suspected DHF were enrolled and followed up during their hospitalization. Blood samples were collected at admission and at regular intervals to measure NS1 antigen levels and platelet counts. Clinical and laboratory data were collected to assess disease severity. Results: A total of 150 patients were included in the study. The majority of patients were adults (median age, 32 years) with a female predominance (58%). The median duration of fever at presentation was 4 days. NS1 antigen levels were significantly higher in patients with DHF compared to those with dengue fever (DF) (p &lt; 0.001). Platelet counts were significantly lower in patients with DHF compared to those with DF (p &lt; 0.001). NS1 antigen levels showed a negative correlation with platelet counts (r = -0.62, p &lt; 0.001). The levels of NS1 antigen and platelet count were also significantly associated with disease severity. Conclusion: The dynamics of NS1 antigen and platelet levels during the acute phase of DHF provide valuable insights into disease pathogenesis and can aid in the early diagnosis and prediction of disease severity. The negative correlation between NS1 antigen and platelet levels suggests a potential role of NS1 in the development of thrombocytopenia in DHF. Further studies are needed to elucidate the exact mechanisms underlying these observations.

Evaluation of therapeutic response to algorithm assisted improvement of oral mucosa damage in male AIDS patients

HIV/AIDS is now the biggest cause of mortality in Africa and the fourth highest cause of death globally. Half or more of HIV-infected individuals and as many as 80% of AIDS patients develop oral lesions. People living with HIV/AIDS may benefit from early testing, diagnosis, and treatment if oral lesions are detected, as they are the initial clinical characteristics of the infection and strong indicators of immunodeficiency. Oral candidiasis (OPC), oral hairy leukoplakia (OHL), oral Kaposi’s sarcoma (OKS), and HIV-associated periodontal diseases were the subjects of this comprehensive review designed to assess the available data for the management of these and other common oral mucosa damage that are linked to HIV. Further exacerbating the condition are host variables such as xerostomia, smoking, dental caries, oral prosthesis, diabetes, and cancer treatments. A separate portion of this Worldwide Workshop discusses the treatment of salivary gland illness linked with HIV. Oral mucosa injury in AIDS patients does not have a reliable diagnostic approach. Improving the early diagnosis of Oral Mucosa damage in male AIDS patients was the primary goal of this work, which sought to construct an Artificial Intelligence (AI) diagnostic model with high sensitivity. To demonstrate a Gradient Boosting Regression (GBR) based method for assessing the efficacy of treatments for oral mucosa damage in AIDS patients. Both investigation and diagnostic applications may benefit from this predictor. Results show that, compared to existing models, the suggested AI and GBR methods can accurately predict oral mucosa deterioration in AIDS patients. This study significantly contributes to the profession by improving the accuracy of diagnoses and providing useful information for treatment options.