Early Identification Research Articles

Long-term follow-up in congenital diaphragmatic hernia

With improvements in initial care for patients with congenital diaphragmatic hernia (CDH), the number of CDH patients with severe disease who are surviving to discharge has increased. This growing population of patients faces a unique set of long-term challenges, multisystem adverse outcomes, and post-intervention complications requiring specialized multidisciplinary follow-up. Early identification and intervention are essential to mitigate the potential morbidity associated with these challenges. This manuscript outlines a general framework for long-term follow-up for the CDH patient, including cardiopulmonary, gastrointestinal, neurodevelopmental, surgical, and quality of life outcomes.

Analysis of Differences in Neonatal Sepsis Caused by Streptococcus Agalactiae and Escherichia Coli.

Streptococcus agalactiae (GBS) and Escherichia coli (E. coli) are the main pathogenic bacteria in neonatal sepsis. Therefore, the clinical characteristics, nonspecific indicators, and drug susceptibilities of these two bacteria were studied. In total, 81 and 80 children with sepsis caused by GBS and E. coli infection, respectively, admitted to the neonatal department of our hospital between May 2012 and July 2023, were selected, and the clinical characteris-tics of the two groups were analyzed. Nonspecific indicators and drug sensitivity test results were analyzed retrospectively. Birth weight, tachypnea, groan, tachycardia or bradycardia, and the incidence of complications, such as pneumonia, respiratory failure, and purulent meningitis, were higher in the GBS group than in the E. coli group. The children were born prematurely, and the mother had a premature rupture of membranes. The incidence of jaundice, abdominal distension, atypical clinical manifestations, and complications of necrotizing enterocolitis was lower than of the E. coli group, and the differences were statistically significant (p < 0.05). The WBC, NE#, NE#/LY#, hs-CRP, and PCT of the GBS group were higher than those of the E. coli group, whereas the MPV, D-D, and FDP levels were lower than those in the E. coli group. The differences were all statistically significant (p < 0.05). The 81-bead GBS had high resistance rates against tetracycline (95%), erythromycin (48.8%), and clindamycin (40%), and no strains resistant to vancomycin, linezolid, penicillin, or ampicillin appeared, whereas 80 strains of E. coli were more resistant to penicillin and third-generation cephalosporins, with the higher resistance rates to ampicillin (68.30%), trimethoprim/sulfamethoxazole (53.6%), and ciprofloxacin (42.90%). Resistance rates to carbapenems and aminoglycosides were extremely low. Both GBS and E. coli neonatal sepsis have specific clinical characteristics, especially in terms of clinical manifestations, complications, non-specific indicators, and drug resistance. Early identification is important for clinical diagnosis and treatment.

NEWS2, S/F-ratio and ROX-index at emergency department for the prediction of adverse outcomes in COVID-19 patients: An external validation study

BackgroundIn the context of the COVID-19 pandemic, the early and accurate identification of patients at risk of deterioration was crucial in overcrowded and resource-limited emergency departments. This study conducts an external validation for the evaluation of the performance of the National Early Warning Score 2 (NEWS2), the S/F ratio, and the ROX index at ED admission in a large cohort of COVID-19 patients from Colombia, South America, assessing the net clinical benefit with decision curve analysis. MethodsA prospective cohort study was conducted on 6907 adult patients with confirmed COVID-19 admitted to a tertiary care ED in Colombia. The study evaluated the diagnostic performance of NEWS2, S/F ratio, and ROX index scores at ED admission using the area under the receiver operating characteristic curve (AUROC) for discrimination, calibration, and decision curve analysis for the prediction of intensive care unit admission, invasive mechanical ventilation, and in-hospital mortality. ResultsWe included 6907 patients who presented to the ED with confirmed SARS-CoV-2 infection from March 2020 to November 2021. Mean age was 51 (35–65) years and 50.4% of patients were males. The rate of intensive care unit admission was 28%, and in-hospital death was 9.8%. All three scores have good discriminatory performance for the three outcomes based on the AUROC. S/F ratio showed miscalibration at low predicted probabilities and decision curve analysis indicated that the NEWS2 score provided a greater net benefit compared to other scores across at a 10% threshold to decide ED admission at a high-level of care facility. ConclusionsThe NEWS2, S/F ratio, and ROX index at ED admission have good discriminatory performances in COVID-19 patients for the prediction of adverse outcomes, but the NEWS2 score has a higher net benefit underscoring its clinical utility in optimizing patient management and resource allocation in emergency settings.

Emerging Biohybrids of Aptamer-Based Nano-Biosensing Technologies for Effective Early Cancer Detection.

Cancer is a leading global cause of mortality, which underscores the imperative of early detection for improved patient outcomes. Biorecognition molecules, especially aptamers, have emerged as highly effective tools for early and accurate cancer cell identification. Aptamers, with superior versatility in synthesis and modification, offer enhanced binding specificity and stability compared with conventional antibodies. Hence, this article reviews diagnostic strategies employing aptamer-based biohybrid nano-biosensing technologies, focusing on their utility in detecting cancer biomarkers and abnormal cells. Recent developments include the synthesis of nano-aptamers using diverse nanomaterials, such as metallic nanoparticles, metal oxide nanoparticles, carbon-derived substances, and biohybrid nanostructures. The integration of these nanomaterials with aptamers significantly enhances sensitivity and specificity, promising innovative and efficient approaches for cancer diagnosis. This convergence of nanotechnology with aptamer research holds the potential to revolutionize cancer treatment through rapid, accurate, and non-invasive diagnostic methods.

Optimizing Student Development through Effective Assessment Practices: Insights from School Counselors in Indonesia

Since the advent of the Industrial Revolution 4.0, education has gained significant attention from academics and practitioners. The transformative initiatives introduced by Indonesia's Minister of Education and Culture, Nadiem Makarim, have reshaped the educational landscape, particularly through the "Merdeka Belajar" (Freedom to Learn) program. This qualitative study, utilizing a descriptive approach, investigates the use of assessments by school counselors (BK teachers) and their implementation in guidance and counseling services. The research involved 11 informants, including school principals, BK teachers, and students, selected through purposive sampling. Data were collected using observations, interviews, and documentation, and analyzed following Miles &amp; Huberman's methodology. Findings reveal that while BK teachers follow structured steps in using assessments, they face challenges such as the lack of standardized instruments, limited time, and inadequate technological integration. Despite these obstacles, BK teachers strive to improve their practices by effectively communicating assessment results, integrating technology, and implementing actionable insights. The study underscores the necessity for better resources and applications to support the effective use of assessments. Assessments are crucial for understanding students' strengths and needs, providing tailored guidance, and facilitating academic, social, and emotional development. This data-driven approach enhances early problem identification, informed interventions, and the development of students' unique potentials. The study concludes that effective assessment implementation, supported by a positive school environment and adequate resources, is vital for enhancing the quality of guidance and counseling services, ultimately contributing to improved educational outcomes and student well-being.

Genome assembly and resequencing shed light on evolution, population selection, and sex identification in Vernicia montana.

Vernicia montana is a dioecious plant widely cultivated for high-quality tung oil production and ornamental purposes in the Euphorbiaceae family. The lack of genomic information has severely hindered molecular breeding for genetic improvement and early sex identification in V. montana. Here, we present a chromosome-level reference genome of a male V. montana with a total size of 1.29 Gb and a contig N50 of 3.69Mb. Genome analysis revealed that different repeat lineages drove the expansion of genome size. The model of chromosome evolution in the Euphorbiaceae family suggests that polyploidization-induced genomic structural variation reshaped the chromosome structure, giving rise to the diverse modern chromosomes. Based on whole-genome resequencing data and analyses of selective sweep and genetic diversity, several genes associated with stress resistance and flavonoid synthesis such as CYP450 genes and members of the LRR-RLK family, were identified and presumed to have been selected during the evolutionary process. Genome-wide association studies were conducted and a putative sex-linked insertion and deletion (InDel) (Chr 2: 102 799 917-102 799 933bp) was identified and developed as a polymorphic molecular marker capable of effectively detecting the gender of V. montana. This InDel is located in the second intron of VmBASS4, suggesting a possible role of VmBASS4 in sex determination in V. montana. This study sheds light on the genome evolution and sex identification of V. montana, which will facilitate research on the development of agronomically important traits and genomics-assisted breeding.

Investigation of quantitative precursory indicators for rock failure using spatio-temporal characteristics of velocity

Stress redistribution and crack development are prominent features in rock failure. However, this process is complex and challenging to analyze intuitively, making early warning of instability in rock engineering difficult. To characterize the rock failure process and obtain reliable precursory indicators, the active and passive collaborative imaging method was employed to construct the velocity field during the rock failure process in this study. The micro-crack propagation law and its potential connection with the stress environment were investigated by mapping the velocity field, the acoustic emission (AE) density field, and the energy field. Moreover, the Mutation Trend Coefficient (MTC) and Deformation Coefficient (DC) were proposed as precursory indicators of instability based on the spatio-temporal correlation and directional differences of velocity evolution. Results show that the nucleation of AE sources and the release of energy accumulation are key to the formation of the velocity gradient, and progressive rock failure is accompanied by the intensification of velocity anisotropy. Additionally, low-velocity regions usually preferentially extend in the direction parallel to the principal stress, while expansion in the direction vertical to the principal stress is dominant in the plastic stage, indicating that the stress environment controls the spatial heterogeneity of the velocity field. The evolution trend of precursor indicators shows that the increase of MTC from a low value and the continuous decrease of DC can be regarded as the initiation of rock secondary cracks. The proposed indicators and method not only provide beneficial complements to the understanding of the evolution mechanism of rock damage but also have potential in the early warning and identification of the early stage of crack propagation, offering references for the safety prevention and control of rock engineering disasters.

NEWS2, S/F-ratio and ROX-index at emergency department for the prediction of adverse outcomes in COVID-19 patients: An external validation study

BackgroundIn the context of the COVID-19 pandemic, the early and accurate identification of patients at risk of deterioration was crucial in overcrowded and resource-limited emergency departments. This study conducts an external validation for the evaluation of the performance of the National Early Warning Score 2 (NEWS2), the S/F ratio, and the ROX index at ED admission in a large cohort of COVID-19 patients from Colombia, South America, assessing the net clinical benefit with decision curve analysis. MethodsA prospective cohort study was conducted on 6907 adult patients with confirmed COVID-19 admitted to a tertiary care ED in Colombia. The study evaluated the diagnostic performance of NEWS2, S/F ratio, and ROX index scores at ED admission using the area under the receiver operating characteristic curve (AUROC) for discrimination, calibration, and decision curve analysis for the prediction of intensive care unit admission, invasive mechanical ventilation, and in-hospital mortality. ResultsWe included 6907 patients who presented to the ED with confirmed SARS-CoV-2 infection from March 2020 to November 2021. Mean age was 51 (35–65) years and 50.4% of patients were males. The rate of intensive care unit admission was 28%, and in-hospital death was 9.8%. All three scores have good discriminatory performance for the three outcomes based on the AUROC. S/F ratio showed miscalibration at low predicted probabilities and decision curve analysis indicated that the NEWS2 score provided a greater net benefit compared to other scores across at a 10% threshold to decide ED admission at a high-level of care facility. ConclusionsThe NEWS2, S/F ratio, and ROX index at ED admission have good discriminatory performances in COVID-19 patients for the prediction of adverse outcomes, but the NEWS2 score has a higher net benefit underscoring its clinical utility in optimizing patient management and resource allocation in emergency settings.

A novel rapid visual nucleic acid detection technique for tick-borne encephalitis virus by combining RT-recombinase-aided amplification and CRISPR/Cas13a coupled with a lateral flow dipstick

Tick-borne encephalitis virus (TBEV), a zoonotic pathogen, can cause severe neurological complications and fatal outcomes in humans. Early diagnosis of TBEV infection is crucial for clinical practice. Although serological assays are frequently employed for detection, the lack of antibodies in the early stages of infection and the cross-reactivity of antibodies limit their efficacy. Conventional molecular diagnostic methods such as RT-qPCR can achieve early and accurate identification but require specialized instrumentation and professionals, hindering their application in resource-limited areas. Our study developed a rapid and visual TBEV molecular detection method by combining RT-recombinase-aided amplification, the CRISPR/Cas13a system, and lateral flow dipsticks. The diagnostic sensitivity of this method is 50 CFU/ml, with no cross-reactivity with a variety of viruses. The detection can be carried out within 1 h at a temperature between 37 and 42 °C, and the results can be visually determined without the need for complex instruments and professionals. Subsequently, this assay was used to analyze clinical samples from 15 patients suspected of TBEV infection and 10 healthy volunteers, and its sensitivity and specificity reached 100 %, which was consistent with the results of RT-qPCR. These results indicate that this new method can be a promising point-of-care test for the diagnosis of tick-borne encephalitis.

Shedding Light on Breast Cancer, its Development, And Methods of Diagnosis and Prevention

It is a complex task to find out a specific reason of breast cancer which are based on multiple factors. Nevertheless, hormones, especially estrogens, are the ones that are mostly responsible for hampering unrestricted division of cancerous cells in the mammary gland. Fully knowing their role is pivotal for matching preventive and therapeutic plans. Chromosomal anomalies are abundant in this inborn module but they are next to BRCA1 and BRCA2, the errors that increase the risk. The diagnostic technologies which include HER2/neu testing and gene expression profiling are made to personalize the therapy practice with the intention to enhance the outcomes. The amalgam of environmental, hormonal, and genetic influences results in the creation of an individuality. The effectiveness of rehabilitation can be drastically boosted through the early identification of a disease process. A mammogram, the top screening tool for breast cancer built-in, can spot a cancer even before it shows any symptoms. In the matter of particles the breast cancer treatment has been changed greatly. Distressed tablets like trastuzumab and aromatase inhibitors in the event when accompanied by traditional chemotherapy, which in return produce efficacy with lesser side effects. Preventative policies encompass the realization of lifestyle changes as well as medical intervention. Maintaining a healthy weight, doing some extra movements, and limiting alcohol intake are all good examples of what you can do to reduce your chances of complications. Successful chemoprevention among high-risk subjects, via drugs like raloxifene and tamoxifene, has been founded. Immunotherapy is a novel approach of curing cancer by triggering immune response of the body.A review of its mechanism of operation, and preventive measures. The precision of staging is improved because of other supplementary information that is available in additional techniques like MRI and ultrasound. Such individuals can be candidates for preventive procedures such as oophorectomy or mastectomy.

Plasma concentration of serum amyloid A and lipopolysaccharide binding protein in horses with laminitis resulted from hindgut acidosis

Many studies have shown a strong correlation between Hindgut Acidosis (HGA) and the occurrence of laminitis in horses; therefore, the early diagnosis of HGA is essential. In this study, we investigated changes in the plasma concentrations of lipopolysaccharide-binding protein (LBP) and serum amyloid A (SAA) as inflammatory markers in horses with laminitis. Sixteen healthy male Arabian horses that had cecal cannulation without visible laminitis or general symptoms were randomly divided into two groups. The horses were fed two different diets in a forage-to-concentrate ratio. Blood samples were collected on Days 1, 10, and 20. The primary objective of this study was to analyze plasma levels of LBP and SAA. Cecal specimens were obtained from each equine subject on three designated days: days 1, 10, and 20. The second objective was to assess the levels of pH and volatile fatty acids (VFA) in the samples. Throughout the study period, horses fed a high-concentrate diet exhibited a significantly elevated average lameness grade on days 10 and 20 compared to the initial stage (P < 0.001). On day 20, a significant increase in the concentration of SAA was observed in horses fed a high-concentrate diet, in contrast to the initial stage of the study. LBP levels in the plasma were significantly elevated on days 10 and 20 in horses fed a high-concentrate diet. Based on our findings, it is recommended that the evaluation of plasma LBP concentrations is more effective than SAA for the early identification of HGA in horses fed a high-grain diet.

Association Between Multisensory Impairment and Depression Among Older Adults: A Population-Based Analysis.

In this study, we examine how impairments in vision, hearing, touch, and olfaction relate to depression in older adults, considering both individual and multisensory impairments (MSIs). Analysis of cross-sectional data from a longitudinal investigation involving black and white older adults aged 70 to 79 at enrollment. We studied 1640 black and white participants in the Health ABC study using complete sensory evaluation data from years 3 to 5. Our MSI assessment utilized data obtained for visual acuity, hearing perception, olfactory performance, and tactile function. We performed multivariable logistic regression analyses to examine the associations between the presence of individual and MSIs and depression which was defined as the presence of antidepressants prescribed for depression, or a Center for Epidemiological Studies Depression Scale score of greater than 10. We observed a possible dose-response relationship between the number of sensory impairments and depression. In adjusted models, when compared to no impairments, vision (odds ratio [OR] = 1.45, 95% confidence interval [CI]: 1.09-1.93) and hearing impairments (OR = 1.49, 95% CI: 1.11-1.99) were significantly associated with depression, whereas olfaction (OR = 1.11, 95% CI: 0.83-1.47) and tactile impairments (OR = 1.28, 95% CI: 0.96-1.70) were not. Participants with 3 sensory impairments had a higher rate of depression (OR = 2.05, 95% CI: 1.22-3.54) compared to those without impairments, and this risk increased further for those with 4 sensory impairments (OR = 2.95, 95% CI: 1.48-5.88). The findings suggest that individuals with MSI represent a high-risk population for depression, warranting close monitoring to screen for depression. The study emphasizes the importance of considering multiple sensory impairments in the context of mental health and supports the early identification and monitoring of depression in this population.

Hypertension and iron deficiency anemia: Exploring genetic associations and causal inference

Background and aimObservational studies have suggested a potential association between hypertension and Iron deficiency anemia (IDA). However, it is unclear whether there is a genetic and causal link between hypertension and IDA. Methods and resultsGenome-Wide Association Studies (GWAS) data for hypertension were sourced from the UK Biobank and FinnGen. Genetic variants data for IDA were extracted from FinnGen and the IEU Open GWAS project, all derived from European populations. The genetic association between hypertension and IDA was assessed using Linkage Disequilibrium Score Regression (LDSC), with MR employed to determine causality. Inverse variance weighted (IVW) as a major analytical method for MR. Sensitivity and heterogeneity analyses were conducted to ensure result reliability. Furthermore, validation analysis was performed to further strengthen the robustness of the findings. A genetic association between hypertension and IDA was observed (rg = 0.121, P = 0.002). Our findings suggest that hypertension increases the risk of developing IDA (OR = 2.493,P = 0.038), and IDA maybe serve as a risk factor for hypertension (OR = 1.006,P < 0.001). Validation analysis yielded consistent results. Importantly, our findings demonstrated no heterogeneity or horizontal pleiotropy. ConclusionRegular testing of iron ions and anemia-related markers in hypertensive patients is crucial for early identification of IDA. If necessary, oral iron supplementation can be prescribed to prevent IDA for hypertensive patients. Furthermore, it is imperative to closely monitor the blood pressure of patients with IDA to promptly identify and diagnose hypertension. The implementation of these integrated health strategies is vital for global efforts to tackle the dual challenges of hypertension and IDA.

Factors influencing meconium-stained amniotic fluid in West Guji, Oromia, Ethiopia: A cross-sectional study

BackgroundMeconium-stained amniotic fluid is an obstetric problem that occurs when a baby passes their first stool into the amniotic fluid before childbirth. It can indicate that the infant is under stress while the mother is giving birth. In addition to increasing the mother's risk of morbidity, meconium-stained amniotic fluid is linked to poor neonatal outcomes such as stillbirth, neonatal death, and meconium aspiration syndrome. However, there is currently little data on this issue. Therefore, the research aimed to determine the percentage of meconium-stained amniotic fluid and the contributing factors among women who gave birth at West Guji hospitals in Oromia, Ethiopia. MethodWe surveyed 314 systematically selected women who gave birth between June 1st and July 30th, 2022. We collected information from their medical records and interviewed them. To code and enter the collected data, Epi Data version 4.6 was utilized. For both descriptive statistics and multivariable logistic regression analysis, SPSS version 25 was used. Statistical significance was declared at a p-value less than 0.05, a 95 % confidence interval, and an adjusted odd ratio. ResultsIn the current study, out of 314, 99 (29.4 %, 95 % CI = 24.6–34.6) women have meconium-stained amniotic fluid. Obstetric factors like premature rupture of membranes (AOR = 3.24, 95 % CI = 1.79–5.88), pregnancy-induced hypertension (AOR = 5.08, 95 % CI = 2.76–9.35), and non-reassuring fetal heart rate (AOR = 2.96, 95 % CI = 1.27–6.91) influenced meconium-stained amniotic fluid. ConclusionThe results of the current study emphasize the significance of close observation to identify possible signs of fetal distress during pregnancy and delivery. To protect the baby's health, pregnant women who have an early rupture of the membranes, high blood pressure, or a non-reassuring fetal heart rate should be closely observed. Early identification of these factors can help health care providers take steps to prevent or minimize complications related to meconium-stained amniotic fluid.

Rethinking bronchiectasis as an inflammatory disease.

Bronchiectasis is understood to be the result of a complex interaction between infection, impaired mucociliary clearance, inflammation, and lung damage. Current therapeutic approaches to bronchiectasis are heavily focused on management of infection along with enhancing mucus clearance. Long-term antibiotics have had limited success in clinical trials, suggesting a need to re-evaluate the concept of bronchiectasis as an infective disorder. We invoke the example of asthma, for which treatment paradigms shifted away from targeting smooth muscle constriction, towards permanently suppressing airway inflammation, reducing risk and ultimately inducing remission with precision anti-inflammatory treatments. In this Review, we argue that bronchiectasis is primarily a chronic inflammatory disease, requiring early identification of at-risk individuals, and we introduce a novel concept of disease activity with important implications for clinical practice and future research. A new generation of novel anti-inflammatory treatments are under development and repurposing of anti-inflammatory agents from other diseases could revolutionise patient care.

Smoking and the Risk of Type 2 Diabetes: A Cross-sectional Analytical Study

Background: India is undergoing epidemiological transitions with the increase in noncommunicable disease (NCD) burden. Targeting the modifiable risk factors through lifestyle changes in the early years of life remains the most effective strategy for decreasing the prevalence of type 2 diabetes mellitus (T2DM). To determine the association between cigarette smoking and T2DM. Materials and Methods: An analytical cross-sectional study was conducted among the patients attending the outpatient department of a tertiary care teaching hospital in Kolkata, West Bengal, India. Patients aged more than 35 years were enrolled, and details regarding sociodemography, clinical status, and NCD risk factors were collected using pretested semistructured questionnaires after obtaining IEC approval. Data collected were entered in MS Excel and analyzed using SPSS software. Simple logistic regression and multivariable logistic regression analysis were used to calculate the crude and adjusted odds ratio with 95% confidence interval. Results: Out of 434 participants, 37.3% had diabetes mellitus, 51.6% were males, and 28.6% had alcohol consumption. Univariate logistic regression analysis revealed age, BMI, systolic BP, diastolic BP, and cigarette smoking were significantly associated with increased risk of T2DM. Multivariable logistic regression analysis revealed cigarette smoking, systolic BP, age, and female gender were significant risk factors for T2DM. Conclusions: Our study reported cigarette smoking and systolic BP are modifiable risk factors associated with T2DM. Early identification of smoking through screening and appropriate control of hypertension in T2DM patients will decrease the morbidities and mortalities in T2DM cases.

Altered tumor microenvironment heterogeneity of penile cancer during progression from non-lymphatic to lymphatic metastasis.

Lymphatic metastasis is the major challenge in the treatment of penile cancer. The prognosis of individuals with lymphatic metastasis is extremely poor. Therefore, early identification of disease progression and lymphatic metastasis is an urgent task for researchers in penile cancer worldwide. In this study, using single-cell RNA sequencing, an immune landscape was established for the cancer ecosystem based on 46,861 cells from six patients with penile cancer (four with lymphatic metastasis [stage IV] and two without lymphatic metastasis [stage I]). Using bulk RNA sequencing, the discrepancy between the cancers and their respective metastatic lymph nodes was depicted based on seven patients with penile cancer. The interaction between epithelial cells, fibroblasts, and endothelial cells, and the functional cooperation among invasion, epithelial-mesenchymal transition, and angiogenesis were found to be important landscapes in the penile cancer ecosystem, playing important roles in progression of cancer and lymph node metastasis. This study is the first to investigate the altered tumor microenvironment heterogeneity of penile cancer as it evolves from non-lymphatic to lymphatic metastasis and provides insights into the mechanisms underlying malignant progression, the premetastatic niche, and lymphatic metastasis in penile cancer.

Classification of tomato leaf images for detection of plant disease using conformable polynomials image features

Plant diseases can spread rapidly, leading to significant crop losses if not detected early. By accurately identifying diseased plants, farmers can target treatment only to the affected areas, reducing the number of pesticides or fungicides needed and minimizing environmental impact. Tomatoes are among the most significant and extensively consumed crops worldwide. The main factor affecting crop yield quantity and quality is leaf disease. Various diseases can affect tomato production, impacting both yield and quality. Automated classification of leaf images allows for the early identification of diseased plants, enabling prompt intervention and control measures. Many creative approaches to diagnosing and categorizing specific illnesses have been widely employed. The manual method is costly and labor-intensive. Without the assistance of an agricultural specialist, disease detection can be facilitated by image processing combined with machine learning algorithms. In this study, the diseases in tomato leaves will be detected using new feature extraction method using conformable polynomials image features for accurate solution and faster detection of plant diseases through a machine learning model. The methodology of this study based on:•Preprocessing, feature extraction, dimension reduction and classification modules.•Conformable polynomials method is used to extract the texture features which is passed classifier.•The proposed texture feature is constructed by two parts the enhanced based term, and the texture detail part for textual analysis.•The tomato leaf samples from the plant village image dataset were used to gather the data for this model. The disease detected are 98.80 % accurate for tomato leaf images using SVM classifier. In addition to lowering financial loss, the suggested feature extraction method can help manage plant diseases effectively, improving crop yield and food security.

Exploration and Validation of Lead Molecules against Yellow Fever through High Throughput Virtual Screening and Molecular Dynamics Simulation

Background: Yellow fever (YF) is a mosquito-borne flaviviral hemorrhagic fever (VHF) that causes severe hepatitis, renal failure, bleeding, and quick terminal events such as shock and multi-organ failure. There are currently no particular anti-viral medications for the management of the YF virus (YFV). Despite the availability of a commercial YFV vaccination, there are roughly 30,000 fatalities globally each year, with instances rising over the previous 20 years. After being translocated into the endoplasmic reticulum lumen, glycosylated NS1 resides as a membrane-associated dimer, where it is required for viral genome replication. The secreted hexamer NS1 has a role in immune evasion and pathogenesis and has been discovered as a possible diagnostic marker for the early identification of viral infections. Objective: The main aim of this study is to analyze the small molecule as a potent drug candidate against the target NS1 protein. Methods: In this study, Computational approaches, including high throughput virtual screening, molecular docking, and dynamics simulation, were carried out against the target NS1 protein using three different chemical libraries Enamine, Asinex, and NCI. The selected lead compounds were validated through HOMO-LUMO analysis, ADME prediction, and Toxicity parameters to analyze the biological and pharmacological properties of the lead small molecules. Results: From the result, it was concluded that the leads possessed the highest docking scores, interacting with the binding residues, and were stable in the simulation period. Conclusion: Overall findings revealed that the lead three small molecules could act as the potential drug candidate for the target NS1 protein to inhibit the diseasing efficacy of Yellow fever.

Which patients are at risk of developing symptom diagnoses that persist for more than a year in primary care? Development and external validation of a prediction model

ObjectivesTo train, test and externally validate a prediction model that supports General Practitioners (GPs) in early identification of patients at risk of developing symptom diagnoses that persist for more than a year. MethodsWe retrospectively collected and selected all patients having episodes of symptom diagnoses during the period 2008 and 2021 from the Family Medicine Network (FaMe-Net) database. From this group, we identified symptom diagnoses that last for less than a year and symptom diagnoses that persist for more than a year. Multivariable logistic regression analysis using a backward selection was used to assess which factors were most predictive for developing symptom diagnoses that persist for more than a year. Performance of the model was assessed using calibration and discrimination (AUC) measures. External validation was tested using data between 2018 and 2022 from AHON-registry, a primary care electronic health records data registry including 73 general practices from the north and east regions of the Netherlands and about 460,795 patients. ResultsFrom the included 47,870 patients with a symptom diagnosis in the FaMe-Net registry, 12,481 (26.1%) had a symptom diagnosis that persisted for more than a year. Older age (≥ 75 years: OR = 1.30, 95% CI [1.19, 1.42]), having more previous symptom diagnoses (≥ 3: 1.11, [1.05, 1.17]) and more contacts with the GP over the last 2 years (≥ 10 contacts: 5.32, [4.80, 5.89]) were predictive of symptom diagnosis that persist for more than a year with an marginally acceptable discrimination (AUC 0.70, 95% CI [0.69–0.70]). The external validation showed poor performance with an AUC of 0.64 ([0.63–0.64]). ConclusionA clinical prediction model based on age, number of previous symptom diagnoses and contacts might help the GP to early identify patient developing symptom diagnoses that persist for more than a year. However, the performance of the original model is limited. Hence, the model is not yet to be ready for a large-scale implementation given its limited performance.