Early Signs Research Articles

Prediction of Parkinson’s Disease using Handwriting Analysis and Voice Dataset- A Review

Parkinson's disease is a common neurological movement illness that impairs motor coordination. Parkinson’s disease (PD) symptoms and severity, however, differ from person to person. By extracting insights, trends, and possibilities from the data, data research can be utilized to uncover solutions to problems in medical research by utilizing data, machine learning algorithms, and cutting-edge technology. Among the less evident early signs of Parkinson's disease are tremors, muscle stiffness, imbalance problems, and difficulty walking. There is currently no test to detect the illness early on, when symptoms might not be evident. However, handwriting and hand- drawn subjects in humans have been linked to PD. In addition to being a useful tool for PD prediction, speech smearing functions as an early warning system. In order to control symptoms and maybe halt the disease's progression, early detection makes it possible to organize treatments and intervene promptly. For those with Parkinson's disease, early application of certain therapies and medications can extend survival and enhance quality of life.

AI-enhanced subsea maintenance for improved safety and efficiency: Exploring strategic approaches

As the oil and gas industry increasingly explores deeper and more remote offshore sites, the maintenance of subsea infrastructure becomes paramount. The use of Artificial Intelligence (AI) in subsea maintenance offers promising solutions to enhance safety and efficiency in these challenging environments. This review explores strategic approaches to integrating AI into subsea maintenance operations. AI facilitates predictive maintenance by analyzing vast amounts of data collected from sensors and historical maintenance records. Machine learning algorithms can detect patterns and predict equipment failures before they occur, enabling proactive maintenance scheduling. This predictive capability reduces downtime and minimizes the risk of accidents by addressing potential issues before they escalate. AI-enabled autonomous underwater vehicles (AUVs) and remotely operated vehicles (ROVs) play a crucial role in subsea inspections and repairs. These AI-enhanced robots can navigate complex subsea environments, perform inspections, and execute maintenance tasks with greater precision and efficiency than human divers. By reducing the need for human intervention in hazardous environments, AI-driven AUVs and ROVs significantly improve safety. Furthermore, AI algorithms can optimize maintenance schedules based on factors such as equipment condition, environmental conditions, and operational requirements. By dynamically adjusting maintenance plans, operators can maximize equipment uptime while minimizing costs and risks. This proactive approach ensures that maintenance activities are conducted at the most opportune times, reducing the likelihood of unplanned downtime and improving overall efficiency. Moreover, AI facilitates condition-based maintenance strategies, where equipment health is continuously monitored in real-time. Sensors installed on subsea infrastructure collect data on factors such as temperature, pressure, and vibration, which is then analyzed by AI algorithms to assess equipment condition. By detecting early signs of degradation or malfunction, AI enables timely interventions, preventing costly breakdowns and ensuring optimal performance. In addition to predictive and condition-based maintenance, AI-driven analytics offer insights into operational performance and asset integrity. By analyzing data from various sources, including sensors, historical records, and operational logs, AI can identify trends, anomalies, and optimization opportunities. These insights enable operators to make data-driven decisions that enhance overall system reliability and efficiency. Strategic approaches to implementing AI in subsea maintenance require collaboration between technology providers, operators, and regulatory bodies. Establishing industry standards and guidelines for AI applications in subsea operations is crucial to ensure safety, reliability, and interoperability. Furthermore, investing in research and development to enhance AI algorithms and robotics technology is essential to unlock the full potential of AI in subsea maintenance. AI-enhanced subsea maintenance offers significant benefits in terms of safety and efficiency. By leveraging predictive analytics, autonomous robotics, and real-time monitoring, operators can optimize maintenance activities, reduce downtime, and minimize risks. Strategic approaches to integrating AI into subsea operations require collaboration, investment, and a commitment to advancing technology to meet the challenges of offshore environments.

Predicting autism traits from baby wellness records: A machine learning approach.

Timely identification of autism spectrum conditions is a necessity to enable children to receive the most benefit from early interventions. Emerging technological advancements provide avenues for detecting subtle, early indicators of autism from routinely collected health information. This study tested a model that provides a likelihood score for autism diagnosis from baby wellness visit records collected during the first 2 years of life. It included records of 591,989 non-autistic children and 12,846 children with autism. The model identified two-thirds of the autism spectrum condition group (boys 63% and girls 66%). Sex-specific models had several predictive features in common. These included language development, fine motor skills, and social milestones from visits at 12-24 months, mother's age, and lower initial growth but higher last growth measurements. Parental concerns about development or hearing impairment were other predictors. The models differed in other growth measurements and birth parameters. These models can support the detection of early signs of autism in girls and boys by using information routinely recorded during the first 2 years of life.

Stress and anxiety during pregnancy and length of gestation: a federated study using data from five Canadian and European birth cohorts.

While its etiology is not fully elucidated, preterm birth represents a major public health concern as it is the leading cause of child mortality and morbidity. Stress is one of the most common perinatal conditions and may increase the risk of preterm birth. In this paper we aimed to investigate the association of maternal perceived stress and anxiety with length of gestation. We used harmonized data from five birth cohorts from Canada, France, and Norway. A total of 5297 pregnancies of singletons were included in the analysis of perceived stress and gestational duration, and 55,775 pregnancies for anxiety. Federated analyses were performed through the DataSHIELD platform using Cox regression models within intervals of gestational age. The models were fit for each cohort separately, and the cohort-specific results were combined using random effects study-level meta-analysis. Moderate and high levels of perceived stress during pregnancy were associated with a shorter length of gestation in the very/moderately preterm interval [moderate: hazard ratio (HR) 1.92 (95%CI 0.83, 4.48); high: 2.04 (95%CI 0.77, 5.37)], albeit not statistically significant. No association was found for the other intervals. Anxiety was associated with gestational duration in the very/moderately preterm interval [1.66 (95%CI 1.32, 2.08)], and in the early term interval [1.15 (95%CI 1.08, 1.23)]. Our findings suggest that perceived stress and anxiety are associated with an increased risk of earlier birth, but only in the earliest gestational ages. We also found an association in the early term period for anxiety, but the result was only driven by the largest cohort, which collected information the latest in pregnancy. This raised a potential issue of reverse causality as anxiety later in pregnancy could be due to concerns about early signs of a possible preterm birth.

Structural and functional characterization of retinal impairment in T1DM patients without diabetic retinopathy: a 3-year longitudinal study.

To analyze the progression of structural and functional retinal impairment in type 1 diabetes mellitus (T1DM) patients with no clinical signs of diabetic retinopathy (DR) during a 3-year follow-up. This was an observational longitudinal study. Post-pediatric T1DM patients without clinical signs of DR, and sex- and age-matched healthy subjects were recruited at San Raffaele Hospital (Milan, Italy). Each patient underwent a comprehensive ophthalmological evaluation, including optical coherence tomography (OCT), OCT-angiography (OCT-A), retinal static and dynamic vessel analysis (DVA), and microperimetry. 21 eyes of 21 T1DM patients (10 females; 24 ± 2years old), and 21 age and sex-matched healthy subjects were enrolled. At baseline, T1DM eyes revealed a significantly decreased vessel length density using OCT-A (p < 0.001 and p = 0.046 in 3 × 3 and 6 × 6mm images) and a significantly increased vessel density index (p = 0.013 and p = 0.087 in 3 × 3 and 6 × 6mm images) of deep capillary plexus. DVA detected a significantly decreased vessel response to flicker light (p = 0.002). A significantly increased thickness of ganglion cellular layer 6-mm-diameter subfields in inferior and superior quadrants was found in diabetic patients (p < 0.001 in both subfields). At 3-years-follow-up no significant longitudinal changes were disclosed in all analyses. Concomitant subclinical microvascular and neurodegenerative damages could be early signs of DR onset that precede functional alterations and clinical signs of DR development. These alterations demonstrated a stable trend over time.

Skin manifestations and human immunodeficiency virus infection in the Tigray region, Ethiopia: Implications for clinical management and epidemiologic surveillance

AbstractBackgroundPatients with human immunodeficiency virus (HIV) infection may present a large variety of skin manifestations, often associated with significant morbidity. In turn, dermatological diseases may represent an early sign of HIV infection, particularly in resource‐limited settings.ObjectivesThis study aimed to assess the spectrum of dermatological diseases and their potential value as clinical proxies for the early detection and management of HIV in a rural region of Ethiopia.MethodsThe study was performed on a population of 67,161 patients with skin diseases attending the Italian Dermatological Center in Mekele, Tigray region, Ethiopia. HIV infection was diagnosed in 1892 individuals (1065 female), all naïve to antiretroviral therapy.ResultsInfectious skin diseases were present in 57.2% of the total HIV population. Among the infectious skin manifestations, dermatophytosis (20.5%), impetigo (5.9%), candidiasis (4.7%) and molluscum contagiosum (4.7%) were significantly more represented in patients with HIV infection (p &lt; 0.001). Regarding the noninfectious manifestations, pruritus and atrophy of the papillae on the tongue were significantly associated with HIV (p &lt; 0.001). Notably, females had a significantly higher incidence of dermatophytosis and seborrheic dermatitis as compared to their male counterparts (p &lt; 0.001), whereas scabies, psoriasis and leishmaniasis were significantly more frequent in males (p &lt; 0.001).ConclusionsSkin manifestations are common in HIV patients, often reflecting compromised immune status. In addition, Dermatophytosis and pruritus were the most frequently reported manifestations of HIV, thus representing useful clinical proxies to raise the suspicion of an underlying HIV infection. Besides, gender differences in skin manifestations should also be considered in the clinical evaluation.

Continuous QT interval monitoring using insertable cardiac monitors during antiarrhythmic loading hospitalization: Results from the "LINQ QT" Study

Abstract Background QT interval prolongation is associated with the development of potentially lethal cardiac arrhythmias. An implantable cardiac monitor (ICM) capable of longitudinal QT monitoring may allow for mobile assessment of dynamic changes in QT and assist in predicting long term cardiotoxicity. Objective Determine feasibility of continuous QTc interval monitoring in patients with ICM hospitalized for antiarrhythmic drug loading. Methods The previously described QT detection algorithm for an ICM determines the QT interval for every beat thus providing continuous long-term QT trends. QT intervals detected from continuously collected ICM ECG data from patients enrolled in a prospective clinical study from three sites was analyzed with the primary objective of studying the long-term QT interval trends in patients undergoing antiarrhythmic drug loading in an inpatient setting. The ICM ECG was processed through the QT detection algorithm which calculates the QTc interval for every beat to generate continuous long term QTc trends. Metrics including mean and median QTc, minimum and maximum QTc, and magnitude of QTc change were studied during the hospitalization period. Continuous QTc interval trend is presented from a patient displaying increase in QTc interval following antiarrhythmic drug loading during the hospitalization period. Results 5 out of 17 patients enrolled (avg. age 71±7.3 years, 40% females) in the QT clinical study had continuous telemetered ICM ECG data available during the index antiarrhythmic loading hospitalization period. All patients were loaded with Sotalol during the hospitalization. All 5 patients had hypertension and atrial fibrillation (AF). 3 patients (60%) had a history of myocardial infarction (MI), congestive heart failure (CHF), and coronary artery disease (CAD) while 1 patient (20%) had diabetes. The magnitude of change in QTc over the hospitalization period was 139±42 msec with over 100 msec QTc change noticed in 4 of 5 patients (80%) (figure 1). Figure 2 shows continuous QTc interval trend observed from a patient (Male; Age:75; history of AF, hypertension, CHF, stroke) from this study showing a continuous increase in QTc interval. Overall, there was over 150 msec change in QTc observed for this patient during the hospitalization period. Premature ventricular complexes (PVCs) in a pattern of bigeminy were observed from ICM ECG for a 3-hr period from 12 pm-3 pm following the second antiarrhythmic dose which coupled with QT prolongation could indicate early signs of cardiotoxicity (figure 2). The five static 12-lead ECG measurements taken for this patient during the hospitalization period is also reported with the difference between these 12-lead QTc measurements and algorithm measured QTc being 22±8 msec. Conclusion ICM QT monitoring performed utilizing a QT interval detection algorithm can provide longitudinal and long-term dynamic QT trends in patients implanted with ICM.

Two-year post-distraction cartilage-related structural improvement is accompanied by increased serum full-length SIRT1

BackgroundPreviously, fragments from Sirtuin 1 (SIRT1) were identified in preclinical and clinical samples to display an increase in serum levels for N-terminal (NT) SIRT1 vs. C-terminal (CT) SIRT1, indicative of early signs of OA. Here we tested NT/CT SIRT1 levels as well as a novel formulated sandwich assay to simultaneously detect both domains of SIRT1 in a manner that may inform us about the levels of full-length SIRT1 in the circulation (flSIRT1) of clinical cohorts undergoing knee joint distraction (KJD).MethodsWe employed an indirect ELISA assay to test NT- and CT-SIRT1 levels and calculated their ratio. Further, to test flSIRT1 we utilized novel antibodies (Ab), which were validated for site specificity and used in a sandwich ELISA method, wherein the CT-reactive served as capture Ab, and its NT-reactive served as primary detection Ab. This method was employed in human serum samples derived from a two-year longitudinal study of KJD patients. Two-year clinical and structural outcomes were correlated with serum levels of flSIRT1 compared to baseline.ResultsAssessing the cohort, exhibited a significant increase of NT/CT SIRT1 serum levels with increased osteophytes and PIIANP/CTX-II at baseline, while a contradictory increase in NT/CT SIRT1 was associated with less denuded bone, post-KJD. On the other hand, flSIRT1 exhibited an upward trend in serum level, accompanied by reduced denuded bone for 2-year adjusted values. Moreover, 2 year-adjusted flSIRT1 levels displayed a steeper linear regression for cartilage and bone-related structural improvement than those observed for NT/CT SIRT1.ConclusionsOur data support that increased flSIRT1 serum levels are a potential molecular endotype for cartilage-related structural improvement post-KJD, while NT/CT SIRT1 appears to correlate with osteophyte and PIIANP/CTX-II reduction at baseline, to potentially indicate baseline OA severity.

CineECG analysis of body surface potential mapping performed in preclinical and clinical plakophilin-2-variant carriers

Abstract Background/introduction Pathogenic variation of the plakophilin-2 (PKP2) gene is associated with arrhythmogenic cardiomyopathy (ACM). Disease manifestation in PKP2-pathogenic variant (PV) carriers differs greatly. Early detection of disease is crucial and could be of benefit in the risk stratification of this population. 67-lead body surface potential mapping (BSPM) could offer more insight into subtle electrical abnormalities. CineECG is a novel tool which can provide an estimation of the average pathway of ventricular activation based on the BSPM-signals, and could be of added value in the detection of electrical abnormalities. Purpose This study aimed to analyze 67-lead BSPM data with CineECG to ascertain the electrical activation pathway in PKP2-PV carriers and to compare these to the normal CineECG. Methods Ten PKP2-PV carriers underwent 67-lead BSPM. Six carriers were without definite ACM diagnosis (preclinical); no Task Force Criteria (TFC) were met apart from the identification of the pathogenic PKP2-variant. The other four carriers were all diagnosed with definite ACM (symptomatic). The average location and direction of ventricular activation was determined with CineECG, resulting in a CineECG trajectory throughout the ventricles. These results were compared to the normal CineECG trajectory, which was established in a previous study with normal ECG’s from the PTB-XL database. A CineECG trajectory that deviated more than 15% from the normal trajectory was considered abnormal. Additionally, to further determine the added diagnostic value of BSPM and CineECG beyond the standard 12-lead ECG, the 12-lead ECG’s were evaluated for abnormalities by three different ECG-experts. Results Expert evaluation of the 12-lead ECG showed that all preclinical PKP2-PV carriers had a normal ECG (no TFC and no other abnormalities such as abnormal electrical heart axis, pathological Q-waves or low voltage). In the symptomatic carriers, all ECG’s showed either presence of TFC or conduction abnormalities. Of the ten PKP2-PV carriers, eight exhibited an abnormal CineECG trajectory. In the preclinical group, four out of six carriers had an abnormal activation trajectory, while all symptomatic carriers had an abnormal CineECG trajectory. Conclusions Through CineECG analysis of 67-lead BSPM, abnormal ventricular activation was identified in the majority of PKP2-PV carriers. Notably, abnormal activation was observed in four out of six preclinical PKP2-PV carriers while the standard 12-lead ECG showed no abnormalities. Future research in a larger group, which also includes follow-up data, is warranted to determine whether these results are an indication of early signs of disease.Figure 1

#2774 Association of serum CA-125 and lung ultrasound with other markers of volumen status in peritoneal dialysis patients

Abstract Background and Aims Volume overload (VO) represents the main risk factor for cardiovascular death in peritoneal dialysis (PD) patients. The lack of objective methods and validated markers constitutes the basis for the high prevalence, which is one of the main causes of technique failure. The use of lung ultrasound, VExUS score and serum CA-125 (SeCA-135), has emerged to assess volume in heart failure patients. In this pilot study, we explored the association of these novel approaches with classical markers of VO Method A cross-sectional cohort study was conducted on fourteen PD outpatients, in which volume status was simultaneously assessed through SeCA-125 levels along with standardized 28-site lung ultrasound, VExUS Score (excluding renal Doppler), NT-proBNP levels, and bioimpedance spectroscopy (BIS). Clinical and physical examination parameters were collected simultaneously, and echocardiographic measures were collected from the clinical history in the previous 6 months. The inclusion criteria were: patients over 18 years old, in a PD program for at least 6 months, with good adherence to the technique. The exclusion criteria were: cardiovascular event in the three months prior to the study initiation, active uncontrolled neoplastic disease, or active infection or intercurrent illness in the 2 months prior to evaluation. Because NT-ProBNP does not follow the normal distribution, we used the Ig transformation (LgNT-proBNP) in the statistical process. Results The mean age was 68.9 ± 14.9 years, with an average of 29.9 ± 19.61 months on dialysis, a mean residual diuresis of 1.22 ± 0.88 liters, and the mean weekly KT/V was 2.10 ± 0.63. 28.6% of the patients have Congestive Heart Failure, 57.1% have Diabetes Mellitus and 100% have hypertension. The patients had a mean Charlson Index of 5.7 ± 2.1 and were using an average of 2.4 ± 1.1 antihypertensive drugs. 28.6% of the patients presented dyspnea, 14.3% had pulmonary crackles, and 35.7% had peripheral edema. Mean ECW/TBW was 0.48 ± 0.02, and overhydration by BIS was 1.18 ± 1.46 L. The mean number of B-lines was 8.79 ± 6.43, Se-CA-125 was 20.42 ± 8.66 IU/mL, and NT-proBNP was 3950 (172-35,000) ng/L. SeCA125 was positively associated with left atrial volume (r = 0.823, p = 0.01), estimated PASP (r = 0.787, p = 0.03), LogNT-proBNP (r = 0.614, p = 0.02) and negatively correlated with TAPSE (r = −0.77, p = 0.05). Likewise, LogNT-proBNP was positively associated with CRP (r = 0.54, p = 0.05), and ECW/TBW ratio (r = 0.57, p = 0.03) and negatively correlated with albumin (r = −0.66, p = 0.01). There was no correlation between the number of B-lines and Se-CA-125 with the diameter or collapsibility of the IVC, pulsatility portal vein, or analysis of Doppler hepatic vein, VExUs grade, ECW/TBW ratio, NT-proBNP levels, renal residual function or the presence of edema or pulmonary crackles. Patients with overhydration by BIS (&amp;gt;7.5% OH/TBW) showed more B-lines (13 ± 6.32 vs. 5.57 ± 5.028 p = 0.04). Patients diagnosed as overloaded by B-lines (&amp;gt;5 lines) did not show a higher level of SeCA-125 (22.2 ± 9.50 vs 16 ± 4.16; p &amp;gt; 0.05), VCI diameter (1.6 ± 9.43 vs 2 ± 0.27; p &amp;gt; 0.05), OH/TBW ratio (8.4 ± 8.55 vs 2.55 ± 4.13; p &amp;gt; 0.05) or Log NT-proBNP (0.91 ± 0.76 vs 3.19 ± 0.91; p &amp;gt; 0.05). Conclusion The number of B-lines in lung ultrasound can detect patients with VO earlier compared to BIS. SeCA-125 levels are sensitive to changes in the echocardiogram. The use of both methods can help us detect early signs of volume overload in peritoneal dialysis patients.

Hidden in plain sight: commonly missed early signs of pancreatic cancer on CT.

Pancreatic ductal adenocarcinoma (PDAC) has poor prognosis mostly due to the advanced stage at which disease is diagnosed. Early detection of disease at a resectable stage is, therefore, critical for improving outcomes of patients. Prior studies have demonstrated that pancreatic abnormalities may be detected on CT in up to 38% of CT studies 5years before clinical diagnosis of PDAC. In this review, we highlight commonly missed signs of early PDAC on CT. Broadly, these commonly missed signs consist of small isoattenuating PDAC without contour deformity, isolated pancreatic duct dilatation and cutoff, focal pancreatic enhancement and focalparenchymal atrophy, pancreatitis with underlying PDAC, and vascular encasement. Through providing commentary on demonstrative examples of these signs, we demonstrate how to reduce the risk of missing or misinterpreting radiological features of early PDAC.

Trichoscopy of Frontal Fibrosing Alopecia Affecting Black Scalp: A Literature Review

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Frontal fibrosing alopecia (FFA) is a primary lymphocytic scarring alopecia characterized by progressive recession of the frontotemporal hairline, affecting mainly postmenopausal and, lately, premenopausal women of African descent. Considering the importance of trichoscopy on FFA diagnosis and the peculiarities found in patients with higher skin phototypes, this study aimed to review the FFA trichoscopy in the black scalp (Fitzpatrick IV–VI), a topic that remains sparsely described in the existing literature. &lt;b&gt;&lt;i&gt;Summary:&lt;/i&gt;&lt;/b&gt; In black patients, FFA may manifest singular features on presentation posing diagnostic clinical and trichoscopic challenges. This group has lower prevalence of the FFA compared to other alopecias. It may have an earlier age of onset and often exhibits more severe manifestations due to the coexistence of other types of alopecia and delay in diagnosis. The early signs of the disease in black patients may manifest in the eyebrows before scalp hair loss and lichen planus pigmentosus may be a herald sign. &lt;b&gt;&lt;i&gt;Key Messages:&lt;/i&gt;&lt;/b&gt; Our research analyzes FFA trichoscopy findings in black patients to help precise diagnosis and treatment. Raising awareness of the disease characteristics on trichoscopy contributes to improving hair care in this population.

Rapid response system for critically ill patients with haematological malignancies: A pre- and post-intervention study.

This study aimed to determine whether implementing a rapid response system (RRS) is associated with improved short-term outcomes in critically ill patients with haematological malignancies. Our monocentric pre- versus post-intervention study was conducted between January 2012 and April 2020. RRS was activated at early signs of haemodynamic or respiratory failure. The primary outcome was the reduction in Sequential Organ Failure Assessment (SOFA) score on Day 3 after intensive care unit (ICU) admission. Secondary outcomes included time to ICU admission and mortality. A total of 209 patients with a median age of 59 years were enrolled (108 in the pre-intervention period and 101 in the post-intervention period). 22% of them had received an allogeneic transplant. The post-intervention period was associated with a shorter time to ICU admission (195 vs. 390 min, p < .001), a more frequent favourable trend in SOFA score (57% vs. 42%, adjusted odds ratio, 2.02, 95% confidence interval, 1.09 to 3.76), no significant changes in ICU (22% vs. 26%, p = .48) and 1-year (62% vs. 58%, p = .62) mortality rates. Detection of early organ failure and activation of an RRS was associated with faster ICU admission and lower SOFA scores on Day 3 of admission in critically ill patients with haematological malignancies.

Hearing Loss and Cognitive Decline in the Aging Population: Emerging Perspectives in Audiology

In this perspective article, the author explores the connections between hearing loss, central auditory processing, and cognitive decline, offering insights into the complex dynamics at play. Drawing upon a range of studies, the relationship between age-related central auditory processing disorders and Alzheimer’s disease is discussed, with the aim of enhancing our understanding of these interconnected conditions. Highlighting the evolving significance of audiologists in the dual management of cognitive health and hearing impairments, the author focuses on their role in identifying early signs of cognitive impairment and evaluates various cognitive screening tools used in this context. The discussion extends to adaptations of hearing assessments for older adults, especially those diagnosed with dementia, and highlights the significance of objective auditory electrophysiological tests. These tests are presented as vital in assessing the influence of aging and Alzheimer’s disease on auditory processing capabilities and to signal cognitive dysfunction. The article underscores the critical role of audiologists in addressing the challenges faced by the aging population. The perspective calls for further research to improve diagnostic and therapeutic strategies in audiology, and emphasizes the need for a multidisciplinary approach in tackling the nexus of hearing loss, auditory processing, and cognitive decline.

Evaluation of Anterior Scleral Thickness and Angle Parameters in Eyes with Pseudoexfoliation Syndrome and Glaucoma.

The relationship between anterior scleral thickness and scleral spur length was disrupted in eyes with pseudoexfoliation, and scleral spur length was shorter in eyes with pseudoexfoliative glaucoma. To evaluate anterior scleral thickness (AST) in eyes with pseudoexfoliation (PX) and to examine the relationship between AST and Schlemm's canal (SC), trabecular meshwork (TM), and scleral spur (SS). Thirty-eight patients with PX syndrome (PXS), thirty-eight patients with pseudoexfoliative glaucoma (PXG), and thirty-eight healthy subjects were included in the study. Using sweep source anterior segment optical coherence tomography, AST (0, 1, 2, and 3mm from the SS), SC, and TM were visualized in the nasal and temporal areas, and measurements were compared between groups. The relationships between corneal thickness, TM, SS, SC, and AST were then evaluated. In all groups, the AST, SC, and TM measurements were similar (P>0.05). In the PXG group, SS lengths in the temporal area were shorter than those in the control and PXS groups (P=0.012). There were significant correlations between TM length and AST in the PXG group (P<0.05). The SS length exhibited moderately positive correlations with SC length and mean TM thickness in the PXG (P<0.05). There was a significant relationship between AST0 and SS in healthy eyes (P<0.05), but not in other eyes. The shorter SS length observed in eyes with PXG may be a sign of structural changes. Additionally, disruption of the relationship between AST and SS may be an early sign of pathological processes, especially in eyes with PXS, and may require closer follow-up of these eyes.

Experimental colitis in young Tg2576 mice accelerates the onset of an Alzheimer’s-like clinical phenotype

Systemic inflammation and neuroinflammation affect the natural course of the sporadic form of Alzheimer’s disease (AD), as supported by epidemiological and preclinical data, and several epidemiological studies indicate a higher prevalence of AD in patients with inflammatory bowel disease. In this study, we explored whether colitis induced by dextran sulfate sodium (DSS) in young, presymptomatic/preplaque mice worsens and/or anticipates age-dependent cognitive impairment in Tg2576, a widely used mouse model of AD. We demonstrated that DSS colitis induced in young Tg2576 mice anticipates the onset age of learning and memory deficit in the Morris water maze test. To explore potential mechanisms behind the acceleration of cognitive decline in Tg2576 mice by DSS colitis, we focused on gut microbiota, systemic inflammation and neuroinflammation markers. We observed a Firmicutes/Bacteroidetes ratio change in Tg2576 DSS animals comparable to that of elderly Tg2576 mice, suggesting accelerated microbiota aging in Tg2576 DSS mice, a change not observed in C57BL6 DSS mice. We also observed substantial differences between Tg2576 and WT mice in several inflammation and neuroinflammation-related parameters as early as 3 months of age, well before plaque deposition, a picture which evolved rapidly (between 3 and 5.5 months of age) in contrast to Tg2576 and WT littermates not treated with DSS. In detail, following induction of DSS colitis, WT and Tg2576 mice exhibited contrasting features in the expression level of inflammation-evoked astrocyte-associated genes in the hippocampus. No changes in microglial features occurred in the hippocampus between the experimental groups, whereas a reduced glial fibrillary acidic protein immunoreactivity was observed in Tg2576 vs. WT mice. This finding may reflect an atrophic, “loss-of-function” profile, further exacerbated by DSS where a decreased of GFAP mRNA expression level was detected. In conclusion, we suggest that as-yet unidentified peripheral mediators evoked by DSS colitis and involving the gut-brain axis emphasize an astrocyte “loss-of-function” profile present in young Tg2576 mice, leading to impaired synaptic morphological and functional integrity as a very early sign of AD.

Categorizing and identifying preferred interests in autistic toddlers.

Preferred interests are characteristic of autism spectrum disorder and are reported by parents starting at an early age. However, limited research has explored the presentation of preferred interests in toddlerhood. Previous literature suggests that both the intensity and type of preferred interests held by autistic individuals differ from those held by peers with developmental delay and no diagnosis and that autistic interests are more unusual in nature. While preferred interests are seen in typical child development, previous research suggests that the presence of preferred interests in children with no diagnosis declines with age. Literature also indicates that the sex and cognitive ability of autistic children influences preferred interests. Identification of early preferred interests commonly held by autistic toddlers could serve as a useful clinical indicator of future diagnosis. This article explored whether diagnostic group, age, sex, and cognitive ability predict the likelihood that parents reported preferred interests in children aged 12-36 months with diagnoses of autism, developmental delay, and those with no diagnosis. Additionally, we explored potential diagnostic group differences in interest type. Results suggest that diagnostic group, but not age, sex, or cognitive ability, predicts the likelihood that parents report preferred interests. No differences in the type of interests among diagnostic groups were identified. These results support the use of preferred interests as an early sign of autism but suggest that interest type may not be a helpful clinical indicator of autism in toddlerhood.

Deep learning and digital pathology powers prediction of HCC development in steatotic liver disease.

Identifying patients with steatotic liver disease who are at a high risk of developing HCC remains challenging. We present a deep learning (DL) model to predict HCC development using hematoxylin and eosin-stained whole-slide images of biopsy-proven steatotic liver disease. We included 639 patients who did not develop HCC for ≥7 years after biopsy (non-HCC class) and 46 patients who developed HCC <7 years after biopsy (HCC class). Paired cases of the HCC and non-HCC classes matched by biopsy date and institution were used for training, and the remaining nonpaired cases were used for validation. The DL model was trained using deep convolutional neural networks with 28,000 image tiles cropped from whole-slide images of the paired cases, with an accuracy of 81.0% and an AUC of 0.80 for predicting HCC development. Validation using the nonpaired cases also demonstrated a good accuracy of 82.3% and an AUC of 0.84. These results were comparable to the predictive ability of logistic regression model using fibrosis stage. Notably, the DL model also detected the cases of HCC development in patients with mild fibrosis. The saliency maps generated by the DL model highlighted various pathological features associated with HCC development, including nuclear atypia, hepatocytes with a high nuclear-cytoplasmic ratio, immune cell infiltration, fibrosis, and a lack of large fat droplets. The ability of the DL model to capture subtle pathological features beyond fibrosis suggests its potential for identifying early signs of hepatocarcinogenesis in patients with steatotic liver disease.

Imaging of human parafoveal area with large field of view in adaptive optics line scanning ophthalmoscope

The parafoveal area, with its high concentration of photoreceptors and fine retinal capillaries, is crucial for central vision and often exhibits early signs of pathological changes. The current adaptive optics scanning laser ophthalmoscope (AOSLO) provides an excellent tool to acquire accurate and detailed information about the parafoveal area with cellular resolution. However, limited by the scanning speed of two-dimensional scanning, the field of view (FOV) in the AOSLO system was usually less than or equal to 2∘, and the stitching for the parafoveal area required dozens of images, which was time-consuming and laborious. Unfortunately, almost half of patients are unable to obtain stitched images because of their poor fixation. To solve this problem, we integrate AO technology with the line-scan imaging method to build an adaptive optics line scanning ophthalmoscope (AOLSO) system with a larger FOV. In the AOLSO, afocal spherical mirrors in pairs are nonplanar arranged and the distance and angle between optical elements are optimized to minimize the aberrations, two cylinder lenses are orthogonally placed before the imaging sensor to stretch the point spread function (PSF) for sufficiently digitizing light energy. Captured human retinal images show the whole parafoveal area with [Formula: see text] FOV, 60[Formula: see text]Hz frame rate and cellular resolutions. Take advantage of the 5∘ FOV of the AOLSO, only 9 frames of the retina are captured with several minutes to stitch a montage image with an FOV of [Formula: see text], in which photoreceptor counting is performed within approximately 5∘ eccentricity. The AOLSO system not only provides cellular resolution but also has the capability to capture the parafoveal region in a single frame, which offers great potential for noninvasive studying of the parafoveal area.

ASSESSMENT OF KNOWLEDGE REGARDING PREVENTION, RISK FACTORS AND EARLY SIGNS OF MYOCARDIAL INFARCTION (MI) AMONG ADULTS IN SELECTED RURAL COMMUNITY, WEST BENGAL

Introduction: The nonexperimental study was undertaken to assess the knowledge regarding prevention, risk factors and early signs of Myocardial Infarction (MI) in selected rural community, West Bengal.Objectives: To determine the knowledge regarding prevention, risk factors and early signs of Myocardial Infarction (MI) among adults.To identify the association between knowledge regarding prevention, risk factors and early signs of Myocardial infarction (MI) among adults with selected demographical variables.Methods: A descriptive study was conducted to assess the knowledge regarding prevention, risk factors and early signs of Myocardial Infarction (MI) among adults in selected rural community, West Bengal. Total 180 participant were selected through non probability convenience sampling technique is used. In the study Conceptual framework based on Rosenstoch’s Health Belief Model. Data was collected from adult of rural community in Dhania Khali by valid and reliable structure interview schedule to assess the knowledge regarding prevention, risk factors and early signs of MI.Result: The findings revealed that most 46.11% adults belonged to the age group of 51-60 years 86.67% adults were Hindu that 83.33% adults had history of MI in the family 52.78% adults passed secondary examination 67.78% adults had no history of addiction. 56.11% adults of rural community had average knowledge, there was a statistically significant association between knowledge score and ageχ2 at (df1) = 3.841, p&gt;0.05, educational status χ2 at (df1) = 3.841, p&gt;0.001 and religion χ2 at (df1) = 3.841, p&gt;0.001, and type of family χ2 at (df1) = 3.841, p&gt;0.001, and income χ2at (df1) = 3.841, p&gt;0.001, and addiction χ2 at (df1) = 3.841, p&gt;0.05. The study finding could implicated in the field of nursing practice, education, administration, and research. Recommendation was need for future research.Conclusion: It in concluded that knowledge of the community people can be increased through awareness programme. Recommendations were a large sample of adults in different settings for making broad generalization.