Higher Percentage Of Positivity Research Articles

Osteoarticular tuberculosis: imaging findings in pediatric patients.

Osteoarticular tuberculosis (TB) is an uncommon form of extrapulmonary TB that has the potential to damage joints and bones, generating long-term impairment. Mainly, the initial diagnosis of osteoarticular TB relies on clinical findings and imaging. When required, imaging can aim for less invasive tissue or fluid sampling for pathology, microbiology, and molecular biology analysis. Most TB diagnosis tests have variable and frequently poor sensitivities; however, bone biopsy samples have demonstrated a high percentage of culture positivity. Clinical and imaging findings of osteoarticular TB often mimic other processes, such as rheumatoid arthritis or chronic recurrent multifocal osteomyelitis. When the infection affects the growth plates, angular deformities and extremity length discrepancies can arise. Unfortunately, several osteoarticular TB cases are detected late due to the nonspecific nature of clinical symptoms and non-characteristic imaging findings. This article reviews the most common and atypical osteoarticular TB imaging presentations to increase awareness of osteoarticular TB.

B-353 High risk HPV genotypes prevalence in Mexico

Abstract Background The greatest risk factor for the development of cervical cancer is infection by human papillomavirus (HPV). To date, more than 200 genotypes have been described, 14 of them considered by the WHO as high risk genotypes (HR) due to their high oncogenic capacity, with special attention given to genotypes 16 and 18. In Mexico, cervical cancer is the third cause of cancer-associated death in women, therefore, the timely detection of HR genotypes in women becomes imperative for the reduction of the burden of this disease. The detection of high-risk HPV genotypes through the PCR molecular test is part of primary cervical cancer screening, however, this practice is not common in Mexico. Here, we analyzed the results of HPV genotyping studies in women attending cervical cancer screening studies at Salud Digna with the objective of determining the prevalence and dsitribution of HR-HPV in Mexico. Methods Retrospective analysis of the results obtained for the detection of HPV in cervical samples from patients who were attended at Salud Digna clinics from june to august 2023. The samples were processed by automated RT-PCR (ROCHE COBAS PRIME-Cobas 6800). The kit used was the COBASHPV which detects the 14 HR genotypes and generates 4 types of results: negative, positive for HPV16, positive for HPV18 and positive for POOL (which includes the remaining 12 genotypes). For the analysis, Mexico was divided into 7 regions which share sociocultural factors (Northwest, North, West, Center, Gulf, South, Southeast). Results The study population was 95,934 patients (mean age of 41y). At the national level, 18.93% (18,159) of patients are positive for HPV POOL, 3.54% (3,399) for HPV 16 and 1.78% (1709) for HPV 18. The regions with the highest positivity are the southeast region for HPV POOL (22.32%), the south region for HPV 16 (3.77%) and HPV 18 (2.44%) while the region with the lowest percentage is the Northwest region (HPV POOL 17.86%, HPV16 3.39%, HPV18 1.57%). The age range with the highest percentage of positivity is 14-29y for HPV POOL, 30-39y for HPV 16, and 30-39y for HPV 18. Conclusions We found that Mexican patients are becoming infected at an early age with the genotypes that are part of the pool, however, we observe a marked trend towards a decrease in cases as the age of the population advances.The regions of the country with a higher percentage of HPV positive patients are the south and the southeast, regions that also concentrate most of the extreme poverty in Mexico. These numbers should be taken with caution given that in absolute values these are also are the regions of the country where the least people go for a cervical cancer screening study, emphasizing the need to promote these studies in these regions. In the case of genotypes with a greater oncogenic capacity, both HPV16 and HPV18 show a greater prevalence in economically productive age ranges. Retrospective studies like provide information that allow governments to generate public policies focused on the most affected regions.

Real-time PCR for malaria diagnosis and identification of Plasmodium species in febrile patients in Cubal, Angola

BackgroundMalaria is the parasitic disease with the highest morbimortality worldwide. The World Health Organization (WHO) estimates that there were approximately 249 million cases in 2022, of which 3.4% were in Angola. Diagnosis is based on parasite identification by microscopy examination, antigen detection, and/or molecular tests, such as polymerase chain reaction (PCR). This study aimed to evaluate the usefulness of real-time PCR as a diagnostic method for malaria in an endemic area (Cubal, Angola).MethodsA cross-sectional study was carried out at the Hospital Nossa Senhora da Paz in Cubal, Angola, including 200 patients who consulted for febrile syndrome between May and July 2022. From each patient, a capillary blood sample was obtained by finger prick for malaria field diagnosis [microscopy and rapid diagnostic test (RDT)] and venous blood sample for real-time PCR performed at the Hospital Universitario Vall d’Hebron in Barcelona, Spain. Any participant with a positive result from at least one of these three methods was diagnosed with malaria.ResultsOf the 200 participants included, 54% were female and the median age was 7 years. Malaria was diagnosed by at least one of the three techniques (microscopy, RDT, and/or real-time PCR) in 58% of the participants, with RDT having the highest percentage of positivity (49%), followed by real-time PCR (39.5%) and microscopy (33.5%). Of the 61 discordant samples, 4 were only positive by microscopy, 13 by real-time PCR, and 26 by RDT. Plasmodium falciparum was the most frequent species detected (90.63%), followed by P. malariae (17.19%) and P. ovale (9.38%). Coinfections were detected in ten participants (15.63%): six (60%) were caused by P. falciparum and P. malariae, three (30%) by P. falciparum and P. ovale, and one (10%) triple infection with these three species. In addition, it was observed that P. falciparum and P. malariae coinfection significantly increased the parasite density of the latter.ConclusionsRDT was the technique with the highest positivity rate, followed by real-time PCR and microscopy. The results of the real-time PCR may have been underestimated due to suboptimal storage conditions during the transportation of the DNA eluates. However, real-time PCR techniques have an important role in the surveillance of circulating Plasmodium species, given the epidemiological importance of the increase in non-falciparum species in the country, and can provide an estimate of the intensity of infection.Graphical abstract

Characterization of tuberculosis diagnostics by GeneXpert MTB/Rif in Villa Clara, Cuba

GeneXpert MTB/RIF is a real-time polymerase chain reaction molecular test recommended since 2010 that is able to simultaneously detect the presence of Mycobacterium tuberculosis and Rifampicin resistance within two hours. The aim of the research was to characterize the diagnosis of tuberculosis by GeneXpert MTB/RIF in the Provincial Laboratory of Microbiology and Sanitary Chemistry of the Provincial Centre of Hygiene Epidemiology and Microbiology of Villa Clara, Cuba in the period January 2018-December 2020. A descriptive cross-sectional study was conducted. The study population consisted of 710 samples from patients suspected of tuberculosis. Of the total number of samples studied, 131 (18.5%) were positive; Ciego de Avila and Camagüey were the provinces with the highest percentage of positive results, with 53.8% and 32.0%, respectively. Sputum was the predominant sample type with the highest percentage of positivity (20.7%). The group of those previously treated had the highest percentage of positivity (40.0%). It is concluded that the provinces of Ciego de Avila and Camagüey were the provinces with the highest percentages of positivity, and sputum proved to be the most useful sample for GeneXpert MTB/RIF.

Herbal Formulation of High Phenols and Flavonoids with the Extract of Phyllanthus emblica, Punica granatum, and Illicium verum and Assessment of Hematotoxicity Assay: An In vitro Study.

A growing number of consumers are embracing the philosophy that natural products are better for their health and the environment. As such, they are seeking products they perceive to be safer, healthier, and without toxic chemical or synthetic ingredients. Natural products are gentle enough for daily use and provide a less abrasive alternative to more potent prescription formulations meant for short-term use. Herbal antimicrobial and antioxidant mouth rinses are considered effective adjuncts to toothbrushing and flossing for patients having gingivitis who have undergone implant treatment, providing a clinically significant benefit in the reduction of dental plaque, and also being antioxidant in nature. Three types of plant species were taken into consideration. Phyllanthus emblica fruit, Punica granatum flower, and Illicium verum fruit and seed were collected from the native trees of Chennai, Tamil Nadu. We conclude that P. emblica fruit, P. granatum flower, and I. verum fruit and seed exhibit large amounts of flavonoids, phenolics, and tannins. This study also shows that these samples can be used in clinical practice as it has less hematotoxixity percentage. P. granatum that is a pomegranate flower shows a high positive percentage in the presence of flavonoids and phenols. These plant extracts can be used in further studies and in clinical use as mouthwash or topical gel by adding preservatives and flavoring agents.

Unexpected positive cultures of humeral head detected with dithiothreitol in primary shoulder arthroplasty

BackgroundUnexpected positive cultures (UPCs) are frequently observed in primary shoulder arthroplasty and its clinical significance has not yet been well defined. The aim is to evaluate the UPCs in humeral head in primary shoulder replacement and to understand if UPCs increase in patients with risk factors for contamination (previous surgery or infiltrations). MethodsPatients undergoing total shoulder replacement were enrolled in this prospective observational study. To reduce the risk of humeral head contamination, all known procedures to reduce C. acnes burden of the skin were implemented. Patients were divided into 2 groups, namely patients who had undergone previous rotator cuff repair or infiltration and patients with no risk factors for contamination. All the humeral heads harvested were treated with Dithiothreitol, in a specific device (MicroDTTect), to increase the sensitivity of the cultures for bacterial identification. The cultures were analyzed for aerobic and anaerobic bacteria for up to 14 days. ResultsThe UPCs positivity rate of the 80 patients in the study was 19 % (15 patients). The positivity rates for UPCs in the group with and without risk factors were 30 % (12 patients) and 7.5% (3 patients), respectively. The rate of positive culture was higher in men (87%) than in women (13%).The observed positivity was due to Cutibacterium acnes and peptoniphilus asaccarolyticus, both slow-growing anaerobes. ConclusionsPatients with previous surgery or infiltrations had a 4-fold higher rate of positivity for UPCs compared with patients without previous risk factors. The higher percentage of positivity in patients with risk factors could be related to changes in the joint microenvironment after shoulder procedures. We do not know whether the presence of UPCs could be associated with the development of periprosthetic infections at longer follow-up.

Evaluating legal age of 18 years through observation of third molars using Gambier et al. method in an orthopantomographic sample of subadults from South India

In forensic practice, medicolegal physicians are often tasked with estimating age using dental evidence. This calls for an uncomplicated, reliable, and reproducible method for dental age estimation, enabling physicians to proceed without specific odontological expertise. Among various dental methods, third molar eruption analyses are less complicated and easier to perform. In our study, we explored the effectiveness of Gambier et al.'s scoring system, which examines the eruption of all third molars. We retrospectively analysed 1032 orthopantomograms (528 males and 504 females) of individuals aged between 15 and 24 years. The mean chronological age increased with the progression of stages (1 to 3) and phases (A to D) of the third molar eruption for both sexes. In terms of stages, none showed significant discrimination between minors (<18 years) and adults (>18 years), especially for males. However, Gambier’s phase D displayed a relatively high likelihood of being 18 years or older, with an overall 85.9 % of males and 95.7 % of females having all third molars in stage 3 being 18 years or older. While the tested method could be helpful in indicating the completion of the 18th year of life, caution is advised (due to a high percentage of false positives), and it should be used alongside other age assessment methods by experts.

Abstract P05: Testing patterns and referrals for monoclonal protein detection at John Peter Smith hospital

Abstract Background: Multiple myeloma (MM) is an incurable disease. Blacks have a higher incidence of MM and are diagnosed at a younger age compared to other populations. Safety-net hospitals (SNH) treat a high proportion of Black patients. Early detection of myeloma is important to prevent permanent organ dysfunction. Serum monoclonal protein testing using expanded panel aids in the diagnosis and monitoring of monoclonal gammopathies. This test result has 16 discrete components and any out-of-range value can be confusing to the ordering providers, triggering referrals to hematology oncology (hemonc). We sought to identify the testing and referral patterns at John Peter Smith (JPS) Hospital, a SNH in North Texas. Methods: Data was obtained from JPS Data Analytics and Reporting department. All serum monoclonal protein expanded panel (LAB174) orders and results for patients tested from 1-1-2022 to 12-31-2022 were abstracted from EPIC EMR. Demographic information was collected along with details about ordering providers and referrals. We sorted the data and excluded all orders by oncology providers as well as all inpatient orders. Data analysis was completed using Excel. Results: A total of 1063 tests were performed on 1026 patients. 39% were Non-Hispanic White (NHW), 36% were Black, and 13% were Hispanic. Median age was 57 years. Monoclonal band was seen in 143 (13%) samples; immunoglobulin (IG) kappa (k) 59, IG lambda (λ) 68, both IG k and IG λ 9. Results with gamma (γ) and beta (β) band were seen in 22 and 3 respectively. Measurable k band (&amp;gt;0.1 g/dL) was seen in 12 tests, &amp;gt; 1 g/dL in 5, and &amp;gt; 3 g/dL in only 1 test. Measurable λ band seen in 9 tests, &amp;gt; 1 g/dL in 3, and &amp;gt; 3 g/dL in no tests. Serum protein electrophoresis (SPEP) was normal in 525, and immunofixation (IFE) was normal in 507. Polyclonal SPEP was noted in 169 tests. Hypogammaglobinemia was seen in 11. 72 out of 369 (20%) Blacks had abnormal bands vs 47 out of 397 (12%) NHW. Two-tailed t-test was significant at p-value 0.00327. Referrals were generated to hemonc in 201 patients. Rheumatology accounted for 19% of tests, nephrology 18%, neurology 19%, and remaining were from primary care and other specialties. 212 patients were referred to hematology oncology using ICD10 diagnosis code R77.8. Rheumatologists referred 48 patients, which is 25% of all patients that they tested. Referrals from neurology: 39 (20%) and nephrology: 25 (13%). Conclusions: At JPS, clinical care providers are conducting tests to identify precursor conditions to myeloma. The test positivity rate was 13% in the non-oncology outpatient setting. Blacks had a higher percentage of positivity, reinforcing the need for a higher index of suspicion. The complexity of the test results, however, is overwhelming to the ordering providers, triggering referrals to the hemonc division, prompting recruitment and training of midlevel providers within hemonc to ensure proper monitoring of patients with precursor conditions. JPS Office of Clinical Research is planning to participate in early detection clinical trials for myeloma. Citation Format: Kavya Athipatla, Melissa Howell, Anuradha Lingam, Kayani Narra. Testing patterns and referrals for monoclonal protein detection at John Peter Smith hospital [abstract]. In: Proceedings of the Blood Cancer Discovery Symposium; 2024 Mar 4-6; Boston, MA. Philadelphia (PA): AACR; Blood Cancer Discov 2024;5(2_Suppl):Abstract nr P05.

Analysis of Antinuclear Antibody Test Referral Patterns in a Tertiary Care Hospital over Three Years: A Retrospective Observational Study

Introduction: Antinuclear Antibodies (ANA) detection by Human Epithelial Substrate (Hep2) is the recommended screening test for the diagnosis of ANA-Associated Rheumatic Diseases (AARD). ANA is ordered by various specialists in a tertiary care hospital, and a positive ANA result is followed by testing for specific autoantibodies. High pretest probability, pattern type with intensity, and referral departments are key factors determining the autoimmune diagnosis. Aim: To analyse the ANA referral patterns among the various departments and also to estimate the prevalence and clinical significance of rare ANA patterns. Materials and Methods: A retrospective observational study was conducted at Nizam's Institute of Medical Sciences, Hyderabad, a tertiary care hospital, in Hyderabad, Telangana, India where ANA test reports (n=16,994) from various departments over three years (November 2017 to October 2020) were evaluated between November 2022 to December 2022. ANA tests were performed on Hep2 substrate at a 1:100 dilution, and ANA patterns were reported according to the International Consensus on ANA Patterns (ICAP) nomenclature. Statistical analysis of department- wise ANA positivity and fluorescence intensity was conducted, and the final diagnoses of patients with rare ANA patterns (&lt;1%) were noted from clinical records. Fischer's-exact test was used for comparing categorical variables, considering p-value &lt;0.05 as statistically significant. Results: The majority of ANA requests were from the Rheumatology department (5859; 34.5%), followed by nephrology (3132; 18.4%), neurology (1940; 11.4%), general medicine (1646; 9.7%), haematology (1106; 6.5%), and casualty (878; 5.2%), accounting for 85.6% of total referrals. The highest percentage of positivity among ANA referrals was observed in Rheumatology (333; 5.7%), with 58% of positive ANA showing 4+ intensity. No positives were observed from many surgical departments. Rare ANA patterns with a prevalence of less than 1% were observed in 22 patients with mitotic patterns accounting for the majority of rare patterns seen in 11 out of 22 (50%) cases followed by nuclear envelope, rods rings, and nuclear dense fine speckled patterns were observed in six, four, and one patient(s), respectively. The majority of rare ANA patterns had 2+ fluorescence intensity without any associated autoimmune diagnosis. Conclusion: The highest and lowest positivity among ANA referrals were observed in the rheumatology and surgical departments, respectively. Considering the pretest probability of AARD before ordering an ANA test would lead to the optimum utilisation of laboratory services. Mitotic patterns constituted the majority of rare ANA patterns and need to be clinically correlated with antibody titers.

Prevalence of Bovine leukemia virus in Egyptian women’s breast cancer tissues

ABSTRACT Bovine leukemia virus (BLV) infects cattle around the world and presents in commercial bovine products. Several studies have suggested that BLV may play a role in breast oncogenesis. This study aimed to determine the risk factors for BLV infection and the presence of the BLV gene in breast tissue. A total of 100 formalin-fixed and paraffin-embedded breast tissue specimens were collected (50 confirmed cancer samples and 50 negative samples). DNA was extracted from breast tissues, and nested PCR was done to detect the tax gene of BLV. Immunohistochemical staining for ER, PR, Her2/neu, and Ki-67 was applied. Bovine leukemia virus DNA was detected in 16% of breast cancer tissue samples and in only 4% of tissue samples without cancer. No statistically significant association was reported between the presence of BLV and tumor grade, stage, or LN metastasis. A high percentage of positivity (100%, 88%, and 75%) was reported for ER, PR, and Ki-67 in BLV-positive cancer samples, respectively. There was a significant association between the BLV tax gene and breast cancer in Egyptian women. Thus, there is a need to control BLV transmission to humans from cattle, and further investigations about its risk related to public health are highly required.

Investigating Students' Attitudes &amp; Trust in AI During COVID-19

Artificial Intelligence (AI) has been a part of society for a considerable amount of time since its formal foundation in 1956 and can be used to perform cognitive tasks at a level similar or greater than humans. In our modern era of advanced intelligence machines and processing capabilities, AI is being pushed further into society at a fast rate. With advancing AI like ChatGPT and self-driving vehicles, it is important for society to understand the implications of trusting this technology. Studies have discussed AI being used in the medical field to combat mental health issues and identify attitudes. However, there is a gap in research over adults' levels of trust towards AI and how those feelings have evolved over the course of COVID-19. This research paper explores how trust college/university undergraduate/graduate adults evolved over the COVID-19 pandemic and aims to fill that gap. To address the general attitudes and levels of trust towards AI, a mixed-method quantitative and qualitative study was conducted utilizing a survey. The survey inquired about general attitudes using the General Attitudes towards AI Scale (GAAIS) and open-ended questions to measure levels of trust in relation to the pandemic. It was concluded that while participants demonstrated a positive attitude towards AI (70.4% ), most participants had low levels of trust reflected in their fears and concerns of future AI implementation. A high percentage of positivity towards AI coupled with low levels of trust indicates a complex attitude towards artificial intelligence.

T-shirt Illustration for Griya Baca's Street Children as an Awareness Campaign Media

Street children are a social problem that is an interesting phenomenon in social life. Quoting from street children who are cared for by Griya Baca Malang, here there are a lot of children who do not get an education like ordinary children, due to their circumstances which require them to live on the streets, even earn money by busking/begging, their background is mostly from economic pressure. , from this problem it is important for the community to care more about them because after all they are the nation's generation, after research on the problem, the solution for this is to hold a awareness campaign through t-shirt illustrations. The purpose of designing this t-shirt illustration is as a form of public awareness to be more concerned with street children. Illustrations will make it easier to convey messages and have their own charm so that messages from the campaign can be conveyed properly. Product effectiveness testing was carried out on February 16, 2022, showing that the results of the assessment of this t-shirt illustration obtained a fairly high positive percentage, namely 29 out of 30 respondents. This book received a positive response from respondents based on the results obtained from this test.&#x0D; Keywords: Street children, illustration, campaign

Utilizing flow cytometry sorting signal width to enrich for cells positive to endogenous gene integration of fluorescent proteins.

Endogenous gene knock-in using CRIPSR is becoming the standard for fluorescent tagging of endogenous proteins. Some protocols, particularly those that utilize insert cassettes that carry a fluorescent protein tag, can yield many types of cells with off-target insertions that have diffuse fluorescent signal throughout the whole cell in addition to scarce cells with on-target gene insertions that show the correct sub-cellular localization of the tagged protein. As such, when searching for cells with on-target integration using flow cytometry, the off-target fluorescent cells yield a high percentage of false positives. Here, we show that by changing the gating used to select for fluorescence during flow cytometry sorting, namely utilizing the width of the signal as opposed to the area, we can highly enrich for positively integrated cells. Reproducible gates were created to select even minuscule percentages of correct subcellular signal, and these parameters were validated by fluorescence microscopy. This method is a powerful tool to rapidly enhance the generation of cell lines with correctly integrated gene knock-ins encoding endogenous fluorescent proteins.

A novel anterior nasal swab to detect respiratory viruses: a prospective study of diagnostic accuracy

Detection of respiratory viruses requires testing of the upper respiratory tract to obtain specimens for analysis. However, nasal and throat swabs can cause discomfort and procedural anxiety in children. Respiratory sampling methods which are accurate and less invasive are needed. We aim to determine the positive and negative percentage agreement of a novel anterior nasal swab (ANS) compared with the combined throat and anterior nasal swab (CTN), the reference standard, for detection of respiratory viruses. Children 5 – 18 years of age presenting to a tertiary paediatric hospital with respiratory symptoms were tested with both swabs in randomised order. Respiratory samples were tested on a multiplex RT-PCR panel. Viral detections, RT-PCR cycle-threshold values and child/parent/clinician experience of the swab were recorded. There were 157 viral detections from 249 participant CTN swabs. In comparison with the CTN, the overall positive and negative percentage agreement of ANS for detection of respiratory viruses was 96.2% (95% CI, 91.8–98.3%) and 99.8% (95% CI, 99.6–99.9%), respectively. The ANS was “extremely comfortable”, or only a “little uncomfortable” for 90% of children compared with 48% for CTN. 202 children (84%) rated the ANS as the preferred swab, and 208 (87%) indicated they would prefer ANS for future testing. The ANS required additional laboratory handling processes compared to the CTN. The ANS has high positive percentage agreement and is comparable to the current standard of care. The high acceptability from the less invasive ANS provides a more comfortable method for respiratory virus testing in children.Trial registrationClinicalTrials.gov ID NCT05043623.

Study on the expression of CK7, CK20 and other immunohistochemical markers for diagnosis of malignant tumours

Introduction: Cancer is malignant disease, one of the leading cause of deadth at the global level. The determination of origin of tumors is really essential for not only prognosis but also effective treatment orientation for cancerous patients. Objective: Defining histopathological types of malignant epithelial tumors and determining the origin of tumors by CK7, CK20 and other immunohistochemical markers. Patients and methods: A cross-sectional study of 50 patients diagnosed carcinoma and CK7, CK20 and other immunohistochemical markers stain at Hue University of Medicine and Pharmacy Hospital from January, 2020 to December, 2020. Results: The results of histopathological types: lymph node metastatic carcinoma took up the highest percentage (30%), followed by lung cancer, hepatocellular cell carcinoma, gastric cancer and other organs with 28%, 18%, 10% and 2% respectively. The value of expression of CK7, CK20 and other immunohistochemical markers in differentiated diagnosis of the origin of tumors: CK7, CK20 positive 46%, 12% respectively. The combination of expression of CK7 and CK20: the co-expression of CK7 and CK20 with positive and negative was 2%, 44% respectively; the expression of CK7 positive and CK20 negative and vice versa was 44% and 10% respectively. CKAE1/3 with TTF1 (11/19), P63 (7/14), CEA (6/6), Ki-67 (13/2) and CK19 (10/6) had high positive percentage. Conclusion: Lymph node metastatic carcinoma was one of the most popular histopathological type. There was a statistically significant relationship between the expression of CK7 and CK20. The use of CK7, CK20 and other immunohistochemical markers can assist pathologists in determining exactly the origin of malignant tumors. Key words: carcinoma, CK7/CK20, histopathology, immunohistochemistry, metastasis.

Prevalence of Influenza Virus in Patients with Severe Acute Respiratory Infections (SARI)

BACKGROUND&#x0D; Influenza is viral fever with the main symptoms of the respiratory tract like cough, fever, breathlessness, nasal discharge, sore throat &amp; myalgia. Pandemic 2009 H1N1 influenza A was the virus that presented a significant public health threat on a global scale. This prospective study was undertaken to analyse the prevalence of the influenza virus in patients with a severe acute respiratory infection (SARI) and also to determine the demographic characteristics and seasonal variations.&#x0D; METHODS&#x0D; This was a hospital-based prospective study done in the Department of Microbiology, Silchar Medical College &amp; Hospital, Silchar for 1 year from June 2021 to May 2022. Respiratory specimens were tested for Influenza virus by one step real-time reverse transcription polymerase chain reaction (RT-PCR).&#x0D; RESULTS&#x0D; In real-time PCR, the influenza virus was detected in 6 out of 85 SARI patients (7%). Of 6 total positives, 4(67%) were influenza A and 2(33%) were influenza B. Among 4 influenza A positive cases, 3(75%) were influenza A (H1N1) pdm09 and 1(25%) was seasonal influenza A (H3N2). The highest percentage of positivity (50%) was detected in the age group of 15-29 years. The most common symptoms among the positive influenza cases were fever (100%), cough (88%), and breathlessness (56%). Other associated symptoms were sore throat (63%), nasal discharge (75%), and myalgia (75%).&#x0D; CONCLUSIONS&#x0D; This study clearly shows that influenza is an important cause of severe acute respiratory infection. It also suggests the need for continuous effective surveillance of influenza viruses to detect cases and control outbreaks. Early intervention and proper management of influenza virus cases are required to curb the disease burden.

Blockchain-Based Privacy Preservation Scheme for Misbehavior Detection in Lightweight IoMT Devices.

The Internet of Medical Things (IoMT) has risen to prominence as a possible backbone in the health sector, with the ability to improve quality of life by broadening user experience while enabling crucial solutions such as near real-time remote diagnostics. However, privacy and security problems remain largely unresolved in the safety area. Various rule-based methods have been considered to recognize aberrant behaviors in IoMT and have demonstrated high accuracy of misbehavior detection appropriate for lightweight IoT devices. However, most of these solutions have privacy concerns, especially when giving context during misbehavior analysis. Moreover, falsified or modified context generates a high percentage of false positives and sometimes causes a by-pass in misbehavior detection. Relying on the recent powerful consolidation of blockchain and federated learning (FL), we propose an efficient privacy-preserving framework for secure misbehavior detection in lightweight IoMT devices, particularly in the artificial pancreas system (APS). The proposed approach employs privacy-preserving bidirectional long-short term memory (BiLSTM) and augments the security through integrating blockchain technology based on Ethereum smart contract environment. The effectiveness of the proposed model is bench-marked empirically in terms of sustainable privacy preservation, commensurate incentive scheme with an untraceability feature, exhaustiveness, and the compact results of a variant neural network approach. As a result, the proposed model has a 99.93% recall rate, showing that it can detect virtually all possible malicious events in the targeted use case. Furthermore, given an initial ether value of 100, the solution's average gas consumption and Ether spent are 84,456.5 and 0.03157625, respectively.

Detection of Real-Time Malicious Intrusions and Attacks in IoT Empowered Cybersecurity Infrastructures

Computer viruses, malicious, and other hostile attacks can affect a computer network. Intrusion detection is a key component of network security as an active defence technology. Traditional intrusion detection systems struggle with issues like poor accuracy, ineffective detection, a high percentage of false positives, and an inability to handle new types of intrusions. To address these issues, we propose a deep learning-based novel method to detect cybersecurity vulnerabilities and breaches in cyber-physical systems. The proposed framework contrasts the unsupervised and deep learning-based discriminative approaches. This paper presents a generative adversarial network to detect cyber threats in IoT-driven IICs networks. The results demonstrate a performance increase of approximately 95% to 97% in terms of accuracy, reliability, and efficiency in detecting all types of attacks with a dropout value of 0.2 and an epoch value of 25. The output of well-known state-of-the-art DL classifiers achieved the highest true rate (TNR) and highest detection rate (HDR) when detecting the following attacks: (BruteForceXXS, BruteForceWEB, DoS_Hulk_Attack, and DOS_LOIC_HTTP_Attack) on the NSL-KDD, KDDCup99, and UNSW-NB15 datasets. It also maintained the confidentiality and integrity of users’ and systems’ sensitive information during the training and testing phases.

Randomly controlled drivers using minimally invasive sampling: assessment of drug prevalence in Western Switzerland over two time periods

BackgroundAccording to the World Health Organization, road traffic injuries lead to 1.3 million deaths each year and represent the leading cause of death for young adults under 30 years old. The use of psychoactive substances, including alcohol, drugs and pharmaceuticals, is a well-known risk factor for road traffic injuries. Our study aims to assess the prevalence of substances consumed by drivers in western Switzerland. Such studies are pivotal to improving prevention and developing public awareness campaigns.MethodsTo assess the prevalence of psychoactive substances among drivers, roadside controls were performed in collaboration with local police, using their classical sampling procedures to detect drivers under the influence of drugs or alcohol over two time periods (P1: 2006-2008, P2: 2017-2020). When impaired driving was not suspected by the police, minimally invasive sampling strategies (i.e., oral fluids during P1 and dried blood spots during P2) were performed on volunteer drivers after a road safety survey. A posteriori analyses and statistical interpretation were then performed.ResultsAmong the 1605 drivers included in the study, 1048 volunteers provided an oral fluid sample, while 299 provided a dried blood spot sample. The percentage of drivers testing positive for at least one substance that can impact driving abilities was stable over time, with a rate of 10.5% positivity measured over both periods. Considering the different categories of substances, a slight variation was observed between both periods, with 7.6 and 6.3% of pharmaceuticals and 3.6 and 4.9% of illicit drugs for P1 and P2, respectively. Regarding the consumption of illicit drugs, the highest percentage of positivity was measured in biological fluids of drivers under the age of 35, during nights and week-ends, periods which are considered particularly prone to fatal accidents for this age group. Disturbingly, the road safety survey highlighted that drivers’ perception of the risk of getting positively controlled while driving after drug consumption is low (3.3 on a 1-to-10 scale, N = 299).ConclusionThe number of positive cases measured in voluntary drivers who passed the preliminary police check demonstrates the importance of systematic biofluid sampling strategies regarding driving under the influence of psychoactive substances. Although the number of fatal road accidents globally has decreased over time, the results of this study reveal the need for both better prevention and deterrent processes that could potentially reduce the risk of fatal road accidents associated with drug consumption.

Machine-learning algorithm in acute stroke: real-world experience

To assess the clinical performance of a commercially available machine learning (ML) algorithm in acute stroke. CT and CT angiography (CTA) studies of 104 consecutive patients (43 females, age range 19-93, median age 62) performed for suspected acute stroke at a single tertiary institutionwith real-time ML software analysis (RAPID™ ASPECTS and CTA) were included. Studies were retrospectively reviewed independently by two neuroradiologists in a blinded manner. The cohort included 24 acute infarcts and 16 large vessel occlusions (LVO). RAPID™ ASPECTS interpretation demonstrated high sensitivity (87.5%) and NPV (87.5%) but very poor specificity (30.9%) and PPV (30.9%) for detection of acute ischaemic parenchymal changes. There was a high percentage of false positives (51.1%).In cases of proven LVO, RAPID™ ASPECTS showed good correlation with neuroradiologists' blinded independent interpretation, Pearson correlation coefficient = 0.96 (both readers), 0.63 (RAPID™ vs reader 1), 0.69 (RAPID™ vs reader 2). RAPID™ CTA interpretation demonstrated high sensitivity (92.3%), specificity (85.3%), and negative predictive (NPV) (98.5%) with moderate positive predictive value (PPV) (52.2%) for detection of LVO (N=13). False positives accounted for 12.5% of cases, of which 27.3% were attributed to arterial stenosis. RAPID™ CTA was robust and reliable in detection of LVO. Although demonstrating high sensitivity and NPV, RAPID™ ASPECTS interpretation was associated with a high number of false positives, which decreased clinicians' confidence in the algorithm. However, in cases of proven LVO, RAPID™ ASPECTS performed well and had good correlation with neuroradiologists' blinded interpretation.