Identification Of Cases Research Articles

Epidemiology of transient ischemic attack in the normandy stroke population-based study.

Transient ischemic attack (TIA) is a frequent neurological emergency which management and definition have changed radically over the last 15 years. However, recent epidemiological studies of TIA are scarce. We report here on the impact of the shift from a time-based to a tissue-based definition of TIA on its incidence and risk of recurrence in a new population-based cohort with a high rate of patients investigated by MRI. We prospectively included all TIAs that occurred between May 2017 and May 2021 from the Normandy Stroke Study, a population-based registry using multiple overlapping sources for exhaustive case identification in Caen la Mer area. TIAs were classified as either time-based (symptoms <24 h) or tissue-based (<24 h and no lesion on brain imaging). Attack and incidence rates were calculated, as was the 90-day ischemic stroke rate. Five hundred and sixty-seven TIAs (549 single patients) were included, with 80.6% having a brain MRI. Four hundred and ten (72.3%) met the definition of tissue-based TIA. The age standardized attack (to the 2013 European population) rate was 39.5 (95% CI 35.7-43.5) and the age-standardized incidence rate (first ever cerebrovascular event) was 29.7 (95% CI 27.3-34.2). The overall recurrent stroke rate at 90 days was 2.7%, with no difference between patients with or without ischemic lesions on MRI. We found that the use of the tissue-based definition of TIA resulted in a 27.5% reduction in incidence as compared to the time-based definition, but had no impact on the 90-day stroke rate. The burden of TIA remains high, and is likely to increase as the population ages.

Emerging Trends of Gold Nanostructures for Point-of-Care Biosensor-Based Detection of COVID-19.

In 2019, a worldwide pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged. SARS-CoV-2 is the deadly microorganism responsible for coronavirus disease 2019 (COVID-19), which has caused millions of deaths and irreversible health problems worldwide. To restrict the spread of SARS-CoV-2, accurate detection of COVID-19 is essential for the identification and control of infected cases. Although recent detection technologies such as the real-time polymerase chain reaction delivers an accurate diagnosis of SARS-CoV-2, they require a long processing duration, expensive equipment, and highly skilled personnel. Therefore, a rapid diagnosis with accurate results is indispensable to offer effective disease suppression. Nanotechnology is the backbone of current science and technology developments including nanoparticles (NPs) that can biomimic the corona and develop deep interaction with its proteins because of their identical structures on the nanoscale. Various NPs have been extensively applied in numerous medical applications, including implants, biosensors, drug delivery, and bioimaging. Among them, point-of-care biosensors mediated with gold nanoparticles (GNPSs) have received great attention due to their accurate sensing characteristics, which are widely used in the detection of amino acids, enzymes, DNA, and RNA in samples. GNPS have reconstructed the biomedical application of biosensors because of its outstanding physicochemical characteristics. This review provides an overview of emerging trends in GNP-mediated point-of-care biosensor strategies for diagnosing various mutated forms of human coronaviruses that incorporate different transducers and biomarkers. The review also specifically highlights trends in gold nanobiosensors for coronavirus detection, ranging from the initial COVID-19 outbreak to its subsequent evolution into a pandemic.

Digital contact tracing technology in the COVID-19 pandemic: a systematic review

IntroductionThe COVID-19 pandemic prompted public health teams across the world to emphasize case identification, contact tracing, and isolation in outbreak management strategies. Contact tracing was advanced by global access to mobile phones to develop and implement digital contact tracing (DCT) technology with the objective of increasing the rate of contact tracing while reducing the resources required.PurposeThis study aimed to describe the DCT technology used during the COVID-19 pandemic across the world, and to identify differences and similarities between characteristics and uses.MethodsThis review followed the PRISMA (2020) guidelines for systematic reviews. Literature searches were conducted using Embase, MEDLINE, and PubMed and were restricted to English studies published between 2019 to 2023. Studies were excluded if they did not report findings for DCT during COVID-19, did not provide data for technology characteristics or outcomes, or were a study design listed for exclusion.ResultsSixty one studies were included in the review producing results for 147 digital contact tracing technologies across 83 countries. The majority of digital contact tracing (DCT) technologies are government-owned (75.6%), primarily developed for COVID-19 tracing (96.4%). Bluetooth is the most favored technology (70%) used in their development, followed by GPS (30%) and QR codes (22%). Applications are the preferred platform (90.9%), with a few using applets (6.3%) and wearable devices (1.4%). Only 2 DCT technologies have achieved over 100 million downloads or uses (3.1%). Most DCTs fall into the 1–9.99 million downloads range (27.7%) and 10,000–99,999 downloads (20%). The majority of DCTs are voluntarily used by the population (63.6%), while 27.3% are mandated for use.ConclusionsDigital contact tracing technologies were developed and implemented globally as a strategy in emergency outbreak management to reduce the spread of disease. This review describes the use of DCT across the world by identifying key features and characteristics that will serve as a lesson learned for improvement of existing DCT technologies for other emergency response outbreak management.

Contextual analysis of the first SARS-CoV-2 RNA screening period in nasopharyngeal swabs, 2020-2022: a comparison of two diagnostic tests

Background: exceptionally consistent COVID-19 laboratory diagnostics are crucial for case identification, patient management and contact tracing. The Coronavirus-2019 (COVID-19) pandemic affected over 771.407.825 people up until October 2023, with over 6.9 million deaths. The current process of clinical laboratory consolidation, impacting large geographic areas, presents an opportunity for the efficient and cost-effective implementation of novel laboratory technologies, as well as advancements in translational research and development. The aim of this study was to assess which of the two instruments could offer the most effective support to our laboratory’s activities, minimizing errors during the pre-analytical phase, optimizing human resources, and reducing the Turn-Around-Time (TAT). Materials and Methods: the diagnostic instruments available in the Microbiology laboratory of the Azienda Ospedaliero- Universitaria SS Antonio e Biagio e Cesare Arrigo (AOUAL) were the COBAS 6800 and the ALINITY platforms. Conclusions: the Alinity platform offers clinicians a more user-friendly approach to understanding patient infectivity, compared to the closed Cobas system. It permits clinicians to review curves and access a cumulative Cycle Threshold (Ct), facilitating the hypothesis of acute or initial/final infection stages. This positions Alinity by Abbott as the preferred system over other instruments.

Abstract PO2-14-12: Accurate quantification of slide-level HER2 scores in breast cancer using a machine-learning model, AIM-HER2 Breast Cancer

Abstract Background: HER2 expression level is a key factor in determining the optimal treatment course for breast cancer patients. Roughly 15% of breast cancers are HER2(+), and determination of HER2 status is routinely assessed by immunohistochemistry (IHC). Accurate assessment of the HER2 IHC score (0, 1+, 2+, 3+) by pathologists is therefore critical, especially in light of novel therapeutic approaches demonstrating efficacy in the HER2-low setting (IHC scores 1+, and 2+/FISH-)1,2. To assist pathologists with the consistent provision of reproducible and accurate scores across the entire HER2 scoring range, we developed a machine-learning model (“AIM-HER2”) to generate accurate, slide-level HER2 scores aligned with ASCO-CAP guidelines in clinical breast cancer HER2 IHC specimens. Methods: AIM-HER2 was developed using whole-slide images (WSI; N=4261) from clinical and commercial sources. WSI were split into training (N=2694, 63%) and optimization (N=1567, 37%) sets. An additive multiple instance learning (aMIL) model3 was trained to predict HER2 scores directly from WSI and create interpretable heatmaps that depict HER2 predictions in tissue images. Image artifacts and in situ carcinomas were identified using previously trained artifact and tissue segmentation models and were excluded, leaving only regions of invasive carcinoma to be analyzed. AIM-HER2 performance was assessed on additional slides obtained from five academic or commercial sources (N=804 total, 770 evaluable) on which HER2 IHC was performed. Board-certified pathologists (N=52) with relevant experience provided manual HER2 scores based on ASCO-CAP guidelines. Nested pairwise non-inferiority analysis4 was used to compare model performance to that of pathologists (N=3 pathologists per slide). In the nested pairwise framework, agreement among pathologists was compared to agreement between AIM-HER2 and pathologists via linear kappa, so that summary metrics account for inter-pathologist variability. Results: High concordance was observed between AIM-HER2-predicted and pathologist-labeled slide-level HER2 scores, both overall and for each scoring level. Similar results were observed when assessing AIM-HER2 performance on multiple slide scanners and after IHC with multiple HER2 IHC antibody clones. Results are summarized in Table 1. Conclusions: We developed AIM-HER2, a novel aMIL-based approach for predicting slide-level HER2 IHC scores. AIM-HER2 has similar levels of agreement with pathologists as pathologists have with each other for determining HER2 score. This result is upheld when slides imaged using multiple scanning platforms and stained using multiple HER2 antibody clones. The performance of AIM-HER2 on multiple scanners and after multiple assays supports broad applicability of this algorithm in clinical laboratories, including for the identification of HER2-low cases. Work is ongoing to perform similar analyses in an independent, real-world dataset.

An outbreak of Legionnaires' disease linked to a municipal and industrial wastewater treatment plant, The Netherlands, September-October 2022.

Wastewater treatment plants (WWTPs) are increasingly identified as Legionnaires' disease (LD) sources. An outbreak investigation was initiated following five LD cases reported in September 2022 in Houten, the Netherlands. Case identification was based on the European LD case definition, with symptom onset from 1 September 2022, residence in or within 5 km of Houten, or visit to Houten within the incubation period, without other likely sources. We sampled potential sources and genotyped environmental and clinical isolates. We identified 15 LD cases with onset between 13 September and 23 October 2022. A spatial source identification and wind direction model suggested an industrial (iWWTP) and a municipal WWTP (mWWTP) as potential sources, with the first discharging water into the latter. Both tested positive for Legionella pneumophila serogroups 1 and 6 with multiple sequence types (ST). We detected L. pneumophila sg1 ST42 in the mWWTP, matching with one of three available clinical isolates. Following control measures at the WWTPs, no further cases were observed. This outbreak underlines that municipal and industrial WWTPs can play an important role in community LD cases and outbreaks, especially those with favourable conditions for Legionella growth and dissemination, or even non-favourable conditions for growth but with the influx of contaminated water.

Application of boosted trees to the prognosis prediction of COVID-19.

The precise prediction of COVID-19 prognosis remains a clinical challenge. In this regard, early identification of severe cases facilitates the triage and management of COVID-19 cases. The present paper aims to explore the prognosis of COVID-19 patients based on routine laboratory tests taken when patients are admitted. A data set including 1455 COVID-19 patients (727 male, 728 female) and their routine laboratory tests conducted upon hospital admission, age, Intensive Care Unit (ICU) admission, and outcome were gathered. The data set was randomly split into the train (75% of the data) and test data set (25% of the data). The explainable boosting machine (EBM) and extreme gradient boosting (XGBoost) were used for predicting the mortality and ICU admission of COVID-19 cases. Also, feature importance was extracted using EBM and XGBoost. The EBM and XGBoost achieved 86.38% and 88.56% accuracy in the test data set, respectively. In addition, EBM and XGBoost predicted the ICU admission with an accuracy of 89.37%, and 79.29% in the test data set for COVID-19 patients, respectively. Also, obtained models indicated that aspartate transaminase (AST), lymphocyte, blood urea nitrogen (BUN), and age are the most significant predictors of COVID-19 mortality. Furthermore, the lymphocyte count, AST, and BUN level were the most significant ICU admission predictors of COVID-19 patients. The current study indicated that both EBM and XGBoost could predict the ICU admission and mortality of COVID-19 cases based on routine hematological and clinical chemistry evaluation at the time of admission. Also, based on the results, AST, lymphocyte count, and BUN levels could be used as early predictors of COVID-19 prognosis.

Universal Screening for Syphilis at University of California, Davis, Labor and Delivery: A Response to National Trends [ID 2683426

INTRODUCTION: The number of congenital syphilis cases have been rapidly increasing in the United States despite prenatal screening. In Sacramento County, the rates of congenital syphilis are among the highest in the California. In response to the rapid rise in syphilis rates, there is universal syphilis screening on admission to University of California, Davis, labor and delivery. METHODS: Syphilis IgG was added to the admission order set for patients admitted to University of California, Davis, labor and delivery. To assess the effect of this intervention, charts were reviewed from the electronic medical record 6 months prior to and 6 months after the intervention was implemented. RESULTS: In the 6 months prior to implementing routine screening, there were nine individuals who screened positive for syphilis. Of those individuals, eight had scant or no prenatal care. Seven had a history of syphilis with prior treatment. Three required re-treatment based on follow-up titers. There were no false-positive screens. Four patients had concomitant sexually transmitted infection (STI) diagnoses, and seven had a history of or current drug use. Five had unstable housing. In comparison, after 6 months of routine syphilis screening, there were six individuals who screened positive for syphilis. Two had scant prenatal care. Three of the patients had history of syphilis and two required re-treatment based on follow-up titers. There were three false-positive screens. One patient had concomitant STI diagnosis. Two patients had unstable housing. The two groups had similar demographics in regard to age, gravidity, and parity. CONCLUSION: In the first 6 months of routine screening, there was no increase in identification of syphilis cases when compared to risk-based screening (P=0.17). This finding suggests that using a risk-based model (for example, screening individuals with scant to no prenatal care) is sufficient for identifying individuals in need of treatment.

Agnostic identification of plasma biomarkers for postpartum hemorrhage risk

Postpartum hemorrhage is difficult to predict, is associated with significant maternal morbidity, and is the leading cause of maternal mortality worldwide. The identification of maternal biomarkers that can predict increased postpartum hemorrhage risk would enhance clinical care and may uncover mechanisms that lead to postpartum hemorrhage. This retrospective case-control study employed agnostic proteomic profiling of maternal plasma samples to identify differentially abundant proteins in controls and postpartum hemorrhage cases. Maternal plasma samples were procured from a cohort of >60,000 participants in a single institution's perinatal repository. Postpartum hemorrhage was defined as a decrease in hematocrit of ≥10% or receipt of transfusion within 24 hours after delivery. Postpartum hemorrhage cases (n=30) were matched by maternal age and delivery mode (vaginal or cesarean) with controls (n=56). Mass spectrometry was used to identify differentially abundant proteins using integrated peptide peak areas. Statistically significant differences between groups were defined as P<.05 after controlling for multiple comparisons. By study design, cases and controls did not differ in race, ethnicity, gestational age at delivery, blood type, or predelivery platelet count. Cases had slightly but significantly lower predelivery and postdelivery hematocrit and hemoglobin. Mass spectrometry detected 1140 proteins, including 77 proteins for which relative abundance differed significantly between cases and controls (fold change >1.15, P<.05). Of these differentially abundant plasma proteins, most had likely liver or placental origins. Gene ontology term analysis mapped to protein clusters involved in responses to wound healing, stress response, and host immune defense. Significantly differentially abundant proteins with the highest fold change (prostaglandin D2 synthase, periostin, and several serine protease inhibitors) did not correlate with predelivery hematocrit or hemoglobin but identified postpartum hemorrhage cases with logistic regression modeling revealing good-to-excellent area under the operator receiver characteristic curves (0.802-0.874). Incorporating predelivery hemoglobin with these candidate proteins further improved the identification of postpartum hemorrhage cases. Agnostic analysis of maternal plasma samples identified differentially abundant proteins in controls and postpartum hemorrhage cases. Several of these proteins are known to participate in biologically plausible pathways for postpartum hemorrhage risk and have potential value for predicting postpartum hemorrhage. These findings identify candidate protein biomarkers for future validation and mechanistic studies.

Role of Serum Micro-RNA-122-5p Expression as a Circulatory Biomarker in People Having Both Knee Osteoarthritis and Osteoporosis: A Case-Control Study.

Background Although knee osteoarthritis (KOA) and osteoporosis (OP) manifest distinct pathophysiologies, they share numerous similarities. These health conditions are commonly found in older individuals, particularly among women. The objective of this study is to explore the expression of micro-RNA (miRNA) 122-5p (miR-122-5p) in people affected by both KOA and OP. The main aim is to identify diagnostic biomarkers and potential therapeutic targets, which could help develop personalized treatment approaches. Methods As part of the study, a total of 268 serum samples were collected from the participants, who were divided into four groups: KOA, OP, KOA and OP, and controls, with 67 subjects per group. The miRNA species-containing total RNA was isolated from the serum samples using an miRNeasy serum/plasma kit by QIAGEN (Hilden, Germany). The expression of miR-122-5p was examined in each group using real-time quantitative polymerase chain reaction. Results Expression of miR-122-5p in all three groups (KOA, OP, and common group of KOA and OP) was significantly upregulated, and the fold change value was much higher in the group having both diseases. Conclusions These results might contribute to the identification of cases at risk, early diagnosis, and development, and might also contribute to the development of therapeutic targets in subjects having both KOA and OP.

Morphometric Analysis of Hip Bones for Gender Identification in Unexpected Death Cases in Kabul, Afghanistan

Introduction: Unexpected deaths in Kabul Afghanistan often involve victims who cannot be identified due to facial disfigurement or missing identity documents. Gender identification is an important step in the forensic identification process, especially in cultural and religious contexts that have strict norms regarding gender. Pelvic bone morphometric analysis offers an accurate and non-invasive method for gender identification. This study aims to evaluate the effectiveness of hip bone morphometric analysis in identifying gender in cases of unexpected death in Kabul, Afghanistan. Methods: The samples consisted of 100 human pelvises, 50 of each gender, collected from skeletal remains at Kabul hospitals and burial grounds. Pelvic dimensions were measured using calibration techniques and statistical analysis was performed to identify significant morphometric differences between the gender. Results: Morphometric analysis showed significant differences in several pelvic dimensions between men and women. The most informative dimensions for gender identification are pelvic width, pelvic height, and superior diameter of the acetabulum. The prediction model developed using these dimensions achieved a gender identification accuracy of 94%. Conclusion: Pelvic bone morphometric analysis can be a valuable tool for forensic identification in cases of unexpected deaths in Kabul Afghanistan. This method offers high accuracy, is non-invasive and easy to apply, and can help in the process of identifying victims and resolving legal cases.

Strengthening event-based surveillance (EBS): a case study from Afghanistan

SummaryThe sustained instability in Afghanistan, along with ongoing disease outbreaks and the impact of the COVID-19 pandemic, has significantly affected the country.During the COVID-19 pandemic, the country’s detection and response capacities faced challenges. Case identification was done in all health facilities from primary to tertiary levels but neglected cases at the community level, resulting in undetected and uncontrolled transmission from communities. This emphasizes a missed opportunity for early detection that Event-Based Surveillance (EBS) could have facilitated.Therefore, Afghanistan planned to strengthen the EBS component of the national public health surveillance system to enhance the capacity for the rapid detection and response to infectious disease outbreaks, including COVID-19 and other emerging diseases. This effort was undertaken to promptly mitigate the impact of such outbreaks.We conducted a landscape assessment of Afghanistan’s public health surveillance system to identify the best way to enhance EBS, and then we crafted an implementation work plan. The work plan included the following steps: establishing an EBS multisectoral coordination and working group, identifying EBS information sources, prioritizing public health events of importance, defining signals, establishing reporting mechanisms, and developing standard operating procedures and training guides.EBS is currently being piloted in seven provinces in Afghanistan. The lessons learned from the pilot phase will support its overall expansion throughout the country.

Effectiveness of Balloon Tamponade with a Condom Catheter versus Using a Sengstaken-Blakemore Tube in Patients with Primary Postpartum Hemorrhage

Balloon tamponade or Sengstaken-Blakemore tube, are gaining fame because of its low complications, low invasiveness, rapid approach, painless removal, and rapid identification of failed cases in primary postpartum hemorrhage. Objective: To compare the efficacy of balloon tamponade versus Sengstaken-Blakemore tube in patients with primary postpartum hemorrhage. Methods: This comparative/cross-sectional was conducted at the department of Obstetrics and Gynaecology at Bahawal Victoria Hospital, Bahawalpur from July 2023 to December 2023. A total of 64 patients (32 in each group) females aged between 18 and 40 years of parity 1-6, gravida 1-6, gestational age 31 to 41 weeks, with primary postpartum hemorrhage were recruited. Females in balloon tamponade group underwent balloon tamponade, and those in Sengstaken-Blakemore tube group underwent Sengstaken-Blakemore tube insertion and balloon removal after 24 hours. The effectiveness was labelled as yes where there was no blood loss for 24 hours after the removal of the pack or foleys. Results: The mean age was 31.05 ± 5.92 years. The effectiveness of the treatment was observed among 51 (79.7%) females. In balloon tamponade group, mean blood loss was 787.81 ± 265.11 ml and 791.34 ± 254.78 ml in Sengstaken-Blakemore tube group. In balloon tamponade group, 29 (90.6%) patients had effectiveness of treatment while 22 (68.8%) females in Sengstaken-Blakemore tube group reported effectiveness (p=0.030). Conclusion: Tamponade with a balloon attached to a condom catheter were more successfully in stop bleeding after delivery of primary PPH cases.

Screening for risk factors for type 2 diabetes mellitus using the Canadian Diabetes Risk Questionnaire (CANRISK) in the East Java Provincial Health Service, Indonesia

Diabetes Mellitus remains a serious and growing global challenge for public health. Early identification of cases prevents delays in treating diabetes mellitus, which often causes various complications in the body. Diabetes Mellitus screening includes anamnesis for family and personal history of the disease, measurement of height, weight, abdominal circumference, blood pressure examination, and examination of sugar levels. One instrument that can be used to assess the risk of developing type 2 diabetes mellitus is the Canadian Diabetes Risk Questionnaire (CANRISK). The aim of this research is to find out the characteristics of respondents and the risk categories of respondents suffering from type 2 diabetes mellitus in the next 10 years using CANRISK. This research uses quantitative methods. Based on the type of research, this research uses descriptive observational research. The research design used was cross sectional. The results showed that 78% of respondents had a low-moderate risk of developing type 2 DM, 6% had a high risk of developing type 2 DM, and 16% had a very high risk of developing type 2 DM. The conclusion of this study was that the risk factors for developing Type 2 DM 2 are age, BMI, waist circumference, physical activity habits, vegetable and fruit consumption habits, history of high blood pressure and high blood sugar, history of giving birth to a baby more than 4.1 kg, family history of diabetes, parents' ethnic group, and level of education.

Clinical accuracy of instrument-based SARS-CoV-2 antigen diagnostic tests: a systematic review and meta-analysis

BackgroundDuring the COVID-19 pandemic, antigen diagnostic tests were frequently used for screening, triage, and diagnosis. Novel instrument-based antigen tests (iAg tests) hold the promise of outperforming their instrument-free, visually-read counterparts. Here, we provide a systematic review and meta-analysis of the SARS-CoV-2 iAg tests’ clinical accuracy.MethodsWe systematically searched MEDLINE (via PubMed), Web of Science, medRxiv, and bioRxiv for articles published before November 7th, 2022, evaluating the accuracy of iAg tests for SARS-CoV-2 detection. We performed a random effects meta-analysis to estimate sensitivity and specificity and used the QUADAS-2 tool to assess study quality and risk of bias. Sub-group analysis was conducted based on Ct value range, IFU-conformity, age, symptom presence and duration, and the variant of concern.ResultsWe screened the titles and abstracts of 20,431 articles and included 114 publications that fulfilled the inclusion criteria. Additionally, we incorporated three articles sourced from the FIND website, totaling 117 studies encompassing 95,181 individuals, which evaluated the clinical accuracy of 24 commercial COVID-19 iAg tests. The studies varied in risk of bias but showed high applicability. Of 24 iAg tests from 99 studies assessed in the meta-analysis, the pooled sensitivity and specificity compared to molecular testing of a paired NP swab sample were 76.7% (95% CI 73.5 to 79.7) and 98.4% (95% CI 98.0 to 98.7), respectively. Higher sensitivity was noted in individuals with high viral load (99.6% [95% CI 96.8 to 100] at Ct-level ≤ 20) and within the first week of symptom onset (84.6% [95% CI 78.2 to 89.3]), but did not differ between tests conducted as per manufacturer’s instructions and those conducted differently, or between point-of-care and lab-based testing.ConclusionOverall, iAg tests have a high pooled specificity but a moderate pooled sensitivity, according to our analysis. The pooled sensitivity increases with lower Ct-values (a proxy for viral load), or within the first week of symptom onset, enabling reliable identification of most COVID-19 cases and highlighting the importance of context in test selection. The study underscores the need for careful evaluation considering performance variations and operational features of iAg tests.

Digital Phenotypes for Early Detection of Internet Gaming Disorder in Adolescent Students: Explorative Data-Driven Study.

Limited awareness, social stigma, and access to mental health professionals hinder early detection and intervention of internet gaming disorder (IGD), which has emerged as a significant concern among young individuals. Prevalence estimates vary between 0.7% and 15.6%, and its recognition in the International Classification of Diseases, 11th Revision and Diagnostic and Statistical Manual of Mental Disorders, 5th Edition underscores its impact on academic functioning, social isolation, and mental health challenges. This study aimed to uncover digital phenotypes for the early detection of IGD among adolescents in learning settings. By leveraging sensor data collected from student tablets, the overarching objective is to incorporate these digital indicators into daily school activities to establish these markers as a mental health screening tool, facilitating the early identification and intervention for IGD cases. A total of 168 voluntary participants were engaged, consisting of 85 students with IGD and 83 students without IGD. There were 53% (89/168) female and 47% (79/168) male individuals, all within the age range of 13-14 years. The individual students learned their Korean literature and mathematics lessons on their personal tablets, with sensor data being automatically collected. Multiple regression with bootstrapping and multivariate ANOVA were used, prioritizing interpretability over predictability, for cross-validation purposes. A negative correlation between IGD Scale (IGDS) scores and learning outcomes emerged (r166=-0.15; P=.047), suggesting that higher IGDS scores were associated with lower learning outcomes. Multiple regression identified 5 key indicators linked to IGD, explaining 23% of the IGDS score variance: stroke acceleration (β=.33; P<.001), time interval between keys (β=-0.26; P=.01), word spacing (β=-0.25; P<.001), deletion (β=-0.24; P<.001), and horizontal length of strokes (β=-0.21; P=.02). Multivariate ANOVA cross-validated these findings, revealing significant differences in digital phenotypes between potential IGD and non-IGD groups. The average effect size, measured by Cohen d, across the indicators was 0.40, indicating a moderate effect. Notable distinctions included faster stroke acceleration (Cohen d=0.68; P=<.001), reduced word spacing (Cohen d=.57; P=<.001), decreased deletion behavior (Cohen d=0.33; P=.04), and longer horizontal strokes (Cohen d=0.34; P=.03) in students with potential IGD compared to their counterparts without IGD. The aggregated findings show a negative correlation between IGD and learning performance, highlighting the effectiveness of digital markers in detecting IGD. This underscores the importance of digital phenotyping in advancing mental health care within educational settings. As schools adopt a 1-device-per-student framework, digital phenotyping emerges as a promising early detection method for IGD. This shift could transform clinical approaches from reactive to proactive measures.

Way forward in the involvement of forensic anthropology in the identification of human remains

ABSTRACT Forensic anthropology should not continue to be the last resource in the identification of a forensic case. The methods to be applied in a forensic case are dictated by the state of preservation of the human remains. Forensic anthropologists (and other forensic stakeholders) should be aware of a broad spectrum of methods, their scope and limitations, to be able to perform or recommend all approaches necessary for a successful identification. The value of the so-called secondary identifiers, best designated as biological identifiers, should be reconsidered. The importance of objectivity, and impartiality will be emphasized. During a death investigation, forensic anthropologists should always formulate deductions on the biological aspects of the body before acquiring antemortem information of missing persons to avoid bias in conclusions. To illustrate our arguments, a case study is presented, where expertise in forensic anthropology has been crucial for the identification of a body in advanced state of decomposition. In this case, interdisciplinary collaborative efforts and use of multiple identifiers have led to a positive identification.

Eruption Pattern of Permanentcanine and Premolar Teeth among School Children aged 10 to 12 Years in a Rural Area: A Cross-Sectional Study

Background: Forensic dentistry is a specialized field that evaluates dental evidence to identify unidentified individuals and missing persons in legal proceedings. Dental charts are compared with known records to establish identity. Accurate age determination is crucial, and dental age assessment is reliable up to 17 years. The study aims to analyze permanent teeth eruption patterns of canines and premolars in school children aged 10 to 12, contributing valuable insights for accurate age determination and identification in legal cases. The research seeks to aid the interest of justice in criminal, civil, and employment-related scenarios by understanding dental eruption patterns in this age group.Methods: This was across-sectional study conducted among the school children of south Kerala belonging to age group of 10-12 years. Eruption pattern of permanent canines and premolars of 562 subjects were recorded and analyzed using SPSS software.Conclusion: Sequence of eruption pattern of permanent canines and premolars were compared and it was observed with statistical significance that eruption of canineprecedes the eruption of second premolars. All the teeth erupted earlier in females compared to males.There was a significant relation with reduced body mass index and delayed eruption of teeth.

Sampling is decisive to determination of Leishmania (Viannia) species.

Accuracy of molecular tools for the identification of parasites that cause human cutaneous leishmaniasis (CL) could largely depend on the sampling method. Non-invasive or less-invasive sampling methods such as filter paper imprints and cotton swabs are preferred over punch biopsies and lancet scrapings for detection methods of Leishmania based on polymerase chain reaction (PCR) because they are painless, simple, and inexpensive, and of benefit to military and civilian patients to ensure timely treatment. However, different types of samples can generate false negatives and there is a clear need to demonstrate which sample is more proper for molecular assays. Here, we compared the sensitivity of molecular identification of different Leishmania (Viannia) species from Peru, using three types of sampling: punch biopsy, filter paper imprint and lancet scraping. Different composite reference standards and latent class models allowed to evaluate the accuracy of the molecular tools. Additionally, a quantitative PCR assessed variations in the results and parasite load in each type of sample. Different composite reference standards and latent class models determined higher sensitivity when lancet scrapings were used for sampling in the identification and determination of Leishmania (Viannia) species through PCR-based assays. This was consistent for genus identification through kinetoplastid DNA-PCR and for the determination of species using FRET probes-based Nested Real-Time PCR. Lack of species identification in some samples correlated with the low intensity of the PCR electrophoretic band, which reflects the low parasite load in samples. The type of clinical sample can directly influence the detection and identification of Leishmania (Viannia) species. Here, we demonstrated that lancet scraping samples consistently allowed the identification of more leishmaniasis cases compared to filter paper imprints or biopsies. This procedure is inexpensive, painless, and easy to implement at the point of care and avoids the need for anesthesia, surgery, and hospitalization and therefore could be used in resource limited settings for both military and civilian populations.

Insights into COVID-19 data collection and management in Malawi: exploring processes, perceptions, and data discrepancies.

The completion of case-based surveillance forms was vital for case identification during COVID-19 surveillance in Malawi. Despite significant efforts, the resulting national data suffered from gaps and inconsistencies which affected its optimal usability. The objectives of this study were to investigate the processes of collecting and reporting COVID-19 data, to explore health workers' perceptions and understanding of the collection tools and processes, and to identify factors contributing to data quality. A total of 75 healthcare professionals directly involved in COVID-19 data collection from the Malawi Ministry of Health in Lilongwe and Blantyre participated in Focus Group Discussions and In-Depth Interviews. We collected participants' views on the effectiveness of surveillance forms in collecting the intended data, as well as on the data collection processes and training needs. We used MAXQDA for thematic and document analysis. Form design significantly influenced data quality and, together with challenges in applying case definitions, formed 44% of all issues raised. Concerns regarding processes used in data collection and training gaps comprised 49% of all the issues raised. Language issues (2%) and privacy, ethical, and cultural considerations (4%), although mentioned less frequently, offered compelling evidence for further review. Our study highlights the integral connection between data quality and the design and utilization of data collection forms. While the forms were deemed to contain the most relevant fields, deficiencies in format, order of fields, and the absence of an addendum with guidelines, resulted in large gaps and errors. Form design needs to be reviewed so that it appropriately fits into the overall processes and systems that capture surveillance data. This study is the first of its kind in Malawi, offering an in-depth view of the perceptions and experiences of health professionals involved in disease surveillance on the tools and processes they use.