Medical Screening Research Articles

Optimizing cardiopulmonary rehabilitation duration for long COVID patients: an exercise physiology monitoring approach

The presence of prolonged symptoms after COVID infection worsens the workability and quality of life. 200 adults with long COVID syndrome were enrolled after medical, physical, and mental screening, and were divided into two groups based on their performance. The intervention group (n = 100) received supervised rehabilitation at Department of Pulmonology, Semmelweis University with the registration number 160/2021 between 01/APR/2021–31/DEC/2022, while an age-matched control group (n = 100) received a single check-up. To evaluate the long-term effects of the rehabilitation, the intervention group was involved in a 2- and 3-month follow-up, carrying out cardiopulmonary exercise test. Our study contributes understanding long COVID rehabilitation, emphasizing the potential benefits of structured cardiopulmonary rehabilitation in enhancing patient outcomes and well-being. Significant difference was found between intervention group and control group at baseline visit in pulmonary parameters, as forced vital capacity, forced expiratory volume, forced expiratory volume, transfer factor for carbon monoxide, transfer coefficient for carbon monoxide, and oxygen saturation (all p < 0.05). Our follow-up study proved that a 2-week long, patient-centered pulmonary rehabilitation program has a positive long-term effect on people with symptomatic long COVID syndrome. Our data showed significant improvement between two and three months in maximal oxygen consumption (p < 0.05). Multidisciplinary, individualized approach may be a key element of a successful cardiopulmonary rehabilitation in long COVID conditions, which improves workload, quality of life, respiratory function, and status of patients with long COVID syndrome.

The Role of Stem Cell Therapies in the Treatment of Neurodegenerative Diseases.

Cellular replacement therapy and genetic transfer in injured brains provide new pathways for treating human neurological illnesses. Current progress in the field focuses on the production of neurons and glial cells from many types of stem cells, such as embryonic, induced pluripotent, mesenchymal, and neural stem cells. This has led to a significant increase in research on brain transplantation treatments. Extended neurodegeneration results in the progressive decline of certain neuronal subtypes or whole neuronal cells. An analysis of the progress made in induced pluripotent and mesenchymal stem cells reveals their significant promise in disease modeling, regeneration, and medication screening. The requirement for stem cells in neurodegenerative disease studies has been crucial in recent years. Stem cells provide the potential for replacing impaired neurons, comprehending disease needs modeling, and creating efficient treatments, but they have many challenges in culturing and acceptability to the host immune cells. The need to use their potential in discovering novel therapies for diseases such as Alzheimer's, Parkinson's, and amyotrophic lateral sclerosis leads to promising therapy. This review examines the function of stem cells in the pathogenesis and treatment of Huntington's disease, Parkinson's disease, Alzheimer's disease, and multiple sclerosis. This review further examines hurdles such as immunological reactions and delivery systems intending to overcome these problems. This article offers a detailed viewpoint on the use of stem cell-based nanotherapies as revolutionary treatments for various neurological illnesses.

Different modalities to manage rheumatoid arthritis: an A to Z story.

Aim: To investigate different approaches to RA treatment that might lead to greater efficacy and better safety profiles. Methods: The Search strategy was based on medical subject headings, and screening and selection were based on inclusion/exclusion criteria. Results & discussion: Early therapy is critical for disease control and loss of bodily function. The most promising outcomes came from the development of disease-modifying anti-rheumatic drugs. Different foods have anti-inflammatory and antioxidant qualities that protect against the development of rheumatoid arthritis (RA). Some dietary patterns and supplements have been shown to have potential protective benefits against RA. Conclusion: Improvement in the quality of life of RA patients requires a tailored management approach based on the current patient medical data.

Advancement in Cancer Vasculogenesis Modeling through 3D Bioprinting Technology.

Cancer vasculogenesis is a pivotal focus of cancer research and treatment given its critical role in tumor development, metastasis, and the formation of vasculogenic microenvironments. Traditional approaches to investigating cancer vasculogenesis face significant challenges in accurately modeling intricate microenvironments. Recent advancements in three-dimensional (3D) bioprinting technology present promising solutions to these challenges. This review provides an overview of cancer vasculogenesis and underscores the importance of precise modeling. It juxtaposes traditional techniques with 3D bioprinting technologies, elucidating the advantages of the latter in developing cancer vasculogenesis models. Furthermore, it explores applications in pathological investigations, preclinical medication screening for personalized treatment and cancer diagnostics, and envisages future prospects for 3D bioprinted cancer vasculogenesis models. Despite notable advancements, current 3D bioprinting techniques for cancer vasculogenesis modeling have several limitations. Nonetheless, by overcoming these challenges and with technological advances, 3D bioprinting exhibits immense potential for revolutionizing the understanding of cancer vasculogenesis and augmenting treatment modalities.

Hypoglycemic TCM formulas (Huangqi-Gegen drug pair) have the potential as an Alzheimer's disease

BackgroundAlzheimer's disease (AD) is a neurological disorder. There is a considerable unmet medical need among those suffering from it. Hypothesis and purposeGiven the link between type-2 diabetes mellitus (T2DM) and AD, hypoglycemic traditional Chinese medicine formulas (TCMFs) may be a treatment for AD. We investigated the possibility of identifying anti-AD medicines in hypoglycemic TCMFs and presented another option for the screening of AD medications. Study design and methodsParalysis of the transgenic Caenorhabditis elegans (C. elegans) strain CL4176 (caused by amyloid beta (Aβ)1–42 aggregates) was used to evaluate the anti-AD effect. The toxicity and neurodegeneration induced by neuronal expression of Aβ in the transgenic C. elegans strain CL2355 were determined using a 5-hydroxytryptamine (5-HT) assay. The transgenic Aβ-expressing strain CL 2006 and transgenic tau-expressing strain BR5270 were used to explore the effect of TCMFs on protein expression in C. elegans using ELISAs. Then, network pharmacology was used to determine the mechanism of action. The Traditional Chinese Medicine Inheritance Support System platform was used to investigate prescription patterns, core drugs, and optimum combinations of hypoglycemic TCMFs for AD. ResultsSixteen hypoglycemic TCMFs prolonged the PT50 (half paralysis time) of the CL4176 strain of C. elegans, reduced the percentage of worms paralyzed. The results of network pharmacology showed that prostaglandin-endoperoxide synthase 2 (PTGS2) and acetylcholine esterase (AChE) are main targets of hypoglycemic TCMFs. Enriched pathway analysis showed that the cholinergic receptor-related pathway was the core pathway of hypoglycemic TCMFs. According to the “four qi and five flavors” system of TCM theory, the main pharmacological qualities were “cold” and “sweet.” Through the analysis by TCMISS, we found that Huangqi-Gegen drug pair as the significant Chinese herbs of hypoglycemic TCMFs. The Huangqi–Gegen pairing had the most robust therapeutic effect when delivered at a 2:1 (v/v) ratio. It reduced the paralysis caused by 5-HT, decreased protein expression of AChE and PTGS2, and reduced Aβ deposition in the brain of the CL2006 strain of C. elegans. ConclusionsHuangqi–Gegen is a promising treatment of AD, and its mechanism may be induced by suppressing the protein production of AChE and PTGS2, reducing 5-HT intake, and then decreasing Aβ deposition.

Biomedical Laboratory Practices and Challenges in Digitalization: A Review

Biomedical laboratory plays an important role in the healthcare system by providing services for medical screening, diagnosis, and treatment selection, which is the backbone of a healthcare system. The growing demand for complex testing has placed biomedical laboratories under heavy pressure, leading to an increase in collaboration and bridging the service gaps among laboratories. During the COVID-19 pandemic, laboratories around the globe struggled to perform a large number of COVID-19 laboratory tests every day, as the country combats through the outbreak. This review provides an overview of biomedical laboratory settings and assurance, and discusses current biomedical laboratory practices and their level of digitalisation in Malaysia and a few other countries, such as the United States, Europe, Saudi Arabia, and Africa, during the outbreak. Despite the variety of laboratory practices in different countries, digitalisation remains important in supporting the healthcare system during the COVID-19 pandemic. This review also highlighted the challenges of current practices, which should be addressed to further enhance the accessibility and reliability of biomedical laboratory services. The suggestion of collaboration within the healthcare system has also been discussed to improve laboratory services for handling outbreak situations.

Raman hyperspectroscopy of saliva and machine learning for Sjögren’s disease diagnostics

Sjögren's disease is an autoimmune disorder affecting exocrine glands, causing dry eyes and mouth and other morbidities. Polypharmacy or a history of radiation to the head and neck can also lead to dry mouth. Sjogren's disease is often underdiagnosed due to its non-specific symptoms, limited awareness among healthcare professionals, and the complexity of diagnostic criteria, limiting the ability to provide therapy early. Current diagnostic methods suffer from limitations including the variation in individuals, the absence of a single diagnostic marker, and the low sensitivity and specificity, high cost, complexity, and invasiveness of current procedures. Here we utilized Raman hyperspectroscopy combined with machine learning to develop a novel screening test for Sjögren's disease. The method effectively distinguished Sjögren's disease patients from healthy controls and radiation patients. This technique shows potential for development of a single non-invasive, efficient, rapid, and inexpensive medical screening test for Sjögren's disease using a Raman hyper-spectral signature.

Impact of a Mental Health Screening Process in a Pediatric Emergency Department.

The aim of this study was to describe how specific mental health-trained social workers can assist in the evaluations and follow-up of patients presenting with mental health concerns in the pediatric emergency department (ED). Work was performed at a quaternary children's hospital ED with 95,000 annual ED visits across 2 locations. Patients requiring mental health services identified based on presenting complaint or from universal suicide screen were included. Emergency department team first evaluates the patients for medical screening and then consults a team of social workers specialized in acute mental health screening (AMHS). The team evaluates and provides recommendation for disposition and assists in plan completion. For patients not admitted, AMHS team makes 24- and 48-hour calls to ensure safety. We collected and analyzed the data on all eligible patients from September 2015 through June 2019 for (1) demographic information, (2) trends in number of consults to AMHS, (3) disposition plans and trends by year, and (4) frequency of follow-up phone calls. A total of 5950 patient visits were reviewed, for 4454 distinct patients. Most patients were 12 to 17 years of age, female, and White, with Medicaid being the predominant insurance. The most common chief complaint was suicidal ideation/plan/attempt. Self-referrals were the majority of assessments, and 59% of patients were already receiving mental health services. Median team response time was 19 minutes. There was an upward trend in consults. Psychiatric hospitalization was the most common disposition; more than 95% of the other visits had timely follow-up phone calls. Despite an increasing number of patients presenting to the ED with mental health crisis, safe and efficient management is possible with ED staff-social worker partnership. This approach can ensure that eligible patients receive consistent and evidence-based evaluations and can allow ED clinicians to respond to medical emergencies that require their attention.

Bromine‐Enhanced Organic Materials for X‐ray Sensors: Unveiling the Potential of Small Molecules and Polymers through Material Design and Film Fabrication

AbstractOrganic X‐ray sensors are a promising new class of detectors with the potential to revolutionize medical imaging, security screening, and other applications. However, the development of high‐performance organic X‐ray sensors is challenged by low sensitivity. This paper reports on the development of nine X‐ray sensors based on new organic materials. It is demonstrated that the incorporation of bromine atoms into the sidechains of carbazolyl‐containing organic molecules significantly enhances their X‐ray sensitivity. This research suggests that incorporating a variety of high‐atomic‐number chemical elements into well‐established organic semiconductors is a promising strategy for designing efficient X‐ray sensor materials.

Impact of air quality on the health of present-day workers in an Asbestos roof manufacturing industry, Sri Lanka.

The study's objective was to determine the air quality in an asbestos-related industry and its impact on current workers' respiratory health. Seventy-seven air and 65 dust samples were collected at 5-day intervals in an asbestos roofing sheets production factory in Sri Lanka having two production facilities. Sampling was performed in ten sites: Defective sheets-storage, Production-plant, Pulverizer, Cement-silo, and Loading-area. A detailed questionnaire and medical screening were conducted on 264 workers, including Lung Function Tests (LFT) and chest X-rays. Asbestos fibres were observed in deposited dust samples collected from seven sites. Free chrysotile fibres were absent in the breathing air samples. Scanning Electron Microscopy confirmed the presence of asbestos fibres, and the Energy Dispersive X-ray analysis revealed Mg, O, and Si in depositions. The average concentrations of trace metals were Cd-2.74, Pb-17.18, Ni-46.68, Cr-81.01, As-7.12, Co-6.77, and Cu-43.04mg/kg. The average Zn, Al, Mg, and Fe concentrations were within 0.2-163g/kg. The highest concentrations of PM2.52.5 and PM1010, 258 and 387µg/m3, respectively, were observed in the Pulverizer site. Forty-four workers had respiratory symptoms, 64 presented LFT abnormalities, 5 indicated chest irregularities, 35.98% were smokers, and 37.5% of workers with abnormal LFT results were smokers. The correlation coefficients between LFT results and work duration with respiratory symptoms and work duration and chest X-ray results were 0.022 and 0.011, respectively. In conclusion, most pulmonary disorders observed cannot directly correlate to Asbestos exposure due to negligible fibres in breathing air, but fibres in the depositions and dust can influence the pulmonary health of the employees.

Методика расчета эффективности профилактических осмотров и диспансеризации определённых групп взрослого населения при выявлении злокачественных новообразований.

One of the objectives of the Federal Project «Fighting Cancer» is to achieve «The proportion of malignant neoplasms detected at early stages, Percentage.» One method to achieve the set goals is to improve the efficiency of preventive medical examinations and screenings of certain adult population groups. The study aims to provide a methodological rationale for calculating the efficiency indicators of preventive medical examinations and screenings of certain adult population groups in terms of detecting malignant neoplasms. Materials and methods. For conducting the study, we used normative legal documents regulating the procedures for conducting preventive medical examinations and screenings of certain adult population groups, as well as industry-specific statistical report forms № 131/o «Information on conducting preventive medical examinations and screenings of certain adult population groups» from 11 subjects of the Northwestern Federal District for the period 2017–2022. Results. According to the analysis of the indicator «The share of residents of the Russian Federation subjects undergoing PME (Preventive Medical Examination) and SCS (Screening for Certain Groups) compared to the number of residents fitting the criteria for PME and SCS», this indicator has practically not changed over the period from 2017 to 2022, being 0,41 in 2017 and 0,42 in 2022. The coverage by preventive examinations and screenings of certain population groups in the Russian Federation subject in the Northwestern Federal District from 2017 to 2022 decreased from 0,92 to 0,75 of what was due. When calculating the actual coverage by preventive examinations and screenings of certain adult population groups in the Northwestern Federal District, the indicator slightly decreased from 0,37 in 2017 to 0,32 in 2022. The «overall» contribution of preventive medical examinations and screenings of certain adult population groups in the Northwestern Federal District slightly increased from 0,11% in 2017 to 0,14% in 2022. When analysing the «crude» index of the contribution of PME and SCS in detecting malignant neoplasms from 2017 to 2022, an increase from 3,34% to 7,6% is noted. The standardised contribution of preventive examinations and screenings of certain adult population groups to the diagnosis of breast cancer malignant neoplasms increased from 3,7% in 2017 to 8,5%, and the diagnosis of malignant neoplasms of colon, rectum, and anal canal (C18-C20) for the same period increased from 4% to 7,9%. Conclusion. Regardless of which indicator is used to calculate the efficiency of conducted preventive measures, manual data entry and the formation of statistical forms 131/o must be stopped. Manual data entry can lead to data distortion and introduce significant fluctuations in indicators when comparing the same indicator among different subjects of the Russian Federation.

FREQUENCY OF POST-EXERTIONAL MALAISE AMONG INDIVIDUALS WITH POST ACUTE SEQUELAE OF SARS-COV-2 INFECTION

INTRODUCTION AND AIM Post acute sequelae of SARS-CoV-2 infection (PASC) is a multifaceted disorder with varying symptoms. Fatigue is commonly reported; however, it is unclear if similarities exist between PASC and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). We sought to determine the frequency of post-exertional malaise in individuals with PASC; a hallmark symptom of ME/CFS. METHODS 116 participants (Age: 53.4±8.4, 36% Male) were identified to have PASC through medical screening. The Duke Activity Status Index (DASI) subjectively evaluated functional capacity, and participants achieving &amp;lt;100% of age and sex defined norms were eligible for the study. Participants attended one of three sites across Victoria and Tasmania to complete Cardiopulmonary Exercise Testing (CPET). Two days post CPET they were asked to complete the DePaul Symptom Questionnaire (DSQ) post-exertional malaise (PEM). PEM was defined as a score ≥ 2 for frequency and severity on DSQ-PEM items 1-5. A personalised exercise rehabilitation program is currently underway for participants, with results on responses to training to be available at the time of the conference. RESULTS 106 (91%) of the participants who completed a CPET achieved less than 85% of predicted relative VO2peak (21.79±5.72ml.min-1.kg-1). The DSQ-PEM questionnaire was completed in 75% (n=79) of participants. Among these individuals 78% (n=62) met the threshold for PEM. The PEM group were older (53±8 vs 48±8 years, p=0.04), had higher BMI (30.5±7.6 vs 26.7±3.9kg.m2, p=0.02), lower VO2peak (21.6±5.7 vs 25.6±5.4ml.min-1.kg-1, p=0.01) and six-minute walk distance (491±131 vs 583±112m, p=0.02). There was a similar proportion of men and women between both groups. CONCLUSION Like with ME/CFS, PEM is a common symptom in PASC. Additionally, these individuals are more deconditioned than PASC sufferers without PEM. Thus, practitioners should carefully consider the impact of PEM and deconditioning when developing rehabilitation programs.

Revolutionizing vascular health through the temporal convolutional transformer for drug screening and model evolution

Vascular illnesses include a spectrum of disorders affecting the blood vessels and continue to be major global health challenges. Vascular disorders are major worldwide health concerns that require ongoing development of drug screening models in order to find efficient treatment approaches. The ever-changing field of vascular health demands novel ways to medication screening due to the enduring difficulties presented by a variety of illnesses. This abstract explores a paradigm shift, highlighting the innovative role of the Temporal Convolutional Transformer (TCT) in redefining drug screening techniques and promoting model evolution. With its seamless integration of transformer mechanisms and temporal convolutional layers, the TCT is a revolutionary hybrid algorithm. Because of this special combination, the model can simultaneously identify spatial subtleties and capture temporal dynamics in complicated biological information. The temporal convolutional layers of the TCT are particularly good at revealing the sequential dependencies that are present in the development of vascular disorders. The model ensures a detailed knowledge of the developing nature of these diseases by analyzing temporal dynamics with skill. Simultaneously, the TCT’s transformer mechanisms enable a thorough examination of long-range interdependence and global interconnections. The TCT’s dual capability establishes it as a comprehensive solution by offering a nuanced perspective on spatial patterns that are essential for identifying the complexity of vascular health. The TCT is hybrid in the sense that it can learn features at several scales, supporting different temporal and spatial resolutions. This flexibility guarantees that the model may extract pertinent information at various scales, enhancing the characterization of the complex nature of vascular illnesses. The TCT is positioned as a holistic solution since its transformer mechanisms allow for a thorough investigation of long-range dependencies and global interconnections at the same time. This combined capacity offers a sophisticated viewpoint on spatial patterns that is essential for understanding the intricacies of vascular health. Moreover, the remarkable flexibility of the TCT to dynamic temporal scales is consistent with the dynamic character of biological processes, providing a strong and adaptable framework for drug screening. The TCT is used in many different fields of vascular disease research. The model performs well in image-based screening, collecting sequential dependencies over time and processing spatial information from medical imaging datasets. The TCT’s capacity to identify long-range dependencies is essential for molecular interaction research since it helps to clarify the complex pathways associated with vascular disorders. Its adaptability also extends to personalized treatment approaches, which allow for the efficient modeling of patient-specific data, including genetic information. The TCT is a revolutionary tool that will continue to evolve as drug screening models do. By integrating temporal convolutional and transformer mechanisms, its all-encompassing methodology provides a sophisticated and comprehensive approach to deciphering the intricacies of vascular disorders. Across all evaluated metrics, the proposed method achieves near-perfect accuracy of 98.45%, sensitivity of 93.45%, specificity of 98.43%, precision of 84.25, AUC of 99 % and F1 score values 96.01%, respectively. This abstract sheds light on how the TCT has significantly changed drug development approaches, opening the door for more focused and effective therapies in the field of vascular health.

Renal artery occlusion in a young woman - a tale of mysterious thrombosis.

Renal artery thrombosis is rare and limited reports exist in the young population. The most common aetiology is thromboembolic disease or abdominal trauma in this population and isolated occurrences are extremely rare. We present the case of an 18-year-old woman with spontaneous unilateral renal artery thrombosis and infarction for whom reperfusion was achieved through endovascular intervention. The aetiology of her thrombosis remains unclear and is under investigation with differential diagnoses being fibromuscular dysplasia, large and medium vessel vasculitis, and thromboembolic causes. To demonstrate the value in attempting salvage of an ischaemic kidney in a young patient with an unexplained spontaneous renal thrombosis. JM is an 18-year-old woman who presented to a large regional tertiary hospital with 3days of right flank pain. She had no infective symptoms and no urinary or bowel changes before admission. She was not pregnant, and her only medication was the oral contraceptive pill commenced 3months prior. A CT angiogram demonstrated right renal artery thrombosis with renal infarction. The kidney was deemed potentially salvageable, and ultrasound defined adequate vessel calibre to access for thrombectomy in the context of a negative coagulopathy screen. The patient underwent thrombolysis, thrombectomy and balloon angioplasty. Intraoperatively, a thin segment of distal stenosis was identified, and angiogram reperfusion was achieved with subsequent improvement in renal function. Renal artery thrombosis in young people is extremely rare and presents a diagnostic and management challenge requiring input from multiple teams including nephrology, rheumatology, paediatrics and vascular surgery. Systemic coagulopathy and vasculitis are differentials against anatomical aetiologies such as fibromuscular dysplasia. Our case adds to the limited literature regarding this in the young population. Renal artery thrombosis with occlusion in young people is very rare and is most often associated with a systemic coagulopathic disorder, such as antiphospholipid syndrome or structural pathology of the renal vasculature such as fibromuscular dysplasia. The work-up of a young female presenting with renal artery thrombosis without any previous medical history screens for a wide range of pathological processes.

Translating a motivational interviewing intervention for childhood cancer survivors into an eHealth tool: A user-centered design process.

Childhood cancer survivors have a higher risk of developing cardiomyopathy than members of the general population. Screening echocardiograms can facilitate early detection and treatment of cardiomyopathy. Furthermore, motivational interviewing can increase uptake of cardiac screening. However, such approaches are time- and resource-intensive, which limits their reach to the survivors who need them. We describe how we utilized a user-centered design process to translate an in-person motivational interviewing intervention into an eHealth tool to improve cardiac screening among childhood cancer survivors. We used an iterative, three-phase, user-centered design approach: (i) setting the stage (convening advisory boards and reviewing the original intervention), (ii) content programming and development (writing and programming intervention text and flow), and (iii) intervention testing (research team testing and cognitive interviews.) For cognitive interviews, participants were recruited via institutional participant registries and medical records. Data were analyzed using rapid qualitative analysis. During Phase 1, we identified survivor and provider advisors and outlined elements of the in-person intervention to change for the eHealth tool. During Phases 2 and 3, advisors recommended several modifications that guided the final intervention content and flow. Examples include: acknowledging potential hesitation or apprehension surrounding medical screenings, addressing barriers and facilitators to obtaining screening, and improving the tool's usability and appeal. In Phase 3, cognitive interview participants suggested additional refinements to the intervention language. This translation process shows that continued in-depth engagement of community advisors and iterative testing can improve the applicability of an eHealth to survivors' lived experiences and social contexts.

Non-Interventional Weight Changes Are Associated with Alterations in Serum Uric Acid Levels.

Background/Objectives: Serum uric acid is an established cardiovascular risk factor. Higher serum uric acid levels are associated with overweight and obesity. We assessed whether non-interventional weight changes affect serum uric acid levels. Methods: We performed a retrospective analysis of 19,193 participants referred to annual medical screening. Body mass index (BMI) and serum uric acid were measured annually. Subjects were divided into five groups according to changes in BMI between visits: large reduction (reduction of more than 5% in BMI), moderate reduction (reduction of more than 2.5% and 5% or less in BMI), unchanged (up to 2.5% change in BMI), moderate increase (increase of more than 2.5% and 5% or less in BMI), and large increase (increase of more than 5% in BMI). The primary outcome was serum uric acid level changes between visits. Results: A decrease in serum uric acid levels was evident as BMI decreased and an increase in serum uric acid levels was associated with an increase in BMI. The proportion of patients whose serum uric acid levels were increased by at least 10% between visits increased with the relative increase in BMI, while the proportion of patients whose serum uric acid levels were reduced by at least 10% decreased with the relative decrease in BMI. Conclusions: Non-interventional weight changes, even modest, are associated with significant alterations in serum uric acid levels. Our findings may aid in better risk stratification and the primary prevention of cardiovascular morbidity and mortality.

Impact of Audio Data Compression on Feature Extraction for Vocal Biomarker Detection: Validation Study.

Vocal biomarkers, derived from acoustic analysis of vocal characteristics, offer noninvasive avenues for medical screening, diagnostics, and monitoring. Previous research demonstrated the feasibility of predicting type 2 diabetes mellitus through acoustic analysis of smartphone-recorded speech. Building upon this work, this study explores the impact of audio data compression on acoustic vocal biomarker development, which is critical for broader applicability in health care. The objective of this research is to analyze how common audio compression algorithms (MP3, M4A, and WMA) applied by 3 different conversion tools at 2 bitrates affect features crucial for vocal biomarker detection. The impact of audio data compression on acoustic vocal biomarker development was investigated using uncompressed voice samples converted into MP3, M4A, and WMA formats at 2 bitrates (320 and 128 kbps) with MediaHuman (MH) Audio Converter, WonderShare (WS) UniConverter, and Fast Forward Moving Picture Experts Group (FFmpeg). The data set comprised recordings from 505 participants, totaling 17,298 audio files, collected using a smartphone. Participants recorded a fixed English sentence up to 6 times daily for up to 14 days. Feature extraction, including pitch, jitter, intensity, and Mel-frequency cepstral coefficients (MFCCs), was conducted using Python and Parselmouth. The Wilcoxon signed rank test and the Bonferroni correction for multiple comparisons were used for statistical analysis. In this study, 36,970 audio files were initially recorded from 505 participants, with 17,298 recordings meeting the fixed sentence criteria after screening. Differences between the audio conversion software, MH, WS, and FFmpeg, were notable, impacting compression outcomes such as constant or variable bitrates. Analysis encompassed diverse data compression formats and a wide array of voice features and MFCCs. Wilcoxon signed rank tests yielded P values, with those below the Bonferroni-corrected significance level indicating significant alterations due to compression. The results indicated feature-specific impacts of compression across formats and bitrates. MH-converted files exhibited greater resilience compared to WS-converted files. Bitrate also influenced feature stability, with 38 cases affected uniquely by a single bitrate. Notably, voice features showed greater stability than MFCCs across conversion methods. Compression effects were found to be feature specific, with MH and FFmpeg showing greater resilience. Some features were consistently affected, emphasizing the importance of understanding feature resilience for diagnostic applications. Considering the implementation of vocal biomarkers in health care, finding features that remain consistent through compression for data storage or transmission purposes is valuable. Focused on specific features and formats, future research could broaden the scope to include diverse features, real-time compression algorithms, and various recording methods. This study enhances our understanding of audio compression's influence on voice features and MFCCs, providing insights for developing applications across fields. The research underscores the significance of feature stability in working with compressed audio data, laying a foundation for informed voice data use in evolving technological landscapes.

Establishment of a Unified Register of Donor Sexual Gametes in the Republic of Kazakhstan.

The purpose of this narrative review paper was to review the state and development of the field of donor gametes in Kazakhstan, compare its legislative and technical capabilities with other countries and identify key steps towards the establishment of a unified register of donor gametes in the Republic. The narrative review paper conducted an analysis of scientific publications and legal documents to examine the implementation of Assisted Reproductive Technologies (ART), focusing on Donor Sexual Gametes (DSG), globally. It utilized medical publications from 2019 to 2023, legal acts, and recommendations from global health organizations to analyze eligibility criteria, legal regulations, and the social aspects of ART across different regions. In Kazakhstan, ART is regulated by legislation, with DSG procedures governed by age limits, medical screening, and restrictions on the number of children born from donated gametes. Worldwide, practices vary, but there is growing interest in establishing a unified register of reproductive donor material to enhance transparency and accountability. However, legal gaps and ethical considerations must be addressed. The study identifies gaps in Kazakhstan's legislation compared to Western countries, emphasizing the necessity for enhanced legal rights for donors and recipients, including options for anonymity. Ethical concerns highlight the importance of confidentiality and data security in accessing the donor registry. Overall, implementing such a register promises to enhance transparency, safety, and accountability in reproductive medicine.

Clinical Profile and Outcome of Neonates Admitted in Intensive Care Unit: A Cross Sectional Study in District Hospital

Neonatal period, which is the first 28 days of an infant’s life, is the most crucial and vulnerable period. A remarkable decline in mortality rates during neonatal period for the past two decades is due to the advances of obstetric practice in term of medical screening and surveillance and increased neonatal specialization. However, respiratory tract disorders, along with sepsis and other types of infection, are the major causes of neonatal morbidities and mortalities. Hence, this study is aimed to bridge these gaps and provide inputs to the program implementers to design necessary interventions that could contribute to the reduction of neonatal morbidity and mortality.Aims: To determine the clinical profile and neonatal outcome admitted to NICU in district hospitalObjectives: 1. To determine the socio demographic factors associated with neonatal outcome 2. To determine the obstetric profile associated with neonatal outcome.Methods: This hospital based retrospective study was conducted in the NICU of Tumakuru district hospital from Jan to March 2023. Records of all the admitted neonates were reviewed. The details were collected based on a structured questionnaire prepared in English. This contained information regarding obstetric and antenatal care (ANC), gestational age at birth, birth weight, sex, APGAR score, age at admission, admission diagnosis, neonatal outcomes and other related details. The data collected was entered in Microsoft excel (MS Excel) and quantitative variables was analysed by mean and qualitative variable by proportion by epi in go 3.4.3. Chi square was used to find out the association between the neonatal outcome and other variables. P value &lt;0.05 was considered significant.&#x0D; Results: A total of 120 neonates were admitted during the study period. 47 (39.1%) mothers of the neonates were aged 21-25years and followed by 34 (28.3%) mothers in the age of 26-30 years. Association between neonatal outcome and socio demographic components was not statistically significant but definitely outcome was better with the good socio demographic profile. Regarding ANC follow up, 119 (99.1%) mothers had attended at leastone prenatal visit and majority 100 (80%) were having ANC check-up at government hospital. The most commoncauses of neonatal mortality were respiratory distress syndrome 4(3.33%), followed by low birth weight 4(3.33%), and preterm 3(2.5%).Conclusion: Inspite of improved technology and facilities available still the neonatal outcome is worst. These all are preventable causes of neonatal mortality and morbidities which has to be taken care bygiving due importance to its predictors. Maternal and environmental factors has to be taken care and dealt.

HIV status of individuals who underwent pre-employment medical screening at a federal tertiary health institution in southeast Nigeria

Background: The human immunodeficiency virus (HIV) targets the host immune system, particularly the CD4 T cells. The host resistance to opportunistic and non-opportunistic infections such as tuberculosis, fungal infections, severe bacterial infections, and several malignancies is weakened as a result of destruction of these CD4 cells by HIV. The purpose of this study was to determine the prevalence of HIV among individuals who participated in pre-employment medical screening at David Umahi Federal University Teaching Hospital Uburu, Ebonyi State, Nigeria, with the aim of connecting those who are HIV-positive to voluntary counseling and treatment programs.&#x0D; Methodology: This was a retrospective analysis of the medical records of 537 eligible participants who underwent pre-employment medical screening exercise, and whose blood samples were tested for presence of HIV antibodies at the University Teaching Hospital, using the Determine HIV-1/2 (T1) and Unigold HIV-1/2 (T2), and the tie breaker Statpak HIV-1/2 (T3) tests. The serological results were interpreted according to the national HIV testing algorithm, with test result declared negative for HIV antibodies if T1 was negative or if only T1 was positive but T2 and T3 were both negative.&#x0D; Results: Of the total record of 756 pre-employment participants for the medical screening exercise, only 537 met the inclusion criteria for the study. The mean age of the 537 participants was 34.2±6.9 and age range of 18-67 years; 325 (61.0%) were females while 212 (39.0%) were males. The seroprevalence of HIV among the study participants was 2.4% (13/537), with 1.4% (3/212) in the males and 3.1% (10/325) in the females (x2=0.879, OR=0.45; 95% CI=0.12-1.60, p=0.3485). Only participants in the age range 26–35 and 36–45 years were HIV seropositive, with prevalence of 2.9% (9/310) and 2.4% (4/169) respectively but the HIV seroprevalence was not significantly associated with age and gender of the participants (p&gt;0.05).&#x0D; Conclusion: The study findings provide useful information for the hospital administration of the HIV situation of its planned workforce, which will help with decisions on HIV positive participants to enrol in antiretroviral therapy program.&#x0D; Contexte: Le virus de l'immunodéficience humaine (VIH) cible le système immunitaire de l'hôte, en particulier les lymphocytes T CD4. La résistance de l'hôte aux infections opportunistes et non opportunistes telles que la tuberculose, les infections fongiques, les infections bactériennes graves et plusieurs tumeurs malignes est affaiblie en raison de la destruction de ces cellules CD4 par le VIH. Le but de cette étude était de déterminer la prévalence du VIH chez les personnes ayant participé à un dépistage médical préalable à l'emploi à l'hôpital universitaire fédéral David Umahi d'Uburu, dans l'État d'Ebonyi, au Nigeria, dans le but de connecter les personnes séropositives à des conseils volontaires et des programmes de traitement.&#x0D; Méthodologie: Il s'agissait d'une analyse rétrospective des dossiers médicaux de 537 participants éligibles qui ont subi un exercice de dépistage médical préalable à l'emploi et dont les échantillons de sang ont été testés pour la présence d'anticorps anti-VIH à l'hôpital universitaire, à l'aide du système de détermination du VIH-1/2 (T1) et Unigold HIV-1/2 (T2), ainsi que les tests de départage Statpak HIV-1/2 (T3). Les résultats sérologiques ont été interprétés selon l'algorithme national de dépistage du VIH, le résultat du test étant déclaré négatif pour les anticorps anti-VIH si T1 était négatif ou si seul T1 était positif mais que T2 et T3 étaient tous deux négatifs.&#x0D; Résultats: Sur le total de 756 participants préalables à l'emploi pour l'exercice de sélection médicale, seuls 537 répondaient aux critères d'inclusion de l'étude. L'âge moyen des 537 participants était de 34,2±6,9 ans et la tranche d'âge était de 18 à 67 ans; 325 (61,0%) étaient des femmes tandis que 212 (39,0%) étaient des hommes. La séroprévalence du VIH parmi les participants à l'étude était de 2,4% (13/537), dont 1,4% (3/212) chez les hommes et 3,1% (10/325) chez les femmes (x2=0,879; OR=0,45; 95% IC=0,12-1,60; p=0,3485). Seuls les participants âgés de 26 à 35 ans et de 36 à 45 ans étaient séropositifs au VIH, avec une prévalence de 2,9% (9/310) et 2,4% (4/169) respectivement, mais la séroprévalence du VIH n'était pas significativement associée à l'âge et au sexe des personnes les participants (p&gt;0,05).&#x0D; Conclusion: Les résultats de l'étude fournissent des informations utiles à l'administration hospitalière sur la situation VIH de sa main-d'oeuvre prévue, ce qui aidera à prendre des décisions concernant les participants séropositifs à s'inscrire à un programme de thérapie antirétrovirale.