Positive Cases Research Articles

Scaling effectivity in manifold methodologies to detect driver’s fatigueness and drowsiness state

The state of fatigueness and drowsiness relates to the stressed physical and mental condition of a driver that reduces the ability of a driver to drive safely leading to fatal consequences of road accidents. With a rising concerns about the road safety, the premium and modern vehicles are coming up with a sophisticated technology to detect and rise alarm during the positive case of fatigueness and drowsiness. Irrespective of availability of archives of literatures towards solving this problem, it is quite unclear about the strength and weakness of varied methodologies. Therefore, this paper presents a crisp and insightful discussion about the recent methodologies associated with detecting driver's attention, fatigueness, drowsiness along with highlights of commercial devices to realize various limiting factors and constraints associated with them. The paper contributes to introduce a well-structured flow of research trend to realize various patterns of current trend adopted towards solving varied problems and significant research gaps have been identified in this process. The outcome of this paper presents that still there is an open scope of an improvement towards accomplishing the agenda towards safer driving.

Disentangling Police-recorded Crime Change in Hong Kong amid the COVID-19 pandemic

Without a doubt, the ongoing COVID-19 pandemic has profoundly impacted the landscape of human life across the globe. It may further lead to a substantial behavioral change in individuals, including the pattern of criminal victimization victimization. Although some previous studies suggested that there was a crime drop in Western societies after the pandemic outbreak, the effect of the pandemic on crime rates in the non-Western context was still vague. Therefore, the present study analyzed the police-recorded data in Hong Kong, a city in the south side of China that continued to enact a "dynamic zero covid" control of positive cases. In line with the previous studies, traditional crime, such as assaults in Hong Kong, dropped steadily after the pandemic outbreak. Yet, surprisingly, the overall crime rate alternatively increased amid the pandemic which is mainly attributed to the surge in cybercrime, especially deceptions and blackmail. This paper thus warrants more thorough investigations of the change in routine activities to the virtual world and the risks of cyber victimizations. Limitations and policy implications were discussed.

A Comprehensive Analysis of various Covid-19 Detection and Pandemic Prevention Systems and Methods Using Data Science

Abstract: The paper proposes a technique for early Covid-19 test prediction using AI and data science. The study analyzes various data sources to understand the patterns and trends of the pandemic and the impact of various interventions on the spread of the virus. The proposed system integrates data from multiple sources to identify potential cases and can also track the spread of the virus in real-time. The system has high accuracy in predicting positive cases and has the potential to improve our ability to detect and predict Covid-19 cases, ultimately saving lives and reducing the economic impact of the pandemic. The proposed technique for early Covid-19 test prediction using AI and data science can be a game- changer in our fight against the pandemic. With the integration of multiple data sources, including individual health records, social media, and geographic data, the system can identify potential cases even before symptoms appear. This early detection can help individuals get timely medical attention and prevent the spread of the virus to others.

Screening of essential oils against oxacillin-resistant Staphylococcus aureus strains isolated from bovine mastitis

Bovine mastitis is a disease with far-reaching consequences for the dairy industry. Staphylococcus aureus is a pathogen that is especially resistant to antibiotics. The objective of this study was to evaluate the antimicrobial activity of the essential oils Lippia citriodora (Lam.), Thymus vulgaris (L), and a mixture of the essential oils Lippia citriodora and Thymus vulgaris (50/50 v/v), against isolates of oxacillin-resistant Staphylococcus aureus (n=15) of positive cases of bovine mastitis. For the statistical analysis, the IBM SPSS statistical package was used. The mixture of essential oils (Lippia citriodora and Thymus vulgaris (50/50 v/v)) obtained the most significant antimicrobial activity in relation to pure essential oils. It is therefore concluded that the mixture of these oils boosts their antimicrobial activity (p<0.05). The minimum inhibitory and bactericidal concentration of this mixture for the total isolations was 12 μL/L and 25 μL/mL, respectively.

Evaluation of an artificial intelligence model for identification of mass effect and vasogenic edema on computed tomography of the head.

Mass effect and vasogenic edema are critical findings on CT of the head. This study compared the accuracy of an artificial intelligence model (Annalise Enterprise CTB) to consensus neuroradiologist interpretations in detecting mass effect and vasogenic edema. A retrospective standalone performance assessment was conducted on datasets of non-contrast CT head cases acquired between 2016 and 2022 for each finding. The cases were obtained from patients aged 18 years or older from five hospitals in the United States. The positive cases were selected consecutively based on the original clinical reports using natural language processing and manual confirmation. The negative cases were selected by taking the next negative case acquired from the same CT scanner after positive cases. Each case was interpreted independently by up to three neuroradiologists to establish consensus interpretations. Each case was then interpreted by the AI model for the presence of the relevant finding. The neuroradiologists were provided with the entire CT study. The AI model separately received thin (≤1.5mm) and/or thick (>1.5 and ≤5mm) axial series. The two cohorts included 818 cases for mass effect and 310 cases for vasogenic edema. The AI model identified mass effect with sensitivity 96.6% (95% CI, 94.9-98.2) and specificity 89.8% (95% CI, 84.7-94.2) for the thin series, and 95.3% (95% CI, 93.5-96.8) and 93.1% (95% CI, 89.1-96.6) for the thick series. It identified vasogenic edema with sensitivity 90.2% (95% CI, 82.0-96.7) and specificity 93.5% (95% CI, 88.9-97.2) for the thin series, and 90.0% (95% CI, 84.0-96.0) and 95.5% (95% CI, 92.5-98.0) for the thick series. The corresponding areas under the curve were at least 0.980. The assessed AI model accurately identified mass effect and vasogenic edema in this CT dataset. It could assist the clinical workflow by prioritizing interpretation of abnormal cases, which could benefit patients through earlier identification and subsequent treatment. AI = artificial intelligence; AUC = area under the curve; CADt = computer assisted triage devices; FDA = Food and Drug Administration; NPV = negative predictive value; PPV = positive predictive value; SD = standard deviation.

A 2-year longitudinal study examining the change in psychosocial factors under the COVID-19 pandemic in Japan

To examine changes in individuals’ psychosocial variables (e.g., psychological distress, social isolation, and alcohol use) during the prolonged COVID-19 pandemic, a two-year longitudinal survey was conducted at approximately one-year intervals between May 2020 and May 2022, after the first COVID-19-related state of emergency was announced in Japan. The online survey was conducted on May 11-12, 2020 (Phase 1), June 14–20, 2021 (Phase 2), and May 13–30, 2022 (Phase 3). The survey in Phase 1 was conducted during the first emergency declaration period, the survey in Phase 2 was conducted during the third emergency declaration period, and the survey in Phase 3 was conducted at a time when there was no state of emergency but many COVID-19 positive cases. Notably, 3,892 participants responded to all three surveys. In addition to psychosocial inventories often used worldwide, survey items included lifestyle and stress management indicators related to COVID-19 and various sociodemographic items including occupation (e.g., healthcare workers) or income, history of medical treatment for mental problems, severe physical illnesses, and COVID-19.

Clinical importance of anti-Ro52 antibody for polymyositis and dermatomyositis.

To clarify clinical features of anti-Ro52 antibody (Ab)-positive polymyositis (PM)/dermatomyositis (DM). We retrospectively examined clinical features and status of anti-Ro52 Ab in patients with PM/DM admitted at the University of Tsukuba Hospital between January 2019 and February 2023. We compared anti-Ro52 Ab-positive and -negative groups. A total of 40 patients were selected and analyzed. Median age at diagnosis was 61.5 (48.8-69.3) years and 34 cases were female. Twenty-three cases were PM and 17 cases were DM (including 6 clinically amyopathic dermatomyositis: CADM). Twenty-two cases were positive for anti-Ro52 Ab, 14 for anti-ARS Ab, and 6 for anti-MDA5 Ab. Interstitial lung disease (ILD) was detected in 29 cases, 9 of which were rapidly progressive. Glucocorticoid (GC)-resistant cardiomyopathy was detected in 6 cases, malignancy in 3 cases, and Sjögren's syndrome (SS) in 4 cases. Of the 22 anti-Ro52 Ab positive cases, only 3 were single-positive and the remaining 19 cases simultaneously had other autoantibodies. Comparing the anti-Ro52 Ab-positive and -negative groups, the frequencies of anti-ARS Ab positivity (63.6% vs. 0%), ILD (95.5% vs. 44.4%), GC-resistant cardiomyopathy (27.3% vs. 0%), concomitant use of immunosuppressants (95.5% vs. 55.6%), and levels of C-reactive protein (CRP) were significantly higher in the anti-Ro52 Ab-positive group (p<0.05). The frequencies of PM/DM, positivity of anti-MDA5 Ab, malignancies, and SS were comparable between groups. Anti-Ro52 Ab were frequently positive in PM/DM and anti-Ro52 Ab-positive patients showed significantly higher rates of anti-ARS Ab positivity and ILD, GC-resistant cardiomyopathy, concomitant use of immunosuppressants, and higher levels of CRP. Anti-Ro52 Ab may be useful as a severity marker in PM/DM.

Acrylates and Methacrylates Sensitization in Patients with Orthopedic and Dental Prostheses: Asymptomatic Pre-Implant and Symptomatic Post-Implant Testing.

Acrylates and methacrylates are widely used in dental and orthopedic prostheses, false nails, adhesives, glues, and paints, and are strong sensitizers. The aim of our study was to assess the prevalence of acrylate sensitization in patients before the application of dental or orthopedic prostheses or after the application in case of potentially related contact dermatitis. Methods: The subjects were tested according to haptens reported in safety data sheets, including methyl methacrylate (MMA) 5%, methyl acrylate (MA) 1%, ethyl methacrylate (EMA) 2%, ethyl acrylate (EA) 1%, butylacrylate 0.1%, 2 hydroxyethyl methacrylate (HEMA) 5%, ethylene glycol dimethacrylate 2% (EGDMA), tetraethylene glycol dimethacrylate 2% (TEGDMA), and dimethyl amino ethyl methacrylate 0.2% (DAEMA). Multivariable logistic regression was used to study the factors associated with (meth)acrylate sensitization. Results: Six hundred sixty-five patients (75.4% of the total sample) without contact dermatitis before the placement of any dental or orthopedic prosthesis and 217 patients (24.6% of the total sample) with contact dermatitis potentially due to already placed prostheses were involved. In total, 37 cases of patch test positivity to at least 1 acrylate (4.2%) were found. In the pre-implant population, previous dermatitis and respiratory allergy were associated with increased sensitization to acrylates in multivariable regression analysis (odds ratio [OR] 2.38, 95% confidence interval [CI] 1.05-5.39; OR 2.96, 95% CI 1.32-6.64, respectively). The prevalence of sensitization was 3.5% for EGDMA, 2.7% for EA, 1.5% for 2-HEMA, 1.4% for both MA and MMA, 1.28% for DAEMA, and 0.8% for EMA. No statistically significant difference was found in the prevalence of sensitization between the pre- and post-implant groups. Discussion: Our study found a similar profile of sensitization in pre-implant and post-implant patients, suggesting the need to better study the specificity and sensitivity of patch tests to (meth)acrylate and to define relevance considering a detailed history of exposure.

A Prospective Analysis of Screen-Detected Cancers Recalled and Not Recalled by Artificial Intelligence.

The use of artificial intelligence has potential in assisting many aspects of imaging interpretation. We undertook a prospective service evaluation from March to October 2022 of Mammography Intelligent Assessment (MIA) operating "silently" within our Breast Screening Service, with a view to establishing its performance in the local population and setting. This evaluation addressed the performance of standalone MIA vs conventional double human reading of mammograms. MIA analyzed 8779 screening events over an 8-month period. The MIA outcome did not influence the decisions made on the clinicalpathway. Cases were reviewed approximately 6 weeks after the screen reading decision when human reading and/or MIA indicated a recall. There were 146 women with positive concordance between human reading and MIA (human reader and MIA recalled) in whom 58 breast cancers were detected. There were 270 women with negative discordance (MIA no recall, human reader recall) for whom 19 breast cancers and 1 breast lymphoma were detected, with 1 cancer being an incidental finding at assessment. Six hundred and four women had positive discordance (MIA recall, human reader no recall) in whom 2 breast cancers were detected at review. The breast cancers demonstrated a wide spectrum of mammographic features, sites, sizes, and pathologies, with no statistically significant difference in features between the negative discordant and positive concordant cases. Of 79 breast cancers identified by human readers, 18 were not identified by MIA, and these had no specific features or site to suggest a systematic error for MIA analysis of 2D screening mammograms.

The Expression of Hypoxia-Inducible Factor-1 Alpha (HIF-1α) as a Potential Target for Hypoxic Therapy in COVID-19 Cases

Background: The cellular response to hypoxia is characterized by the stabilization of the HIF-1α protein, which will form a transcription factor that activates genes for low oxygen adaptation. Positive cases of COVID-19 are often characterized by hypoxia, especially in patients with comorbidities. This hypoxic condition will mediate drug resistance or weaken the patient's condition, resulting in lengthening treatment time and even causing death. This study aims to analyze the cellular expression of the HIF-1α gene in patients confirmed positive for COVID-19 with the alpha, beta, delta, and omicron variants. Methods: The research design used was observational, with parameters measuring HIF-1 mRNA expression (RT-PCR, protein (ELISA), and its correlation. The samples used were nose-throat swabs from COVID-19 patients. Results: The expression of HIF-1α mRNA and protein levels produced in variants of COVID-19 patients was compared with controls (times; ng/mL): alpha (0.53; 18.08), beta (0.92; 19.98), delta (0.65; 25.83), and omicron (0.73; 19.85) (Kruskal-Wallis test, p &lt;0.01). The correlation between mRNA expression of HIF-1α and HIF-1α proteins was found to be significantly negative (Pearson Correlation test R = -0.589). Conclusion: In this study, it was found that a decrease in HIF-1α mRNA expression (the result of transcription) increased the levels of HIF-1α protein (the result of translation) and stable HIF-1α expression. Moreover, cellular hypoxia occurred in patients with confirmed positive for COVID-19, with the alpha, beta, delta, and omicron variants. This study can be used as a basis for therapy to control viruses that cause hypoxia in the future. result: The expression of HIF-1α mRNA and protein levels produced in variants of COVID-19 patients compared with controls (times; ng/mL): alpha (0.53; 18.08), beta (0.92; 19.98), delta (0.65 ; 25.83), omicron (0.73; 19.85) (Kruskal Wallis test, p &lt;0.01); The correlation between mRNA expression of HIF-1α and HIF-1α proteins obtained strong negative results (Pearson Correlation test R = -0.589 ).

Quality check: concordance between two monitoring systems for postoperative organ/space-surgical site infections in rectal cancer surgery. Linkage of data from the Catalan Cancer Plan and the VINCat infection surveillance programme

BackgroundThe Catalan Cancer Plan (CCP) undertakes periodic audits of cancer treatment outcomes, including organ/space surgical site infections (O/S-SSI) rates, while the Catalan Healthcare-associated Infections Surveillance Programme (VINCat) carries out standardized prospective surveillance of surgical site infections (SSI) in colorectal surgery. This cohort study aimed to assess the concordance between these two monitoring systems for O/S-SSI following primary rectal cancer surgery.MethodsThe study compared O/S-SSI incidence data from CCP clinical audits versus the VINCat Programme in patients undergoing surgery for primary rectal cancer, in 2011-12 and 2015-16, in publicly funded centres in Spain. The main outcome variable was the incidence of O/S-SSI in the first 30 days after surgery. Concordance between the two registers was analysed using Cohen’s kappa. Discordant cases were reviewed by an expert, and the main reasons for discrepancies evaluated.ResultsPooling data from both databases generated a sample of 2867 patients. Of these, O/S-SSI was detected in 414 patients—235 were common to both registry systems, with satisfactory concordance (κ = 0.69, 95% confidence interval 0.65–0.73). The rate of discordance from the CCP (positive cases in VINCat and negative in CCP) was 2.7%, and from VINCat (positive in CCP and negative in VINCat) was 3.6%. External review confirmed O/S-SSI in 66.2% of the cases in the CCP registry and 52.9% in VINCat.ConclusionsThis type of synergy shows the potential of pooling data from two different information sources with a satisfactory level of agreement as a means to improving O/S-SSI detection. ClinicalTrials.gov Identifier: NCT06104579. Registered 30 November 2023.

Differential diagnosis of exanthematous viruses during the 2022 Mpox outbreak in Minas Gerais, Brazil.

Brazil ranks second in the number of cases during the global monkeypox epidemic. The study, conducted in Minas Gerais, the second most populous state in Brazil with over 20 million inhabitants, utilized differential diagnostics, revealing a significant number of positive cases for other exanthematous viruses and emphasizing the need for accurate diagnoses. During the study, we were able to assess the co-circulation of other viruses alongside monkeypox, including varicella-zoster virus, molluscum contagiosum virus, and other orthopoxviruses. The significance of the research is underscored by the concentration of positive cases in populous areas, highlighting the challenges posed by emerging infectious diseases. This demographic context further amplifies the importance of the research in guiding public health policies and medical interventions, given the substantial population at risk. The study not only addresses a global concern but also holds critical implications for a state with such a large population and geographic expanse within Brazil. Overall, the study emphasizes the pivotal role of surveillance and precise diagnosis in guiding effective public health responses and ensuring appropriate medical interventions.

#162 Single-nucleus RNA-seq of biopsy-confirmed IgA nephropathy reveals cell-specific transcriptomic alteration

Abstract Background and Aims Single-nucleus RNA-seq (SnRNA-seq) is a valuable method for identifying cell-specific transcriptomic alterations in kidney cells. Our objective was to investigate SnRNA-seq data from biopsy-confirmed IgA nephropathy (IgAN) cases and identify cell-specific alterations in the transcriptome. Method We collected snap-frozen kidney biopsy tissues from 6 cases of IgA nephropathy (IgAN) and 7 nephrectomy control cases. The disease control group included 3 cases of diabetic kidney disease, 6 cases of minimal change disease, and 6 PLA2R-Ab positive membranous nephropathy cases. SnRNA-seq was performed on the kidney tissues, and kidney cells were identified in the dataset through UMAP clustering. We investigated differences in the proportion of kidney cell types and identified differentially expressed genes (DEGs). Additionally, we searched for representative gene loci previously reported in a multiethnic genome-wide association study (GWAS). Results We successfully collected transcriptomic profiles of &amp;gt;50 000 cells from IgAN, with a considerable enrichment of intraglomerular cells. The DEG analysis revealed a high number of DEGs in mesangial cells, fibroblasts, and vascular smooth muscle cells in the IgAN transcriptome compared to the nephrectomy and disease control cases. In the gene set enrichment analysis, the epithelial-mesenchymal transition pathway was enriched in the glomerular cells of IgAN. Furthermore, among various GWAS loci, ETS1 was the gene significantly highly expressed in the mesangial cells of IgAN, consistent across the compared control groups. Conclusion This investigation represents the largest SnRNA-Seq profiling of IgAN kidney cells to date. We identified notable enriched cell-specific pathways in IgAN. ETS1 may be a kidney-indwelling causal factor for IgAN pathophysiology, considering its notable significance in both previous GWAS results and the current SnRNA-Seq data.

#2606 Clinically boosted exome-sequencing is necessary for accurate and highly sensitive genetic diagnosis of ADTKD-MUC1

Abstract Background and Aims The human genome includes tandem repeats with variable length (VNTR) and a subset of these repeats have been associated with rare human diseases. Specific frameshift variants in the coding-VNTR of the MUC1 gene cause autosomal dominant tubulointerstitial kidney disease—MUC1 (ADTKD-MUC1). Calling variants from VNTR using short-read sequencing (SRS) is challenging due to poor read mappability, motif complexity (34*60-mer motifs are known up to now), variable repetition, and enormous motif sequence similarity. We have recently developed a computational pipeline called VNtyper, tailored for the precise detection of disease-causing variants within the MUC1 VNTR region using short-read sequencing data. This advancement allowed us to identify overlooked cases in a hereditary renal disease registry, leading to the diagnosis of at least 40 patients. Given that regular exome sequencing with low VNTR coverage proved inefficient for VNtyper, our focus shifted to boost the capture of MUC1 VNTR in exome. This improvement aims to enable the application of VNtyper in ADTKD-MUC1 diagnosis through exome sequencing. Method VNtyper utilizes two independent genotyping algorithms (Kestrel and code-adVNTR) along with MUC1 VNTR-specific reference sequence for the variant detection and is sensitive to the VNTR coverage. We employ Twist custom panels with v1 protocol for target enrichment in both our panel and exome sequencing. This procedure allows for the inclusion of spike-in probes without interfering with other targets. We designed an NTI panel that specifically targets 6 genes associated with ADTKD, including UMOD, MUC1, HNF1B, REN, SEC61A1, and DNAJB11. These genes were captured using a 1x tiling approach, whereas the MUC1 VNTR region was captured with 4x tiling approach. During the exome target enrichment process, we included the NTI probes as a spike-in to boost VNTR coverage. We conducted a routine exome sequencing on a total of 6 samples, consisting of 3 positive controls and 3 negative controls. Additionally, we conducted 16 boosted exome, using 3 negative controls and 13 MUC1 positive samples. Prior to using VNtyper on both exomes, we conducted initial quality controls to verify that there were no alterations in the coverages of other genes. Results The mean coverage of MUC1 VNTR in the regular exome was 72.1x, while in the boosted exome, it exhibited a significant increase to 144x. Adding spike in probes did not have significant effect on the coverage of the contig and there was no alteration in ratio of heterozygosity. As anticipated, in the regular exome, VNtyper was unsuccessful in identifying pathogenic variation in 2 out of 3 true positives. However, all negative controls tested negative. When we used the enhanced exome, we accurately identified all 13 true positive cases, while the negative control cases stayed negative. Through downsampling experiments (reducing read depth from 50% to 5% of the total) on panel data with a mean coverage of 700x, we determined that coverage below 100 should be considered as low coverage for VNTR genotyping using our pipeline. This underscores the critical importance of maintaining adequate coverage for accurate and reliable VNTR genotyping. Conclusion We have achieved successful enhancements in the accuracy and sensitivity of ADTKD diagnosis through the application of VNtyper on clinically boosted exome data. While VNtyper could identify MUC1-positive patients in regular exome data, the effectiveness is influenced by the number of repeats in both alleles and the specific motif in which the variation is present, which significantly decreases the sensitivity. In summary, the VNtyper pipeline demonstrates its ability to detect pathogenic variations in ADTKD-MUC1 on panel data (100% sensitivity), and the improvement in VNTR capture in exome significantly enhances the sensitivity of the ADTKD diagnosis.

#2886 Machine learning-based assessment of serum creatinine and NT-proBNP levels for predicting mortality in patients with heart failure and kidney injury

Abstract Background and Aims In a population hospitalized for acute heart failure, about 20% are affected by acute kidney injury, a significant independent factor linked to increased mortality both during hospitalization and within one year. While existing research offers insights, crafting a precise model to predict mortality in heart failure cases remains a complex task, primarily due to the difficulties in pinpointing critical determinants and achieving high accuracy. The aim of our research was to assess the efficacy of serum creatinine and NT-proBNP levels as predictors for mortality in heart failure patients, using machine learning. Method In our retrospective cross-sectional study, we examined the records of 1,042 patients hospitalized due to acute heart failure at the Institute of Cardiovascular Diseases of Vojvodina, spanning the period from January 1, 2021, to December 31, 2022. The data was initially cleaned, after which we employed a Random Forest model for our analysis. The dataset was partitioned into a training subset, constituting 70% of the data, and a testing subset, comprising the remaining 30%. To achieve optimal precision, we ran the model 100 times. Key performance metrics, including mean sensitivity, specificity, accuracy, F1 score, Matthew's correlation coefficient (MCC), and the area under the Receiver Operating Characteristic (ROC) curve (AUC), were derived from the model to assess its efficacy. Results Following data cleansing, the dataset encompassed a total of 389 patients, of which 58% were male. The median age in this cohort was 71 years, with an interquartile range (IQR) of 63 to 79 years. Key laboratory findings included a median serum creatinine level of 111 µmol/L (IQR: 85-167 µmol/L) and a median NT-proBNP level of 6,589 pg/mL (IQR: 2,822-15,608 pg/mL). After the partition, the median number of patients in the training set was 272 and the testing set comprised 117 patients. The performance of the Random Forest model was characterized by a sensitivity of 0.530, specificity of 0.916, an overall accuracy of 0.856, and an F1 score of 0.516. The MCC stood at 0.439 with the AUC under the ROC curve being 0.713. Conclusion While the relatively low sensitivity observed in our model could be attributed to the generally lower levels of serum creatinine upon admission and the retrospective nature of the study, which may have influenced the model's ability to identify all true positive cases effectively, serum creatinine and NT-proBNP levels hold promise as effective predictors for mortality in heart failure patients.

Maternal COVID-19 exposure and placental characteristics.

The impact of COVID-19 on the placenta is poorly described, particularly among minority women. This is a retrospective case-control study. Micro- and macroscopic placental pathologic findings were compared for 15 COVID-19 positive and 36 negative mothers. Cases and controls were frequency matched on gestational age, race, maternal comorbidities, and delivery type. Data from the electronic medical record were supplemented with independent review of microscopic slides. Placentas from cases and controls were similar except the median distance from the site of the cord insertion to the nearest disk margin was statistically significantly shorter among placentas from COVID-19 positive cases (3.5 versus 6.0 cm, p = 0.006). Case status was not associated with an increased risk of placental pathologies. There are few pathologic differences between placentas of COVID-19 positive and negative mothers. Additional studies are needed to investigate the role of timing of infection.

Pathological and phylogenetic characteristics of fowl AOAV-1 and H5 isolated from naturally infected Meleagris Gallopavo

BackgroundIn this study, we investigated the prevalence of respiratory viruses in four Hybrid Converter Turkey (Meleagris gallopavo) farms in Egypt. The infected birds displayed severe respiratory signs, accompanied by high mortality rates, suggesting viral infections. Five representative samples from each farm were pooled and tested for H5 & H9 subtypes of avian influenza viruses (AIVs), Avian Orthoavulavirus-1 (AOAV-1), and turkey rhinotracheitis (TRT) using real-time RT-PCR and conventional RT-PCR. Representative tissue samples from positive cases were subjected to histopathology and immunohistochemistry (IHC).ResultsThe PCR techniques confirmed the presence of AOAV-1 and H5 AIV genes, while none of the tested samples were positive for H9 or TRT. Microscopic examination of tissue samples revealed congestion and hemorrhage in the lungs, liver, and intestines with leukocytic infiltration. IHC revealed viral antigens in the lungs, liver, and intestines. Phylogenetic analysis revealed that H5 HA belonged to 2.3.4.4b H5 sublineage and AOAV-1 belonged to VII 1.1 genotype.ConclusionsThe study highlights the need for proper monitoring of hybrid converter breeds for viral diseases, and the importance of vaccination programs to prevent unnecessary losses. To our knowledge, this is the first study that reports the isolation of AOAV-1 and H5Nx viruses from Hybrid Converter Turkeys in Egypt.

PD-L1 expression, tumor-infiltrating lymphocytes, and mismatch repair proteins status in digestive neuroendocrine neoplasms: exploring their potential role as theragnostic and prognostic biomarkers.

Theragnostic biomarkers are still needed to select patients with digestive neuroendocrine neoplasms (NENs) for an optimal management. The PD-1/PD-L1 pathway plays a pivotal role in T cells activation and host immune response to cancer and PD-L1 expression in tumor and/or immune cells is used to identify patients who would benefit of treatment with immune checkpoint inhibitors. However, its role as a biomarker is still unclear in digestive NENs. We investigated PD-L1 expression in 68 well-characterized digestive NENs (32 NETs, 32 NECs and 4 MiNENs) and TPS and CPS scores were calculated. In addition, tumor infiltrating T-lymphocytes and mismatch repair protein expression (MMR) were evaluated. All results were correlated with clinicopathological features. PD-L1 expression was higher in NECs than in NETs: TPS > 1% and/or CPS > 1 were observed in 16% of NETs, 68.8% of NECs and 50% of MiNENs (p: 0.05). The mean TPS score in positive cases was 6.3% in NETs, 16.2% in NECs and 5% in MiNENs. The CPS score was 4.8 in NETs, 8.1 in NECs and 6 in MiNENs. MMR-deficient neoplasms were more frequently observed in NECs than in NETs (p: < 0.05) as well as intra-tumor immune infiltration (p: 0.00001). No correlation between PD-L1 expression and survival or other clinicopathological parameters was observed. Our results suggest that treatment with immune checkpoint inhibitors may have a potential role only in selected cases, mainly in NECs and MiNENs.

Sepsis risk in diabetic patients with urinary tract infection.

Urinary tract infections (UTI) is a prevalent condition in those with diabetes, and in severe cases, it may escalate to sepsis. Therefore, it is important to analyze the risk variables associated with sepsis in diabetes individuals with UTI. This research was a retrospective cross-sectional analysis. From January 2011 to June 2022, a group of individuals with diabetes were identified as having UTI at a tertiary hospital situated in Southeastern China. Patient data, including information on urine culture, was collected retrospectively from a clinical record database. The participants were categorized into the sepsis and non-sepsis groups. The risk variables were derived using both uni-and multiple- variable regression analysis. The research included 1919 patients, of whom 1106 cases (57.63%) had positive urine cultures. In total, 445 blood culture samples were tested, identifying 186 positive cases (41.80%). The prevalence of bacteria in urine and blood samples was highest for Escherichia coli and Klebsiella pneumoniae, respectively. Moreover, 268 individuals (13.97%) exhibited sepsis. The regression analysis indicated a positive correlation between sepsis and albumin (ALB)<34.35 g/L, C-reactive protein (CRP)>55.84 mg/L and white blood cell count (WBC) >8.485 X 109/L in diabetic cases with UTIs. By integrating the three aforementioned parameters, the area under the receiver operating characteristic curve was 0.809. The early detection of sepsis in diabetic individuals with UTI may be achieved using a comprehensive analysis of CRP, WBC, and ALB test findings.

Over-the-Counter Medications Encountered in the Postmortem Pediatric Population from 2010-2020.

In forensic toxicology, the pediatric population requires special focus when evaluating positive findings because of the many toxicokinetic and toxicodynamic differences (e.g., metabolic capabilities, body size, etc.) between the pediatric and adult populations. In particular, the administration of over-the-counter (OTC) medications needs careful consideration, as dosages given to the pediatric population (0 days - 18 years), particularly those given to individuals less than five years of age, tend to be lower than those given to individuals closer to adulthood. Postmortem pediatric data from eleven years (2010-2020) was compiled. A total of 1413 positive cases contained one or more of the following common OTC medications: antihistamines (brompheniramine, chlorpheniramine, diphenhydramine, doxylamine, and pheniramine), pain relievers (acetaminophen, naproxen, ibuprofen, and salicylates), cold/flu medications (dextro/levomethorphan, guaifenesin, ephedrine, and pseudoephedrine), gastrointestinal (GI) aids (dicyclomine and loperamide), and/or sleep aids (melatonin). Antihistamines, cold/flu medications, and pain relievers are the most common classes of drugs encountered in the postmortem pediatric population. To evaluate trends, three main age groups were created: ≤5 years old (5U, birth-5 years old), middle childhood (MC, 6-11 years old), and early adolescence (EA, 12-18 years old). When considering the data, it must be noted that many of these drugs may be co-administered in single and/or multi-drug formulations. In addition, some drugs may have a variety of uses, e.g., antihistamines may also be used as sleep aids. Of note, the prevalence of cases involving those aged 6-11 years old was far less than their younger and older pediatric counterparts. With the widespread availability of OTC medications, unintentional overdoses, recreational misuse, and suicidal overdoses can occur in the vulnerable, pediatric population.