Preventive Medicine Research Articles

Small ruminant quality assurance (SRQA) – considerations and practices

There are multiple quality assurance programs in existence for livestock industries in the United States. This includes the Beef Quality Assurance program and Pork Quality Assurance Program. Although technically a Sheep Safety and Quality As­surance program does exist through the American Sheep In­dustry Association, it is not as nationally known or recognized compared to programs featuring major food animal species. No formal quality assurance programs exist for goats in the United States. This proceeding will discuss aspects of small ruminant (sheep and goat) management, preventive medicine and medi­cal treatment that influences quality assurance..

Molecules secreted by visceral adipocytes in patients with coronary atherosclerosis and insulin resistance

Aim. To study the association of adipocytokine levels with insulin resistance (IR) and stable/unstable plaques in patients with coronary atherosclerosis.Material and methods. This cross-sectional observational study included 109 men aged 38-79 years with class II-III stable angina pectoris without acute coronary syndrome (ACS), with coronary atherosclerosis verified by coronary angiography. Biochemical tests were carried out using the enzymatic method on a Konelab 30i analyzer at the Laboratory of Clinical Biochemical and Hormonal Studies of Internal Diseases of the Research Institute of Internal and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics. All patients also underwent anthropometric examination.Results. Patients with coronary atherosclerosis and IR had higher levels of GIP by 1,4 times (p=0,005), GLP-1 by 1,7 times (p=0,032), IL-6 by 3,2 times (p=0,017), leptin by 2,3 times (p=0,001) and pancreatic polypeptide (PP) by 1,9 times (p=0,006). In patients with stable plaques and IR, leptin was 2 times higher, and PP was 1,7 times higher, compared to patients without IR. In patients with unstable plaques and IR, leptin and PP levels are 5,1 and 1,7 times higher, respectively, compared to the group of patients without IR. In patients with IR and stable plaques, PYY was 1,5 times higher than in patients with IR and unstable plaques, while the adiponectin level was 1,9 times higher. Logistic regression analysis demonstrated that PP is associated with IR in patients with unstable plaques.Conclusion. Patients with coronary atherosclerosis and IR had higher levels of GIP, GLP-1, IL-6, leptin and PP. Leptin and PP levels are higher in patients with both stable and unstable plaques and IR, and PYY and adiponectin levels are higher in patients with stable plaques and IR compared with patients without IR. PP is associated with IR in patients with unstable plaques.

Physiological values of phagocytic capacity in marine mammals and alterations during pathological situations.

The study of the immune function in marine mammals is essential to understand their physiology and can help to improve their welfare in the aquariums. Dedicating efforts to studying marine mammal physiology, pathophysiology, and implementing new diagnostic and therapeutic tools promote progress towards preventive medicine in aquariums by facilitating early detection and treatment of diseases. However, biological and clinical research on marine mammals is currently very limited due to difficult access to these species and their biological samples. With this objective, our group has adapted to marine mammals a commercially available assay routinely used to evaluate the phagocytic capacity of monocytes and granulocytes in human whole blood samples. We adapted IngoflowEx kit to bottlenose dolphins (Tursiops truncatus), beluga whales (Delphinapterus leucas), walruses (Odobenus rosmarus), Patagonian sea lions (Otaria flavescens), and harbor (Phoca vitulina). In this paper, we report the modifications carried out on the original protocol for their correct functioning in marine mammals. We obtained physiological values of phagocytic capacity in each species after repeated sampling for 4 years in various individuals of each species. Specific results revealed that the % phagocytic cells that ingested E.coli in bottlenose dolphins were 59.6 ± 1.27, in walruses 62.6 ± 2.17, in sea lions 57.5 ± 4.3, and in beluga whales 61.7 ± 1.4. In the case of the % phagocytic cells producing respiratory burst in bottlenose dolphins were 34.2 ± 3.6, in walruses 36.3 ± 4.3, in sea lions 40.8 ± 10.2, and in beluga whales 26.3 ± 3.7. These preliminary results can be used as a reference to detect alterations in phagocytic capacity either by immunosuppression or by exacerbation of the response in infectious inflammatory processes. Clinical applicability of the assay was verified in two clinical cases in which Ingoflow was useful to detect immune alterations in two diseased individuals, before and after the onset of clinical signs.

Abstract PO4-19-02: Genetic risk estimation in breast cancer and assessing health disparities

Abstract Background: Breast Cancer (BC) incidence and the distribution of BC risk factors vary between racial and ethnic groups within the United States. It has been demonstrated that providing education on individualized breast cancer risk will improve patient uptake to recommended BC screening and prevention strategies. Most clinical risk assessment tools, including the validated IBIS model were derived from data using non-Hispanic white women. Consortia have also now identified over 300 common genetic susceptibility loci for BC, summarized by the polygenic risk score (PRS). When combined with clinical risk assessment tools, such as the IBIS or BCRAT models, the PRS can further refine risk estimation for patients. To date, most studies on the use of PRS have been done in non-Hispanic white women. While these PRS still perform well in racial minorities, there has been a recognized need to improve racial and ethnic diversity in genomic research cohorts. Herein, we aim to combine clinical risk assessment models that are already used in routine clinical practice with information derived from PRS testing in women of racial minorities to determine if this can improve risk estimation, patient understanding, and uptake to recommended breast cancer screening and prevention strategies. Design: This is a minimal risk prospective study with a single arm incorporating the PRS into a standard breast cancer risk reduction consultation, followed by annual surveys over 10 years to determine if and how the information provided by the PRS influenced patient decisions regarding recommended BC screening and prevention. Patients will have IBIS and BCRAT risks calculated at baseline visit. A survey of patient perceptions/understanding of risk, intention to undergo screening, and use of preventive medicine is completed after baseline visit prior to receiving the PRS results. Blood sample is obtained at baseline and DNA samples are analyzed for approximately 300 SNPs on a custom-designed, targeted SNP panel from ThermoFisher Scientific by the Mayo Clinic Genomics Laboratory. This PRS result is then combined with the clinical risk assessments (IBIS and BCRAT scores) using the R package Individualized Coherent Absolute Risk Estimators (iCare) tool to provide a new estimate of breast cancer risk for 5year, 10year, and lifetime risk. Patients are seen for follow-up to review results and then complete a second survey to assess their understanding of the results, BC risk, and how the PRS impacted their decision to undergo screening/prevention strategies. Eligibility Criteria: Women who self-identify as African American/Black or Hispanic/Latinx between 30-75 years old with any of the following: 1.)IBIS score of ≥5% for the 10 year risk OR BCRAT score of ≥ 3 % for the 5 year risk. 2.) History of biopsy proven atypical hyperplasia 3.) History of biopsy proven lobular carcinoma in situ. Specific Aims: Aim 1: The primary aim of this study is to explore if the addition of PRS to the BCRAT and IBIS score will improve intentions to undergo recommended breast cancer screening strategies such as mammography, MRI, or molecular breast imaging in women of underserved racial minorities Aim 2: To explore if the addition of the PRS to the BCRAT and IBIS risk score will aid women of racial minorities in deciding whether to take preventative endocrine therapy. Aim 3: To understand how individualized risk assessment and information on PRS may alter perceived risk of breast cancer. Statistical Methods Analysis will be mostly descriptive. Continuous variables will be summarized as mean (standard deviation) or median (range) and categorical variables will be reported as frequency (percentage). Kaplan-Meier method will be used to estimate the long-term cumulative risk of cancer. Current Accrual: 3. Target Accrual: 50 Citation Format: Lauren Cornell, Sandhya Pruthi, Linda Hasadsri, Sarah McLaughlin. Genetic risk estimation in breast cancer and assessing health disparities [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-19-02.

Inflammation, Autoimmunity and Neurodegenerative Diseases, Therapeutics and Beyond.

Neurodegenerative disease (ND) incidence has recently increased due to improved life expectancy. Alzheimer's (AD) or Parkinson's disease (PD) are the most prevalent NDs. Both diseases are poly genetic, multifactorial and heterogenous. Preventive medicine, a healthy diet, exercise, and controlling comorbidities may delay the onset. After the diseases are diagnosed, therapy is needed to slow progression. Recent studies show that local, peripheral and age-related inflammation accelerates NDs' onset and progression. Patients with autoimmune disorders like inflammatory bowel disease (IBD) could be at higher risk of developing AD or PD. However, no increase in ND incidence has been reported if the patients are adequately diagnosed and treated. Autoantibodies against abnormal tau, β amyloid and α- synuclein have been encountered in AD and PD and may be protective. This discovery led to the proposal of immune-based therapies for AD and PD involving monoclonal antibodies, immunization/ vaccines, pro-inflammatory cytokine inhibition and anti-inflammatory cytokine addition. All the different approaches have been analysed here. Future perspectives on new therapeutic strategies for both disorders are concisely examined.

Missing the person: Are preventive medicine and clinical practice guidelines contributing to physician burnout?

Missing the person: Are preventive medicine and clinical practice guidelines contributing to physician burnout?

We outside: Modeling equity‐centered, antiracist, community‐driven partnerships in resident education

AbstractBackgroundCommunity engagement is increasingly recognized as a necessity in addressing intractable racial and ethnic health disparities in the United States. However, institutions have not adequately trained resident physicians in developing symbiotic community partnerships that preserve community autonomy and identity without exploitation. Our goals were to highlight the experiences of expert academic emergency physicians in creating innovative, community‐driven, and anti‐racist solutions to achieving measurable equity in health outcomes and to introduce a novel framework entitled the Social Change Method to take a community‐embedded intervention from concept to creation.MethodsThe methodology was based on the development of a didactic session at the 2023 SAEM Annual Meeting. The three novel initiatives discussed were Emergency Medicine Remix (EMR); Trust, Research, Access, and Prevention (TRAP) Medicine; and The Health Equity Accelerator (HEA). A team of multi‐institutional experts convened to develop the session objectives through priority setting.ResultsOur expert panel discussed successes and challenges encountered while using evidence‐informed strategies to conduct their community‐based programming. Participant questions were centered on fostering sustainability, emphasizing the importance of carefully crafted interventions in the face of uncertain legislative challenges and strategies to empower others.ConclusionsEmergency medicine residency education should incorporate training on methods to leverage community partnerships to improve individual and community health outcomes. The Social Change Method can be used as a conceptual framework to generate easily re‐creatable and scalable partnerships that establish trust and forge relationships that honor identity and autonomy without exploiting community members.

Development of the VEGANScreener, a Tool for a Quick Diet Quality Assessment among Vegans in Europe.

Plant-based diets are not inherently healthy. Similar to omnivorous diets, they may contain excessive amounts of sugar, sodium, and saturated fats, or lack diversity. Moreover, vegans might be at risk of inadequate intake of certain vitamins and minerals commonly found in foods that they avoid. We developed the VEGANScreener, a tool designed to assess the diet quality of vegans in Europe. Our approach combined best practices in developing diet quality metrics with scale development approaches and involved the following: (a) narrative literature synthesis, (b) evidence evaluation by an international panel of experts, and (c) translation of evidence into a diet screener. We employed a modified Delphi technique to gather opinions from an international expert panel. Twenty-five experts in the fields of nutrition, epidemiology, preventive medicine, and diet assessment participated in the first round, and nineteen participated in the subsequent round. Initially, these experts provided feedback on a pool of 38 proposed items from the literature review. Consequently, 35 revised items, with 17 having multiple versions, were suggested for further consideration. In the second round, 29 items were retained, and any residual issues were addressed in the final consensus meeting. The ultimate screener draft encompassed 29 questions, with 17 focusing on foods and nutrients to promote, and 12 addressing foods and nutrients to limit. The screener contained 24 food-based and 5 nutrient-based questions. We elucidated the development process of the VEGANScreener, a novel diet quality screener for vegans. Future endeavors involve contrasting the VEGANScreener against benchmark diet assessment methodologies and nutritional biomarkers and testing its acceptance. Once validated, this instrument holds potential for deployment as a self-assessment application for vegans and as a preliminary dietary screening and counseling tool in healthcare settings.

Behavioral and metabolic markers of cow morbidity in early lactation

The high productivity of cows on modern dairy farms means that their bodies are used almost at full capacity. Even minor violations in the conditions of keeping or feeding can lead to a significant increase in the morbidity of animals. In such conditions, preventive veterinary medicine is the main task of a veterinarian. In practice, preventing the development of the disease means the veterinarian's ability to predict the occurrence of a problem, identify its cause in time and offer preventive measures. The purpose of this work was to get acquainted with behavioral and metabolic markers for predicting morbidity in cows during early lactation. According to the methodology for systematic reviews of the literature, a search and analysis of scientific articles according to the topic of the study, which were published during 2000–2023, was carried out. To search for scientific articles, the scientometric databases of the Web of Science Core Collection and PubMed were used. Analysis of the study of behavioral and metabolic markers of morbidity in cows during early lactation showed the significant relevance of the problem for dairy farming. A significant number of scientific articles are devoted to the study of this issue. A significant amount of the results of scientific research has practical significance and is used in production. The other part serves as a basis for the formation of new substantiated scientific hypotheses. This gives reason to believe that solving the problem of timely diagnosis and prevention of cow diseases during the transition period is a matter of the near future. Certain physiological and behavioral parameters (duration of chewing and feeding, time of rest and motor activity, social interaction) during the dry period can be important indicators of metabolic changes or diseases in cows at the beginning of lactation. The accuracy of forecasting with the help of such parameters increases with the increase in the duration of the study and the number of indicators used. Physiological and behavioral parameters recorded by automated milking systems can be successfully used to diagnose and predict health problems of dairy cows. Further research in this field is an important challenge for veterinary science. An increase in the time spent in a lying position, the number of periods of rest and agonistic contractions per day, a decrease in the duration of chewing, feeding and motor activity, especially in the last trimester of pregnancy, are associated with an increased likelihood of transition period diseases (ketosis, abomasum displacement, reproductive disorders, etc.). The study of behavioral and metabolic markers of morbidity in cows during early lactation proved the significant relevance of the problem for dairy farming. A significant number of scientific articles are devoted to the study of this issue. We believe that solving the problem of timely diagnosis and prevention of cow diseases during the transition period is an important task of veterinary medical science today.

Risk factors for decreased bone mineral density in patients with metabolic dysfunction-associated steatotic liver disease: A cross-sectional study at a health examination center

Background & AimsSteatotic liver disease (SLD) is often detected in health examinations. However, although individuals with metabolic dysfunction-associated SLD (MASLD) may have decreased bone mineral density (BMD), the specific risk factors remain unclarified. The objective of this study was to identify the factors associated with decreased BMD in patients with MASLD. MethodsIndividuals who underwent abdominal ultrasonography and BMD measurements at our healthcare center were included. The BMD of the calcaneus was assessed using an AOS-10SA bone densitometer. Decreased BMD was defined as a T-score below -1.0 SD or the administration of osteoporosis treatment. SLD was diagnosed based on specific ultrasonographic criteria. ResultsA total of 1,410 patients were diagnosed with MASLD. The median age was 52 years. Multivariate analysis using a logistic regression model revealed that the independent predictors of decreased BMD were a low body mass index (BMI) or a small waist circumference (odds ratio (OR): 0.48, 95% confidence interval (CI): 0.34–0.67), hypertriglyceridemia (OR: 1.29, 95% CI: 1.00–1.65), and a weak grip strength (OR: 0.98, 95% CI: 0.97–1.00). Subgroup analyses of individuals aged 50 years or older, men, and individuals with a FIB-4 index of 1.3 or greater revealed that the absence of a high BMI or a large waist circumference was associated with decreased BMD. The subgroup analysis of men revealed that a weaker grip strength was associated with decreased BMD. ConclusionThe present study suggested several potential risk factors for decreased BMD in patients with MASLD. Individuals with the abovementioned risk factors should be encouraged to undergo BMD measurement from the perspective of preventive medicine.

Sociodemographic, Lifestyle and Media Factors Associated with Health Screening: Evidence from Timor-Leste

Preventive medicine plays an important role in combating the surge in non-communicable diseases (NCDs). By using health screening, individuals can prevent and monitor the development of NCDs. This study aims to examine sociodemographic, lifestyle and media factors associated with the use of health screening (blood pressure and blood glucose tests) among adults in Timor-Leste. Data used in this study were derived from the Timor-Leste Demographic and Health Survey 2016. A total of 4,264 adults aged between 30 and 59 years were included in the bivariate probit analysis. Results showed that the use of health screening remained low in Timor-Leste. Males, rural dwellers, less-educated individuals, individuals who were in the poorer and poorest wealth quintiles, and unmarried individuals were less likely to use blood pressure test compared with females, urban dwellers, well-educated individuals, individuals who were in the richest wealth quantile and married individuals. Adults less likely to use blood glucose tests were less educated and unmarried. However, the use of health screening was not correlated with a respondent’s lifestyle behaviour and mass media exposure. In short, sociodemographic factors were associated with the use of health screening in Timor-Leste. Policymakers should consider designing intervention measures based on different sociodemographic groups.

Gender and age peculiarities of autophagy in men and women induced by a comprehensive wellness program: a prospective observational study

Background. Autophagy refers to an evolutionary physiological mechanism of cell self-purification. The use of its positive effects in regenerative and preventive medicine implies this process to be investigated under the conditions of various therapeutic factors.Objective. To investigate the influence of gender, age and somatic-morphological factors on the autophagy processes induced by a comprehensive wellness program as expressed by the marker protein Beclin-1.Methods. A prospective observational study involved 107 patients to be monitored before and after comprehensive wellness procedures. All study participants underwent a wellness program in the clinic of OOO Centr Zdorovie (Maykop, Russia). The study was conducted in the periods of September‒December 2020 and January 2021. The study involved measuring the concentration of Beclin-1 protein in the blood before and 12 days after the wellness procedures. In order to characterize the degree of activation of the autophagy process, the index “delta-Beclin-1” was introduced (difference between the initial level of Beclin-1 protein concentration and the level registered after 12 days). The autophagy response was evaluated in terms of its upward or downward direction (positive/negative delta- Beclin-1 value, respectively). The effect of the comprehensive wellness procedures on the functional systems of the organism was determined in accordance with the laboratory tests (complete blood count, lipid profile), morphometric evaluation, and the assessment of body composition by impedance monitoring. The obtained data were processed using SPSS Statistics 26.0 (IBM, USA).Results. Monitoring of Beclin-1 protein concentration revealed that basic autophagy activity is age-specific and significantly lower in individuals over 60 years as compared to both individuals under 60 years and healthy persons. This correlation with age appears more pronounced in obese individuals (r = -0.59). The basic activity of autophagy in men was 30% lower than in women, however, after a set of wellness procedures the mentioned response in men increased by 7%. The study found that not all patients responded unidirectionally to the comprehensive wellness procedures: 49 out of 77 patients showed an increase in Beclin-1 protein concentration, while 28 — a decrease. Patients who participated in the wellness program demonstrated negative correlation between the level of Beclin-1 protein expression and age, while those responding with an increase in Beclin-1 protein level — with body mass index, weight and fat mass. The source of autophagy activity in men under 60 years can refer to fat mass, and in women — lean body mass, especially in the mature age of period II (36‒60 years).Conclusion. The factors of basic autophagy and autophagy induced by the complex of wellness procedures include age, gender and body weight. These factors obtain different significance at different age periods. A comprehensive wellness program can serve as an alternative to existing pharmacological methods for activating autophagy in humans.

Problem questions of prevention and precising control of diseases associated with hypoxia

Cardiovascular diseases are the one of the main causes of death in the 21st century. Their rating is not expected to be decreased in the near future despite all the successes in the wide distribution and using of high-tech methods of treatment. This article is devoted to the problem of introducing fundamental recent discoveries into practical medicine as part of the development of preventive, personalized and precision medicine. The author considers not used mechanisms of endogenous adaptation, prevention and preclinical diagnosis of hypoxia-associated diseases in the clinic and concludes that introducing of a new marker of adaptation to visceral hypoxemia is perspective approach in therapy of the cardiovascular diseases.

Analysis of the relationship between actual nutrition and physical activity and smoking among russian and foreign students of a medical university

A significant contribution to the preservation and improvement of the population health is made by a healthy lifestyle, one of the components of which is rational nutrition. Considering severe stress experienced by students due to the changed social environment, the study of nutritional characteristics and the role of behavioral factors in eating behavior among medical students remains an extremely topical issue of modern preventive medicine. Material and methods. As a result of a cross-sectional study, 197 students of the Saratov Medical University were interviewed, 100 (51 %) of them were russian students, 97 (49 %) were citizens of Central African countries. The method of 24-hour reproduction of daily diet, program complex “Individual diet 5.0 professional version”, questionnaire were used. Results and discussions. The study showed an imbalance in macro- and micronutrients intake of the daily food ration, a violation in the diet, insufficient consumption of vegetables and fruits, rare hot meals, dissatisfaction with the organization of meals in student canteens, frequent use of fast food by students regardless of their country of origin. The relationship of physical activity and smoking with the diet and the frequency of consumption of vegetables and fruits, low awareness of unbalanced nutrition as a risk factor for the development of alimentary-dependent diseases have been established. Conclusions. The nutritional behavior of russian and foreign students of Saratov Medical University does not meet all the principles of healthy eating recommended by WHO. Thus, it is necessary to improve the organization of catering in student canteens, taking into account the taste preferences of foreign students, the introduction of educational activities and healthy nutrition programs with the involvement of the students themselves in their preparation. The analysis of actual nutrition is a very important task, as it allows assessing the current socio-economic situation, as well as the effectiveness of educational programs in the framework of national projects on a healthy lifestyle and proper nutrition.

An innovative development of a whole-body diagnostic device led to the ingenious discovery of comprehensive digital medicine that has potential to lead to health promotion of humankind and consequential rapid economic growth of the world

After working for a few decades, gas-discharge-visualization (GDV) device, alternatively called electro-photonic-imaging (EPI) device, was innovatively developed by Prof. K.G. Korotkov in 1995. The sophisticated GDV diagnostic device additionally is being used as an important tool for generating comprehensive-digital-medicine by feeding an electromagnetic signal from the GDV device to the comprehensive-digital-medicine preparation device, involving very low cost. This medicine helps to achieve near zero disease-levels in the various organs as well as the immune, endocrine and nervous systems of all health-conscious persons, who want to continue sincerely with the optimal combination of the preventive medicines of digital-homeopathy and evolved-homeopathy, and occasional GDV (once in a month) check-up. When this condition is achieved, about 20 years age-reduction is felt along with improvement of physical and mental stamina and increment in longevity. To begin with, the global organizations and insurance companies will have to provide for the first few years fund and offer suitable incentives (may be, appropriate annual cash-incentives after remaining under coverage of comprehensive-digital-medicine prevention scheme), since vast majority of the apparently healthy part of humankind believe that they’re healthy, although all of their organs are having imperceptible disease level between 0.8 to 1.0, and such disease level in immune system (including Spleen) cannot prevent tumors/ cancer and many other severe diseases. After a span of few years, global GDP can increase by 5% over a year (in contrast with the present 3%), when this increased GDP (due to better health and increase in retirement age) can fund such schemes.

Kidney Disease Prediction with Encrypted Data Sharing in Healthcare

A vital component of contemporary healthcare is disease risk assessment, which makes it possible to estimate a person's propensity to develop particular medical problems. Analyzing a variety of risk factors, including age, gender, lifestyle decisions, past medical history, and genetic susceptibility, is part of this procedure. The ability to access vast healthcare datasets and the development of sophisticated machine learning algorithms have greatly increased the accuracy of illness risk prediction. Using machine learning techniques, this proposed strategy offers an outline of the methodology involved in kidney disease prediction. Kidney disease Prediction seeks to enable early detection and intervention by utilizing machine learning (ML) techniques, such as Support Vector Machines (SVM), to predict the risk of kidney disease based on user query data. The project intends to increase treatment efficiency, improve quality of life for those at risk of renal disease, and expedite healthcare delivery through the integration of an appointment booking system and secure exchange of prescriptions and ideas. Utilizing the findings of the disease risk assessment, customized preventative plans are created based on the risk profile of the individual. These tactics could involve genetic counselling, specialized screening techniques, lifestyle adjustments, or preventative medicine. In order to keep models current with the most recent developments in medicine and data patterns, they must be continuously monitored and adjusted

Understanding How Parasites from Farmed Fish May Influence Wild Fish Declines Using Epidemiological Modelling

Beside various fields of its applications, in this study epidemiological modelling was used to understand how parasites from farmed fish may cause wild fish declines. Two separate strategic models were constructed addressing the transmission of micro-parasites and macro-parasites between farmed and wild fish: A SIR (Susceptible-Infective-Removed) model for micro-parasite infections and a compartmental density-dependent model for macro-parasite infestations. The results indicated that parasites originated in wild fish populations, after infecting farmed fish can cause epizootics. Subsequently, these parasites can be transmitted from farmed to wild fish and might have negative impact on the dynamics of wild fish populations. Sensitivity analysis of the basic model parameters in both models showed that model parameters, which are influenced by abiotic factors and allow passive manipulation, such as pathogen specific transmission rate (β), pathogen specific transmission rate between infected farmed and susceptible wild fish (δ), the rate of production of infective stages by an adult parasite (λ) and transmission rate between host and parasite infective stages (β) are more sensitive compared to model parameters which encompass chemical control and fallowing. This emphasizes the importance of the preventive medicine rather than intervention procedures in aquaculture aiming at eradicating epizootics caused by parasites and protecting wild fish stocks.

A sensitivity indicator screening and intelligent classification method for the diagnosis of T2D-CHD.

The prevalence of Type 2 Diabetes Mellitus (T2D) and its significant role in increasing Coronary Heart Disease (CHD) risk highlights the urgent need for effective CHD screening within this population. Despite current advancements in T2D management, the complexity of cardiovascular complications persists. Our study aims to develop a comprehensive CHD screening model for T2D patients, employing multimodal data to improve early detection and management, addressing a critical gap in clinical practice. We analyzed data from 699 patients, including 471 with CHD (221 of these also had T2D) and a control group of 228 without CHD. Employing strict diagnostic criteria, we conducted significance testing and multivariate analysis to identify key indicators for T2D-CHD diagnosis. This led to the creation of a neural network model using 21 indicators and a logistic regression model based on an 8-indicator subset. External validation was performed with an independent dataset from an additional 212 patients to confirm the models' generalizability. The neural network model achieved an accuracy of 90.7%, recall of 90.78%, precision of 90.83%, and an F-1 score of 0.908. The logistic regression model demonstrated an accuracy of 90.13%, recall of 90.1%, precision of 90.22%, and an F-1 score of 0.9016. External validation reinforced the models' reliability and effectiveness in broader clinical settings. Our AI-driven diagnostic models significantly enhance early CHD detection and management in T2D patients, offering a novel, efficient approach to addressing the complex interplay between these conditions. By leveraging advanced analytics and comprehensive patient data, we present a scalable solution for improving clinical outcomes in this high-risk population, potentially setting a new standard in personalized care and preventative medicine.

Associations of cartilage intermediate layer protein 1 and hypoxia-inducible factor-1-alpha with transthoracic echocardiography results in patients with heart failure with preserved ejection fraction

Aim. To evaluate the relationship of serum concentrations of myocardial remodeling and cellular hypoxia biomarkers cartilage intermediate layer protein 1 (CILP-1) and hypoxia-inducible factor-1-alpha (HIF-1α) with paraclinical parameters in patients with heart failure with preserved ejection fraction (HFpEF) and in the control group.Material and methods. The study included 47 patients diagnosed with HFpEF, aged from 47 to 79 years, who were treated from May 2018 to December 2019 in the hospital of the National Medical Research Center for Therapy and Preventive Medicine. The control group consisted of 32 people without a diagnosis of HFpEF, matched by sex and age. All participants underwent transthoracic echocardiography with assessment of diastolic function. Serum concentrations of CILP-1 and HIF-1α were determined by enzyme immunoassay using standardized test systems (RayBio and Clone-Cloud, USA).Results. In patients with HFpEF, the median serum concentrations of CILP-1 (3,24 ng/ml) and HIF-1α (14,3 pg/ml) were not significantly different from the values obtained in the control group (3,6 ng/ml and 7,5 pg/ml, respectively). Significant correlations of CILP-1 with echocardiographic indicators of the left ventricular interstitial fibrosis severity were revealed, while echocardiographic markers of HFpEF positively correlated with the HIF-1α level.Conclusion. Although the serum concentrations of CILP-1 and HIF-1α do not differ depending on HFpEF presence, it demonstrates an association with a number of echocardiographic parameters both in subgroups of patients with HFpEF and in subgroups of controls with different body mass index.

Medical reasons for permanent and temporary disqualification of Turkish civil aviation pilots

The aim of this study was to identify diseases that result in permanent and temporary medical disqualification for civil aviation pilots and their changes over the years. A retrospective analysis was conducted on the medical examination records performed in Turkey from 2018 to 2022, in accordance with ICAO and EASA standards. The permanent disqualification rate was 1.3%, and the temporary disqualification rate was 6.6%. The most common reasons for permanent disqualification among pilots were circulatory system diseases (24%), mental and behavioral disorders (22.9%), and nervous system diseases (11.5%). The most common reasons for temporary disqualification among pilots were circulatory system diseases (17.9%), digestive system diseases (11.8%), and health problems related to COVID-19 infection (9.5%). The data obtained from this study may be useful in developing preventive medicine approaches to prevent medical disqualifications and in-flight medical incapacitation.