Signs Of Illness Research Articles

Additive value of simultaneous exercise echocardiography to cardiopulmonary exercise testing in unexplained dyspnea

Abstract Background/Introduction Exertional dyspnea is a nonspecific symptom and frequently serves as the initial sign of numerous cardiac and non-cardiac illnesses. Cardiopulmonary exercise testing (CPET) is often used in the workup of dyspnea, but specific markers for cardiac and peripheral causes of dyspnea are lacking. Combining CPET with exercise echocardiography (CPETecho) can non-invasively identify all pathophysiological mechanisms limiting exercise capacity, including cardiac, pulmonary, and peripheral disorders. Purpose To evaluate the use of CPETecho in patients with unexplained exertional dyspnea compared to CPET alone. Methods In this retrospective observational study, we evaluated patients with unexplained dyspnea (normal resting echocardiography and normal lung function) who underwent CPETecho at two university hospitals between July 2021 and November 2023. CPETecho was conducted on a semi-supine bicycle ergometer. At rest, submaximal exercise (heart rate ±100 bpm) and peak exercise echocardiography was performed. Respiratory gases, heart rate, and electrocardiogram were recorded continuously. We evaluated limitations to exercise according to cutoffs in published literature and compared them to diagnoses obtained via CPET alone, with exercise echo values being blinded. CPET reports were interpreted by 3 independent reviewers with expertise in cardiac rehabilitation and consensus was obtained. Results We enrolled 123 patients (63% women, mean age 67 ± 12 years). CPETecho identified a cause for dyspnea in 101 patients (81%), compared to 87 patients (71%) with CPET alone. However, only 36 patients (29%) had a ‘certain and complete’ diagnosis using CPET alone. CPET alone missed a diagnosis in 48% of patients, most commonly missing heart failure with preserved ejection fraction (HFpEF 27%), exercise pulmonary hypertension (20%) and LV or RV systolic dysfunction (20 and 20% respectively). Twenty eight patients were deemed to have a normal test by CPET, however CPETecho identified a cause for dyspnea in 89% of these patients, mainly cardiac disorders. Conclusion In summary, our study emphasizes the value of CPETecho in assessing patients with exertional dyspnea. CPETecho offers superior diagnostic accuracy compared to CPET alone, specifically aiding in the identification of cardiac disorders.

P-2239. RNA Signatures for Diagnosing or Predicting Febrile Illness: A Descriptive Analysis

Abstract Background Fever is a common sign of illness; it may self-resolve or be present in serious illnesses requiring hospitalization. Investigating the cause of fever can be extremely resource intensive requiring multiple diagnostic tests and healthcare providers thereby delaying time to diagnosis. RNA molecules present in the blood can be easily detected and reflect a patient’s disease state, making them ideal biomarkers. Our objective was to identify RNA common to signatures that diagnose and predict the outcome of febrile illnesses. Our secondary objectives were to assess whether signatures are being validated and translated. Methods We conducted a scoping review of published research articles, including preprints, from EMBASE and Medline that measured blood RNA in patients with febrile illness. Here we are analyzing a articles that used array or RNA-seq to generate original signatures. Results We identified 248 original blood RNA signatures for the diagnosis or prognosis of febrile illness. 154 were diagnostic, 56 prognostic, 15 diagnostic/prognostic and 23 exploratory. The most common illnesses studied were sepsis (n=83), viral infections (n=74) and tuberculosis (n=38). From all sepsis signatures there were 214 unique RNA and 74 RNA present in multiple signatures. The most common RNA, C3AR1 (complement receptor) and MPO (myeloperoxidase), appeared in 5 signatures. For viral infections there were 54 signatures, and IFI27 (interferon) appeared in 8 signatures. For tuberculosis there were 26 signatures, and the most common RNA were BATF2 (transcription factor) and FCGR1B (Fc receptor) each appearing in 4 signatures. 158/248 signatures were validated. Clinical sensitivity and specificity in validation groups were 54-100% and 79-97%, respectively. 9/248 studies claimed that they had filed or were filing for a patent. Conclusion Blood RNA molecules can be used for the diagnosis and prognosis of febrile illnesses. Currently, < 65% of RNA signatures are validated and < 5% of signatures are commercialized. In conducting this analysis, we encountered a lack of standardization in methods reporting. Further work to improve transparency and encourage validation is needed so RNA signatures can be adapted into simple, molecular diagnostic tests and translated for patient use. Disclosures Shaun Morris, MD, MPH, DTM&H, FRCPC, FAAP, GSK Canada: Advisor/Consultant|GSK Canada: Honoraria|Pfizer: Advisor/Consultant|Pfizer: Honoraria|Sanofi Canada: Advisor/Consultant|Sanofi Canada: Honoraria

Perception and utilisation of veterinary services by rodent owners in the United Kingdom.

There is limited research on how rodent owners use and perceive veterinary services and what the demand for pet insurance for these species is. An online survey of owners of pet rodents (guinea pigs, hamsters, rats, gerbils and mice) measured owner confidence in recognising signs of illness, their opinions on and use of veterinary services and their willingness to purchasepet insurance. A total of 1700 respondents completed the survey. Rat owners had increased confidence in recognising signs of illness, as did owners who acquired their pet from a breeder or rescue centre. Most respondents had used veterinary services, with owners perceiving exotics specialists to have increased knowledge. Economic challenges with accessing veterinary care were common. Where rodents were purchased for children, the amount owners were willing to spend on veterinary care was significantly less. Responses may have been biased towards keen owners who self-selected to participate in the survey. Respondents were predominantly female, which may have affected willingness to access and pay for veterinary services. Veterinary spending was not affected by income; however, owners who purchased their animal for their children were less willing to pay for veterinary services and pet insurance.

Neurological disorders in Pregnancy: Radiological insights and Obstetric implications.

To explore the radiological findings of neurological disorders in obstetrics patients, their obstetric and fetal outcome. The cross-sectional study was conducted at Lady Ready Hospital (LRH), Peshawar from June 2022 till March, 2023. Sixty two obstetric patients with neurological symptoms were included. Their clinical records were explored. MRI/MRV brain were performed in patients requiring brain imaging and followed till the end of pregnancy. Seizures were the commonest symptom found in 74.2% patients followed by hemiparesis; 8.1%. About 92% had never experienced hypertension and 62.3% had pregnancy-induced hypertension in current pregnancy. Twenty eight patients underwent MRI, revealing Dural sinus thrombosis (DST) in 42.9%, posterior reversible encephalopathy syndrome (PRES) in 17.9%, infarcts in 14.3% and hemorrhage in 7.1%. Normal baby was born in 69% patients; stillbirth, preterm birth and miscarriage were found in 25.9%, 3.2% and 1.6% respectively. Apgar scores of 7-10, 4-6 and 0-3 were found in 67.2%, 6.9% and 25.9% respectively. Fits were observed in 10.3% babies and 32.8% required neonatal intensive care unit (NICU) care. Fits and ischemic infarct were commoner in prenatal. DST and PRES were commoner in postnatal patients. All PRES patients presented with fits. DST patients presented with fits, headache, hemiparesis and altered consciousness. All PRES patients delivered normal alive babies. DST mothers delivered alive babies at term in 81.8%, dead pre-term baby and miscarriage in 9.1% each. Pregnancy-related neurological problems should be taken carefully and evaluated, since even seemingly insignificant symptoms like headaches may be signs of serious illnesses like PRES or DST.

Healthcare seeking for people diagnosed with severe mental illness: Sensations, symptoms and diagnostic work.

For people with mental and somatic illnesses, the interpretive process of attending to a multitude of bodily sensations and recognising them as potential symptoms represents daily and 'chronic homework'. Based on 16 months of ethnographic fieldwork in Denmark, this study explores diagnostic work and healthcare seeking among people with severe mental and somatic illnesses. As multiple studies have shown, the transformation process for a perceived sensation to become a symptom is a socially constructed interpretative process highly dependent on social legitimisation and shaped by prior cultural knowledge. We found that people with severe mental and somatic illnesses often struggle to 'read' the body and its boundaries and to define and distinguish when a symptom becomes a potential sign of illness. Furthermore, they often lack opportunities for social recognition of symptoms due to the absence of social relations. Finally, lifelong experiences with the healthcare system have taught them that they must distinguish between 'mental' and 'somatic' symptoms to fit the systemic organisation of the healthcare system. This deeply rooted mind-body dualism in the organisation of healthcare services and the daily struggles of diagnostic work to comply with this organisation impacted the interlocutors' healthcare seeking strategies. Moreover, even though they 'make up their minds' to seek healthcare, they risk being met with diagnostic overshadowing and reductionist clinical approaches.

DEK::AFF2 fusion-associated middle ear non-keratinizing squamous cell carcinoma: A case report

BACKGROUND Primary squamous cell carcinoma (SCC) of the middle ear is rare, with non-keratinizing basaloid types being exceptionally uncommon. Distinguishing these cancers, often caused by viral factors (e.g. , human papillomavirus or Epstein-Barr virus), or specific genetic alterations (e.g. , bromodomain-containing protein 4-nuclear protein in testis fusion gene or Ewing sarcoma breakpoint region 1 gene fused with FLI chromosomal rearrangement), from other cranial conditions, is difficult. The recently identified DEK::AFF2 non-keratinizing SCC (NKSCC) is a novel subtype, fitting the World Health Organization classification of head and neck neoplasms. Less than 30 cases have been reported, highlighting the need for further studies. CASE SUMMARY A 55-year-old female patient first exhibited signs of illness over 10 years ago with persistent discomfort in the left external auditory canal, accompanied by skin irritation and bleeding. One month prior to seeking professional help, she experienced hearing loss and a sensation of obstruction in the affected ear, intermittently accompanied by ringing sounds, but no dizziness. An unusual mass was detected in the left auditory canal, confirmed through biopsy as moderately differentiated epithelial squamous cancer cells. This led to her admission to our hospital, where the final diagnosis confirmed as “NKSCC linked to a positive DEK::AFF2 fusion”. The patient underwent surgical excision, followed by three cycles of local radiation therapy. Yet, metastasis to the lumbar vertebrae occurred 19 months post-treatment, followed by neck lymph node swelling detected three months after a physical examination. The patient died nine months later despite surgical removal of the metastatic lesion. CONCLUSION DEK::AFF2 gene fusion-associated NKSCC of the middle ear carries a grim prognosis and presents an emerging challenge.

A cluster randomized trial assessing the effect of a digital health algorithm on quality of care in Tanzania (DYNAMIC study)

Digital clinical decision support tools have contributed to improved quality of care at primary care level health facilities. However, data from real-world randomized trials are lacking. We conducted a cluster randomized, open-label trial in Tanzania evaluating the use of a digital clinical decision support algorithm (CDSA), enhanced by point-of-care tests, training and mentorship, compared with usual care, among sick children 2 to 59 months old presenting to primary care facilities for an acute illness in Tanzania (ClinicalTrials.gov NCT05144763). The primary outcome was the mean proportion of 14 major Integrated Management of Childhood Illness (IMCI) symptoms and signs assessed by clinicians. Secondary outcomes included antibiotic prescription, counseling provided, and the appropriateness of antimalarial and antibiotic prescriptions. A total of 450 consultations were observed in 9 intervention and 9 control health facilities. The mean proportion of major symptoms and signs assessed in intervention health facilities was 46.4% (range 7.7% to 91.7%) compared to 26.3% (range 0% to 66.7%) in control health facilities, an adjusted difference of 15.1% (95% confidence interval [CI] 4.8% to 25.4%). Only weight, height, and pallor were assessed statistically more often when using the digital CDSA compared to controls. Observed antibiotic prescription was 37.3% in intervention facilities, and 76.4% in control facilities (adjusted risk ratio 0.5; 95% CI 0.4 to 0.7; p<0.001). Appropriate antibiotic prescription was 81.9% in intervention facilities and 51.4% in control facilities (adjusted risk ratio 1.5; 95% CI 1.2 to 1.8; p = 0.003). The implementation of a digital CDSA improved the mean proportion of IMCI symptoms and signs assessed in consultations with sick children, however most symptoms and signs were assessed infrequently. Nonetheless, antibiotics were prescribed less often, and more appropriately. Innovative approaches to overcome barriers related to clinicians’ motivation and work environment are needed.

Therapeutic efficacy of JNJ-49214698, an RSV fusion inhibitor, in RSV-infected neonatal lambs.

Respiratory syncytial virus (RSV) is a leading cause of respiratory infection, hospitalization and death in infants worldwide. No fully effective RSV therapy using direct antivirals is marketed. Since clinical efficacy data from naturally infected patients for such antivirals are not available yet, animal studies are indispensable to predict therapeutic intervention. Here, we report the impact of an RSV fusion inhibitor, JNJ-49214698, on severe RSV-associated acute lower respiratory tract infection (ALRTI) in neonatal lambs. Randomized animals were treated once daily with 25 mg/kg JNJ-49214698, starting either before RSV infection, 1 day post-infection or as late as peak lung viral load on Day 3 post-infection. Treatment efficacy was assessed by scoring clinical signs of illness, development of RSV-induced gross and microscopic lung lesions and measuring virus titres in the lungs. Treatment with JNJ-49214698 was very effective in all treatment groups. Even in animals for which treatment was delayed until peak viral load was reached, a reduced amount and severity of gross and microscopic lesions, as well as RSV titres and RNA levels, were found. These results strongly suggest that treatment with small-molecule fusion inhibitors is an effective strategy to treat patients who are diagnosed with an RSV-induced ALRTI.

MEDICO-SOCIAL CHALLENGES FACED BY ORPHANS RESIDING IN ORPHANAGES IN KADUNA

Background: The plight of orphans, particularly in sub-Saharan Africa, has intensified due to increasing incidences of disease, conflict, and natural disasters. In Nigeria, the orphan crisis is driven by factors such as the HIV/AIDS epidemic, terrorism, and other forms of violence. Orphans in orphanages often experience a range of challenges, including abuse, malnutrition, poor healthcare access, stigmatization, and behavioral and psychological disorders. Although some interventions address material needs, there remains a significant gap in comprehensive care that integrates medical, psychosocial, and social welfare support. This study examines the medical and social challenges faced by orphans living in orphanages in Kaduna, Nigeria. Methodology: A cross-sectional descriptive study was conducted with 100 orphans in three orphanages in Kaduna. Data collection involved the use of interviewer-administered questionnaires to gather information on socio-demographic characteristics, medical issues, behavioral patterns, levels of stigma, psychosocial well-being, and coping mechanisms. Results: The mean age of respondents was 10 years, with 68% of the participants being male. Although 54.9% of the respondents had access to balanced diets, 53.7% were underweight, pointing to ongoing nutritional challenges. Medical concerns included clinical signs of illness in 33.7% of the children, and 46.7% were not fully immunized. Behavioral disorders were prevalent, with 27% of the children showing symptoms of hyperactivity, 22.3% suffering from enuresis, and 1.8% diagnosed with major depressive disorder. Despite these challenges, 83.3% of the orphans reported positive peer relationships, 89.2% had good self-esteem, and 97.8% attended school. However, instances of bullying (11.4%) and stigmatization (9%) persisted. Conclusion: The study highlights the significant medical, social, and psychological challenges facing orphans in Kaduna orphanages. While access to education and peer support was encouraging, the high prevalence of malnutrition, under-immunization, and behavioral disorders underscores the need for integrated care models. A holistic approach to care, incorporating medical, psychosocial, and educational interventions, is crucial for improving the well-being of these vulnerable children. ‎

What Clinicians Think About When They Think About Sepsis: Results From a Survey Across the University of Maryland Medical System.

Sepsis, a leading cause of death in the hospital, is a heterogeneous syndrome without a defined or specific set of symptoms. We conducted a survey of clinicians in practice to understand which clinical findings they tend to associate with sepsis. A survey was distributed to physicians and advanced practice providers across a multihospital health system during April 2022 and May 2022 querying likelihood of suspecting sepsis and initiating sepsis care in response to various normal and abnormal clinical findings. Strength of association between clinical findings and suspicion of sepsis were based on median and interquartile range of complete responses. Comparisons between individual questions were performed using Wilcoxon rank-sum testing. Among 179 clinicians who opened the survey, 68 (38%) completed all questions, including 53 (78%) attending physicians representing six different hospitals. Twenty-nine respondents (43%) worked primarily in the ICU, and 16 (24%) worked in the emergency department. The clinical findings most strongly associated with suspicion of sepsis were hypotension, tachypnea, coagulopathy, leukocytosis, respiratory distress, and fever. The abnormal clinical findings least likely to prompt suspicion for sepsis were elevated bilirubin, elevated troponin, and abdominal examination suggesting ileus. On average, respondents were more likely to suspect sepsis with high temperature than with low temperature (p = 0.008) and with high WBC count than with low WBC count (p = 0.003). Clinicians in practice tend to associate the diagnosis of sepsis with signs of severe illness, such as hypotension or respiratory distress, and systemic inflammation, such as fever and leukocytosis. Except for coagulopathy, nonspecific laboratory indicators of organ dysfunction have less influence on decision-making.

Exploring Nontraumatic Brain Hemorrhage in Sudden and Unexpected Deaths: A Novel Autopsy-Based Investigation

Abstract Background There has been a surge in sudden and unexpected deaths, presenting a significant challenge for health policymakers and researchers. These individuals showed no signs of recent or past illnesses and died suddenly during routine activities like walking, standing, or working. Objective This study focuses on exploring nontraumatic brain hemorrhage as a cause of death in autopsies of individuals without prior illnesses. The research aims to explore patterns, prevalence, and risk factors associated with nontraumatic brain hemorrhage, specifically obesity in sudden and unexpected deaths. Materials and Methods This retrospective, observational study was conducted using autopsy cases with nontraumatic brain hemorrhage as the identified cause of sudden and unexpected deaths. Information on demographic details, medical history, and circumstances surrounding the deaths was collected. The cases were classified based on the body mass index according to the classification of the World Health Organization. Results From April 2023 to January 2024, 10 cases of sudden and unexpected deaths due to nontraumatic brain hemorrhage were identified. Key findings included predominantly cases of obesity or overweight, deaths occurring predominantly between 8 p.m. and midnight, and all cases being males. Conclusion The study sheds light on the surge in sudden deaths, specifically attributed to nontraumatic brain hemorrhage. The findings reveal a significant association between obesity and brain hemorrhage in sudden deaths, especially among males. The study's temporal analysis adds depth to understanding these patterns.

Using Latent Class Analysis to Characterize Sickness Signaling in Relation to Familism and Public and Private Religiosity in a Stratified US Sample.

In response to contracting an infection, individuals usually display a suite of external signs (including sickness behavior) as an outward indication of illness. This context-dependent phenomenon seems to weigh the benefits and costs of eliciting sympathy by indicating sickness versus hiding signs of illness to avoid exposing others to potential infection. In a dynamically social species like humans, non-kin may be as likely to respond to these signs with care as family members, particularly fellow church members. We explore the relative contributions of religiosity and familism in shaping self-reported sickness signaling styles as two dimensions central to human altruism using latent class analysis (LCA). LCA was used to characterize the signaling styles of the study participants. Data come from a large 2018 survey (n = 1259) of sickness and health behaviors among US adults. We used denomination public (church attendance) and private religiosity (time spent in prayer, meditation, etc.) and the God Locus of Health Control scale to assess the impact of God on health. Sickness signaling style was assessed with the SicknessQ and three additional items. Covariates included age, gender, education, and income. We identified four classes (Familiar, Moderate, Gregarious, and Stoic) tied to signaling styles. The Familiar Signaling class displayed sickness verbally to familiar others, were the oldest, and were least guided by an internal sense of religion. The Moderate Signaling class was younger and had lower public and private religiosity (except regarding health issues) than the Stoic and Gregarious Signaling classes. The Gregarious class signaled to both close others and strangers and scored highest in familism and religiosity. The Stoic class did not verbally signal but indicated sickness worsening when around both close others and strangers, were less likely to be married or endorse private religiosity, and were least likely to recall recent illness as severe. The signaling classes strongly resembled aspects of the introvert-ambivert-extrovert spectrum. We conclude that variation is important at multiple levels, including personality types, and potentially prevents the loss of immunological diversity.

Using Compressed Virtual Reality Exposure Therapy for an Adult Critical Illness Survivor: A Case Report.

Nearly one-quarter of adult critical illness survivors develop posttraumatic stress disorder symptoms triggered by sensory stimuli after intensive care unit discharge. Intensive care unit delirium is a risk factor for posttraumatic stress disorder. Compressed virtual reality exposure therapy (C-VRET) incorporates sensory stimuli to reduce posttraumatic stress disorder symptoms through habituation. A critical illness survivor developed intensive care unit delirium and enrolled in a C-VRET trial to treat posttraumatic stress disorder. She reported self-isolation because of infection fears and posttraumatic stress disorder symptoms triggered by medical commercials and lawn equipment sounds. She repetitively checked her heart rate at night for fear of missing illness signs and waking up intubated. The participant completed therapy. Screening tests were administered before, 2 weeks after, and 3 months after therapy to measure posttraumatic stress disorder symptoms (Clinician-Administered PTSD Scale for DSM-5; range, 0-60), depression (Center for Epidemiologic Studies Depression Scale; range, 0-60), physical activity (International Physical Activity Questionnaire), and resiliency (Connor-Davidson Resilience Scale; range, 0-100). The participant's posttraumatic stress disorder symptom scores declined from 36 to 11 to 5; depression scores declined from 19 to 5 to 1; physical activity scores increased from 499 to 2013 to 4599; and resiliency scores increased from 70 to 76 to 83. This report highlights the severity of posttraumatic stress disorder symptoms in critical illness survivors and the importance of strategies to limit delirium and posttraumatic stress disorder. Compressed virtual reality exposure therapy may reduce posttraumatic stress disorder symptoms in critical illness survivors.

RESILIENCE AND ADAPTATION: COPING STRATEGIES OF CHILDREN LIVING IN KADUNA ORPHANAGES

Background: The situation of orphans in sub-Saharan Africa, particularly Nigeria, has worsened due to factors such as HIV/AIDS, terrorism, and natural disasters. Orphans face not only the loss of parental care but also a wide range of social, emotional, and medical challenges. Despite existing interventions, many orphanages prioritize material needs, overlooking comprehensive psychosocial and medical support. This study aims to explore the coping strategies and resilience of children living in orphanages in Kaduna, Nigeria, by assessing their medical, social, and psychological challenges. Methodology: A cross-sectional descriptive study was conducted among 100 orphans in three selected orphanages in Kaduna. Data were collected through interviewer-administered questionnaires, focusing on socio-demographics, health status, behavioural problems, stigma, and coping strategies. Results: The findings revealed a mean age of 10 years, with a male majority (68%). Nutritional challenges were significant, with 53.7% classified as underweight despite 54.9% having access to balanced meals. Medical issues were prevalent, including incomplete immunization (46.7%) and clinical signs of illness in 33.7% of respondents. Behavioural disorders were also notable, with 27% having hyperactivity and 1.8% showing signs of major depressive disorder. Enuresis affected 22.3%. While most children (83.3%) had positive peer relationships, bullying (11.4%) and stigma (9%) were reported. Encouragingly, 89.2% of respondents demonstrated good self-esteem, and educational attendance was high, with only 2.2% not attending school. In terms of coping, 46.8% adapted their goals to manage their situations, while 35.2% reported strong social support. Conclusion: The study highlights the complex challenges faced by orphans in Kaduna orphanages, encompassing medical, psychological, and social dimensions. While positive peer relationships and educational participation are strong points, the high prevalence of health issues and behavioural disorders points to the need for holistic care approaches. Strengthening psychosocial support and healthcare systems will be vital to improving their overall well-being.

Neonatal Clinical Assessment of the Puppy and Kitten: How to Identify Newborns at Risk?

Neonatal puppies and kittens have physiological and anatomical characteristics that differ from those of adult animals, which impacts the interpretation of physical examination and complementary tests. The veterinarian must be familiar with the clinical, laboratory, and imaging aspects observed in neonates. It is necessary to thoroughly evaluate the litter and the mother to notice the most subtle signs of illness and advise the owner to constantly monitor the newborns, quickly sending them to specialized care. This review describes how to perform clinical assessments of newborns systematically and recognize clinical signs of neonatal changes or affections in puppies and kittens.

Identification of potential key circular RNAs associated with Escherichia coli-infected bovine mastitis using RNA-sequencing: preliminary study results.

Escherichia coli (E. coli) is commonly found in dairy farms and can invade mammary gland tissue, often causing acute clinical mastitis. Mammary infections with E. coli have shown a wide range of clinical signs, causing abnormal appearance of the milk, udder inflammation and systemic signs of illness. Circular RNA is a class of endogenous non-coding RNA that plays an important role in the occurrence and development of various inflammatory diseases. However, there is little information on the circRNA associated with bovine mastitis. In this study investigated the involvement of circRNAs in bovine mastitis through the construction of an E. coli-infected bovine mastitis model by injecting of E. coli into the mammary gland of dairy cows, using healthy gland mammary tissue as a control (M_C). High-throughput RNA-seq was performed on the E. coli-infected mammary gland tissue (M_E) and differentially expressed circRNAs between theM_C and M_E groups, followed by an analysis of their potential functions using bioinformatics methods. A total of 164 differentially expressed circRNAs were identified, including 92 downregulated circRNAs and 72 upregulated circRNAs. As shown by Gene Ontology enrichment analysis these DE circRNAs were mostly enriched in ras protein signal transduction, cytoplasmic vesicle parts, and enzyme binding, and Kyoto Encyclopedia of Genes and genome singal pathway enrichment analysis indicated significant associations with phagosome signal pathway. Additionally, the expression of bovine mastitis-related circRNAs, including novel_circRNA_0000128, novel_circRNA_0011103, novel_circRNA_0012656, novel_circRNA_0015099, novel_circRNA_005648, novel_circRNA_000074, and novel_circRNA_0011796 were verified via quantitative reverse-transcription polymerase chain reaction (RT-qPCR). These results provide a new direction for further investigation of the molecular mechanisms underlying bovine mastitis.

Dolphin Health Classifications from Whistle Features

Bottlenose dolphins often conceal behavioral signs of illness until they reach an advanced stage. Motivated by the efficacy of vocal biomarkers in human health diagnostics, we utilized supervised machine learning methods to assess various model architectures’ effectiveness in classifying dolphin health status from the acoustic features of their whistles. A gradient boosting classifier achieved a 72.3% accuracy in distinguishing between normal and abnormal health states—a significant improvement over chance (permutation test; 1000 iterations, p < 0.001). The model was trained on 30,693 whistles from 15 dolphins and the test set (15%) totaled 3612 ‘normal’ and 1775 ‘abnormal’ whistles. The classifier identified the health status of the dolphin from the whistles features with 72.3% accuracy, 73.2% recall, 56.1% precision, and a 63.5% F1 score. These findings suggest the encoding of internal health information within dolphin whistle features, with indications that the severity of illness correlates with classification accuracy, notably in its success for identifying ‘critical’ cases (94.2%). The successful development of this diagnostic tool holds promise for furnishing a passive, non-invasive, and cost-effective means for early disease detection in bottlenose dolphins.

Improving Mental Health Literacy Among Law Enforcement: A Pilot Study on Mental Health First Aid for Public Safety

Mental Health First Aid (MHFA) is an 8-h curriculum conducted in various communities to improve mental health literacy. Given the high rates of suicide among law enforcement professionals and the frequency of interactions between police and corrections officers with the severely mentally ill, mental health literacy is a relevant concept for the law enforcement field. This study examined the effectiveness of MHFA in improving mental health literacy in a small sample (n = 56) of law enforcement employees. A preexperimental one-group posttest-only design using nonprobability convenience sampling was used to analyze secondary data from courses taught by the author. The sample was comprised of law enforcement officers in various law enforcement agencies, including community police departments and corrections employees. Based on the posttest, the course improves participants’ confidence in recognizing signs of mental illness, asking about suicide, being aware of personal views, and assisting people in obtaining support.

Community-Based Mental Health Improvement Initiatives: A Narrative Review and Indiana Case Study.

There is a global mental health crisis: mental illness is underrecognized, underdiagnosed, and undertreated with adverse effects on mental, physical, and social health. In the United States, there is an insufficient number of traditional psychiatric and psychological resources to provide the mental health care needed to solve this crisis. Community-based interventions could be an important adjunct to traditional mental health care. An evaluation of peer-reviewed articles was performed describing community-based interventions and identified 3 approaches with some evidence of effectiveness: (1) interventions that enhance community mental health literacy to improve recognition of early signs of mental illness for early engagement and provide community, family, and peer support; (2) community clinics providing social, medical, and mental health care and support to transition-age youth (15-25 years); and (3) social networking activities to enhance interactions among elders suffering from social isolation and loneliness. Multisector, multidisciplinary, and multicomponent interventions involving health care providers and community-based organizations had the best evidence of effectiveness and should target transition-age youth and elders.

Age-dependent haemogram and sex-dependent serum biochemistry values in semi-feral Konik horses.

Semi-feral, free-roaming Konik polski horses are used in some European countries for preserving semi-open pasture landscapes. The estimation of their health status is still limited by insufficient data on various blood parameters. Therefore, our study aimed at the sex- and age-dependent analysis of haemogram and selected biochemistry parameters in healthy, semi-feral Koniks. In order to reach this aim, we took blood samples from 53 female and 18 male (8 uncastrated, 10 castrated) Koniks living in two Middle German nature reserves. They were of different age (9-266 months) and without signs of illness. Blood samples were analysed by an accredited laboratory. We identified age- but not sex-dependent changes in the white blood cell count (WBC). Higher age mainly caused a decrease in lymphocytes. Therefore, WBC correlated negatively and granulocyte-to-lymphocyte ratio positively with increasing age. Serum values of selected biochemical parameters did not depend on age but showed some sex-related differences. In this regard, serum total protein, triglyceride and the enzymatic activities of alkaline phosphatase, aspartate transaminase and g-glutamyltransferase were higher in males than females. However, the sex dependency of these enzymatic activities was restricted to uncastrated males. They also showed higher serum values for calcium and selenium than castrated males or all females. As far as the respective group sizes permitted, we then calculated age- or sex-dependent reference interval values for all parameters analysed. These values improve now the estimation of the health status of semi-feral, free-roaming Konik horses and provide a stable basis for future studies.