Identified by the eponym “Edwards’ Syndrome,” trisomy 18 (T18) represents the second most common autosomal trisomy after T21. The pathophysiology underlying the extra chromosome 18 is a nondisjunction error, mainly linked with the advanced maternal age. More frequent in female fetuses, the syndrome portends high mortality, reaching a rate of 80% of miscarriages or stillbirths. The three-step evaluation includes first trimester screening for fetal aneuploidy using a combination of maternal age, fetal nuchal translucency thickness, fetal heart rate and maternal serum free ß-hCG and PAPP-A; followed by the research for fragments of fetal DNA in maternal blood; and, finally, invasive techniques leave to the established diagnosis. Starting with the first trimester scan, selected ultrasound findings should be investigated to define not only the impact of the genetic problem on the fetus, but also to address the prenatal counselling. Previous series underline that T18 is not uniformly lethal. An active dialogue on the choices in the management of infants with T18 has emerged, sustained by the transition from the comfort care to the intervention attitude. Survival rates for individuals with supposedly fatal conditions have increased. In this novel scenario, an ad hoc counselling is pivotal. To support it, a comparative analysis by pictorial assays between ultrasound and autopsy findings could be beneficial. We provide an illustrative tool from a clinical case managed in early second trimester, with the purpose to strive a balanced approach in the hard choice faced by couples of fetuses with T18.

As a relatively high percentage of adenoma polyps are missed, a computer-aided diagnosis (CAD) tool based on deep learning can aid the endoscopist in diagnosing colorectal polyps or colorectal cancer in order to decrease polyps missing rate and prevent colorectal cancer mortality. Convolutional Neural Network (CNN) is a deep learning method and has achieved better results in detecting and segmenting specific objects in images in the last decade than conventional models such as regression, support vector machines or artificial neural networks. In recent years, based on the studies in medical imaging criteria, CNN models have acquired promising results in detecting masses and lesions in various body organs, including colorectal polyps. In this review, the structure and architecture of CNN models and how colonoscopy images are processed as input and converted to the output are explained in detail. In most primary studies conducted in the colorectal polyp detection and classification field, the CNN model has been regarded as a black box since the calculations performed at different layers in the model training process have not been clarified precisely. Furthermore, I discuss the differences between the CNN and conventional models, inspect how to train the CNN model for diagnosing colorectal polyps or cancer, and evaluate model performance after the training process.

This study was to investigate and assess salivary biomarkers as a means of diagnosing periodontitis. A total of 121 subjects were included: 28 periodontally healthy subjects, 24 with stage I, 24 with stage II, 23 with stage III, and 22 with stage IV periodontitis. Salivary proteins including active matrix metalloproteinase-8 (MMP-8), pro-MMP-8, total MMP-8, C-reactive protein, secretory immunoglobulin A and planktonic bacteria including Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas nigrescens, Parvimonas micra, Campylobacter rectus, Eubacterium nodatum, Eikenella corrodens, Streptococcus mitis, Streptococcus mutans, Staphylococcus aureus, Enterococcus faecalis, and Actinomyces viscosus were measured from salivary samples. The performance of the diagnostic models was assessed by receiver operating characteristics (ROC) and area under the ROC curve (AUC) analysis. The diagnostic models were constructed based on the subjects’ proteins and/or microbial profiles, resulting in two potential diagnosis models, which achieved better diagnostic powers with an AUC value > 0.750 for the diagnosis of stage II, III, and IV periodontitis (Model PC-I; AUC: 0.796, sensitivity: 0.754, specificity: 0.712) and for the diagnosis of stage III and IV periodontitis (Model PC-II; AUC: 0.796, sensitivity: 0.756, specificity: 0.868). This study can contribute to screening for periodontitis based on salivary biomarkers.

Ulcerative colitis (UC) is one of the two disorders known as inflammatory bowel diseases (IBD) along with Crohn’s disease (CD), with complex pathogenesis, requiring costly invasive investigations. Objective: to examine the most recent biomarkers proposed for UC diagnosis; to establish the strategy used to make the differential diagnosis between UC and CD relying on these biomarkers, also adding the benefit of finding new non-invasive tools in managing this condition. The search was performed in a single database (Web of Science) using the specific keywords „ulcerative colitis”, „biomarkers” and „diagnosis” for the last five years. Study eligibility criteria: clinical trials on adults and pediatric patients with ulcerative colitis compared with Crohn’s disease. Results: We selected 57 studies, randomized controlled trials (RCTs) and clinical case series (CCS), summarizing the latest most specific biomarkers in diagnosis of UC. Limitations: we considered RCTs and CCS from one database, limited to the search topics. Our findings indicate a important number of potential biomarkers with diagnostic value, which bring the advantage of a non-invasive method to approach this challenging disorder.

Raman Spectroscopy has long been anticipated to augment clinical decision making, such as classifying oncological samples. Unfortunately, the complexity of Raman data has thus far inhibited its routine use in clinical settings. Traditional machine learning models have been used to help exploit this information, but recent advances in deep learning have the potential to improve the field. However, there are a number of potential pitfalls with both traditional and deep learning models. We conduct a literature review to ascertain the recent machine learning methods used to classify cancers using Raman spectral data. We find that while deep learning models are popular, and ostensibly outperform traditional learning models, there are many methodological considerations which may be leading to an over-estimation of performance: primarily, small sample sizes which compound upon sub-optimal choices regarding sampling and validation strategies. Amongst several recommendations is a call to collate large benchmark Raman datasets, similar to those that have helped transform digital pathology, which researchers can use to develop and refine deep learning models.

Study objective Since December 2019, the coronavirus disease (COVID-19) pandemic has caused over a million deaths and resulted in adverse socio-economic impacts worldwide. However, predictability and prognostication of clinical features vary among different populations. Methods We search PubMed, EMBASE, Cochrane Library, Google Scholar, and WHO Global Health Library from December 2019 to April 2020 for studies reporting the risk factors, clinical features, and outcomes. The random-effect models for transformed prevalence (single-arm) or bivariate random-effect models (sensitivity and specificity) for correlated performance indicators. Results Among the 189 included studies representing 53,659 patients, the most sensitive predictor for COVID-19 infection was fever in adults (83%, 95% confidence interval [CI]:73–90%), and the most specific predictor was fatigue (96%, 95% CI: 80–99%). Fever was the most sensitive symptom in predicting the severity (89%, 95% CI:83–92%), followed by cough (71%, 95% CI:63–78%). The most specific predictor of severe COVID-19 was a chronic obstructive pulmonary disease (99%, 95% CI:98–99%). The stage of the outbreak and age significantly affect the prevalence of fever, fatigue, cough, and dyspnea. Fever, cough, fatigue, hypertension, and diabetes mellitus combined have a 3.06 positive likelihood ratio (PLR) and a 0.59 negative likelihood ratio (NLR) in the diagnosis. Additionally, fever, cough, sputum production, myalgia, fatigue, and dyspnea combined have a 10.44 PLR and a 0.16 NLR in predicting severe COVID-19. Conclusions Understanding the different distribution of predictors essential for screening potential COVID-19 infection and severe outcomes and the combination of symptoms could improve the pre-test probability.

This study aims to develop a performance evaluation system that can facilitate performance evaluation at region, hospital, and department levels to enable better cost management for sustainable development. A multi-level system of performance evaluation informs a hierarchical assessment of cost management from regions to hospitals to departments using diagnosis-related group (DRGs). Various metrics are developed employing the variances between targets and actuals where targets are determined from two perspectives: benchmarking using external regional prices and change management using internal data. Targets for the latter are statistically based and specifically incorporate variability. The model is applied to two hospitals, twenty departments, nine DRGs and 1071 inpatients. The analyses indicate that the approach can provide a practical evaluation tool that allows for particular characteristics at multiple levels. The system provides macro-micro and external-internal perspectives in performance, enabling high-level variances to be decomposed thereby identifying sources of performance variability and financial impact.

In recent years, intelligent fault diagnosis algorithms using deep learning method have achieved much success. However, the signals collected by sensors contain a lot of noise, which will have a great impact on the accuracy of the diagnostic model. To address this problem, we propose a one-dimensional convolutional neural network with multi-scale kernels (MSK-1DCNN) and apply this method to bearing fault diagnosis. We use a multi-scale convolution structure to extract different fault features in the original signal, and use the ELU activation function instead of the ReLU function in the multi-scale convolution structure to improve the anti-noise ability of MSK-1DCNN; then we use the training set with pepper noise to train the network to suppress overfitting. We use the Western Reserve University bearing data to verify the effectiveness of the algorithm and compare it with other fault diagnosis algorithms. Experimental results show that the improvements we proposed have effectively improved the diagnosis performers of MSK-1DCNN under strong noise and the diagnosis accuracy is higher than other comparison algorithms.

Immunostaining is an essential histochemical technique for analyzing pathogenesis and making a histopathological diagnosis. The needs are prompted by technical development and refinement, commercial availability of a variety of antibodies, deepened knowledge of immunohistochemical markers, accelerated analysis of morphofunctional correlations, progress in molecular target therapy, and the expectation of advanced histopathological diagnosis. However, immunostaining does have various pitfalls and caveats. We should learn from mistakes and failures, as well as from false positivity and false negativity. The present review article describes various devices, technical hints and trouble-shooting guides to keep in mind in performing immunostaining.

Multiple Myeloma (MM) is the second most common type of hematological disease and, although it is rare among patients under 40 years of age, its incidence rises in elderly subject. MM manifestations are usually known with the abbreviation CRAB (hyperCalcemia, Renal failure, Anaemia, and lytic Bone lesions). In particular, the extent of the bone disease is negatively related to a decreased patients’ quality of life and, in general, bone disease in MM increases both morbidity and mortality. The detection of lytic bone lesions on imaging, especially CT and MRI, is becoming crucial from the clinical viewpoint to separate asymptomatic from symptomatic MM patients and the detection of focal lytic lesion in these imaging data is becoming relevant even when no clinical symptoms are present. Therefore, radiology is pivotal in the staging and accurate management of patients with MM even in early phases of the disease. In this review we describe the opportunities offered by quantitative imaging and radiomics in multiple myeloma. At present time there is still high variability in the choice between various imaging methods to study MM patients and high variability in image interpretation with suboptimal agreement among readers even in tertiary centres. Therefore, the potential of medical imaging for patients affected by MM is still to be completely unveiled. In the next years, new insights to study MM with medical imaging will derive from artificial intelligence (AI) and radiomics usage in different bone lesions and from the wide implementations of quantitative methods to report CT and MRI. Eventually, medical imaging data can be integrated with the patient's outcomes with the purpose to find radiological biomarkers for predicting the disease prognostic flow and its therapeutic response.

The aim of this study was to examine pathologic complete response (pCR) and overall survival (OS) of patients diagnosed with non-metastatic inflammatory breast cancer (IBC). A total of N=8,550 cases undergoing surgery were identified between 2004-2013, using the National Cancer Database (NCDB). Patients were grouped into 4 biologic subtypes (HR+/HER2-, HR+/HER2+, HR-/HER2+, HR-/HER2-). The median age at diagnosis was 56 years. On average, women were followed for 3.7 years [interquartile range=3.0]. The majority were white (80%), had private health insurance (50%), and presented with poorly differentiated tumors (57%). Approximately 46% of the cancers were >5cm. Most patients underwent mastectomy (94%) and received radiotherapy (71%). Differences by biologic subtypes were observed for grade, lymph node invasion, race, and tumor size (p<.0001). Compared with non-pCR (54%), patients experiencing pCR had superior 5-year survival (77%) (p<.0001). Survival was poor for triple-negative (TN) tumors (37%) vs. other biologic subtypes (60%) (p<.0001). On multivariable analysis, TN-IBC, positive margins, and not receiving either chemotherapy, hormonal therapy or radiotherapy were independently associated with poor 5-year survival (p<.0001). In this large multicentric analysis of IBC, categorized by biologic subtypes, we observed significant differential tumor, patient and treatment characteristics, and OS.

The vibration feature of weak gear fault is often covered in strong background noise, which makes it necessary to establish weak feature enhancement methods. Among the enhancement methods, stochastic resonance (SR) has the unique advantage of transferring noise energy to weak signals and has a great application prospection in weak signal extraction. But the traditional SR potential model cannot form a richer potential structure and may lead to system instability when the noise is too great. To overcome these shortcomings, the article presents a periodic potential underdamping stochastic resonance (PPUSR) method after investigating the potential function and system signal-to-noise ratio (SNR). In addition, system parameters are further optimized by using ant colony algorithm. Through simulation and gear experiments, the effectiveness of the proposed method was verified. We concluded that compared with the traditional underdamped stochastic resonance (TUSR) method, the PPUSR method had a higher recognition degree and better frequency response capability.

Background: Malignant pleural mesothelioma (MPM) is an atypical, belligerent tumor that matures into cancer in the pleura, a stratum of tissue bordering the lungs. Pleural mesothelioma is a common type of mesothelioma that accounts for about 75 percent of all mesothelioma diagnosed yearly in the United States. Diagnosis of mesothelioma takes several months and is expensive. Given the difficulty of diagnosing MPM, early identification is crucial for patient survival. Our study implements artificial intelligence and recommends the best fit model for early diagnosis and prognosis of MPM. Method: We retrospectively retrieved patient’s medical reports generated by Dicle University, Turkey and implemented multi-layered perceptron (MLP), voted perceptron (VP), Clojure classifier (CC), kernel logistic regression (KLR), stochastic gradient decent SGD), adaptive boosting (AdaBoost), Hoeffding tree (VFDT), and primal estimated sub-gradient solver for support vector machine (s-Pegasos). We evaluated the models, compared and tested using paired T-test (corrected) at 0.05 significance based on their respective classification accuracy, f-measure, precision, recall, root mean squared error, receivers characteristic curve (ROC), and precision-recall curve (PRC). Results: In phase-1 SGD, AdaBoost.M1, KLR, MLP, VFDT generates optimal results with the highest possible performance measures. In phase-2, AdaBoost with a classification accuracy of 71.29% outperformed all other algorithms. C-reactive protein, platelet count, duration of symptoms, gender, and pleural protein were found to be the most relevant predictors that can prognosticate mesothelioma. Conclusion: This study confirms that data obtained from biopsy and imagining tests are strong predictors of mesothelioma but are associated with high cost, however, can identify mesothelioma with optimal accuracy. Predictive analytics without using biopsy results can diagnose mesothelioma with acceptable accuracy. Implementation of phase-2 followed by phase-1 can address diagnosis expenses and maximize disease prognosis. Additionally, results indicate improved MPM diagnosis using AI methods dependent upon the specific application.

Although rRT-PCR is the gold standard method for SARS-CoV-2 detection, some factors, such as amplification inhibitors presence, lead to false-negative results. Here we describe differences between rRT-PCR results for SARS-CoV-2 infection in normal and diluted samples, simulating the need for dilution due to amplification inhibitors presence. Viral RNA extraction of nasopharyngeal swabs samples from 20 patients previously detected as 'Negative' and 21 patients detected as 'Positive' for SARS-CoV-2 was realized with the EasyExtract DNA-RNA (Interprise®). rRT-PCR was realized with OneStep/COVID-19 (IBMP) kit with normal and diluted (80µl of H₂O RNAse free) samples, totaling 82 tests. The results indicate that there is an average variation (ɑ < 0.05) delaying Cq between the amplification results of internal control (IC), N Gene (NG), and ORF-1ab (OF) of 1.811 Cq, 3.840 Cq, and 3.842 Cq, respectively. The extraction kit does not completely purify the inhibitor compounds, therefore non-amplification by inhibitors may occur. In this study, we obtained a 19.04% false-negative diagnosis after sample dilution, and this process reduces the efficiency of rRT-PCR to 29.80% for detecting SARS-CoV-2. Knowing the rRT-PCR standards of diluted samples can help in the identification of false-negative cases, and consequently avoid a wrong diagnosis.

Aim. The purpose of the work was the development of a machine learning model for diagnosing the stage of liver fibrosis in patients with chronic viral hepatitis C according to the data of routine clinical examination. Materials and methods. A total of 1240 patients with chronic viral hepatitis C was examined. A set of data obtained from 689 patients balancing by the stage of liver fibrosis was used for developing and testing machine learning models. 9 routine clinical parameters were selected as the most important predictors for determining the likelihood of liver fibrosis the 3–4 stages presence: age, height, weight and body mass index of the patient, the number of platelets in the clinical blood test, levels of alanine transaminase, aspartate transaminase, gamma-glutamyltransferase, and total bilirubin in a biochemical blood test. Results. The accuracy of the developed method for determining the 3–4 stages of liver fibrosis in patients with chronic viral hepatitis C in comparison with the «gold standard» of diagnosis (liver biopsy) was 80.56% (95% CI: 69.53–88.94%), sensitivity — 66.67%, specificity — 94.44%. Conclusion. The developed method is an alternative to more expensive and geographically inaccessible studies. The method does not require the purchase of additional equipment or software, as well as additional laboratory tests, when used in real clinical practice. The introduction of the method into clinical practice can help to solve the problem of low material and territorial availability of diagnostic tests and allow determining the stage of liver fibrosis in patients with chronic viral hepatitis C.

The fault diagnosis of wind turbine systems represent a challenging issue, especially for offshore installations, thus justifying the research topics developed in this work. Therefore, this paper addresses the problem of the fault diagnosis of wind turbines, and it present viable solutions of fault detection and isolation techniques. The design of the so--called fault indicator consists of its estimate, which involves data--driven methods, as they result effective tools for managing partial analytical knowledge of the system dynamics, together with noise and disturbance effects. In particular, the suggested data--driven strategies exploit fuzzy systems and neural networks that are employed to determine nonlinear links between measurements and faults. The selected architectures are based on nonlinear autoregressive with exogenous input prototypes, as they approximate the dynamic evolution of the system along time. The designed fault diagnosis schemes are verified via a high--fidelity simulator, which describes the normal and the faulty behaviour of an offshore wind turbine plant. Finally, by taking into account the presence of uncertainty and disturbance implemented in the wind turbine simulator, the robustness and the reliability features of the proposed methods are also assessed. This aspect is fundamental when the proposed fault diagnosis methods have to be applied to offshore installations.

Several studies suggest that COVID-19 may be accompanied by symptoms such as a dry cough, muscle aches, sore throat, and mild to moderate respiratory illness. The symptoms of this disease indicate the fact that COVID-19 causes noticeable negative effects on the lungs. Therefore, considering the health status of the lungs using X-rays and CT scans of the chest can significantly help diagnose COVID-19 infection. Due to the fact that most of the methods that have been proposed to COVID-19 diagnose deal with the lengthy testing time and also might give more false positive and false negative results, this paper aims to review and implement artificial intelligence (AI) image-based diagnosis methods in order to detect coronavirus infection with zero or near to zero false positives and false negatives rates. Besides the already existing AI image-based medical diagnosis method for the other well-known disease, this study aims on finding the most accurate COVID-19 detection method among AI methods such as machine learning (ML) and artificial neural network (ANN), ensemble learning (EL) methods.

Background. A previous study demonstrated the performance of the Salivette® (SARSTEDT, Numbrecht, Germany) as a homogeneous saliva collection system to diagnose COVID-19 by RT-qPCR, notably for symptomatic and asymptomatic patients. However, for convalescent patients, the corroboration of molecular detection of SARS-CoV-2 in paired nasopharyngeal swabs (NPS) and saliva samples was unsatisfactory. Objectives. The aim of the present work was to assess the concordance level of SARS-CoV-2 detection between paired sampling of NPSs and saliva collected with Salivette® at two time points, with ten days of interval. Results. A total of 319 paired samples from 145 outpatients (OP) and 51 healthcare workers (HW) were collected. Due to significant waiting rate at hospital, most of the patients ate and/or drank in waiting their turn. Consequently, a mouth washing was systematically proposed prior saliva collection. None of the HW were diagnosed SARS-CoV-2 positive using NPS or saliva specimens at both time points (n=95) by RT-qPCR. The virus was detected in 56.3% (n=126/224) of the NPS samples from OP, but solely 26.8% (n=60/224) of the paired saliva specimens. The detection of the internal cellular control, the human RNase P, in more than 98% of the saliva samples, underlined that the low sensitivity of saliva specimens (45.2%) for SARS-CoV-2 detection was not attributed to an improper saliva sample storing or RNA extraction. Conclusions. Then, the mouth washing decreased viral load of buccal cavity conducting to impairment of SARS-CoV-2 detection. Viral loads in saliva neo-produced appeared insufficient for molecular detection of SARS-CoV-2. At the time that saliva tests could be a rapid, simple and noninvasive strategy to assess on large scale schooled children in France, the determination of the performance of saliva collection become imperative to standardize procedures.

For the diagnosis of disease, the ability to quantitatively detect trace amounts of the causal proteins from bacteria/viruses as biomarkers in patient specimens is highly desirable. Here we introduce a simple, rapid, and colorimetric assay as a de novo, ultrasensitive detection method. This ultrasensitive assay consists of sandwich enzyme-linked immunosorbent assay (ELISA) and thionicotinamide-adenine dinucleotide (thio-NAD) cycling, forming an ultrasensitive ELISA, in which the signal substrate (i.e., thio-NADH) accumulates in a triangular manner, and the accumulated thio-NADH is measured at its maximum absorption wavelength of 400 nm. We have successfully achieved a limit of detection of ca. 10–18 moles/assay for a target protein. As an example of infectious disease detection, HIV-1 p24 could be measured at 0.0065 IU/assay (i.e., 10⁻¹⁸ moles/assay), and as a marker for a lifestyle-related disease, adiponectin could be detected at 2.3 × 10⁻¹⁹ moles/assay. In particular, despite the long-held belief that the trace amounts of adiponectin in urine can only be detected using a radioisotope, our ultrasensitive ELISA was able to detect urinary adiponectin. This method is highly versatile, because simply changing the antibody enables the detection of various proteins. This assay system requires only the measurement of absorbance, thus it requires equipment that is easily obtained by medical facilities, which facilitates diagnosis in hospitals and clinics. Moreover, we describe an expansion of our ultrasensitive ELISA to a non-amplification nucleic acid detection method for nucleic acids using hybridization. These de novo methods will enable simple, rapid, and accurate diagnosis.

Disease-related data and information collected by physicians, patients, and researchers seem insignificant at first glance. Still, the same unorganized data contain valuable information that is often hidden. The task of data mining techniques is to extract patterns to classify the data accurately. One of the various Data mining and its methods have been used often to diagnose various diseases. In this study, a machine learning (ML) technique based on distributed computing in the Apache Spark computing space is used to diagnose diabetics or hidden pattern of the illness to detect the disease using a large dataset in real-time. Implementation results of three ML techniques of Decision Tree (DT) technique or Random Forest (RF) or Support Vector Machine (SVM) in the Apache Spark computing environment using the Scala programming language and WEKA show that RF is more efficient and faster to diagnose diabetes in big data.

Manual interpretation of these huge amounts of image volumes are susceptible to inter-reader variability and human error. Thus, accurate automated CAD scheme is highly desirable in clinical pathological diagnosis. In this research, plethora of machine learning paradigms (e.g. feature extraction, dimensionality reduction and supervised classification methods) were explored, evaluated, compared and analyzed to identify the optimal pathway for brain MR images (normal vs neoplastic) binary classification task. External validation dataset was used to test the generalizability of the optimal predictive models implemented. Relevant and informative features were selected to construct cross-validated decision tree and eventually simple rule set was built based on the decision tree. The experimental results show that almost all pattern recognition paradigms achieve high accuracy with careful selection of number of attributes. LDA+ELM with 55 features are the optimal pipelines which achieve perfect classification when training and test data are of same source; and achieving (accuracy=97.5%, AUC=0.989, sensitivity=95% and specificity=100%) under balanced test dataset; (accuracy=99.5%, AUC=0.988, sensitivity=95% and specificity=100%). Cross-validated decision tree model also shows comparable performance: accuracy=98.8%, AUC=99.1%, sensitivity=99.6% and specificity=98.2%. Three highly relevant and robust attributes are visualized and selected for construction of decision tree models and finally a rule sets are read directly off the decision tree. This rule sets can potentially serve as fast and accurate classification algorithm.

The latest World Atlas of Desertification represents a turning point in the diagnosis of desertification. While it forgoes desertification mapping due to the intrinsic complexity of the phenomenon and the impossibility of measuring it using a single indicator, it introduces the Convergence of Evidence paradigm, which identifies socioeconomic and biophysical variables whose behavior allows pointing out those areas prone to desertification. The Spanish National Action Program Against Desertification (PAND), back to 2008, already implemented a similar approach to identify five “desertification landscapes” within Spain using both socio-economic and climatic information. The PAND was not only pioneering but also, unfortunately, accurate. Desertification in Spain has continued to worsen and the first two decades of the 21st century have consolidated an agri-food model whose dynamics have exacerbated the desertification processes identified in the PAND. Despite its scientific value, the PAND lacked a proper action plan and was completely detached from the diagnosis. As a result the diagnosis it provided was not followed by effective actions to halt desertification in Spain. The Spanish Government's recent declaration of climate and environmental emergency requires a new strategy to combat desertification. This commitment is an excellent opportunity to update the diagnosis of the situation and, more crucially, to unify the different desertification sectoral policies and actions under a single front. We provide here elements for a roadmap to be designed around the pressures, impacts, and drivers that define today's Spanish desertification landscapes to manage them effectively and avoid their further degradation.

The Covid-19 pandemic spreads in waves for a year and a half, despite significant worldwide efforts, the development of biochemical diagnostic methods and population vaccination. One of the reasons for the infection spread is the impossibility of early disease detection through biochemical diagnostics, since biochemical processes slowly develop in a body. At the same time, well known that behavioral characteristics of a person, measured based on reflex movements, are capable for inertialess assessment of psychophysiological parameters. Vibraimage technology is the method of head micromovements video processing by inter-frame difference accumulation and converting spatial and temporal characteristics of the inter-frame difference into behavioral and psychophysiological parameters. Here we shown that behavioral parameters measured by vibraimage changed during COVID-19 infection. The identification of changes signs in behavioral parameters detected by AI trained on patients and controls. The best diagnostic accuracy (higher 94%) obtained using instantaneous values of behavioral parameters measured with the following vibraimage settings: 10Hz frequency of basic measurements; 25 inter-frame difference accumulations and averaging the diagnostic results over period of at least 5 seconds. COVID-19 diagnoses by behavioral parameters showed earlier (5-7 days) detection of the disease compared to symptoms and positive results of biochemical RT-PCR testing. Proposed method for COVID-19 diagnosis indicates infected persons within 5 seconds video processing using standard television cameras (web, IP) and computers, allows mass testing/selftesting and will stop the pandemic spread. We assume that head micromovements analysis for diagnosis of various diseases is possible not only with the help of vibraimage technology. Further research of human head micromovement analysis will help stop the COVID-19 pandemic and will contribute to the development of new contactless and environmentally friendly methods for early diagnosis of diseases.

Fault diagnosis of the gearbox is a decisive part of the modern industry to find the many gearbox defects like gear tooth crack, chipped or broken, etc. But sometimes, the nonstationary properties of vibration signal and low energy of minimal faults make this procedure very challenging. Previously, many types of techniques have been developed for gearbox condition monitoring. But most of the methods are dealing with conventional techniques of the gearbox condition monitoring, such as time-domain analysis or frequency domain analysis. Most of the conventional methods are not suitable for the nonstationary vibration signal. Thus, this paper presents a novel gearbox fault diagnosis technique using conditional temporal moments and an optimizable support vector machine (SVM). This work also presents an integrated features extraction technique based on the standard features, i.e., statistical and spectral features with the combinations of moment features. The impact of the four conditional temporal moments of each gearbox condition is also presented. This work shows that the proposed method successfully classifies and categorizes the gearbox faults at an early stage.

Background: The reference test for SARS-CoV-2 detection is the reverse transcriptase real time PCR (real time RT-PCR). However, evidences reported that real time RT-PCR has a lower sensitivity compared with the droplet digital PCR (ddPCR) leading to possible false negative in low viral load cases. Methods: We used ddPCR for viral genes N1 and N2 on 20 negative (no detection) samples from symptomatic hospitalized COVID-patients presenting fluctuating real time RT-PCR results and 10 suspected samples (Ct value>35) from asymptomatic not hospitalized subjects. Results: ddPCR performed on RNA revealed 65% of positivity for at least one viral target in the hospitalized patients group of samples (35% for N1 and N2, 10% only for N1 and 20% only for N2) and 50% in the suspected cases (30% for N1 and N2, while 20% only for N2). On hospitalized patients’ samples, we applied also a direct ddPCR approach on the swab material, achieving an overall positivity of 83%. Conclusion: ddPCR, in particular the direct quantitation on swabs, shows a sensitivity advantage for the SARS-CoV-2 identification and may be useful to reduce the false negative diagnosis, especially for low viral load suspected samples.

Admission and discharge diagnoses of in-hospital patients are often in discord. Incorrect admission diagnoses are related to increased cost of care and patient safety. Additionally, due to the seasonality of many conditions, this discord may vary across the year. In this paper, we used medical claims data to develop a methodological framework that examines these differences, for Medicare beneficiaries. We provide examples for pneumonia, a condition with seasonal implications, and aneurysm, where early detection can be life-saving. Following a Bayesian approach, our work quantifies and visualizes with time series plots the degree that any clinical condition is correctly diagnosed upon admission. We examined differences in weekly intervals, during a calendar year. The mean length of stay and hospital charges were furthermore compared between matching and non-matching {admission, discharge Dx} pairs, and 95% confidence intervals of the difference of means were estimated. We applied Statistical Process Control methods and then visualized differences, for the hospital charges and the length of stay, per week, with time series plots. Our methodology and the visualizations underline the importance of a rigorous and non-delayed diagnostic process upon admission since there are significant implications in terms of hospital outcomes and cost of care.

A surgical microscope is large in size, making portability impossible. The distance between the surgical microscope and the observation tissue is 15 to 30 cm, while the maximum adjustment range of the camera to the right and left is 30°. Therefore, surgical microscopes cause attenuation (above 58%) of the irradiation optical source owing to the long working distance. Moreover, the observation of tissue was dazzled with ambient light because the optical power source was strong (50 to 160 mW/cm2). Owing to the limited ability to adjust the camera to the right and left, a blind spot occurs with a surgical microscope. Therefore, it is difficult to clearly observe a tumor. In this study, a compact pen-type probe with a portable surgical microscope is proposed. The pen-type probe is small with a portable shape, and is capable of adjusting the working distance between itself and the observed tissue. It is also possible to adjust the viewing angle and fluorescence brightness. The proposed pen-type probe has no blind spots or optical density loss.

A 12 year old boy was diagnosed with temporal lobe epilepsy (TLE) along with mesial temporal sclerosis based on MRI (magnetic resonance imaging) results. The diagnosis was further confirmed by genetic analysis. He also had minor psychiatric symptoms of obsessive-compulsive disorders and mood swings. After 4 years of treatment with Sodium Valproate no change in symptoms was observed. Genetic testing along with deep phenotyping revealed altered glutamate pathway and metabolism. Post genetic testing the patient was put on a combination of Sodium Valproate and Valproic acid along with supplementation of N-acetylcysteine (NAC), Cyanocobalamin, Pyridoxine and Cholecalciferol. Within three months of this combined therapy the patient experienced complete elimination of seizures and drastic improvement in mood and social behaviour. The case report highlights the importance of precision diagnosis in understanding the underlying perturbed pathways in structural epilepsy like TLE and demonstrates the importance of non-invasive targeted therapy in such cases.

Objective: The Acute Cystitis Symptom Score (ACSS) was developed and validated as a self-reporting questionnaire for diagnosing and monitoring acute, uncomplicated cystitis (AC) in female patients. The study aims at the translation of the ACSS into Greek from original Russian as a source and American English as a new master version and at its linguistic validation. Material and Methods: Three independent professional native Greek translators, two of them experts in Russian and one in English, translated the ACSS from Russian and American English into Greek. The second group of three translators translated each of the three versions back into the original language to detect or correct any important discrepancies. These three Greek versions were then used for linguistic validation. Results: The English to Greek translation reflected more the spoken language, the two Russian to Greek translations more the written, formal language. A total of 60 randomly selected females and 30 healthcare professionals was asked about their preferences and to comment on each of the three translations. Considering all comments the scientific committee (SC) developed the Greek consensus version. For cognitive assessment additional 30 healthcare professionals and 30 females were asked to comment on the intelligibility of all items. Considering their comments the linguistically validated Greek study version was established by the SC. Conclusion: The linguistically validated Greek version of the ACSS can now be used for the clinical validation study.

Hadhramout Initiative Against Corona (HIAC ) formed a working group of clinicians relevant to the management of COVID-19 to formulate clinical practice guidelines (CPG) for clinicians caring for the patients infected with COVID-19 in Yemen. The regional guidelines on the management of COVID-19 were thoroughly reviewed and its applicability was assessed for Yemen. HIAC’s recommendations covered (2) sections: the first one is the diagnosis, including case definition, risk stratification of the affected cases, investigations (prioritization of reverse transcription-polymerase chain reaction (RT-PCR) testing, D-dimer, chest x-ray, and chest computed tomography, while the second part covers the treatments (mainly Favipiravir, Remdesivir, Hydroxychloroquine, and Glucocorticoid, Anticoagulants, and Supportive measures). In conclusion, the adoption of cost-effective and evidence-based guidelines in Yemen will standardize the management of the patients infected with COVID-19 and protect both the patients and the health care workers from malpractice.

Induction machines drive many industrial processes, and their unexpected failure can cause heavy production losses. The analysis of the current spectrum can identify online the characteristic fault signatures at an early stage, avoiding unexpected breakdowns. Nevertheless, frequency domain analysis requires stable working conditions, which is not the case for wind generators, motors driving varying loads, etc. In these cases an analysis in the time-frequency domain -such as a spectrogram- is required for detecting faults signatures. The spectrogram is built using the short frequency Fourier transform, but its resolution depends critically on the time window used to generate it: short windows provide good time resolution, but poor frequency resolution, just the opposite than long windows. Therefore, the window must be adapted at each time to the shape of the expected fault harmonics, by highly skilled maintenance personnel. In this paper, this problem is solved with the design of a new multi-band window, which generates simultaneously many different narrow-band current spectrograms, and combines them into a single, high resolution one, without the need of manual adjustments. The proposed method is validated with the diagnosis of bar breakages during the start-up of a commercial induction motor.

In the recent years, intelligent data-driven faultdiagnosis methods on gearboxes have been successfully developedand popularly applied in the industries. Currently, most ofthe machine learning techniques require that the training andtesting data are from the same distribution. However, thisassumption is difficult to be met in the real industries, sincethe gearbox operating conditions usually change in practice,which results in significant data distribution gap and diagnosticperformance deteriorations in applying the learned knowledgeon the new conditions. This paper proposes a deep learning-based domain adaptation method to address this issue. Theraw current signals are directly used as the model inputs fordiagnostics, which are easy to collect in the real industries andfacilitate practical applications. The maximum mean discrepancymetric is introduced to the deep neural network, the optimizationof which guarantees the extraction of generalized machineryhealth condition features across different operating conditions.The experiments on a real-world gearbox condition monitoringdataset validate the effectiveness of the proposed method, whichoffers a promising tool for cross-domain diagnosis in the realindustries.

Malaria remains an important cause of death, especially in sub-Saharan Africa with about 228 million malaria cases worldwide and an estimated 405,000 deaths in 2019. Currently, malaria is diagnosed in the health facility using a microscope (BS) or rapid malaria diagnostic test (MRDT) and with area where these tools are inadequate the presumptive treatment is performed. Apart from that self-diagnosis and treatment is also practiced in some of the households. With the high-rate self-medication on malaria drugs, this study aimed at computing the most significant features using feature selection methods for best prediction of malaria in Tanzania that can be used in developing a machine learning model for malaria diagnosis. A malaria symptoms and clinical diagnosis dataset were extracted from patients’ files from four (4) identified health facilities in the regions of Kilimanjaro and Morogoro. These regions were selected to represent the high endemic areas (Morogoro) and low endemic areas (Kilimanjaro) in the country. The dataset contained 2556 instances and 36 variables. The random forest classifier a tree based was used to select the most important features for malaria prediction. Regional based features were obtained to facilitate accurate prediction. The feature ranking as indicated that fever is universally the most influential feature for predicting malaria followed by general body malaise, vomiting and headache. However, these features are ranked differently across the regional datasets. Subsequently, six predictive models, using important features selected by feature selection method, were used to evaluate the features performance. The features identified complies with malaria diagnosis and treatment guideline provided with WHO and Tanzania Mainland. The compliance is observed so as to produce a prediction model that will fit in the current health care provision system in Tanzania.

The power converter is the significant device in a wind power system. Wind turbine will be shut down and off grid immediately with the occurrence of the IGBT module open-circuit fault of power converter, which will seriously impact the stability of grid and even threaten personal safety. However, in the existing diagnosis strategies of power converter, there are few single and double IGBT modules open-circuit fault diagnosis methods producing negative results including erroneous judgment, omissive judgment and low accuracy. In this paper, a novel method to diagnose the single and double IGBT modules open-circuit faults of the permanent magnet synchronous generator (PMSG) wind turbine grid-side converter (GSC) is proposed. Above all, collecting the three-phase current varying with wind speed of 22 failure states including a normal state of PMSG wind turbine GSC as the original signal data. Afterward, the original signal data are decomposed by using variational mode decomposition (VMD) to obtain the mode coefficient series, which are analyzed by the proposed method base on fault trend feature for extracting the trend feature vectors. Finally, the trend feature vectors are used as the input of deep belief network (DBN) for decision-making and obtaining the classification results. The simulation and experimental results show that the proposed method can diagnose the single and double IGBT modules open-circuit faults of GSC, and the accuracy is higher than the benchmark models.

Pattern analysis of salivary metabolic profile has been proven accurate to discriminate generalized periodontitis (GP) patients from healthy individuals (HI) as disease modifies the salivary concentrations of specific metabolites. Due to the scarcity of data in the literature, the aim of this study was to determine whether non-surgical periodontal therapy (NST) could change salivary metabolomic profile in GP to one more similar to HI. Unstimulated whole saliva of 11 HI and 12 GP patients were obtained prior to and 3 months after NST. Metabolic profiling was performed using Nuclear Magnetic Resonance (NMR) spectroscopy, followed by supervised multivariate statistical approach on entire saliva spectra and partial least square (PLS) discriminant analysis. In GP group, periodontal treatment improved all clinical parameters, but not all the diseased sites were eradicated. PLS revealed an accuracy of 100% in discriminating the metabolomic profile of each GP patient before and after NST. OPLS was able to discriminate the 3 groups of subjects with an accuracy of 85.6%. However the post-NST metabolic profile of GP patients could not be completely assimilated to that of HS. Although NST may produce significant changes in the metabolic profile, GP patients maintained a distinctive fingerprint compared to HI.

Machine fault diagnosis systems need to collect and transmit dynamic monitoring signals, like vibration and current signals, at high-speed. However, industrial wireless sensor networks (IWSNs) and Industrial Internet of Things (IIoT) are generally based on low-speed wireless protocols, such as ZigBee and IEEE802.15.4. To address this tension when implementing machine fault diagnosis applications in IIoT, this paper proposes a novel IWSN with on-sensor data processing. On-sensor wavelet transforms using four popular mother wavelets are explored for fault feature extraction, while an on-sensor support vector machine classifier is investigated for fault diagnosis. The effectiveness of the presented approach is evaluated by a set of experiments using motor bearing vibration data. The experimental results show that compared with raw data transmission, the proposed on-sensor fault diagnosis method can reduce the payload transmission data by 99.95%, and reduce the node energy consumption by about 10%, while the fault diagnosis accuracy of the proposed approach reaches 98%.

Background and Objectives: The IPED study showed that a smartphone-based event recorder increased the number of patients in whom an ECG was captured during symptoms over five-fold to more than 55% at 90 days compared to standard care [1] and concluded that this safe, non-invasive and easy to use device should be considered part of on-going care to all patients presenting acutely with unexplained palpitations or pre-syncope. This study reports the process of establishing a smartphone palpitation and pre-syncope service. Materials and Methods: A clinical Standard Operating Procedure (SOP) was devised, and funding was secured through a business case for the purchase of 40 AliveCor devices in the first instance. The clinic was launched on 22nd July 2019. Results: Between 22nd July 2019 and 31st October 2019, 68 patients seen in the ED with palpitations or pre-syncope were referred to SPACC. 30 were male and 38 female and mean age was 45.8 (SD 15.1) with a range from 18 to 80 years. 50 (74%) patients underwent full investigation. 7 (11%) patients were deemed on first assessment to have non-cardiac palpitations and were not fitted with the device. All patients who underwent full investigation achieved symptomatic rhythm correlation most with sinus rhythm, ventricular ectopics or bigeminy. A symptomatic cardiac dysrhythmia was detected in 6 (8.8%) patients. 3 patients had supraventricular tachycardia; SVT (4%), 2 had atrial fibrillation (3%) and 1 atrial flutter (2%). Qualitative feedback from the SPACC team suggested several areas where improvement to the clinic could be made. Conclusion: We believe a smartphone palpitation service based in ambulatory care is simple to implement and is effective at detecting cardiac dysrhythmia in ED palpitation patients.

: Emaravirus (Order Bunyavirales; Family Fimoviridae) is a genus comprising over 20 emerging plant viruses with a worldwide distribution and economic impact. Emaraviruses infect a variety of host plants and have especially become prevalent in important long-living woody plants. These viruses are enveloped, with a segmented, single-stranded, negative-sense RNA genome and are transmitted by eriophyid mites or mechanical transmission. Emaraviruses have four core genome segments encoding an RNA-dependent RNA polymerase, a glycoprotein precursor, a nucleocapsid protein, and a movement protein. They also have additional genome segments, whose number varies widely. We report here that the proteins encoded by these segments form three main homology groups: a homolog of the sadwavirus Glu2 Pro glutamic protease; a protein involved in pathogenicity, which we named “ABC”; and a protein of unknown function, which we named “P55”. The distribution of these proteins parallels the emaravirus phylogeny and suggests, with other analyses, that emaraviruses should be split into at least two genera. Reliable diagnosis systems are urgently needed to detect emaraviruses, assess their economic and ecological importance, and take appropriate measures to prevent their spread (such as routine testing, hygiene measures, and control of mite vectors). Additional research needs include understanding the function of emaravirus proteins, breeding resistant plants and clarifying transmission modes.

Invasive candidiasis (IC) is associated with high morbidity and mortality in hospitalized patients if not diagnosed early. Long-term use of central venous catheters is a predisposing factor for IC. Hyphal forms of Candida albicans (the major etiological agent of IC) are related to invasion of host tissues. The secreted proteins of hyphae are involved in virulence, host interaction, immune response, and immune evasion. To identify IC diagnostic biomarker candidates, we characterized the C. albicans hyphal secretome by gel-free proteomic analysis, and further assessed the antibody-reactivity patterns to this subproteome in serum pools from 12 patients with non-catheter-associated IC (ncIC), 11 patients with catheter-associated IC (cIC), and 11 non-IC patients. We identified 301 secreted hyphal proteins stratified to stem from the extracellular region, cell wall, cell surface, or intracellular compartments. ncIC and cIC patients had higher antibody levels to the hyphal secretome than non-IC patients. Seven secreted hyphal proteins were identified to be immunogenic (Bgl2, Eno1, Pgk1, Glx3, Sap5, Pra1 and Tdh3). Antibody-reactivity patterns to Bgl2, Eno1, Pgk1 and Glx3 discriminated IC patients from non-IC patients, while those to Sap5, Pra1 and Tdh3 differentiated between cIC and non-IC patients. These proteins may be useful for development of future IC diagnostic tests.

Unicellular eukaryotes of the Trypanosomatidae family include human and animal pathogens that belong to the Trypanosoma and Leishmania genera. Diagnosis of the diseases they caused requires the sampling of body fluids (blood, lymph, peritoneal fluid, cerebrospinal fluid, etc.) or organ biopsies (bone marrow, spleen, etc.), which are mostly obtained through invasive methods. Body fluids or appendages can be alternatives to these invasive biopsies but appropriateness remains poorly studied. To further address this question, we perform a systematic review on clues evidencing the presence of parasites, genetic material, antibodies, and antigens in body secretions, appendages, or the organs or proximal tissues that produce these materials. Paper selection was based on searches in PubMed, Web of Science, WorldWideScience, SciELO, Embase, Google. The information of each selected article (n=333) was classified into different sections and data were extracted from 77 papers. The presence of Trypanosomatidae parasites has been tracked in most of organs or proximal tissues that produce body secretions or appendages, in naturally or experimentally infected hosts. The meta-analysis highlights the paucity of studies on Human African Trypanosomiasis and a the absence on animal Trypanosomiasis. Among the collected data high heterogeneity in terms of the I² statistic (100%) is recorded. A high positivity is recorded for antibody and genetic material detection in urine of patients and dogs suffering leishmaniasis, and of antigen for leishmaniasis and Chagas disease. Data on conjunctival swab can be analyzed with molecular methods solely for dogs suffering canine visceral leishmaniasis. Saliva and hair/bristle showed a pretty good positivity that support their potential to be used for leishmaniasis diagnosis. In conclusion, our study pinpoints significant gaps that need to be filled in order to properly address the interest of body secretion and hair or bristle for the diagnosis of infections caused by Leishmania and by other Trypanosomatidae parasites.

The purpose of feature selection is to find important features from the original high-dimensional space. As atypical feature selection algorithm, Locally linear embedding(LLE)-based feature selection algorithm, which applies the idea of LLE to the graph-preserving feature selection framework, has been received wide attention. However, LLE-based feature selection framework is sensitive to noise and K-nearest neighbors. To address these problems, an improved LLE-based feature selection algorithm, robust LLE (RLLE) vote, is proposed. In this algorithm, $l_1$ and $l_2$ regularization are introduced into the high-dimensional reconstruction model of LLE. Furthermore, RLLE vote also proposes a criterion to measure the difference between the reconstruction features and the original features, and then the importance features can be selected by this criteria. Extensive experiments are carried out on a benchmark fault data set and the bearing data set collected from our own laboratory, and the experimental results demonstrate that RLLE vote achieves the most significant performance compared existing state-of-art methods.

System level diagnosis is an abstraction of high level and, thus, its practical implementation to particular cases of complex systems is the task which requires additional investigations, both theoretical and modeling. Mostly, diagnosis at system level intends to identify only permanently faulty units. In the paper, we consider the case when both permanently and intermittently faulty units can occur in the system. Identification of intermittently faulty units has some specifics which we have considered in this paper. We also suggest the method which allows distinguishing among different types of intermittent faults. Diagnosis procedure was suggested for each type of intermittent faults.

Volatile compounds, abundant in breath, can be used to accurately diagnose and monitor a range of medical conditions. This offers a non-invasive, low-cost approach with screening applications; however, uptake of this diagnostic approach has been limited by conflicting published outcomes. Most published reports rely on large scale screening of the public, at single time points and without reference to ambient air. Here, we present a novel approach to volatile sampling from cellular headspace and mouse breath that incorporates multi-time point analysis and ambient air subtraction revealing compound flux as an effective proxy of active metabolism. This approach to investigating breath volatiles offers a new avenue for disease biomarker discovery and diagnosis. Using gas chromatography mass spectrometry (GC/MS), we focus on low molecular weight, metabolic substrate/by-product compounds and demonstrate that this non-invasive technique is sensitive (reproducible at ~1 µg cellular protein, or ~500,000 cells) and capable of precisely determining cell type, status and treatment. Isolated cellular models represent components of larger mammalian systems and we show that stress- and pathology-indicative compounds are detectable in mice, supporting further investigation using this methodology as a tool to identify volatile targets in human patients.

In recent years, Parkinson's Disease (PD) as a progressive syndrome of the nervous system has become highly prevalent worldwide. In this study, a novel hybrid technique established by integrating a Multi-layer Perceptron Neural Network (MLP) with the Biogeography-based Optimization (BBO) to classify PD based on a series of biomedical voice measurements. BBO is employed to determine the optimal MLP parameters and boost prediction accuracy. The inputs comprised of 22 biomedical voice measurements. The proposed approach detects two PD statuses: 0– disease status and 1– reasonable control status. The performance of proposed methods compared with PSO, GA, ACO and ES method. The outcomes affirm that the MLP-BBO model exhibits higher precision and suitability for PD detection. The proposed diagnosis system as a type of speech algorithm detects early Parkinson’s symptoms, and consequently, it served as a promising new robust tool with excellent PD diagnosis performance.

Since its 2013 emergence in the Americas, chikungunya virus (CHIKV) has posed a serious threat to public health. Early and accurate diagnosis of the disease, though currently lacking in clinics, is integral to enable timely care and epidemiological response. We developed a dual detection system: a CHIKV antigen E1/E2-based enzyme-linked immunosorbent assay (ELISA) and a lateral flow test using high-affinity anti-CHIKV antibodies. The ELISA was validated with 100 PCR-tested acute Chikungunya fever samples from Honduras. The assay had an overall sensitivity and specificity of 51% and 96.67%, respectively, with accuracy reaching 95.45% sensitivity and 92.03% specificity at a Ct cutoff of 22. As the Ct value increased from 22, ELISA sensitivity decreased. We then developed and validated two lateral flow tests using independent antibody pairs. The sensitivity and specificity reached 100% for both lateral flow tests using 39 samples from Colombia and Honduras at Ct cutoffs of 20 and 27, respectively. For both lateral flow tests, sensitivity decreased as the Ct increased after 27. Because CHIKV E1/E2 are exposed in the virion surfaces in serum during the acute infection phase, these sensitive and specific assays demonstrate opportunities for early detection of this emerging human pathogen.

A diagnosis of typical chronic lymphocytic leukemia (CLL) requires the presence of ≥5000 clonal B-lymphocytes/μL with the coexistence of CD19, CD20, CD5, and CD23 and the restriction of light chain immunoglobulin, and the lack of expression of antigens CD22 and CD79b. Atypical CLL (aCLL) can be distinguished from typical CLL morphologically and immunophenotypically. Atypical CLL cells are defined as prolymphocytes; morphologically, these present as deeply-clefted lymphocytes which are larger than those in typical CLL, with condensed chromatin and without prominent nucleoli. However, current aCLL diagnostics rely more on immunophenotypic characteristics rather than atypical morphology. Immunophenotypically, atypical CLL differs from classic CLL in the lack of expression of one or fewer surface antigens, most commonly CD5 and CD23, and the patient does not meet the criteria for a diagnosis of any other B-cell lymphoid malignancy. Morphologically atypical CLL has more aggressive clinical behavior and worse prognosis than classic CLL. Patients with aCLL are more likely to display markers associated with poor prognosis, including trisomy 12, unmutated IGVH, and CD38 expression compared with classic CLL. However, no standard or commonly-accepted criteria exist for differentiating aCLL from classic CLL and the clinical significance of aCLL is still under debate. This review summarizes the current state of knowledge on the morphological, immunophenotypic and genetic abnormalities of aCLL.

Nowadays, colon cancer prognosis still difficult to predict, especially in the early stages. Recurrences remain elevated, even in the early stages after curative surgery. Carcidiag Biotechnologies has developed an immunohistochemistry (IHC) kit called ColoSTEM Dx, based on a MIX of biotinylated plant lectins that specifically detects colon cancer stem cells (CSCs) through glycan patterns that they specifically (over)express. A retrospective clinical study was carried out on tumor tissues from 208 non-treated and 21 treated patients with colon cancer, that were stained by IHC with the MIX. Clinical performances of the kit were determined, and prognostic and predictive values were evaluated. With 78.3% and 70.6% of diagnostic sensitivity and specificity respectively, our kit shows great clinical performances. Moreover, patient prognosis is significantly poorer when the MIX staining is “High” compared to “Low”, especially at 5-years of overall survival and for early stages. The ColoSTEM Dx kit allows an earlier and a more precise determination of patients’ outcome. Thus, it affords an innovating clinical tool for predicting tumor aggressiveness earlier and determining prognosis value regarding therapeutic response in colon cancer patients.

Early diagnosis of malaria and treatment seeking behavior play key role in controlling and preventing further complication related to malaria disease. Aim of this study was to determine the responses on early malaria diagnosis and treatment seeking behavior among outpatient clients attending at Sekou toure regional referral hospital in Mwanza, Tanzania. Methods: A cross-sectional study was conducted among outpatient client at Sekou-Touré regional referral hospital, convenient simple random sampling used and self-administered questionnaire were used to collect data and data was entered into Microsoft excel and then exported to SPSS version 25.0 for further analysis and presented on the percentages and table. The analysis of strength of relationships between categorical variables was conducted using the Chi-square test. A p-value of ≤ 0.05 was considered to be statistically significant. Results: A total of 192 respondents completed the study with a response rate of 97.6%. The study revealed that Most of the respondents about 90.6% stated they would seek treatment from health facility when symptoms appear. However, only 6.3% seek treatment within 24 hours of onset of illness (p= 0.017). Half of respondents (50.5%) experienced malaria symptoms in the past six months and only 30% seek for treatment at health facility. Preference of health facility, (51%) respondents were going direct to pharmacy to buy medicine for self-treatment. Overall, cost of service, time consumed and distance of health facility especially health center shows significant with such delay. Conclusion: A low proportion of malaria-suspected patients sought treatment within 24 h of fever onset compared to the national target. Distance from the health facility, cost of service and time consumed were found to be predictors of early treatment-seeking behavior for malaria. Strengthening strategies tailored to increasing awareness for communities about malaria, importance of going hospital and early treatment-seeking behavior is essential.

Mobile health devices are emerging applications that could help deliver point-of-care (POC) diagnosis, particularly in settings with limited laboratory infrastructure, such as sub-Saharan Africa (SSA). The advent of coronavirus has resulted in an increased deployment and use of mHealth-linked POC diagnostics in SSA. We performed a systematic review and meta-analysis to evaluate the accuracy of mobile-linked point-of-care diagnostics in SSA. Our systematic review and meta-analysis were guided by the Preferred Reporting Items requirements for Systematic Reviews and Meta-Analysis (PRISMA). We exhaustively searched PubMed, Science Direct, Google Scholar, MEDLINE, and CINAHL with full-text via EBSCOhost databases from mHealth inception to March 2021. The statistical analyses were conducted using OpenMeta-Analyst software. All 11 included studies were considered for the meta-analysis. The included studies focused on malaria infections, Schistosoma haematobium, Schistosoma mansoni, soil-transmitted helminths, and trichuris trichiura. The pooled summary of sensitivity and specificity estimates were moderate compared to the gold reference standard. The overall pooled estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of mobile-linked POC diagnostic devices were as follows: 0.499 (95% CI: 0.458-0.541); 0.535 (95% CI: 0.401-0.663); 0.952 (95% CI: 0.60-1.324); 1.381 (95% CI: 0.391-4.879); and 0.944 (95% CI: 0.579-1.538), respectively. Evidence shows that mobile-linked POC diagnostics' diagnostic accuracy is presently moderate in detecting infections in sub-Saharan Africa. Future research is recommended to evaluate mHealth devices' diagnostics with excellent sensitivities and specificities in diagnosing diseases in this setting.

Diesel engines, as power equipment, are widely used in the fields of automobile industry, ship and power equipment. Due to wear or faulty adjustment, the valve train clearance abnormal fault is a typical failure of diesel engines, which may result in the performance degradation, even valve fracture and cylinder hit fault. However, the failure mechanism features mainly in time domain and angular domain, on which the current diagnosis methods based, are easily affected by working conditions or hard to extract accurate enough, as the diesel engine keeps running in transient and non-stationary process. This work arms at diagnosing this fault mainly based on frequency band features which would change when the valve clearance fault occurs. For the purpose of extracting a series of frequency band features adaptively，a decomposition technique based on improved variational mode decomposition is investigated in this work. As the connection between the features and the fault is fuzzy, the random forest algorithm is used to analyze the correspondence between features and faults. In addition, the feature dimension is reduced to improve the operation efficiency according to importance score. The experimental results under variable speed condition show that the method based on variational mode decomposition and random forest is capable to detect valve clearance fault effectively.

Early identification of fetal abnormalities is a huge challenge for modern obstetrics. Quantitative fluorescent polymerase chain reaction (QF-PCR) has quickly become an effective means of chromosome anomaly detection due to its advantages in terms of timing, manpower and accuracy. The QF-PCR results also make a significant change in clinicians’ attitude to some extent, assisting them providing parents with professional and valuable advice on pregnancy management. In this review, the advantages and drawbacks of QF-PCR will be explored. By reviewing studies published in Vietnamese Medical Journals, we conclude QF-PCR can become a potential screening test in the field of prenatal diagnosis.

Alzheimer’s disease is the most common neurodegenerative disease and affects persons of all races, ethnic groups, and sexes. The disease is characterized by neuronal loss leading to cognitive decline and memory loss. There is no cure and the effectiveness of existing treatments is limited and depends on the time of diagnosis. The long prodromal period, during which patients’ ability to live a normal life is not affected despite neuronal loss, often leads to a delayed diagnosis because it can be mistaken for normal aging of the brain. In order to make a substantial impact on AD patients, early diagnosis may provide a greater therapeutic window for future therapies to slow AD-associated neurodegeneration. Current gold standards for disease detection include magnetic resonance imaging and positron emission tomography scans, which visualize amyloid β and phosphorylated tau depositions and aggregates. Liquid biopsies, already an active field of research in precision oncology, are hypothesized to provide early disease detection through minimally or non-invasive sample collection techniques. Liquid biopsies in Alzheimer’s disease have been studied in cerebrospinal fluid, blood, ocular, oral, and olfactory fluids. However, most of the focus has been on blood and cerebrospinal fluid due to biomarker specificity and sensitivity attributed to the effects of the blood-brain barrier and inter-laboratory variation during sample collection. Many studies have identified amyloid β and phosphorylated tau levels as putative biomarkers, however, advances in next-generation sequencing-based liquid biopsy methods have led to significant interest in identifying nucleic acids species associated with Alzheimer’s disease from liquid tissues. Differences in cell-free RNAs and DNAs have been described as potential biomarkers for AD and hold the potential to affect disease diagnosis, treatment, and future research avenues.

Rapid post-earthquake damage diagnosis of bridges can guide decision-making for emergency response management and recovery. This can be facilitated using digital technologies to remove the barriers of manual post-event inspections. Prior mechanics-based Finite Element (FE) models can be used for post-event response simulation using the measured ground motions at nearby stations; however, the damage assessment outcomes would suffer from uncertainties in structural and soil material properties, input excitations, etc. For instrumented bridges, these uncertainties can be reduced by integrating sensory data with prior models through a model updating approach. This study presents a sequential Bayesian model updating technique, through which a linear/nonlinear FE model, including soil-structure interaction effects, and the foundation input motions are jointly identified from measured acceleration responses. The efficacy of the presented model updating technique is first examined through a numerical verification study. Then, seismic data recorded from the San Rogue Canyon Bridge in California are used for a real-world case study. Comparison between the free-field and the foundation input motions reveals valuable information regarding the soil-structure interaction effects at the bridge site. Moreover, the reasonable agreement between the recorded and estimated bridge responses shows the potentials of the presented model updating technique for real-world applications. The updated FE model is considered as the digital twin of the bridge and can be used to analyze the bridge and monitor the structural response at element, section, and fiber levels to diagnose the location and severity of any potential damage mechanism.

Recently, nanobodies have taken center stage in research on drug discovery and development. Several therapeutic possibilities using nanobodies are presently undergoing clinical trials and waiting for FDA approval. The goal of this study was to emphasize the potential of nanobodies as therapeutic agents by concentrating on the most recent published studies that examined their properties, manufacturing, and possible applications. This article demonstrates that the unique properties of nanobodies in comparison to conventional antibodies, which are based on their small size and offer a number of benefits, make them seem to have a promising future. These advantages include the ability to access complex or hidden target sites that may be elusive to their larger antibody counterparts, and increased resilience against extreme conditions like tempera-ture changes and pH variations. As a result, nanobodies seem to have a bright future as adaptable tools for imaging in cancer and non-malignant diseases, as well as for in vitro and in vivo diagnostic and therapeutic potential for a variety of conditions, including oncology, infectious, metabolic, neurological, and other conditions like ophthalmologic, immune-mediated, and genetic disorders. More research is required to determine their effectiveness and safety in clinical applications. The current analysis offers a thorough overview of the therapeutic uses for nanobody products that are either on the market or undergoing clinical trials.

MicroRNAs are used as biomarkers for classification of cancer subtypes since certain miRNAs are differentially expressed in normal and patient samples. Moreover, miRNAs target mRNAs and can heavily influence Gene Expressions. Thus, deregulation of miRNAs is linked to various disorders. Thus, miRNAs can be used for prognosis and developing personalized health solutions for patients. Given the importance of miRNAs, there has been substantial work done in the field. In this paper, recent works in the field of using miRNAs expressions of patients were considered. A total of 20 papers were surveyed which utilized feature selection ensembles, fuzzy logic as well as deep learning. 10 papers have been reported which offer insight into how miRNAs can be utilized for subtype-specific or generalized cancer diagnosis.

Epilepsy is one of the most common disorders of the central nervous system, impacting nearly 50 million people around the world. Heterogeneous in nature, epilepsy presents in children and adults alike. Currently, surgery is the only treatment that can cure epilepsy. However, not all individuals are eligible or have successful outcomes. Difficulty in accessing samples of human brain tissue along with advances in sequencing technology have driven researchers to investigate sampling liquid biopsies in blood, serum, plasma, and cerebrospinal fluid within the context of epilepsy. Liquid biopsies provide minimal or non-invasive sample collection approaches and can be assayed relatively easily across multiple time points, unlike tissue-based sampling. Various efforts have investigated circulating nucleic acids from these samples including microRNAs, cell-free DNA, transfer RNAs, and long non-coding RNAs. Here, we review nucleic acid-based liquid biopsies in epilepsy to improve understanding of etiology, diagnosis, prediction, and therapeutic monitoring.

Scrub typhus (ST) is one of the most neglected tropical diseases, a leading cause of acute undifferentiated febrile illness in areas of the ‘tsutsugamushi triangle’, diagnosed frequently in South Asian countries. The bacteria Orientia tsutsugamushi is the causative agent of the disease, which enters to human body through the bite of trombiculid mite (Chigger) of the genus Leptotrombidium deliense.The diagnosis of the disease becomes challenging as its early symptoms mimic other febrile illnesses like dengue, influenza, and corona viruses. Lack of rapid, reliable, and cost-effective diagnostic methods further complicates the identification process. Northeast India, a mountainous region with a predominantly rural tribal population, has witnessed a resurgence of scrub typhus cases in recent years. Various ecological factors, including rodent population, habitat characteristics, and climatic conditions, influence its prevalence. Entomological investigations have confirmed the abundance of vector mites, highlighting the importance of understanding their distribution and the probability of transmission of scrub typhus in the region. Proper diagnosis, awareness campaigns, and behavioral interventions are essential for controlling scrub typhus outbreaks and reducing its impact on public health in Northeast India. Further research and community-based studies are necessary to accurately assess the disease burden and implement effective prevention strategies.

Background: Cytomegalovirus (CMV) infection has been associated with venous thromboembolism (VTE) and acute coronary syndromes (ACS). Methods: A retrospective study was conducted within the OSF HealthCare System in Peoria, Illinois. The objectives were to determine the incidence of acute VTE and ACS within one year of CMV testing. The “study group” included patients with positive CMV IgM or positive CMV Polymerase Chain Reaction (PCR). The “seropositive control” group included patients with positive CMV IgG and negative IgM. The “seronegative control” group included patients with negative CMV IgG and IgM, or negative PCR. Results: Within one year of CMV infection, 38 of 379 patients (10.0%) developed VTE in the study group compared to 41 of 1334 patients (3.1%) in the seropositive control and 37 of 1249 (3.0%) in the seronegative control. Adjusting for age and gender, both control groups were less likely to have VTE than the study group within one year (Seropositive Control: OR = 0.3, 95% CI 0.2-0.5, p <0.0001; Seronegative Control: OR = 0.4, 95% CI 0.2-0.6, p <0.0001). ACS was more likely to occur in the study group, with incidence of 7.7% compared to 4.7% (p <0.0001) in the seropositive control and 1.9% (p <0.0001) in the seronegative control. Adjusting for age and gender, the seronegative control was less likely to develop ACS than the study group within one year (OR = 0.4, 95% CI 0.2-0.7, p = 0.003). Conclusions: This retrospective study demonstrates that CMV infection may be a significant risk factor for VTE and ACS.

Background: Polycystic ovary syndrome (PCOS) is a common endocrinopathy that is highly prevalent in women of Indian ethnicity. Clinical practice guidelines do not adequately consider ethnic-cultural differences in the care of women with PCOS. This study aimed to explore ethnic Indian women’s experiences with PCOS diagnosis and management, their concerns and it’s impact on their quality of life (QoL). Methods: Global online survey of ethnic Indian women of reproductive age living with PCOS. Results: Respondents (n=4409) had a mean age of 26.8 (SD 5.5) years and the majority were diagnosed with one or more co-morbidities (anxiety/depression being the most common). Women waited one year on average before seeking treatment following symptom onset. Irregular periods, cysts on the ovaries and excess unwanted facial hair growth were their three major concerns. Weight and emotional concerns had the greatest impact on QoL. One-third did not receive information on long-term complications, appropriate behavioral advice to improve diet or exercise, or emotional support following diagnosis. Among those who received information at diagnosis, the majority were dissatisfied. Conclusions: Ethnic Indian women wait for a considerable time before seeking medical help for PCOS, have poor QoL relating to weight and mental health and are dissatisfied with the information and support provided at diagnosis. These gaps in care should be addressed in clinical practice and future research.

Neurodegeneration is a major problem in neuroscience and medicine as it causes and worsens many neurological and psychiatric disorders. It involves gradual loss of neurons at different levels of the brain, affecting cognition, emotion, behavior, consciousness, and attention. Understanding the causes and consequences of neurodegeneration is crucial for identifying the risk factors, biomarkers, and treatments. However, the current therapies are mostly symptomatic and ineffective. Therefore, new and innovative methods, such as noninvasive brain stimulation (NIBS), are needed to modulate brain activity and plasticity in a safe and reversible manner. This field is rapidly developing, with a focus on exploring new clinical applications, mechanisms, and combinations of NIBS and drugs. This special issue covers the latest progress and challenges in the study of neurodegeneration in cognitive impairment and mood disorders from the experimental, clinical, and translational perspectives. It addresses the complexity and diversity of these conditions, the lack of disease-modifying treatments, the ethical and practical issues of conducting research in vulnerable and diverse populations, the integration and interpretation of data from multiple sources and modalities, and the development and validation of novel methods such as NIBS, artificial intelligence, and drug repurposing. Collaborative efforts among various stakeholders are needed to improve our knowledge and treatment of neurodegeneration underlying cognitive impairment and mood disorders.

Increased chronic glucose is associated with pandemic diseases. To date, there is not a practical, as well as accurate sample for reflecting that level. We measured earwax glucose in 37 controls. They provided standard serum samples, Glycated Haemoglobin (HbA1c) and earwax samples on two time-points, one month a part. The specimens measured baseline fasting glucose, a follow-up postprandial glucose level and a between sample chronic glucose, calculated using the average level on the two occasions. The baseline earwax sample was obtained using a clinical method and the follow-up using a novel self-sampling earwax device. The earwax analytic time was significantly faster using the novel device in comparison to the clinical use of the syringe. Earwax accurately reflected glucose at both assessments with stronger correlations than HbA1c. Follow-up postprandial concentrations were more significant than their respective fasting baseline concentrations, reflecting differences in fasting and postprandial glycaemia and more efficient standardisation at follow up. Earwax demonstrated to be more predictable than HbA1c in reflecting systemic fasting, postprandial and long-term glucose levels and immune by confounders. Earwax glucose was approximately 60% more predictable than HbA1c in reflecting glycaemia over a month. The self-sampling device provided a sample that might accurately reflect chronic glycaemia.

The combination of statistical learning technologies with large databases of psychophysiological data has appropriately generated enthusiastic interest in future clinical applicability. It is argued here that this enthusiasm should be tempered with the understanding that significant obstacles must be overcome before the systematic introduction of psychophysiological measures into neuropsychiatric practice becomes possible. The nonspecificity of psychophysiological measures complicates their use in diagnosis. Low test-retest reliability complicates use in longitudinal assessment, and quantitative psychophysiological measures can normalize in response to placebo intervention. Ten cautionary observations are introduced and, in some instances, possible directions for remediation are suggested.

Early detection of cancer increases the probability of recovery. This paper presents an intelligent decision support system (IDSS) for the early diagnosis of cancer based on gene expression profiles collected using DNA microarrays. Such datasets pose a challenge because of the small number of samples (no more than a few hundred) relative to the large number of genes (on the order of thousands). Therefore, a method of reducing the number of features (genes) that are not relevant to the disease of interest is necessary to avoid overfitting. The proposed methodology uses the information gain (IG) to select the most important features from the input patterns. Then, the selected features (genes) are reduced by applying the grey wolf optimization (GWO) algorithm. Finally, the methodology employs a support vector machine (SVM) classifier for cancer type classification. The proposed methodology was applied to two datasets (Breast and Colon) and was evaluated based on its classification accuracy, which is the most important performance measure in disease diagnosis. The experimental results indicate that the proposed methodology is able to enhance the stability of the classification accuracy as well as the feature selection

Prion diseases are progressive and irreversible neurodegenerative disorders with a low incidence (1.5–2 cases per million per year). Genetic (10-15%), acquired (anecdotal) and sporadic (85%) forms of the disease have been described. The clinical spectrum of prion diseases is very varied, although the most common symptoms are rapidly progressive dementia, cerebellar ataxia and myoclonus. Mean life expectancy from the onset of symptoms is 6 months. There are currently diagnostic criteria based on clinical phenotype as well as neuroimaging biomarkers (magnetic resonance imaging), neurophysiological tests (electroencephalogram and polysomnogram) and cerebrospinal fluid biomarkers (14-3-3 protein and real-time quaking induced conversion (RT-QuIC)). The sensitivity and specificity of some of these tests (electroencephalogram and 14-3-3 protein) is under debate and the applicability of other tests such as RT-QuIC is not universal. However, the usefulness of these biomarkers beyond the most frequent prion disease, sporadic Creutzfeldt-Jakob disease, remains unclear. Therefore, research is being carried out on new, more efficient cerebrospinal fluid biomarkers (total tau, ratio total tau/phosphorylated tau and neurofilament light chain) and potential blood biomarkers (neurofilament light chain among others) to try to universalize access to early diagnosis in the case of prion diseases.

Tuberculosis (TB) disease still remain a major global threat due to the growing number of drug-resistant species and global warming. Despite the fact that there are new molecular diagnostic approaches, however, majority of developing countries and remote clinics depends on conventional approaches such as Tuberculin test, microscopic examinations and radiographic imaging (Chest X-ray). These techniques are hindered by several challenges which can lead to miss-diagnosis especially when interpreting large number of sample cases. Thus, in order to reduce workload and prevent miss-diagnosis, scientists incorporated computer-aided technology for detection of medical images known as Computer aided Detection (CADe) or Diagnosis (CADx). The use of AI-powered techniques has shown to improve accuracy, sensitivity, specificity. In this review, we discussed about the epidemiology, pathology, diagnosis and treatment of tuberculosis. The review also provides background information on Artificial Intelligence (AI), Machine Learning (ML), Deep Learning (DL), Transfer Learning (TL) and their applications in detection of tuberculosis from both microscopic slide images and X-ray images. The review also proposed an IoT/AI powered system which allows transfer of results obtained from DL models with end users through internet networks. The concept of futuristic diagnosis, limitations of current techniques and open research issues are also discussed.

Safe, high-quality and economical electric energy transportation is the basic requirements of modern power system operation. Transformer, as one of the core equipment of power system and national grid system, has the characteristics of diverse types, variable models and wide deployment. It is the basic equipment for power system to realize voltage change and electric energy distribution. Because the power system transformer needs to operate with load for a long time, the probability of failure is usually higher than that of other power equipment in general. This paper starts from the transformer fault and fault diagnosis. Firstly, the transformer fault types, traditional transformer fault diagnosis techniques and the advantages of machine learning in transformer fault diagnosis are reviewed. Secondly, the application of information system theory and information entropy in transformer fault diagnosis is introduced. Then it introduces machine learning technology, feature selection and extraction technology in transformer fault diagnosis, and machine learning algorithms such as support vector machine and extreme learning machine for transformer fault diagnosis. Finally, the potential development trend of information system theory, information entropy and machine learning in transformer fault diagnosis is forecasted. The combination of transformer fault prediction and machine learning algorithm is helpful for power system maintenance personnel to accurately predict the running state of power equipment, and also provides a new method and technology for the safe and reliable operation and regular maintenance of power system.

An electrocardiograph (ECG) reflects the health of the human heart and is used to help diagnose arrhythmia and myocardial infarction(MI) in clinical practice. Early diagnosis of arrhythmia helps implement preventive measures and plays a crucial role in saving a patient's life. With the increasing demand of clinicians for ECG analysis technology, intelligent detection and diagnosis of ECG signals has become a more efficient means to assist physicians in diagnosing cardiovascular diseases. This paper introduces an ECG diagnosis approach based on an ensemble deep learning combination of CNN(convolutional neural network) and SLAP(stacked-long short term memory architecture for prediction) architecture. ECG data is denoised and further divided into single heartbeats to achieve data standardization and sample diversity. Adam optimizer and BCEwithlogitsloss multi-classification loss function were used to enhance the model effect, and the system achieved the classification effect of 99.3% average accuracy, 99.0% F1-value, and 99.2% sensitivity in MIT-BIH standard database classification. It also shows good generalization ability on the Tianchi data set.

Dirofilaria immitis infection is one of the most severe parasitic diseases of dogs. Prevention is achieved by the administration of drugs containing macrocyclic lactones (MLs). These products are very safe and highly effective, targeting the third and fourth larval stages (L3, L4) of the parasite. Until 2011, claims of ineffectiveness of MLs, reported as “Lack of Efficacy” (LOE), were generally attributed to owners’ non-compliance, or other reason for inadequate preventative coverage. There was solid argumentation that a resistance problem is not likely to occur because of i) the great extent of refugia, ii) the complexity of resistance development to MLs, and iii) the possible big number of genes involved in resistance selection. Nevertheless, today it is unequivocally proven that ML resistant D. immitis strains exist, at least in the Lower Mississippi region, USA. Accordingly, tools have been developed, to evaluate and confirm the susceptibility status of D. immitis strains. A simple, in-clinic, microfilariae suppression test, 14-28 days after ML administration, and a “decision tree” (algorithm), including compliance and preventatives’ purchase history, and testing gaps, may be applied for assessing any resistant nature of the parasite. On the molecular level, specific SNPs may be used as markers of ML resistance, offering a basis for validation of clinically suspected resistant strains. In Europe, no LOE/resistance claims have been reported so far, and the existing conditions (stray dogs, rich wildlife, majority of owned dogs not on preventive MLs treatment) do not favor selection pressure on the parasites. Considering the genetic basis of resistance and the epizootiological characteristics of D. immitis, ML resistance neither establishes easily nor spreads quickly, a fact confirmed by the current known dispersion of the problem, which is limited. Nevertheless, ML resistance may propagate from an initial geographical point, via animal and vector mobility, to other regions, while it can also emerge as an independent evolutionary process in a new area. For these reasons and considering the current chemoprophylaxis recommendations and increasing use of ML endectoparasiticides as a potential selection pressure, it is important to remain vigilant for timely detection of any ML LOE/resistance, in all continents where D. immitis is enzootic.

Diffuse interstitial lung diseases (DILD) are a heterogeneous group of over 200 entities, some with dramatical evolution and poor prognostic. Because of their overlapping clinical, physiopathological and imagistic nature, successful management requires early detection and proper progression evaluation. This paper tests a complex networks (CN) algorithm for imagistic aided diagnosis fitness for the possibility of achieving relevant and novel DILD management data. 65 DILD and 31 normal high resolution computer tomography (HRCT) scans were selected and analyzed with the CN model. The algorithm is showcased in two case reports and then statistical analysis on the entire lot shows that a CN algorithm quantifies progression evaluation with a very fine accuracy, surpassing functional parameters’ variations. The CN algorithm can also be successfully used for early detection, mainly on the ground glass opacity Hounsfield Units band of the scan.

Background To develop and validate the American-English version of the self-reporting Acute Cystitis Symptom Score (ACSS), a suitable tool for diagnosis and patient-reported outcome in female patients with acute uncomplicated cystitis (UC). Methods After certified translation into American-English and cognitive assessment, the clinical validation of the ACSS was performed as an embedded study in a US phase II trial (ClinicalTrials.gov Identifier: NCT03129295). Results A total of 167 female patients with typical symptoms of UC were included in the study following FDA guidance. At Day 1 (diagnosis) the mean(SD) sum score of the six ACSS typical symptoms reached 10.60(2.51). Of 100 patients followed-up last time on Day 5 or 6 (End-of-treatment, EoT), 91 patients showed clinical success according to the favoured ACSS criteria (sum score of typical symptoms 0.98(1.94)). There was no correlation between the severity of symptoms on Day 1 or between clinical success rate at EoT and level of bacteriuria on Day 1. Conclusion The American-English ACSS showed high predictive ability and responsiveness, and excellent levels of reliability and validity. It can now be recommended as the new master version in clinical and epidemiological studies, in clinical practice or for self-diagnosis of women with symptoms of UC.

The diagnosis of a rolling bearing for monitoring its status is critical for maintaining industrial equipment using rolling bearings. The traditional method of diagnosing faults of the rolling bearing has low identification accuracy, which needs artificial feature extraction to enhance the accuracy. 1D-CNN method not only can diagnose bearing faults accurately but also overcome shortcomings of the traditional methods. Different from machine learning and other deep learning models, the 1D-CNN method does not need pre-processing one-dimensional data of rolling bearing’s vibration. Thus, it enhances the processing speed and improves the network structure to have a reasonable design for small sample data sets. This study proposes and tests a 1D-CNN method for diagnosing rolling bearings. By introducing the dropout operation, the method obtains high accuracy and improves the generalizing ability. The experimental results show 99.52% of the average accuracy under a single load and 98.26% under different loads.

Many physiotherapy treatments begin with a diagnosis process. The patient describes symptoms, upon which the physiotherapist decides which tests to perform until a final diagnosis is reached. The relationships between the anatomical components are too complex to keep in mind and the possible actions are abundant. A trainee physiotherapist with little experience naively applies multiple tests to reach the root cause of the symptoms, which is a highly inefficient process. This work proposes to assist students in this challenge by presenting three main contributions: (1) A compilation of the neuromuscular system as components of a system in a Model-Based Diagnosis problem; (2) The PhysIt is an AI-based tool that enables an interactive visualization and diagnosis to assist trainee physiotherapists; and (3) An empirical evaluation that comprehends performance analysis and a user study. The performance analysis is based on evaluation of simulated cases and common scenarios taken from anatomy exams. The user study evaluates the efficacy of the system to assist students in the beginning of the clinical studies. The results show that our system significantly decreases the number of candidate diagnoses, without discarding the correct diagnosis, and that students in their clinical studies find PhysIt helpful in the diagnosis process.

The diagnosis of papillary thyroid carcinoma has always been a concerned and challenging issue and it is very important and meaningful to have a definite diagnosis before the operation. In this study, we tried to use an artificial intelligence algorithm instead of medical statistics to analyze the genetic fingerprint from gene chip results to identify papillary thyroid carcinoma. We trained 20 artificial neural network models with differential genes and other important genes related to the cell metabolic cycle as the list of input features, and apply them to the diagnosis of papillary thyroid cancer in the independent validation data set. The results showed that when we used the DEGs and all genes lists as input features the models got the best diagnostic performance with AUC=98.97% and 99.37% and the accuracy were both 96%. This study revealed that the proposed artificial neural network models constructed with genetic fingerprints could achieve a prediction of papillary thyroid carcinoma. Such models can support clinicians to make more accurate clinical diagnoses. At the same time, it provides a novel idea for the application of artificial intelligence in clinical medicine.

African swine fever (ASF) is one of the major threats to pig production, and real-time PCR (qPCR) protocols are integral part of ASF laboratory diagnosis. With the pandemic spread of ASF, commercial kits have risen on the market. In Germany, the kits have to go through an approval process and thus, general validation can be assumed. However, they were never compared to each other. In this study, 12 commercial PCR kits were compared to an OIE recommended method. Samples representing different matrices, genome loads, and genotypes were included in a panel that was tested under diagnostic conditions. The comparison included user-friendliness, internal controls, and the time required. All qPCRs were able to detect ASFV genome in different matrices across all genotypes and disease courses. With one exception, there were no significant differences when comparing the overall mean. The overall specificity was 100 % [95 % CI 87.66 - 100], and the sensitivity was between 95 % and 100 % [95 % CI 91.11 - 100]. As can be expected, variability concerned samples with low genome load. Concluding, all tests were fit for purpose. The test system can therefore be chosen based on compatibility and prioritization of the internal control system.

The overwhelming majority of bladder cancers are transitional cell carcinomas. Albeit mostly monotonous, carcinomas in the bladder may occasionally display a broad spectrum of histological features that should be recognized by pathologists because some of them represent a diagnostic problem and/or lead prognostic implications. Sometimes these features are focal in the context of conventional transitional cell carcinomas, but some others are generalized across the tumor making its recognition a challenge. For practical purposes, the review distributes the morphologic spectrum of changes in architectural and cytological. So, nested and large nested, micropapillary, myxoid stroma, small tubules and adenoma nephrogenic-like, microcystic, verrucous, and diffuse lymphoepithelioma-like, on one hand, and plasmacytoid, signet ring, basaloid-squamous, yolk-sac, trophoblastic, rhabdoid, lipid/lipoblastic, giant, clear, eosinophilic (oncocytoid), and sarcomatoid, on the other, are revisited. Key histological and immunohistochemical features useful in the differential diagnosis are mentioned. In selected cases, molecular data associated with the diagnosis, prognosis, and/or treatment are also included.

Attempts to use computers to aid in the detection of breast malignancies date back more than 20 years. Despite significant interest and investment, this has historically led to minimal or no significant improvement in performance and outcomes with traditional computer aided detection. However, recent advances in artificial intelligence and machine learning are now starting to deliver on the promise of improved performance. There are at present more than 20 FDA approved AI applications for breast imaging, but adoption and utilization are widely variable and overall low. Breast imaging is unique and has aspects that create both opportunities and challenges for AI development and implementation. Breast cancer screening programs worldwide rely on screening mammography to reduce the morbidity and mortality of breast cancer and many of the most exciting research and available AI applications focus on cancer detection for mammography. There are however multiple additional potential applications for AI in breast imaging including decision support, risk assessment, breast density quantitation, workflow and triage, quality evaluation, response to neoadjuvant chemotherapy assessment, and image enhancement. In this review the current status, availability, and future directions of investigation of these applications are discussed, as well as the opportunities and barriers to more widespread utilization.

Meteorites represent the recoverable portions of asteroids occurring between Mars and Jupiter within the solar system that reach the surface of the Earth. Meteorites are rare extraterrestrial objects studied extensively to improve understanding of planetary evolution. In this work, calibration-free laser-induced breakdown spectroscopy (CF-LIBS) evaluates quantitative elemental and molecular analysis of the Dergaon meteorite, an H 4-5 chondrite fall sample, Assam, India. Spectral signatures of H, N, O, Na, Mg, Al, Si, P, K, Ca, Ti, Cr, Mn, Fe, Co, Ni, Ir, are measured. Along with the atomic emission, this work reports as well molecular emission from FeO molecules. The concentration of the measured elements obtained using CF-LIBS are in close agreement with earlier reports. The elements H, N and O and their concentrations are estimated using CF-LIBS for the first time. This study applies laser spectroscopy to establish presence of Ni, Cr, Co, and Ir in meteorites. Elemental analysis forms the basis for establishment of potential molecular composition of the Dergaon meteorite. Moreover, the elemental analysis approach bodes well for in-situ analyses of extraterrestrial objects including applications in planetary rover missions.

When an aircraft malfunctions, quickly and accurately identifying the faulty unit is essential for ensuring normal operation. Unfortunately, maintenance engineers often struggle to acquire the necessary fault-related knowledge due to poor management and utilization of aircraft fault documents. To address this issue, we introduce knowledge graph technology into the field of aircraft fault diagnosis, exploring its construction and application for effective knowledge management. Our work starts by analyzing the critical knowledge elements required for aircraft fault diagnosis and designing a schema layer for fault knowledge graphs. We then we then combine deep learning and heuristic rules to extract fault knowledge from both structured and unstructured data, enabling the construction of aircraft fault knowledge graphs. Finally, we develop a fault question-answering system based on fault knowledge graphs that can accurately give solutions to questions posed by maintenance engineers. Our practice demonstrates that knowledge graphs provide an effective means of managing aircraft fault knowledge, assisting engineers in locating fault reasons accurately and quickly.

The purpose of this review is to present the current knowledge about the diagnostic and treatment options in bladder cancer (BCa) patients with clinically positive lymph nodes (cN+). In this review compaction of CT and MRI performance in preoperative prediction of lymph node invasion (LNI) in BCa patients was presented, along with other diagnostic methods. Most scientific societies do not distinguish cN+ patients in their guidelines, recommendations concern muscle-invasive bladder cancer (MIBC) and differ between associations. Currently, the standard treatment of patients with MIBC is radical cystectomy (RC) with bilateral pelvic lymph node dis-section (PLND). The template of PLND and its therapeutic value remain debatable. Moreover, most guidelines recommend neoadjuvant chemotherapy (NAC). However, there is still lack of definitive evidence of the superiority of neoadjuvant chemotherapy over adjuvant chemotherapy. Nevertheless, the curative treatment that provides the best long-term survival in cN+ patients is a multimodal approach with a combination of chemotherapy and RC. Recent studies demonstrate the growing importance of immunotherapy. Special attention should be paid to cN+ BCa patients as the oncological outcomes are significantly worse for this group.

Background: Epidemiological surveillance of nursing diagnosis is an approach anchored on a post-modern epidemiology focused on persons health-disease responses. Regarding to public health priorities, the population where our study occurred had as priority problem the arterial hypertension. Related to this chronical disease, nursing diagnoses about health-disease responses in primary healthcare has as major focus Therapeutic Regime Management. Our aim was to study the nursing diagnosis in this issue, from an epidemiological approach. Methods: A descriptive study from an epidemiological approach was developed, analyzing nursing diagnoses in hypertensive patients. Results: We found 17,7% of undiagnosed patients and better diagnoses in patients with complications than in those without complications. Conclusions: nursing records need to be improved in order to promote more robust studies in the post-modern epidemiology defended for the future.

Expert system approach, although quite old, is still quite effective in scientific areas where experts are required to make diagnoses and predictions. One of those areas is fish disease diagnosis. It is an application domain that currently employs complicated processes, which require high level skills for making accurate diagnoses. On the other hand, complete datasets for full diagnosis to be able to use machine learning techniques are not available. Therefore, in aquaculture, now more than ever, fish farmers do not have the required expertise or equipment to accurately diagnose a fish disease. For that reason, expert systems that can help in the diagnosis, prevention and treatment of diseases have been developed. In this paper, we attempt to give an overview of the expert system approaches for fish disease diagnosis developed in the last two decades. Based on the analysis of their technical and non-technical characteristics, we propose an expert system architecture and a fish disease diagnosis process aiming at improving the deficiencies of existing such systems. The proposed system can handle all kinds of fish diseases based on image and non-image data as well as on molecular tests results and can provide explanations. The diagnosis process goes through four consecutive levels, where each next level considers an additional category of parameters and provides diagnoses with higher certainty.

Heart disease is one of the most common diseases in middle-aged citizens. Among the vast number of heart diseases, coronary artery disease (CAD) is considered a common cardiovascular disease with a high death rate. The most popular tool for diagnosing CAD is the use of medical imaging, e.g., angiography. However, angiography is known for being costly and also associated with a number of side effects. Hence, the purpose of this study is to increase the accuracy of coronary heart disease diagnosis by selecting significant predictive features in order of their ranking. In this study, we propose an integrated method using machine learning. The machine learning methods of random trees (RTs), the decision tree of C5.0, support vector machine (SVM), the decision tree of Chi-squared automatic interaction detection (CHAID) are used in this study. The proposed method shows promising results and the study confirms that the RTs model outperforms other models.

The fault diagnosis of safety critical systems such as wind turbine installations includes extremely challenging aspects that motivate the research issues considered in this paper. In fact, the prompt detection and the reliable diagnosis of faults in their earlier occurrence represent the key point especially for offshore installations. For these plants, operation and maintenance procedures in harsh environments would inevitably increase the cost of the energy production. Therefore, this work investigates fault diagnosis solutions that are considered in a viable way and used as advanced techniques for condition monitoring of dynamic processes. To this end, the work proposes the design of fault diagnosis strategies that exploit the estimation of the fault by means of data--driven approaches. This solution leads to the development of effective methods allowing the management of partially unknown information of the system dynamics, while coping with measurement errors, the model--reality mismatch and other disturbance effects. In mode detail, the proposed data--driven methodologies exploit fuzzy systems and neural networks in order to estimate the nonlinear dynamic relations between the input and output measurements of the considered process and the faults. To this end, the fuzzy and neural network structures are integrated with auto--regressive with exogenous input descriptions, thus making them able to approximate unknown nonlinear dynamic functions with arbitrary degree of accuracy. Once these models are estimated from the input and output data measurement acquired from the considered dynamic process, the capabilities of their fault diagnosis capabilities are validated by using a high--fidelity benchmark that simulates the healthy and the faulty behaviour of a wind turbine system. Moreover, at this stage the benchmark is also useful to analyse the robustness and the reliability characteristics of the developed tools in the presence of model--reality mismatch and modelling error effects featured by the wind turbine simulator. On the other hand, a hardware--in--the--loop tool is finally implemented for testing and comparing the performance of the developed fault diagnosis strategies in a more realistic environment and with respect to different fault diagnosis approaches.

Background: Liquid biopsies are revolutionary tools to detect tumor-specific genetic alterations in body fluids, and cell-free DNA (cfDNA) can be used for molecular diagnosis in cancer patients. In brain tumors cerebrospinal fluid (CSF) cfDNA might be more informative than plasma cfDNA. Here, we assess the use of CSF cfDNA in pediatric embryonal brain tumors (EBT) for molecular diagnosis. Methods: CSF cfDNA of pediatric patients with medulloblastoma (n=18), ATRT (n=3), ETMR (n=1), CNS NB FOXR2 (n=2) and pediatric EBT NOS (n=1) (mean cfDNA concentration 48 ng/mL; range 4-442 ng/mL) and matched tumor genomic DNA were sequenced by WES, and/or a targeted sequencing approach, to determine single nucleotide variations (SNVs)/copy number alterations (CNA). A specific capture covering transcription start sites (TSS) of genes of interest was used for nucleosome footprinting in CSF cfDNA. Results: 15/25 CSF cfDNA samples yielded informative results, with informative CNA and SNVs in 11 and 15 cases, respectively. For cases with paired tumor and CSF cfDNA WES (n=15), a mean of 83 (range 1-160) shared SNVs was observed, including SNVs in classical medulloblastoma genes such as SMO and KMT2D. Interestingly, tumor-specific SNVs (mean 18; range 1-62) or CSF-specific SNVs (mean 5; range 0-25) were observed suggesting clonal heterogeneity. The TSS panel resulted in differential coverage profiles across all 112 studied genes in 7 cases, indicating distinct promoter accessibility. Conclusion: CSF cfDNA sequencing yielded informative results in 60% of cases (15/25), with WES feasible in 83% (15/18). These results pave the way for implementation of these novel approaches for molecular diagnosis and minimal residual disease monitoring.

Male breast cancers are uncommon, as men account for less than 1 percent of all breast carcinomas. Among the predisposing risk factors for male breast cancer, the following appear to be significant: a) breast/chest radiation exposure, b) estrogen use, diseases associated with hyper-estrogenism, such as cirrhosis or Klinefelter syndrome, and c) family health history. Furthermore, there are clear familial tendencies, with a higher incidence among men who have a large number of female relatives with breast cancer and d) major inheritance susceptibility. Moreover, in families with BRCA mutations, there is an increased risk of male breast cancer, although the risk appears to be greater with inherited BRCA2 mutations than with inherited BRCA1 mutations. Due to diagnostic delays, male breast cancer is more likely to present at an advanced stage. A core biopsy or a fine needle aspiration must be performed to confirm suspicious findings. Infiltrating ductal cancer is the most prevalent form of male breast cancer, while invasive lobular carcinoma is extremely uncommon. Male breast cancer is almost always positive for hormone receptors. A worse prognosis is associated with a more advanced stage at diagnosis for men with breast cancer. And randomized controlled trials which recruit both female and male patients should be developed in order to gain more consistent data on the optimal clinical approach.

Breast cancer represents the most frequent cancer and the leading cause of cancer death among women. Thus, the prevention and early diagnosis of breast cancer appears to be of primary urgency as well as the development of new treatments able to improve its prognosis. Nerve Growth Factor (NGF) is a neurotrophic factor that plays a key role in the regulation of neuronal functions thought the binding to the Tropomyosin receptor kinase A (TrkA) and the Nerve Growth Factor receptor or Pan-Neurotrophin Receptor 75 (NGFR/p75NTR). Also, its precursor (pro-NGF) can extert biological activity by forming a trimeric complex with NGFR/p75NTR and sortilin or by binding to TrkA receptors with low affinity. Both in vitro and in vivo studies showed that NGF is synthesized and released by breast cancer cells and has mitogen, antiapoptotic and angiogenic effects on these cells through the activation of different signaling cascades that involve TrkA and NGFR/p75NTR receptors. Conversely, pro-NGF signaling has been related to breast cancer invasion and metastasis. Other studies suggested that NGF and its receptors could represent a good diagnostic and prognostic tool, as well as promising therapeutic targets for breast cancer. Here, we comprehensively summarize and systematically review the current experimental evidence on this topic.

One of the most dangerous diseases that threaten people is Cancer. Cancer if diagnosed in earlier stages can be eradicated with its life threatening consequences. In addition, accuracy in prediction plays a major role. Hence, developing a reliable model that contributes much towards the medical community in early diagnosis of Biopsy images with perfect accuracy come to the scenario. The article aims towards development of better predictive models using multi-variate data and high-resolution diagnostic tools in clinical cancer research. This paper proposes the social spider optimization (SSO) algorithm tuned neural network to classify microscopic biopsy images of cancer. The significance of the proposed model relies on the effective tuning of the weights of the NN classifier by the SSO algorithm. The performance of the proposed strategy is analysed with the performance metrics, such as accuracy, sensitivity, specificity, and MCC measures, and are attained to be 95.9181%, 94.2515%, 97.125%, and 97.68% respectively, which shows the effectiveness of the proposed method in effective cancer disease diagnosis.

In order to overcome this problem our group designed a novel machine learning technique, multivariate linear method (MLM) which can capture convergent data from voxel-based morphometry, functional resting state and task-related neuroimaging and the relevant clinical measures. In this paper we report results from convergent cross-validation of biological signatures of disease in a sample of patients with schizophrenia as compared to depression. Our model provides evidence that the combination of the neuroimaging and clinical data in MLM analysis can inform the differential diagnosis in terms of incremental validity to reach 90 % accuracy of the prediction.

A patient in her early 20s presented with constant and progressive lower abdominal and back pain, mainly on the right side of the abdomen, purulent vaginal discharge and pyrexia. Radio-logical assessment revealed a possible tuboovarian abscess and incidental diagnosis of ipsilateral renal agenesis. The patient was treated for pelvic inflammatory disease (PID), however after antibiotic administration and since the symptoms were not resolving, an abdominal MRI was requested which revealed a uterus didelphys with two cervices, an obstructed haemivagina and evidence of haematocolpos. The diagnosis of OHVIRA syndrome was confirmed and the patient underwent an excision of the vaginal septum, drainage of the haematopyocolpos and laparoscopic drainage of the tuboovarian abscess. She achieved a good recovery.

Borderline Personality Disorder (BPD) is a complex and severe mental disorder. It is associated with greater use of medical services. It is characterized by intense fear of abandonment, recurring suicidal thoughts or self-harm, paranoid ideation or dissociation, identity difficulties, chronic feelings of emptiness, impulsive behavior and unstable moods and relationships. BPD is one of the most prevalent personality disorders with a higher diagnosis in females. For a diagnosis of BPD in patients, they must have a chronic pattern of functional impairment in addition to five of nine listed DSM-5 criteria. This review was a narrative literature search between 2000 to 2023 with a focus on BPD comorbidities. Results: Researchers observed a complex pattern of comorbidities with BPD that connects with other externalizing and internalizing disorders. BPD has a high comorbidity rate with mood disorders including bipolar I and II disorders, major depressive disorder, anxiety disorders, panic disorder alcohol use disorder, nicotine dependence, marijuana dependance, posttraumatic stress disorder, other personality disorders, binge eating disorder and ADHD. Diagnosis and management of BPD in presence of some of these disorders are discussed.

Background: The liver is involved in disseminated tuberculosis in more than 80% of the cases while primary liver involvement is rare, representing < 1% of all cases. Hepatic tuberculosis (TB) can be treated by conventional anti-TB therapy, however, diagnosing this disease still remains a challenge. The diagnosis might be particularly difficult in patients with a single liver lesion that could be misdiagnosed as a tumor or other focal liver lesions. While computed tomography and magnetic resonance imaging findings have been described, there is a paucity of literature on contrast-enhanced ultrasound (CEUS) features of hepatic TB. Case Summary: herein, we describe a case of a patient with tuberculous lymphadenopathy and chronic HCV-related liver disease who developed a single macronodular hepatic TB lesion. Due to the finding of a hepatocellular carcinoma (HCC) highly suggestive CEUS pattern, specifically a LR5 category according to the Liver Imaging Reporting and Data System (LI-RADS), and a good response to antitubercular therapy, a non-invasive diagnosis of HCC was made, and the patient underwent liver resection. We also review the published literature on imaging features of hepatic TB and discuss the diagnostic challenge represented by hepatic TB when occurs as a single focal liver lesion. Conclusions: this report shows for the first time that CEUS pattern of hepatic TB might be misinterpreted as HCC and specific imaging features are lacking. Personal history and epidemiological data are mandatory in interpreting CEUS findings of a focal liver lesion even when the imaging pattern is highly suggestive of HCC.

Objective: Radiomics and deep transfer learning are two popular technologies used to develop computer-aided detection and diadnosis (CAD) schemes of medical images. This study aims to investigate and compare advantages and potential limitations of applying these two technologies in developing CAD schemes. Methods: A relatively large and diverse retrospective dataset including 3,000 digital mammograms is assembled in which 1,496 images depict malignant lesions and 1,054 images depict benign lesions. Two CAD schemes are developed to classify breast lesions. The first scheme is developed using four steps namely, applying an adaptive multi-layer topographic region growing algorithm to segment lesions, computing initial radiomics features, applying a principal component algorithm to generate an optimal feature vector, and building a support vector machine classifier. The second CAD scheme is built based a pre-trained residual net architecture (ResNet50) as a transfer learning model to classify breast lesions. Both CAD schemes are trained and tested using a 10-fold cross-validation method. Several score fusion methods are also investigated to classify breast lesions. CAD classification performance is evaluated by the area under ROC curve (AUC). Results: ResNet50 model-based CAD scheme yields AUC = 0.85±0.02, which is significantly higher than radiomics feature-based CAD scheme with AUC = 0.77±0.02 (p < 0.01). Additionally, fusion of classification scores generated by two CAD schemes does not further improve classification performance. Conclusion: This study indicates that using deep transfer learning is more efficient to develop CAD schemes and enables to yield higher lesion classification performance than CAD schemes developed using radiomics-based technology.

Abstract: Female pelvic floor dysfunction (FPFD) is a series of conditions caused by the displacement or dysfunction of the patient's pelvic organs due to defects, injuries, and deterioration of the pelvic floor supportive structures, with stress urinary incontinence and pelvic organ prolapse being the most common. The mechanism of pelvic floor dysfunction is complex and not yet fully understood, and is often related to one or more functional abnormalities of muscles, connective tissues, fascia, nerves and blood vessels. Specialized clinicians are often unable to cover the comprehensive medical professional information of various specialties such as gynecology and obstetrics, urology, anus and intestines, imaging, etc., and the systematic and comprehensive diagnosis and treatment of the disease will be limited. The application of artificial intelligence concepts in the medical field not only improves the diagnostic efficiency of physicians, but also provides reference and basis for the development of comprehensive treatment programs. This article follows and draws on the diagnosis and treatment process of pelvic floor dysfunction recommended in various guidelines, incorporates physical therapy techniques into the conventional non-surgical treatment of pelvic floor dysfunction, provides guidance for the diagnosis and treatment of pelvic floor dysfunction, and briefly introduces the clinical application and value of pelvic floor intelligent diagnosis and treatment in pelvic floor dysfunction.

The difficulty in the clinical diagnosis of labor is due to an evolutionary mismatch. The ability to hide the signs and symptoms of labor is an evolutionary trait that was once advantageous, but became maladaptive due to environmental changes. Prospective diagnosis of labor is not possible with certainty using only clinical criteria; however, by analyzing the urinary metabolome of women in labor, this diagnosis is likely possible in all cases. In this review, we explain why the two methods (clinical and metabolomic) differ in efficacy and sensitivity, and we try to fit this difference into an evolutionary framework that explains these discrepancies considering evolutionary mismatch. The study of metabolomics allows the truth to emerge from the past, and the diffusion of metabolomic techniques and their application to clinical reality in the form of POC (Point of Care) could change the management of labor and childbirth in the future.

The recent COVID-19 pandemic has caused tremendous damage to social economy and people’s health. Some major issues fighting COVID-19 include early and accurate diagnosis and the shortage of ventilator machines for critical patients. In this work, we propose a closed-loop solution to deal with COVID-19: portable biosensing and wearable photoacoustic imaging for early and accurate diagnosis of infection and magnetically neuromodulation or minimally invasive electrical stimulation to replace the traditional ventilation. Proposed technique can guarantee ubiquitous and onsite detection, and electrical hypoglossal stimulator can be more effective in helping severe patients as well as reducing complications caused by ventilators.

Background: Transient Hypogammaglobulinemia of Infancy (THI) is a primary immunodeficiency caused by a temporary decline of serum levels of immunoglobulin G (IgG) greater than 2 standard deviations below the mean age-specific reference values in an infant between 5 and 24 months of age. Preterm infants are particularly susceptible to THI, as, in the third trimester of pregnancy, IgG is transferred across the placenta from mother to infant.Objective: To systematically review the diagnostic criteria of Transient Hypogammaglobulinemia of infants.Design & Methods: Systematic Review. Manual searching of 3 electronic databases (PubMed, Medline, & Google Scholar) from September 2021 – April 2022. Abstracts were screened to assess fit to the inclusion criteria. Data was extracted from the selected studies by using an adapted extraction tool from Cochrane.org. Studies were then assessed for bias by using an assessment tool also adapted from Cochrane.org.Results: Of the 215 articles identified, 16 were eligible for examining the diagnostic criteria of THI. These studies were also assessed for bias in 6 domains. 5 studies (31%) had a low risk of bias, while 4 studies (25%) had a high risk of bias, & 7 studies (44%) were unclear for bias.Conclusion: We can conclude that THI is only definitively diagnosed after the abnormal IgG levels have normalized, hence THI is mostly a benign condition, but must be monitored for subsequent recurrent infections. The diagnostic criterion also includes vaccine & isohaemagglutinin responses to differentiate against other immunological disorders in infants.

Background and Objectives: Overuse and inappropriate use of testing and hospital admission are common in syncope evaluation and management. Though guidelines are available to optimize syncope care, study suggested that the current clinical guidelines have not significantly impacted resource utilization surrounding emergency department (ED) evaluation of syncope. Matching implementation strategies to barriers and facilitators and tailoring strategies to local context hold significant promise for a successful implementation of clinical practice guideline (CPG). Our team applied implementation science principles to develop a stakeholder-based implementation strategy. Methods and Materials: We partnered with patients, family caregivers, frontline clinicians and staff, and health system administrators at four health systems to conduct quantitative surveys and qualitative interviews for context assessment. The identification of implementation strategies was done by applying the CFIR-ERIC Implementation Strategy Matching Tool and soliciting stakeholders’ inputs. We then co-designed with patients and frontline teams, developed and tested specific strategies. Results: 114 clinicians completed surveys and 32 clinicians and stake-holders participated in interviews. Results from the surveys and interview indicated low awareness of syncope guidelines, and communication challenges with patients, lack of CPG protocol integration into ED workflows, and organizational process to change were recognized as major barriers. Thirty-one patients and their family caregivers participated in interviews and ex-pressed their expectations: clarity regarding their diagnosis, context surrounding care plan and diagnostic testing, and a desire to feel cared about. After identifying change methods to address those barriers, the multilevel, multicomponent implementation strategy, MISSION, included pa-tient educational materials, mentored implementation, academic detailing, Syncope Optimal Care Pathway and corresponding Mobile App, and Lean quality improvement methods. The pilot of MISSION demonstrated feasibility, acceptability and initial success on appropriate testing. Con-clusions: Effect multifaceted implementation strategies that target individuals, teams, and healthcare systems can be employed to plan successful implementation and promote adherence to syncope CPGs.

Background: Esophageal cancer was hardly diagnosed in early stage, and more potential biomarkers should be found. Methods: 252 patients and normal controls which recruited in Renmin Hospital of Wuhan University, were divided into esophageal carcinoma group (105 cases), disease control group (75 cases) and the control group of healthy people (72 cases). Moreover, TISIDB and GEPIA databases were used to investigate the different expression of EC and normal tissues, and explore the roles of C1q in tumor-immune system interactions in EC. Results: The concentration of serum C1q in EC group is 196.8(180~219.4) mg/L, which is higher than the level of DC [178.10(153.70~200.85) mg/L]and HC [183.00(167.75~201.00) mg/L] (P<0.05). A higher expression level of C1q was observed in Ⅲ and Ⅳ grades [214(192~237.3) mg/ml] than grades Ⅰ and Ⅱ [180.95(172.03~193.85) mg/L] (P<0.05). C1q was positively correlated with eosinophils, active CD8 T cells, myeloid derived suppressor cells, natural killer cells, monocytes and macrophages (r = 0.373; r = 0.659; r = 0.846; r = 0.760; r = 0.499; r = 0.757; P<0.05). Conclusion: The concentrations of C1q increased in EC and related to the severity of EC, which had potential value of diagnosis of EC. There were correlations in C1q and tumor-infiltrating lymphocytes.

A broad spectrum of lesions, including hyperplastic, metaplastic, inflammatory, infectious, and reactive, may mimic cancer all along the urinary tract. This narrative collects most of them from a clinical and pathologic perspective offering urologists and general pathologists their most salient definitory features. Together with classical, well-known, entities such as urothelial papillomas (conventional and inverted), nephrogenic adenoma, polypoid cystitis, fibroepithelial polyp, prostatic-type polyp, verumontanum cyst, xanthogranulomatous inflammation, reactive changes secondary to BCG instillations, schistosomiasis, keratinizing desquamative squamous metaplasia, post-radiation changes, vaginal-type metaplasia, endocervicosis/endometriosis (müllerianosis), malakoplakia, florid von Brunn nest proliferation, cystitis/ureteritis cystica and glandularis, among others, still other cellular proliferations with concerning histological features and poorly understood etiopathogenesis like IgG4-related disease, PEComa, and pseudosarcomatous myofibroblastic proliferations (post-operative spindle cell nodule, inflammatory myofibroblastic tumor), are reviewed. Some of these diagnoses are problematic for urologists, other for pathologists, and still others for both. Interestingly, the right identification of their definitory features will allow their correct diagnoses thus avoiding overtreatment. The literature selected for this review also focuses on the immunohistochemical and/or molecular data useful to delineate prognosis.

Delineating the epidemic of vaccine injury from the coterminous condition long covid is a challenging prospect, but one with many implications not just for treatment, but also has important legal considerations for settlements of vaccine injury. The shared etiological factor of the spike protein in both vaccine injury and long covid make differentiation difficult, and while treatment is largely similar between vaccine injury and long covid, there are important distinctions. Furthermore, diagnostics are important for monitoring treatment progress and assessing the extent of subclinical vaccine injury in population having received a covid-19 vaccine. The development of rigorous diagnostics is an important step towards the recognition of both long covid and vaccine injury, as those suffering these conditions have faced immense challenges in having their conditions recognized, treated, and compensated by insurance companies or national health services.