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Objectives Animals Procedures Results Conclusions Keratoconjunctivitis sicca (KCS) is characterized by decreased aqueous tear film components, leading to ocular surface damage. Diagnosis involves clinical examination, Schirmer Tear Test (STT1), and Tear Film Break‐Up Time (TFBUT) measurement. This retrospective study aimed to assess dry eye syndrome in intact, purebred, Aksaray Malakli breed dogs, and investigate potential associations with hereditary ocular diseases due to inbreeding for phenotype preservation.Fifty healthy, purebred, intact Aksaray Malakli dogs of varying ages and sexes, all exhibiting conjunctival hyperemia and mucoid ocular discharge. Dogs with chronic diseases, systemic medication, or ongoing ophthalmic treatment were excluded.Demographic data, ophthalmic examination results, and ocular anomalies were recorded. STT1 and TFBUT assessments were performed to measure tear production and film stability. STT1 values were scored from 1 (normal) to 4 (severe dry eye), and TFBUT ≥20 s was considered normal. Statistical analyses were used to evaluate correlations and differences.The correlation between age and STT1 values (r = −.182, p = .206) was not statistically significant. Mean STT1 was higher in females than males, though not significantly (p = .849). Dogs without third eyelid gland prolapse had significantly higher STT1 and TFBUT measurements compared to those with prolapse (p = .027). No significant sex difference was found in the frequency of third eyelid prolapse (p = .289). A significant positive correlation was observed between STT1 and TFBUT (r = .924; p < .001).Aksaray Malakli dogs, particularly those with third eyelid gland prolapse, are predisposed to mild to moderate KCS. These findings suggest the need for further clinical and genetic investigations to better understand and manage dry eye syndrome in this breed. [ABSTRACT FROM AUTHOR]

Chemical studies usually consist of measurements made on large ensembles of molecules with data representing average values for the population. It has been shown that individual molecules of a given enzyme have different properties. Large-scale averaging has in the past masked these differences. Alkaline phosphatase has been used as a model to study this enzyme heterogeneity. The catalytic rates of the individual molecules have been found to differ by over 10-fold, and the activation energy of catalysis by more than two-fold. Differences in properties indicate that differences in structure must exist between the molecules. For alkaline phosphatase, the structural differences have been suggested to be differences in glycosylation, differences due to partial proteolysis, and due to some molecules containing mixtures of active and inactive subunits. The determination of the distribution of activities of populations of this enzyme within a sample has also been shown to be a useful tool in diagnostics. This review discusses the advent of single-molecule enzymology and summarizes its use in the study of alkaline phosphatase using capillary electrophoresis, microscopic well assays, and single-molecule tracking. [ABSTRACT FROM AUTHOR]

Background: One of the main challenge for controlling the morbidity and mortality related to malaria is the absence of reliable treatment and precise diagnostic tools in malaria-prone regions. Despite the number of diagnostic techniques used, and inconsistent results were found from previous studies. The aim of this study is to assess the effectiveness of 18S nested PCR(Polymerase Chain Reaction),microscopy, and CarestartTMpf/pan RDT(Rapid Diagnostic Tests) as malaria diagnostic methods using Microscopy and 18S nested PCR as reference techniques. Methods: A facilities and community based cross-sectional study was conducted in the villages of Batodegama kebele and Adama malaria control center from December 2016 to February 2017. A fingerprick blood sample was collected from each participant for the CarestartTM pf/pan RDT test, microscopy, and dry blood spot (DBS) analysis and 18S nested PCR assay. Data were analyzed using STATA11 to calculate the sensitivity, specificity, predictive values, and accuracy. Results: Among the 128 asymptomatic patients, 26 (20.3%) were positive for malaria nested 18S PCR, 5 (3.9%) through RDT, and 8 (6.3%) through microscopy. From 202 symptomatic Patients, 55 (27.23%), 26 (12.87%), and 28 (13.86%) individuals were positive for 18S nested PCR, RDT, and microscopy, respectively. Comparative analysis of 18S nested PCR, microscopy, and CarestartTMpf/pan RDT have similar sensitivities of 50% and specificities of 100%.for diagnosing symptomatic malaria infections. Furthermore, species level analysis showed that 18S nested PCR has a higher detection rate of 26 (20.31%) than microscopy 8 (6.25%) and CareStartTM pf/pan RDT 5 (4.1%). The CarestartTMpf/pan RDT had a sensitivity of 15.4% and specificity of 98% in detecting asymptomatic malaria infections. However, the two methods have comparable sensitivities. Conclusions: The 18S nested PCR assay showed superior performance in all circumstances. On the other hand, the overall performance of CareStart TM pf/pan RDTs was found to be comparable to that of microscopy. This finding highlights the value of parallel application of CareStart TM pf/pan RDTs and microscopy in a resource-limited setup. [ABSTRACT FROM AUTHOR]

Background: Delirium is an acute and fluctuating disturbance in attention, awareness, and cognition, commonly observed in hospital settings, particularly among older adults, critically ill and surgical patients. Delirium poses significant challenges in patient care, leading to increased morbidity, mortality, prolonged hospital stays, and functional decline. Aim: The aim of this review is to map existing evidence on delirium diagnostic tools suitable for use in patients treated surgically due to hip fracture, to inform clinical practice and enhance patient care protocols in the postoperative setting. Method: We will conduct a scoping review on delirium diagnostic tools used for adult patients in the postoperative setting according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR). Eligibility criteria encompass all languages, publications dates, and study designs, with exception of case‐reports. We will systematically search multiple databases and include unpublished trials, ensuring a comprehensive review based on a predefined protocol. Results: Results will be presented descriptively, with supplementary tables and graphs. Studies will be grouped by design, surgical specialties, and diagnostic tools to identify potential variations. Conclusion: This scoping review will provide an overview of existing delirium diagnostic tools used in the postoperative setting and highlight knowledge‐gaps to support future research. Due to the large number of patients affected by postoperative delirium, evidence mapping is much needed to facilitate evidence‐based practice. [ABSTRACT FROM AUTHOR]

Zulipikaer Maimaiti, Liang Liu Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, People’s Republic of ChinaCorrespondence: Liang Liu, Email Liuliang@ccmu.edu.cnBackground: Bone and joint infections (BJIs) are challenging to diagnose. This study evaluated the utility of 16S rRNA gene sequencing in diagnosing BJIs, comparing it with conventional bacterial culture to explore microbial diversity in orthopedic infections.Methods: Thirty patients with BJIs were enrolled from January 2019 to September 2020 at a single orthopedic center. Diagnoses were based on the Musculoskeletal Infection Society standards. DNA extraction, 16S rRNA sequencing, and microbial composition analysis were performed. Conventional bacterial culture results were compared with metagenomics detection, and associations with blood routine and biochemical test factors were analyzed.Results: The study enrolled 30 patients with BJIs. Traditional bacterial culture successfully identified pathogens in 60% (18/30) of cases, predominantly Staphylococcus aureus. In contrast, 16S rRNA metagenomics sequencing revealed distinct microorganisms in all cases, it unveiled a diverse microbial landscape. The correlation between bacterial culture and metagenomics detection showcased both concordance and discrepancies. Consistency of detection between the two methods showed that metagenomics detection detected the same genus or species in 14 (87.5%) of the 16 samples identified as species by bacterial culture. In nearly half of the patients with negative cultures, pathogenic microorganisms were detected, highlighting the capability of 16S rRNA sequencing to identify microorganisms, even in samples with negative or unidentified culture results. Moreover, no significant correlation was observed between bacterial culture, metagenomics detection and the factors of blood routine and biochemical test.Conclusion: This study deepens our understanding of the microbial complexity in BJIs. While traditional culture methods are cost-effective and practical, 16S rRNA gene sequencing proves valuable for complementary microbial analysis, particularly when traditional methods fail or rapid identification is critical. This emerging diagnostic approach can enhance the accuracy and speed of pathogen identification, enabling more effective interventions in the management of BJIs.Keywords: bone and joint infections, 16S rRNA gene sequencing, microbial complexity, diagnostic tool, clinical management

Abstract Background One of the main challenge for controlling the morbidity and mortality related to malaria is the absence of reliable treatment and precise diagnostic tools in malaria-prone regions. Despite the number of diagnostic techniques used, and inconsistent results were found from previous studies. The aim of this study is to assess the effectiveness of 18S nested PCR(Polymerase Chain Reaction),microscopy, and CarestartTMpf/pan RDT(Rapid Diagnostic Tests) as malaria diagnostic methods using Microscopy and 18S nested PCR as reference techniques. Methods A facilities and community based cross-sectional study was conducted in the villages of Batodegama kebele and Adama malaria control center from December 2016 to February 2017. A fingerprick blood sample was collected from each participant for the CarestartTM pf/pan RDT test, microscopy, and dry blood spot (DBS) analysis and 18S nested PCR assay. Data were analyzed using STATA11 to calculate the sensitivity, specificity, predictive values, and accuracy. Results Among the 128 asymptomatic patients, 26 (20.3%) were positive for malaria nested 18S PCR, 5 (3.9%) through RDT, and 8 (6.3%) through microscopy. From 202 symptomatic Patients, 55 (27.23%), 26 (12.87%), and 28 (13.86%) individuals were positive for 18S nested PCR, RDT, and microscopy, respectively. Comparative analysis of 18S nested PCR, microscopy, and CarestartTMpf/pan RDT have similar sensitivities of 50% and specificities of 100%.for diagnosing symptomatic malaria infections. Furthermore, species level analysis showed that 18S nested PCR has a higher detection rate of 26 (20.31%) than microscopy 8 (6.25%) and CareStartTM pf/pan RDT 5 (4.1%). The CarestartTMpf/pan RDT had a sensitivity of 15.4% and specificity of 98% in detecting asymptomatic malaria infections. However, the two methods have comparable sensitivities. Conclusions The 18S nested PCR assay showed superior performance in all circumstances. On the other hand, the overall performance of CareStart TM pf/pan RDTs was found to be comparable to that of microscopy. This finding highlights the value of parallel application of CareStart TM pf/pan RDTs and microscopy in a resource-limited setup.

Abstract Asthma underdiagnosis and overdiagnosis remain significant problems for healthcare systems worldwide and indicate considerable pain points with current guidelines and diagnostic methods; therefore, new, targeted approaches seem crucial. This study introduces a novel spirometry-based approach using digital tools for objective asthma diagnosis support. This was a single-centre (Warsaw Medical University, Poland) prospective cohort study. It included adults with suspected asthma per GINA 2020, without confirmed obstruction in ambulatory spirometry. Patients were equipped and trained with a portable spirometer with built-in manoeuvre quality features AioCare® (HealthUp, Poland). The protocol included twice-daily spirometry examinations over four weeks and symptom reporting in the mobile app. The number of obstructions detected, probability of finding obstruction over time, spirometry values’ variability, technical correctness, and reported symptoms were evaluated. 26 patients enrolled (14 females, mean age 37.6 years old, BMI 24.7 kg/m^2), with a primary outcome of observed obstruction in 42% of participants (3.08 per patient, 95%CI: 0.78–5.37). The detection probability of obstruction plateaued at 100% within the first 21 days of monitoring. Diurnal PEF and FEV1 variability were exceeded (≥ 10%) in 73% and 66% of patients, respectively. 88% of participants performed over half of their tests correctly. 85% of patients reported symptoms at least once. The Spirometry Holter is a novel and feasible tool for monitoring airway limitation variability in line with GINA guidelines. It shows promise in objectively supporting asthma diagnoses in treatment-naive patients lacking documented prior obstruction.

Abstract Exosomes are extracellular vesicles well known for facilitating cell-to-cell communication by distributing essential macromolecules like proteins, DNA, mRNA, lipids, and miRNA. These vesicles are abundant in fluids distributed throughout the body, including urine, blood, saliva, and even bile. They are important diagnostic tools for breast, lung, gastrointestinal cancers, etc. However, their application as cancer biomarkers has not yet been implemented in most parts of the world. In this review, we discuss how OMICs profiling of exosomes can be practiced by substituting traditional imaging or biopsy methods for cancer detection. Previous methods like extensive imaging and biopsy used for screening were expensive, mostly invasive, and could not easily provide early detection for various types of cancer. Exosomal biomarkers can be utilized for routine screening by simply collecting body fluids from the individual. We anticipate that the use of exosomes will be brought to light by the success of clinical trials investigating their potential to enhance cancer detection and treatment in the upcoming years. Graphical Abstract

Eucalyptus spp. in plantations are negatively affected by canker and wilt diseases caused by several species of Ceratocystis , particularly those in the Latin American Clade (LAC). Ceratocystis eucalypticola and Ceratocystis manginecans are of particular concern where disease epidemics are reported globally, with recent outbreaks emerging in South African and Indonesian Eucalyptus plantations. Consequently, a rapid screening protocol is required for these pathogens. In this study, a high-resolution melting curve analysis (HRMA) was developed to detect C. eucalypticola and C. manginecans that bypasses time-consuming isolation and post-PCR procedures. Primers targeting a 172 bp region of the cerato-platanin (CP) gene were designed. Using these primers, the accuracy of HRMA to detect and distinguish between these two LAC species was assessed using pure fungal DNA, and DNA extracted directly from Eucalyptus samples naturally infected with C. eucalypticola. The assay accurately detected the presence of C. eucalypticola and C. manginecans and quantifies their DNA, both from cultures, and directly from wood samples. HRMA further differentiated these two species from all other tested LAC individuals. This assay was also able to detect the presence of all the tested LAC species and distinguish seven of these, including C. fimbriata, to species level. Ceratocystis polyconidia was the only non-LAC off-target species detected. Based on these results, the developed assay can be used to rapidly identify C. eucalypticola and C. manginecans directly from infected plant material or fungal cultures, with the potential to also screen for several other LAC species. • Rapid diagnostic assay to detect and differentiate C. eucalypticola and C. manginecans in the form of a qPCR-HRMA assay. • The assay can identify C. eucalypticola and C. manginecans from fungal cultures or directly from infected plant material. • The assay shows the potential to be used for other species in the LAC. [ABSTRACT FROM AUTHOR]

Introduction: Long‐read whole genome sequencing like Oxford Nanopore Technology, is increasingly being introduced in clinical settings. With its ability to simultaneously call sequence variation and DNA modifications including 5‐methylcytosine, nanopore is a promising technology to improve diagnostics of imprinting disorders. Methods: Currently, no tools to analyze DNA methylation patterns at known clinically relevant imprinted regions are available. Here we present NanoImprint, which generates an easily interpretable report, based on long‐read nanopore sequencing, to use for identifying clinical relevant abnormalities in methylation levels at 14 imprinted regions and diagnosis of common imprinting disorders. Results and conclusion: NanoImprint outputs a summarizing table and visualization plots displays methylation frequency (%) and chromosomal positions for all regions, with phased data color‐coded for the two alleles. We demonstrate the utility of NanoImprint using three imprinting disorder samples from patients with Beckwith‐Wiedemann syndrome (BWS), Angelman syndrome (AS) and Prader‐Willi syndrome (PWS). NanoImprint script is available from https://github.com/carolinehey/NanoImprint. [ABSTRACT FROM AUTHOR]

We describe the development and analysis of an online diagnostic tool implemented in the Numbas elearning system and used in an Australian university mathematics refresher program. Following the rapid transition to online delivery of the refresher program caused by COVID-19, the diagnostic instruments and methods used within the pre-pandemic, in-person, version of the program were lost. In 2022, we undertook to revive them in a way that would honour their original diagnostic purpose but offer a more sophisticated approach utilising the Numbas diagnostic exam type. Improvement of the tool after its initial deployment has involved the use of Rasch-based item analysis and recursive refinement of the knowledge map underlying the items. [ABSTRACT FROM AUTHOR]

Background/Aim: In this study, we introduce an innovative deep-learning model architecture aimed at enhancing the accuracy of detecting and classifying organizing pneumonia (OP), a condition characterized by the presence of Masson bodies within the alveolar spaces due to lung injury. The variable morphology of Masson bodies and their resemblance to adjacent pulmonary structures pose significant diagnostic challenges, necessitating a model capable of discerning subtle textural and structural differences. Our model incorporates a novel architecture that integrates advancements in three key areas: Semantic segmentation, texture analysis, and structural feature recognition. Materials and Methods: We employed a dataset of whole slide imaging from 20 patients, totaling 100 slides of OP, segmented into training, validation, and testing sets to reflect real-world application scenarios. Our approach utilizes a modified multi-head self-attention mechanism combined with ResUNet for semantic segmentation, enhanced by superpixel concepts. This method facilitates the generation of representative token features through iterative super-token blocks, creating high-resolution token maps that leverage local and high-level feature information for improved accuracy. Results: Benefiting from token features and distribution for enhanced texture alignment with fewer falsepositives, the super-token transformer (STT) model achieved a mean intersection over union (mIOU) of 72.42%, with a sensitivity of 47.81%, specificity of 99.83%, positive predictive value of 64.03%, and negative predictive value of 99.94%, highlighting superior efficacy in Masson body segmentation in complex cross-tissue analyses. Conclusion: Our team developed an iterative learning model based on the STT approach, emphasizing token features of super token, including texture and distribution, that enable enhanced alignment with the unique textures of Masson bodies to improve sensitivity and mIOU, The development of this STT model presents a significant advancement in the field of medical image analysis for OP that offers a promising avenue for improving diagnostic precision and patient outcomes in pulmonary pathology. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is a progressive irreversible neurodegenerative disorder that represents a major global public health concern. Traditionally, AD is diagnosed using cerebrospinal fluid biomarker analysis or brain imaging modalities. Recently, less burdensome, more widely available blood biomarker (BBM) assays for amyloid-beta (Aβ42/40) and phosphorylated-tau concentrations have been found to accurately identify the presence/absence of brain amyloid plaques and tau tangles and have helped to streamline AD diagnosis. However, few BBMs have been rigorously analytically validated. Herein, we report the analytical validation of a novel liquid chromatography–tandem mass spectrometry (LC-MS/MS) multiplex method for quantifying plasma phosphorylated-tau217 (p-tau217) and non-phosphorylated-tau217 (np-tau217) peptide concentrations. We combined the p-tau217/np-tau217 concentrations ratio (%p-tau217) and the previously validated LC-MS/MS multiplex assay for plasma Aβ42/40 into a new multianalyte assay with algorithmic analysis (MAAA; PrecivityAD2™ test) that identifies brain amyloid status based on brain amyloid positron emission tomography. We found (a) the %p-tau217 assay is precise, accurate, sensitive, and linear over a wide analytical measurement range, and free from carryover and interference; (b) the pre-analytical specimen collection, processing, storage, and shipping conditions that maintain plasma tau peptide stability; and (c) using the measured analytical imprecision for plasma Aβ42/40 and p-tau217/np-tau217 levels in a worst-case scenario model, the PrecivityAD2 test algorithm for amyloid pathology classification changed for only 3.5% of participants from brain amyloid positive to negative, or from negative to positive. The plasma sample preparation and LC-MS/MS methods underlying the PrecivityAD2 test are suitable for use in the clinical laboratory and valid for the test's intended purpose: to aid in the diagnostic evaluation of individuals aged 55 and older with signs or symptoms of mild cognitive impairment or dementia. [ABSTRACT FROM AUTHOR]

Exosomes are extracellular vesicles well known for facilitating cell-to-cell communication by distributing essential macromolecules like proteins, DNA, mRNA, lipids, and miRNA. These vesicles are abundant in fluids distributed throughout the body, including urine, blood, saliva, and even bile. They are important diagnostic tools for breast, lung, gastrointestinal cancers, etc. However, their application as cancer biomarkers has not yet been implemented in most parts of the world. In this review, we discuss how OMICs profiling of exosomes can be practiced by substituting traditional imaging or biopsy methods for cancer detection. Previous methods like extensive imaging and biopsy used for screening were expensive, mostly invasive, and could not easily provide early detection for various types of cancer. Exosomal biomarkers can be utilized for routine screening by simply collecting body fluids from the individual. We anticipate that the use of exosomes will be brought to light by the success of clinical trials investigating their potential to enhance cancer detection and treatment in the upcoming years. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) remains a leading cause of mortality in low-resource settings and poses a diagnostic challenge in human immunodeficiency virus (HIV)-negative populations because of limitations in traditional diagnostic methods such as sputum smear microscopy (SSM) and sputum Xpert Ultra. There is a lack of effective, non-invasive diagnostic options for TB diagnosis in HIV-negative populations. This scoping review explores the potential of urinary lipoarabinomannan (ULAM) as a point-of-care diagnostic tool for Mycobacterium tuberculosis (MTB) in HIV-negative individuals. Aim: To evaluate the diagnostic performance of ULAM in detecting TB among HIV-negative populations and assess its feasibility as a rapid, non-invasive diagnostic method. Method: A systematic search was conducted across PubMed, Google Scholar and Scopus. Articles were selected based on relevance to the topic. Results: The search yielded 210 articles, with 11 meeting our inclusion criteria. These studies reported varying diagnostic performance metrics for ULAM: sensitivity ranged from 10.0% to 66.7% and specificity from 90.0% to 98.1% among different assays. Notably, the studies demonstrated that the novel assays such as Electrochemiluminescence LAM and the second-generation FujiLAM showed higher sensitivities of 66.7% and 53.2%, respectively. Despite these advancements, the overall effectiveness of ULAM in HIV-negative populations remains limited, with standard assays exhibiting sensitivities as low as 10.0%. Conclusion: While ULAM holds potential as a diagnostic tool in HIV-associated TB, its application in HIV-negative populations is constrained by low sensitivity of the currently available assays. Contribution: The development and validation of high-sensitivity assays are crucial for broadening the utility of ULAM in these populations.

Background: The establishment of a formal diagnosis of post-traumatic stress disorder (PTSD) for children and adolescents is the foundation for advancing pertinent clinical research and formulating proper treatment and management. However, a validated diagnostic tool for PTSD in children and adolescents is lacking in Japan.Objective: To examine the cross-cultural validity and reliability of the Japanese Clinician-Administered PTSD Scale for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), child and adolescent version (CAPS-CA-5-J).Method: Overall, 73 children who had experienced potentially traumatic events were recruited from three medical facilities. The linguistically validated CAPS-CA-5-J was conducted by trained psychiatrists and psychologists. Additionally, children and their caretakers completed questionnaires such as the UCLA PTSD reaction index for DSM-5 (PTSD-RI-5), Depression Self-Rating Scale for Children (DSRDC), and Strength and Difficulties Questionnaire (SDQ); 16 participants were randomly selected for the inter-rater reliability assessment.Results: Owing to missing values in the CAPS-CA-5-J and PTSD-RI-5, 68 children were included in the final analysis. Regarding reliability, the CAPS-CA-5-J showed excellent internal consistency (Cronbach’s alpha coefficient = 0.90) and interrater agreement (kappa coefficient = 0.88). Convergent validity was supported by a strong correlation between the total severity scale of the CAPS-CA-5-J and the PTSD-RI-5 scores (Pearson’s correlation coefficient = 0.82). Divergent validity was indicated by a moderate correlation between the CAPS-CA-5-J and DSRDC, and no correlation was found with the SDQ scores.Conclusions: This study is the first to validate a structured clinical interview for children and adolescents with PTSD in Japan. The psychometric properties of the CAPS-CA-5-J were good enough and comparable to those reported in previous validation studies. Therefore, the CAPS-CA-5-J can be considered reliable and valid for use in Japan.

The validation process of a gap-filling diagnostic tool that allows educators to monitor children’s mental health status by processing parental observations is presented. This quantitative pilot study, conducted on a Hungarian convenience sample, highlighted that the results obtained with the Mental Health Status Questionnaire - parental version are consistent with the results of parent surveys measuring other aspects of children’s psychological quality of life, e.g. subjective well-being, peer support or risk of internet addiction. Analyses along the categories of mentally healthy, vulnerable, and endangered calculated from the questionnaire items also revealed significant differences along the above indicators of psychological quality of life, so the measure may also have a screening function. It also provides an informative categorisation of the risk of so-called internalising problems, which are important in childhood and adolescence but tend to be more hidden. However, parental observations should be treated with caution, especially for children in dysfunctional families, so the questionnaire should be used as part of a sufficiently broad pedagogical methodological toolkit, compared to the results of other methods of collecting pedagogical information and working in close collaboration with mental health professionals.

Abstract Several studies suggested the utility of artificial intelligence (AI) in screening left ventricular hypertrophy (LVH). We hence conducted systematic review and meta-analysis comparing diagnostic accuracy of AI to Sokolow–Lyon’s and Cornell’s criteria. Our aim was to provide a comprehensive overview of the newly developed AI tools for diagnosing LVH. We searched MEDLINE, EMBASE, and Cochrane databases for relevant studies until May 2023. Included were observational studies evaluating AI’s accuracy in LVH detection. The area under the receiver operating characteristic curves (ROC) and pooled sensitivities and specificities assessed AI’s performance against standard criteria. A total of 66,479 participants, with and without LVH, were included. Use of AI was associated with improved diagnostic accuracy with summary ROC (SROC) of 0.87. Sokolow–Lyon’s and Cornell’s criteria had lower accuracy (0.68 and 0.60). AI had sensitivity and specificity of 69% and 87%. In comparison, Sokolow–Lyon’s specificity was 92% with a sensitivity of 25%, while Cornell’s specificity was 94% with a sensitivity of 19%. This indicating its superior diagnostic accuracy of AI based algorithm in LVH detection. Our study demonstrates that AI-based methods for diagnosing LVH exhibit higher diagnostic accuracy compared to conventional criteria, with notable increases in sensitivity. These findings contribute to the validation of AI as a promising tool for LVH detection.

Background: Rheumatic diseases are chronic diseases that affect joints, tendons, ligaments, bones, muscles, and other vital organs. Detection of rheumatic diseases is a complex process that requires careful analysis of heterogeneous content from clinical examinations, patient history, and laboratory investigations. Machine learning techniques have made it possible to integrate such techniques into the complex diagnostic process to identify inherent features that lead to disease formation, development, and progression for remedial measures. Methods: An automated diagnostic tool using a multilayer neural network computational engine is presented to detect rheumatic disorders and the type of underlying disorder for therapeutic strategies. Rheumatic disorders considered are rheumatoid arthritis, osteoarthritis, and systemic lupus erythematosus. The detection system was trained and tested using 70% and 30% respectively of labelled synthetic dataset of 100,000 records containing both single and multiple disorders. Results: The detection system was able to detect and predict underlying disorders with accuracy of 97.48%, sensitivity of 96.80%, and specificity of 97.50%. Conclusion: The good performance suggests that this solution is robust enough and can be implemented for screening patients for intervention measures. This is a much-needed solution in environments with limited specialists, as the solution promotes task-shifting from the specialist level to the primary healthcare physicians.

Abstract Background Trigonocephaly occurs due to the premature fusion of the metopic suture, leading to a triangular forehead and hypotelorism. This condition often requires surgical correction for morphological and functional indications. Metopic ridges also originate from premature metopic closure but are only associated with mid-frontal bulging; their surgical correction is rarely required. Differential diagnosis between these two conditions can be challenging, especially in minor trigonocephaly. Methods Two hundred seven scans of patients with trigonocephaly (90), metopic rigdes (27), and controls (90) were collected. Geometric morphometrics were used to quantify skull and orbital morphology as well as the interfrontal angle and the cephalic index. An innovative method was developed to automatically compute the frontal curvature along the metopic suture. Different machine-learning algorithms were tested to assess the predictive power of morphological data in terms of classification. Results We showed that control patients, trigonocephaly and metopic rigdes have distinctive skull and orbital shapes. The 3D frontal curvature enabled a clear discrimination between groups (sensitivity and specificity > 92%). Furthermore, we reached an accuracy of 100% in group discrimination when combining 6 univariate measures. Conclusion Two diagnostic tools were proposed and demonstrated to be successful in assisting differential diagnosis for patients with trigonocephaly or metopic ridges. Further clinical assessments are required to validate the practical clinical relevance of these tools.

Summary Background Objectives Study design Methods Results Main limitations Conclusions Reaching a specific diagnosis in horses with chronic or recurrent abdominal pain may be challenging and elusive.The aim of this study was to report indications, findings and outcomes of equine exploratory laparoscopy in a case series to support its diagnostic value and identify potential limitations.Retrospective cases series.Sixty‐nine client‐owned horses underwent laparoscopic exploration of the abdomen due to chronic colic symptoms. All horses were operated standing while sedated and under local anaesthesia. Diagnosis, follow‐up, surgical or medical interventions, as well as intra‐ and postoperative complications were recorded.A definitive diagnosis could be made by laparoscopy in 61 horses. However, no abnormal findings were found by laparoscopic exploration of the abdominal cavity in eight horses. Overall, the sensitivity of diagnostic laparoscopy in the standing horse in our study was 88% and its specificity was 15%. No severe intra‐ or postoperative complications occurred. Exploratory flank laparoscopy in the standing horse can be a valuable diagnostic tool for chronic abdominal pain.The limitations of the present study are its retrospective nature, missing some details in the reports. In addition, no long‐term follow‐up was available for the horses which underwent surgical intervention, and whether the colic signs reoccurred after a period of time or complications occurred in the long‐term postoperative period are not known. No confirmation of the laparoscopic diagnosis was available in some horses, and a post‐mortem examination or histology of a biopsy sample would have been beneficial.Exploratory flank laparoscopy in the standing horse can be considered in horses with chronic abdominal pain in view of the high sensitivity and low complication rate of this study. [ABSTRACT FROM AUTHOR]

Measuring the level of literacy has been of interest to educators for decades. Reading involves many different componentsphonemic awareness, ability to decode and construct sounds, comprehension, fluency and speed-most batteries differ in the methodology that they use and in the abilities that they assess. Some international tools - like PIRLS (Progress in International Reading Literacy Study, International Association for the Evaluation of Educational Achievement), PISA (Program for International Student Assessment, OECD) measure reading ability for children above the age of 7-8 years. This makes intervention difficult for poor readers. The Let's Read Reading Age Diagnostic Tool (LR-RADT) is based on the Let's Read program and follows the common pattern of teaching reading through phonics in most of the Montessori and preschools in India. It was developed to track the acquisition of decoding and syllabification reading skills in children as early as four years. This article is written to establish the validity and reliability of this tool as an effective and efficient test for acquisition of phonetic reading skills in Early Years. [ABSTRACT FROM AUTHOR]

Chirality, the property of molecules having mirror‐image forms, plays a crucial role in pharmaceutical and biomedical research. This review highlights its growing importance, emphasizing how chiral drugs and nanomaterials impact drug effectiveness, safety, and diagnostics. Chiral molecules serve as precise diagnostic tools, aiding in accurate disease detection through unique biomolecule interactions. The article extensively covers chiral drug applications in treating cardiovascular diseases, CNS disorders, local anesthesia, anti‐inflammatories, antimicrobials, and anticancer drugs. Additionally, it explores the emerging field of chiral nanomaterials, highlighting their suitability for biomedical applications in diagnostics and therapeutics, enhancing medical treatments. [ABSTRACT FROM AUTHOR]

Background: This systematic review examines and evaluates the relationship between salivary cortisol levels and temporomandibular disorder (TMD) in young adult patients. Method: Six databases—PubMed, Scopus, Web of Science, Google Scholar, ProQuest, and Cochrane Library—were utilized to screen eligible studies. A systematic search was performed based on PECO questions and eligibility criteria. The research question for this review was "Do salivary cortisol levels correlate with TMD in individuals aged 18–40?" The risk of bias for quality assessment was determined by the Cochrane tool. PRISMA guidelines were followed while performing this review. Result: A total of fourteen studies were included in this review. Of these, eleven were observational studies (four cross-sectional and seven case–control), and three were randomized control trials. Eleven of the included studies presented a low to moderate risk in the qualitative synthesis. The total sample size of the included studies was 751 participants. The included studies suggest higher salivary cortisol levels in TMD patients than in healthy individuals. Conclusions: The findings of this review indicate higher salivary cortisol levels in adult patients with TMD than in healthy controls. Thus, supportive psychological treatment and clinical modalities should be provided to patients with TMD. Moreover, higher-quality studies with low heterogeneity are required to support this finding. [ABSTRACT FROM AUTHOR]

Objective: To determine what symptom differences are prevalent in patients with differing ages of endometriosis symptom onset. Material and methods: We obtained clinical and demographic data from 1560 individuals with suspected pelvic conditions undergoing laparoscopy from the Endometriosis Patient Registry at Ponce Health Science University-Ponce Research Institute. We then generated predictive models by fitting logistic regressions to the patient data. We determined association between symptoms and age at symptom onset in patients with endometriosis by generating predictive linear and multinomial logistic regression models. Results: Our best model had an accuracy of 81.76%, with a sensitivity of 89.32% and a specificity of 64.57% at an optimal threshold of 0.75. Classic endometriosis symptoms such as dyspareunia and pelvic pain showed different prevalence rates based on patient age at onset of symptoms. Conclusion: Symptom-based predictive models are able to predict patients' likelihood of having endometriosis in a non-invasive and accessible manner. Gynecologic and pelvic symptoms including dyspareunia and presence of uterine fibroids are significantly associated with age at symptom onset. [ABSTRACT FROM AUTHOR]

Background: Rheumatic diseases are chronic diseases that affect joints, tendons, ligaments, bones, muscles, and other vital organs. Detection of rheumatic diseases is a complex process that requires careful analysis of heterogeneous content from clinical examinations, patient history, and laboratory investigations. Machine learning techniques have made it possible to integrate such techniques into the complex diagnostic process to identify inherent features that lead to disease formation, development, and progression for remedial measures. Methods: An automated diagnostic tool using a multilayer neural network computational engine is presented to detect rheumatic disorders and the type of underlying disorder for therapeutic strategies. Rheumatic disorders considered are rheumatoid arthritis, osteoarthritis, and systemic lupus erythematosus. The detection system was trained and tested using 70% and 30% respectively of labelled synthetic dataset of 100,000 records containing both single and multiple disorders. Results: The detection system was able to detect and predict underlying disorders with accuracy of 97.48%, sensitivity of 96.80%, and specificity of 97.50%. Conclusion: The good performance suggests that this solution is robust enough and can be implemented for screening patients for intervention measures. This is a much-needed solution in environments with limited specialists, as the solution promotes task-shifting from the specialist level to the primary healthcare physicians. [ABSTRACT FROM AUTHOR]

Background: Trigonocephaly occurs due to the premature fusion of the metopic suture, leading to a triangular forehead and hypotelorism. This condition often requires surgical correction for morphological and functional indications. Metopic ridges also originate from premature metopic closure but are only associated with mid-frontal bulging; their surgical correction is rarely required. Differential diagnosis between these two conditions can be challenging, especially in minor trigonocephaly. Methods: Two hundred seven scans of patients with trigonocephaly (90), metopic rigdes (27), and controls (90) were collected. Geometric morphometrics were used to quantify skull and orbital morphology as well as the interfrontal angle and the cephalic index. An innovative method was developed to automatically compute the frontal curvature along the metopic suture. Different machine-learning algorithms were tested to assess the predictive power of morphological data in terms of classification. Results: We showed that control patients, trigonocephaly and metopic rigdes have distinctive skull and orbital shapes. The 3D frontal curvature enabled a clear discrimination between groups (sensitivity and specificity > 92%). Furthermore, we reached an accuracy of 100% in group discrimination when combining 6 univariate measures. Conclusion: Two diagnostic tools were proposed and demonstrated to be successful in assisting differential diagnosis for patients with trigonocephaly or metopic ridges. Further clinical assessments are required to validate the practical clinical relevance of these tools. [ABSTRACT FROM AUTHOR]

Cystic Echinococcosis (CE) is a zoonotic disease caused by the larval stage of the tapeworm Echinococcus granulosus sensu lato (s.l.). This study aims to investigate the use of two monoclonal antibodies (mAbEmG3 and mAbEm2G11) by immunohistochemistry (IHC) to confirm the diagnosis of CE in human patients, in particular in those cases in which other techniques fail to provide a correct or conclusive diagnosis. For this purpose, a survey on 13 patients was performed. These subjects were referred to Sardinian hospitals (Italy) from 2017 to 2022 and were suspected to be affected by CE. Our findings from these 13 patients showed the detection of E. granulosus sensu stricto by IHC in 12 of 13 echinococcal cysts, as one sample was of a non-parasitological origin. The results confirmed that IHC, by means of the mAbEmG3 and mAbEm2G11, is a reliable diagnostic tool that showed a very high performances when tested on strain of E. granulosus s.l. from Sardinia. [ABSTRACT FROM AUTHOR]

A male patient in his late twenties presented with ambiguous genitalia to our tertiary specialist unit with complaints of short stature and inadequate copulation. There was no history of consanguinity, and a physical examination raised concerns about possible disorders of sexual development (DSD). Karyotyping and fluorescence in situ hybridization results were consistent with the presence of two X chromosomes, revealing the patient to be a genotypic female. Sanger sequencing showed a heterozygous pathogenic mutation in the CYP21A2 gene known to be associated with 21-hydroxylase deficiency, thus confirming the diagnosis of congenital adrenal hyperplasia (CAH), Prader stage V. DSD with CAH is distressing for the patient and their families, and the management needs a multidimensional approach involving diverse medical, genetic, and psychological considerations. Cytogenetic and molecular genetic studies play an essential role in diagnosis and decision-making and should be made affordable in developing countries for better patient care. [ABSTRACT FROM AUTHOR]

Schistosomiasis is a neglected tropical disease that affects more than 200 million people and 45% of infections have been shown to occur in school-aged children. A large percentage of the disease burden lies in Africa. In 2012, the WHO outlined a roadmap for the elimination of schistosomiasis by 2020; however, this was not achieved. Treatment for schistosomiasis is by the use of Praziquantel, a drug in use for over 30 years and there is a concern for emerging drug resistance. There are several species of the genus Schistosoma causing infection in humans. For this study, Schistosoma mansoni which causes intestinal schistosomiasis will be investigated. There are reports of lowering cure rates and suboptimal response to praziquantel following several cycles of mass drug administration (MDA). Praziquantel resistance has also been reported in some countries and laboratory-bred schistosome experiments. To address the concerns of resistance, this study aims to employ a two-part approach to assess the prevalence of S. mansoni. praziquantel resistance amongst school-aged children in schistosomiasis endemic communities in Ghana and develop a diagnostic tool to aid in field assessment of infections. To achieve this, the study will attempt to answer the following research questions: 1. Is there developing S. mansoni praziquantel resistance in communities that have undergone several mass drug administrations? 2. Is there an interplay between intermediate host exposure to praziquantel and the development of praziquantel drug resistance in the definitive host? [ABSTRACT FROM AUTHOR]

In this paper, the second part of a two-part series, we explore the cultural stability of the Association of Southeast Asian Nations (ASEAN). The analytical framework adopted, formulated on a background of social cybernetics, uses Mindset Agency Theory (MAT) within a metacybernetic framework. Our exploration involves a thorough investigation of signs pointing to cultural instability, identification of potential pathologies, and the provision of insights into the underlying dynamics within ASEAN. Expanding on the theoretical foundation established in the first part, we explore the notion that regional organisations (ROs) like ASEAN can be viewed as complex adaptive systems with agency. Heterogeneity of RO membership can be both beneficial and detrimental, especially when this delivers cultural diversity. If detrimental, pathologies can arise that affect both ROs' institutional dynamics and their affiliated regional organisations, a significant interest of this paper. In response to certain cybernetic aspects introduced in part 1 of the research, MAT is shown to be a specialised framework imbued with systemic and reflexive elements. Through this, the analysis sheds light on how an agency's mindset connects with its behaviour and performance. ROs exhibit coherence in their operations when they successfully achieve adaptive goals. ROs, as agencies defined through a population of state agents, have mutual relationships and are encouraged to pursue shared regional objectives, such as economic growth, social welfare, security, and democracy. However, in highly diverse cultural environments, this poses unique challenges to achieving and maintaining cultural stability. The analysis scrutinises ASEAN's behaviour, relating it to manifestations of cultural instability, and deduces conditions that encompass an inability to undertake collective action, covert narcissism, and a lack of authority. Employing MAT as a diagnostic tool to comprehend ASEAN's intricate nature, the paper concludes with practical recommendations aimed at enhancing ASEAN's cultural health and sustainability. The ultimate vision is to foster a more integrated and proactive regional entity. [ABSTRACT FROM AUTHOR]

Early diagnosis of Bell's palsy is crucial for effective patient management in primary care settings. This study aimed to develop a simplified diagnostic tool to enhance the accuracy of identifying Bell's palsy among patients with facial muscle weakness. Data from 240 patients were analyzed using seven potential clinical evaluation indicators. Two diagnostic benchmarks were established: one based on clinical assessment and the other incorporating magnetic resonance imaging (MRI) findings. A multivariate logistic regression model was developed based on these benchmarks, resulting in the construction of a predictive tool evaluated through latent class models. Both models retained four key clinical indicators: absence of forehead wrinkles, accumulation of food and saliva inside the mouth on the affected side, presence of vesicular rash in the ear or pharynx, and lack of pain or symptoms associated with tick exposure, rash, or joint pain. The first model demonstrated excellent discriminative ability (area under the curve [AUC] = 0.96, 95% confidence interval [CI] 0.94 - 0.99) and calibration (P < 0.001), while the second model also showed good performance (AUC = 0.88, 95% CI 0.83 - 0.92) and calibration (P = 0.005). Bootstrap validation indicated no significant overfitting. The latent class defined by the first model significantly aligned with the clinical diagnosis group, while the second model showed lower consistency.

Early diagnosis of HIV-1 is crucial to minimize transmission, morbidity, and mortality, particularly for neonates with developing immune systems. This study aimed to develop and evaluate a simplified, high-sensitivity assay for early HIV-1 detection before seroconversion. The assay utilizes reverse-transcription-polymerase chain reaction (RT-PCR) to amplify the HIV-1 RNA protease gene. Digoxigenin (dig)-labeled forward, and biotin-labeled universal reverse primers are used, generating digoxigenin-amplicon-biotin (DAB) products. These products are detected using a lateral flow assay (LFA) containing a conjugated pad with colloidal gold-labeled 6-histidine tag-fused maltose-binding protein-monomeric streptavidin (6HISMBP-mSA-CGC). Anti-dig monoclonal antibody (mAb) and biotinylated-BSA are immobilized in the test and control line zones, respectively. Five plasma samples with known viral load (VL) were used to simulate the efficacy of early HIV-1 detection. RNA extracted from these samples was amplified by RT-PCR using the labeled primers, and DAB products were examined on agarose gel electrophoresis and LFA. RT-PCR from diluted clinical samples yielded visible DNA bands in agarose gel electrophoresis, consistent with positive LFA results. Conversely, negative samples only displayed the control line on LFA. This assay exhibited a limit of detection (LOD) of 82.29 RNA copies/mL, comparable to other nucleic acid amplification tests (NAATs). This novel technique provides a highly sensitive assay for early HIV-1 diagnosis, even with low VL, making it suitable for resource-limited settings.

Ampaiwan Chuansumrit,1 Rungrote Natesirinilkul,2 Nongnuch Sirachainan,1 Praguywan Kadegasem,1 Pacharapan Surapolchai,3 Noppawan Tangbubpha,1 Ketsuda Kempka,1 Tanyanee Khlangtan1 1Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 3Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, ThailandCorrespondence: Ampaiwan Chuansumrit, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Rachathewi District, Bangkok, 10400, Thailand, Tel +66 2 2011749, Fax +66 2 2011748, Email ampaiwan.jua@mahidol.ac.thBackground: Hemophilia cannot be diagnosed in most laboratories of economically less-developed countries leading to high mortality and morbidity rates.Aim: A diagnostic tool was established ranging from bleeding assessment and a simple bedside test of mixing venous clotting time (VCT) to comprehensive DNA analysis for patients with hemophilia.Methods: Patients with known (n=80) and suspected hemophilia (n=14) were included. Their bleeding symptoms were initially evaluated using verified translated-Thai ISTH bleeding assessment tool. Then, blood samples were drawn using a two-syringe technique, 2 mL each was placed in three tubes, for the mixing VCT and citrate blood was kept for coagulogram and coagulation factor assay. Finally, DNA analysis was determined.Results: A total of 94 patients with hemophilia (A68, B26) defined as severe (A 57, B 17), moderate (A 7, B 5), and mild degrees (A 4, B 4) with the mean (SD) age of 14.0 (11.7) years and 24 normal controls aged 25.5 (4.5), were enrolled in the study. The mean (SD) bleeding score of patients with hemophilia was 13.5 (5.5), which did not significantly differ between patients with hemophilia A and B. The mixing venous clotting time offered the presumptive diagnosis of hemophilia A and B, which were subsequently confirmed by the prolonged APTT, low FVIII:C and FIX:C and mutations on the factor VIII and IX genes.Conclusion: A diagnostic tool for bleeding assessment, mixing venous clotting time, coagulogram, coagulation factor assay, and DNA analysis for patients with hemophilia has been established in the existing health-care system.Keywords: diagnostic tool, hemophilia A & B, bleeding score, mixing VCT, F8 & F9 gene mutation

Alzheimer’s disease (AD) is a progressive irreversible neurodegenerative disorder that represents a major global public health concern. Traditionally, AD is diagnosed using cerebrospinal fluid biomarker analysis or brain imaging modalities. Recently, less burdensome, more widely available blood biomarker (BBM) assays for amyloid-beta (Aβ42/40) and phosphorylated-tau concentrations have been found to accurately identify the presence/absence of brain amyloid plaques and tau tangles and have helped to streamline AD diagnosis. However, few BBMs have been rigorously analytically validated. Herein, we report the analytical validation of a novel liquid chromatography–tandem mass spectrometry (LC-MS/MS) multiplex method for quantifying plasma phosphorylated-tau217 (p-tau217) and non-phosphorylated-tau217 (np-tau217) peptide concentrations. We combined the p-tau217/np-tau217 concentrations ratio (%p-tau217) and the previously validated LC-MS/MS multiplex assay for plasma Aβ42/40 into a new multianalyte assay with algorithmic analysis (MAAA; PrecivityAD2™ test) that identifies brain amyloid status based on brain amyloid positron emission tomography. We found (a) the %p-tau217 assay is precise, accurate, sensitive, and linear over a wide analytical measurement range, and free from carryover and interference; (b) the pre-analytical specimen collection, processing, storage, and shipping conditions that maintain plasma tau peptide stability; and (c) using the measured analytical imprecision for plasma Aβ42/40 and p-tau217/np-tau217 levels in a worst-case scenario model, the PrecivityAD2 test algorithm for amyloid pathology classification changed for only 3.5% of participants from brain amyloid positive to negative, or from negative to positive. The plasma sample preparation and LC-MS/MS methods underlying the PrecivityAD2 test are suitable for use in the clinical laboratory and valid for the test’s intended purpose: to aid in the diagnostic evaluation of individuals aged 55 and older with signs or symptoms of mild cognitive impairment or dementia.

Abstract Objective This study aimed to develop a simplified diagnostic tool for assessing sarcopenia and myosteatosis in gastrointestinal cancer patients, focusing on the creatinine to cystatin C ratio (CCR) as an evaluation marker. Methods 955 patients were split into training (n = 671) and validation (n = 284) cohorts. Using logistic regression, risk factors for sarcopenia and myosteatosis were identified. The predictive capacity of the developed model was examined. The association between CCR and muscle imaging parameters, along with its impact on clinical outcomes, was analyzed. Results No significant differences were observed in baseline traits between cohorts. CCR emerged as a significant risk factor for both sarcopenia and myosteatosis. Nomograms for diagnosing these conditions demonstrated strong predictive ability, with AUC values indicating high accuracy (sarcopenia AUC: 0.865–0.872; myosteatosis AUC: 0.848–0.849). The clinical utility of the nomograms was confirmed through decision curve analysis. CCR showed significant association with muscle imaging parameters and was a reliable indicator for assessing the risk of sarcopenia, myosteatosis, and cachexia. Moreover, CCR was able to differentiate between patient survival and disease progression rates. Conclusion A diagnostic tool for sarcopenia and myosteatosis in gastrointestinal cancer patients was developed, with CCR being a pivotal biomarker for disease diagnosis and prognosis prediction. Graphical Abstract

This study estimates the steady-state performance of a proton exchange membrane fuel cell (PEMFC) under conditions of air depletion in the preferential oxidation reactor (PrOx) and fuel depletion at the anode, which has not been previously studied. Considering the detailed chemical reactions of the reforming process, the composition of the reformed gas at the anode inlet is determined using the temperature and pressure data measured at various state points in the PEMFC system. To calculate the voltage loss at the anode due to the air depletion in PrOx or reformate gas depletion before the anode, the electrochemical reaction of the reformed gas in the anode catalyst layer is studied. The calculations show that when the fuel entering the anode or air entering the PrOx decreases, the amount of CO at the anode increases depending on the reduction, resulting in activation loss at the anode, and thereby leading to power loss. This analysis of the power loss in a PEMFC due to a lack of air or fuel can serve as an auxiliary diagnostic tool to identify faulty parts in the Balance of Plant (BOP).

Siddha system of medicine is one of the most traditional medicines and has many unique preparations of higher order internal medicines, external therapies for various diseases. But still the validation of the reliable diagnostic tools has not yet been documented. Covid-19 which was a massive epidemic in 2019, and the world is still in search of medicines and diagnostic parameters. The Siddha's Eight-fold diagnostic tool, Neerkuri and neikuri are very sensitive and exclusively Siddha methods of diagnostic urine examination propounded by Sage Theraiyar. This is an efficient method in elucidating the prognosis of the given disease. This Observational study, evaluates the Eight-fold Diagnostic tools and Neerkuri, Neikuri among the COVID Patients. COVID patients were selected based on their CORADS score and studied with the eight-fold diagnostic tools and exclusively with Neerkuri and Neikuri using the guidelines mentioned as per the Siddha Literature. Based on the observation of the pattern of spread of oil drop in the urine of subjects, and by recording the changes of the En vagai thervu the results were recorded and tabulated. From the obtained results it may be concluded that 70% of the neikkuri findings were in pearl shape indicating kabam. In future, clinical studies will be conducted to standardize this Siddha Diagnostic tools in other diseases. [ABSTRACT FROM AUTHOR]

Anoplophora chinensis (Forster, 1771), the citrus longhorned beetle, and Anoplophora glabripennis (Motschulsky, 1853), the Asian longhorned beetle, are wood borers of great economic importance, infesting a wide range of ornamental trees and shrubs. Native to Asia, their presence has been detected in several countries on different continents. Both are included in the EPPO A2 list of pests recommended for regulation as quarantine pests. A duplex molecular test based on TaqMan probe technology for the identification of the two species has been set up, using specimens (adults and larvae) of the two species. To test the duplex real‐time PCR on frass, an artificial frass ('manufactured sawdust') has been created using wood chips from healthy branches of Acer negundo, spiked with a known amount of DNA from larvae of the species. The analytical specificity, analytical sensitivity, repeatability and reproducibility of the duplex real‐time PCR test were evaluated according to EPPO Standards. This new molecular tool allows distinction, with only one test, between these two Anoplophora species using DNA isolated from the adult, larvae and/or frass. [ABSTRACT FROM AUTHOR]

Climate changes are accelerating and leading to climate and weather extremes with the most destructive impacts and negative consequences on the planet. For these reasons, precise forecasting, and announcement of weather disasters of a convective nature, from local to synoptic scales, is very important. The Novel Thunderstorm Alert System (NOTHAS) has shown outstanding results in forecasting and early warning of different modes of convection, including local hazards in mid-latitudes. In this study, an attempt has been made to apply this tool in the prediction of different atmospheric systems that occur in different climatic regions. The upgraded prognostic and diagnostic algorithm with adjusted complex parameters and criteria representative of tropical storms and tropical cyclones showed good coincidence with the available observations. NOTHAS showed skill and success in assessing the dynamics and intensity of Hurricane Ian, which hit the west coast of Florida on 30 September 2022 and caused great material damage and human losses. This advanced tool also detected the most intense-extreme Level-5 on 1 September 2021, over New York, when catastrophic flooding occurred within the remnants of Hurricane Ida. Likewise, the upgraded model configuration very correctly predicted the trajectory, modifications, and strength of super typhoon Nanmadol over Japan (19 September 2022), 24–48 h in advance, and super typhoon Noru over the Philippines (25 September 2022). The system showed the temporal and spatial accuracy of the location of the heavy rainfall and flash flood. In general, the obtained results for all evaluated cases are encouraging and provide a good basis for further testing, verification, and severe weather warnings and guidance for weather services worldwide. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to develop a simplified diagnostic tool for assessing sarcopenia and myosteatosis in gastrointestinal cancer patients, focusing on the creatinine to cystatin C ratio (CCR) as an evaluation marker. Methods: 955 patients were split into training (n = 671) and validation (n = 284) cohorts. Using logistic regression, risk factors for sarcopenia and myosteatosis were identified. The predictive capacity of the developed model was examined. The association between CCR and muscle imaging parameters, along with its impact on clinical outcomes, was analyzed. Results: No significant differences were observed in baseline traits between cohorts. CCR emerged as a significant risk factor for both sarcopenia and myosteatosis. Nomograms for diagnosing these conditions demonstrated strong predictive ability, with AUC values indicating high accuracy (sarcopenia AUC: 0.865–0.872; myosteatosis AUC: 0.848–0.849). The clinical utility of the nomograms was confirmed through decision curve analysis. CCR showed significant association with muscle imaging parameters and was a reliable indicator for assessing the risk of sarcopenia, myosteatosis, and cachexia. Moreover, CCR was able to differentiate between patient survival and disease progression rates. Conclusion: A diagnostic tool for sarcopenia and myosteatosis in gastrointestinal cancer patients was developed, with CCR being a pivotal biomarker for disease diagnosis and prognosis prediction. [ABSTRACT FROM AUTHOR]

Gestational diabetes (GDM) is a frequent complication during pregnancy. We aimed to develop a score to predict future insulin dependency in gestational diabetes (GDM). Data from 1611 patients from Charité Berlins gestational diabetes clinic from 2015 to 2022 were utilized. A stepwise backwards regression, including patient characteristics obtained at the initial presentation, was performed. Predictors examined included age, fasting blood glucose level, blood glucose levels one and two hours after oral glucose tolerance test, pre-pregnancy BMI, number of previous pregnancies and births, and fetal sex. The ideal cutoff value between high and low risk for insulin dependency was assessed and the score was internally validated. There were 1249 (77.5%) women diagnosed with dietary GDM and 362 (22.5%) were diagnosed with insulin-dependent GDM. The CHarité AssessmeNt of GEstational Diabetes (CHANGED) Score achieved an area under the curve of 0.77 (95% confidence interval 0.75–0.80; 0.75 in internal validation). The optimal cutoff value was calculated at a score value of 9 (72% sensitivity, 69% specificity). We developed an easily applicable tool to accurately predict insulin dependency in gestational diabetes. The CHANGED Score is routinely available and can potentially improve maternal and fetal outcomes. [ABSTRACT FROM AUTHOR]

The Gifted Rating Scales - School Form (GRS-S), an evaluation tool for the identification of gifted elementary and middle school children, was the subject of the current study, which focused on its psychometric features (internal consistency reliability and structural validity). Four hundred and eighty-nine teachers (342 women, 139 men, and 8 without gender declaration) used the GRS-S to estimate the dimensions of giftedness in their students for the current study. Particularly, 489 children (253 girls and 236 boys) were evaluated by their teachers. Eight elementary and middle school classes and sixteen 6-month age bands were used to stratify the student population. The scales' outstanding internal consistency and good factorial validity were revealed by statistical analyses (EFA, CFA, and Cronbach's coefficients). According to the current research findings, the GRS-S as a reliable and valid assessment tool for identifying gifted students (by their teachers) within the Greek cultural environment. [ABSTRACT FROM AUTHOR]