Leprosy in children in Cuba: Epidemiological and clinical description of 50 cases from 2012–2019

Introduction In 1993, Cuba achieved leprosy elimination according to the World Health Organization’s (WHO) indicator of less than one case per 10,000 population. Despite this achievement, detection of new cases occurs every year among all age groups including children. Detection of new cases in children reveals persistent transmission of the infection. Objective To describe the clinical and epidemiological features of leprosy in individuals younger than 15 years (childhood leprosy) reported to the Cuban National Leprosy Control Program (NLCP) between 2012 and 2019. Methods We conducted a retrospective descriptive study between 2012 and 2019 to assess the clinical and epidemiologic features of individuals under the age of 15 years with a confirmed diagnosis of leprosy reported to the NLCP. We reviewed the NLCP database and collected data to better define the total number of cases of leprosy in adults, children (younger than 15 years). We assessed socio-demographic variables (age, gender, and province of residence) as well as variables of clinical interest including operational classification and staging at diagnosis, bacillary index, grade of disability by WHO staging. Additionally, we evaluated epidemiological variables including passive versus active surveillance of cases, contact investigation focusing specifically in household transmission, and the degree of kinship as well as standing of the child within the focus of transmission when there were additional cases. Results We identified fifty children during the study period corresponding to 3% of the overall cases of leprosy comprising all age groups in Cuba. In the age group younger than 15 years, the majorities of cases was from the Granma province and most were between the ages of 10 and 14 years. Clinically, multibacillary/lepromatous forms were the most common type identified with positive bacillary index. The majority of children diagnosed with leprosy during our study period had a history of a relative with a confirmed diagnosis of leprosy. Conclusions Detection of cases of leprosy in individuals younger than 15 years of age in Cuba demonstrates ongoing transmission of M. leprae in specific geographic hotspots. Its frequency in the early adolescence, the predominant clinical forms, and the mode of detection associated with sources of suspected familiar infection demonstrated that there is a need for further efforts by the NLCP to conduct active surveillance activities among affected communities to identify cases of leprosy earlier with the goal of preventing further household and community transmission.

Quantitative breast density analysis to predict interval and node-positive cancers in pursuit of improved screening protocols: a case–control study

Background This study investigates whether quantitative breast density (BD) serves as an imaging biomarker for more intensive breast cancer screening by predicting interval, and node-positive cancers. Methods This case–control study of 1204 women aged 47–73 includes 599 cancer cases (302 screen-detected, 297 interval; 239 node-positive, 360 node-negative) and 605 controls. Automated BD software calculated fibroglandular volume (FGV), volumetric breast density (VBD) and density grade (DG). A radiologist assessed BD using a visual analogue scale (VAS) from 0 to 100. Logistic regression and area under the receiver operating characteristic curves (AUC) determined whether BD could predict mode of detection (screen-detected or interval); node-negative cancers; node-positive cancers, and all cancers vs. controls. Results FGV, VBD, VAS, and DG all discriminated interval cancers (all p < 0.01) from controls. Only FGV-quartile discriminated screen-detected cancers (p < 0.01). Based on AUC, FGV discriminated all cancer types better than VBD or VAS. FGV showed a significantly greater discrimination of interval cancers, AUC = 0.65, than of screen-detected cancers, AUC = 0.61 (p < 0.01) as did VBD (0.63 and 0.53, respectively, p < 0.001). Conclusion FGV, VBD, VAS and DG discriminate interval cancers from controls, reflecting some masking risk. Only FGV discriminates screen-detected cancers perhaps adding a unique component of breast cancer risk.

LungAI: A Deep Learning Convolutional Neural Network for Automated Detection of COVID-19 from Posteroanterior Chest X-Rays

COVID-19 is an infectious disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). As of December 2020, more than 72 million cases have been reported worldwide. The standard method of diagnosis is by Real-Time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) from a Nasopharyngeal Swab. Currently, there is no vaccine or specific antiviral treatment for COVID-19. Due to rate of spreading of the disease manual detection among people is becoming more difficult because of a clear lack of testing capability. Thus there was need of a quick and reliable yet non-labour intensive detection technique. Considering that the virus predominantly appears in the form of a lung based abnormality I made use of Chest X-Rays as our primary mode of detection. For this detection system we made use of Posteroanterior (PA) Chest X-rays of people infected with Bacterial Pneumonia (2780 Images), Viral Pneumonia (1493 Images), Covid-19 (729 Images) as well as those of perfectly Healthy Individuals (1583 Images) procured from various Publicly Available Datasets and Radiological Societies. LungAI is a novel Convolutional Neural Network based on a Hybrid of the DarkNet and AlexNet architecture. The network was trained on 80% of the dataset with 20% kept for validation. The proposed Coronavirus Detection Model performed exceedingly well with an accuracy of 99.16%, along with a Sensitivity value of 99.31% and Specificity value of 99.14%. Thus LungAI has the potential to prove useful in managing the current Pandemic Situation by providing a reliable and fast alternative to Coronavirus Detection given strong results.

Metal-Salen-based Probes for the Selective Detection of Phosphates via a Disassembly Approach

Polyoxophosphates are ubiquitous in nature and play important roles in biological systems and in the environment. Pyrophosphate (PPi), an important member of this family, is produced in over 200 biochemical reactions and is a marker in clinical diagnosis. In addition to its endogenous role, PPi alias E450 is currently used as preservative, emulsifier or taste intensifier in foodstuff. Despite this widespread occurrence and biological importance, it is rather surprising that robust chemical systems that detect selectively and sensitively PPi in challenging matrices are still lacking. This mini review focuses on metal-salen complexes as reaction-based fluorescent sensors for the selective detection of PPi and other phosphates. The mode of detection is based on a novel disassembly approach in which the metal ion is sequestered by the target analyte from the complex and the metal-free ligand hydrolyses spontaneously into its fluorescent subunits. Optimizations of the probe and applications for PPi detection in cells and foodstuff are described.

The Mode of Detection Is Not Associated with Quality of Life in Women with Breast Cancer

Introduction: Apart from saving lives, mammography screening programs (MSP) are expected to reduce negative side effects of treatment by detecting cancer earlier, when it is more responsive to less aggressive treatment. This study compared quality of life (QoL) among women with breast cancers that were detected either by screening mammography, as interval cancers, or clinically among women not participating in the MSP. Methods: Retrospective study of first-ever invasive breast cancers detected among MSP-eligible women aged 50–69 years between 2006 and 2012 in Münster, Germany. EORTC QLQ-C30 and -BR23 questionnaires were mailed to 1,399 cases still alive in 2015 (response rate 64.1%). Results: Women’s responses were obtained on average 6.1 years after diagnosis. Mean crude and age-adjusted scores for overall QoL, breast and body image (BBI), and five functional scales (FS) were comparable between groups of detection mode. Clearly lower adjusted means for most scores were observed in women with interval cancers, if time since diagnosis was less than 5 years. Cases younger than 60 years showed lower values for some FS, particularly among interval and screen-detected cases. Discussion/Conclusion: In summary, cases with breast cancer showed health-related score values that were similar to the general population of the same age. There was also no indication that mode of detection markedly influenced these scores. However, after adjusting for tumor stage and other influential factors, screening participants appeared more susceptible to score declines after a diagnosis of cancer than non-participants.