Early warning signs of alcoholism.
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Alcoholism↗
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Results for “Early warning”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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VA hospital initiates early warning system for suspicious deaths.
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Accident Prevention↗
Whole-genome sequencing of adenovirus 41 directly from wastewater using nested overlapping PCR and MinION.
Human adenovirus F41 (HAdV-F41) is one of the leading causes of children's acute gastroenteritis and was recently linked to an outbreak of severe acute hepatitis of unknown etiology among children during 2021 to 2022. While most evidence is based on clinical data, wastewater-based epidemiology offers a community-level approach to monitoring circulating strains and enhancing outbreak preparedness. In this study, we developed an overlapping amplicon-based whole-genome sequencing approach to directly detect HAdV-F41 from archived wastewater samples, using nested PCR with 13 primer sets. Archived wastewater samples were collected between 2021 and 2022 from three treatment plants in Seattle, USA. The viral load ranged from 1.2 × 103 to 8.4 × 103 genome copies per liter. The Oxford Nanopore platform was used for whole-genome sequencing. Complete or partial (>84%) HAdV-F41 genomes were recovered from wastewater samples, with mean coverage depths ranging from 10³ to 10⁵. The consensus sequences showed more than 99% similarity to reference genomes in the NCBI database. The phylogenetic analysis revealed that 2 sequences clustered within lineage 2a and 11 within lineage 2b, reflecting that at least two sub-lineages were circulating in the community at that time. Our results demonstrate that the overlapping amplicon-based whole-genome sequencing approach using the Oxford Nanopore platform reliably recovers HAdV-F41 genomes from wastewater. This method offers high-resolution genomic surveillance of circulating, clinically relevant HAdV-F41, supporting wastewater-based epidemiology as a valuable tool for detecting emerging variants and strengthening the early warning system for future disease outbreaks.IMPORTANCEHuman adenovirus F41 is a primary cause of childhood gastroenteritis and has been linked to recent outbreaks of severe acute hepatitis in children, yet community-level genomic surveillance of this virus remains limited. This study shows that wastewater can be used to recover nearly complete HAdV-F41 genomes through a targeted overlapping-amplicon sequencing strategy on the Oxford Nanopore platform. By applying this method to archived wastewater samples, we detected the simultaneous circulation of multiple viral lineages in a large city. These findings extend wastewater-based epidemiology beyond SARS-CoV-2 and emphasize its importance for monitoring clinically significant enteric viruses. The method described here offers a scalable tool for tracking viral evolution in communities and enhancing early warning systems for future outbreaks.
Wastewater↗
[Valve movement of the mussel Dreissena polymorpha as a monitoring system for bodies of water].
A new biological "early warning system" for continuous water control is presented that is based on the valve movements of the freshwater mussel Dreissena polymorpha. For two groups of up to 42 mussels, both the percentage of open mussels and the number of valve movements during a time interval are used to describe the activity behaviour of the zebra mussel. A main prerequisite of such a biomonitor should be the knowledge of the "normal" behaviour in correlation to changing environmental conditions. Preliminary results in Dreissena demonstrate the influence of the temperature, the daily cycle of light and the food concentration on both characteristics of the activity pattern. During toxicity tests, the mussels reacted significantly within 3-30 minutes after the addition of a toxicant. This was normally observed by both the decrease of the percentage of open mussels and the increase of the number of valve movements. Therefore--and against the background of the well-known "normal" behaviour--reliable limits for the detection of a harassing event can be defined. First experiments with Pentachlorophenol, Lindane, Atrazine and 2-Nitrophenol demonstrated to some extent a higher sensitivity compared to other "early warning systems".
Animals↗
[Increased Scandinavian cooperation in vaccination. Hot line for early influenza warning].
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Humans↗
Use of capnography to monitor pulmonary circulation during cardiac resuscitation.
Three cases are described where capnography gave very early warning of ineffective cardiac massage or impending cardiovascular failure. Life-saving information can be obtained at an early stage if the capnograph is used routinely in the care of critically ill patients.
Carbon Dioxide↗
Metaviromic profiling of mosquito excreta using superhydrophobic collection devices expands the known RNA virome of North America.
Nearly 30% of emerging infectious disease events worldwide are transmitted by arthropod vectors, and this proportion continues to rise. Rapid and accurate detection is critical for directing vector control interventions, thereby reducing the likelihood of widespread transmission. Surveillance of infected mosquitoes can provide an early warning of impending human infection; however, conventional virus testing relies on processing large pools of mosquitoes and requires labor-intensive pre-processing. During rapidly developing epidemic or panzootic events, these delays may limit the effectiveness of public health responses. Mosquito excreta has recently emerged as a promising alternative substrate for pathogen detection. Sugar-fed mosquitoes regularly excrete gut contents, offering a rich source of nucleic acids. In this study, we developed and applied custom superhydrophobic excreta-collection funnels that efficiently aggregate excreta produced by field-collected Culex mosquitoes into attached microcentrifuge tubes. Shotgun metagenomic sequencing of this material revealed a diverse RNA virome, including both globally distributed viruses and those reported here for the first time from the Americas. Beyond virus detection, additional analyses enabled confirmation of host mosquito species and identification of trypanosomatid parasites, demonstrating the broader utility of mosquito excreta for integrated surveillance. We anticipate that methods and devices of this type will become valuable components of vector surveillance programs, particularly in remote or resource-limited settings where repeated collections are challenging. Overall, our findings highlight the potential of excreta-based monitoring to improve early detection of emerging or unknown pathogens of One Health importance, refine our understanding of mosquito virome biogeography, and facilitate the discovery of previously undescribed viruses.IMPORTANCEMany infectious diseases that affect people and animals are spread by mosquitoes and other biting insects, and the number of these outbreaks is increasing. Detecting pathogens in mosquito populations early can provide a critical warning before human cases begin, allowing health officials to act quickly. However, traditional surveillance requires collecting and processing large numbers of mosquitoes, which can be slow and labor-intensive during fast-moving outbreaks. Here we demonstrate a simpler approach: testing mosquito waste. When mosquitoes feed on sugar, they excrete material that contains genetic traces of viruses and other organisms. Using specially designed collection devices and modern genetic sequencing, we show that mosquito excreta can reveal a wide range of viruses and parasites while also identifying the mosquito species present. This method could make disease surveillance faster and more practical in remote or resource-limited settings, improving our ability to detect emerging pathogens that threaten human, animal, and environmental health.
Animals↗
Re-emerging Marburg virus disease in Africa: spillover ecology, geographic expansion, and surveillance vulnerabilities.
Marburg virus disease (MVD) is re-emerging across Africa as a high-consequence zoonosis shaped by expanding ecological suitability, repeated spillover, and uneven surveillance capacity. This review synthesizes current evidence on the ecological, epidemiological, and operational determinants of contemporary Marburg virus (MARV) emergence. We conceptualize MVD as an ecological-emergence system produced by interactions among reservoir-host biology, environmental change, human exposure, health-system readiness, and mobility, rather than as a series of isolated outbreaks. Recent detections in multiple African regions indicate wider enzootic circulation than previously recognized and support repeated, reservoir-associated introductions from distributed ecological foci. Spillover risk is heightened where mining, land-use change, agricultural encroachment, settlement growth, climate-sensitive habitat disruption, and population movement increase contact with Egyptian rousette bats (Rousettus aegyptiacus) and contaminated roost environments. Following primary spillover, diagnostic delays, fragmented surveillance, limited laboratory decentralization, healthcare-associated transmission, and mobility-linked exposure can enable outbreak amplification and delayed recognition. Serological findings further suggest possible "shadow epidemiology," with unrecognized or mild MARV infections occurring outside confirmed outbreak chains. Critical preparedness gaps persist in ecological risk mapping, longitudinal reservoir surveillance, decentralized molecular diagnostics, genomic sequencing, data integration, and cross-border early warning. Future preparedness should move beyond reactive containment toward integrated One Health approach combining predictive ecological surveillance, rapid community-level detection, real-time genomics, infection prevention, risk communication, and regional coordination to identify spillover early and prevent human transmission.
Animals↗
Bowen's disease and squamous cell carcinoma. Occurrence in a patient with psoriasis after topical, systemic, and PUVA therapy.
Multiple lesions of Bowen's disease and squamous cell carcinoma on the penis and pubic areas developed in a 32-year-old patient with psoriasis who was undergoing treatment with psoralen and long-wave ultraviolet radiation (PUVA). A cumulative dose of more than 3,700 joules/sq cm of UVA had been administered over a three-year period. This case may be an early warning of possible carcinogenicity of PUVA therapy, alone or as part of sequential therapy with other agents.
Adult↗
Intracranial pressure reserve testing. Initial clinical observations.
Sequential subdural injections of fluid through an intracranial pressure (ICP) monitoring cup catheter have been employed to measure "ICP reserve" in a series of 136 determinations in 30 patients over a total of 155 days of recordings. This dynamic method of quantitating the brain's ability to adapt to increased intracranial volume tests the brain's compensatory mechanisms over a five-minute time span. The test, incorporating several safety features, has been found to be reliable, safe, and well tolerated. A series of observations have been made using this test in patients with subdural drains and in response to fluid, mannitol, and dexamethasone therapy. Deteriorating ICP reserve gave early warning of the need for reoperation for postoperative hematoma, massive brain swelling, or cystic reaccumulation. Intracranial pressure reserve testing also quantitated the evolution of postoperative brain edema. Changes in ICP reserve could be detected as much as 48 hours before changes in baseline ICP and as much as 72 hours before clinical deterioration was evident.
Brain↗
Continuous intra-arterial PO2 monitoring during thoracic surgery.
Intermittent blood gas sampling has several disadvantages, the most important being that samples are usually taken at set intervals, or when changes in oxygenation are suspected--when it is too late. Another problem is inaccuracy caused by careless blood sample handling. Continuous intravascular PaO2 monitoring eliminates these problems. This study shows that the Continucath sensor is an easy-to-use and reliable monitor, with specific early warning capabilities for hypoxia, thereby improving anesthetic and intensive care management. Its characteristics are: a stabilization period of 10 minutes, a 90% response time of 90 seconds, temperature dependence of 4% per degree celsius, a flow dependence of less than 1% if the flow is more than 5 cm/sec, a drift of less than 0.7% per hour, a correlation coefficient of 0.92 when compared to blood gas analysis during surgery.
Adult↗
Biochemical markers in Hodgkin's disease and non-Hodgkin's lymphoma.
Vertical studies indicate that, in general, acute phase reactant proteins (APRP) reflect disease activity in both Hodgkin's disease and non-Hodgkin's lymphoma. Longitudinal studies of the selected APRP profile demonstrate the following: 1. The stable profile is characteristic of remission. 2. Considerable elevation of APRPs coincides with relapsed disease. 3. An unstable profile is a feature of relapsing disease and may give early warning of relapse. 4. Patients responding inadequately to treatment frequently have unstable APRP profiles.
Adult↗
Money and mental disorder: toward behavioral cost accounting for primary prevention.
This paper reviews recent retrospective sociological research suggesting that rises as well as falls in the economy are associated with such indicators of mental disorder as suicide and mental hospitalization. The review emphasizes that a lag exists between economic change and the changes in associated mental indicators. It is suggested that these findings hold promise both for early warning for practitioners and for primary prevention. Also described is a survey in four centers of 93 community mental health workers, indicating that such workers are receptive to the use of such economic indicators but not well-informed about them. Suggestions are made for prospective research to relate economic change to mental disorder through such intervening constructs as life change and stress. Such research, it is hoped, would expand the capacities of community psychologists to account for the behavioral costs of economic policy alternatives.
Adaptation, Psychological↗
Influenza surveillance in Israel, 1976--77.
An influenza surveillance program developed and conducted in three districts in Israel during winter 1976--77, was based mainly on morbidity data in the general population, corroborated by sero-epidemiologic surveys on selected groups. This information was supplemented by data on mortality organized according to specific age groups. During the period under study, similar results were observed in each of the three districts surveyed. Two successive waves of influenza were recorded: an early wave due to B/Hong Kong/5/72 followed by an A/Victoria/3/75 outbreak. Both waves were of moderate extent, with the highest frequency of clinical influenza occurring in the youngest group, age 0--14 years. The age-specific mortality rates were highest and rather similar in the extreme age groups 65+ and 0. The search of A/New Jersey/8/76 antibody revealed a considerable proportion of positives with a higher titer in the older age groups. A special serologic survey among Yemenite Jews over 50 years of age, who immigrated to Israel in 1949, showed that the 1918 influenza pandemic also reached that isolated country. The surveillance program provided an early warning system as well as a rather accurate measurement of influenza impact in Israel.
Adolescent↗
Malignant hyperthermia.
Malignant hyperthermia of anesthesia is a severe complication and must be treated vigorously. The anesthetic should be stopped and the core body temperature reduced. Systemic complications must be anticipated, hopefully prevented, and appropriately treated. Appropriate laboratory studies must be obtained. A comprehensive family survey may alert the physician to a tendency toward this problem. Temperature monitoring during surgery may give an early warning of malignant hyperthermia developing. I would suggest that routine temperature monitoring during surgery be considered by the anesthesia department during each general anesthetic administration.
Adult↗
Acute hepatic failure and Henoch-Schönlein syndrome appearing in a patient with severe cranio-facial injuries.
A case of acute hepatic failure is described following multiple general anaesthetics administered for the treatment of cranio-facial trauma. The dangers of multiple anaesthetics within a short period is stressed. The possibility that unexplained pyrexia following a general anaesthetic may be and early warning sign is mentioned in relation to this case. The subsequent development of the Henoch-Schönlein syndrome is reported, and the occurrence of the two conditions in the same patient is thought to be possibly unique.
Acute Disease↗
Automated assay of N-acetyl-beta-glucosaminidase in normal and pathological human urine.
An automated method for the assay of N-acetyl-beta-glucosaminidase in human urine is described and a normal range of urinary N-acetyl-beta-glucosaminidase activity is reported. The automated method has been used routinely over a twelve month period in two London hospitals for monitoring the excretion of N-acetyl-beta-glucosaminidase in renal transplant patients. The abnormal elevation of urinary N-acetyl-beta-glucosaminidase provides an early warning of rejection by indicating the presence of renal parenchymal damage. The automated assay of urinary N-acetyl-beta-glucosaminidase may also be used in screening for the presence of renal disease.
Acetylglucosaminidase↗
Evaluation of ultrasonic bubble detectors in vitro using calibrated microbubbles at selected velocities.
Two standard Doppler ultrasonic devices, currently used for detecting bubbles in vivo, have been evaluated and compared in vitro using carefully calibrated uniform micro-bubbles rising at terminal velocity through a static aqueous medium. Two unexpected findings were observed: (a) the focal length of the transducer apparently decreases for smaller bubble sizes, and (b) a significant horizontal convection current was produced by one of the instruments. When the medium was in motion, it was found that the sensitivity varied markedly with bubble velocity, varying from a minimum detectable diameter of 40 mum at 55 cm/sec to 170 mum at 20 cm/sec. These findings are discussed with regard to the limitations of the Doppler technique for monitoring gas emboli in vivo and as an early warning for decompression sickness in divers.
Decompression Sickness↗