Automated Screening Devices Research Articles

Agar plate-based activity assay for easy and fast screening of recombinant Pichia pastoris expressing unspecific peroxygenases.

Unspecific peroxygenases (UPOs) are promising biocatalysts that catalyze oxyfunctionalization reactions without the need for costly cofactors. Pichia pastoris (reclassified as Komagataella phaffii) is considered an attractive host for heterologous expression of UPOs. However, integration of UPO-expression cassettes into the genome via a single cross-over yields recombinant Pichia transformants with different UPO gene copy numbers resulting in different expression levels. Selection of the most productive Pichia transformants by a commonly used screening in liquid medium in 96-well plates is laborious and lasts up to 5 days. In this work, we developed a simple two-step agar plate-based assay to screen P. pastoris transformants for UPO activity with less effort, within shorter time, and without automated screening devices. After cell growth and protein expression on agar plates supplemented with methanol and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), an additional top agar layer supplemented with ABTS and peroxide is added. UPO activity is visualized within 15min by formation of green zones around UPO-secreting P. pastoris transformants. The assay was validated with two UPOs, AbrUPO from Aspergillus brasiliensis and evolved PaDa-I from Agrocybe aegerita. The assay results were confirmed in a quantitative 96-deep well plate screening in liquid medium.

Automated screening devices for vision screening in preschool children: A comparison of the PlusoptiX S12C photoscreener and retinomax K+3 autorefractor.

Automated vision screening devices such as photoscreeners and autorefractors have been used to accurately identify amblyopia, refractive amblyopia risk factors (ARFs), and refractive error in young children; however, there is conflicting data about the effectiveness of different screening devices. We compared the performance of two commercially available screening devices in preschool children. Children aged 3 to 5 years attending 5 preschools in Anaheim Elementary School District were screened with the PlusoptiX S12C photoscreener using ROC 3 referral criteria and Retinomax K+3 autorefractor in March 2022. Screened children were offered free cycloplegic eye examinations performed by optometrists on the UCI EyeMobile for Children mobile clinic. Children were evaluated for the presence of refractive ARFs using 2021 American Association for Pediatric Ophthalmology and Strabismus age-based referral criteria guidelines for instrument-based screening. A total of 158 children were screened and 79 children received cycloplegic examinations. At least one refractive ARF was found in 20% of examined children, corresponding to a sensitivity/specificity/positive predictive value (PPV)/negative predictive value (NPV) of 94%/89%/68%/98% for the PlusoptiX and 100%/65%/42%/100% for the Retinomax. In detecting refractive ARFs, the PlusoptiX was found to have a higher specificity and PPV while the Retinomax had a higher sensitivity and NPV. While both devices demonstrated a high sensitivity and NPV, we found that the PlusoptiX performed better overall as a screening device for our program as the Retinomax referred too many children.

AAPOS uniform guidelines for instrument-based pediatric vision screen validation 2021

As instrument-based pediatric vision screening technology has evolved, the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) has developed uniform guidelines (2003, updated 2013) to inform the development of devices that can detect specified target levels of amblyopia risk factors (ARFs) and visually significant refractive error. Clinical experience with the established guidelines has revealed an apparent high level of over-referral for non-amblyopic, symmetric astigmatism, prompting the current revision. The revised guidelines reflect the expert consensus of the AAPOS Vision Screening and Research Committees. For studies of automated screening devices, AAPOS in 2021 recommends that the gold-standard confirmatory comprehensive examination failure levels include anisometropia >1.25 D and hyperopia >4.0 D. Astigmatism >3.0 D in any meridian and myopia <-3 D should be detected in children <48 months, whereas astigmatism >1.75 D and myopia < -2 D should be detected after 48 months. Any media opacity >1 mm and manifest strabismus of >8Δ should also be identified. Along with performance in detecting ARFs and refractive error, validation studies should also report screening instrument performance with regard to presence or absence of amblyopia. Instrument receiver operating characteristic curves and Bland-Altman analysis are suggested to improve comparability of validation studies. Examination failure criteria have been simplified and the threshold for symmetric astigmatism raised compared to the 2013 guidelines, whereas the threshold for amblyogenic anisometropia has been decreased. After age 4 years, lower magnitudes of symmetric astigmatism and myopia are also targeted despite a low risk of amblyopia, because they can influence school performance and may warrant consideration of myopia prevention therapy.

Instrument-based screening for amblyopia risk factors in a primary care setting in children aged 18 to 30months.

Amblyopia is the leading cause of vision impairment in children, and its early detection can avoid irreversible consequences for a child's visual ability. In this prospective study, to detect amblyopia risk factors, we examined patients aged 18 to 30months in primary care settings. Patients were referred to an ophthalmologist for confirmation. The main aims were to detect amblyogenic risk factors and to assess the usefulness of a photoscreener in such settings. Out of 453 patients, 42 (9.3%) presented visual alterations according to the photoscreener, with astigmatism being the most common. The instrument had good sensitivity (89%) and specificity (91%), with a positive predictive value of 76% and a negative predictive value of 96%. Overall, 38% of the patients required follow-up, and 47% needed glasses. The automated screening device allowed these children to be diagnosed at an early stage.Conclusions: The use of a photoscreener to screen 2-year-old children in primary care settings was helpful and accurate. What is Known: • Early detection of amblyopic risk factors is important to avoid vision defects. However, it is very difficult to measure visual acuity using visual charts in children younger than 4years old. What is New: • Instrument-based screening in children aged 18 to 30months allows excellent detection of early amblyopia risk factors in primary care settings.

Globalization of Health Examinations

Health examinations requiring short hospital stays began in the 1950s in Japan, and automated health checks using automated screening devices and computers began in the 1960s in the United States. Automated health checks have now become standard for general health examinations in Japan. While voluntary health examinations went into decline in Western countries mostly due to a lack of evidence on improving health by health examinations, more than 5 million subjects are receiving health examinations each year in Japan. Moreover, a type of medical tourism promoted increase in number of people visiting Japan to undergo health examinations. Although views concerning personal health, preventative medicine and medical evidence are different in Western countries versus Japan, we need to disseminate information from Japan regarding the concept of our excellent health examination system globally.

Assessment of Manual Workload Limits in Gynecologic Cytology

Previous prospective studies have shown different results when comparing automated and manual screening of gynecologic cytology. The results of 3 large prospective studies were reviewed and relative sensitivity used as a gold standard. No significant differences could be shown in relative sensitivity between the ThinPrep Imaging System and the FocalPoint GS Imaging System (P > .05). When manual screening was restricted to less than 6 hours per day, 50 or fewer slides per day, and at least 6 minutes per slide (<10 slides/h), the relative sensitivity for automation was significantly lower for atypical squamous cells of undetermined significance and above (ASC+) (0.81; 95% confidence interval [CI], 0.79-0.83) than when manual screening was not restricted (1.07; 95% CI, 1.03-1.10). All 3 sites that screened 10 or more slides per hour manually had a relative sensitivity for automation that was significantly higher for high-grade squamous intraepithelial lesions and above (HSIL+) than for the remaining groups who screened less than 10 slides per hour (1.40 [95% CI, 1.22-1.60] vs 0.97 [95% CI, 0.95-1.00]). These results suggest that location finding of abnormalities (ASC+) may be more strongly associated with time spent screening per day, whereas classification/interpretation skills (HSIL+) may depend on time spent on an individual case. There is no evidence that automated screening devices are more sensitive than manual screening performed at lower well-defined workloads. More restricted workloads (≤41 slides/d, ≤4.5 h/d) for manual screening may perform significantly better than automated screening devices as measured by histologic cervical intraepithelial neoplasia 2 and above.

Human Papillomavirus and Pap Smear

High-risk human papillomavirus (HPV) infection and viral persistence is a major risk factor in the development of squamous intraepithelial lesions and invasive carcinoma of the cervix. In the United States, deaths due to squamous cell carcinoma of the cervix have fallen by 75% since the 1960s because of Papanicolaou (Pap) smear screening. However, the traditional Pap had a sensitivity of about 70% for detecting clinically significant precancerous lesions and cancer because of sampling and interpretive errors. The introduction of 2 liquid-based Pap smear collection systems in the 1990s, the use of HPV testing as a triage and co-testing with Pap smear, and the introduction of 2 automated screening devices have had a significant impact on improving the detection of such precancerous lesions. This review provides an analysis of the changes in Pap smear collection, improvements in screening, the evolutionary changes of high-risk HPV testing, reporting terminology of Pap smears, and clinical management guidelines. The future impact of 2 prophylactic HPV vaccines on the incidence of cervical carcinoma is also discussed. This article also discusses alternatives such as primary screening for high-risk HPV testing with visual inspection for cervical cancer detection used in resource-poor settings with a high incidence of cervical cancer.

Rapid prescreening is as effective at reducing screening error as postscreening with the FocalPoint automated screening device

Both manual (rapid prescreening) and automated methods have been devised to reduce screening error compared with routine review of 10% of negative gynecologic cases. To date these two methods have not been compared. A total of 5,139 liquid-based (SurePath Pap Test, BD Diagnostics) cases were subjected to 100% rapid prescreening and routine manual screening. All cases diagnosed as negative on routine screening were placed on the FocalPoint (BD Diagnostics, Franklin Lakes, NJ) automated screening device. All cases that were negative on routine screening and abnormal on rapid prescreening or in the top 15% of cases by FocalPoint were rescreened and a final diagnosis obtained. Cases were blinded during rapid prescreening and routine manual screening. Abnormal was defined as any diagnosis of atypical squamous cells (ASC) or worse. A total of 427 (8%) of cases were abnormal on routine screening. The sensitivity of rapid prescreening was 44.6%. Rapid prescreening identified an additional 14 abnormal cases (13 ASC and 1 LSIL) and FocalPoint identified nine cases (eight ASC, one LSIL) that were not detected by routine screening. Three of these cases were detected by both methods. The sensitivity of routine screening was 93.1%. Rapid prescreening increased the overall sensitivity significantly (96.0%, P = 0.04); FocalPoint increased the sensitivity but this change was not significant (95.0%, P = 0.21). Estimated screening time was 30 seconds for rapid prescreening and 6 minutes for routine screening with the result that rapid prescreening required 2,570 minutes while review of the FocalPoint Slides required 2,694 minutes. The sensitivity of routine screening in the second half of the study (95.3%) was higher than that in the first half of the study (91.6%) but the difference was not significant (P = 0.11). Rapid prescreening is as effective as directed review using FocalPoint at reducing screening errors and requires no additional screening time. Continued use of these methods may improve the sensitivity of routine screening

Newborn hearing screening in Western Australia.

To report the preliminary findings of a pilot program to screen newborn babies for congenital bilateral permanent hearing loss. The five largest maternity hospitals in Perth, Western Australia. Screening was gradually introduced over seven months from February to August 2000. All babies born at these hospitals after the introduction of hearing screening until 30 June 2001. One or both of two automated screening devices were used: one measuring transient evoked otoacoustic emissions (TEOAE) and the other automated auditory brainstem responses (AABR). If a "pass" was not obtained in both ears, screening was repeated. All babies who did not obtain a pass in either ear at follow-up were referred for audiological assessment. Prevalence of permanent bilateral hearing loss. Of 13 214 eligible babies, 12 708 (96.2%) received screening. The main reason for missing screening was early hospital discharge (309; 2.3%). Of the screened babies, 99% had a pass response in both ears at either the initial or follow-up screen. Twenty-three babies were referred for audiological assessment, and nine were diagnosed with bilateral permanent hearing loss (0.68/1000; 95% CI, 0.31-1.28). Despite our program meeting process quality indicators, our detection rate was low. Before extending the program to smaller hospitals, we need to validate our screening instruments and put in place a system to monitor false negative results.

The Automation Trend in Cytology

Automation of laboratory medicine is a growing concept that has involved virtually every type of clinical laboratory testing. This article discusses the automated devices currently available for use in the cytology laboratory and the principles governing the action of these automated instruments. The instruments are grouped into 3 main categories: specimen collection and preparation devices, manual screening adjunctive devices, and automated screening devices.

Automated Screening Devices

Automated Screening Devices

The search for early indicators of social service need among elderly hospital patients.

ABSTRACT: A study was made of the possible usefulness of certain sociodemo‐graphic characteristics as early indicators of the need for referral of elderly hospital patients to Social Service. The study population covered the 5,312 elderly patients accommodated in the private, semiprivate and teaching wards of the hospital's medical and surgical services during the year 1967. Of these patients, 520 were referred to Social Service. The data on 6 items (age, sex, marital status, religion, color, and medical service location) routinely recorded on each admission sheet were collected to determine whether they would prove predictive of the need for referral to Social Service; if so, they would constitute an inexpensive automated screening device for this purpose. At present, most elderly patients who need the services of social workers are referred only late in the course of hospitalization. Incidental to the original plan of study was the collection of data on the length of hospital stay. The 6 “admission” variables were found to be of no value as early predictors, but the ancillary variable (length of stay) proved to be importantly related to the overall need for Social Service. However, since the data on this variable can be obtained only at the time of discharge, they cannot be used as a screening device for early identification of the need. Further studies may reveal a means of early prediction of the length of hospital stay.