Screening Center Research Articles

Post-deployment performance of a deep learning algorithm for normal and abnormal chest X-ray classification: A study at visa screening centers in the United Arab Emirates

BackgroundChest radiographs (CXRs) are widely used to screen for infectious diseases like tuberculosis and COVID-19 among migrants. At such high-volume settings, manual CXR reporting is challenging and integrating artificial intelligence (AI) algorithms into the workflow help to rule out normal findings in minutes, allowing radiologists to focus on abnormal cases. MethodsIn this post-deployment study, all the CXRs acquired during the visa screening process across 33 centers in United Arab Emirates from January 2021 to June 2022 (18 months) were included. The qXR v2.1 chest X-ray interpretation software was used to classify the scans into normal and abnormal, and its agreement against radiologist was evaluated. Additionally, a digital survey was conducted among 20 healthcare professionals with prior AI experience to understand real-world implementation challenges and impact. ResultsThe analysis of 1309,443 CXRs from 1309,431 patients (median age: 35 years; IQR [29–42]; 1030,071 males [78.7 %]) in this study revealed a Negative Predictive Value (NPV) of 99.92 % (95 % CI: 99.92, 99.93), Positive Predictive Value (PPV) of 5.06 % (95 % CI: 4.99, 5.13) and overall percent agreement of the AI with radiologists of 72.90 % (95 % CI: 72.82, 72.98). In the survey, majority (88.2 %) of the radiologists agreed to turnaround time reduction after AI integration, while 82 % suggested that the AI improved their diagnostic accuracy. DiscussionIn contrast with the existing studies, this research uses a substantially large data. A high NPV and satisfactory agreement with human readers indicate that AI can reliably identify normal CXRs, making it suitable for routine applications.

Clinical Utility of Deep Learning Assistance for Detecting Various Abnormal Findings in Color Retinal Fundus Images: A Reader Study.

To evaluate the clinical usefulness of a deep learning-based detection device for multiple abnormal findings on retinal fundus photographs for readers with varying expertise. Fourteen ophthalmologists (six residents, eight specialists) assessed 399 fundus images with respect to 12 major ophthalmologic findings, with or without the assistance of a deep learning algorithm, in two separate reading sessions. Sensitivity, specificity, and reading time per image were compared. With algorithmic assistance, readers significantly improved in sensitivity for all 12 findings (P < 0.05) but tended to be less specific (P < 0.05) for hemorrhage, drusen, membrane, and vascular abnormality, more profoundly so in residents. Sensitivity without algorithmic assistance was significantly lower in residents (23.1%∼75.8%) compared to specialists (55.1%∼97.1%) in nine findings, but it improved to similar levels with algorithmic assistance (67.8%∼99.4% in residents, 83.2%∼99.5% in specialists) with only hemorrhage remaining statistically significantly lower. Variances in sensitivity were significantly reduced for all findings. Reading time per image decreased in images with fewer than three findings per image, more profoundly in residents. When simulated based on images acquired from a health screening center, average reading time was estimated to be reduced by 25.9% (from 16.4 seconds to 12.1 seconds per image) for residents, and by 2.0% (from 9.6 seconds to 9.4 seconds) for specialists. Deep learning-based computer-assisted detection devices increase sensitivity, reduce inter-reader variance in sensitivity, and reduce reading time in less complicated images. This study evaluated the influence that algorithmic assistance in detecting abnormal findings on retinal fundus photographs has on clinicians, possibly predicting its influence on clinical application.

FlyRNAi.org 2025 update-expanded resources for new technologies and species.

The design, analysisand mining of large-scale 'omics studies with the goal of advancing biological and biomedical understanding require use of a range of bioinformatics tools, including approaches tailored to needs specific to a given species and/or technology. The FlyRNAi database at the Drosophila RNAi Screening Center and Transgenic RNAi Project (DRSC/TRiP) Functional Genomics Resources (https://fgr.hms.harvard.edu/tools) supports an increasingly broad group of technologies and species. Recently, for example, we expanded the database to include additional new data-centric resources that facilitate mining and analysis of single-cell transcriptomics. In addition, we have applied our approaches to CRISPR reagent and gene-centric bioinformatics approaches in Drosophila to arthropod vectors of infectious diseases. Building on our previous comprehensive reports on the FlyRNAi database, here we focus on new and updated resources with a primary focus on data-centric tools. Altogether, our suite of online resources supports various stages of functional genomics studies for Drosophila and other arthropods, and facilitate a wide range of reagent design, analysis, data miningand analysis approaches by biologists and biomedical experts studying Drosophila, other common genetic model species, arthropod vectorsand/or human biology.

Prevalence and Molecular Characterization of β-Thalassemia in Kirkuk Province of Northern Iraq

To determine the prevalence and molecular basis of β-thalassemia in the Northeastern Iraqi province of Kirkuk, a total of 3954 individuals attending the provincial premarital screening center were recruited. The prevalence of β-thalassemia minor among the screened individuals was found to be 3.0%, while those of Hemoglobin E, and δβ-thalassemia carrier states were 0.05%, and 0.03% respectively. Molecular characterization of the β-thalassemia mutations was achieved by multiplex PCR and reverse hybridization, followed by next generation sequencing for those left uncharacterized by the former technique. Among 19 β-thalassemia mutations identified, seven were the most frequent, namely: IVS-II-1 (G > A), codon 8/9 (+G), IVS-I-6 (T > C), IVS-I-110 (G > A), IVS-I-I (G > A), IVS-I-5 (G > C) and codon 44 (-C) accounting for 78.5% of the mutations. This study further illustrates the heterogeneity of the spectrum of β-thalassemia in different parts of Iraq, and provides an essential step to facilitate prenatal diagnosis in the setting of a future national thalassemia prevention program.

Is decreased psoas volume a risk factor for hip fracture? A comparative study of patients with and without hip fractures using the exact matching technique

IntroductionSarcopenia is linked to increased fall and hip fracture risk. However, studies often overlook comprehensively controlling for age, sex, bone mineral density (BMD), and body mass index (BMI). Our study aimed to determine if sarcopenia, determined by evaluating the psoas muscle volume, is an independent risk factor for hip fractures. We employed a methodological approach that includes the exact matching technique. MethodsIn this cross-sectional comparative study, we compared the data of patients who sustained hip fractures between 2015 and 2021 with those of a control group from a health screening center in a single center. The study included 545 patients with hip fractures and 1292 without fractures. We collected data on demographics, BMD determined using dual-energy X-ray absorptiometry, and abdominal and pelvic computed tomography (APCT) scans for psoas muscle volume analysis. ResultsThe analysis after exact matching of 266 pairs revealed that psoas volume/height2 was the most significant and dominant risk factor among the evaluated indices. Multivariate logistic regression analysis, adjusting for age, sex, BMI, and BMD, identified height or height2-adjusted psoas muscle volume as an independent risk factor for hip fractures (p = 0.042 and p = 0.002, respectively). Age, female sex, lower BMI, and lower BMD were associated with an increased risk of hip fractures. ConclusionDecreased psoas muscle volume adjusted for patient height independently predicts hip fracture risk. Psoas volume assessment via APCT is a practical tool for identifying at-risk individuals, emphasizing the necessity of including sarcopenia in hip fracture risk assessments.

Prevalence and Mutation Analysis of Short-Chain acyl-CoA Dehydrogenase Deficiency Detected by Newborn Screening in Hefei, China.

Short-chain acyl-CoA dehydrogenase deficiency (SCADD) is an autosomal recessive inborn error of mitochondrial fatty acid oxidation with highly variable biochemical and genetic characteristics. The present study aimed to estimate the prevalence and genetic characteristics of SCADD in newborns identified through screening. A total of 782,930 newborns were screened for SCADD in Hefei Neonatal Screening Center from January 2016 to December 2023. The blood samples from newborns were measured by tandem mass spectrometry (MS/MS). The suspected SCADD neonates were rechecked using next-generation gene sequencing for diagnosis. Sanger sequencing was used to verify the mutation site for patients with SCADD and their parents. A total of 21 SCADD cases were confirmed, with an incidence rate of 1/37,282. Genetic mutations were identified in all 21 cases, including 15 cases of compound heterozygous variation and 6 cases of homozygous variation. Twenty-one different mutation types and forty-two mutation sites were discovered, with the most frequent mutation being c.1031A>G, accounting for 21.43% (9/42), followed by c.1130C>T, accounting for 16.67% (7/42). Our findings expand the SCADD mutational spectra. c. 1031A>G and c.1130C>T are the common mutation sites for SCADD genes in newborns. SCADD diagnosed through NBS is primarily a benign condition, and early diagnosis is not necessarily essential.

Adverse events after colonoscopy in a randomised colorectal cancer screening trial

ObjectiveColonoscopy-related adverse events increase the burden of colorectal cancer (CRC) screening. This cross-sectional study evaluates adverse events during and after colonoscopy in a large, randomised CRC screening trial in Norway...

Trends in admission to the Wildlife Screening Center in Espírito Santo State, Brazil, from 2011 to 2021

Background and Aim: The Wild Animal Screening Center in Espírito Santo State (CETAS-ES), Brazil, treats wildlife from trafficking and illegal trade, accidents, captivity, and rescue from out of their habitat. The present study described the trends in wildlife admission to the CETAS-ES over the past 10 years and discussed the impact of animal exploitation. Materials and Methods: This descriptive study used a database provided by the CETAS-ES with data on animals admitted between 2011 and 2021, including admission year, origin, place of captivity, taxonomic category, sex, life stage, and health status. Results: Over 10 years, 23,176 animals were admitted, with an annual average of 2,106 admissions. Seizing was the most common origin (60.39%), followed by rescues/collections (22.60%) and voluntary delivery (11.7%), whereas 5.3% had unidentified origins. Birds were the most frequently admitted animals (80.6%) and were predominant among those seized (97.5%), rescued/collected (46.7%), and voluntarily delivered (73.2%). Mammals represented 45.0% of rescues/collections and reptiles represented 19.0% of voluntary deliveries. Conclusion: The admissions reveal a vulnerable scenario for wildlife in the Brazilian Atlantic Rainforest of Espírito Santo State, mainly affecting birds. Seizing was a common occurrence over the decade, reinforcing the necessity of actions to prevent wildlife trafficking and illegal trade. Keywords: Atlantic Rainforest, biodiversity, fauna, wildlife trade.

Isoniazid resistance pattern among pulmonary tuberculosis patients in Bangladesh: An exploratory study

ObjectivesIn high tuberculosis (TB) burden countries such as Bangladesh, research and policy tend to focus on rifampicin (RIF)-resistant TB patients, leaving RIF-sensitive but isoniazid (INH)-resistant (Hr-TB) patients undiagnosed. Our study aims to determine the prevalence of INH resistance among pulmonary TB patients in selected health care facilities in Bangladesh. MethodsThis study was conducted across nine TB Screening and Treatment Centres situated in Bangladesh. Sputum samples from 1084 Xpert-positive pulmonary TB patients were collected between April 2021 and December 2022 and cultured for drug susceptibility testing. Demographic and clinical characteristics of Hr-TB and drug-susceptible TB patients were compared. ResultsAmong available drug susceptibility testing results of 998 culture-positive isolates, the resistance rate of any INH regardless of RIF susceptibility was 6.4% (64/998, 95% CI: 4.9–8.2). The rate was significantly higher in previously treated (21.1%, 16/76, 95% CI: 12.0–34.2) compared with newly diagnosed TB patients (5.2%, 48/922, 95% CI: 3.8–6.9) (p < 0.001). The rate of Hr-TB was 4.5% (45/998, 95% CI: 3.3–6.0), which was also higher among previously treated patients (6.6%, 5/76, 95% CI: 1.4–13.5) compared with newly diagnosed TB patients (4.3%; 40/922, 95% CI: 3.1–5.9) (p 0.350). Most importantly, the rate of Hr-TB was more than double compared with MDR-TB (4.5%, 45/998, vs. 1.9%, 19/998) found in the current study. DiscussionThis study reveals a high prevalence of Hr-TB, surpassing even that of the multi-drug-resistant TB in Bangladesh. This emphasizes the urgent need to adopt WHO-recommended molecular tools at the national level for rapid detection of INH resistance so that patients receive timely and appropriate treatment.

Application of machine learning algorithms in predicting carotid artery plaques using routine health assessments.

Cardiovascular diseases (CVD) constitute a grave global health challenge, engendering significant socio-economic repercussions. Carotid artery plaques (CAP) are critical determinants of CVD risk, and proactive screening can substantially mitigate the frequency of cardiovascular incidents. However, the unequal distribution of medical resources precludes many patients from accessing carotid ultrasound diagnostics. Machine learning (ML) offers an effective screening alternative, delivering accurate predictions without the need for advanced diagnostic equipment. This study aimed to construct ML models that utilize routine health assessments and blood biomarkers to forecast the onset of CAP. In this study, seven ML models, including LightGBM, LR, multi-layer perceptron (MLP), NBM, RF, SVM, and XGBoost, were used to construct the prediction model, and their performance in predicting the risk of CAP was compared. Data on health checkups and biochemical indicators were collected from 19,751 participants at the Beijing MJ Health Screening Center for model training and validation. Of these, 6,381 were diagnosed with CAP using carotid ultrasonography. In this study, 21 indicators were selected. The performance of the models was evaluated using the accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), F1 score, and area under the curve (AUC) value. Among the seven ML models, the light gradient boosting machine (LightGBM) had the highest AUC value (85.4%). Moreover, age, systolic blood pressure (SBP), gender, low-density lipoprotein cholesterol (LDL-C), and total cholesterol (CHOL) were the top five predictors of carotid plaque formation. This study demonstrated the feasibility of predicting carotid plaque risk using ML algorithms. ML offers effective tools for improving public health monitoring and risk assessment, with the potential to improve primary care and community health by identifying high-risk individuals and enabling proactive healthcare measures and resource optimization.

Adaptation of the socioecological model to address disparities in engagement of Black men in prostate cancer genetic testing

BackgroundBlack men consistently have higher rates of prostate cancer (PCA)- related mortality. Advances in PCA treatment, screening, and hereditary cancer assessment center around germline testing (GT). Of concern is the significant under-engagement of Black males in PCA GT, limiting the benefit of precision therapy and tailored cancer screening despite longstanding awareness of these disparities. To address these critical disparities, the Socioecological Model (SEM) was employed to develop comprehensive recommendations to overcome barriers and implement equitable strategies to engage Black males in PCA GT.MethodsClinical/research experts, national organization leaders, and community stakeholders spanning multiple regions in US and Africa participated in developing a framework for equity in PCA GT grounded in the SEM. A novel mixed-methods approach was employed to generate key areas to be addressed and informed statements for consensus consideration utilizing the modified Delphi model. Statements achieving strong consensus (> =75% agreement) were included in final equity frameworks addressing clinical/community engagement and research engagement.ResultsAll societal levels of the SEM (interpersonal, institutional, community, and policy/advocacy) must deliver information about PCA GT to Black males that address benefits/limitations, clinical impact, hereditary cancer implications, with acknowledgment of mistrust (mean scores [MS] 4.57-5.00). Interpersonal strategies for information delivery included engagement of family/friends/peers/Black role models to improve education/awareness and overcome mistrust (MS 4.65-5.00). Institutional strategies included diversifying clinical, research, and educational programs and integrating community liaisons into healthcare institutions (MS 4.57-5.00). Community strategies included partnerships with healthcare institutions and visibility of healthcare providers/researchers at community events (MS 4.65–4.91). Policy/advocacy included improving partnerships between advocacy and healthcare/community organizations while protecting patient benefits (MS 4.57-5.00). Media strategies were endorsed for the first time at every level (MS 4.56-5.00).ConclusionThe SEM-based equity frameworks proposed provide the first multidisciplinary strategies dedicated to increase engagement of Black males in PCA GT, which are critical to reduce disparities in PCA-mortality through informing tailored screening, targeted therapy, and cascade testing in families.

Association of Evening Shifts, Night Shifts, and Consistent Overtime Exceeding 10 Hours per Day with Sudden Cardiac Arrest: A Case-Control Study.

Background: We investigated the relationship between employment status, work patterns, and sudden cardiac arrest (SCA). Methods: This was a case-control study from September 2017 through December 2022 involving 17 emergency departments and 9 public health centers. The cases included patients aged 20-79 years with SCA, excluding those with traumatic arrest, terminal illness, pregnancy, unreliable information, or a "Do Not Resuscitate" order. Controls were selected from various health screening centers in Korea. All participants completed structured questionnaires. Propensity score matching was used to ensure comparability by age, sex, and socioeconomic status. Results: Of the 1536 patients enrolled, 116 from the case group were excluded due to missing employment data, leaving 1420 cases and 2304 controls for analysis. Employment was reported by 47.5% of cases and 59.4% of controls. There was no significant difference in the proportion of sole proprietors (20.6% vs. 22.5%, p = 0.39). The case group had a higher proportion of employers (13.2% vs. 6.5%, p < 0.001) and fewer employees (63.3% vs. 69.1%, p = 0.02). Professional roles were more common among controls (23.6% vs. 31.6%, p < 0.001), while labor-intensive jobs were more frequent in cases (27.7% vs. 17.8%, p < 0.001). The case group had more evening and night shifts (odds ratio [OR]: 1.04, 95% confidence interval [CI]: 1.01-1.06; OR: 1.05, 95% CI: 1.01-1.09) and longer workdays (OR: 1.06, 95% CI: 1.03-1.08). Conclusions: SCA patients were more likely to work evening and night shifts and have longer workdays, often exceeding 10 h.

Combination of exhaled breath condensate samples with lipoarabinomannan point of care assay for pulmonary tuberculosis (TB) diagnosis: protocol for a diagnostic accuracy study

IntroductionThe WHO estimates a gap of about 30% between the incident (10.6 million) and notified (7.5 million) cases of tuberculosis (TB). Combined with the growing recognition in prevalence surveys of...

Body mass index and the prevalence of high-risk colorectal adenomas in a population undergoing screening colonoscopy in Alberta, Canada.

There is limited evidence regarding body mass index (BMI) as an early marker of high-risk adenoma (HRA) at the time of screening colonoscopy. Because high-risk adenomas (HRA) can develop into colorectal cancer (CRC), BMI could serve as an important clinical predictor of future risk of CRC. We examined data from 1831 adults undergoing screening colonoscopy at the Forzani & MacPhail Colon Cancer Screening Center in Alberta, Canada. We fit multivariable logistic regression models to examine the association between BMI and HRA. Non-linear relationships for BMI on HRA were also evaluated using restricted cubic splines. The mean BMI in patients with HRA was 28.2kg/m2 compared to 27.4kg/m2 in patients without adenomas (t test: p=0.003). In the adjusted models, those with a BMI over 30kg/m2 had 1.45 (95% CI 1.05-2.00) times the odds of HRA detected during colonoscopy compared to those with a BMI below 25kg/m2. Examining BMI as continuous, the odds of HRA were 1.20 (95% CI 1.04-1.37) times higher for every 5kg/m2 increase in BMI. The findings of this study suggest that excess body mass is associated with higher risk of HRA among a screening population and may be useful an early marker of future disease.

Post kala-azar dermal leishmaniasis burden at the village level in selected high visceral leishmaniasis endemic upazilas in Bangladesh

ObjectivesAs post kala-azar Dermal Leishmaniasis (PKDL) threatens the success of the Visceral Leishmaniasis (VL) elimination initiative, we aimed to investigate the PKDL burden, including an active search for PKDL in leprosy-negative skin lesion cases. We also investigated their health-seeking behavior and perceived level of stigma. MethodsThis was a cross-sectional survey among inhabitants in the VL-endemic villages of the five most VL-endemic upazilas. VL experts trained medical officers in Upazila Health Complexes (UHCs) and leprosy facilities in PKDL management. Frontline workers conducted house-to-house surveys, referring PKDL suspects to designated centers. Data analysis involved Epi Info version 7 and IBM SPSS Statistics 25. ResultsAmong 472,435 screened individuals, 4022 had past VL (0.85 %). Among the screened population, 82 were PKDL suspects, and 62 PKDL cases were confirmed. The overall PKDL burden was 1.3 (95 % CI: 1.0-1.7) in the 10,000 population in the endemic villages. Male predominance and macular form of PKDL were observed. Thirty-nine PKDL patients perceived stigma of different levels. Only 27 of 62 (44 %) had received PKDL treatment. Medicine's unavailability and side effects were a major reason behind treatment interruption. Active screening among 137 leprosy-negative PKDL suspects yielded 10 (7.3 %) PKDL cases. ConclusionThe existence of PKDL cases in the VL endemic areas is a concern as those are inter-epidemic reservoirs. As per the WHO roadmap, the PKDL burden must be reduced by 70 % and 100 %, respectively, by 2026 and 2030. NKEP can take the current burden of 1.3 per 10,000 people in VL endemic villages as a baseline. Integrating active case detection for PKDL in leprosy hospitals and screening centers is feasible and worth deploying nationwide.

Migrant workers’ perception and awareness of health insurance coverage in Brunei Darussalam

BackgroundMigrant workers are recognized as a vulnerable group of population in the context of accessibility to healthcare services as they are likely to experience multiple challenges and barriers. This study aimed to assess the awareness and perceived knowledge on health insurance coverage among documented migrant workers in Brunei Darussalam.MethodsThis cross-sectional, interviewer-administered study used a pre-designed questionnaire on migrant workers attending the Foreign Worker Health Screening Centre from June until September 2019. Data were analyzed for association between perceived insurance status on health-seeking behavior.ResultsThe study obtained responses from 469 documented migrant workers (93.8%). 75.1% reported being aware of and having health insurance coverage; and of these, 57.1% were aware of the type of health insurance cover they had. 45.5% and 50.6% had poor knowledge whether their health insurance covered for hospitalization or outpatient expenses, respectively. No significant association was found between the migrant workers’ perceived status of insurance and not seeking medical care due to financial barriers (p > 0.05).ConclusionsA high proportion of documented migrant workers in Brunei Darussalam reported knowledge of having health insurance; however, there was lack of awareness on its actual coverage. By including migrants’ health in a nation’s healthcare governance, the health rights of migrant workers can be addressed thus aiming to achieve universal health coverage for all individuals.

Development and pilot implementation of a novel protocol to assess capacity and readiness of health systems to adopt HPV detection-based cervical cancer screening in Europe

BackgroundCervical cancer remains a significant public health concern in Europe. Effective introduction and scaling up of human papillomavirus (HPV) detection-based cervical cancer screening (CCS) requires a systematic assessment of health systems capacity. However, there is no validated capacity assessment methodology for CCS programmes, especially in European contexts. Addressing this gap, our study introduces an innovative and adaptable protocol for evaluating the capacity of CCS programmes across varying European health system settings.MethodsOur research team developed a three-step capacity assessment framework, incorporating a health policy review checklist, a facility visit survey, and key informants’ interview guide followed by a strengths, weaknesses, opportunities and threats (SWOT) analysis. Piloting this comprehensive approach, we explored the CCS capacity in three countries: Estonia, Portugal and Romania. These countries were selected due to their contrasting healthcare structures and resources, providing a diverse overview of the European context.ResultsConducted over a period of 9 months, the capacity assessment covered multiple resources, 27 screening centres, 16 colposcopy and treatment centres and 15 key informant interviews. Our analysis highlighted both shared and country-specific challenges. A key common issue was ensuring high compliance to follow-up and management of screen-positive women. We identified considerable heterogeneity in resources and organization across the three countries, underscoring the need for tailored, rather than one-size-fits-all, solutions.ConclusionsOur study’s novelty lies in the successful development of this capacity assessment methodology implementable within a relatively short time frame, proving its feasibility for use in various contexts and countries. The resulting set of materials, adaptable to different cancer types, is a ready-to-use toolkit to improve cancer screening processes and outcomes. This research marks a significant stride towards comprehensive capacity assessment for CCS programmes in Europe. Future directions include deploying these tools in other countries and cancer types, thereby contributing to the global fight against cancer.

Evaluation of a multigenomic liquid biopsy (PROSTest) for prostate cancer detection and follow-up in a Caribbean population

IntroductionThe PROSTest is a novel machine learning-based liquid biopsy assay that functions as a diagnostic and prognostic tool in prostate cancer (PCa). The algorithm outcome (scored 0–100) has a cutoff of >50 to indicate PCa. In this study, we evaluated the screening utility of the test in comparison with the commonly used PSA test. Materials and Methods509 men (median age: 62 [40–88]), predominantly Afro-Caribbean (n=449, 88.2 %) were enrolled in this study at a referral centre for prostatic cancer screening and management. These included 417 symptomatic patients with urinary tract (UT) problems, of which 12 were diagnosed with PCa, 53 with benign prostatic hyperplasia (BPH) and 352 were free from prostatic diseases, prior to PROSTest (Cohort 1). The remaining 92 of the 509, with relatively young age (median 49 and range 40–75 years) were screened with the PROSTest first and included 28 with UT symptoms and 64 asymptomatic but with a family history of cancer (Cohort 2). PROSTest and PSA was performed on all subjects. ResultsIn Cohort 1, the PROSTest was positive in 11 (91.7 %) PCa, 9 (17.0 %) of BPH, and 29 (8.2 %) of subject with UT symptoms but no disease. In Cohort 2, PROSTest was positive in 4 of 28 (14.3 %) symptomatic patients and in 5 of 64 (7.8 %) asymptomatic subjects. A total of 111 individuals (from both cohorts) were identified as "at risk" (PSA >4 ng/mL). Sixteen of 111 (14.4 %) were PROSTest-positive. Thirty-nine percent (43/111) have completed a 1-year follow-up. Of the 43 with elevated PSA, 2 out of 2 (100 %) who were also PROSTest-positive, were diagnosed with PCa. ConclusionPROSTest is a more sensitive and specific biomarker than PSA in the diagnosis and, potentially, screening for PCa. The seemingly false positive PROSTest results in BPH or symptomatic UT require a longer follow-up of these patients.

Evaluation of Breast Cancer Screening Program in Al-Warith Hospital

Introduction: Breast cancer is a significant threat to Iraqi women's health. Early diagnosis of breast cancer increases the chance of recovery and life expectancy. Screening is the primary tool for early diagnosis and timely treatment of breast cancer in the early stages. Objectives: To evaluate the screening program in detecting breast cancer in the Al-Warith screening center, Karbalaa, Iraq, from 1/8/2023 to 1/5/2024. Methods: A cross-sectional descriptive study was conducted among 510 Iraqi women who came to the outpatient breast clinic. Their demographic information related to the current research was selected randomly; it was taken from the medical records in the statistics unit in the hospital. The collected data were coded and entered into SPSS 16.0 (Statistical Package for the Social Sciences (SPSS) 22.0 by IBM) (SPSS for Windows, Rel. 22.0., 2016, SPSS Inc., Chicago, IL, USA). The categorical data were analyzed by frequency and percentage. Results: 167 were screened, representing 32.75% of the total mean age (54.3±13.20) years old. Clinical screening identified normal findings in 87.50% of participants, while 4.17% had benign findings, and 8.33% were clinically screened and advised to review breast clinical recurrently. Ultrasound screening showed normal findings in 32.00% of patients and benign results in 60.00%, with 8.00% having BIRAD [4, 5] results. Mammography screening revealed normal findings in 40.43% of patients and benign results in 53.19%, with 6.38% having BIRAD [4, 5] results. Biopsies were performed on eight patients, resulting in 75.00% undergoing FNA and 25.00% undergoing True Cut Biopsy. Ultimately, breast cancer was detected in 1.20% of the asymptomatic patients screened. Conclusion: The data highlights the crucial role of regular screening for both asymptomatic and symptomatic women in the early detection of breast conditions. Raising public awareness is a vital strategy for healthcare providers. These efforts can greatly enhance the early detection and treatment of breast cancer and other related conditions. By following these recommendations, we can achieve better patient outcomes and improve overall public health.

Systematic Review of Newborn Screening Programmes for Spinal Muscular Atrophy.

Spinal muscular atrophy (SMA) is a genetic neuromuscular disorder causing the degeneration of motor neurons in the spinal cord. Recent studies suggest greater effectiveness of treatment in the presymptomatic stage. This systematic review synthesises findings from 37 studies (and 3 overviews) of newborn screening for SMA published up to November 2023 across 17 countries to understand the methodologies used; test accuracy performance; and timing, logistics and feasibility of screening. All studies screened for the homozygous deletion of SMN1 exon 7. Most (28 studies) used RT-PCR as the initial test on dried blood spots (DBSs), while nine studies also reported second-tier tests on DBSs for screen-positive cases. Babies testing positive on DBSs were referred for confirmatory testing via a range of methods. Observed SMA birth prevalence ranged from 1 in 4000 to 1 in 20,000. Most studies reported no false-negative or false-positive cases (therefore had a sensitivity and specificity of 100%). Five studies reported either one or two false-negative cases each (total of six cases; three compound heterozygotes and three due to system errors), although some false-negatives may have been missed due to lack of follow-up of negative results. Eleven studies reported false-positive cases, some being heterozygous carriers or potentially related to heparin use. Time to testing and treatment varied between studies. In conclusion, several countries have implemented newborn screening for SMA in the last 5 years using a variety of methods. Implementation considerations include processes for timely initial and confirmatory testing, partnerships between screening and neuromuscular centres, and timely treatment initiation.