Check Programme Research Articles

The Existence of the Halting Function in a Purely Mathematical Context and the Solution of Halting paradox with termination checking of programs over definite Topological spaces. (AMS MSC2020 03-08) Category: Mathematics and computation

The Existence of the Halting Function in a Purely Mathematical Context and the Solution of Halting paradox with termination checking of programs over definite Topological spaces. (AMS MSC2020 03-08) Category: Mathematics and computation

Spontaneous clearance of Chlamydia trachomatis and its associated factors among women attending screening for chlamydia in Shenzhen, China

ObjectivesThis study aimed to investigate the factors associated with the spontaneous clearance of Chlamydia trachomatis, a phenomenon that, despite a growing body of literature, remains understudied in the context of women in China. MethodsSpontaneous clearance was defined as the transition from a positive to negative Chlamydia status over time without the use of antichlamydial therapy. Data from 5935 women aged 18 years and older who participated in the Clinical-Based Health Check program were analyzed. Eligible participants had no history of Neisseria gonorrhoeae infection, pelvic inflammatory disease, recent antibiotic use, or pregnancy and had an interval between the screening and follow-up visits of more than 3 days. Logistic regression was used to identify factors influencing spontaneous clearance. ResultsSpontaneous clearance occurred in 23.9% (50/209) of the participants, typically with a median interval of 27 days. Significant factors included an interval >45 days, an age >35 years, the use of an intrauterine device (IUD), and the presence of clue cells. ConclusionSpontaneous clearance of C. trachomatis is significantly affected by age, the interval between two tests, IUD use, and the presence of clue cells. Screening strategies should prioritize women under 35 years of age who do not use IUDs and test negative for clue cells for more effective chlamydia prevention and management.

Development, Evaluation, and Initial Findings of New York State Department of Health Community Drug Checking Pilot Programs.

The illicit drug landscape in the United States is dynamic, featuring a risky and erratic drug supply. Drug checking programs (DCP) have been successfully implemented and studied extensively in Canada and Europe but are scarce in the United States. Integrating DCP at harm reduction programs provides an opportunity to engage people at the point-of-care and deliver a combination of harm reduction services, access to healthcare services, and linkages to treatment. The New York State Department of Health (NYSDOH) developed and supports operation of 8 pilot community DCP sites throughout the state. The DCP were trained to utilize Fourier-transform infrared spectroscopy (FTIR) technology to deliver real-time results to participants. The NYSDOH community DCP pilot began development in 2022. Partnerships were formed across multiple domains including other DCP, universities, forensic laboratories, syringe service and harm reduction programs, and legal and regulatory offices within the NYSDOH. The first pilot sites began operating in mid-2023 and program expansion is on-going. Evaluation staff were extensively engaged in development and implementation phases. Qualitative evaluation focused on barriers, facilitators, and lessons learned from program staff and technicians. Quantitative evidence was gathered to assess the reach of the DCP and accuracy of results attained by drug checking technicians during their training periods. Drug checking results helped characterize the illicit drug supply. Development and implementation of DCP in NYS was facilitated by strong partnerships across sectors including public health and harm reduction. DCP may involve diverse partners who do not regularly collaborate, and health departments are positioned to build relationships and convene partners for program implementation. Evaluation findings highlight the importance of facilitating on-going training and technical assistance to DCP for quality assurance. The initial successes and lessons learned from the NYSDOH DCP demonstrate state public health departments' ability to successfully deploy this innovative harm reduction strategy.

Higher-Order Model Checking of Effect-Handling Programs with Answer-Type Modification

Model checking is one of the successful program verification methodologies. Since the seminal work by Ong, the model checking of higher-order programs―called higher-order model checking, or HOMC for short―has gained attention. It is also crucial for making HOMC applicable to real-world software to address programs involving computational effects. Recently, Dal Lago and Ghyselen considered an extension of HOMC to algebraic effect handlers, which enable programming the semantics of effects. They showed a negative result for HOMC with algebraic effect handlers―it is undecidable. In this work, we explore a restriction on programs with algebraic effect handlers which ensures the decidability of HOMC while allowing implementations of various effects. We identify the crux of the undecidability as the use of an unbounded number of algebraic effect handlers being active at the same time. To prevent it, we introduce answer-type modification (ATM), which can bound the number of algebraic effect handlers that can be active at the same time. We prove that ATM can ensure the decidability of HOMC and show that it accommodates a wide range of effects. To evaluate our approach, we implemented an automated verifier EffCaml based on the presented techniques and confirmed that the program examples discussed in this paper can be automatically verified.

How substance use preferences and practices relate to fentanyl exposure among people who use drugs in Rhode Island, USA

BackgroundOver 107,000 people died in the United States (U.S.) from drug overdose in 2022, with over one million overdose deaths since 1999. The U.S. drug market is characterized by a highly toxic, unregulated, and rapidly changing supply. Understanding the extent of exposure to fentanyl among people who use drugs (PWUD) will guide public health interventions aimed to decrease overdose. MethodsWe utilized baseline data from the Rhode Island Prescription and Illicit Drug Study, a randomized controlled trial of harm reduction-oriented interventions for PWUD in Rhode Island from 2020 to 2023. We evaluated sociodemographic and drug use-related covariates and examined fentanyl presence in urine drug testing (UDT). We built a classification and regression tree (CART) model to identify subpopulations with the highest likelihood of fentanyl presence in UDT. ResultsAmong 446 participants, those with fentanyl present in UDT tended to be younger, non-Hispanic white, and had recently injected drugs (p<0.05 for all). The CART analysis demonstrated a large variation in sample sub-groups’ likelihood of fentanyl presence in UDT, from an estimated probability of 0.09 to 0.90. Expected recent fentanyl exposure was the most important predictor of fentanyl in UDT. ConclusionsUnivariate analyses and CART modeling showed substantial variation in the presence of fentanyl in UDT among PWUD. Harm reduction services for people actively injecting drugs and drug checking programs based on capacity-building, empowerment, and targeted towards those not yet engaged in services are urgently needed to support PWUD in navigating the current volatile drug supply.

The challenges for psychiatric care posed by synthetic drugs

In addition to the drugs that have been known for decades, several hundred mainly synthetic substances have been identified as drugs for the first time in the last 20years. Presentation of the various groups of substances and their psychotropic effects, the epidemiology of their use and the legal and social background of this development. Narrative literature review. The most important new psychoactive substances (NPS) are synthetic cannabinoids, synthetic stimulants (cathinones), halluginogens and new synthetic opioids (NSO), in particular fentanyl and related substances. The new substances do not have any qualitatively new psychotropic effects. They were brought onto the market in particular as substitutes for substances subject to the Narcotics Act but are often associated with dangerous side effects and even mortality. The increasing availability of these substances has gone hand in hand with the establishment of the Internet as asource of knowledge (e.g. for synthesis routes) and as amarketplace. Substance group-related regulations have also been established in Germany (New Psychoactive Substances Act). In Germany the prevalence of NPS use is significantly lower than that of cannabis; however, there are indications that the production and distribution of synthetic drugs is more profitable for drug dealers than with conventional plant-based drugs, such as heroin. In the USA, for example, NSOs are the primarily drugs used for opioid addiction. It remains to be seen whether NPS and NSOs will replace conventional drugs. The availability of synthetic drugs is more difficult to reduce than that of plant-based drugs. Harm reduction measures should be expanded, e.g., early warning systems for new drugs, drug checking and naloxone programs.

Targeted Prostate Health Checks, a novel system to identify men with prostate cancer-A pilot study.

The objective of this study is to report the pilot phase of the Targeted Prostate Health Check programme that aims to identify men in the Surrey and Sussex region who have prostate cancer and who failed to be detected during the Covid era. Men aged 50 to 70, or 45 to 70 if Black or with a family history of prostate cancer, were identified from participating general practitioner (GP) records. Short message service (SMS) texts invited men to visit www.talkprostate.co.uk for information on prostate cancer and give consent to prostate-specific antigen (PSA) checks coordinated by a third-party virtual healthcare provider. Elevated age-related PSA levels, or levels below age-related thresholds but at 3ng/mL or more, triggered referral to a rapid access urology clinic. GPs were informed of the results. From 1842 text messages inviting 1549 people, 544 men consented to a PSA check. From 500 phlebotomy appointments, 485 (30% of invited men) took the PSA test of whom 68 (14%) were referred with an elevated PSA. After clinical review with multiparametric magnetic resonance imaging (mp-MRI), 22 patients underwent transperineal biopsies, and prostate cancer was detected in 18 men of whom 17 (95%) had clinically significant cancer. Our Targeted Prostate Cancer Health Check system identifies men at risk without burdening primary care. Awareness on prostate cancer risk was raised in 1549 invited men, half of whom were further educated via the registration website. One third of invited men were checked in whom clinically significant prostate cancer was found in 3.5%.

Polygenic risk score adds to a clinical risk score in the prediction of cardiovascular disease in a clinical setting.

A cardiovascular disease polygenic risk score (CVD-PRS) can stratify individuals into different categories of cardiovascular risk, but whether the addition of a CVD-PRS to clinical risk scores improves the identification of individuals at increased risk in a real-world clinical setting is unknown. The Genetics and the Vascular Health Check Study (GENVASC) was embedded within the UK National Health Service Health Check (NHSHC) programme which invites individuals between 40-74 years of age without known CVD to attend an assessment in a UK general practice where CVD risk factors are measured and a CVD risk score (QRISK2) is calculated. Between 2012-2020, 44,141 individuals (55.7% females, 15.8% non-white) who attended an NHSHC in 147 participating practices across two counties in England were recruited and followed. When 195 individuals (cases) had suffered a major CVD event (CVD death, myocardial infarction or acute coronary syndrome, coronary revascularisation, stroke), 396 propensity-matched controls with a similar risk profile were identified, and a nested case-control genetic study undertaken to see if the addition of a CVD-PRS to QRISK2 in the form of an integrated risk tool (IRT) combined with QRISK2 would have identified more individuals at the time of their NHSHC as at high risk (QRISK2 10-year CVD risk of ≥10%), compared with QRISK2 alone. The distribution of the standardised CVD-PRS was significantly different in cases compared with controls (cases mean score .32; controls, -.18, P = 8.28×10-9). QRISK2 identified 61.5% (95% confidence interval [CI]: 54.3%-68.4%) of individuals who subsequently developed a major CVD event as being at high risk at their NHSHC, while the combination of QRISK2 and IRT identified 68.7% (95% CI: 61.7%-75.2%), a relative increase of 11.7% (P = 1×10-4). The odds ratio (OR) of being up-classified was 2.41 (95% CI: 1.03-5.64, P = .031) for cases compared with controls. In individuals aged 40-54 years, QRISK2 identified 26.0% (95% CI: 16.5%-37.6%) of those who developed a major CVD event, while the combination of QRISK2 and IRT identified 38.4% (95% CI: 27.2%-50.5%), indicating a stronger relative increase of 47.7% in the younger age group (P = .001). The combination of QRISK2 and IRT increased the proportion of additional cases identified similarly in women as in men, and in non-white ethnicities compared with white ethnicity. The findings were similar when the CVD-PRS was added to the atherosclerotic cardiovascular disease pooled cohort equations (ASCVD-PCE) or SCORE2 clinical scores. In a clinical setting, the addition of genetic information to clinical risk assessment significantly improved the identification of individuals who went on to have a major CVD event as being at high risk, especially among younger individuals. The findings provide important real-world evidence of the potential value of implementing a CVD-PRS into health systems.

Impact of a proactive patient assistance program for diverse ambulatory oncology patients: A retrospective cohort study.

e13513 Background: Significant differences persist in cancer incidence, survival, morbidity, and mortality among populations in the U.S. Individuals of lower socioeconomic status (SES) suffer disproportionately from cancer and other disease burdens compared to individuals with higher SES. Financial hardship is increasingly common, with many cancer survivors reporting difficulty paying medical bills, high financial distress, and delaying or forgoing care because of cost. Cancer patients reporting financial hardship are more likely to have psychosocial distress. Financial distress has been linked with several clinically relevant patient outcomes including quality of life, symptom burden, compliance, and survival. An NCI-designated comprehensive cancer center (CCC) with a diverse racial, ethnic, and linguistic patient population utilizes My Wellness Check (MWC) program to identify patients experiencing emotional, physical, practical, and social concerns. Among 4,117 MWC patient responders representing 43.1% of eligible patients during October 2019 - February 2022, 801 patients (19.5%) with 976 supportive or practical needs alerts were triggered to social workers where only 68.4% of the alerts were acted upon within a 72-hour window. For patients identified by MWC as having financial toxicity, Social Workers identified available resources to assist with patients’ out-of-pocket costs. Methods: In July 2022, the CCC launched a patient financial assistance program which included screening of all patients receiving systemic therapy administered at infusion centers. A third-party partner was contracted to provide patient advocates and technology augmenting the EHR. Patient Advocates identified eligible patients and enrolled them into financial assistance programs. Results: A retrospective analysis was performed for the period of May 2022 - December 2023, comparing patients receiving philanthropic medical financial assistance consisting of copay assistance and grants sponsored by drug manufacturers and diagnosis based non-profit foundations with infusion center patient population demographic data. The cohort participating in patient assistance programs included a higher percentage of female, Hispanic, age 27-64, commercially insured, and patients that reside in high and medium-high Social Vulnerability Index (SVI) counties. Conclusions: A proactive patient financial assistance program can help reduce financial distress for patients with cancer, especially those residing in high and medium high SVI counties. Leveraging the expertise of a third party helps mitigate financial toxicity in the short term and can help drive more equitable cancer outcomes.

Survey of occupational health-related activities in Hokkaido and Tohoku hospitals

This study aimed to evaluate occupational health-related activities and factors related to the violation of labor-related regulations in hospitals in Hokkaido and Tohoku districts. The study questionnaires were distributed to 1,108 Hokkaido and Tohoku hospitals in April 2024, among whom 307 (answered by June 2) participated. The questionnaires included queries on hospital characteristics, occupational health-related activities, and labor-related laws. Relationships between the hospital location, number of hospital beds, number of employees, and provision of emergency services and the number of labor-related regulation violations (assignments of occupational physicians and health officers, agreement on overtime [per Article 36 of the Labour Standards Act], physician interviews for workers with prolonged overtime, and implementation of the Stress Check program) were analyzed using multivariable ordinal logistic regression. Among the hospitals, 4.2%, 11.9%, 11.1%, 8.5%, and 2.6% did not assign occupational physicians, assigned directors as occupational physicians, did not assign health officers, did not have an agreement on overtime, and did not implement the Stress Check program, respectively. The multivariable ordinal logistic regression analysis revealed that hospitals with few beds and employees and those that did not offer emergency services had significantly higher odds of violating labor-related regulations. Smaller hospitals and hospitals that did not offer emergency services in Hokkaido and Tohoku districts had some difficulties complying with labor-related regulations. These hospitals may need external support for occupational health-related activities.

When to reinvite initially ineligible populations for targeted lung cancer screening?

IntroductionTargeted low-dose CT lung cancer screening reduces lung cancer mortality. England’s Targeted Lung Health Check programme uses risk prediction tools to determine eligibility for biennial screening among people with a...

Exploring a Lux® i-Amylose-3 column in normal phase and polar-organic mode for chiral separation of cathinone derivatives and pyrovalerones using high-performance liquid chromatography.

Each year, new psychoactive substances appear on the global drug market leading to constant changes. Most of these compounds with stimulating effect possess a chiral center, thus leading to two enantiomers with presumably different pharmacological properties. Among them, synthetic cathinones, often misleadingly traded as "bath salts," play an important role. There is little knowledge about the distinct effect of the enantiomers. The aim of this study was to test a commercially available Lux® i-Amylose-3 column by HPLC-UV for enantiorecognition of cathinone derivatives. Overall, 80 compounds were tested in normal phase mode, where 75 substances were separated under initial conditions. After method optimization, at least partial separation was achieved for the remaining compounds. The same set of substances was measured in polar-organic mode, where 63 analytes were resolved into their enantiomers under initial conditions with very short retention times. Both modes showed complementary results for the individual compounds. Furthermore, the tested methods proved to be suitable for differentiation of positional isomers, which can be useful for drug checking programs. All measurements were carried out under isocratic conditions, and intraday and interday repeatability tests were performed.

187 Targeted Lung Health Check Programme at Frimley Health Foundation Trust

187 Targeted Lung Health Check Programme at Frimley Health Foundation Trust

170 Patients diagnosed with lung cancer through the Targeted Lung Health Check Programme have a better performance status than patients from other sources of referral, as well as earlier stage disease

170 Patients diagnosed with lung cancer through the Targeted Lung Health Check Programme have a better performance status than patients from other sources of referral, as well as earlier stage disease

179 When should patients in remission be invited to re-enter the Targeted Lung Health Check Programme? A review of patient feedback following treatment for lung cancer

179 When should patients in remission be invited to re-enter the Targeted Lung Health Check Programme? A review of patient feedback following treatment for lung cancer

Model checking programs in process-oriented IEC 61131-3 Structured Text

The process-oriented programming is a paradigm based on the process concept where each process is a concurrent finite state machine inside. The paradigm is intended for PLC (programmable logic controllers) developers to write Industry 4.0-enabled software. The poST language is a promising process-oriented extension of the IEC 61131-3 Structured Text (ST) language designed to provide a conceptual consistency of the PLC source code with technological description of the process under control. This language combines the advantages of FSM-based programming with the standard syntax of the ST language. We propose transformational semantics of poST providing rules for translation of poST language statements to Promela — the input language of the SPIN model checker. Following these semantic rules, our Xtext-based translator outputs a Promela model for the poST program. Our contribution is the poST transformational semantics and the method for automatic generation of the Promela code from poST control programs. The resulting Promela program is ready to be verified with SPIN model checker against linear temporal logic requirements to the source poST program. In the paper we provide an overview of related work, as well as a brief description of the poST and Promela languages. Further, the Promela poST translation rules cover control flow statements, process creation and state management constructs, and timeout management. Then we define service processes for modeling the external environment and managing high-level LTL specifications. Then we present the main ideas of implementing the translator poST to Promela. We also illustrate our approach using the example of a system for managing electricity consumption and production, including renewable sources.

BİR TOPLUM ECZANESİNDE KARŞILAŞILAN ANTİASİTLER KAYNAKLI İLAÇ ETKİLEŞİMLERİNİN TESPİTİ: GÖZLEMSEL BİR ÇALIŞMA

Objective: This study aimed to reveal drug-drug interactions (DDIs) due to antacids through programs used to detect DDIs. Material and Method: Within the scope of this study, 207 prescriptions containing at least one antacid and a drug from a different pharmacological group were evaluated in terms of DDIs. Evaluations were made on the prescriptions received in a community pharmacy serving in Van, Türkiye. Three different DDI checking programs were used for this evaluation. Result and Discussion: Antacid-induced DDIs were detected in 64 of the prescriptions. Interactions occurred between 52 active ingredient pairs, and it was revealed that DDIs were most common between calcium carbonate and famotidine. This interaction is minor and has been detected by only one database. Another common interaction was found between the calcium carbonate and cholecalciferol (Vitamin D) pair, and this interaction was reported as Level 2 and should be closely monitored in two different databases. As a result, DDIs induced by antiacids generally were found to be at moderate levels. However, it is seen that three DDI checking programs used in the study provide different results in detecting DDIs.

Comparing screening based on the NHS Health Check and Polypill Prevention Programmes in the primary prevention of heart attacks and strokes.

To compare the NHS Health Check Programme with the Polypill Prevention Programme in the primary prevention of heart attacks and strokes. Use of published data and methodology to produce flow charts of the two programmes to determine screening performance and heart attacks and strokes prevented. The UK population. The NHS Health Check Programme using a QRISK score on people aged 40-74 to select those eligible for a statin is compared with the Polypill Prevention Programme in people aged 50 or more to select people for a combination of a statin and three low-dose blood pressure lowering agents. In both programmes, people had no history of heart attack or stroke. In 1000 people, the number of heart attacks and strokes prevented in the two programmes. In the hypothetical perfect situation with 100% uptake and adherence to the screening protocol, in every 1000 persons, the NHS Health Check would prevent 287 cases of a heart attack or stroke in individuals who would gain on average about 4 years of life without a heart attack or stroke amounting to 1148 years in total, the precise gain depending on the extent of treatment for those with raised blood pressure, and 136 would be prescribed statins with no benefit. The corresponding figures for the Polypill Prevention Programme are 316 individuals who would, on average, gain 8 years of life without a heart attack or stroke, amounting to 2528 years in total, and 260 prescribed the polypill with no benefit. Based on published estimates of uptake and adherence in the NHS Health Check Programme, in practice only 24 cases per 1000 are currently benefitting instead of 287, amounting to 96 years gained without a heart attack or stroke. The Polypill Prevention Programme is by design simpler with the potential of preventing many more heart attacks and strokes than the NHS Health Check Programme.

Predictability of the National Psychological Stress Screening for Subsequent Long-Term Psychiatric Sick Leave Among Employees: A Multicenter Nested Case-Control Study.

The aim of the study is to predict employees' long-term sick leave due to psychiatric disorders using the national psychological stress screening program. University employees who took long-term psychiatric sick leave in 2016-2018 were assigned as cases. Those who were present at work and matched for sex, age, and occupation type were assigned as controls. Answers in a 57-item questionnaire were analyzed by multivariable regression, and a prediction model was developed. It was validated in cases and matched controls in 2019. Six items were identified as independent predictors by multivariable regression and included in a prediction model. The area under the receiver-operating characteristics curve was 0.768 (95% confidence interval: 0.723-0.813). This finding was similar to that in the validation sample. The performance of the prediction model was modest and the national Stress Check Program should be further refined.

Examining the social validity of the Double Check Online Program: Helping to scale-up professional development for culturally responsive practices

This paper presents social validity findings from a mixed methods study of educators who used a recently adapted online version of the research-based Double Check culturallyresponsive practices and student engagement program. Results from 41 participants indicated that the program was easy to use, prompted them to reflect on their own culture, and that they would continue using the website. Although most users reported they would recommend the program, participants indicated they would like a wider variety of examples and more guidance for novice teachers. Additional conclusions and recommendations for improving Double Check and other online teacher professional development programs are discussed.