Screening Criteria Research Articles

Evaluation of the 2021 ESC recommendations for family screening in hereditary transthyretin cardiac amyloidosis

Abstract Background The 2021 European Society of Cardiology (ESC) screening recommendations for individuals carrying a pathogenic transthyretin amyloidosis (ATTR) variant (ATTRv) are based on expert opinion. We aimed to (1) determine the yield of ATTR cardiomyopathy (ATTR-CM) at baseline; (2) evaluate the performance of the 2021 ESC position statement on initiating screening for ATTRv carriers; (3) establish the value of first-line tests recommended in ATTRv carriers; and (4) examine the yield of serial evaluation. Methods We included 159 relatives (median age 55.6 [interquartile range 43.2-65.9] years, 52% male) at-risk for developing ATTR-CM from 10 centres. ATTR-CM diagnosis was defined as the presence of either 1) cardiac tracer uptake in bone scintigraphy as recommended; or 2) cardiac biopsy proven positive for ATTR. Our secondary endpoint was a composite of heart failure symptoms (NYHA class³II) and conduction disorders necessitating pacemaker implantation. An individual fulfilled screening criteria as proposed by the 2021 ESC position statement if: 1) cardiac screening was performed ~10 years prior to disease onset in the proband (or in other individuals with the same variant if disease onset in the family was unknown); or 2) had extracardiac amyloidosis as diagnosed by a Neurologist or Ophthalmologist. Results At baseline, 40/159 (25%) relatives were diagnosed with ATTR-CM. Of those 40 relatives, 20 (50%) met the secondary endpoint. Relatives diagnosed with ATTR-CM were significantly older (66.5 [61.0-75.2] vs. 49.2 [40.8-58.8] years, p<0.001)(Figure 1A). Figure 1B-C visualizes the yield of screening by screening indications of the 2021 ESC position statement. Both screening for age, extra-cardiac amyloidosis or both age and extra-cardiac amyloidosis as indication to screen had a 31% (n=17/54), 18% (n=2/11) and 68% (n=19/28) yield of ATTR-CM, respectively. Diagnosis of ATTR-CM in relatives without an indication to screen was rare (3%; n=2/66). As a result, indication to screen as proposed by the 2021 ESC position statement yielded an almost excellent negative predictive value (97%). Other independent pre-screening predictors were infrequently identified variants and male sex. Of note, 13% of relatives with ATTR-CM did not show any "red flags" of cardiac amyloidosis on electrocardiogram (ECG), echocardiogram, and laboratory parameters. Excluding those who meet the secondary endpoint (i.e. those who already should have been diagnosed based on symptoms), ATTR-CM diagnosis in the absence of "red flags" increased from 13% to 26%. The yield of repeat bone scintigraphy (n=41 ATTRv carriers; follow-up 3.1 [2.2-5.2] years) at 3-years’ interval was 9.4% (Figure 2). Conclusion The recommendations made by the 2021 ESC position statement are adequate. Clinicians should adhere to the 3-year repeat bone scintigraphy as progressing to ATTR-CM in the absence of "red flags" and symptoms is not uncommon.Cardiac amyloidosis at baselineATTR-CM development during follow-up

Confirmation of Solid Phase Extracted Post‐Blast Explosives Residues Analyzed Using Pulsed Split Injection GC/MS

AbstractA pulsed split injection method was developed for the improved detection of explosives using gas chromatography with mass spectrometric detection (GC/MS) with negative chemical ionization for 12 organic explosives (nitramines, nitrate esters, nitroalkanes, nitroaromatics) and electron ionization with selected ion monitoring for triacetone triperoxide (TATP). An order of magnitude increase in signal (average factor of 13) was observed for all organic explosives with the utilization of the pulsed split injection for samples processed by solid phase extraction (SPE). The method was successfully applied to post‐blast explosives residue processed by SPE and syringe filtration as a confirmatory technique following gas chromatography with electron capture detection (GC/ECD) screening. Compared to current methodologies previously reported, a decrease in the false screen rate (the number of compounds that passed the screening criteria, but not confirmed present) was achieved when employing this method. Processing of post‐blast explosives samples using SPE decreased the false screen rate from 60% to 34%, while using syringe filtration decreased the false screen rate from 73% to 51%.

Clinical Assessment and Genetic Testing for Hereditary Polyposis Syndromes in an Italian Cohort of Patients with Colorectal Polyps

Background: Hereditary polyposis syndromes are clinically and genetically heterogeneous conditions associated with increased colorectal cancer risk. They are classified based on polyp histology, inheritance mode, causal gene, and colonic and extracolonic manifestations. Their diagnosis is challenging due to overlapping and heterogeneous clinical presentations. Methods: A multigene next-generation sequencing panel was used to screen 75 index cases with colorectal polyps and a personal/family history of cancer for key hereditary polyposis-associated genes (APC, BMPR1A, MUTYH, PTEN, SMAD4, and STK11) in order to identify germline genetic variants. Results: In the screened index cases, we found 14 pathogenic variants involving APC, MUTYH, SMAD4, and STK11 and 6 variants of uncertain significance involving APC, BMPR1A, and SMAD4. In this cohort, four patients not fulfilling the recommended eligibility criteria of current National Comprehensive Cancer Network (NCCN) guidelines for genetic testing were molecularly diagnosed with a hereditary polyposis syndrome. Conclusions: Our findings indicate that stringent NCCN eligibility criteria for molecular screening may lead to missing some of the patients affected by hereditary polyposis syndromes. This highlights the need for a careful evaluation of patients’ clinical manifestations, polyp number, age of polyp onset, and family history to select appropriate candidates for molecular diagnosis of these conditions.

Risk profiles for rheumatoid arthritis-associated interstitial lung disease in a cohort of patients with five-year follow-up

Objectives Early identification of interstitial lung disease (ILD) among patients with rheumatoid arthritis (RA) is a challenge for clinicians. The aim of this study was to evaluate screening algorithms for ILD by comparing the proportion of patients assigned a high-risk profile by three recently proposed models. Method We used the four-factor risk score, categorizing patients into high and low risk; the ILD screening criteria, categorizing patients into high, intermediate, and low risk; and the risk score for detection of subclinical RA-ILD, with four different risk categories, on patients with RA followed for 5 years after the RA diagnosis with pulmonary function tests, dyspnoea score, and pulmonary imaging. Results The four-factor risk score identified 22% of the cohort (25/115) as eligible for further ILD investigations, while the ILD screening criteria identified 37% as high risk (43/115) and 34% as intermediate risk (39/115). The risk score for detection of subclinical RA-ILD identified 44% of the cohort as being at increased risk, with 7% in the highest risk group. The agreement between high-risk groups in the two clinical ILD screening models was moderate (kappa 0.43). Three patients in the cohort had clinical or subclinical ILD, and they were identified as high risk in the two clinical models. Conclusion The three algorithms identified approximately one-third of the cohort as being at increased risk of ILD. Further development and validation of these algorithms are needed to reduce false positives and balance the potential benefit of earlier ILD diagnosis and healthcare resources used for respiratory assessment.

Combining metabolomics and machine learning to discover biomarkers for early-stage breast cancer diagnosis.

There is an urgent need for better biomarkers for the detection of early-stage breast cancer. Utilizing untargeted metabolomics and lipidomics in conjunction with advanced data mining approaches for metabolism-centric biomarker discovery and validation may enhance the identification and validation of novel biomarkers for breast cancer screening. In this study, we employed a multimodal omics approach to identify and validate potential biomarkers capable of differentiating between patients with breast cancer and those with benign tumors. Our findings indicated that ether-linked phosphatidylcholine exhibited a significant difference between invasive ductal carcinoma and benign tumors, including cases with inconsistent mammography results. We observed alterations in numerous lipid species, including sphingomyelin, triacylglycerol, and free fatty acids, in the breast cancer group. Furthermore, we identified several dysregulated hydrophilic metabolites in breast cancer, such as glutamate, glycochenodeoxycholate, and dimethyluric acid. Through robust multivariate receiver operating characteristic analysis utilizing machine learning models, either linear support vector machines or random forest models, we successfully distinguished between cancerous and benign cases with promising outcomes. These results emphasize the potential of metabolic biomarkers to complement other criteria in breast cancer screening. Future studies are essential to further validate the metabolic biomarkers identified in our study and to develop assays for clinical applications.

Suggested Screening Criteria for Gardnerella vaginalis Based on Established Risk Factors

Suggested Screening Criteria for Gardnerella vaginalis Based on Established Risk Factors

Prognostic value of red blood cell distribution width in sepsis induced cardiomyopathy patients.

The potential association between red blood cell distribution width (RDW) at admission and prognosis in patients with sepsis-induced cardiomyopathy(SIC) remains uncertain. The purpose of this study was to explore the prognostic value of RDW on mortality in patients with SIC. Data for this retrospective study were obtained from the MIMIC IV2.2 database. We used propensity score matching (PSM) and Cox proportional hazards regression analysis to evaluate the main risk factors associated with mortality in SIC patients. This analysis was utilized to develop a predictive nomogram. To assess the predictive accuracy and clinical usefulness of the model, we employed the concordance index (C-index) and decision curve analysis. To define the high- and low-RDW groups among patients with SIC, we determined the optimal cut-off value by maximizing the Youden index. According to the screening criteria, we identified a cohort of 1051 patients diagnosed with SIC. When comparing the high-RDW group to the low-RDW group, it was found that the high-RDW group exhibited longer Los_ICU(4.5 days vs.3.8 days, respectively, P = 0.009) and higher mortality rates at 28 days (33.8% vs. 7.8%, respectively, P < 0.001). A nomogram model was created using matched patients which included various factors such as Age, RDW, LDH, CKMB, creatinine and the administration of β-blocker. The C-index predicting 28-day survival probability was 0.846. Decision curves analysis demonstrated that the inclusion of RDW in the model provided a greater net benefit compared to excluding RDW. The prognosis of patients with SIC can be predicted by the RDW value. The nomogram model provides a useful tool in identifying and managing SIC patients.

The Role of Recruitment Practises in Enabling Workforce Diversity in County Governments in Kenya

Workforce diversity in public sector organizations in sub-Saharan Africa is supported by legal statutes and mandates as opposed to organizational policy initiatives. HR audits indicate a skewed distribution of specific ethnic groups and an aged workforce with redundant skills due to recruitment practices. Due to the dearth of studies on workforce diversity in sub-national governments in Sub-Saharan Africa, the study examined the role of recruitment practices in enabling workforce diversity in the County Government of Trans- Nzoia. The study was guided by the social identity theory and adopted a descriptive design that was cross-sectional in the time dimension. The study censused senior employees of the County Government and employed a questionnaire as the main research instrument The study carried out data analysis through descriptive analysis and used regression analysis using Statistical Package for Social Sciences (SPSS) software version 20.0 and the output presented in the form of graphs, Charts, and tables. The descriptive statistics indicated the county government values employee qualifications and uses both internal and external job advertisements, with a skewed but consistent selection process. Use of interviews with little application of the psychometric test of candidates as a screening criteria. Workforce diversity significantly correlated with the recruitment practices; with job advertisements (r = 0.781, p&lt; 0.05), and screening process (r = 0.679, p&lt; 0.05), The study concluded that the recruitment practices have a positive effect on workforce diversity. Based on the findings, the study recommends that the county government support competitive recruitment procedures to improve workforce diversity. The study implications are that sector organizations can promote workforce diversity through efficient practices. The study calls for the HR professional to critically examine the different aspects of HRM in public sector organizations. The study findings are beneficial to sub-national governments, policymakers/legislators, and other scholars in Kenya

A Systematic Literature Review and Network Meta-analysis of Azilsartan Medoxomil Compared to Other Anti-hypertensives Efficacy in Lowering Blood Pressure Amongst Mild to Moderate Hypertensive Patients.

A systematic literature review and network meta-analysis was conducted on azilsartan medoxomil (AZL-M) versus other antihypertensive drugs' efficacy in hypertensive patients. The search utilized English platforms, from January 2000 until December 2023, resulting in 10,380 articles being screened. Screening criteria included hypertension (mild or moderate); first-line treatment and washout periods; studies (monotherapy) with AZL-M, angiotensin type II receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor neprilysin inhibitor (ARNIs), beta-blockers, calcium channel blockers (CCBs), and diuretics, either as intervention or comparator; and antihypertension efficacy as an outcome measure. Study design was randomized clinical trials. Efficacy variables included absolute office systolic and diastolic blood pressure (BP) reductions. A total of 21 publications provided adequate data for analysis, of which 20 studies reported both systolic and diastolic BP and one study reported only the diastolic BP. In 21 studies on systolic BP, against the common comparator placebo, the differences in systolic BP were significantly in favor of AZL-M, amlodipine, candesartan, irbesartan, nebivolol, nifedipine, olmesartan, sacubitril valsartan, telmisartan, and valsartan. The surface under the cumulative ranking curve (SUCRA) ranking shows that AZL-M 80mg had the highest ranking, with a possibility of 93% being the best in all other included treatments. In 20 studies on diastolic BP, against the common comparator placebo, the differences in diastolic BP were significantly in favor of AZL-M, amlodipine, bisoprolol, nebivolol, olmesartan, sacubitril valsartan, telmisartan, and valsartan. The SUCRA ranking shows that AZL-M 80mg had the highest ranking, with a possibility of 90% being the best in all other included treatments. AZL-M at 40mg and 80mg shows favorable efficacy compared to other anti-hypertensives, and the 80mg dosage seemed to be the most efficacious of all the included treatments in reducing both office systolic and diastolic BP in patients with mild-to-moderate hypertension.

Enhancing Sepsis Care at an Academic Emergency Department in a Resource-Constrained Setting: A Quality Improvement Initiative.

The early recognition of sepsis and septic shock is crucial for improved patient outcomes. Quality improvement programs have ameliorated processes and outcomes in the care of patients with sepsis and septic shock. This study aimed to improve the proportion of patients receiving antibiotics within 1 hour of triage and compliance with sepsis bundles. A multidisciplinary sepsis task force was created to monitor and improve sepsis care. The program lasted 24 months from January 1, 2018, to December 31, 2019. A unique screening criterion was created by combining items from the systemic inflammatory response syndrome, quick sequential organ failure assessment, and National Early Warning Score systems. Thereafter, a sepsis flowsheet was implemented in the emergency department for monitoring. The measures between the first 12 months and the last 12 months were compared. The proportion of patients receiving antibiotics within 1 hour of triage improved from 44% to 84%, intravenous crystalloid administration within 3 hours improved from 62% to 94%, serum lactic acid measurement within 3 hours improved from 62% to 94%, and vasopressor initiation within 6 hours improved from 76% to 94%. The mortality rates decreased from 32% to 21% between the 2 study periods. This program emphasizes the impact of a structured quality improvement program on the process and outcomes of care.

Design of Electrocatalysts with High Performance Based on Thermodynamics and Kinetics: Progress and Prospects

AbstractEfficient and robust electrocatalysts play a central role in clean energy conversion, enabling a number of sustainable processes for future technologies. The traditional explorations of electrocatalyst relying on the trial‐and‐error approaches are definitely tedious and inefficient. Theoretical progresses on reactive thermodynamics and kinetics in recent years have initiated a powerful theory‐guided design strategy of electrocatalysts. Herein, this review first summarizes design principles for reactive activity and stability, presenting the thermodynamics, kinetics, and the synergistic thermokinetic correlation in electrocatalytic reaction. Second, the screening criterion, reasonable design, mechanistic understanding, and performance evaluation of the typical electrocatalysts as divided into the thermodynamics oriented‐, kinetics oriented‐, and thermokinetic correlation oriented‐designs are discussed. The necessity of correlating thermodynamics and kinetics into the rational design and mechanism clarification is highlighted. Finally, the conclusions and perspectives of the development of highly efficient electrocatalysts are proposed.

Identification and Validation of a novel Circulating miRNA Predictive Biomarkers for acquired Bortezomib Resistance in Multiple Myeloma patients at Southeast Medical Center

Abstract Introduction/Objective Bortezomib is used to treat multiple myeloma but some patients become resistant to it. MiRNAs, small non-coding RNAs that regulate gene expression, may serve as biomarkers for drug resistance in cancer. Dysregulation of miRNA expression is common in cancer development. We investigated whether plasma miRNAs can serve as clinical indicators for bortezomib resistance in multiple myeloma. We hypothesize that there is a significant difference in miRNA signature between sensitive and resistant Bortezomib multiple myeloma samples derived from African American male patients. Methods/Case Report Specific Aim 1: Discovery: To identify miRNAs using five BTZ-resistant and five sensitive African American male bone marrow samples using RNA sequencing technology. Using log2fold change ≥ 1.3, p ≤ 0.05, and known function as screening criteria of statistically significant upregulated miRNAs. Specific Aim 2: Analytical validation: Quantitative reverse-transcription PCR (qRT-PCR) technology using bone African American Male Bone Marrow samples to confirm the differential expression of candidate miRNAs identified in Aim 1. Using log2fold change ≥ 1.3, p ≤ 0.05, and Two-tailed student T-Test known function as screening criteria of statistically significant upregulated miRNAs. Specific Aim 3: Clinical Validation: To be performed using patients’ serum and qRT-PCR technology. Using log2fold change ≥ 1.3, p ≤ 0.05, known function, and Two-tailed student T-Test as the screening criteria of statistically significant upregulated miRNAs. Results (if a Case Study enter NA) We identified upregulated and downregulated miRNAs from African American males with MM in 5-BTZ-resistant and 5-BTZ-sensitive bone marrow samples using RNA sequencing. Four statistically significant upregulated miRNAs were identified and validated using RT-qPCR and bioinformatic target prediction (has-miR-18a-3p, has-miR-18a-5p, has-miR-20a-5p, has-mir-664a-5p). Using log2fold change ≥ 1.3, p ≤ 0.05, and Two-tailed student T-Test, and known function as screening criteria, has-miR-18a-5p and has-miR-20a-5p were validated as statistically significant upregulated miRNAs among the BTZ-resistant bone marrow samples. These miRNAs will now undergo clinical validation. Conclusion According to the qRT-PCR analysis, significant differential expression was observed between the Bortezomib-sensitive and Bortezomib-resistant groups was has-miR-18a-5p (p ≤ 0.02) and has-miR-20a-5p (p ≤ 0.04) as statistically significant differential expressed miRNAs and are associated with promoting carcinogenesis.

Safety, Tolerability, Pharmacodynamics, and Pharmacokinetics of Recombinant Neorudin, a New Anticoagulant Drug in Patients With Acute Coronary Syndrome.

This study evaluated the safety, tolerability, pharmacodynamics, and pharmacokinetics of recombinant neorudin (EPR-hirudin [EH]) in patients with acute coronary syndrome (ACS), providing a basis for further therapeutic research. This open-label, single-center, nonrandomized, nonblinded, and noncontrolled trial categorized 24 patients with nonprogressive ACS who met the screening criteria into 3 groups. They received an intravenous injection of neorudin (0.4mg/kg), followed by an intravenous drip at doses of 0.15, 0.30, and 0.45mg/kg/h for 3 days in the low-, medium-, and high-dose groups, respectively. The safety, tolerability, pharmacodynamics, and pharmacokinetics of EH were assessed after treatment, indicating that neorudin was safe and well tolerated in nonprogressive ACS. No serious adverse events or clinical composite end points were observed. The activated partial thromboplastin time and thrombin time increased significantly and dose dependently following EH administration across all groups compared to pretreatment values. Conversely, thrombin activity significantly decreased after drug administration but returned to baseline levels shortly after drug withdrawal. Within the administered dose range, neorudin exposure increased with the dose, and its half-life was approximately 2hours. Neorudin was found to be safe and tolerable for treating patients with nonprogressive ACS, demonstrating therapeutic efficacy at doses up to 0.45mg/kg/h over a 3-day period.

7740 Adult-Onset Hypophosphatasia Presenting As Low Alkaline Phosphatase Level Following Denosumab Use For Osteoporosis

Abstract Disclosure: J. Ocampo Mascaro: None. P. Wax: None. M. Al Mukaddam: Grant Recipient; Self; Ipsen, Incyte Research Funding. Background: Hypophosphatasia (HPP) is a genetic disease characterized by low activity of the tissue non-specific alkaline phosphatase. It has a broad range of clinical phenotypes, with adults usually presenting with an incidental low alkaline phosphatase (ALP) finding. Differentiating this from other causes of low ALP is challenging, especially when treating osteoporosis, as antiresorptive therapy such as denosumab and bisphosphonates may cause low ALP and carry the potential of increasing risk of atypical femoral fractures in patients with undiagnosed HPP. Clinical Case: A 64-year-old woman with history of nephrolithiasis, hypercalciuria, and osteoporosis (screening DXA lowest T-score -3.3 in femoral neck (FN)) but no prior fractures or dental issues was seen in clinic. Initial bloodwork showed normal range calcium, 25-OH vitamin D, and intact PTH. Pre-treatment ALP was 42 IU/L (N 39-117). Work up for secondary causes of osteoporosis was negative. Three yearly doses of IV zoledronic acid resulted in +4.2% BMD increase in lumbar spine (LS) but no changes in FN. She had no side effects but was found to have a decrease in ALP to 33 IU/L. This normalized back to 42 IU/L during a three-year drug holiday. Follow up DXA noted significant decline in BMD, hence denosumab was initiated. ALP decreased back to the 30-35 IU/L range. Fasting Vitamin B6 level (off B6 supplements for 1 week) was 23.4 ng/ml (N 2.1-21). Urine phosphoethanolamine was mildly elevated at 5 mmol/mol creatinine (N ≤4). Genetic testing evidenced a pathogenic ALPL variant (Exon 6, c.575T&amp;gt;C (p.Met192Thr), heterozygous) compatible with HPP. She had tolerated three doses of denosumab by then with BMD improvement of 5.0% in LS but no changes in FN and no atypical femoral fracture. Denosumab was stopped. Abaloparatide was started for osteoporosis with close monitoring for worsening hypercalciuria. Conclusion: This case demonstrates that adult HPP patients may present with subtle findings and lower range of normal ALP and may tolerate short courses of antiresorptive agents. There is a need for better screening and diagnostic criteria for adult HPP patients whose ALP levels may not be initially low before initiating antiresorptive drugs for osteoporosis. The risk of adverse effects from therapy will likely vary significantly based on the clinical severity/presentation of HPP as some adults with lower ALP ranges might be more susceptible to developing atypical femur fractures (1). Balancing atypical femur fracture risk with the benefits of antiresorptive treatment in decreasing risk of osteoporotic fractures highlights the need for better risk stratification to prevent undertreatment of osteoporosis. Reference: 1. Warren AM, Ebeling PR, Grill V, Seeman E, Sztal-Mazer S. Bilateral atypical femoral fractures during denosumab therapy in a patient with adult-onset hypophosphatasia. Endocrinol Diabetes Metab Case Rep. 2021 Sep 1;2021:21-0096. Presentation: 6/2/2024

Assessment of Motor Imagery and Its Relationship to Functional Impairment in Post-Stroke Patients: A Descriptive Cross-Sectional Study.

Background: Motor and cognitive sequelae are common in patients who have experienced a stroke. Recent advances in neuroscience have enabled the development of novel therapeutic approaches, such as motor imagery, which facilitate motor learning. The objective of this study is to examine the relationship between implicit and explicit motor imagery abilities and their correlation with functional impairment in post-stroke patients. Methods: A descriptive cross-sectional study was conducted with 36 patients who had experienced a stroke between March 2008 and March 2023. The capacity to generate both implicit and explicit motor imagery and to perform physical functions was evaluated. The relationship between implicit and explicit motor imagery measures was investigated using Pearson's correlation coefficient. The factorial structure, which encompasses the capacity to generate motor imagery, whether implicit or explicit, and physical function, was subjected to analysis. Results: A correlation was identified between the time taken to identify images and the accuracy of this process, with the right hand (R = 0.474), the left hand (R = 0.568), and the left foot (R = 0.344) all demonstrating significant associations. Additionally, a notable correlation was observed between the two subscales of the KVIQ-10 scale (R = 0.749). No association was identified between the capacity to generate implicit and explicit motor imagery. Two- and three-factor solutions were obtained for the right and left hemibodies, respectively. On both sides, accuracy in identifying images and physical function constituted a single factor, while time to generate images for both hands and feet constituted a second factor. Conclusions: In conclusion, no significant data were reported regarding the association between the capacity to generate implicit and explicit motor imagery in the studied sample. However, the ability to generate implicit motor imagery was related to physical function, suggesting that it may serve as a screening criterion for implementing specific therapeutic approaches in post-stroke patients.

Leak aperture recognition of natural gas pipeline based on variational mode decomposition and mutual information

The acoustic emission (AE) signals generated by natural gas pipeline leaks are affected by various noises, making the accurate extraction of feature signals a challenging task. Therefore, this paper introduces a novel adaptive signal denoising approach utilizing Variational Mode Decomposition (VMD).and mutual information (MI). Firstly, the parameters K and α of VMD are optimized using the energy difference. Simultaneously, the correlation coefficient between adjacent IMF components is used as the evaluation criterion to determine the optimal values of K and α. Then, based on MI, a screening criterion is proposed to select effective IMF components for reconstruction. Finally, the ISSA-SVM model was established by introducing Tent chaotic mapping and inertia weight adjustment strategy on the basis of the traditional sparrow search algorithm (SSA). Experimental results demonstrate that the proposed method effectively eliminates noise from pipeline leak AE signals, with a recognition accuracy reaching up to 96.09%.

Using a Polygenic Risk Score to Improve the Risk Prediction of Non-Small Cell Lung Cancer in Taiwan.

Low-dose computed tomography (LDCT) can help reducing lung cancer mortality. In Taiwan, the existing screening criteria revolve around smoking habits and family history of lung cancer. The role of genetic variation in non-small cell lung cancer (NSCLC) development is increasingly recognized. In this study, we aimed to investigate the potential benefits of polygenic risk scores (PRSs) in predicting NSCLC and enhancing the effectiveness of screening programs. We conducted a retrospective cohort study that included participants without prior diagnosis of lung cancer and later received LDCT for lung cancer screening. Genetic data for these participants were obtained from the project of Taiwan Precision Medicine Initiative. We adopted the model of genome-wide association study-derived PRS calculation using 19 susceptibility loci associated with the risk of NSCLC as reported by Dai et al. We studied a total of 2,287 participants (1,197 male, 1,090 female). More female participants developed NSCLC during the follow-up period (4.4% v 2.5%, P = .015). The only risk factor of NSCLC diagnosis among male participants was age. Among female participants, independent risk factors of NSCLC diagnosis were age (adjusted hazard ratio [aHR], 1.08 [95% CI, 1.04 to 1.11]), a family history of lung cancer (aHR, 3.21 [95% CI, 1.78 to 5.77]), and PRS fourth quartile (aHR, 2.97 [95% CI, 1.25 to 7.07]). We used the receiver operating characteristics to show an AUC value of 0.741 for the conventional model. With the further incorporation of PRS, the AUC rose to 0.778. The evaluation of PRS for NSCLC prediction holds promise for enhancing the effectiveness of lung cancer screening in Taiwan especially in women. By incorporating genetic information, screening criteria can be tailored to identify individuals at higher risks of NSCLC.

OA17.06 Impact of Using Smoking Duration in Place of Pack-Years as Eligibility Criteria for Lung Cancer Screening to Reduce Racial and Ethnic Disparities

OA17.06 Impact of Using Smoking Duration in Place of Pack-Years as Eligibility Criteria for Lung Cancer Screening to Reduce Racial and Ethnic Disparities

EP.04C.04 Extended Inclusion Criteria for Lung Cancer Screening to Tabacco Related Diseases: Comparison of Preliminary Results in Two Prospective Cohorts

EP.04C.04 Extended Inclusion Criteria for Lung Cancer Screening to Tabacco Related Diseases: Comparison of Preliminary Results in Two Prospective Cohorts

An Overlooked Disease: Minimal Autonomous Cortisol Secretion (MACS). A Narrative Review.

A far more common disease than Cushing's syndrome is subclinical hypercortisolism or mild autonomous cortisol secretion (MACS), with an overall prevalence of 0.2-2%. This review aims to shed light on the prevalence, screening and diagnostic criteria, comorbidities, and management of Mild Autonomous Cortisol Secretion (MACS). Studies eligible targeted MACS regarding prevalence, screening, comorbidities, management, and clinical outcome. This is a mini-review. IRB approval was not needed. The 1 mg Dexamethasone suppression test (DST) remains the first screening test. MACS is associated with adverse cardiometabolic and renal outcomes, osteoporosis and osteopenia, immunodeficiency, depression, coagulopathy, and sarcopenia. Surgery is the gold standard treatment. Medical therapy is recommended when surgery is contraindicated or not feasible. Clinically silent hypercortisolism is a frequent entity that necessitates early detection and treatment. The production of cortisol should be looked at as a spectrum where subtle, undetectable levels can still be produced. They know its association with adverse health outcomes. MACS is no longer considered an asymptomatic disorder; repeated hormonal and functional tests are crucial to prevent multiorgan damage.