Screening Criteria Research Articles

Enhanced Recovery After Surgery (ERAS) Protocol for Craniotomy Patients: A Systematic Review

Context: The enhanced recovery after surgery (ERAS) protocol is a multidisciplinary approach aimed at improving surgical outcomes, reducing complications, minimizing hospital stays, and lowering healthcare costs. Objectives: This study assesses the impact of the ERAS protocol on elective craniotomies, a routine procedure in neurosurgery. Methods: A comprehensive search across PubMed, Embase, Scopus, and Web of Science identified 562 articles. Following strict screening criteria, 54 studies were reviewed, and ultimately 10 studies meeting the inclusion criteria were selected for detailed analysis. Results: The review encompassed ten studies [one prospective, one systematic review, and eight randomized controlled trials (RCTs)] published between 2016 and 2023. Key components of the ERAS protocol included preoperative counseling, high-protein intestinal nutrition, preoperative fasting while avoiding carbohydrate intake within 2 hours of surgery, standardized anesthetic and analgesic regimens, and early postoperative initiation of enteral feeding. Postoperative outcomes showed fewer complications, early mobilization, and notably shorter hospital stays, all of which contributed to improved patient recovery. Conclusions: This review demonstrates that the ERAS protocol, when applied to elective craniotomies, is effective in enhancing postoperative recovery, improving functional outcomes, and reducing hospitalization duration.

Causal relationship between benign prostatic hyperplasia and prostate cancer: a bidirectional Mendelian randomization analysis.

Our aim is to explore the relation between benign prostatic hyperplasia (BPH) and prostate cancer (PCa) from a genetic level utilizing Mendelian randomization (MR). The IEU genome-wide association studies database was surveyed for single nucleotide polymorphisms (SNPs) associated with BPH, PCa, and PCa (validation cohort). Single nucleotide polymorphisms were subjected to stringent quality control based on rigorous screening criteria. BPH and PCa risk were evaluated using the inverse-variance weighted method (IVW), MR-Egger, simple mode, weighted median, and weighted mode. Horizontal pleiotropy of single nucleotide polymorphisms was assessed using the MR-Egger intercept test, while heterogeneity was evaluated using Cochran's Q test. Reverse causality was assessed by evaluating PCa as the exposure and BPH as the outcome. A validation database was used to verify the exposure and outcome. The risk of PCa increased significantly with genetically predicted BPH (IVW: OR [95% CI] = 1.3849 × 107 [2330, 8.2294 × 1010], P = 2.0814 × 10-4). In reverse MR analysis, PCa also increased the risk of BPH (IVW: OR [95% CI] = 1.0011 [1.0003, 1.0019], P = 0.0031). The findings were consistent with the MR analysis results of the PCa validation cohort. Sensitivity analyses indicated the presence of heterogeneity but no horizontal pleiotropy. The study presents proof of a significant bidirectional causal relationship between genetically predicted BPH and an increased risk of PCa. Key message Three research questions and three bullet points What is already known on this topic? Observational studies suggest a controversial relationship between BPH and PCa. MR allows investigation of causality using genetic variants as instrumental variables (IVs). What does this study add? The study presents proof of a significant bidirectional causal relationship between genetically predicted BPH and an increased risk of PCa. How this study might affect research, practice, or policy? Recognizing the bidirectional relationship between BPH and PCa, men diagnosed with BPH may benefit from more stringent PCa screening protocols.

Drivers of brand love for organic wine brands: moderating role of ethnocentrism

PurposeThe consumption of organic wine has witnessed exponential growth, mainly because of changing lifestyles, rising disposable income, modernity aspects and claimed health benefits. Understanding the motivations and attributes affecting organic wine consumption (OWC) provides a limited perspective on consumption and behavioral patterns.Design/methodology/approachThis study used a set of screening criteria to arrive at the final choice of fine-dining restaurants and bars that serve wine in their outlets. Based on the selected locations, we gathered responses from 558 consumers aged 18 years and above with prior experience of buying organic and non-organic wine. The hypothesized model was validated using covariance-based structural equation modeling (CB-SEM). From the perspective of organic wine consumption, the research findings exhibit significant links between the drivers.FindingsThe findings underscore the moderating impact of ethnocentrism toward shaping consumers’ attitudes and brand love. Additionally, gender and consumption frequency indicated significant variations among consumers of organic wine. Female consumers strongly believe that consumption of organic wine provides health benefits, societal acceptance and moments of joy. Additionally, men usually associate wine consumption with enhanced their affective, convivial and sensory pleasure.Originality/valueThis study examines the drivers and marketing outcomes of organic wine consumption using Behavioral Reasoning Theory (BRT) and the Theory of Hedonic Asymmetry (THA).

Effects of a Tailored Mobile Messaging Intervention for Indoor Tanning Cessation in Young Females: A Randomized Clinical Trial.

Indoor tanning increases the risk of skin cancer and can become addictive. There is little research on indoor tanning cessation interventions. From 2019-2022, we conducted a clinical trial (n=265) testing a tailored mobile messaging cessation intervention in 18-30-year-old females screened for indoor tanning addiction. Participants were randomized to a control arm receiving standard risk education or a cessation intervention arm receiving tailored mobile messaging for 4 weeks. Main outcomes were indoor tanning cessation, motivation to quit, quit attempts, and indoor tanning cognitions assessed at end of treatment and 3 months later. At end of treatment, intervention participants were more likely to report quitting indoor tanning (OR = 2.10, 95% CI = 0.99 - 4.44, p <.05), but there were no significant differences by 3 months (OR = 1.54, 95% CI = 0.82 - 2.87, p = 0.17). Intervention participants who did not quit reported higher motivation to quit than control participants at the end of treatment (M = 3.40, SD = 1.72, M = 2.54, SD=1.63, p's < 0.01) and 3 months (M = 3.75, SD = 1.93, M = 2.85, SD = 1.85, p's < 0.01). Tailored mobile messaging successfully impacts indoor tanning cessation behaviors and cognitions in young adult females who meet screening criteria for tanning addiction. This trial provides preliminary support for the efficacy of a mobile cessation intervention for young adult females who meet screening for tanning addiction. Results indicate additional intervention features should be tested to increase durability of effects.

Cardio Vascular Disease Risk Assessment by Medical Officers According to the Guidelines at Healthy Lifestyle Centers in Western and North Western Provinces and the Factors Affecting Implementation of Guidelines

Introduction: Healthy Lifestyle Centers (HLC) were established in 2011 to carry out Cardiovascular Disease (CVD) Risk Assessments and follow up with patients. The capacity of primary care institutions (PCI) for CVD risk assessment has not been studied in the recent past.Objective: To evaluate the existing CVD risk assessment guideline and assess its application process by Medical Officers (MOs) and facilities available at HLCs for CVD risk assessment.Methodology: A descriptive study with three components was carried out. Component one – CVD risk assessment Guideline evaluated through Key informant interviews (KII); component two- assessment of the Knowledge and practices on CVD risk assessment of all MOs working in HLCs using a self-administered questionnaire and an observational checklist; component three- assessment of available facilities and resources to carry out CVD risk assessment using a checklist.Results and Discussion: The study was conducted in 141 HLCs accessible during the Covid period. Assessment of CVD risk assessment guidelines showed Problems in methodological standards and in the identification and summary of evidence. MOs need to gain Knowledge in screening those under 35 years, in reading the WHO/ISH Risk Prediction Chart and in advising on further management and follow-up. All HLCs have at least one medical officer, but there is a lack of nursing officers and health care assistants.Conclusions and recommendations: There was a gap in Knowledge in screening criteria and management of those under 35 years of age. It is recommended to carry out training at national level every six months so all staff newly appointed to primary care could be trained. It is also recommended to appoint at least one nursing officer or a Public Health Nursing Officer (PHNO) to an HLC.

Donor-Derived Infections: A Journey from Evidence to Policy

The prevalence of donor-derived Bartonella quintana infection poses an emerging issue in solid organ transplantation. Further studies are needed to validate criteria for donor screening to prevent transmission without negatively affecting organ utilization.

Abstract 4114308: Defective in LYPLA1-Mediated Lysophosphatidylcholine Metabolism Contributes to Diabetes-Induced Atherosclerosis and Subsequent Myocardial Dysfunction

Background and Objective: Diabetes mellitus (DM) is a chronic metabolic condition that can cause serious damage to blood vessels and the heart. While current metabolomics research mainly focused on metabolic profiles during disease onset or at advanced stages, there remains a gap in understanding the molecular mechanisms of metabolites in the progression of diabetic cardiovascular disease. This study aims to explore effective strategies for preventing cardiovascular complications in diabetics by excavating metabolic pathways and mechanisms. Methods: Peripheral blood samples were obtained from 21 healthy individuals, 20 patients diagnosed with DM, 20 patients with coronary heart disease (CHD), and 25 patients with both DM and CHD (DC). Cardiac function, biochemical parameters and serum metabolome were detected. A specialized methodology with rigorous screening criteria was employed to identify differential metabolites associated with diabetes-induced CHD and cardiomyopathy. Mice were injected with LPC16:0 to assess cardiovascular function. Models of diabetes and diabetic atherosclerosis were induced by STZ injection and high-fat diet feeding in WT and ApoE -/- mice. Cardiac function and differential metabolites in aortic and cardiac tissues were assessed. The effect and molecular mechanism of LYPLA1 on vascular function, mitochondrial function, and metabolites-related enzymes were examined in human aortic endothelial cells (HAECs) and AC16 cardiomyocytes. Results: Cardiac function was markedly declined in DM and DC patients, as well as in mice with diabetes and diabetic atherosclerosis. However, CHD patients and atherosclerosis alone did not exhibit evident cardiac dysfunction. Key metabolites associated with diabetic cardiomyopathy and diabetes-induced CHD were identified as LPE18:1 and LPC16:0, respectively. Intraperitoneal administration of LPC16:0 in mice led to decreased LYPLA1, severe myocardial anomalies, and the appearance of plaques in the aortic arch. Either LYPLA1 knockdown or the treatment with high glucose and palmitic acid in HAECs resulted in impaired mitochondrial function, reduced intracellular NO and eNOS activity, which were mitigated by LYPLA1 overexpression. Conclusion: The metabolite LPC16:0 and the regulatory enzyme LYPLA1 are pivotal in driving the advancement of cardiovascular complications triggered by diabetes. Targeting LYPLA1 could represent a promising strategy for preventing diabetes-induced CHD and subsequent cardiomyopathy.

Predicting the risk of treatment-requiring retinopathy of prematurity in preterm infants in Greece. External validation of DIGIROP prognostic models.

To assess the predictive performance of DIGIROP-v1.0 models in identifying treatment-requiring ROP among infants undergoing ROP screening at a tertiary neonatal intensive care unit in Greece. Retrospective cohort analysis of 640 consecutive screened preterm infants with gestational age (GA) 240/7 to 306/7 weeks and known ROP outcome in the 2nd Neonatology Department of Aristotle University of Thessaloniki (2009-2021). The primary outcome was the development of type 1 ROP according to the Early Treatment of ROP criteria or treatment based on the ophthalmologist's judgement. Sensitivity, specificity, area under the curve (AUC) with corresponding 95% confidence intervals (CI) and calibration plots for the DIGIROP-v1.0 models were displayed. The DIGIROP-Birth-v1.0 model correctly identified 35/43 treated infants (sensitivity 81.4% [95% CI, 66.6%-91.6%], specificity 61.5% [95% CI, 57.4%-65.4%], AUC 0.82 [95% CI, 0.75-0.90]). During the postnatal weeks 6-14 the sensitivity of the DIGIROP-Screen-v1.0 model ranged from 82.6% to 100%. Eleven infants, all with severe comorbidities, that is, congenital malformation(s), syndrome(s), hydrocephalus or history of intestinal surgery, that were treated, were missed by the model, but met criteria for screening according to DIGIROP-v1.0 models' recommendations, and to our unit's routine standards. The DIGIROP-v1.0 models resulted in lower sensitivity and higher specificity in this Greek cohort compared with the Swedish development group. Despite higher GA and BW, infants in our cohort had higher incidence of treated ROP than in Sweden, resulting in an under-estimation of their risk for treatment-requiring ROP. Further validation of the DIGIROP-v2.0 models and potential adjusting are recommended to maximize generalizability in populations with different characteristics.

How to prevent postextubation respiratory failure.

Postextubation respiratory support treatment approaches, indications, and subgroups of patients with different responses to those therapies are rapidly changing. Planning optimal therapy in terms of choosing devices, timing of application and selecting settings with the goal of minimizing extubation failure is becoming a challenge. This review aims to analyze all the available evidence from a clinical point of view, trying to facilitate decision making at the bedside. There is evidence for high flow nasal cannula support in patients at low risk of extubation failure. Noninvasive ventilation based strategies should be prioritized in patients at very high risk, who are obese or are hypercapnic at the end of a spontaneous breathing trial. Patients not included in the previous groups merit a tailored decision based on more variables.Optimizing the timing of therapy can include facilitation of extubation by transitioning to noninvasive respiratory support or prolonging a planned preventive therapy according to clinical condition. Planning postextubatin respiratory support must consider the risk for failing and the presence of some clinical conditions favoring noninvasive ventilation.Extubation can be safely accelerated by modifying screening criteria and spontaneous breathing trial settings, but there is room to increase the role of postextubation noninvasive respiratory support for this indication, always keeping in mind the dangers of delaying a needed intubation.

Current Situation of Heat Stress Studies on Kendo Players: A Scoping Review

Background/Objectives: Global warming and the rise in the average temperature in recent years have increased the risk of heat stroke and also deteriorated performance among athletes. Kendo, a traditional Japanese martial art and also a competitive sport, is reported to have high incidents of heat stroke and related mortality. However, there is no heat management guideline for this specific sport to date and research on its heat management practices and risk factors for heat stroke are limited. The present study conducted a scoping review on studies focused on heat stress and the heat management practices of Kendo players. Methods: A literature search was conducted using five databases (PubMed, SCOPUS, Ichu-shi Web, CiNii, and Google Scholar) and also manually from the references of searched articles. Results: Overall, the studies that have investigated the heat stress of Kendo players are scarce and outdated. Of the 15 references that met screening criteria, 11 studies were conducted in a field setting. The vast majority were conducted on male university students and there was a lack of research on females and on different age groups. Common measures of heat management practices used in previous studies were weight changes before and after training (n = 14), body temperature (n = 9), and heart rate (n = 8). Only a few studies used multiple measures to determine heat stress. Conclusions: Considering the continuation of global warming and the increasing risk of heat stroke, further investigation on heat stress, its association with health and performance, and current heat management practices in Kendo players are warranted.

PlexinA1 (PLXNA1) as a novel scaffold protein for the engineering of extracellular vesicles.

Extracellular vesicles (EVs) had been described as a next-generation drug delivery system, due to the compelling evidence that they can facilitate the transfer of a variety of biomolecules between cells. The most frequently used strategy for loading protein cargoes is the endogenous engineering of EVs through genetic fusion of the protein of interest (POI) and scaffold proteins with high EV-sorting ability. However, the lack of scaffold proteins had become a major issue hindering the promotion of this technology. Herein, we proposed novel screening criteria that relax the inclusion requirement of candidate scaffold proteins and eventually identified a new scaffold protein, PLXNA1. The truncated PLXNA1 not only inherits the high EV-sorting ability of its full-length counterpart but also allows the fusion expression of POI in both outer surface and luminal areas, individually or simultaneously. In conclusion, our screening criteria expanded the range of potential scaffold proteins. The identified scaffold protein PLXNA1 showed great potential in developing therapeutic EVs.

Clinical and epidemiological characteristics of patients with pheochromocytoma and retroperitoneal paraganglioma

Introduction. Pheochromocytoma/paraganglioma (PPGL) is a rare hormonally active tumor of chromaffin tissue. Delayed diagnosis of this disease can lead to severe, even fatal, complications. Surgical treatment of PPGL without the necessary preoperative preparation can cause intraoperative uncontrolled hemodynamic impairment. In addition, since 2017, PPGL has been recognized as a malignant tumor due to the presence of metastatic potential. All these factors determine the need for early diagnosis of PPGL, which is based, first of all, on knowledge of the clinical picture by specialists in various fields.Aim. To check and confirm the epidemiological characteristics of PPGL as well as the most common clinical symptoms in the whole group of PPGL and in subgroups of clinical forms; to form a risk group for screening for PPGL.Materials and methods. There were enrolled 353 patients in the study. These patients were operated on at the St. Petersburg State University Hospital in the period from 2010 to 2022 inclusive. All the patients were verified PPGL diagnosis histologically. Clinical symptoms were assessed: a) retrospectively, by analyzing complaints and anamnesis from the initial examination in medical histories upon admission to the hospital for surgical treatment b) both in the entire group as a whole and in subgroups of clinical forms (paroxysmal, constant, mixed, asymptomatic). Statistical analysis was performed using the Python 3.11 programming language (Python Software Foundation, USA). descriptive statistics of quantitative characteristics are presented in the form of medians, first and third quartiles in me format [q1; q3], categorical features – in the form of absolute and relative frequencies in the format n (%). the frequency histogram was constructed using the Matplotlib 3.8.2 library.Results. PPGL is most common in women over 40 years of age. The most common symptoms of PPGL are the following: a feeling of rapid heartbeat (55.95%), headache (41.07%), arterial hypertension (AH) in the form of hypertensive crises (55.65%), constant increase in blood pressure (38.39%), episodes of moderate increases in blood pressure (24.11%), sweating (30.65%), general weakness and fatigue (26.19%), hot flashes or chills (24.11%). These symptoms are formed into the criteria for screening for PPGL. In the asymptomatic clinical form – lower back pain is more common (14%); with paroxysmal – panic attacks (10%); with mixed – thirst and dry mouth (10%), and with constant form – the actual constant nature of hypertension (100%).Conclusion. In a large sample of patients with a rare pathology, the most characteristic symptom complex was identified, characteristic of both PPGL and individual clinical forms. A risk group has been formed for screening for PPGL.

Improving psychological and social support needs after traumatic birth: A qualitative study

IntroductionEmergency deliveries increase maternal risk for postpartum depression (PPD) and post-traumatic stress disorder (PTSD). One in three women describe their birth experience as traumatic, but patient-centered support needs are unclear. We conducted a qualitative study of women with traumatic birth to identify patient-centered priorities to optimize mental health support. MethodsSemi-structured interviews were conducted with women who experienced an emergency during birth, and who self-identified as experiencing traumatic birth. The Stanford Acute Stress Reaction Questionnaire and PTSD Checklist were completed. Interviews included open-ended questions about birth events that improved or worsened their delivery experience, perceptions of mental, physical, and emotional support provided by staff, and patient perspectives about psychological and social support referrals after emergent deliveries. ResultsA majority of participants met positive screening criteria for PTSD at the time of interviews. Birth experiences were affected by prenatal expectations, as well as the style and quality of clinical staff communication during and after delivery. There were four key themes central to their experiences and perceptions: (1) Emotional Impact and Intensity, (2) Factors Influencing Birth Experience, (3) Perceived Lack of Emotional Support, and (4) Desire for Post-Birth Follow-Up and Support. Participants almost unanimously desired to be offered psychosocial services after birth trauma. ConclusionThere are significant gaps in emotional support and communication for patients experiencing traumatic births. Offering structured, in-hospital mental health referrals may address immediate psychological needs, aid in trauma recovery, and potentially mitigate long-term mental health consequences. These findings advocate for a more holistic approach to postpartum care that prioritizes both physical and emotional well-being.

Updating Research on Extracellular Vesicles of the Male Reproductive Tract in Farm Animals: A Systematic Review.

This systematic review examined research studies on extracellular vesicles (EVs) of the male reproductive tract in livestock species to summarize the research topics and methodologies used, key findings, and future directions. PubMed and Scopus were searched for time ranges up to 1 September 2024, and 1383 articles were identified. The application of screening and eligibility criteria resulted in the selection of 79 articles focusing on male reproductive EVs in livestock. Porcine and bovine male reproductive EVs were the most studied. A variety of EV isolation techniques were used, with ultracentrifugation being the most common. Characterization of male reproductive EVs in livestock was a weak point, with only 24.05% of the articles characterizing EVs according to MISEV guidelines. Inadequate characterization of EVs compromises the reliability of results. The results of 19 articles that provided a good characterization of EVs showed that male reproductive EVs from livestock species are phenotypically and compositionally heterogeneous. These papers also showed that these EVs would be involved in the regulation of sperm functionality. Research on male reproductive EVs in livestock species remains scarce, and further research is needed, which should include appropriate characterization of EVs and aim to find efficient methods to isolate them and assess their involvement in the functionality of spermatozoa and the cells of the female genital tract.

Can Corporate Site Visits Improve ESG Ratings?

AbstractAs environmental, social, and governance (ESG) becomes an increasingly popular criterion for investment screening, drivers of ESG performance have attracted attention from a wide range of stakeholders. In this study, we test whether corporate site visits can improve ESG ratings using a unique dataset of site visits from Chinese listed firms. We find that corporate site visits can lead to improved ESG performance for listed firms, which is robust even after adding a series of control variables, alternative model specifications, and accounting for endogeneity issues. This effect is attributed to the mediating effects of ESG information disclosure and corporate internal control quality. We also find that the more ESG‐related discussion during site visits the better managers learn to improve ESG performance of their firms. Furthermore, there is evidence that the positive effect of site visits on ESG are more pronounced among firms that are not audited by Big Four accounting firms, not cross‐listed, and when Qualified Foreign Institutional Investors are involved. Overall, this paper contributes to the literature by providing complementary evidence that site visits are an important platform for communicating between investors and corporate management, which can have profound implications on incentivizing managers to deliver better ESG performance. Our findings also offer practical and policy implications to regulators on the promotion and implementation of ESG in listed firms.

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&amp;lt;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.