Effective Screening Research Articles

Long term effects of preventive activities of youth health care in The Netherlands: results of a four-part study

Background. In this article the results are presented of a four part study on the effect of screening for scoliosis and (repeated) well-care visits and freely accessible consultation hours at secondary schools, on the incidence and prevalence of (para)suicide, mental health, adolescent health compromising behaviour and lastly obesity. Methods. An ecologic case-referent study design was used with data from the Netherlands Bureau of Statistics, the Ministry of Defence, the 1992 High-School Student Study, all of the youth health care departments in The Netherlands and relevant censuses. Results. Attention to mental and physical health and health compromising behaviour, either during screening, open consultation hours or during well-care visits seems to be ineffective and in some instances even detrimental to youth health. Of the 18 different outcome measurements, 5 were significantly negative and none were significantly positive. Conclusions. This four part study does not support the hypothesis that on a population level, the preventive activities of youth health care departments such as screening for scoliosis, (more) frequent well-care visits or offering open consultation hours at secondary schools, have a beneficial effect on prevention of (para)suicide, poor mental health, health compromising behaviour or obesity.

The Interventional Capacity of Community Health Volunteers for Screening and Linkages of Non-Communicable Diseases in Nyeri County, Kenya

Purpose: Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (LMICs), where 80% of NCD-related deaths occur. This study evaluated barriers and challenges to effective screening and linkages of NCDs in Nyeri County. Methodology: A quasi-experimental non-equivalent pre-and post-test design was conducted from May 2022 to March 2023. The study employed multistage cluster and random sampling to select ten community units, resulting in 150 community health volunteers (CHVs) in the control unit and 150 in the intervention group. Data collection was facilitated through the KOBO app. Quantitative data was analyzed using SPSS version 28.0, and qualitative data was audio-recorded, transcribed, and analyzed via N-Vivo 12 and findings were presented in textual descriptions and thematic analysis that included direct quotes from participants, descriptions of observed behaviors, and interpretations of patterns and themes. Findings: The study shows that 59.3% of respondents have minimal information, and 92.7 % (n =139) have no clear understanding of NCDs, with a pre-intervention capacity of 48.8%. Independent sample t-test showed a significant difference in capacity from a pre-intervention average of 48.75 (SD±5.7) %, which increased to 68.28 (SD±7.6) %, p<0.001. Unique Contribution to Theory, Practice and Policy: There is a need for a comprehensive, and culturally sensitive training for that will focus on modern healthcare practices, implementing more structured, community-centric approaches involving effective communication, mobilization, and sensitization will enhance the capacity and acceptance of CHVs' roles in combating NCDs. Continuous research and evaluation should ensure practical changes including innovations and use of mobile apps like NCDs app and wheel. An easy-to-use CHV mobile app, continuous capacity building and increased awareness and training will greatly improve on CHVs screening and linkages. Therefore, in this era of technology and use of mobile phones, there is need to develop an app that can be integrated with CHVs mobile phones, Healthcare facility and clients for close NCD monitoring and referral.

Fluorescent Quantum Dots Based Lateral Flow Assay for Rapid Quantitative Detection of Ciliary Neurotrophic Factor in Glaucoma

AbstractEarly and accurate diagnosis of glaucoma is crucial to prevent the progressive deterioration that leads to irreversible vision loss. It is imperative to develop an effective screening tool for glaucoma. Ciliary neurotrophic factor (CNTF) is a tear biomarker implicated in glaucoma pathogenesis. Lateral flow assay (LFA) provides an ideal platform for detection of glaucoma in tear fluid. A quantum dot‐based fluorescence LFA, integrated with a 3D printed readout box, is developed for fast (30 min), sensitive, and quantitative CNTF detection in tears. A standard curve is firstly generated for the quantitative detection of CNTF. The limit of detection (LOD) of the obtained LFA strip at 6.45 pg·mL−1 is comparable to that of the enzyme‐linked immunosorbent assay (ELISA) at 6.42 pg·mL−1. This enables the identification of low CNTF levels (25.7 ± 14.9 pg·mL−1) reported in tear fluid from glaucoma patients. This LFA is found to be highly selective for CNTF and maintained consistent results in different pH condition. The strip remaines stablewhen stored in the darkat room temperature. A smartphone app is developed to simplify analysis and enable prompt and easily obtainable results. This method shows great potential to be a powerful tool for point‐of‐care glaucoma screening.

The meta-analyses on effectiveness and safety of colorectal cancer screening.

The meta-analyses on effectiveness and safety of colorectal cancer screening.

Opportunistic prediction of osteoporosis in patients with degenerative lumbar diseases: a simplified T12 vertebral bone quality approach

BackgroundOsteoporosis is one of the risk factors for screw loosening after lumbar fusion. However, the probability of preoperative osteoporosis screening in patients with lumbar degenerative disease is low. Therefore, the aim of this study was to investigate whether a simplified vertebral bone quality (VBQ) score based on T12 T1-MRI could opportunistically predict osteoporosis in patients with degenerative lumbar spine diseases.MethodsWe retrospectively analyzed cases treated for lumbar degenerative diseases at a single institution between August 2021 and June 2022. The patients were divided into three groups by the lowest T-score: osteoporosis group, osteopenia group, and normal bone mineral density (BMD) group. The signal intensity based on the T12 vertebral body divided by the signal intensity of the cerebrospinal fluid was calculated to obtain the simplified VBQ score, as well as the CT-based T12HU value and the traditional L1-4VBQ score. Various statistical analyses were used to compare VBQ, HU and DEXA, and the optimal T12VBQ threshold for predicting osteoporosis was obtained by plotting the receiver operating curve (ROC) analysis.ResultsTotal of 166 patients were included in this study. There was a statistically significant difference in T12VBQ scores between the three groups (p < 0.001). Pearson correlation showed that there was a moderate correlation between T12VBQ and T-score (r=-0.406, p < 0.001). The AUC value of T12VBQ, which distinguishes between normal and low BMD, was 0.756, and the optimal diagnostic threshold was 2.94. The AUC value of T12VBQ, which distinguishes osteoporosis from non-osteoporosis, was 0.634, and the optimal diagnostic threshold was 3.18.ConclusionT12VBQ can be used as an effective opportunistic screening method for osteoporosis in patients with lumbar degenerative diseases. It can be used as a supplement to the evaluation of DEXA and preoperative evaluation.Trial registrationretrospectively registered number:1502-009-644; retrospectively registered number date:27 oct 2022.

Solvent-doped PEDOT:PSS: Structural transformations towards enhanced electrical conductivity and transferable electromagnetic shields

The enhanced electrical conductivity of solvent-doped poly(3,4-ethylenedioxythiophene): poly(styrene sulfonate) (PEDOT:PSS) is attributed to the screening effect between PSS and PEDOT chains. Yet, the precise manner in which this effect influences the crystalline structure and conformation of PEDOT:PSS remains unclear. In this study, we utilize Raman spectroscopy, X-ray photoelectron spectroscopy (XPS), and Grazing-incidence wide-angle X-ray scattering (GIWAXS) to examine the conformational changes and two-dimensional (2D) crystalline structure of PEDOT:PSS when doped with a variety of solvents, including dimethyl sulfoxide (DMSO), ethylene glycol (EG), dimethylformamide (DMF), methanol (MeOH), ethanol (EtOH), tetrahydrofuran (THF), and acetone. Our observations unveil that solvent doping improves the electrical conductivity of PEDOT:PSS by modifying its crystalline structure. This alteration leads to reduced inter-lamellar (d200) and π-π stacking (d010) distances, facilitating the formation of densely packed and well-ordered PEDOT crystallites in both face-on and edge-on orientations. Moreover, this doping process enhances the transferability and mechanical properties of drop-casted films, resulting in a flexible and transferable electromagnetic interference (EMI) shield with exceptional total shielding effectiveness (SET) of 35.70 dB and specific shielding effectiveness (SSE/t) of 7105.34 dB cm2.g−1.

SimCol3D — 3D reconstruction during colonoscopy challenge

Colorectal cancer is one of the most common cancers in the world. While colonoscopy is an effective screening technique, navigating an endoscope through the colon to detect polyps is challenging. A 3D map of the observed surfaces could enhance the identification of unscreened colon tissue and serve as a training platform. However, reconstructing the colon from video footage remains difficult. Learning-based approaches hold promise as robust alternatives, but necessitate extensive datasets. Establishing a benchmark dataset, the 2022 EndoVis sub-challenge SimCol3D aimed to facilitate data-driven depth and pose prediction during colonoscopy. The challenge was hosted as part of MICCAI 2022 in Singapore. Six teams from around the world and representatives from academia and industry participated in the three sub-challenges: synthetic depth prediction, synthetic pose prediction, and real pose prediction. This paper describes the challenge, the submitted methods, and their results. We show that depth prediction from synthetic colonoscopy images is robustly solvable, while pose estimation remains an open research question.

The utility of the dilute prothrombin time in the interpretation of antiphospholipid syndrome testing.

To evaluate the utility of the dilute prothrombin time (DPT) in diagnosing antiphospholipid syndrome (APS), alone and when paired with the dilute Russell viper venom time (DRVVT). Dilute prothrombin time and DRVVT testing was performed on plasma samplesspiked with apixaban or rivaroxaban, or depleted of vitamin K-dependent clotting factors. A retrospective analysis of all functional APS testing results over a 44-month period at the University of Chicago Medical Center was performed. In spiking studies, the screening clotting time in the DPT (DPTS) is more sensitive to deficiency of vitamin K-dependent factors than is the screening clotting time in the DRVVT (DRVVTS). The converse is true for factor Xa direct oral anticoagulant (DOAC)-spiked plasma. In a 44-month retrospective analysis, only 2.6% of clinical APS panels showed isolated positivity in the DPT-based system. Comparing the DPT-based system with the DRVVT-based system showed utility in identifying false-positive DRVVT results due to anticoagulation. A DRVVTS/DPTS ratio of 0.785 or lower predicted an international normalized ratio of 1.5 or higher (sensitivity, 86.3%; specificity, 60.4%; likelihood ratio, 2.18). Conversely, a DRVVTS/DPTS ratio of 1.165 or higher was the optimal cutoff for predicting the identification of factor Xa DOAC (sensitivity, 61.8%; specificity, 77.8%; likelihood ratio, 2.78). Within the data set that had full DRVVT and DPT results, parameters were identified that could further improve identification of samples with anticoagulation interference. Dilute prothrombin time lupus anticoagulant assayis rarely the sole laboratory functional evidence for APS, but when combined with the DRVVT, the DPT can serve as an effective screen for common anticoagulant interference.

Antioxidant, Enzyme Inhibitory, and Protective Effect of Amelanchier lamarckii Extract.

The present study aimed to investigate the chemical content of Romanian juneberries (Amelanchier lamarckii), their effect on antioxidant and enzyme inhibition activities, and their bioaccessibility after simulated in-vitro digestion. In Amelanchier lamarckii extract (AME), 16 polyphenolic compounds were identified by LC-ESI+-MS analysis. The most representative compounds found in the extract were cyanidin-galactoside, 3,4-dihydroxy-5-methoxybenzoic acid, feruloylquinic acid, and kaempferol, all belonging to the anthocyanins, phenolic acids, and flavonols subclasses. The polyphenols of AME exert quenching abilities of harmful reactive oxygen species, as the CUPRAC antioxidant assay value was 323.99 µmol Trolox/g fruit (FW), whereas the FRAP antioxidant value was 4.10 μmol Fe2+/g fruit (FW). Enzyme inhibition assays targeting tyrosinase (IC50 = 8.843 mg/mL), α-glucosidase (IC50 = 14.03 mg/mL), and acetylcholinesterase (IC50 = 49.55 mg/mL) were used for a screening of AME's inhibitory potential against these key enzymes as a common approach for the discovery of potential antidiabetic, skin pigmentation, and neurodegenerative effects. The screening for the potential antidiabetic effects due to the α-glucosidase inhibition was performed in glucose-induced disease conditions in a human retinal pigmented epithelial cell experimental model, proving that AME could have protective potential. In conclusion, AME is a valuable source of phenolic compounds with promising antioxidant potential and metabolic disease-protective effects, warranting further investigation for its use in the nutraceutical and health industries.

Membrane Permeability Dominates over Electrostatic Interactions in Dictating Drug Transport in Osmotically Shocked Escherichia coli.

To combat surging multidrug-resistant Gram-negative bacterial infections, better strategies to improve the efficacy of existing drugs are critical. Because the dual membrane cell envelope is the first line of defense for these bacteria, it is crucial to understand the permeation properties of the drugs through it. Our recent study shows that isosmotic conditions prevent drug permeation inside Gram-negative bacteria, Escherichia coli, while hypoosmotic stress enhances the process. Here, we unravel the reason behind such differential drug penetration. Specifically, we dissect the roles of electrostatic screening and low membrane permeability in the penetration failure of drugs under osmotically balanced conditions. We compare the transport of a quaternary ammonium compound malachite green in the presence of an electrolyte (NaCl) and a wide variety of commonly used organic osmolytes, e.g., sucrose, proline, glycerol, sorbitol, and urea. These osmolytes of different membrane permeability (i.e., nonpermeable sucrose and NaCl, freely permeable urea and glycerol, and partially permeable proline and sorbitol) clarify the role of osmotic stress in cell envelope permeability. The results showcase that under balanced osmotic conditions, drug molecules fail to penetrate inside E. coli cells because of low membrane permeabilities and not because of electrostatic screening imposed by the osmolytes. Contribution of the electrostatic interactions, however, cannot be completely overruled as at osmotically imbalanced conditions, drug transport across the bacterial subcellular compartments is found to be dependent on the osmolytes used.

Psychosocial Comorbidities in patients with pediatric alopecia areata: A Literature Review.

Alopecia areata (AA), a chronic autoimmune disorder causing non-scarring hair loss, has a greater prevalence in the pediatric population. Like many visible dermatologic disorders, AA can cause significant psychosocial impairment, particularly in children who are undergoing critical periods of psychosocial development. This paper investigates the psychosocial impact of AA on children. A systematic review was conducted using PRISMA guidelines. SCOPUS and PubMed databases were utilized with the terms "alopecia areata," "pediatric," and "psychosocial comorbidities." 12 articles were reviewed, with 6 meeting inclusion criteria for detailed analysis. The review revealed prominent associations between AA and psychosocial comorbidities in children. Psychiatric conditions including anxiety, depression, and OCD, were prevalent in pediatric AA patients, with exacerbation due to increased disease severity. These negatively impacted the Quality of Life (QoL) in affected children. Additionally, the comorbidities extended beyond psychiatric diagnoses, impacting self-esteem, academic performance, peer relationships, and body image satisfaction in children. This literature review highlights the significant impact of various psychosocial comorbidities in children with AA, emphasizing the need for early identification and intervention. Healthcare professionals, including psychiatrists, therapists, and dermatologists, can play a significant role in treating pediatric patients with AA. Dermatologists can play a critical role in diagnosing AA and identifying psychosocial comorbidities that may arise and refer patients to appropriate care. Future research should focus on elucidating effective screening tools for dermatologists to identify these comorbidities early, ultimately improving the overall well-being of children with AA.

The association between the triglyceride–glucose index and the risk of cardiovascular disease in US population aged ≤ 65 years with prediabetes or diabetes: a population-based study

BackgroundThe relationship between the triglyceride–glucose (TyG) index and the risk of cardiovascular disease (CVD) in the U.S. population under 65 years of age with diabetes or prediabetes is unknown. The purpose of this study was to investigate the relationship between baseline TyG index and CVD risk in U.S. patients under 65 years of age with diabetes or prediabetes.MethodsWe used data from the 2003–2018 National Health and Nutrition Examination Survey (NHANES). Multivariate regression analysis models were constructed to explore the relationship between baseline TyG index and CVD risk. Nonlinear correlations were explored using restricted cubic splines. Subgroup analysis and interaction tests were also conducted.ResultsThe study enrolled a total of 4340 participants with diabetes or pre-diabetes, with a mean TyG index of 9.02 ± 0.02. The overall average prevalence of CVD was 10.38%. Participants in the higher TyG quartiles showed high rates of CVD (Quartile 1: 7.35%; Quartile 2: 10.04%; Quartile 3: 10.71%; Quartile 4: 13.65%). For CVD, a possible association between the TyG index and the risk of CVD was observed. Our findings suggested a linear association between the TyG index and the risk of CVD. The results revealed a U-shaped relationship between the TyG index and both the risk of CVD (P nonlinear = 0.02583) and CHF (P nonlinear = 0.0208) in individuals with diabetes. Subgroup analysis and the interaction term indicated that there was no significant difference among different stratifications. Our study also revealed a positive association between the TyG index and comorbid MetS in the U.S. population under 65 years of age with prediabetes or diabetes.ConclusionsA higher TyG index was linked to an increased likelihood of CVD in the U.S. population aged ≤ 65 years with prediabetes and diabetes. Besides, TyG index assessment will contribute to more convenient and effective screening of high-risk individuals in patients with MetS. Future studies should explore whether interventions targeting the TyG index may improve clinical outcomes in these patients.

Survey of awareness and beliefs about cancer (ABC) in Tehran Province, Iran

IntroductionKnowledge, attitudes, and practices are essential measures for planning and evaluating cancer control programs. Little is known about these in Iran.MethodsWe conducted a population-based interview survey of adults aged 30–70 using the Farsi version of the Awareness and Beliefs about Cancer questionnaire in the capital province of Tehran, Iran, 2019. We calculated weighted estimates of levels of cancer knowledge, attitudes, and practices to allow for different selection probabilities and nonresponse. We used multivariate logistic regression to understand demographic factors associated with bowel, cervix, and breast screening practices.ResultsWe interviewed 736 men and 744 women. The mean number of recalled cancer warning signs was less than one; 57.7% could not recall any cancer warning signs. Participants recognized 5.6 out of 11 early cancer warning signs and 8.8 of 13 cancer risk factors. Most (82.7%) did not know that HPV infection was a cancer risk factor. Approximately, half had negative attitudes towards cancer treatment, but over 80% had positive attitudes towards the effectiveness of screening for improving survival. Colorectal, breast, and cervical screening rates were 24%, 42%, and 49%, respectively. Higher socioeconomic status increased the odds of taking up screening for cancer. Women aged 60–70 were less likely to report taking up breast and cervical screening than younger women.DiscussionThe Iranian population has poor awareness and negative attitudes about cancer, and participation in screening programs is low. Public awareness and early detection of cancer should be promoted in Iran.

Trailblazing ASD Behavioral Research: Leveraging Modified MLP with Cross-Weighted Attention Mechanism at the Forefront

Autism spectrum disorder (ASD) is an enduring and intricate condition that encompasses issues with behavior and communication. This disability has become common among several individuals globally. To ensure that all the autistic individuals get the correct support and care throughout their lifetime, it is significant that the autism signs are realized and the condition is spotted in the initial phase itself to avoid further complications. However, the process of ASD diagnosis is time-consuming, with expensive testing procedures. An effective screening method is needed for early treatment to improve the quality of the ASD patient’s life. Several conventional studies thrived on attaining ASD identification with machine learning and deep learning) but lacked in accuracy and computation. Therefore, the propounded system employs modified multi-layer perceptron (MLP) with cross-weighted attention mechanism. MLP is utilized for its capability in resolving intricate nonlinear complications, handling huge datasets, and enhancing the accuracy of the model. Though existing studies have utilized MLP for various identification processes, it still lacks identification speed, has overfitting issues, and requires more parameters. To overcome these issues, the proposed system employs cross-weighted attention mechanism, to enhance the identification process. As few researchers focused only on identifying and diagnosing the ASD adult, the proposed system uses autism screening in adult datasets and intends to improve the diagnosis of ASD adult patients. Attention ASD-modified MLP with cross-weighted algorithm is applied to classify and perform with various algorithms such as random forest, MLP, and Naïve Bayes. Furthermore, the performance is examined with certain metrics to calculate the efficacy of the proposed system.

New Born Screening of Hemoglobinopathies in a Center Tunisian Population.

Sickle cell diseases, β-thalassemia, and other hemoglobinopathies are common in Africa. Their distribution differs from one region to another. There are higher frequencies in Western and Northern Africa. Their clinical complications presented a real public health problem in each country. For this, early treatment can improve the severity of these diseases. Hemoglobinopathies targeted by screening are associated with SCD, β, and α thalassemia. Our study aim is to report our experience with newborn screening for hemoglobinopathy in Tunis. The 156 newborn's cord blood was collected at the time of childbirth in the center region (Farhat Hached Hôspital). We opted for hemoglobin exploration to achieve maximum efficiency and effectiveness in screening. After that, all patients suspected to have hemoglobinopathies are affected by molecular investigation. Our findings showed the presence of some hemoglobinopathies such as β-thalassemia and α-thalassemia with the following frequencies: 12% and 0.33%. The molecular results show the presence of HBB: c.93-21G>A, IVS-I-110G>A, HBBc. -106G>A -56G>C, HBBc.404T>C, Hb Yaounde described for the first time in Tunisia and α 3,7 . In conclusion, newborn screening diagnoses neonates with different examples of hemoglobinopathies, which will be beneficial not only for the care of the child but also for genetic counseling of the potential risk's parents.

Novel dipeptidyl peptidase IV inhibitory peptides derived from sesame proteins: Screening, mechanisms and anti-hyperglycemic effects in zebrafish larvae

The growing global concern regarding diabetes, particularly type 2 diabetes (T2D), calls for innovative approaches to disease management. Inhibition of dipeptidyl peptidase-IV (DPP-IV) has emerged as a promising strategy for T2D treatment. Food-derived peptides from various sources have shown potential in inhibiting DPP-IV activity. Sesame, a significant crop rich in nutrients, holds untapped potential in this regard. In this study, we used in silico tools to identify and screen two novel DPP-IV inhibitory tripeptides (WPR and MPR) from sesame proteins. Both tripeptides displayed robust inhibitory activity in vitro, with WPR exhibiting non-competitive inhibition (IC50 of 85.85 ± 2.54 µM) and MPR showing competitive inhibition (IC50 of 160.17 ± 5.46 µM). Significantly, WPR demonstrated strong stability across a range of temperature and pH conditions compared to MPR. Molecular docking analysis revealed that WPR formed three hydrogen bonds with DPP-IV at Asp545, Val546, and Gly741, while MPR established five hydrogen bonds at His740, Ser630, and Tyr547. Molecular dynamics simulations analysis indicated that WPR and MPR bind stably to DPP-IV. In vivo experiments using zebrafish larvae showed the effectiveness of both WPR and MPR in reducing glucose levels, coupled with their regulatory influence on glucagon and insulin genes expression. These findings emphasize the potential of sesame-derived tripeptides as a novel and secure source of DPP-IV inhibitors.

Perfect confinement of crown ethers in MOF membrane for complete dehydration and fast transport of monovalent ions.

Fast transport of monovalent ions is imperative in selective monovalent ion separation based on membranes. Here, we report the in situ growth of crown ether@UiO-66 membranes at a mild condition, where dibenzo-18-crown-6 (DB18C6) or dibenzo-15-crown-5 is perfectly confined in the UiO-66 cavity. Crown ether@UiO-66 membranes exhibit enhanced monovalent ion transport rates and mono-/divalent ion selectivity, due to the combination of size sieving and interaction screening effects toward the complete monovalent ion dehydration. Specifically, the DB18C6@UiO-66 membrane shows a permeation rate (e.g., K+) of 1.2 mol per square meter per hour and a mono-/divalent ion selectivity (e.g., K+/Mg2+) of 57. Theoretical calculations and simulations illustrate that, presumably, ions are completely dehydrated while transporting through the DB18C6@UiO-66 cavity with a lower energy barrier than that of the UiO-66 cavity. This work provides a strategy to develop efficient ion separation membranes via integrating size sieving and interaction screening and to illuminate the effect of ion dehydration on fast ion transport.

Screening of aspiration pneumonia using the modified Mallampati classification tool in older adults.

Pneumonia is a major cause of morbidity and mortality in older adults. In the aging society, screening methods for predicting aspiration pneumonia are crucial for its prevention. Changes in the oropharyngeal morphology and hyoid bone position may increase the risk of aspiration pneumonia. This multicenter study aimed to investigate a simple and effective screening method for predicting dysphagia and aspiration pneumonia. Overall, 191 older adults (aged 65 years or older) were randomly sampled using the simple random sampling technique. Oropharyngeal morphology was assessed using the modified Mallampati classification, which reflects the size of the tongue in the oropharyngeal cavity. The hyoid position was measured as the distance between the menton and laryngeal prominence to evaluate aging-related changes in the muscles of the laryngopharynx. Dysphagia was assessed using the repetitive saliva swallowing test (RSST), which measures the number of swallowing movements in 30 seconds; dysphasia is defined as less than 3 swallowing movements in 30 seconds. The aspiration signs were assessed based on history of choking or coughing reflex during eating or drinking and medical history of pneumonia. The study findings revealed that the modified Mallampati classification was significantly correlated with a medical history of pneumonia. A higher incidence of pneumonia was evident in the lower Mallampati classification, which shows the smaller size of the tongue base in the oropharyngeal cavity. The results of this study suggest that the modified Mallampati classification may be a possible screening method to predict the occurrence of pneumonia.

Which men benefit from prostate cancer screening? Prostate cancer mortality by subgroup in the European Randomised Study of Screening for Prostate Cancer.

To evaluate whether a subgroup of men can be identified that would benefit more from screening than others. This retrospective cohort study was based on three European Randomised Study of Screening for Prostate Cancer (ERSPC) centres, Finland, the Netherlands and Sweden. We identified 126 827 men aged 55-69 years in the study who were followed for maximum of 16 years after randomisation. The primary outcome was prostate cancer (PCa) mortality. We analysed three age groups 55-59, 60-64 and 65-69 years and PCa cases within four European Association of Urology (EAU) risk groups: low, intermediate, high risk, and advanced disease. The hazard ratio (HR) for PCa mortality in the screening arm relative to the control arm for men aged 55-59 years was 0.96 (95% confidence interval [CI] 0.75-1.24) in Finland, 0.70 (95% CI 0.44-1.12) in the Netherlands and 0.42 (95% CI 0.24-0.73) in Sweden. The HR for men aged 60-64 years was 1.03 (95% CI 0.77-1.37) in Finland, 0.76 (95% CI 0.50-1.16) in the Netherlands and 0.97 (95% CI 0.64-1.48) in Sweden. The HR for men aged 65-69 years was 0.80 (95% CI 0.62-1.03) in Finland and 0.57 (95% CI 0.38-0.83) in the Netherlands, and this age group was absent in Sweden. In the EAU risk group analysis, PCa mortality rates were materially lower for men with advanced disease at diagnosis in all three countries: 0.67 (95% CI 0.56-0.82) in Finland, 0.28 (95% CI 0.18-0.44) in the Netherlands, and 0.48 (95% CI 0.30-0.78) in Sweden. We were unable to unequivocally identify the optimal age group for screening, as mortality reduction differed among centres and age groups. Instead, the screening effect appears to depend on screening duration, and the number and frequency of screening rounds. PCa mortality reduction by screening is largely attributable to stage shift.

Catching Suicide Before It Harms: Universal Suicide Screening in a Pediatric Emergency Department.

Suicide is the second leading cause of death in people aged 10 to 24 years. We aim to assess the effectiveness of universal suicide screening in a pediatric ED. Since April 7, 2019, all patients 10 years and older who presented to the pediatric ED of our freestanding children's hospital were screened with the validated Columbia Suicide Severity Rating Scale and categorized as mild, moderate, or severe risk for suicide. Screenings from 2019 were reviewed by investigators. All children aged 10 to 18 years who were screened were included. Data collected included demographic information, previous ED visits, past chief complaints), suicidal ideation, suicide attempt, and disposition. A total of 11,469 subjects were screened for suicide risk. Of those screened, 340 were positive on Columbia Suicide Severity Rating Scale, and 5 were excluded for being outside of the age range. Of the remaining 335 subjects who screened positive, 116 (34.5%) of them presented with a primarily medical chief complaint. A total of 120 subjects screened mild risk (35.8%), 46 were moderate (13.7%), and 169 were severe (50.4%). Overall, 141 positive subjects were admitted for mental health concerns. Several patients who screened positive for suicide risk did not present with a mental health concern. Nearly half of screen-positive children who were admitted for mental health concerns had been seen in the ED in the year before their visit. Initiation of universal suicide screening in the pediatric ED identified a significant number of children with unrecognized suicide risk.