General Screening Research Articles

Research on Illegal Mobile Device Identification Based on Radio Frequency Fingerprint Feature

Internet of Things (IoT) technology is widely used in new power systems, and it also provides many new modes for network attacks. Illegal terminal device identification is also a significant topic in the field of wireless authentication technology. Some kinds of power network equipment are located in sparsely populated areas and rely on IoT terminals for real-time monitoring. Attackers use illegal terminals to connect power IoT devices for production monitoring and to carry out network attacks, which may cause serious damage, such as power data theft and misoperation of power network equipment. Radio frequency fingerprint (RFF) can extract hardware features from different devices, and is widely used for device identification and authentication. The area over which power network equipment placed is vast, and there are many wireless communication devices and terminals. It is difficult to identify illegal devices through commonly used network management techniques, thus making it difficult to distinguish between the mobile terminals of employees and illegal terminals in general spectrum screening. In response to the above situation, this paper uses the characteristics of the squared spectrum of random access preamble signals to extract hardware device features, proposes an illegal device identification algorithm based on Gaussian distribution theory, and evaluates its performance. The experimental results show that, when the signal-to-noise ratio (SNR) is greater than 15 dB, the average recognition result is greater than 92%. In addition, the algorithm has low computational complexity and high engineering application value.

The Effect of Intrapersonal Intelligence of Sports Sciences Faculty Students on Metacognitive Awareness

The aim of the research is to investigate the effect of intrapersonal intelligence profiles of students studying at Faculty of Sport Sciences on their metacognitive awareness levels. General screening and relational screening models were used. The research group consisted of 308 students studying at Afyon Kocatepe University Faculty of Sport Sciences in the 2021-2022 academic year. In the research, Intrapersonal Intelligence part of the “Self-Assessment Inventory in Multiple Intelligence Domains” and “Metacognitive Awareness Inventory” were used as data collection tools. Frequency values, percentage values, one-way variance analysis “ANOVA” test, Independent Samples t-test, and “Tukey HSD test” were used for data analysis. In addition, Correlation and Regression tests were applied to determine the relationships between intrapersonal intelligence and metacognitive awareness levels. In conclusion, significant differences were found between the students’ intrapersonal intelligence and metacognitive awareness levels and the procedural knowledge sub-dimension, according to the gender variable. According to the department variable, there were found significant differences between the sub-scales of planning, monitoring, and managing knowledge and the intrapersonal intelligence means, however there weren’t seen significant differences according to the branch variable. In the correlation and regression tests, it was seen a positive and significant relationship between the level of intrapersonal intelligence and the sub-scales of metacognitive awareness.

Oral Health Screening for Risk Reduction for Early Periprosthetic Joint Infections of Hip and Knee Endoprostheses—Results of a Prospective Cohort Study

This prospective observational study had two aims: (I) to assess whether a preoperative dental screening before endoprosthesis (EP) implantation with need-based dental intervention would decrease the prevalence of periprosthetic joint infection (PJI) and (II) to evaluate whether instructed orthopedic surgeons would achieve similar results in oral screening as dentists. The preoperative oral health statuses of the patients, prior to EP insertion, were either evaluated by the patients’ general dentists (Ia) or, if the patient had not visited a general dentist, by an instructed orthopedic surgeon (Ib). Both the dentist and orthopedic surgeon used standardized risk estimation (low risk, moderate risk, and high risk) for an oral-health-related infectious complication after EP insertion, including a recommendation for further management of the patient. If required, a need-based dental rehabilitation was performed. In addition, retrospective data evaluation of a comparison group (II) was performed, which had not been screened orally preoperatively. A total of 777 patients (screening group (I): n = 402, of which 229 were screened by a dentist (Ia), 173 were screened by an orthopedic surgeon (Ib); comparison group (II): n = 375) were included. No general association between early infection rate and preoperative oral screening in general was found (1% PJI in screening group (I), 1.6% PJI in comparison group (II); p = 0.455). However, screening performance (dentist vs. orthopedic surgeon) had a significant impact on the prevalence of developed PJIs (p = 0.021). Thereby, 100% of observed infections in the screening group (I) occurred in the group with previous oral screening by an orthopedic surgeon (Ib). Furthermore, the C-reactive protein (CRP) value at discharge was significantly lower when general preoperative oral screening had been performed (group I vs. group II, p = 0.03). Only preoperative oral screening by a dentist had the potential to reduce oral-focus-associated EP infections; therefore, increased attention should be paid to the further promotion of interdisciplinary work between dentists and orthopedic surgeons. Dental screenings, using objectifiable criteria, as applied in this study, seem reasonable but require further validation in larger cohorts.

EarLy Surveillance for autoimmune type 1 diabetes - paediatric screening in the UK.

Children with pre-symptomatic type 1 diabetes can be identified through testing for circulating islet autoantibodies. Identifying children at risk reduces the rates of diabetic ketoacidosis at presentation and allows participation in clinical trials for type 1 diabetes prevention. The Early Surveillance for Autoimmune diabetes study (ELSA) is exploring feasibility and acceptability of UK paediatric general population screening. The ELSA study runs from July 2022 to August 2024 and aims to recruit 20 000 children aged 3-13 years. ELSA is screening for islet autoantibodies via dried blood spot (DBS) and subsequent staging via oral glucose tolerance testing. ELSA is exploring feasibility and acceptability of UK paediatric general population screening. At the time of writing, 2582 children have been consented to the study. In the preliminary beta version (July-October 2022), there were 59 expressions of interest, 37 children consented (63%) and 22 kits returned (59%). Of the consented children, 17 families were invited and 8 were passive recruits through friends/family. Reasons for not returning the kit included issue with home-testing (n=1) and concern about the lancet (n=1). One of the DBS kits screened positive (4.5%), but the serum confirmation did not detect autoantibodies. The study launched nationally via social media on 14 November 2022 (World Diabetes Day) leading to a surge in expressions of interest (n=3070). Of these, 2141 children were consented within 36 hours. Social media has been an effective route to recruitment. Community outreach to schools and general practices will be implemented as this study evolves, to explore optimal recruitment modalities and acceptability.

The Relationship Between Physical Activity Level of Teachers, Obesity Prevelance and Life Satisfaction

The present study aims to determine the relationship between teachers' physical activity (PA) levels, obesity prevalence, and life satisfaction (LS). The study has a descriptive nature, and it was conducted following the relational screening method, which is a general screening model. A total of 401 volunteer teachers were included in the study. Descriptive statistics, t-tests, and ANOVA tests were used for data analysis. When the PA levels and LS of the teachers were examined, it was found that 28.7% were inactive, 44.6% were moderately active, and 26.7% were active; It was determined that 17.2% had very little LS, 40.6% had medium LS, 34.4% high LS, 7.0% full LS. When the body mass index (BMI) was examined, it was determined that 1.2% of the teachers were underweight, 54.1% were healthy weight, 35.7% were overweight, and 9.0% were obese. The study's findings showed a weak and positive relationship between teachers' LS and PA participation levels. The results indicated that PA levels differed significantly according to gender, marital status, and active sports, and LS levels differed significantly according to gender, marital status, income, age, BMI according to gender, marital status, income, and age.

Development of a metabolite calculator for diagnosis of pancreatic cancer.

Carbohydrate antigen (CA) 19-9 is a known pancreatic cancer (PC) biomarker, but is not commonly used for general screening due to its low sensitivity and specificity. This study aimed to develop a serum metabolites-based diagnostic calculator for detecting PC with high accuracy. A targeted quantitative approach of direct flow injection-tandem mass spectrometry combined with liquid chromatography-tandem mass spectrometry was employed for metabolomic analysis of serum samples using an Absolute IDQ™ p180 kit. Integrated metabolomic analysis was performed on 241 pooled or individual serum samples collected from healthy donors and patients from nine disease groups, including chronic pancreatitis, PC, other cancers, and benign diseases. Orthogonal partial least squares discriminant analysis (OPLS-DA) based on characteristics of 116 serum metabolites distinguished patients with PC from those with other diseases. Sparse partial least squares discriminant analysis (SPLS-DA) was also performed, incorporating simultaneous dimension reduction and variable selection. Predictive performance between discrimination models was compared using a 2-by-2 contingency table of predicted probabilities obtained from the models and actual diagnoses. Predictive values obtained through OPLS-DA for accuracy, sensitivity, specificity, balanced accuracy, and area under the receiver operating characteristic curve (AUC) were 0.9825, 0.9916, 0.9870, 0.9866, and 0.9870, respectively. The number of metabolite candidates was narrowed to 76 for SPLS-DA. The SPLS-DA-obtained predictive values for accuracy, sensitivity, specificity, balanced accuracy, and AUC were 0.9773, 0.9649, 0.9832, 0.9741, and 0.9741, respectively. We successfully developed a 76 metabolome-based diagnostic panel for detecting PC that demonstrated high diagnostic performance in differentiating PC from other diseases.

The Role of the Art of Chinese Calligraphy and Music in Developing Creative Thinking Skills in Preschoolers Using Flipped Technology.

The article aims to study the influence of music and music-calligraphy practice on the development of creative thinking among preschool children. The study used the general screening model of the Torrance Thinking Creatively in Action and Movement test (TCAMt) to assess the level of motor creativity in children. The study participants were 120 4-5 year-old children. The results of the calculations demonstrate an increase in the values of the four factors after the interventions. Fluency increased on average: for group A, which practiced musical intervention, by 28%; for group B, which practiced musical-calligraphic intervention, by 29%. The imagination factor increased for group A by 23.5% and for group B by 45.5%. This study has shown that the use of musical-calligraphic practice provides higher creative thinking skills in the categories of "imagination" and "originality", while "fluency" and "flexibility" are not different from the use of a single musical practice. This study has practical and scientific value, as it proves the influence of music and music-calligraphy practices on creativity development in children. The study results can be applied in preschool educational institutions, which are interested in increasing students' creativity.

1451-P: Risk of Progression to Clinical Type 1 Diabetes in Older Adolescents Positive for Islet Autoantibodies

Objective: Evaluate progression to type 1 diabetes (T1D) among adolescents with persistent islet autoimmunity. Background: Few studies have continued to follow adolescents with islet autoimmunity through to young adulthood. With the emergence of treatments to delay clinical diabetes and general population screening, there is need to accurately predict and communicate risk for progression to T1D in autoantibody positive persons. Methods: Included in this analysis were 203 participants of prospective studies (DAISY, TEDDY Graduates, ASK) who were persistently positive for islet autoantibodies and free of diabetes between 13-15 y of age. Of those, 51% were female, 52% non-Hispanic white, and 32% had a first-degree T1D relative. Autoantibodies to insulin, GAD, IA-2, and ZnT8 were measured using standard radio-binding assays. Results: During the median 3.0 y (IQR 1.2-5.2) follow-up, 14.8% (n=30) of the participants progressed to T1D. The 5-year risk of progression to clinical diabetes was 33.1% (95%CI 20.0-51.7%) among adolescents with multiple autoantibodies vs 7.8% (95%CI 3.9-15.2%) in those with a single persistent autoantibody. Independent predictors of progression to diabetes included: multiple autoantibodies (HR=3.2, 95%CI 1.4-7.5, p=0.008) and higher baseline HbA1c (HR=1.7 per 0.5%, 95%CI 1.2-2.2. p=001). A receiver operating characteristic based on autoantibody status and HbA1c (AUC 0.78) did not improve significantly with addition of sex, ethnicity, and family history of T1D (AUC 0.81). Conclusion: One third of adolescents with multiple islet autoantibodies progress to clinical diabetes within 5 years, with baseline HbA1c being highly predictive of progression. Disclosure K.Waugh: None. C.Geno rasmussen: None. F.Dong: None. P.D.Gesualdo: None. B.I.Frohnert: Advisory Panel; Provention Bio, Inc. M.Rewers: Research Support; Provention Bio, Juvenile Diabetes Research Foundation (JDRF), Hemsley Charitable Trust, Dexcom, Inc., Janssen Research & Development, LLC. Funding National Institutes of Health (5R01DK032493-36); JDRF (2-SRA-2022-1270-S-B)

1265-P: Insights and Implications—Creating and Executing the First National-Scale Home Sample Collected Autoantibody Screening Service for Type 1 Diabetes (T1D) Risk Assessment for JDRF’s T1Detect

On December 12, 2020, a unique home-collected sample T1D autoantibody detection program was launched online. Serving 48 states, the JDRF T1Detect autoantibody screening program features a pioneering 3-year collaboration between the JDRF and a clinical reference laboratory spun out of the University of California at Berkeley and Stanford University. Using a completely novel, and now patented, way of detecting antibodies - using unique DNA barcodes that bind to antibodies and are thus readable by standard PCR machines - the T1Detect program was able to offer gold-standard-matching accuracy using easily-collectable dried blood spot samples. The approach, called Antibody Detection by Agglutination PCR (ADAP) was co-invented by 2022 Nobel Laureate in Chemistry, Stanford Prof. Carolyn Bertozzi. ADAP was validated over 6 years via multiple studies with the NIDDK, TrialNet, the National Science Foundation, the JDRF, the Joslin Diabetes Center, Mayo Clinic and Stanford Pediatric Endocrinology. The presentation covers these aspects: Econometric, individual and public health benefits of T1D risk screening, including selecting patients for closer glycemic monitoring and consideration for therapeutic intervention. Summary of both pediatric and adult T1D incidence studies underlying the emerging consensus around longitudinal general population screening. How the joint program with JDRF was conceived and executed - from ideation to realization. Key T1Detect screening program data findings and outcomes to date. How clinicians can best collaborate with screening programs to enhance the care of first-degree relatives of T1D patients and their general patient population. In summary, the developmental journey of this T1D testing initiative with JDRF and the resulting insights are distinctively first-in-class and can be uniquely instructive and helpful to clinicians and researchers alike. Disclosure D.Seftel: Employee; Enable Biosciences, Inc. Funding National Institute of Diabetes and Digestive and Kidney Diseases (5R44DK111005-03); The Leona M. and Harry B. Helmsley Charitable Trust; Sweden National Science Foundation (1758698); JDRF (2-SRA-2018-535-S-B)

Using Lean-and-Green Supersaturated Poly-Factorial Mini Datasets to Profile Energy Consumption Performance for an Apartment Unit

The Renovation Wave for Europe initiative aspires to materialize the progressive greening of 85–95% of the continental older building stock as part of the European Green Deal objectives to reduce emissions and energy use. To realistically predict the energy performance even for a single apartment building is a difficult problem. This is because an apartment unit is inherently a customized construction which is subject to year-round occupant use. We use a standardized energy consumption response approach to accelerate the setting-up of the problem in pertinent energy engineering terms. Nationally instituted Energy Performance Certification databases provide validated energy consumption information by taking into account an apartment unit’s specific shell characteristics along with its installed electromechanical system configuration. Such a pre-engineered framework facilitates the effect evaluation of any proposed modifications on the energy performance of a building. Treating a vast building stock requires a mass-customization approach. Therefore, a lean-and-green, industrial-level problem-solving strategy is pursued. The TEE-KENAK Energy Certification database platform is used to parametrize a real standalone apartment. A supersaturated mini dataset was planned and collected to screen as many as 24 controlling factors, which included apartment shell layout details in association with the electromechanical systems arrangements. Main effects plots, best-subsets partial least squares, and entropic (Shannon) mutual information predictions—supplemented with optimal shrinkage estimations—formed the recommended profiler toolset. Four leading modifications were found to be statistically significant: (1) the thermal insulation of the roof, (2) the gas-sourced heating systems, (3) the automatic control category type ‘A’, and (4) the thermal insulation of the walls. The optimal profiling delivered an energy consumption projection of 110.4 kWh/m2 (energy status ‘B’) for the apartment—an almost 20% reduction in energy consumption while also achieving upgrading from the original ‘C’ energy status. The proposed approach may aid energy engineers to make general empirical screening predictions in an expedient manner by simultaneously considering the apartment unit’s structural configuration as well as its installed electromechanical systems arrangement.

#5650 METABOLIC BLOOD BIOMARKER PROFILING FOR CHRONIC KIDNEY DISEASE PREDICTION – EVIDENCE FROM 275,000 INDIVIDUALS IN THE UK BIOBANK

Abstract Background and Aims Early identification of individuals at high risk of developing chronic kidney disease and other chronic conditions is essential for targeted prevention. Here, we assess the utility of metabolic blood biomarkers in predicting the onset of chronic kidney disease in over 250,000 individuals from UK Biobank, beyond established risk factors and polygenic risk scores. Method Circulating blood biomarkers, including lipids, fatty acids, amino acids, glycolysis metabolites and inflammation markers were measured by a low-cost nuclear magnetic resonance (NMR) metabolomics assay in around 275,000 plasma samples from the UK Biobank. During a prospective 10-year follow-up, over 6000 incident chronic kidney disease events were obtained from national health registries. Using multivariable regression modelling, we derived a 10-year risk score for chronic kidney disease onset. We assessed the predictive performance of the biomarker risk score in comparison to standard risk factors (age, sex, prevalent diabetes, body mass index, systolic and diastolic blood pressure, smoking status and use of cholesterol lowering medication), clinical chemistry measurements (HbA1c, LDL and HDL cholesterol, total cholesterol and eGFR) and polygenic risk scores. We evaluated the performance of the risk score in two practical scenarios: in a general population screening setting and in a clinical use case of stratifying kidney disease risk among prevalent type 2 diabetics. We further illustrate applications of the biomarker risk scores in predicting the risk of other chronic diseases, such as cardiovascular outcomes, in general population settings. Results In the general population screening setting, adding the metabolic biomarkers to a simple model of standard risk factors substantially improved the predictive performance, with area under the receiver operating characteristic curve (AUC) increasing from 0.74 to 0.82. When compared to more comprehensive model including also clinical chemistry measurements and polygenic risk scores, the improvements were also significant, albeit more modest, with the AUC increasing from 0.81 to 0.83. Even more substantial gains were observed in a clinical use case scenario of stratifying risk of chronic kidney disease onset among prevalent type 2 diabetics. Among diabetics with mildly to moderately decreased kidney function at the time of blood sampling (eGFR 60-90), adding the metabolic biomarkers in a comprehensive model including standard risk factors, clinical chemistry measurements and polygenic risk scores increased the AUC from 0.60 to 0.70. Conclusion Circulating metabolic biomarkers enhanced the prediction of chronic kidney disease onset beyond standard risk factors and polygenic risk scores. From a translational perspective, this may complement the identification of high-risk individuals in both general population and clinical settings beyond current risk factor assessment, while simultaneously informing on the risk of other chronic diseases.

#2667 CARDIOVASCULAR AND MORTALITY RISKS IN YOUNG HEALTH SCREENING EXAMINEES WITH MARGINAL ESTIMATED GLOMERULAR FILTRATION RATE

Abstract Background and Aims Additional evidence is necessary to interpret the kidney function parameters in young adults, particularly in those with marginal eGFR values. We aimed to study the clinical significance of marginal eGFR values in large-scale general health screening examinees of young age (20-39 years). Method We performed a nationwide retrospective cohort study using the health screening database of South Korea. We included young adults aged 20-39 years without a history of major cardiovascular events (MACE) or end-stage kidney disease who underwent a nationwide health screening in 2012. The study exposure was eGFR categorized into 15 mL/min/1.73 m2 intervals, with a reference group and a main group of interest: < 30, 30-45, 45-60, 60-75, 75-90 (reference), 90-105, 105-120, and ≥ 120 mL/min/1.73 m2. The risks of all-cause mortality and MACE were calculated using Cox regression analysis adjusted for various clinicodemographic characteristics. Results In total, 3,132,409 young adults were included in this study. During a median follow-up of 7.3 years, marginal eGFR (60-75 mL/min/1.73 m2) was not significantly associated with a higher risk of all-cause mortality [adjusted HR 0.92 (0.86-0.99)]. The results were similarly identified for the MACE outcome [adjusted HR 1.01 (0.94-1.07)]. On the other hand, those with presence of albuminuria, even the marginal eGFR range was significantly associated with higher risks of all-cause mortality [adjusted HR 1.52 (1.01-1.29)] and ischemic stroke [adjusted HR 1.73 (1.10-2.74)]. Conclusion Marginal eGFR alone was not associated with higher risks of all-cause mortality and MACE in general young adults. However, in those with albuminuria, the mortality risk was higher even in eGFR of 60-75 mL/min/1.73 m2.

An observational cohort study of interstitial lung abnormalities (ILAs) in a large Japanese health screening population (Kumamoto ILA study in Japan: KILA-J)

BackgroundInterstitial lung abnormalities (ILAs) are subtle or mild parenchymal abnormalities observed in more than 5% of the lungs on computed tomography (CT) scans in patients in whom interstitial lung disease was not previously clinically suspected and is considered. ILA is considered to be partly undeveloped stages of idiopathic pulmonary fibrosis (IPF) or progressive pulmonary fibrosis (PPF). This study aims to clarify the frequency of subsequent IPF or PPF diagnosis, the natural course from the preclinical status of the diseases, and the course after commencing treatment.MethodsThis is an ongoing, prospective, multicentre observational cohort study of patients with ILA referred from general health screening facilities with more than 70,000 annual attendances. Up to 500 participants will be enrolled annually over 3 years, with 5-year assessments every six months. Treatment intervention including anti-fibrotic agents will be introduced in disease progression cases. The primary outcome is the frequency of subsequent IPF or PPF diagnoses. Additionally, secondary and further endpoints are associated with the efficacy of early therapeutic interventions in cases involving disease progression, including quantitative assessment by artificial intelligence.DiscussionThis is the first prospective, multicentre, observational study to clarify (i) the aetiological data of patients with ILA from the largest general health check-up population, (ii) the natural course of IPF or PPF from the asymptomatic stage, and (iii) the effects and outcomes of early therapeutic intervention including anti-fibrotic agents for progressive cases of ILA. The results of this study could significantly impact the clinical practice and treatment strategy for progressive fibrosing interstitial lung diseases.Trial registration numberUMIN000045149.

Facilitators and Barriers to Nurses Screening for Frailty in Acute Care in a Provincial Health-Care System: a Survey Study Guided by the Theoretical Domains Framework.

Older adults living with frailty represent the largest population of hospitalized patients in Canada, but they do not always receive the quality of care needed. Nurses are well-positioned to screen for frailty, but current frailty screening practices are poorly understood. A cross-sectional survey study was conducted over a six-week period with nurses from Alberta, Canada working in acute care with older adults. Demographics were descriptively reported. Frailty screening methods were quantified on 5-point frequency scales, reported descriptively and compared by practice area using linear regression. The top-five mean scores from a 43-item, 6-point Likert-type questionnaire based on the Theoretical Domains Framework were compared by practice area. Frailty screening by clinical impression was "usually" used (median = 4, IQR = 4-5), while tools were "rarely" used (median = 2, IQR = 1-3). Medical and/or surgical nursing had higher general frailty screening tool use (β = 0.81, r = .31, p < .001), but no significant (p > .05) differences for using clinical impression, or preference of screening method. The top facilitator was the disbelief that frailty screening negatively impacts relationships with older adults. The top barrier was belief that conducting frailty screening was routine. Nursing practice area influenced frailty screening beliefs. There is an opportunity to implement frailty screening tools into the nursing practice of Alberta' nurses working in acute care. Frailty screening tools that become routine have greater likelihood for utilization. Nursing practice areas may have unique situations that require tailored approached to tool implementation.

OKUL ÖNCESİ ÖĞRETMENLERİNİN TEKNOLOJİK PEDAGOJİK ALAN BİLGİSİ ÖZGÜVENİ İLE TEKNOLOJİYE YÖNELİK TUTUMU ARASINDAKİ İLİŞKİNİN İNCELENMESİ

The purpose of this study is to examine the relationship between preschool teachers' technological pedagogical content knowledge (TPACK) confidence and their attitude towards technology. In addition, it was aimed to examine whether preschool teachers' technological pedagogical content knowledge and its sub-dimensions predict teachers' attitudes towards technology. The study group consists of 200 preschool teachers who teach 36-72-month-old preschool children in the 2020-2021 academic year. This study is a quantitative study designed in the single and relational screening model, one of the general screening models. The data were collected using the "Technological Pedagogical Content Knowledge Self-Confidence Scale (TPACKACKS)", "Attitude Towards Technology Scale" and "Personal Information Form". The data obtained were analyzed with SPSS 26.0 and JASP 0.16 programs and normality test, Pearson Correlation test and multiple linear regression analysis methods were used. As a result of the study, when the relationship between preschool teachers' attitudes towards technology and technological pedagogical content knowledge and sub-factors of it was examined, a significant positive relationship was found. When the other findings obtained from the research were examined, it was concluded that the relationship between preschool teachers' attitude towards technology scores and technological content knowledge sub-dimension scores was relatively low compared to other sub-dimensions.

General population screening for paediatric type 1 diabetes-A qualitative study of UK professional stakeholders.

Identifying children at risk of type 1 diabetes allows education for symptom recognition and monitoring to reduce the risk of diabetic ketoacidosis at presentation. We aimed to explore stakeholder views towards paediatric general population screening for type 1 diabetes in the United Kingdom (UK). Qualitative interviews were undertaken with 25 stakeholders, including diabetes specialists, policymakers and community stakeholders who could be involved in a future type 1 diabetes screening programme in the UK. A thematic framework analysis was performed using the National Screening Committee's evaluative criteria as the overarching framework. Diabetic ketoacidosis prevention was felt to be a priority and proposed benefits of screening included education, monitoring and helping the family to better prepare for a future with type 1 diabetes. However, diabetes specialists were cautious about general population screening because of lack of evidence for public acceptability. Concerns were raised about the harms of living with risk, provoking health anxiety and threatening the child's right to an 'open future'. Support systems that met the clinical and psychological needs of the family living with risk were considered essential. Stakeholders were supportive of research into general population screening and acknowledged this would be a priority if an immunoprevention agent were licensed in the UK. Although stakeholders suggested the harms of UK paediatric general population screening currently outweigh the benefits, this view would potentially be altered if prevention therapies were licensed. In this case, an evidence-based screening strategy would need to be formulated and public acceptability explored.

Risk of fracture according to temporal changes of low body weight changes in adults over 40 years: a nationwide population-based cohort study

BackgroundLow body weight is associated with an increased risk of fractures. However, the effect of temporal changes in the low body weight status on the risk of fracture remains unknown. This study aimed to evaluate the relationships between temporal changes in low body weight status and the risk of fractures in adults over the age of 40 years.MethodsThis study included data on adults over 40 years old who underwent two biannual consecutive general health examinations between January 1, 2007 and December 31, 2009 extracted from the National Health Insurance Database, a large nationwide population database. Fracture cases in this cohort were monitored from the time of the last health examination to the end of the designated follow-up period (from January 1, 2010 to December 31, 2018) or the participant's death. Fractures were defined as any fracture resulting in hospitalization or outpatient treatment claim after the date of general health screening. The study population was then separated into four groups based on the temporal changes in low body weight status as follows: low body weight to low body weight (L-to-L), low body weight to non-low body weight (L-to-N), non-low body weight to low body weight (N-to-L), and non-low body weight to non-low body weight (N-to-N). The hazard ratios (HRs) for new fractures, depending on weight changes over time, were calculated using Cox proportional hazard analysis.ResultsAdults in the L-to-L, N-to-L, and L-to-N groups had a substantially increased risk of fractures after multivariate adjustment (HR, 1.165; 95% confidence interval [CI], 1.113–1.218; HR, 1.193; 95% CI, 1.131–1.259; and HR, 1.114; 95% CI, 1.050–1.183, respectively). Although the adjusted HR was greater in participants who changed into having a low body weight, followed by those with consistently low body weight, those with low body weight remained to have an elevated risk of fracture independent of weight fluctuation. Elderly men (aged over 65 years), high blood pressure, and chronic kidney disease were significantly associated with an increase in fractures (p < 0.05).ConclusionIndividuals aged over 40 years with low body weight, even after regaining normal weight, had an increased risk of fracture. Moreover, having a low body weight after having a normal body weight increased the risk of fractures the most, followed by those with consistently low body weight.

Assessment of Personality Disorders in Older Adults. A Practice Guide.

Assessment of personality disorders (PDs) in older adults is a nuanced trade of its own. The aim of this practice guide is to illustrate gerontological assessment challenges using 3 case vignettes. We argue that it is important to pay extra attention to the influence of cognitive and medical (somatic) disorders on personality functioning in older adults during personality assessment. We also note that information provided by informants contributes added value to personality assessment. Personality assessment should be sufficiently age-specific to prevent overdiagnosis or underdiagnosis in older adults. Furthermore, given the reduced psychological or somatic capacity of some older adults, phased or sequential personality assessment is recommended. This should be focused on the assessment questions to be answered, for example starting with short general screening of personality functioning, followed by more in-depth exploration. Personality assessment should be kept as brief and simple as possible in terms of formulation of the items.

A tRNAModification-based strategy for Identifying amiNo acid Overproducers (AMINO)

Amino acids have a multi-billion-dollar market with rising demand, prompting the development of high-performance microbial factories. However, a general screening strategy applicable to all proteinogenic and non-proteinogenic amino acids is still lacking. Modification of the critical structure of tRNA could decrease the aminoacylation level of tRNA catalyzed by aminoacyl-tRNA synthetases. Involved in a two-substrate sequential reaction, amino acids with increased concentration could elevate the reduced aminoacylation rate caused by specific tRNA modification. Here, we developed a selection system for overproducers of specific amino acids using corresponding engineered tRNAs and marker genes. As a proof-of-concept, overproducers of five amino acids such as L-tryptophan were screened out by growth-based and/or fluorescence-activated cell sorting (FACS)-based screening from random mutation libraries of Escherichia coli and Corynebacterium glutamicum, respectively. This study provided a universal strategy that could be applied to screen overproducers of proteinogenic and non-proteinogenic amino acids in amber-stop-codon-recoded or non-recoded hosts.

Optimising Population Based AAA Screening of 65 Year Old Men By Exploring Risk Factor Based Targeted Screening Strategies: In Light of Declining Prevalence

Objective: The prevalence of AAA has declined over the past decades and contemporary studies demonstrate prevalence rates of 1.3 – 1.5% 1,2 among 65 year old men, in contrast to historical rates of 4.9 – 7.2% 3,4 in the large scale screening RCTs conducted in the 1990s and early 2000s. Cost efficiency 5 can be demonstrated for screening programmes with even lower rates, but the clinical legitimacy of general AAA screening of 65 year old men can be questioned with falling prevalence rates. This study analyses risk factor data among large cohorts of 65 year old men screened in the Swedish population based general AAA screening programme – with the aim of exploring selective targeting screening strategies to reach men with the highest risk of having an AAA.