Home Screening Research Articles

Use of SMART objectives in an interprofessional training event: screening for fall and osteoporosis risk

IntroductionSMART objectives are a major component of health coaching and lifestyle medicine, however, there are limited studies describing their use in current health care curriculums. This study incorporated SMART objectives within an Interprofessional Education (IPE) event offered to students who were screening community-dwelling adults within their community for falls and osteoporosis risk. The purpose was to evaluate if students could confidently develop a SMART objective with their client that was relevant to the screening results. MethodsStudent participants were recruited from pharmacy, nursing, and physical therapy programs at Rutgers University. The IPE event consisted of an educational pre-session assignment, 2-h virtual training session, student-led home screening with a self-selected community volunteer, and a 2-h virtual educational and debriefing session. Students taught peers through interprofessional education on their respective discipline's screening assessment tools during each session. Based on the screening results, students collaborated with their clients to develop a SMART objective aimed at addressing an identified problem. ResultsPost 3 yearly programs, 520 pharmacy, nursing, and DPT students completed the SMART objective, and 518 SMART objectives were analyzed. Analysis indicated all students were about 90 % confident in developing SMART objectives and 92 % confident in communicating with clients. Most students, regardless of discipline, felt comfortable developing a SMART objective and communicating with clients. ConclusionA significant number of people screened were found to have risk factors for falls or osteoporosis. Regardless of discipline, students worked with their client to develop appropriate SMART objectives. SMART objectives can enhance IPE programs, curriculums that include client counseling regarding lifestyle changes, and client engagement.

Ambulatory polygraphy as a screening tool for obstructive sleep apnea in combination with semi-continuous rhythm monitoring in patients with atrial fibrillation: a pilot study

Abstract Background Obstructive sleep apnea (OSA) is a common, yet underdiagnosed risk factor in atrial fibrillation (AF) patients. Polysomnography (PSG) is the gold standard for OSA diagnosis but is also costly, time-consuming, and labor-intensive. (Cardio)-respiratory polygraphy (PG) offers an ambulatory screening for OSA detection. Studying the impact of OSA diagnosis and treatment on AF recurrence will require scalable tools for semi-continuous heart rhythm monitoring. Purpose The NOXFib-AF pilot study assessed the feasibility of PG as an OSA screening tool in patients with AF. The study monitored AF recurrences using a Fitbit smartwatch for heart rhythm monitoring with the FibriCheck algorithm. This pilot assessed the feasibility and patient compliance. Methods Overnight OSA testing was performed with the Noxturnal T3 (NOX-T3s) PG device used at home by AF patients, followed by four weeks of heart rhythm monitoring. Both semi-continuous monitoring with the Fitbit Versa 2 smartwatch with FibriCheck algorithm, and spot-check measurements on a smartphone (twice daily and in case of symptoms) were used. Patients with OSA suspicion on PG (Apnea-Hypopnea Index (AHI) cut-off ≥ 11.1 based on previous studies) were referred for PSG confirmation. Patient satisfaction with the PG and Fitbit smartwatch was evaluated through questionnaires. Results Thirty symptomatic AF patients underwent an overnight PG-based OSA screening, achieving an overall success rate of 96.7% (29/30). Interim analysis of 19 patients who underwent PSG evaluation upon referral showed that 12 (63.2%) were correctly diagnosed with at least moderate OSA (i.e., AHI ≥ 15) and were eligible for reimbursed CPAP treatment. PG and PSG agreement for OSA classification was fair (Cohen’s kappa = 0.230), with 68.4% (13/19) correctly classified (normal-mild, moderate-severe). There was high patient adherence to wearing the smartwatch for four weeks, with median compliance (i.e., adherence to the expected number of measurements) of 96.9% (IQR: 94.3% – 97.6%). A median of 150 (IQR: 145 – 151) daily automatic measurements were performed. Spot-check measurements via the smartphone also showed high compliance (110%, IQR: 100.0% – 135.5%) and high patient motivation (i.e., consistency of performing measurements; 90.3%, IQR: 67.7% – 96.8%). Patients were positive for both PG screening (Figure 1A) and Fitbit-based FibriCheck monitoring (Figure 1B). Conclusions PG is a feasible approach as a home screening tool for OSA, positively perceived by patients. Also, the acceptance of semi-continuous Fitbit-based FibriCheck monitoring was high. In a follow-up study, both tools will be used to evaluate the impact of a structured OSA screening and treatment trajectory on AF burden.

Evaluation of the Clinical Impact of a Smartphone Application for Cataract Detection.

Background Approximately 10 million people in India suffer from bilateral blindness, with cataracts accounting for roughly 70% of these cases. However, there is a severe scarcity of ophthalmologists in India (12,000 across the country), which makes routine cataract screening very difficult, particularly in rural areas. To tackle this problem, we investigated the use of an artificial intelligence (AI)-based application for cataract screening at All India Institute of Medical Sciences (AIIMS), Bibinagar, that can be used by nursing officers and other healthcare professionals as a primary screening tool. Ophthalmologists from AIIMS Bibinagar additionally validate the results of this application. Purpose The aim of this study was to assess the clinical performance of a smartphone-based cataract screening application that uses an AI module to identify cataracts in photos taken with the device's camera. The study compared the application's results with diagnoses made by ophthalmologists using a slit lamp. Methods At AIIMS Bibinagar, 495 patients participated in a prospective clinical trial. The AI-based screening solution examined smartphone images that were taken in accordance with a set protocol to identify whether cataracts were present. The results of the application were then compared with the diagnoses made by ophthalmologists based on slit-lamp tests. Results The study included 990 eye images. The AI screening application demonstrated an overall accuracy of 90.01% for cataract detection. Specific metrics include a sensitivity of 89.50%, specificity of 89.73%, precision of 91.43%, and an F1 score of 90.36%. The positive predictive value (PPV) was approximately 91.3%, based on 485 true positives and 46 false positives. The negative predictive value (NPV) was approximately 87.6%, based on 402 true negatives and 57 false negatives. Conclusions The smartphone-based cataract screening application proves to be an effective tool for community-level cataract screening in remote areas where access to expensive equipment and specialized ophthalmic care is limited. Its high accuracy and efficiency make it a valuable option for low-resource settings and suitable for home screening, particularly in the post-COVID era.

Engagement and factors associated with annual anal human papillomavirus screening among sexual and gender minority individuals.

While self-sampling could help address anal cancer screening barriers, no studies have investigated annual engagement with this method or compared it to annual screening with a provider. Building on our baseline paper,(7) we compared annual anal screening engagement between home-based self-sampling and clinic-based clinician sampling. The Prevent Anal Cancer Self-Swab Study recruited and randomized sexual and gender minority individuals 25 years and over who have sex with men to a home or clinic arm. Home-based participants were mailed an anal human papillomavirus self-sampling kit at baseline and 12 months, while clinic-based participants were asked to schedule and attend one of five participating clinics at baseline and 12 months. Using Poisson regression, we conducted an intention-to-treat analysis of 240 randomized participants who were invited to screen at both timepoints. 58.8% of participants completed annual (median = 370 days) anal screening. In the home arm, 65.0% of participants engaged in annual screening compared to 52.5% of clinic-based participants (p = 0.049). When stratified by HIV status, persons living with HIV had a higher proportion of home (71.1%) versus clinic (22.2%) annual screening (p < 0.001). Non-Hispanic Black participants participated more in home-based annual anal screening(73.1%) than annual clinic screening(31.6%) (p = 0.01). Overall, annual screening engagement was significantly higher among participants who had heard of anal cancer from an LGBTQ organization, reported "some" prior anal cancer knowledge, preferred an insertive anal sex position, and reported any prior cancer diagnosis. Annual screening engagement among those at disproportionate anal cancer risk was higher in the home arm.

Assessment of the effectiveness of artificial intelligence-based oral screening solution in the diagnosis of dental calculus, stains, and dental caries (Logy AI oral screening solution)

Background: The objective of this study was to clinically evaluate the precision of Logy AI's oral screening solution. This innovative module, driven by artificial intelligence, operates seamlessly through WhatsApp and as a standalone smartphone application. It is designed to detect various dental issues such as stains, calculus, and caries, utilizing images captured by a smartphone camera. The accuracy of the module was assessed by comparing its diagnoses with those made by dental professionals. Methods: A prospective clinical study was conducted in Saveetha Dental College, a tertiary care hospital in the southern part of India with 325 patients. Smartphone images taken were sent to the Logy AI oral screening solution which predicted if the patient had any oral hygiene issues like stains, calculus, and caries. Patients were examined by a dentist with visual-tactile and orthopantomogram (OPG) examination and were documented. Both were compared. Results: The accuracy of the Logy AI oral screening solution for the detection of stains, calculus, and caries was comparable with the dentist's diagnosis. The accuracy was 85% for caries, 97% for stains, and 83% for calculus. The sensitivity was 88% for caries, 89% for stains, and 82% for calculus. Conclusions: The Logy AI oral screening module demonstrates potential as an efficient oral screening tool suitable for community-level deployment, particularly in remote regions lacking access to costly dental equipment and healthcare professionals. Its accuracy and efficiency make it well-suited for operation in low-resource settings. Moreover, it holds promise as a valuable home screening tool for individuals seeking to monitor their oral health proactively.

Amateur vs Professional Users of the YO Home Sperm Test: An Assessment of Usability

ObjectivesTo assess the accuracy of home-test use by a real-world / amateur user. MethodsThis multi-site study investigated whether amateur users could use the FDA cleared YO® Home Sperm Test to obtain accurate MSC results when compared to trained laboratory technicians. The qualitative motile sperm concentration (MSC) results of amateur and professional YO users were compared to each other as well as to the results of an established automated sperm quality analyzer (SQA-V above and below a 6m/mL MSC cut-off). ResultsThis was a blinded, prospective study of 316 amateur users and 3 professional laboratory technicians across 3 study sites. Amateur vs. Professional YO users demonstrated accuracy of >97%. Qualitative results of amateurs and professionals vs. SQA-V results showed >95.7% accuracy. ConclusionAmateur users with no prior training were able to follow the YO test directions to receive highly accurate qualitative MSC results. The YO test is user-friendly and can be used as an effective initial home screening tool to gain preliminary insight into the fertility status of the male in a real-world setting. Furthermore, the YO test results correlated with those obtained by the FDA cleared SQA-V laboratory analyzer, confirming that the YO test delivers accurate MSC results in the hands of amateur users.

Hcv Reinfection in Active Drug Users from Facts to Explanations and Possible Solutions

Background and Aims: Perpignan (in south of France) was 600 000 people very low-income area. Main sociological characteristics associated, many homeless and drugs users local insecurity therefore low-price cocaine, national attractiveness for consumers and traffickers, overconsumption with these lower price, local manufacture of cannabis and road transport effects redistribution of drugs purchased in Spain. This was the only place where coke rail was sold under 5 dollars, 50% lower than the price in the rest of France. Mobile hepatitis team (MHT) was created in 2013 and cured about 1000 HCV patients in an outreach and test to cure approach. MHT used HCV POCT, HCV real time viral load, liver fibrosis measure by FIBROSCAN and nurse DAA prescription. For 2 years, MHT observed increase of reinfections. Method: Observational and Sociological Study of HCV Reinfections. Results: In 2023, MHT (nurses (44%) and hepatologist (56%) prescriptions) treated 89 HCV patients: men 68%, mean age 46 years, reinfection rate 21%. This rate was higher (31%) in patients treated by nurses. They were younger, more often homeless, and active drugs users. A clinical psychological study by patients’ interview showed than reinfected patients were younger, lower educational level, more often homeless, with history of psychiatric illnesses and prison. There was no correlation with precariousness score. More the patient thinks that he was responsible for his illness, the more impulsive he was (dimension urgency emotional impulsiveness). More the patient was aware of the consequences of his illness, the more impulsive he was (dimension urgency emotional impulsivity). The more impulsive the patient was (total score, emergency emotional impulsivity dimension), higher the neuroticism score (negativist personality trait). We individualized 2 specific groups of reinfected patients : gypsies in prison and homeless in the city. More the patient participates in harm reduction workshops, the more he feels responsible for his illness and the consequences of his illness, with magical thoughts about his contamination. The paradoxical outcome was people reinfected had more risk and harm reduction sessions after first infection. There was no fear about DAA treatment as HCV interferon and ribavirin treatment. DAA are always well tolerated and efficient, even in reinfection. Conclusion: Direct-acting antivirals are an effective tool for the treatment of hepatitis C virus, enabling the elimination of the virus. However, some patients who have been successfully treated with direct-acting antivirals are at risk of reinfection. Our findings showed that the risk of reinfection was highest among people with ractive injection drug use..In low-income population exposed to cocaine and other low price drugs, HCV reinfection was a trivialized life event. For reduce it, MHT had set up 3 specific projects: 1. home screening in gypsy women and neighborhood 2. Peers fingersticks HCV screening in homeless people and orientation of HCV positive patients to MHT 3. Prison zero hepatitis program with all HCV inmates same time treatment. Combination of these projects reduced to 22% rate of HCV reinfection in active drugs users during first quarter of their deployment.

Home screening of taste and oral trigeminal function: a feasibility study

Purposegustatory ability is a marker of health not routinely tested in the medical practice. The current study wants to assess whether taste strips can be useful to monitor taste function from home.Methodswe performed simple sensory tests in lab setting vs. unassisted testing at home, and compared the results with self-reports ability to taste and smell. Using paper strips impregnated with sweet, bitter, salty, or sour tastants, and with two trigeminal stimuli (capsaicin, tannins) in high and low concentrations, we assessed gustatory and trigeminal function in 74 participants (47 women) in the lab, where paper strips were administered by an experimenter, and in 77 participants (59 women) at home, where they self-administered the test.Resultswe found that high (but not low) concentration taste strips are correctly identified by vast majority of participants. On average, taste identification, intensity and pleasantness scores did not differ for the 8 taste strips, while identification of capsaicin was significantly better in the lab. Taste identification scores correlated with intensity ratings in both settings (r = 0.56, in the lab, r = 0.48, at home, p < 0.005). Self-rated taste ability correlated with self-rated smell ability (r = 0.68, and r = 0.39, p ≤ 0.005), but not with scores in the strips test.Conclusionhome testing with impregnated taste strips is feasible, and can be used for telemedical purposes.

Abstract LB232: Implementation of population-based risk assessment for hereditary cancer in primary care: Results from the Early Detection of Genetic Risk (EDGE) Trial

Abstract The EDGE (Early Detection of GEnetic risk) trial compared two population-based engagement strategies for identifying primary care patients with a family or personal history of cancer and offered eligible individuals genetic testing for cancer susceptibility (GT). A total of twelve clinics from two healthcare systems (6 clinics each) participated in Montana, Wyoming and Washington State. Clinics were cluster-randomized to one of two engagement approaches: 1) point of care screening (POC), conducted by clinic staff when a patient came in for their appointment and 2) direct patient engagement (DPE), where letter and email outreach facilitated online home screening. Patients who completed screening and met pre-specified personal and family history criteria were offered GT via a home-delivered saliva kit at no cost. The two primary outcomes of the trial were the fraction of active clinic patients who 1) completed the risk assessment tool and 2) completed GT. Logistic regression models were used to compare POC and DPE, allowing for overdispersion and including clinic as a design factor. Analyses in the screened population were adjusted for age, sex, personal and/or family history of cancer, and healthcare system. Over a 12-month engagement window, 95,623 patients were seen in the 12 clinics (Table 1). The POC approach resulted in a higher proportion screened for hereditary risk (19.1% vs. 8.7%), but a similar proportion completed testing (1.5% vs. 1.6%). Notably, the rate of testing among eligible patients approached via POC was approximately half the rate observed with DPE (24.7% vs. 44.7%). POC screen completers were less likely to have a personal history of cancer (9.1% vs. 10.7%), a significant family history of cancer (9.5% vs. 12.8%), and, if eligible, order a test kit (33.8% vs. 58.1%). Overall, a POC approach resulted in higher screening rates for familial cancer risk but a similar fraction completing GT, with DPE screeners self-selecting due to greater personal and/or family history of cancer. Analyses are ongoing to examine patient, clinic and system-level factors predicting screening and testing uptake, which can inform best practices for population-based hereditary cancer screening efforts. POC % (N) DPE % (N) Unadjusted OR (POC vs DPE) Adjusted OR * (POC vs DPE) p-value Patient Denominator 51,693 43,930 Completed Screening 19.1% (9892) 8.7% (3813) 2.49 - 0.0074 Completed GT 1.5% (757) 1.6% (717) 0.89 - 0.75 Screened Participants 9892 3813 % screened with any personal cancer history 9.1% (902) 10.7% (406) 0.77 &amp;lt;0.0001 % of screened with significant** family history of cancer 9.5% (935) 12.8% (487) - 0.69 &amp;lt;0.0001 % of screened found eligible for GT 31.0% (3070) 42.0% (1603) - 0.65 &amp;lt;0.0001 Participants eligible for GT 3070 1603 % of eligible who ordered test kit 33.8% (1039) 58.1% (932) - 0.43 &amp;lt;0.0001 % of eligible who completed GT 24.7% (757) 44.7% (717) - 0.49 &amp;lt;0.0001 *Adjusted ORs - Adjusted for age, sex, personal cancer history, family cancer history, healthcare system.**Significant family history: 2 or more first degree relatives with a high-risk cancer Citation Format: Elizabeth M. Swisher, Heather M. Harris, Barbara M. Norquist, Jeannine Brant, Brian Shirts, Sarah Knerr, Emerson J. Dusic, Faith Beers, Tesla N. Theoryn, DaLaina Cameron, Howard Cabral, Laurie A. Riemann, Michael Raff, Beth Devine, Deborah J. Bowen, Catharine Wang. Implementation of population-based risk assessment for hereditary cancer in primary care: Results from the Early Detection of Genetic Risk (EDGE) Trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB232.

Ratio fluorescence/colorimetric dual mode aptasensor and smartphones-assisted miniaturized device for early diagnosis of prostate cancer

Prostate specific antigen (PSA) is the most common tumor biomarker for prostate cancer (PCa), and its precise determination is essential to improving survival rate and reducing treatment cost of cancer patient. Here, we have proposed a novel ratio fluorescence/colorimetric dual mode aptasensor based on CdTe-apt + B-CDs + ZrFe MOF system for PSA determination. Specifically, as-prepared ZrFe MOF with good peroxidase like activity can quench the fluorescence of B-CDs + CdTe-apt system via inner filter effect (IFE), while the existence of PSA can restore fluorescence of CdTe-apt but virtually unchanged fluorescence of B-CDs due to specific identification between PSA and aptamer. Similarly, the addition of PSA can recover the peroxidase like activity of ZrFe MOF which is significantly suppressed by PSA aptamer. Based on this, the proposed ratio fluorescence/colorimetric dual mode aptasensor has achieved satisfactory results in PSA analysis of serum specimens. Valuably, an inexpensive, portable but credible smartphones-assisted miniaturized device is expected to be exploited for the early diagnosis of PCa, inspiring the design and construction of advanced portable devices for self-monitoring and home screening of various cancers.

Clinical validation of artificial intelligence-based cataract screening solution with smartphone images (Logy AI cataract screening module)

Background: Purpose of the study was to clinically assess the accuracy of Logy AI cataract screening solution, an artificial intelligence-based module, which works through WhatsApp and also as a separate smart phone application, that can detect cataracts using images taken by a smartphone camera, by comparing with slit lamp based diagnoses made by ophthalmologists. Methods: A prospective clinical study was conducted in an eye clinic of a tertiary care hospital in the southern part of India with 437 patients. Smartphone images taken were sent to the Logy AI cataract screening solution which predicted if the patient had cataract or not. It graded cataracts as immature and mature. Patients were examined by ophthalmologists with slit-lamp and diagnosis was documented. Both were compared. Results: 794 eye images were included in the study. The overall accuracy of the AI screening solution for cataract detection was computed to be 90.08%. Further, the accuracy was 88.02% for immature cataract, 97.16% for mature cataract, and 90.08% normal category. The sensitivity was 90.38%, the specificity was 89.87%, and the F1 score was 87.98%. The positive predictive value was 85.71% and the negative predictive value was 93.29%. Logy AI cataract prediction module’s AUC (0.8946) falls under the good category. Conclusions: Logy AI cataract screening module could work as an effective cataract screening tool at the community level in remote areas where there is no expensive equipment and ophthalmic health care workers considering the accuracy and efficiency to work in low resource settings. It can also be a good home screening tool suitable for the post-COVID era.

Home capillary sampling and screening for type 1 diabetes, celiac disease, and autoimmune thyroid disease in a Swedish general pediatric population: the TRIAD study.

To screen a general pediatric population for type 1 diabetes (T1D), celiac disease (CD), and autoimmune thyroid disease (AITD) after home capillary sampling. Swedish schoolchildren between 6-9 years and 13-16 years of age were invited to screening by taking a capillary sample at home. Samples were returned by mail and assessed for autoantibodies associated with T1D, CD, and AITD. Persistently autoantibody-positive children were referred for clinical follow-up. Of 19,593 invited, 3,527 (18.0%) consented to participate and 2,315/3,527 (65.6%) returned a blood sample of sufficient volume. Hemolysis occurred in 830/2,301 (36.1%) samples. After exclusion of 42 children with previously known T1D, CD, or AITD, and two autoantibody-positive children who declined a confirmatory sample, 2,271/19,593 (11.6%) were included. 211/2,271 (9.3%) had persistent autoantibodies: 60/2,271 (2.6%) with T1D autoantibodies, 61/2,271 (2.7%) with CD autoantibodies, and 99/2,271 (4.4%) with AITD autoantibodies; 9/2,271 (0.4%) were autoantibody positive for ≥1 disease. After clinical follow-up, 3/2,271 (0.1%) were diagnosed with T1D, 26/2,271 (1.1%) with CD, and 6/2,271 (0.3%) with AITD. Children with a first-degree relative (FDR) with T1D, CD, and/or AITD, had higher occurrence of autoantibodies compared to children without an FDR (63/344, 18.3%, vs. 148/1,810, 8.2%) (p < 0.0001, OR 2.52, 95% CI 1.83-3.47), and higher occurrence of screening-detected diagnosis (14/344, 4.1%, vs. 21/1,810, 1.2%) (p < 0.0001, OR 3.61, 95% CI 1.82-7.18). Half of these children screened positive for another disease than the FDR. Screening for T1D, CD, and AITD by home capillary sampling in a Swedish general pediatric population detected autoimmunity in 9.3% and undiagnosed disease in 1.5%.

Improving food insecurity screening across a health system throughout the COVID-19 pandemic

BackgroundFood insecurity has direct and indirect negative outcomes on the physical and mental health of children, with impacts throughout adult life. Rates of food insecurity have increased dramatically since the...

Evaluation of self-sampling-based cervical cancer screening strategy using HPV Selfy CE-IVD test coupled with home-collection kit: a clinical study in Italy

BackgroundPrimary human papillomaviruses (HPV) cervical cancer screening can be strengthened by offering home-collection of biological specimen as a valuable option to increase screening coverage. As recommended by World Health Organization (WHO), screening programs should consider whether the inclusion of HPV self-sampling as a complementary option within their existing screening algorithms could address the gaps in current coverage. However, few HPV screening tests are validated for self-sampling according to international guidelines. This study aimed to test a self-sampling-based screening strategy, complementary to the main screening program based on clinician-collected cervical samples. The study took place in Trieste, Italy, and it aimed to evaluate the feasibility of self-testing at home under an opt-in system during COVID-19 pandemic in order to exploit self-sampling to reduce the screening delay generated by the lockdown.Methods500 women, who should have received the screening call in 2020, were asked, via phone call, to participate in the study. To whom agreed, a home-collection kit, including a vaginal dry swab for specimen collection, was sent. The recipients performed the sample self-collection and sent back the swab through traditional mail using a prepaid envelope. Once received by the hospital, the samples were analyzed with HPV Selfy (Ulisse BioMed, Italy), a CE-IVD HPV screening test specifically validated for self-collection. Results were further compared using cobas® 4800 HPV (Roche, Switzerland).Results80% women sent back their swab, showing one of the highest return rate obtained in comparable studies. 34 HPV-positive women were followed up and underwent the Pap test, that revealed 8 low squamous intraepithelial lesions (LSIL) cases, later triaged to colposcopy. HPV Selfy was confirmed to be an adequate test for self-sampling-based screening.ConclusionsThis study further confirmed the feasibility of self-test at home screening strategy based on self-sampling with an opt-in system as a support method to enhance cervical cancer screening coverage in Italy. Enrolled women showed a high appreciation for this approach. HPV Selfy test demonstrated to be a valuable assay for cervical cancer screening based on home self-collection.Trial registration: ASUGI Trieste n. 16008/2018 and amendment 02-11/09/2020.

Screening for HPV-Related Oropharyngeal Cancer in Gay and Bisexual Men: Acceptability and Predicting Possible Use of "Oral Selfies" by Smartphone as a Secondary Prevention Approach.

Oropharyngeal cancers (OPCa) caused by HPV have emerged as one of the leading causes of malignancies caused by HPV infection. They are also significantly more likely to occur in males and in people with a history of oral sex with multiple partners. Gay and bisexual men are disproportionately affected by HPV-positive oropharyngeal cancers. We studied 1699 gay and bisexual men on 2 major dating sites in the US to assess their knowledge about HPV-related OPCa, attitudes toward screening for it, beliefs about oropharyngeal cancer screening based on the Health Belief Model, and attitudes toward possible screening approaches for OPCa. Knowledge on a 12-item scale was low, with a median of 5 items correct: 72% knew of the benefits of HPV vaccination. Significant predictors of needing OPCa screening included perception of risk for OPCa, seeing it as severe, having lower barriers, fewer reasons to avoid screening, higher knowledge, and being HPV vaccinated were significant predictors, explaining half the total variance. Most participants would accept routine, virtual/online doctor or dental appointments, and over half would accept an in-person screening. Nearly two-thirds stated that they would accept getting checked for OPCa if they could do self-screening at home, and half were prepared to use an online screening tool or app, where they could take an "oral selfie" and send it to a healthcare provider for examination. One-third stated that they would trust the results of a home screening completed by themselves and posted to a website equally as cancer screening completed online by a healthcare provider. Data indicate that despite low OPCA knowledge levels, the risk of HPV-associated OPCa was known. Being at personal risk and having knowledge of disease severity had 70% of the sample thinking about, or preparing to get, screening. Self-screening by a smartphone "oral selfie" transmitted to a screening website was acceptable to many gay and bisexual men, and online screening by a doctor or dentist was acceptable to most. OPCa screening in this population using electronic technology, together with the increasing incidence of HPV-associated OPCa in gay and bisexual men, brings together an opportunity to detect OPCa early.

Risk factors for increasing leprosy treatment dropout cases reported in specific areas in Tangerang District

Link of Video Abstract: https://youtu.be/WPu8KQqNFNM Introduction: In 2020, Indonesia announced the elimination of leprosy in the whole country, including the Banten Province, with new cases detected 568 cases (4.8 per 100,000 population), higher than the national average of 4.12 per 100,000 population. Although information on the percentage of dropouts in Indonesia is not known, it still occurs in the field, If the case is cleared out unchecked, it will become a source of transmission of wellbeing problems in the community. This study aims to determine the influence of socio-demographic factors, leprosy patients, and health services on leprosy dropout rates and detect new cases in the Panongan Community Health Center working area. Methods: Secondary data on leprosy patients at the Panongan Community Health Center during 2019-2022 and primary data from cross-sectional surveys through home visits, interviews, face-to-face, and screening. Screening for leprosy symptoms in close contact with the patient's family using a questionnaire that includes independent variables of socio-demographic, patient, and health center with the dependent variable of treatment dropout. Purposive sampling technique in 5 villages with leprosy cases. The total sample size was 79 people. Data were processed and analyzed using STATA 14.0. Results: The logistic regression test was found to be significant (p-value &lt; 0.05) including age, (p=0.003), occupation (p=0.002), stigma (p=0.001), family of leprosy patients (p=0.003), close contact (p=0,000), healthy eating habits (p=0.002), perception of taking medicine (p=0.000) and a woman, 60 years old, was found to be infected with leprosy within the family of a drug withdrawal patient who was in near contact for 1 year, although multivariate testing was not statistically significant (p-value: &gt; 0.05). Conclusion: Increasing compliance through health education and motivation of patients and families, also monitoring medication taking by health service staff, groups of former patients, and cadres.

Convolutional neural network-based vocal cord tumor classification technique for home-based self-prescreening purpose

BackgroundIn this study, we proposed a deep learning technique that can simultaneously detect suspicious positions of benign vocal cord tumors in laparoscopic images and classify the types of tumors into cysts, granulomas, leukoplakia, nodules and polyps. This technique is useful for simplified home-based self-prescreening purposes to detect the generation of tumors around the vocal cord early in the benign stage.ResultsWe implemented four convolutional neural network (CNN) models (two Mask R-CNNs, Yolo V4, and a single-shot detector) that were trained, validated and tested using 2183 laryngoscopic images. The experimental results demonstrated that among the four applied models, Yolo V4 showed the highest F1-score for all tumor types (0.7664, cyst; 0.9875, granuloma; 0.8214, leukoplakia; 0.8119, nodule; and 0.8271, polyp). The model with the lowest false-negative rate was different for each tumor type (Yolo V4 for cysts/granulomas and Mask R-CNN for leukoplakia/nodules/polyps). In addition, the embedded-operated Yolo V4 model showed an approximately equivalent F1-score (0.8529) to that of the computer-operated Yolo-4 model (0.8683).ConclusionsBased on these results, we conclude that the proposed deep-learning-based home screening techniques have the potential to aid in the early detection of tumors around the vocal cord and can improve the long-term survival of patients with vocal cord tumors.

Ratiometric fluorescence sensor and smartphone-based microfluidic sensing platform based on oxidation induced Ce(III)/Ce(IV) phosphatase-like activity and complexation effect activation for sarcosine detection

Prostate cancer (PCa) has seriously affected men's quality of life and even endangered their lives. Thus, precise and reliable determination of related biomarkers in clinical samples is extremely important for early diagnosis and treatment of PCa. Sarcosine (Sar) is widely regarded as a potential biomarker for non-invasive diagnosis of PCa owing to its specific high-level expression in the development and metastasis of PCa. With the aid of Ce(III) as a bridge between 4-Methylumbelliferyl Phosphate (4-MUP) and orange emitted carbon dots (o-CDs), here we have constructed a new ratiometric fluorescence sensor for Sar determination by reasonably combining the phosphatase-like activity and complexation reaction characteristics of Ce(IV). This sensor indicates high sensitivity, exceptional selectivity, good reliability, and wide linear range of 0.2–120 μM with a detection limit of 89 nM. Besides, our proposed sensor demonstrates excellent precise and stability even in complex actual urine samples. Interestingly, an inexpensive, portable but reliable smartphone-based microfluidic sensing platform has been fabricated and successfully employed for precise determination of Sar in urine samples, which offers a powerful and convenient tool for the early diagnosis of PCa, and even inspires the research and development of other practical optical sensing devices for cancer home screening.

1259-P: Resting Heart Rate and Sleep Disorders in Maturity-Onset Diabetes of the Young

Background: Sleep disturbances have been linked to higher resting heart rate (RHR), a marker of cardiovascular risk. Obstructive sleep apnea (OSA) and insomnia are common in other types of diabetes, but they have not been studied in Maturity Onset Diabetes of the Young (MODY), a unique subtype characterized by patients being lean and not using insulin. Objective: To evaluate sleep disorders and RHR in MODY. Methods: Participants were recruited from the Monogenic Diabetes Registry at the University of Chicago. The presence and severity of OSA was objectively assessed by a validated home screening device. Insomnia was assessed by a validated survey (Insomnia Severity Index). Resting (sleeping) heart rate was assessed by Fitbit activity tracker for 2 weeks. Results: Considering all patients (n=51; Table 1), OSA was found in 37% (31% mild, 2% moderate, 4% severe). Insomnia was found in 47% of patients (10% clinical insomnia and 37% subthreshold insomnia). Overall, the mean RHR was 66±9 bpm, with transcription factor (TF) related MODY (HNF1A, HNF4A, HNF1B) having significantly higher RHR compared to GCK-MODY (70±10 bpm vs. 63±8.7 bpm; p=0.01). Conclusion: OSA and insomnia are common in patients with MODY despite their lack of traditional risk factors for sleep disorders. TF-related MODY has a higher RHR compared to GCK-MODY. Future research should investigate the pathophysiology of sleep-diabetes relationship in MODY. Disclosure M.A.Arosemena: None. K.Wroblewski: None. E.Tasali: None. L.H.Philipson: Advisory Panel; Nevro Corp., Research Support; Novo Nordisk, Dompé, Provention Bio, Inc., Imcyse, Novo Nordisk Foundation.

Preventing Health Disparities during COVID through Perinatal Home Screening as Black Authoritative Knowledge.

During COVID-19 epidemic, health protocols limited face-to-face perinatal visits and increased reliance on telehealth. To prevent increased health disparities among BIPOC pregnant patients in health-underserved areas, we used a pre-post survey design to pilot a study assessing (1) feasibility of transferring technology including a blood pressure (BP) cuff (BPC) and a home screening tool, (2) providers' and patients' acceptance and use of technology, and (3) benefits and challenges of using the technology. Specific objectives included (1) increasing contact points between patients and perinatal providers; (2) decreasing barriers to reporting and treating maternal hypertension, stress/depression, and intimate partner violence (IPV)/domestic violence (DV); and (3) bundling to normalize and facilitate mental, emotional, and social health monitoring alongside BP screening. Findings confirm this model is feasible. Patients and providers used this bundling model to improve antenatal screening under COVID quarantine restrictions. More broadly, home-monitoring improved antenatal telehealth communication, provider diagnostics, referral and treatment, and bolstered patient autonomy through authoritative knowledge. Implementation challenges included provider resistance, disagreement with lower than ACOG BP values to initiate clinical contact and fear of service over-utilization, and patient and provider confusion about tool symbols due to limited training. We hypothesize that routinized pathologization and projection of crisis onto BIPOC people, bodies, and communities, especially around reproduction and continuity, may contribute to persistent racial/ethnic health disparities. Further research is needed to examine whether authoritative knowledge increases use of critical and timely perinatal services by strengthening embodied knowledge of marginalized patients and, thus, their autonomy and self-efficacy to enact self-care and self-advocacy.