Inadequate Screening Research Articles

Is CRISPR/Cas9 a way forward to fast-track genetic improvement in commercial palms? Prospects and limits.

Commercially important palms (oil palm, coconut, and date palm) are widely grown perennial trees with tremendous commercial significance due to food, edible oil, and industrial applications. The mounting pressure on the human population further reinforces palms' importance, as they are essential crops to meet vegetable oil needs around the globe. Various conventional breeding methods are used for the genetic improvement of palms. However, adopting new technologies is crucial to accelerate breeding and satisfy the expanding population's demands. CRISPR/Cas9 is an efficient genome editing tool that can incorporate desired traits into the existing DNA of the plant without losing common traits. Recent progress in genome editing in oil palm, coconut and date palm are preliminarily introduced to potential readers. Furthermore, detailed information on available CRISPR-based genome editing and genetic transformation methods are summarized for researchers. We shed light on the possibilities of genome editing in palm crops, especially on the modification of fatty acid biosynthesis in oil palm. Moreover, the limitations in genome editing, including inadequate target gene screening due to genome complexities and low efficiency of genetic transformation, are also highlighted. The prospects of CRISPR/Cas9-based gene editing in commercial palms to improve sustainable production are also addressed in this review paper.

Diagnostic Routes and Time Intervals for Ovarian Cancer in Nine International Jurisdictions; Findings From the International Cancer Benchmarking Partnership (ICBP)

(Abstracted from Br J Cancer 2022;127:844–854) Ovarian cancer (OC) is the gynecological malignancy with the highest mortality, partially attributable to the lack of effective screening for early-stage disease. Despite inadequate screening methods, there exists significant international variation in the proportion diagnosed at late stage and in OC survival across all stages.

Hypertension in the Young Adults

Background: Hypertension is a non-communicable disease which is an important risk factor for cardiovascular diseases. The prevalence has been documented to be highest in Africa where 46% of the world’s population with hypertension reportedly resides. There is a global concern that hypertension in teenagers and young adults are on the increase and cases are not detected because of inadequate screening in this age group. Objective: To determine the prevalence of hypertension among undergraduates in Rivers State. Materials and Methods: This was a cross-sectional study conducted in Rivers State. The subjects were recruited from University of Port Harcourt, Rivers State University and Ignatius Ajuru University which are the three major tertiary institutions in Rivers State and their ages ranged between 16 and 35 years. Data collected were analyzed using Statistical Package for Social Sciences. Results: A total of 1096 respondents were recruited for the study, there were 570 (52%) males and 526 (48%) females. Sixteen (1.5%) of them were married while 1080 (98.5%) were single. The prevalence of hypertension among the respondents was 21%. Adding salt to meal before eating and noodles consumption were significantly associated with hypertension. Other risk factors which included smoking, alcohol consumption, and physical inactivity, family history of hypertension and/or CVD and use of social drugs were not significantly associated with increased prevalence of hypertension. Conclusion: The prevalence of hypertension was high in this study there was a significant association between hypertension and risk factors such as salt intake and noodles consumption. Health practitioners should enlighten the public on the presence of hypertension in young people. There is also need to create awareness of hypertension even in young adults and promote early lifestyle changes.

DISP-14. DEFINING INTERVENTIONS AND METRICS TO IMPROVE DIVERSITY IN CNS CLINICAL TRIAL PARTICIPATION: A SNO AND RANO EFFORT

Abstract Despite major strides in cancer research, care, and therapy, these advances have not been equitable across race and ethnicity. Groups underrepresented in medicine (URM) are more likely to have inadequate preventive screening, increased delays in diagnosis, and poor representation in clinical trials. Notably, Black and Latino Americans represent 29% of the population but only reflect 8% of oncology clinical trial participants. Recent studies have shown that this disparity is also present in neuro-oncology as women, Black, and Latino Americans remain under-accrued in clinical trials. Brain tumor patients already face unique barriers to clinical trial enrollment and completion due to disease-specific conditions–such as impaired motor function, cognition, language deficits, and caregiver dependency–which pose additional difficulties in clinical trial consent, enrollment, and adherence. As part of this collaborative initiative, we evaluated the impact of how a lack of diversity in cancer research is detrimental to scientific discovery and propose interventions focused on improving URM engagement with clinical research. Recommendations include the creation of inclusive trial design at the onset, decreasing barriers to care, expanding trial eligibility, and equitable access to tumor profiling for personalized medical trials. Additionally, setting reasonable metrics and goals for accrual and engagement with patient and community stakeholders will ultimately help to diversify trial participants. Lastly, diversification and inclusion practices within the neuro-oncology workforce, including all personnel involved in clinical research, will help to minimize bias, promote concordant care, and assist with developing sustainable solutions. The diversification of participation in neuro-oncology clinical trials is imperative. The lack of diversity in clinical trials can contribute to improper generalizability of treatment efficacy, resulting in potentially harmful practices. Equitable access and inclusion of URM brain tumor patients will not only enhance research discoveries but will also result in improved patient care for all cancer patients.

S331 The Impact of PCP Counseling for Colorectal Cancer Screening: A Primary Care Quality Improvement Project

Introduction: Effective primary care physician (PCP) counseling plays a key role in patient adherence to primary prevention cancer screening programs. The impact of PCP counseling on the patients’ adherence to colorectal cancer (CRC) screening programs is believed to be underestimated. Therefore, we conducted a 24-week prospective quality improvement initiative investigating the effects of PCP counseling for CRC screening on patient participation rates. Methods: We identified patients who met the criteria for CRC screening during their routine primary care appointments at the resident-run internal medicine ambulatory clinic at Cleveland Clinic (CCF) from October 2021 to March 2022. A fishbone diagram was used for root-cause analysis which revealed key causes of inadequate CRC screening: lack of patient education and awareness about the importance of CRC screening. Our PDSA cycle included patient education by PCPs about the importance of CRC screening in asymptomatic patients and the benefits of early treatment of the disease. The PCPs explained various screening modalities. The chosen modality was ordered for interested patients. The primary outcomes were the percentage of patients who agreed to undergo CRC screening and the percentage of patients who scheduled or completed the screening test. Results: A total of 52 subjects both met the criteria for CRC screening and attended their routine primary care appointments at CCF where they underwent PCP counseling. Only 4 (8%) patients had undergone a prior CRC screening test. The median age was 55 years, and females compromised 52% of the subjects. A total of 44 subjects (85%) agreed to undergo CRC screening after being counseled by their PCPs. Of those 44 individuals, 42 (95%) chose colonoscopy, and two (5%) chose FOBT. By the end of the study period, eighteen patients (41%) had either scheduled or completed their tests (Figure, Table). Conclusion: Our study demonstrates that PCP counseling is associated with high patient engagement to undergo CRC screening. However, it is still unclear whether PCP counseling in the context of a primary care clinic visit alone is sufficient to ensure the completion of CRC screening. Thus, we plan to examine CRC screening completion rates within a year of the original test being ordered and explore barriers that limit the completion of CRC screening by surveying patients in subsequent clinic visits. We will propose other interventions (email reminders or phone calls) to address these barriers and improve CRC screening completion rates.Figure 1.: Time course of patients who agreed to undergo CRC screening. Table 1. - Summary of the data Age median (range) 55 (45-83) yrs Female vs. Male 52.0% vs 48.0% Percentage of patients were up to date with CRC screening 8.0% Percentage of patients who agreed to undergo CRC screening 85.0% Percentage of patients who scheduled their CRC screening test by the time of data curation 41.0%

S1193 Differences in Prevalence and Treatment of Hepatitis B Virus Infection in Asian and Black Patients

Introduction: Hepatitis B virus (HBV) infection, an important cause of chronic liver disease, has a prevalence of 4.3% in the United States (US) and causes significant morbidity and mortality. Immigrants and racial/ethnic minorities are disproportionately burdened by HBV. Few studies have investigated characteristics of HBV infection and treatment by race; therefore, we sought to understand and compare risk factors, barriers to care, and treatment patterns in Blacks and Asians, the two most disproportionately impacted groups. Methods: Using informatics, we identified patients with possible HBV based on ICD-10 code B18.1, who were seen between May 2010 and July 2021 at a tertiary referral center. We performed retrospective chart review to confirm infection and captured sociodemographic/clinical data. We used descriptive statistics, Kruskal-Wallis and Pearson’s chi squared tests to evaluate for differences between Black and Asian patients. Analyses were conducted using STATA 17.0(College Station, Texas). Results: Out of 673 patients, 509 had confirmed HBV: 308 Black and 201 Asian patients. Compared to Asians, Blacks were older and more likely to be male and US-born. Top birth countries included Haiti, 22%, US, 18%, China, 16%, and Vietnam, 8% (Fig 1a). Risk factors for HBV differed significantly; 44% of Asians had a family history of HBV compared to 8% of Blacks, p < 0.001 (Table). Clinical notes for Black patients were more likely to document history of injection drug use, blood transfusions and tattoos. The predominant HBV genotype was A in Blacks and B in Asians (Fig 1b). Despite no significant differences in prevalence of cirrhosis or infection phenotype, there were treatment differences; 60 % of Blacks vs. 70% of Asians were treated, p 0.04. More Black patients had concurrent HIV or HCV, 14% and 5%, respectively compared to 0-1% of HIV and HCV in Asians. NAFLD was more common in Asians, 27%, vs 12% in Blacks. While 97% of Blacks and 70% of Asians met Hepatocellular carcinoma (HCC) screening criteria, only 67% of Blacks and 44% of Asians of those meeting criteria were screened in the past twelve months. Conclusion: There are significant differences in risk factors, access to care and treatment between Black and Asian patients in our institution. Future studies should seek to understand barriers to treatment and the determinants of inadequate HCC screening in both Asian and Black patients, given the dire consequences of HBV-related HCC in these communities.Figure 1.: a) Birth Country Distribution of HBV Patients, b) Predominant HBV genotype of Black and Asian Patients Table 1. - Demographics and Clinical Characteristics of Black and Asian Patients with HBV Variable Black Asian p-value (n = 308) (n = 201) Median Age, years (IQR) 56.97 (46.21-65.1) 51.54 (42.63-61.86) 0.003 Male Gender, n (%) 199 (64.8) 103 (51.2) 0.002 Hispanic Ethnicity, n (%) 23 (8.1) 3 (1.5) 0.002 English-speakers, n (%) 266 (86.4) 182 (90.6) < 0.001 US-Born, n (%) 73 (32.9) 9 (5.1) < 0.001 Insurance Type, n (%) < 0.001 Private 185 (63.4) 148 (74.8) Medicaid/Medicare 93 (31.9) 33 (16.7) Uninsured 12 (4.1) 12 (6.1) Married (not separated), n (%) 146 (52.1) 143 (72.6) < 0.001 Risk Factors, n (%) Intravenous Drug Use 4 (1.4) 1 (0.5) < 0.001 Intranasal Cocaine 19 (6.6) 1 (0.5) < 0.001 Non-IV Drug Use 19 (6.6) 1 (0.5) < 0.001 Sexually Transmitted Diseases 34 (11.9) 5 (2.5) < 0.001 Transfusions 54 (19.2) 16 (8.1) < 0.001 Family history of hepatitis 11 (3.9) 6 (3.1) < 0.001 Family history of HBV 22 (7.6) 87 (44.4) < 0.001 Family history of HCC 12 (4.2) 37 (18.9) < 0.001 Tattoos 26 (9) 9 (4.6) < 0.001 Other Medical Conditions, n (%) Non-alcoholic Fatty Liver Disease (NAFLD) 32 (11.6) 53 (27.2) < 0.0001 Human Immunodeficiency Virus (HIV) 39 (13.8) 0 (0) < 0.001 Hepatitis C Virus (HCV) 13 (4.5) 2 (1) < 0.001 Ever Treated for HBV, n (%) 166 (60.4) 136 (69.7) 0.037 Currently Treated for HBV, n (%) 148 (52.5) 105 (55) 0.59 Phenotype, n (%) 0.195 Immune tolerant 2 (0.8) 1 (0.5) HbeAg positive active ( > 20000 DNA) 7 (2.7) 2 (1) HbeAg negative active ( > 2000 DNA) 9 (3.5) 6 (3.1) Inactive carrier 175 (67.6) 117 (60.3) Indeterminate 66 (25.5) 68 (35.1) Met criteria for HCC Screening, n (%) 299 (97.1) 141 (70.2) < 0.0001 HCC Screening < 6 months before visit, n (%) 219 (76.6) 91 (46.7) < 0.001 HCC Screening < 12 months before visit, n (%) 190 (66.7) 86 (44.1) < 0.001 Demographics and Clinical Characteristics of Black and Asian Patients with HBVp value of <0.05 is considered significant).

S257 Improving Adherence to Colorectal Cancer Screening Recommendations for First-Degree Relatives of Patients With Advanced Adenomas

Introduction: Advanced adenoma (AA), defined as polyp size ≥1 cm or histologic features with villous or high-grade dysplasia, is common and confers an increased risk of colorectal cancer (CRC) to affected individuals and their first-degree relatives (FDR). Patients are unaware of this associated risk leading to inadequate screening of FDR. Also, practice variation regarding screening age/interval results in inconsistent recommendations. In this quality improvement study, we aimed to improve adherence to CRC screening recommendations for FDR of patients with a multifaceted intervention. Methods: A pre-post study was conducted at a single academic center between 7/2020-5/2022 including adults undergoing outpatient screening/surveillance colonoscopy. Interventions included (1) surveying faculty/fellows on barriers to adhering to guidelines, (2) creating patient education materials in various languages on AA and importance of FDR screening, (3) standardizing screening recommendations with an automated prescriptive template in the endoscopy report, (4) educating providers and nurses, and (5) sharing quarterly compliance reports. The primary outcome was adherence to CRC screening recommendations for FDR of patients with AAs. Data were collected by chart review of the endoscopy report and post-procedure pathology follow up letters. Results: Prior to the intervention, only 7% (11 of 166) with AA received appropriate CRC screening recommendations for their FDR. On the pre-intervention survey (n=38), suboptimal adherence was due to low familiarity with guidelines (47%), variability in delivery of screening recommendations (5% in endoscopy report; 18% spoke to patient; 13% communicated to primary provider; 47% no recommendation), and limited time available to communicate recommendations and provide patient education. Development of an automated template to standardize recommendations was implemented on 12/2021, followed by improved monthly rates of adherence to recommendations, from a baseline of 7% to 50%, 56%, 74%, 77% and 80%, respectively (Figure). Conclusion: Earlier and more intensive screening of FDRs in those with AA is considered an untapped opportunity with the potential to substantially reduce the burden of CRC. This project utilizes stakeholder/patient education and automation of the process to improve compliance with the recommendations. Such novel workflows can play a key role in reducing the burden of CRC by targeting high-risk individuals for CRC screening.Figure 1.: Adherence rate of recommendations for colorectal cancer screening in first-degree relatives of patients with advanced adenomas

P70 Improving safety and efficiency of biologic and DMARD therapy prescribing through development of a multi-disciplinary virtual clinic

P70 Improving safety and efficiency of biologic and DMARD therapy prescribing through development of a multi-disciplinary virtual clinic

Clinicopathologic factors influencing the screening accuracy of oral cytology: A retrospective cohort study.

Cytology is a simple and non-invasive screening method for oral cancer. However, this method is not yet routinely used by clinicians because of its high false negative rate (FNR) and due to lack of sufficient studies examining the factors for high FNRs. The present retrospective study aimed to compare the screening performance of conventional cytology (CC) and liquid-based cytology (LBC) through histological validation, and to elucidate factors inducing false negative screening in oral cytology. Cytological specimens with histological examination and intraoral digital images of the lesion were retrospectively collected between January 2017 and December 2018 for CC and between October 2019 and September 2021 for LBC. Oral cytological screening was conducted based on the oral Bethesda system for oral cytology. Clinical subtypes were re-evaluated using intraoral digital images. The screening accuracy of oral cytology was calculated considering the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting the malignant transformation of oral lesions. No statistically significant difference was noted in the inadequate rate between CC and LBC groups. For CC and LBC, the sensitivities were 60.9 and 59.2%, the specificities were 87.3 and 79.1%, the PPVs were 85.8 and 76.2%, and the NPVs were 63.9 and 63.2%, respectively. Thus, the screening accuracy was similar between methodologies. Among the clinicopathological factors investigated, histological diagnosis and cellularity contributed to false negative results. Homogeneous findings of oral epithelial dysplasia and the superficial growth of carcinoma in situ/squamous cell carcinoma resulted in false negative findings for CC and LBC. Furthermore, LBC samples with a lower cell number (<2,000 squamous cells) exhibited statistically significantly increased FNRs. The present study found that the cytological methods did not affect the inadequate rate and screening accuracy, whereas clinical subtype and cellularity decreased screening accuracy. Therefore, cytological screening and subsequent follow-up should be performed while considering clinical findings and the cellularity of cytology smears.

Patient perspectives on barriers in obtaining timely abortion care in Los Angeles, California

ObjectivesAlthough California is a state with supportive abortion policies, recent evidence suggests people may still encounter barriers to obtaining timely abortion care. To provide an in-depth understanding of these barriers and augment existing literature focusing on restrictive and hostile states, we sought to understand the patient perspectives of barriers to timely abortion care in Los Angeles, California. Study designWe recruited participants from two, high-volume urban clinical sites and conducted semi-structured interviews with 17 individuals who visited three or more clinics and/or encountered more than 2 weeks between seeking and obtaining their abortion. Using thematic analysis, we analyzed deidentified transcripts by first developing and applying codes, then identifying overarching themes to describe barriers to timely abortion care. ResultsParticipants described three primary barriers leading to abortion care delay: (1) difficulties in ensuring insurance coverage or securing authorization for abortion care from private/employer-sponsored insurance, (2) inadequate screening resulting in multiple appointments where desired care could not be provided, and (3) difficulties with expeditious referrals to appropriate clinical sites. Participants also described accumulated fatigue from facing layers of resistance when pursuing avenues for care. ConclusionsEven in supportive abortion policy states, barriers to abortion care from insurance, screening, and referral-related issues may result in delayed or unaccessed care, negatively impacting patient experience. Understanding and mitigating reasons for delays are critical to improving patient experience with abortion care. ImplicationsStandardized telephone triage at local clinic facilities and streamlined MediCal authorization of abortion services may mitigate barriers to timely abortion care.

Understanding variation in oleic acid content of high-oleic virginia-type peanut

Contamination at the FAD2B locus due to inadequate screening protocols is the primary cause of sporadic, insufficient oleic acid content in Virginia-type peanut. The high oleic trait in peanut is conditioned by loss-of-function mutations in a pair of homeologous enzymes and is well known to improve the shelf life of peanut products. As such, the trait is given high priority in current and future cultivars by the North Carolina State University peanut breeding program. For unknown reasons, high oleic cultivars and breeding lines intermittently failed to meet self-imposed thresholds for oleic acid content in internal testing. To determine why, a manual seed chipper, crude DNA isolation protocol, genotyping assays for both mutations, and a web-based SNP calling application were developed. The primary cause was determined to be contamination with normal oleic seeds resulting from inadequate screening protocols. In order to correct the problem, a faster screening method was acquired to accommodate a higher oleic acid threshold. Additionally, results showed the mutation in one homeolog is fixed in the program, dig date had no significant effect on oleic acid content, and minor modifiers segregating within the program explained 6% of the variation in oleic acid content.

New Parent Support Needs and Experiences with Pediatric Care During the COVID-19 Pandemic.

ObjectivesDespite evidence for heightened psychiatric risk and unique parenting challenges during the COVID-19 pandemic, no research exists on the specific needs of parents of infants and responsiveness of pediatric care to their needs. We aimed to describe the support needs of new parents and explore their experiences with pediatric care.MethodsIn late 2020 we conducted semi-structured interviews with 30 mothers of babies born or due that year. Interviews addressed perinatal experiences during the pandemic, with an emphasis on experiences related to social support. In an iterative, inductive process, thematic analysis was used to analyze the data.ResultsThis study identifies a set of support needs specific to the context of parenting an infant during the COVID-19 crisis: coping with the compound psychological impacts of the postpartum period and a pandemic; parenting in the absence of expected social support; risk assessment to keep infant and family safe. This study finds that policies implemented by health care providers to reduce risk of COVID-19 transmission came at a cost to new parents and parent-provider relationships. Participants reported mixed experiences with in-person and telehealth pediatric care, including inadequate and/or uncomfortable postpartum mental health screening and breastfeeding support, and identified specific features that constituted responsive care during the pandemic.ConclusionsNormative changes associated with the postpartum period combined with complex adaptations necessitated by the COVID-19 pandemic presented substantial challenges for families with infants, even relatively privileged families. Providers can incorporate these findings to enhance support for families and promote maternal and child health.

Evaluation of the feasibility of screening for paediatric non-alcoholic fatty liver disease.

To evaluate the feasibility of screening for non-alcoholic fatty liver disease (NAFLD) in clinical practice and the acceptance of a screening strategy, and to identify factors that determine compliance. A screening protocol, based on alanine aminotransferase measurement and introduced to healthcare workers of Dutch outpatient obesity clinics in 2017, was evaluated. Medical files of children who visited the largest outpatient obesity clinic between 2017 and 2020 were evaluated. Focus group discussions (FGDs) were conducted with 14 healthcare workers who had been using the screening protocol. Screening for NAFLD was performed in 477/571 (84%) of the children. Loss of follow-up was the major reason for inadequate screening. Follow-up was performed in 81/134 children with an abnormal screening result (61%). The FGDs indicated 13 barriers for screening, regarding guideline- and knowledge-related issues. Screening for NAFLD was performed in the vast majority of the children. However, adherence to the guideline after an abnormal initial screening result needs to be improved. This can be achieved by improving the loss of follow-up of patients' and physicians' awareness of the relevance of mildly elevated ALT levels.

A hyperspectral dataset of precancerous lesions in gastric cancer and benchmarks for pathological diagnosis.

Gastric cancer (GC) is one of the most common cancers worldwide. A lot of studies have found that early GC has good prognosis. Unfortunately, the diagnosis rate of early GC is suboptimal due to inadequate disease screening and the insidious nature of early lesions. Pathological diagnosis is usually regarded as the "gold standard" for the diagnosis of GC. However, traditional pathological diagnosis is tedious and time-consuming. With the development of deep learning, computer-aided diagnosis is widely used to assist pathologists for diagnosis. As conventional pathology, diagnosis is based on color images, it is not as informative as hyperspectral imaging, which introduces spectroscopy into imaging techniques. This article combines microscopic hyperspectral image (HSI) with deep learning networks to assist in the diagnosis of precancerous lesions in gastric cancer (PLGC). A large scale microscopic hyperspectral PLGC dataset with 924 effective scenes is built and self-supervised learning is adopted to provide pretrained models for HSI. These pretrained models effectively improve the performance of downstream classification tasks. Furthermore, a symmetrically deep connected network is proposed to train with images from different imaging modalities and improve the diagnostic accuracy to 96.59%.

Norepinephrine promotes anoikis resistance in fallopian tube secretory cells through beta adrenergic receptor signaling (247)

<b>Objectives:</b> High-grade serous ovarian cancer (HGSOC) remains the most lethal gynecologic malignancy with a 5-year survival rate approaching 40%. Unfortunately, most women present at an advanced stage due to subtle symptomatology at disease onset and inadequate screening protocols. Thus, understanding the cellular events that lead to the development and malignant transformation of fallopian tube (FT) precursor cells into metastatic disease may lead to actionable targets to improve outcomes. Fallopian tube secretory epithelium is considered the cell of origin of HGSOC, where <i>TP53</i> and other genetic defects accrue to permit exfoliation and seeding of the ovary and peritoneum, leading to widespread metastasis. Follicular fluid bathes the fallopian tube monthly during the reproductive years and contains several factors contributing to carcinogenesis. Recently, neurotransmitters such as norepinephrine (NE) have been implicated in ovarian cancer growth and metastasis through multiple mechanisms and are also present within the follicular fluid. Thus, the objective of the current study was to evaluate the effects of NE on FT epithelial cell function under 3D conditions. <b>Methods:</b> FT cell lines (FT189, FT190, FT194, FT237, FT240, FT246, FT282), previously immortalized through several mechanisms, were plated into round bottom ultralow adhesion plates with 10µM NE or vehicle control (VHC), in the presence or absence of adrenergic antagonist propranolol (10µM). Spheroids were serially imaged over 24h. For FT237 and FT246, live/dead cell staining was performed using ReadyProbe cell viability assay, and apoptotic activity was assessed via annexin staining analyzed by flow cytometry. qPCR and western blotting were used to assess receptor expression. <b>Results:</b> All FT lines examined expressed <i>ADRB1</i> and <i>ADRB2</i> by both western blot and qPCR. Treatment with NE resulted in significant compaction of spheroid formation by 33% (+/- 5%, p <0.001) at 24h compared to VHC. This response was completely abrogated by preexposure to propranolol (p <0.05). NE nor propranolol had a significant impact on cell viability under immunofluorescence. However, annexin staining revealed a significant 5% increase in cell survival with a concomitant decrease in early and late apoptotic cell populations exposed to NE in 3D culture (p<0.05), compared to VHC. FT exposure to NE resulted in significantly increased expression of EMT genes, <i>SNAI1</i> and <i>SNAI2</i>, which was completely reversed by pretreatment with propranolol (p<0.05). <b>Conclusions:</b> Taken together, these findings demonstrate that NE exposure promotes FT cell spheroid formation and EMT gene transcription through activation of ADRB-mediated signaling. Thus, NE may potentiate metastasis of early ovarian cancer precursor lesions through stimulation of EMT genes and enhancing anoikis resistance, two factors that are critical to the coelomic spread of ovarian cancer. Future studies examining NE-induced carcinogenesis in FT cells are warranted.

The Effectiveness of Pre-Operative Screening Tests in Determining Viral Infections in Patients Undergoing Oral and Maxillofacial Surgery.

We analyzed the rate of patients with hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV) infection diagnosed by pre-operative screening and estimated its cost. We retrospectively analyzed patients who underwent elective surgery at our maxillofacial surgery department between April 2014 and March 2022. We compared the number of patients with each infection identified by pre-operative screening and a pre-operative questionnaire. We also compared the prevalence of infections with varying age, sex, and oral diseases, and calculated the cost of screening per positive result. The prevalence of HBV, HCV, and HIV was 0.39% (62/15,842), 0.76% (153/15,839), and 0.07% (10/12,745), respectively. The self-reported rates were as follows: HBV, 63.4% (26/41); HCV, 50.4% (62/123); HIV, 87.5% (7/8). Differences in sex were statistically significant for all infectious diseases; age significantly affected HBV and HCV rates. There was no association between the odds ratio of oral disease and viral infections. The cost per positive result was $1873.8, $905.8, and $11,895.3 for HBV, HCV, and HIV, respectively. Although self-assessment using questionnaires is partially effective, it has inadequate screening accuracy. Formulating an auxiliary diagnosis of infectious diseases with oral diseases was challenging. The cost determined was useful for hepatitis, but not HIV.

Perceived safety of MRI units in the two public hospitals within the central region of South Africa: A pilot study among four MR staff.

Magnetic resonance scanners are considered safe but comes with substantive safety risks to patients seeking radiological diagnostics and health care professionals. This pilot study aimed to assess the safety compliance of MRI units commonly used in the clinical diagnostic imaging of two public hospitals in South Africa. Structured interviews were conducted with four MRI staff assigned to work in the 1.5 and 3.0 T MRI units. Their responses were benchmarked with ACR MR Safety guideline of 2019 to assess any safety compliance deviations. Thematic analysis was conducted by evaluating responses per themes and further expanding on comments provided on Yes or No options. There were few major shortfalls identified that include outdated safety policies, inadequate screening, nonexistence of demarcations and lack of training of MR and non-MR personnel of MRI safety. These challenges could be eliminated by introducing a comprehensive occupational health and safety program, specific to the MRI units.

A Review of Treatments and Clinical Guidelines for Perinatal Depression.

Perinatal depression occurs in approximately 1 in 7 women and is considered the most common complication of pregnancy and childbearing. Management of perinatal depression may include a combination of nonpharmacological and pharmacological therapies depending on the severity of symptoms, the stage of gestation, and maternal preference. Healthcare providers are recommended to review current guidelines and provide information to women during pregnancy and postpartum regarding the risks and benefits of nonpharmacological and pharmacological treatment options for perinatal depression. In addition, healthcare providers should consider common barriers to treatment including inadequate screening and social stigma. This article reviews common treatments of perinatal depression as well as the clinical guidelines provided by the American Association of Obstetricians and Gynecologists (ACOG), the American Psychiatric Association (APA), and the US Preventive Services Task Force (USPSTF). Discussion of nonpharmacological therapies includes cognitive behavioral therapy (CBT) and interpersonal therapy (IPT). Pharmacological treatments are reviewed by drug class and include selective serotonin reuptake inhibitors (SSRIs), serotonin/norepinephrine reuptake inhibitors (SNRIs), norepinephrine/dopamine reuptake inhibitors (NDRIs), and tricyclic antidepressants (TCAs). Adjunctive treatments of severe depression, including second-generation antipsychotics (SGAs), are also discussed.

Introduction of a Protocol for Structured Follow-Up and Texting of Inadequate and Borderline-Positive Newborn Metabolic Screening Results.

A national protocol for structured follow-up and texting of repeat newborn bloodspot screening (NBS) sample requests was introduced. Repeat samples are needed where the initial sample is inadequate or the result borderline-positive. This protocol aimed to improve the timeliness and completeness of receipt of repeat NBS samples. Under the structured protocol, all repeat sample requests were phoned or texted to the lead maternity carer (LMC), in addition to the standard written report issued. Weekly text reminders were sent until 4 weeks or the sample was received. National data were monitored following implementation of the protocol. The proportion of repeat samples received within 10 days of request improved after the introduction of the protocol, from 35.0% in 2013 to 81.4% in 2020 (p < 0.001). The proportion of requests lost to follow-up decreased, from 4.1% in 2013 to 1.3% in 2020 (p < 0.001). A structured NBS follow-up protocol that included SMS text messaging led to an earlier and more complete receipt of repeat samples. This is likely due to practitioners receiving the request more quickly, as well as the laboratory adopting a consistent approach to repeated reminders. SMS text messages are a useful adjunctive method for screening programmes to communicate with health care providers.

Cancer cervix: Epidemiology and disease burden.

Cervical cancer remains a major public health problem, ranking as the fourth most common cause of cancer incidence and mortality in women worldwide. Wide variations in cervical cancer incidence and mortality were observed with highest incidence rates in Sub Saharan Africa and with 85% of deaths occurring in developing regions of the world. Non-existent or inadequate screening in public health care settings and limited access to the standard treatment options explains the large geographic variation in cervical cancer rates. Persistent infection with high-risk Human papillomavirus (HPV) types is the major risk factor for cervical cancer. High parity, long-term use of oral contraceptive pills, tobacco consumption, co-infection with other sexually transmitted agents, lifestyle factors such as multiple sexual partners, younger age at first sexual intercourse, immunosuppression, and diet have been identified as the co-factors most likely to influence the risk of acquisition of HPV infection and its further progress to cervical carcinogenesis. Differential screening rates and changes in epidemiological patterns have contributed to decreasing trends in cervical cancer in some developed regions of the world. Lower rates were also observed in North Africa and the Middle East, which may be attributed to cultural norms and conservative sexual behaviors. Across world regions, HPV prevalence was highest in women younger than 35 years of age, declining to a plateau in middle age and showed significant association between national age standardized incidence rates and corresponding estimates of HPV prevalence. The five most common HPV types in HPV-positive women worldwide were HPV16, HPV18, HPV31, HPV58, and HPV52, representing 50% of all HPV infections with HPV-16 and HPV-18 infections accounting for about 70% of the total infection burden. Tracking changing trends in the cervical cancer epidemiological patterns including HPV genotypes will immensely contribute toward effective prevention and control measures for cervical cancer elimination.