Preferred Screening Research Articles

The US Residency Selection Process After the United States Medical Licensing Examination Step 1 Pass/Fail Change: Overview for Applicants and Educators.

The United States Medical Licensing Examination (USMLE) Step 1, arguably the most significant assessment in the USMLE examination series, changed from a 3-digit score to a pass/fail outcome in January 2022. Given the rapidly evolving body of literature on this subject, this paper aims to provide a comprehensive review of the historical context and impact of this change on various stakeholders involved in residency selection. For this, relevant keyword-based searches were performed in PubMed, Google Scholar, and Scopus to identify relevant literature. Given the unique history of USMLE Step 1 in the US residency selection process and the score's correlation with future performance in board-certifying examinations in different specialties, this scoring change is predicted to significantly impact US Doctor of Medicine students, US Doctor of Osteopathic Medicine students, international medical graduates, and residency program directors, among others. The significance and the rationale of the pass/fail change along with the implications for both residency applicants and educators are also summarized in this paper. Although medical programs, academic institutions, and residency organizing bodies across the United States have swiftly stepped up to ensure a seamless transition and have attempted to ensure equity for all, the conversion process carries considerable uncertainty for residency applicants. For educators, the increasing number of applications conflicts with holistic application screening, leading to the expected greater use of objective measures, with USMLE Step 2 Clinical Knowledge likely becoming the preferred screening tool in lieu of Step 1.

Abstract B031: Preferences for social risk factor screening among breast and prostate cancer survivors in the Washington DC region: A qualitative study

Abstract Despite improvements in cancer outcomes over time, significant disparities remain between Black and White cancer survivors. Medical care is estimated to account for 10-20% of health outcomes, while other modifiable factors explain as much as 80-90% of outcomes. These disparities may thus be driven by multiple factors including social determinants of health, differences in treatment or follow up, or attitudes and behaviors of care teams. As part of a larger project, we conducted a qualitative study to understand cancer survivor preferences for and experiences with social needs screening and referrals. The results of this assessment will inform the delivery of social risk screening for breast and prostate cancer survivors in the multi-site study. Semi-structured interviews were conducted in English between March and April 2022 with breast and prostate cancer survivors from two cancer institutes in Washington DC. Patients were purposively recruited to ensure diversity in age, race, and cancer stage (I-III). Each interview lasted 60 minutes. Transcripts were reviewed for consensus and preferences for social needs screening. Thirteen survivors participated in the interviews. Participants were mostly breast cancer survivors (n=10), African American (n=6), were equal in stages I and II at time of diagnosis (n=5), and ranged in age from 34 to 81 with a median age of 64. Most patients (n=7) did not report social needs screening during their treatment, though all patients welcomed having these conversations with their care team. The majority of patients (n=9) desired face-to-face conversations as opposed to on paper (n=1) or through the patient portal (n=1). Similarly, most patients (n=7) did not mind who on their care team held the conversations. There was difference in opinion on how often social needs should be discussed, with four participants suggesting every appointment to another patient suggesting once at diagnosis. When asked about the needs patients experienced during treatment, food insecurity and nutrition were most cited (n=6), followed by transportation (n=4) and emotional resources (n=4). Only one patient reported not desiring social needs referrals during treatment. Other avenues for seeking out social resources included self-initiated research online or through books (n=2), and another patient described utilizing their local church (n=1). Finally, patients also spoke about challenges in receiving treatment and transitioning to survivorship due to the COVID-19 pandemic, including hospital staff turnover and care team inconsistency (n=1), bringing loved ones to appointments (n=1), and transportation challenges for individuals who relied on public transport to and from the clinic (n=1). This research reveals important insight to the perspective on social needs screening among a group of breast and prostate cancer survivors in the Washington DC region and highlights the ways in which patients have experienced and desire screening for social needs. In future work we will expand the number of interviews and apply these findings into practice. Citation Format: Laura C. Schubel, Mandi L. Pratt-Chapman, Teletia Taylor, Robin A. Littlejohn, Andrea J. Lopez, Judith Lee Smith, Susan Sabatino, Arica White, Joseph Astorino, Bryan O. Buckley, Christopher King, Hannah Arem. Preferences for social risk factor screening among breast and prostate cancer survivors in the Washington DC region: A qualitative study [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B031.

Proof-of-Concept Study of a 3-D Ultrasound Scanner Used for Ankle Joint Assessment.

Joint arthropathies often require continuous monitoring of the joint condition, typically performed using magnetic resonance (MR) or ultrasound (US) imaging. US imaging is often the preferred screening or diagnostic tool as it is fast and inexpensive. However, conventional 2-D US has limited capability to compare imaging results between examinations because of its operator dependence and challenges related to repeat imaging in the same location and orientation. Comparison between several imaging sessions is crucial to assess the interval progression of joint conditions. We propose a novel 3-D US scanner for ankle joint assessment that can partially overcome these issues by enabling 3-D imaging. Here, we (i) present the design of the 3-D US ankle scanner system, (ii) validate the geometric reconstruction accuracy of the system, (iii) provide preliminary images of healthy volunteer ankles and (iv) compare 3-D US imaging results with MR imaging. The 3-D ankle scanner consists of a tub filled with water, a linear US probe attached to the wall of the tub and a motorized unit that rotates the US probe 360° around the center of the tub. As the probe rotates, a 3-D US image is formed of the ankle of the patient positioned in the middle of the tub. US probe height, angle and distance from the tub center can be adjusted. The reconstruction accuracy of the system was validated in each of the coordinate directions at different probe angles using two test phantoms. A phantom consisting of numerous Ø200-µm nylon threads with known spacing and a metal rod with machined grooves was used for validation in the horizontal and vertical directions, respectively. The volumetric reconstruction accuracy validation was performed by imaging an agar phantom with two embedded spheres of known volumes and comparing the segmented sphere volume and surface area with the expected. Three-dimensional US and MR images of both ankles of five healthy volunteers were acquired. Distal tibia and proximal talus were segmented in both imaging modalities and the surfaces of these segmentations were compared using the 95% Hausdorff and mean surface distances. The observed mean linear measurement error in all the coordinate directions and over several probe angles was 2.98%. The mean measured volumetric measurement error was 3.45%. The volunteer study revealed useful features for joint assessment present in the 3-D ankle scanner images, such as joint spacing, distal tibia and proximal talus. The mean 95% Hausdorff and mean surface distances between segmentations in 3-D US and MR images were 5.68 ± 0.83 and 2.01 ± 0.30 mm, respectively. In this proof-of-concept study, the 3-D US ankle scanner enabled visualization of the ankle joint features that are useful for joint assessment.

Culturally targeted message framing and colorectal cancer screening preferences among African Americans.

The current study investigated whether culturally targeted message frames alter preferences for specific colorectal cancer (CRC) screening modalities among African Americans. African Americans who were eligible for CRC screening (N = 457) viewed a video about CRC risks, prevention, and recommended screening options. Participants then received a gain or loss-framed message about screening, with half of participants viewing an additional culturally targeted message about overcoming disparities in CRC through screening. Participants reported their desired thoroughness in CRC screening and preferences for being screened using colonoscopy, sigmoidoscopy, or stool-based fecal immunochemical testing. Relative to gain-framing, loss-framed messaging enhanced desired thoroughness in CRC screening. Targeted loss-framing enhanced preferences for colonoscopy and decreased preferences for stool-based FIT screening. Findings demonstrate that message framing and culturally targeted messaging can impact CRC screening preferences. Altering preferences may carry implications for reducing CRC screening disparities among African Americans. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Development of a Cystic Fibrosis Primary Palliative Care Intervention: Qualitative Analysis of Patient and Family Caregiver Preferences

To prevent or mitigate chronic illness burden, people with cystic fibrosis (pwCF) and their family caregivers need primary (generalist-level) palliative care from the time of diagnosis forward. We used qualitative methods to explore their preferences about a screening-and-triage model ("Improving Life with CF") developed to standardize this care. We purposively sampled and interviewed 14 pwCF and caregivers from 5 Improving Life with CF study sites. Thematic analysis was guided by a priori codes using the National Consensus Project's Guidelines for Quality Palliative Care. Participants included 7 adults and 2 adolescents with CF (3 with advanced disease), 4 parents, 1 partner (7 women; 5 people of color). Few were familiar with palliative care. Illness burden was described in multiple domains, including physical (e.g., dyspnea, pain), psychological (e.g., anxiety), and social (e.g., family well-being; impact on work/school). Most preferred survey-based screening with care coordination by the CF team. Preferences for screening approaches varied. PwCF and caregivers experience illness burden and are receptive to a CF-team delivered primary palliative care screening-and-triage model with flexible processes.

DIFFERENCES IN COMMUNITY AND PROVIDER STAKEHOLDERS' PERCEPTIONS ON BRAIN HEALTH SERVICE GAPS AND SCREENING NEEDS

Abstract Introduction Alzheimer's Disease and Related Dementias (ADRD) management and prevention is a priority for providers and community members. Aligning perceptions regarding resources and screening supports person-centered care while addressing the increased dementia burden attributed to systemic inequity and health disparities. This project aimed to identify needs in lower-income diverse populations.Research Question: What are the differences in perceived service gaps and screening preferences for brain health and ADRD? Methods A convenience sample of 15 providers and 20 community stakeholders (55+) completed a 2021 survey about Richmond's service gaps and screening needs for brain health and ADRD. Results 40% of providers were ADRD focused, 65% of community members reported a memory concern. Overall, providers reported fewer service gaps: Administration on Aging Service Gaps 46.7%/75%, Caregiving gaps 80%/85%, Specialty Health gaps: 53.3%/80%. Clinical ADRD gaps 73.3%/80%, Memory Case Management gaps 86.7%/90%, Memory Social Services gaps 33.3%/90%, Memory Screening gaps 53.3%/85%. Provider and Community stakeholders were more aligned regarding screenings that should be included in a brain health/ADRD management program: Advance Care Planning screening: 80%/80%, Caregiving Status screening: 93.3%/90%, Memory Loss screening: Lifestyle Risk screening: 100%/95%, Cognitive-Comorbidity Risks screening: 100%/75%, Psychosocial Risks screening:100%/100%, Depression screening 100%/100%, Clinical Health screening 73.3%/90%, Substance Use Disorder screening 86%/75%, Sleep Problem screening 93%/75% Conclusion Although there were areas in which both providers and community members aligned, results show that providers underestimate brain health/ADRD service gaps experienced by the community. Both groups are amenable to comprehensive screening for services. However, providers are interested in more expansive ADRD screeners.

In-Plate Chemical Synthesis of Isopeptide-Linked SUMOylated Peptide Fluorescence Polarization Reagents for High-Throughput Screening of SENP Preferences.

Small ubiquitin-like modifiers (SUMOs) are conjugated to protein substrates in cells to regulate their function. The attachment of SUMO family members SUMO1-3 to substrate proteins is reversed by specific isopeptidases called SENPs (sentrin-specific protease). Whereas SENPs are SUMO-isoform or linkage type specific, comprehensive analysis is missing. Furthermore, the underlying mechanism of SENP linkage specificity remains unclear. We present a high-throughput synthesis of 83 isopeptide-linked SUMO-based fluorescence polarization reagents to study enzyme preferences. The assay reagents were synthesized via a native chemical ligation-desulfurization protocol between 11-mer peptides containing a γ-thiolysine and a SUMO3 thioester. Subsequently, five recombinantly expressed SENPs were screened using these assay reagents to reveal their deconjugation activity and substrate preferences. In general, we observed that SENP1 is the most active and nonselective SENP while SENP6 and SENP7 show the least activity. Furthermore, SENPs differentially process peptides derived from SUMO1-3, who form a minimalistic representation of diSUMO chains. To validate our findings, five distinct isopeptide-linked diSUMO chains were chemically synthesized and proteolysis was monitored using a gel-based read-out.

High-risk HPV testing vs liquid-based cytology for cervical cancer screening among 25- to 30-year-old women: A historical cohort study.

High-risk human papilloma virus (hrHPV) DNA testing is more sensitive than cytology screening, achieving greater protection against cervical cancer. Controversy exists regarding the preferred screening method for women 25-30 years of age. At this age, infection with HPV is common and usually transient. Consequently, hrHPV screening in this age group is fraught with high false-positive screening results, leading to more colposcopies and unnecessary treatments with the potential for harm. In the present study, we aimed to compare the results of two screening methods in relation to high-grade cervical intraepithelial lesion detection rate in the young age group of 25-30 years. Retrospective information on cervical cytology, hrHPV testing, colposcopy referrals and histologic results, from one screening round, were retrieved from the Maccabi HealthCare Health Maintenance Organization centralized database during the study period from March 1, 2017 to April 1, 2019 for 25- to 30-year-old women. Screening with hrHPV testing for types 16, 18 and 12 other hrHPV types was compared with the conventional PAP liquid-based cytology (LBC) test. Odds ratio (OR) of detection with 95% confidence interval (CI) was calculated for cervical intraepithelial neoplasia (CIN) grade 3 or higher (CIN 3+). During the study period, 42 244 women 25-30 years old underwent cervical cancer screening; of them, 20 997 were screened with LBC between March 1, 2017 and March 1, 2018 and compared with 21 247 who were screened with hrHPV between April 1, 2018 and April 1, 2019. Testing for hrHPV resulted in a higher colposcopy referral rate compared with primary LBC screening: 9.8% vs 7.8%, respectively; (OR 1.28; 95% CI 1.2-1.37; p< 0.001). Screening with hrHPV led to significantly higher detection of CIN 3+ lesions (OR 1.4; 95% CI 1.2-1.6; p< 0.001) compared with LBC. HPV infections with non-16/18 hrHPV (other hrHPV) were the most prevalent (84.8%). In women 25-30 years old, primary hrHPV screening was associated with a higher detection rate of CIN 3+ compared with cytology screening and should be considered for primary screening in this age group.

Effect of a Patient Decision Aid on Preferences for Colorectal Cancer Screening Among Older Adults

Guidelines recommend individualized decision-making for colorectal cancer (CRC) screening among adults aged 76 to 84 years, a process that includes a consideration of health state and patient preference. To determine whether a targeted patient decision aid would align older adults' screening preference with their potential to benefit from CRC screening. This is a prespecified secondary analysis from a randomized clinical trial. Participants aged 70 to 84 years who were not up to date with screening and had an appointment within 6 weeks were purposively sampled by health state (poor, intermediate, or good) at 14 community-based primary care practices and block randomized to receive the intervention or control. Patients were recruited from March 1, 2012, to February 28, 2015, and these secondary analyses were performed from January 15 to March 1, 2022. Patient decision aid targeted to age and sex. The primary outcome of this analysis was patient preference for CRC screening. The a priori hypothesis was that the decision aid (intervention) group would reduce the proportion preferring screening among those in poor and intermediate health compared with the control group. Among the 424 participants, the mean (SD) age was 76.8 (4.2) years; 248 (58.5%) of participants were women; and 333 (78.5%) were White. The proportion preferring screening in the intervention group was less than in the control group for those in the intermediate health state (34 of 76 [44.7%] vs 40 of 73 [54.8%]; absolute difference, -10.1% [95% CI, -26.0% to 5.9%]) and in the poor health state (24 of 62 [38.7%] vs 33 of 61 [54.1%]; absolute difference, -15.4% [95% CI, -32.8% to 2.0%]). These differences were not statistically significant. The proportion of those in good health who preferred screening was similar between the intervention and control groups (44 of 74 [59.5%] for intervention vs 46 of 75 [61.3%] for control; absolute difference, -1.9% [95% CI, -17.6% to 13.8%]). The findings of this secondary analysis of a clinical trial did not demonstrate statistically significant differences in patient preferences between the health groups. Additional studies that are appropriately powered are needed to determine the effect of the decision aid on the preferences of older patients for CRC screening by health state. ClinicalTrials.gov Identifier: NCT01575990.

The preference of women living with HIV for the HPV self-sampling of urine at a rural HIV clinic in Uganda.

Women living with HIV have a double risk of acquiring cervical cancer (CC) due to repeated human papilloma virus (HPV) infections resulting from reduced immunity, with CC screening being low at 46.7%. To determine the factors associated with the preference for HPV self-sampling using urine as well as establish its feasibility among women living with HIV attending a rural HIV clinic in Uganda. A cross-sectional study design using quantitative data collection methods was used at the HIV clinic, Luweero District Hospital, among 426 women aged between 30 and 65 years. Data were analysed using descriptive statistics and modified Poisson regression. Urine samples were analysed using a Liferiver high-risk HPV genotyping real-time polymerase chain reaction (PCR) kit to determine the prevalence of the 15 HPV subtypes. Cervical intraepithelial neoplasia 2 (CIN2) was determined by visual inspection under acetic acid (VIA) using the nurse-led approach. Most women (296/426, 70%) preferred nurse-led screening. Preference for HPV self-sampling using urine was associated with older age (46-65 years) (adjusted prevalence risk ratios [aPRR] 1.59; 95% confidence interval [CI]: 1.13-2.24), history of sexually transmitted infections (aPRR 0.74: 95% CI: 0.55-0.98) and acquisition of CC information from the television (aPRR 1.48: 95% CI: 1.09-2.02). Approximately 97% (68/70) of women living with HIV tested HPV positive with one or more subtypes. The most prevalent subtype of HPV was HPV 58 (87.1%). Only one woman tested positive with VIA. Nurse-led CC screening is preferred among women living with HIV, and HPV self-sampling using urine is feasible at the HIV clinic. Therefore, educational programmes to reassure the masses about urine HPV self-sampling need to be designed. This study's findings provide early insights into the merits and demerits of the current HPV sample collection approaches. Hence, HPV testing should be tailored to routine HIV care in rural communities.

Clinician practices, knowledge, and attitudes regarding primary human papillomavirus testing for cervical cancer screening: A mixed-methods study in Indiana

Primary human papillomavirus (HPV) testing, in which a high-risk HPV test is administered without cytology, was first included in 2018 US cervical cancer screening guidelines. Subsequent guidelines endorsed primary HPV testing as the preferred method for cervical cancer screening following evidence of its clinical and economic benefits, although many sources still indicate it as an option along with cytology and HPV/Pap co-testing. Primary HPV testing could be key to improving the declining cervical cancer screening rates in the US; however its adoption has been slow as clinicians are hesitant to make the change. Indiana ranks in the top ten states for cervical cancer mortality, with marked race-ethnic disparities in cervical cancer screening and low HPV vaccination rates. To examine clinician practices, knowledge, and attitudes regarding primary HPV testing, in 2021 we conducted an online cross-sectional survey (n = 224) and in-depth interviews (n = 20) with Indiana clinicians practicing cervical cancer screening. Only 3 % reported using primary HPV testing for eligible patients, and only 50 % were willing to adopt it as the preferred cervical cancer screening method for the recommended patient group. In a multivariable logistic regression model, knowledge of the effectiveness (aOR 2.58 [1.41–4.72]) and perceived benefit (aOR 7.35 [3.65–14.81]) of primary HPV testing predicted willingness to adopt. In-depth interviews revealed knowledge gaps, uncertainty, and perceived limitations of this method as the reasons for limited uptake of primary HPV testing. Targeted messages about the benefits and effectiveness may enhance clinician knowledge, acceptance, and adoption.

Economic evaluation of COVID-19 rapid antigen screening programs in the workplace

BackgroundDiagnostic testing has been pivotal in detecting SARS-CoV-2 infections and reducing transmission through the isolation of positive cases. We quantified the value of implementing frequent, rapid antigen (RA) testing in the workplace to identify screening programs that are cost-effective.MethodsTo project the number of cases, hospitalizations, and deaths under alternative screening programs, we adapted an agent-based model of COVID-19 transmission and parameterized it with the demographics of Ontario, Canada, incorporating vaccination and waning of immunity. Taking into account healthcare costs and productivity losses associated with each program, we calculated the incremental cost-effectiveness ratio (ICER) with quality-adjusted life year (QALY) as the measure of effect. Considering RT-PCR testing of only severe cases as the baseline scenario, we estimated the incremental net monetary benefits (iNMB) of the screening programs with varying durations and initiation times, as well as different booster coverages of working adults.ResultsAssuming a willingness-to-pay threshold of CDN$30,000 per QALY loss averted, twice weekly workplace screening was cost-effective only if the program started early during a surge. In most scenarios, the iNMB of RA screening without a confirmatory RT-PCR or RA test was comparable or higher than the iNMB for programs with a confirmatory test for RA-positive cases. When the program started early with a duration of at least 16 weeks and no confirmatory testing, the iNMB exceeded CDN$1.1 million per 100,000 population. Increasing booster coverage of working adults improved the iNMB of RA screening.ConclusionsOur findings indicate that frequent RA testing starting very early in a surge, without a confirmatory test, is a preferred screening program for the detection of asymptomatic infections in workplaces.

Colorectal Cancer Screening Prevalence, Perceived Barriers, and Preference for Screening Colonoscopy Among Hospitalized Women.

A prospective intervention study among 510 hospitalized women, who are cancer-free (except for skin cancer) at enrollment, aged between 50 and 75 years was conducted at an academic center. Socio-demographic, family history, and medical comorbidities data were collected for all patients. A post-hospitalization follow-up survey determined the effect of inpatient intervention on colorectal cancer screening adherence. Unpaired t-test and chi-square tests were used to compare characteristics, perspectives, and preferences for screening among adherent and non-adherent groups. Mean age was 60.5 years, 45% reported an annual household income of <$20 000, 36% of women were African American, 27% of women were overdue for colorectal cancer screening, and 33% never had a screening colonoscopy. The most frequently reported barriers to colorectal cancer screening were "I have other problems more important than getting a colonoscopy," "No transportation to get to the test," and "Not counseled by primary care provider." Sixty-six percent of the non-adherent women would agree to have an inpatient screening colonoscopy if offered. A significant number of hospitalized women are non-adherent to colorectal cancer screening, while the educational intervention was partially successful in enhancing colorectal cancer screening, most hospitalized women remained non-adherent after hospitalization. A majority of these women were amenable to inpatient screening colonoscopy if offered during a hospital stay.

Supplemental Material for Culturally Targeted Message Framing and Colorectal Cancer Screening Preferences Among African Americans

Supplemental Material for Culturally Targeted Message Framing and Colorectal Cancer Screening Preferences Among African Americans

Print or Electronic: Preferences of the New Generation of Medical and Dentistry Students

Objectives: To assess the preference for print or electronic media among undergraduate students of medical and dental colleges of Karachi and to compare the students of public versus private medical and dental colleges according to the study methods they prioritize Methodology: A cross-sectional survey was conducted over a period of more than a year. At the confidence level of 95% and bound on error of 5%, a minimum sample size of 384 was calculated and sample size of 477 was finalized after allowing for a non-response rate of 24%. The convenience sampling technique was employed to select medical students. Data was collected using a structured, self- administered questionnaire in English language after a written Informed Consent was obtained from each participant. Data was analysed using SPSS version 20. The quantitative variables were represented as mean and standard deviation. The qualitative variables were represented as frequencies and percentages. Chi-square test of significance was applied for finding any significant differences. P-value of less than 0.05 was taken as significant. Result: The mean age of n=477 students was 21+/- 2 years. Majority were MBBS students, with 53% from public institutes. We found that 52% students preferred print medium, whereas 26% students preferred screens. There was an association between public sector colleges and preferring print medium (p= 0.0001). A significant association was found between gender and method of study (p=0.0001). Age was associated with preference for print medium (p=0.02), also higher level of study was associated with preferring print medium (p=0.001). Most students prioritized books (71%) but retained better with videos (63%). Most students (56%) preferred textbooks over reference books. Dr. Najeeb's videos were the most preferred videos (75%), furthermore, the most used site was Wikipedia (48%). Internet was the top source for preparing for PBLs (50%). Conclusion: The study showed that majority students still prefer print medium and prioritize books over other methods. Students claimed that they retain best with videos and books. So, increasing the use of videos for teaching is recommended. The Pandemic has necessitated the increased use of online teaching modalities. Students should be encouraged to use more reliable websites.

Nutritional Value of New Sweet Pepper Genotypes Grown in Organic System

The market request for organic vegetables has grown recently for their positive impact on healthy diets. Consumers have progressively shown preferences for various combinations of color, size, and shape of pepper fruits. Facilitating communication, collaboration, and participation in the selection of cultivars with superior performance, flavor, texture, and culinary attributes can represent a key tool in breeding for nutritional and culinary traits. The current research started from the premise that organic production involves achieving adequate nutritional and culinary quality of pepper fruits. The study was conducted to investigate traits related culinary quality of pepper genotypes, especially in the ripening phase of fruits, to select the best resources with a high antioxidant content for breeding programs. The biological material represented by nine genotypes of sweet pepper was cultivated in the open fields during 2019 and 2020 at the experimental stations of the Vegetable Research Development Station of Bacau and of Iasi University of Life Sciences. Agricultural practices and intensive breeding focused on yield and stress tolerance have indirectly led to a reduction in the nutrition and flavor of the produce. Complex approaches, including screening of consumer preferences, phenotyping, and use of modern genomics and analytical chemistry tools in breeding, together with participatory farmer-breeder-chef-consumer collaborations, can represent a strategy to facilitate the development of the next generation of crops aimed to meet the growing demands of safe and nutritionally vegetables featured by culinary standards as good flavor, color, and texture.

Women's Perspectives on a Reproductive Health Services Screening Question: An Alternative to Pregnancy Intention Screening.

Current efforts to integrate reproductive health care into primary care in the United States involve assessing pregnancy intentions and reproductive goals, which are often not meaningful or attainable for some. Alternatively, we designed a reproductive health services-based screening question: "Can I help you with any reproductive health services today, such as preventing pregnancy or planning a healthy pregnancy?" In this study, we describe women's interpretations of this question as part of a larger study, exploring perspectives on reproductive health care quality in primary care. We utilized a third-party research firm to recruit New York women of reproductive age (18-45), who visited a primary care provider in the past year. We conducted five focus groups and eight interviews (N = 30). Semistructured guides queried participants on interpretations of the screening question and preferences for raising reproductive health concerns during a primary care visit. We employed inductive thematic analysis. Participants interpreted the question as offering contraception or pregnancy counseling and care, although younger participants also understood it as offering sexual and reproductive health services broadly. Participants also connected the question with discussions about their ability to conceive. Some participants described experiences with provider assumptions and implicit bias. Tensions emerged around accepting primary care as a setting for reproductive health due to a perceived lack of specialized training. Participants interpreted the screening question as intended, indicating face validity. Primary care settings should increase patients' awareness of reproductive health service availability, such as by routinely introducing a services-based screening question.

Iodine-123 β-methyl-P-iodophenyl-pentadecanoic Acid (123I-BMIPP) Myocardial Scintigraphy for Breast Cancer Patients and Possible Early Signs of Cancer-Therapeutics-Related Cardiac Dysfunction (CTRCD).

(1) Background: The mortality of breast cancer has decreased due to the advancement of cancer therapies. However, more patients are suffering from cancer-therapeutics-related cardiac dysfunction (CTRCD). Diagnostic and treatment guidelines for CTRCD have not been fully established yet. Ultrasound cardiogram (UCG) is the gold standard for diagnosis of CTRCD, but many breast cancer patients cannot undergo UCG due to the surgery wounds or anatomical reasons. The purpose of the study is to evaluate the usefulness of myocardial scintigraphy using Iodine-123 β-methyl-P-iodophenyl-pentadecanoic acid (123I-BMIPP) in comparison with UCG. (2) Methods: 100 breast cancer patients who received chemotherapy within 3 years underwent Thallium (201Tl) and 23I-BMIPP myocardial perfusion and metabolism scintigraphy. The images were visually evaluated by doctors and radiological technologists, and the grade of uptake reduction was scored by Heart Risk View-S software (Nihon Medi-Physics). The scores were deployed in a 17-segment model of the heart. The distribution of the scores were analyzed. (3) Results: Nine patients (9%) could not undergo UCG. No correlation was found between left ventricular ejection fraction (LVEF) and Heart Risk View-S scores of 201Tl myocardial perfusion scintigraphy nor those of BMIPP myocardial metabolism scintigraphy. In a 17-segment model of the heart, the scores of the middle rings were higher than for the basal ring. (4) Conclusions: Evaluation by UCG is not possible for some patients. Myocardial scintigraphy cannot serve as a perfect alternative to UCG. However, it will become the preferable second-choice screening test, as it could point out the early stage of CTRCD.

Optimized hyperbolic tangent function-based contrast-enhanced mammograms for breast mass detection

Breast cancer is a grave concern among women due to its high mortality rate in women as compared to that in men. Mass, an early symptom of breast cancer, is difficult to detect due to its subtle nature. Mammography, an effective and most preferred screening technique, generally uses low-contrast images where identification of some of the mass lesions from surrounding normal tissues is a difficult task even for skilled radiologists. Therefore, to alleviate the issue, this paper introduces an effective computer-aided detection scheme based on a novel contrast enhancement scheme for mammograms to automate the localization procedure of mass cases. Hyperbolic tangent function, a simple yet effective method, is introduced as an enhancement transfer function whose adjustable parameter is optimized by the Tunicate swarm algorithm, a nature-inspired optimization algorithm, via fitness function. To minimize the false positives generated after the detection, the median robust extended local binary pattern, a texture-based descriptor, is introduced, which possesses the ability to capture both micro- and macro-structure information from an image patch. The analysis includes four classifiers: Fisher linear discriminant analysis, K-nearest neighbor, support vector machine, and an ensemble classifier in the feature-based classification for false positive reduction (FPR). The proposed approach of automatic detection of masses when verified using two standard databases, mini-MIAS and Digital Database for Screening Mammography, comprised 68 and 550 mammograms, respectively, achieved sensitivities of 95.3% and 94.1% with 0.36 and 0.40 false positives per image after false positive reduction.

Harnessing academic-community partnerships to improve colorectal cancer screening rates in medically underserved communities.

166 Background: Colorectal cancer continues to be very common, and a widening racial disparity has been demonstrated. Wisconsin’s Comprehensive Cancer Control Program which is a program of the University of Wisconsin Carbone Cancer Center partnered with nine Federally Qualified Health Centers (FQHCs) on this five-year program to increase colorectal cancer (CRC) screening. Methods: This project was funded by the CDC and was a partner of a state’s comprehensive cancer control program and a variety of community health centers. Activities included clinical and environmental assessment and baseline data review of CRC screening, identification of a CRC screening team at each clinic, selection and implementation and evaluation of a panel of evidence-based interventions (EBI) per the The Community Guide to Preventive Services. Ongoing implementation data tracking and monitoring strategies were used to create opportunities for data-informed decisions at each clinic. Results: FIT kits were the preferred CRC screening modality. The preferred EBI were patient reminder systems, provider reminders, reducing structural barriers, professional education, EMR improvements and small media. Screening rates for CRC increased by 17% over the course of the project with a peak weighted average of screening at 51.8% for eligible average risk adults, which was up from a baseline of 34.8%. Over 9,000 take-home stool kits were distributed, and a 60.7% completion rate was achieved. The positivity rate for the FIT kits across all centers was 7.6%. A subset of the patients with a positive FIT (n = 97) were reviewed and 53.7% (n = 51) did not have a documented colonoscopy in their electronic medical record. Conclusions: This project of an academic-community partnership was successful in increasing CRC screening in medically underserved communities in Wisconsin. The positivity rate in this high needs population was higher than expected based on prior publications. Further efforts should focus on decreasing the gap between positive FIT testing and completion colonoscopy.[Table: see text]