Primary Screening Research Articles

Optimization of Culture Conditions and Characterization of Pectinase from Isolated Bacteria and Application in Juice Clarificationz`

Microbial pectinase has high demand in different industries. Pectinase producing bacteria were isolated and purified from soil samples and screened by primary and secondary screening for pectinase production. Out of the 13 bacterial samples, sample 4.1(S4.1) showed consistent enzyme activity. Optimum production of pectinase was high when incubated at 24-hour at 37°C with 2% substrate concentration maintaining pH6. Optimum pectinase activity was observed at temperature 37°C and pH 6. Cu++ was found as activator and Zn++, Ca++ as inhibitors of pectinases. The values for Km and Vmax were found to be 1.181mg/ml and 471.69µM/min respectively. Pectinase was efficiently partially purified by 90% acetone saturation. Specific enzyme activity for partially purified enzyme with acetone was 96870 U/mg and purification fold was 35.41. The utilization of low-cost agro-industrial wastes as substrates has been preferable in pectinase production. The sweet lemon and lemon fruit peel powder was observed good substrate for pectinase production. Furthermore, the yield and clarity of sweet lemon juice increased as the concentration of pectinase increased, indicating its potential use in juice processing. Experimental results suggest pectinases from S4.1 was of high value and can be utilized for fruit juice clarification.

THE SYNERGISTIC EFFECTS OF LIPOPEPTIDES AND BACTERIOCINS PRODUCED BY Lactobacillus sp. OF HUMAN SAMPLES AGAINST CLINICAL PATHOGENS OF WOUND INFECTION

This study was performed for production, purification, characterization and evaluation the antibacterial activity of biosurfactant BS which were produced from local isolate Lactobacillus plantarum Z9 with bacteriocin and studying the synergistic effect .A total 100 different samples 85(%) isolates of Lactobacillus sp. were isolated from different sources and identified by biochemical tests then subjected to the primary and secondary screening processes to select the active isolate for bacteriocin and biosurfactant production. Among the vagina isolates screened, the results found that Lactobacillus sp. Z9 isolated from the clinical samples of Iraqi healthy women had the highest productivity of the bacteriocin and biosurfactant. Partial purification of biosurfactant that produced from L. plantarum Z9 was conducted using solvent system (chloroform: methanol, 2:1). A 1:1 ratio of n-butanol was used to extract of partially purified bacteriocin, where the bacteriocin activity up to 320 AU/ml against both Staphylococcus aureus and Pseudomonas aeruginosa respectively compared to 20 AU/ml before purification.. Antibacterial activity of Bacteriocin displayed a significant activity with inhibition zones diameter ranged from (11 to 26 mm) and (10 to 25 mm) against P. aeruginosa and S. aureus at concentration ranged from 50 to 200 mg/ml. Maximum antibacterial activity of bacteriocin against P. aeruginosa and S. aureus showed at concentration 200 mg/ml of bacteriocin. Partial purified lipopeptide of L. plantarum Z9 was examined against pathogenic bacteria using well diffusion method. The lipopeptide had inhibition zones diameter ranged from (14 to 28 mm) and (13 to 29 mm) against P. aeruginosa and S. aureus respectively at concentration ranged from 25 to 200 mg/ml. The combination of lipopeptide with bacteriocin increased the range of inhibition zones and made the pathogens sensitive.

Screening outcome of HPV-vaccinated women: Data from the Danish Trial23 cohort study.

Danish women-who were HPV-vaccinated as girls-are now reaching an age where they are invited to cervical cancer screening. Because of their expected lower cervical cancer risk, we must reassess our screening strategies. We analyzed Danish HPV-vaccinated women's outcomes after the first screening test at age 23. Our study was embedded in Danish routine cytology-based screening. We conducted an observational study and included women born in 1994, offered the 4-valent HPV vaccine at age 14, and subsequently invited to screening at age 23. Cervical cytology was used for diagnostics and clinical management. Residual material was HPV tested with Cobas® 4800/6800. The most severe histology diagnosis within 795 days of screening was found through linkage with the Danish National Pathology Register. We calculated the number of women undergoing follow-up (repeated testing and/or colposcopy) per detected cervical intraepithelial neoplasia (CIN2+). A total of 6021 women were screened; 92% were HPV-vaccinated; 12% had abnormal cytology; 35% were high-risk HPV-positive, including 0.9% HPV16/18 positive, and 20% had follow-up. In women that were cytology-abnormal and HPV-positive (Cyt+/HPV+), 610 (98.5%) had been followed up, and 138 CIN2+ cases were diagnosed, resulting in 4.4 (95% CI 3.9-5.2) women undergoing follow-up per detected CIN2+. In contrast to recommendations, 182 (12.2%) cytology-normal and HPV-positive (Cyt-/HPV+) women were followed up within 795 days, and 8 CIN2+ cases were found, resulting in 22.8 (95% CI 13.3-59.3) women undergoing follow-up per detected CIN2+. Overall, HPV prevalence was high in HPV-vaccinated women, but HPV16/18 had largely disappeared. In the large group of cytology-normal and HPV-positive women, 23 had been followed up per detected CIN2+ case. Our data indicated that primary HPV screening of young HPV-vaccinated women would require very effective triage methods to avoid an excessive follow-up burden. Trial registration number: NCT0304955.

Eosinophilic Cells in Ovarian Borderline Serous Tumors as a Predictor of BRAF Mutation.

According to recent reports, ovarian serous borderline tumor (SBT) harboring the BRAF V600E mutation is associated with a lower risk of progression to low-grade serous carcinoma. Preliminary observations suggest that there may be an association between eosinophilic cells (ECs) and the above-mentioned mutation, so this study aimed to evaluate interobserver reproducibility for assessing ECs. Forty-two samples of SBTs were analyzed for ECs with abundant eosinophilic cytoplasm. Immunohistochemical staining and genetic pro-filing were performed in all cases to verify the BRAF V600E mutation. A BRAF V600E mutation was found in 19 of 42 (45%) cases. Inter-observer reproducibility in the assessment of ECs was substantial (κ = 0.7). The sensitivity and specificity for predicting the mutation were 79% and 91%, respectively. Patients with BRAF-mutated SBTs were significantly younger than those without mutation (p = 0.005). SBTs with BRAF mutation were less likely to be accompanied by non-invasive implants than wild-type SBT: 12% (2/17) versus 33% (6/18). Seven cases were excluded due to incomplete cytoreductive surgery. Nevertheless, Fisher's exact test showed no significant differences between the two groups (p = 0.228). Overall, this study strengthens the idea that ECs in ovarian SBTs may represent a mutation with prognostic significance, which can serve as a primary screening test for BRAF V600E mutation in this pathologic entity.

Cutoff values of motor and cognitive measures for predicting and discriminating levels of activities of daily living after stroke: a scoping review.

The various assessments performed by rehabilitation professionals not only indicate the patient's current functional status but can also help determine the future status (prediction) or the ability to perform untested tasks (discrimination). In particular, the cutoff values are the simplest predictive and discriminative tool that can be widely used in clinical practice. The purpose of this scoping review was to summarize the current literature on cutoff values of motor and cognitive function for predicting or discriminating levels of activities of daily living after stroke. A literature search was conducted using the PubMed, CINAHL, and Scopus databases. The creation of the search criteria, primary screening of titles and abstract, and secondary screening by full-text review were performed by two rehabilitation professionals. A total of 54 articles were included. The summary of the cutoff values for prediction based on longitudinal studies revealed that an NIHSS score ≤8 and mRMI score ≥19 at acute hospitalization can predict good functional independence and walking independence, respectively, indicating reliable cutoff values. Cutoff values for predicting specific ADLs, such as toilet use or dressing, were not reported, which was a potential research gap identified in this review. Alternatively, the summary of the cutoff values for discrimination based on cross-sectional studies revealed that 288-367.5 m on the 6-min walk test and 25.5-27.6 points on the FMA-LL can discriminate community and noncommunity walkers. Considering the difference between prediction and discrimination, the reliable predicted cutoff values revealed in this review are useful for planning an intervention based on early prediction. Conversely, cutoff values for discrimination can estimate different performances with simpler test, or use as target values during rehabilitation.

Novel Deep Learning Neural Networks for Breast Cancer Malignancy Estimation

Medicine has become one of the huge fields which has its own growth each and every day. Few diseases are still a threat to medical field. Because of its destructive nature, cancer is a disease that causes fear in many people throughout the world. However, most cancers are curable if detected early and treated with the right medical care and computer-assisted diagnosis. These days, diagnosis is more popular because it works well as a primary screening test for many diseases, particularly cancer. Deep learning is a method of artificial intelligence where the computer is given intelligence that attempts to emulate the way a human brain thinks. This research focuses on creating a deep neural network that can accurately predict the malignancy of breast cancer up to 98%, allowing medical personnel to diagnose patients more quickly and administer therapy more effectively.

Enhanced Liver Fibrosis Score for Diagnosing Liver Fibrosis in Chronic Hepatitis.

Background and aims: The enhanced liver fibrosis (ELF) score is a blood test that combines three markers linked to liver fibrosis. The utility of the ELF score has been demonstrated primarily in Western countries, but whether it is useful in areas with a high number of elderly people suffering from chronic liver disease has yet to be determined. Methods: This is a prospective study that included 373 consecutive patients who underwent a liver biopsy and had their ELF score measured on the same day. The diagnostic accuracy of the ELF score for liver fibrosis and the effect of age on the ELF score were investigated. Results: The median (interquartile) ELF scores in F0, F1, F2, F3, and F4 are 8.7 (8.2-9.2), 9.3 (8.8-10.0), 10.1 (9.4-10.7), 10.7 (9.9-11.2), and 12.0 (11.2-12.7), respectively. ELF scores increased with increasing liver fibrosis stage (p < 0.001). The diagnostic accuracy of the ELF score and FIB-4 for significant fibrosis (F2-4) and advanced fibrosis (F3-4) was comparable, but the ELF score had a higher diagnostic accuracy for cirrhosis (F4) than FIB-4. When patients were stratified by age of 60 years, the median ELF score did not differ by age in F2, F3, and F4. However, the median FIB-4 increased in patients with ≥60 years compared to those with <60 years in all fibrosis stages. Conclusions: ELF score has high diagnostic accuracy for liver fibrosis, regardless of age, and it could be used as a primary screening method.

Structure-activity relationship of dual inhibitors containing maleimide and imidazole motifs against glutaminyl cyclase and glycogen synthase kinase-3β

Alzheimer’s disease (AD) is a major cause of dementia and one of the most common chronic diseases affecting the aging population. Because AD is considered a public health priority, there is a critical need to discover novel and effective agents for the treatment of this condition. In view of the known contribution of up-regulated glutaminyl cyclase (QC) and glycogen synthase kinase-3β (GSK-3β) to the initiation of AD, we previously evaluated a series of dual inhibitors containing maleimide and imidazole motifs as potential anti-AD agents. Here, we assessed another series of hybrids containing maleimide and imidazole motifs to gain an in-depth understanding of the structure–activity relationship (SAR). Based on the primary screening, the introduction of 5-methyl imidazole at one side of the molecule did not enhance the QC-specific inhibitory activity of these hybrids (2, IC50 = 1.22 μM), although the potency was increased by 2′ substitution on the maleimide motif at the other side of the molecule. Interestingly, compounds containing 5-methyl imidazole exhibited stronger GSK-3β-specific inhibitory activity (2, IC50 = 0.0021 μM), and the electron-withdrawing group and 2′ and 3′ substitution were favorable. Further investigation of substitutions on the maleimide motif in compounds 14–35 revealed that QC-specific inhibition in the presence of piperidine was improved by introduction of a methoxy group (R2). Increasing the linker length and introduction of a methoxy group (R2) also increased the GSK-3β-specific inhibitory potency. These findings were further confirmed by molecular docking analysis of 33 and 24 with QC and GSK-3β. Overall, these hybrids exhibited enhanced inhibitory potency against both QC and GSK-3β, highlighting an important strategy for improving the potency of hybrids as dual-targeting anti-AD agents.

Hyperforin improves matrix stiffness induced nucleus pulposus inflammatory degeneration by activating mitochondrial fission

ObjectiveThe continuously increasing extracellular matrix stiffness during intervertebral disc degeneration promotes disease progression. In an attempt to obtain novel treatment methods, this study aims to investigate the changes in nucleus pulposus cells under the stimulation of a stiff microenvironment. DesignRNA sequencing and metabolomics experiments were combined to evaluate the primary nucleus pulposus and screen key targets under mechanical biological stimulation. Additionally, small molecules work in vitro were used to confirm the target regulatory effect and investigate the mechanism. In vivo, treatment effects were validated using a rat caudal vertebrae compression model. ResultsOur research results revealed that by activating TRPC6, hyperforin, a herbaceous extract can rescue the inflammatory phenotype caused by the stiff microenvironment, hence reducing intervertebral disc degeneration (IDD). Mechanically, it activates mitochondrial fission to inhibit PFKFB3. ConclusionIn summary, this study reveals the important bridging role of TRPC6 between mechanical stiffness, metabolism, and inflammation in the context of nucleus pulposus degeneration. TRPC6 activation with hyperforin may become a promising treatment for IDD.

Time trend analysis of Injury Severity score of adult trauma patients with emergent CT examination.

Controversy exists about whole-body computed tomography (CT) as a primary screening modality for suspected multiple trauma patients. Therefore, the aim of this study was to analyze time trends of CT examinations for trauma patients in relation to the Injury Severity Score (ISS). We retrospectively analyzed 561 adult trauma patients (mean age = 54 years) who were admitted to the trauma room of our hospital, immediately followed by a CT examination, in 2009, 2013 und 2017. Review of electronic patient charts was performed to determine the cause of injury. ISS was either calculated upon hospital charts and CT imaging reports or documented in the TraumaRegister DGU® for trauma patients with ICU treatment or ISS ≥ 16. An increasing number of CT examinations of acute trauma patients were performed at our hospital with 117 patients in 2009 compared to 192 in 2013 and 252 in 2017. Their mean age increased (50 years in 2009, 54 in 2013 and 55 in 2017;p = 0.046), whereas their mean ISS decreased over time (15.2 in 2009 compared to 12.1 in 2013 and 10.6 in 2017;p = 0.001), especially in women (15.1 in 2009, 11.8 in 2013 and 7.4 in 2017;p = 0.001 both), younger age groups (18 to 24 years:15.6 in 2009, 6.5 in 2013 and 8.9 in 2017; p = 0.033 and 25 to 49 years:15.0 in 2009, 11.2 in 2013 and 8.3 in 2017;p = 0.001) as well as motor vehicle collision (MVC) victims (16.2 in 2009, 11.8 in 2013 and 6.1 in 2017; p < 0.001). Trauma patients with a high ISS were especially more likely of older age (OR 1.02,p < 0.001) and with the type of incident being a fall (< 3m: OR3.84,p < 0.001;>3m: OR6.22,p < 0.001) compared to MVC. Previous studies suggesting a benefit of primary whole-body CT for trauma patients might not reflect the current patient population with decreasing ISS. Especially females, younger age groups and MVC patients might benefit from stricter selection criteria for receiving whole-body CT. Our results also emphasize the importance of prevention of fall or tumble for elderly people.

The levels of women’s awareness, experience, acceptability and preference for Vaginal Human Papillomavirus (HPV) self-sampling in three provinces of China: a cross-sectional study

BackgroundThe primary screening technique for precancerous lesions and cervical cancer is human papillomavirus (HPV) testing, and HPV self-sampling has been shown to be consistent with clinician sampling in terms of the accuracy of the results and may improve cervical cancer screening rates. The aim of this study was to understand the level of awareness, experience, acceptability, and preference for vaginal HPV self-sampling among women in Jiangsu, Zhejiang, and Shanghai, China, and to analyze the possible influencing factors to determine the feasibility of implementing self-sampling.MethodsOverall, 1793 women were included in the data analysis. A self-administered questionnaire was utilized. In addition to descriptive analysis, univariate and multivariate analyses were used to explore the associations between sociodemographic features, history of cervical cancer screening, and the level of awareness, experience, acceptability, and preference for HPV self-samples.ResultsThe participants’ level of awareness of and experience with HPV self-sampling were moderate. A total of 88.8% of participants rated the acceptability as “high”, and self-sampling was preferred by 64.2% of them for cervical cancer screening. People aged 45 to 54 years showed a preference for both clinician sampling(OR = 1.762 (1.116–2.163)) and self-sampling (OR = 1.823 (1.233–2.697)). Those who had graduated from high school or above (OR = 2.305 (1.517–3.503), OR = 2.432 (1.570–3.768), OR = 3.258 (2.024–5.244)) preferred clinician-sampling, and those with a bachelor’s degree or above (OR = 1.664 (1.042–2.657)) preferred self-sampling. Middle- and high-income individuals showed no preference for either sampling method (OR < 1).ConclusionsHPV self-sampling is widely accepted, but awareness, experience and preferences need to be improved. These results may help to adjust public health strategies for the early inclusion of HPV self-sampling as a screening method in national initiatives to prevent cervical cancer.

A Literature Review on the Relative Diagnostic Accuracy of Chest CT Scans versus RT-PCR Testing for COVID-19 Diagnosis.

Reverse transcription polymerase chain reaction (RT-PCR) is the main technique used to identify COVID-19 from respiratory samples. It has been suggested in several articles that chest CTs could offer a possible alternate diagnostic tool for COVID-19; however, no professional medical body recommends using chest CTs as an early COVID-19 detection modality. This literature review examines the use of CT scans as a diagnostic tool for COVID-19. A comprehensive search of research works published in peer-reviewed journals was carried out utilizing precisely stated criteria. The search was limited to English-language publications, and studies of COVID-19-positive patients diagnosed using both chest CT scans and RT-PCR tests were sought. For this review, four databases were consulted: these were the Cochrane and ScienceDirect catalogs, and the CINAHL and Medline databases made available by EBSCOhost. In total, 285 possibly pertinent studies were found during an initial search. After applying inclusion and exclusion criteria, six studies remained for analysis. According to the included studies, chest CT scans were shown to have a 44 to 98% sensitivity and 25 to 96% specificity in terms of COVID-19 diagnosis. However, methodological limitations were identified in all studies included in this review. RT-PCR is still the suggested first-line diagnostic technique for COVID-19; while chest CT is adequate for use in symptomatic patients, it is not a sufficiently robust diagnostic tool for the primary screening of COVID-19.

Primary human papillomavirus testing by clinician- versus self-collection: Awareness and acceptance among cervical cancer screening-eligible women.

Primary human papillomavirus (HPV) testing by clinician-collection is endorsed by U.S. guideline organizations for cervical cancer screening, but uptake remains low and insights into patients' understanding are limited. This study aims to primarily address patient awareness of primary HPV screening by clinician-collection and acceptance of primary HPV screening by clinician- and self-collection, and secondarily assess factors associated with awareness and acceptance. Primary care practices affiliated with an academic medical center. A cross-sectional survey study of screening-eligible women aged 30-65 years was conducted to assess awareness and acceptability of primary HPV screening. We analyzed bivariate associations of respondent characteristics with awareness of primary HPV screening by clinician-collection, willingness to have clinician- or self-collected primary HPV testing, and reasons for self-collection preference. Respondents (n = 351; response rate = 23.4%) reported cervical cancer screening adherence of 82.8% but awareness of clinician-collected primary HPV as an option was low (18.9%) and only associated with HPV testing with recent screening (p = 0.003). After reviewing a description of primary HPV screening, willingness for clinician-collected (81.8%) or home self-collected (76.1%) HPV testing was high, if recommended by a provider. Acceptability of clinician-collected HPV testing was associated with higher income (p = 0.009) and for self-collection was associated with higher income (p = 0.002) and higher education (p = 0.02). Higher education was associated with reporting self-collection as easier than clinic-collection (p = 0.02). Women expected self-collection to be more convenient (94%), less embarrassing (85%), easier (85%), and less painful (81%) than clinician-collection. Educational interventions are needed to address low awareness about the current clinician-collected primary HPV screening option and to prepare for anticipated federal licensure of self-collection kits. Informing women about self-collection allows them to recognize benefits which could address screening barriers.

Retinal image quality assessment in diabetic-retinopathy screening: Real world evidence from a lower-middle income country

Objectives: Sight loss due to diabetic retinopathy (DR) is preventable by early detection and treatment. Digital retinal imaging is the most widely practiced method of screening of DR. Poor quality of images is a major hinder to implement systematic DR screening using digital retinal imaging in low- and middle-income countries with a high prevalence of lens opacities. We aimed to identify the proportion of ungradable images using hand-held retinal imaging and predictors of image gradability in a DR screening feasibility study conducted in Sri Lanka. Material and Methods: The present study is a retrospective data analysis of a validation study conducted to assess the diagnostic test accuracy of a held-held digital retinal imaging model integrated into a tertiary level medical clinic. Two selected physician graders underwent formal training to assess retinal image quality using a “four-quadrant method of assessing gradability.” The procedure was a subjective image quality assessment performed by the physician graders manually, that is, images with more than 50% of the field with poor clarity and not suitable for retinopathy grading were classified as ungradable. Two-field (Field-1: macula centered, Field-2: disc centered) non-mydriatic and mydriatic retinal images were captured (Type of camera: Zeiss-Visuscout 100®, Germany) in a consecutive sample of people with diabetes attended for routine medical care and assessed for quality and graded by two independent physician graders on-site. The reference test was a mydriatic biomicroscopic examination conducted at a separate eye clinic by an experienced specialist retinologist. Mixed model regression analysis was conducted to assess the predictors of gradability. Results: A total of 700 individuals (5508 gradability data points) were included in the study. The proportion of ungradable images in non-mydriatic imaging was 30% for Grader 1 and 24% for Grader 2 and went down to 7% and 5%, respectively, for Grader 1 and 2 after dilating the pupils using mydriatic agents. Non-mydriatic images had almost 20 times higher odds (odds ratio [OR] 19.7, 95% confidence interval [CI] 15.1–25.8) of being rated as ungradable compared to mydriatic images. With the increase of each year in age, the odds of having ungradable digital retinal images in a patient increased by 7% (OR 1.07, 95% CI 1.05–1.09). For visual acuity increase in each level of the Log-MAR scale, the odds of having ungradable images increased by 40% (OR 1.40, 95% CI 1.30–1.51). In lens opacity, 54% higher odds of ungradability were observed when present nuclear opalescence (OR 1.54, 95% CI 1.39–1.70) and posterior subcapsular opacity (OR 1.54, 95% CI 1.24–1.92). Conclusion: Non-mydriatic methods may not be suitable as a primary DR screening strategy in countries with a high prevalence of cataracts. Increasing age, poor visual acuity, and the presence of lens opacity are factors that would affect image quality. The capacity to deliver services for managing cataracts may be an important determinant in achieving effective coverage of digital surveillance of DR in low- and middle-income countries.

Isolation, characterization, and predatory activity of nematode-trapping fungus, Arthrobotrys oligospora PSGSS01

A research study was undertaken to find a fungus that could effectively trap and kill Meloidogyne spp., which are root-knot nematodes that cause significant crop loss worldwide. Soil samples were collected and processed appropriately for the isolation of nematode-trapping fungi. After a primary screening, a potential nematode-trapping fungus, Arthrobotrys oligospora (Orbilia oligospora) PSGSS01 was selected for further investigation. Its growth was tested under various conditions, including different media types, temperatures, and pH levels. Its predatory activity on Meloidogyne incognita was also assessed in vitro. The fungus exhibited septate double-celled conidiospores, trapping hyphae, and radiating and sparse mycelium. Optimal conditions for growth were found to be at 25 °C and a pH of 4.0 and 5.0 on corn meal agar. The best temperature and pH for conidiospore germination were 25°C − 37°C and 5.0, respectively. The isolate could trap 94% of second-stage juveniles of M. incognita, and 92% juvenile mortality was recorded in 120 h at 28°C. Therefore, the study concluded that the isolate A. oligospora (Orbilia oligospora) PSGSS01 could be used as a biological control agent against root-knot nematodes.

Advantages and Limitations of the Body Mass Index (BMI) to Assess Adult Obesity.

Obesity reflects excessive fat deposits. At-risk individuals are guided by healthcare professionals to eat fewer calories and exercise more, often using body mass index (BMI; weight/height2) thresholds for screening and to guide progress and prognosis. By conducting a mini-narrative review of original articles, websites, editorials, commentaries, and guidelines, we sought to place BMI in the context of its appropriate use in population health, clinical screening, and monitoring in clinical care. The review covers studies and publications through 2023, encompassing consensus reviews and relevant literature. Recent consensus reviews suggest that BMI is a valuable tool for population surveys and primary healthcare screening but has limitations in predicting the risk of chronic diseases and assessing excess fat. BMI can guide nutritional and exercise counseling, even if it is inadequate for reliable individual risk prediction. BMI cut-offs must be reconsidered in populations of varying body build, age, and/or ethnicity. Since BMI-diagnosed overweight persons are sometimes physically and physiologically fit by other indicators, persons who are overweight on BMI should be more fully evaluated, diagnosed, and monitored with combined anthropometric and performance metrics to better clarify risks. The use of combined anthropometric and performance metrics involves integrating measurements of body composition with assessments of physical function and fitness to provide a more comprehensive evaluation of an individual's health and fitness status. Eligibility for bariatric surgery or semaglutide satiety/appetite-reduction medications should not be determined by BMI alone. Awareness of the advantages and limitations of using BMI as a tool to assess adult obesity can maximize its appropriate use in the context of population health and in rapid clinical screening and evaluation.

Controlled delivery of procyanidin through magnesium oxide nanoparticles (MgO NPs) to improve the activity and mineralization of osteoblasts under oxidative stress in vitro

Excessive reactive oxygen species (ROS) in the microenvironment of osteoporosis (OP) not only accelerate the bone absorption, but also affect the osteogenic and mineralized effect of osteoblasts. Procyanidins (PC) have been reported to have anti-oxidation effects, but low bioavailability. This study aimed to explore the effect of magnesium oxide nanoparticles (MgO-PC NPs)-loaded PC on the osteogenesis and mineralization of osteoblasts that stimulated by H2O2. PC was loaded onto MgO NPs and characterized by transmission electron microscopy, energy dispersive spectroscopy, dynamic light scattering, and Fourier transform infrared spectroscopy. After primary screening by cytotoxicity assay, MgO-PC NPs containing 20 μM of PC were chosen for further studies. In H2O2-stimulated osteoblasts, dichlorodihydrofluorescein diacetate probe, Cell Counting Kit-8, quantitative real-time polymerase chain reaction, alkaline phosphatase staining/activity and Alizarin red staining were used to detect the ROS production, cell viability and osteogenic and mineralized markers of osteoblasts. PC was loaded onto MgO NPs to successfully receive MgO-PC NPs with a diameter of about 144 nm and negative potential. PC can sustain release from MgO-PC NPs for at least 16 d. The controlled release of PC from MgO-PC NPs can effectively eliminate ROS and thereby promoted the cell activity. Most importantly, the osteogenesis and mineralization of osteoblasts under oxidative stress were also significantly reversed by MgO-PC NPS. Thus, these findings indicate that MgO-PC NPs may be developed as a potential therapeutic strategy for OP.

Lower incidence of vaginal cancer after cervical human papillomavirus screening - long-term follow-up of Finnish randomized screening trial

ObjectiveAround 70% of vaginal cancers and 40–50% of vulvar cancers are attributable to human papillomavirus (HPV). Globally the burden of these diseases is estimated to grow due to the increasing HPV prevalence and rapidly aging global population. We aimed to examine if HPV screening for cervical cancer has an additional beneficial effect in preventing vaginal and vulvar cancers. To assess this, we used long-term follow-up data from the Finnish randomized HPV screening trial. MethodsBetween 2003 and 2008, over 236,000 women were individually randomized (1:1) to primary HPV or cytology screening in Southern Finland. We followed this cohort up to the year 2020. To compare the study arms, we calculated site-specific and pooled incidence rate ratios (IRRs) and mortality rate ratios (MRRs) for vaginal and vulvar cancers using Poisson regression. ResultsDuring 3,5 million person-years of follow-up, the IRR for vaginal cancer in the HPV arm compared to the cytology arm was 0.40 (95% CI 0.17–0.88) and the corresponding MRR was 0.74 (95% 0.21–2.24). The corresponding IRR for vulvar cancer was 0.73 (95% 0.50–1.08) and the MRR was 0.64 (95% 0.23–1.62). The pooled IRR was 0.67 (95% 0.47 ̶ 0.95) and MRR 0.67 (95% 0.31 ̶ 1.37). ConclusionWe found lower incidence of vaginal cancers with HPV screening compared to cytology screening. To validate our results, we recommend analyzing data on vaginal and vulvar cancers also from other HPV screening studies.

Identifying the risk of depression in a large sample of adolescents: An artificial neural network based on random forest.

This study aims to develop an artificial neural network (ANN) prediction model incorporating random forest (RF) screening ability for predicting the risk of depression in adolescents and identifies key risk factors to provide a new approach for primary care screening of depression among adolescents. The data were from a large cross-sectional study conducted in China from July to September 2021, enrolling 8635 adolescents aged 10-17 with their parents. We used the Patient health questionnaire (PHQ-9) to rate adolescent depression symptoms, using scales and single-item questions to collect demographic information and other variables. Initial model variables screening used the RF importance assessment, followed by building prediction model using the screened variables through the ANN. The rate of depression symptoms in adolescents was 24.6%, and the depression risk prediction model was built based on 70% of the training set and 30% of the test set. Ten variables were included in the final prediction model with a model accuracy of 85.03%, AUC of 0.892, specificity of 89.79%, and sensitivity of 70.81%. The top 10 significant factors of depression risk were adolescent rumination, adolescent self-esteem, adolescent mobile phone addiction, peer victimization, care in parenting styles, overprotection in parenting styles, academic pressure, conflict in parent-child relationship, parental rumination, and relationship between parents. The ANN model based on the RF effectively identifies depression risk in adolescents and provides a methodological reference for large-scale primary screening. Cross-sectional studies and single-item scales limit further improvements in model accuracy.

Prevalence and risk factors associated with precancerous and cancerous cervical lesions among HIV-infected women in University of Gondar specialized comprehensive referral hospital, Northwest Ethiopia: cross-sectional study design

BackgroundCervical cancer is one of the leading causes of death in women worldwide. The majority of the cases are found in developing countries. The increasing risk of cervical cancer prevalence and growing danger of death from cervical cancer and the high occurrence of human papillomavirus (HPV) infection in women who are HIV positive give us the ground to study the prevalence and associated risk factors.ObjectiveThe study aims to assess the prevalence of cervical cancer screening and associated risk factors among HIV-positive women attending the Adult ART clinic at the University of Gondar Hospital.MethodsAn institution-based cross-sectional study was conducted from March to August 2021, on adult HIV-positive women attending the Adult ART clinic at Gondar University Referral Hospital by phone calling patients per week for six months to complete a total of 2744 HIV-positive patients who were not screened for cervical cancer before. The data were collected using an interviewer-administered questionnaire. Bivariate and multivariable logistic regression analyses were used to determine the presence and the degree of association between dependent and independent variables. In the multivariable logistic analysis, a P-value of < 0.05 and odds ratio with a 95% confidence interval were considered to determine independent predictors for the prevalence of premalignant or malignant cervical lesions among HIV-positive patients.ResultThis study assessed 915 HIV Positive women who were screened for cervical cancer via visual inspection with acetic acid (VIA) as the primary screening tool and found that 24.48% had positive VIA results. Those with VIA-positive cases pathology examination showed 72.4% had abnormal pathology reports (CIN 1/2/3–51.25%, 17.23% cancer & 3.9% CIS), strengthening the finding in many studies that suggest HIV-positive women have a high rate of premalignant lesions.