Rounds Of Screening Research Articles

Structure-based discovery of a new type of scaffold compound as binding competitors for protein-bound Uremic Toxins.

Protein-bound uremic toxins (PBUTs) are the main cause of uremia, but traditional hemodialysis is ineffective in removing them because of their strong ability to bind to human serum albumin (HSA), highlighting the need for new treatments. In this study, first, structure-based docking was used to screen a diverse library of 200,376 virtual compounds against the active sites I and II. After two rounds of docking screening, 3944 candidate molecules were obtained. Second, 23 candidate molecules were obtained after ADMET prediction and toxicity analysis. Five candidate molecules were finally obtained after visual analysis and MM-PBSA calculations. We subsequently assessed their competitive displacement efficiency through a microdialysis experiment, and the results revealed that ZINC000008791789, ZINC000012297018, and ZINC000012296493 are promising binding competitors for PBUTs, as they have higher dialysis efficiency than the optimal displacer LA, approximately double the dialysis efficiency. The other two molecules, ZINC000031161007 and ZINC000004090361, although less efficient than LA, still outperformed the control group. Notably, four of them shared the same molecular scaffold, and three of them contained a flavonoid group. These findings provide a foundation for the development of more effective PBUT binding competitors, potentially benefiting uremia patients in the future.

Identifying and prioritizing inefficiency causes in Iran's health system.

Enhancing efficiency is crucial in addressing the escalating scarcity of healthcare resources. It plays a pivotal role in achieving Universal Health Coverage (UHC), with the ultimate goal of ensuring health equity for all. A fundamental strategy to bolster efficiency involves pinpointing the underlying causes of inefficiency within the healthcare system through empirical research. This study aimed to determine and prioritize the causes of inefficiency in Iran's health system. This mixed-method study comprised three phases. The initial phase involved identifying the causes of inefficiency through a comprehensive literature review of relevant studies published between January 1, 2010, to January 1, 2021. The causes were then aligned and prioritized using criteria derived from the literature and expert opinion. Finally, the identified causes were ranked based on their significance using Multiple-Criteria Decision Analysis (MCDA). From an initial pool of 307 causes of inefficiency, they were reduced to 121 causes in the first round of screening which were categorized into 13 thematic topics. The second screening process further narrowed the list to 48 causes. Among these, the leading causes of inefficiency included the inadequate supply and unequal distribution of hospital beds, the overuse of health services, and the mismanagement of the health workforce. In contrast, the use of traditional treatment methods was determined to be the least significant factor contributing to inefficiency. This study identified key inefficiencies in Iran's health system, such as resource misallocation, overuse of services, and workforce mismanagement. Addressing these issues is essential for optimizing resource utilization, enhancing service delivery, and achieving UHC. The findings suggest that policymakers should prioritize reforms in hospital bed distribution, implement strategies to reduce unnecessary health service use, and strengthen human resource management. Additionally, targeted policies that focus on decentralizing healthcare decision-making and enhancing primary care could significantly improve system-wide efficiency. Future research should evaluate the effectiveness of these interventions and explore the role of digital health solutions in mitigating identified inefficiencies.

A Microfluidic Multiplex Sorter for Strain Development

AbstractSelecting strains with superior traits from strain improvement strategies is challenging, as it involves navigating the fitness landscape by applying selective pressures that drive variants from peaks of improvement to valleys over time. In recent years, the screening and selection is conducted via droplet microfluidic methods due to its high throughput capabilities. However, the oft‐used binary strategy, targeting only the high levels of improved traits, may not reflect the overall enhancement. A multiplexed sorting method capable of applying an additional threshold to sort traits by phenotypic strength is reported. The novel approach uses a droplet‐digital microfluidic sorter to screen different volumes of droplets using the same device design and sorting parameters. This method is used to sort glucoamylase enzyme mutants with two levels of activity (medium and high) from libraries of diastatic yeast that have been mutated with non‐genetically modified techniques. Using the multiplex system, medium‐performing strains with enhanced (up to 60%) fermentation kinetics in synthetic beverage media, which would have been missed with a binary screening approach, are identified. The multiplex sorting strategy efficiently finds strains with superior fermentation traits in the fitness landscape without requiring extensive screening rounds and mutations.

The Analysis Study of Nutritional Management of Patient with Obesity: A Clinical Nutrition Systematic Review

Background: Obesity is a multifactorial condition influenced by a combination of genetic, behavioral, socioeconomic, and environmental factors. The first-line approach for managing obesity typically involves dietary interventions. This systematic review aim to evaluate the current evidence on various nutritional management for obesity based on the literatures of the last 10 years. Methods: The study adhered to PRISMA 2020 standards, examining English literature from 2014 to 2024. It excluded editorials, reviews from the same journal, and submissions without a DOI. PubMed, SagePub, SpringerLink, and Google Scholar were utilized as literature sources. Result: Initially retrieving 360 articles from online databases (PubMed, SagePub, SpringerLink and Google Scholar) eight relevant papers were selected after three rounds of screening for full-text analysis. Conclusion: Different nutritional strategies offer distinct benefits for managing obesity, with Mediterranean, anti-inflammatory, and low-carbohydrate diets showing promise. The key lies in promoting adherence and maintaining weight loss through tailored, sustainable interventions.

PFAS and menopause onset: Is it just a matter of reverse causation? Cross-sectional and longitudinal analyses in highly exposed women in the Veneto Region

IntroductionSeveral cross-sectional studies have linked perfluoroalkyl substances (PFAS) to prevalence of menopause. These findings might be influenced by reverse causation mechanism, making longitudinal studies more suitable. However, existing longitudinal studies are limited and present conflicting results. AimThis study investigates the association between PFAS and both prevalence and incidence of menopause, using longitudinal designs to limit the impact of reverse causation. MethodsA surveillance program on a PFAS highly exposed population in the Veneto region started in 2017 with two rounds of screening, on average 3.8 years apart. Women who participated in the first screening (n = 11,046) were included in the cross-sectional analysis. Multivariate logistic regression models were used to estimate the Odds Ratios (ORs) of menopause associated with exposure to different PFAS. For incidence analysis a retrospective-prospective design used PFOA concentrations reconstructed to 2013 (n = 8536), and a prospective design involved women participating in both screenings (n = 1709), evaluating their baseline concentrations of PFOA, PFOS, and PFHxS. Cox proportional hazards models with age as the timescale were used to estimate Hazard Ratios (HRs), adjusting for sociodemographic and lifestyle factors. ResultsIncreased menopause prevalence was associated with higher ln-concentrations of PFOA, PFOS, and PFHxS, with ORs of 1.31 (CI: 1.25–1.38), 1.51 (CI: 1.38–1.66), and 1.42 (CI: 1.34–1.51), respectively. The retrospective-prospective study showed increased risk of menopause in higher PFOA reconstructed quartiles, with HRs of 1.01 (CI: 0.87–1.18), 1.17 (CI: 1.02–1.37), and 1.07 (CI: 0.93–1.23) for the second, third and fourth quartiles. The prospective longitudinal study found no association between PFAS and menopause onset. ConclusionsOur results showed a strong cross-sectional association between PFAS exposure and menopause, a weak positive association in the retrospective-prospective study, and no association in the prospective study. This suggests that cross-sectional associations may largely result from reverse causality due to early menopause on reducing PFAS excretion.

Impact of active case finding for tuberculosis with mass chest X-ray screening in Glasgow, Scotland, 1950-1963: An epidemiological analysis of historical data.

Community active case finding (ACF) for tuberculosis was widely implemented in Europe and North America between 1940 and 1970, when incidence was comparable to many present-day high-burden countries. Using an interrupted time series analysis, we analysed the effect of the 1957 Glasgow mass chest X-ray campaign to inform contemporary approaches to screening. Case notifications for 1950 to 1963 were extracted from public health records and linked to demographic data. We fitted Bayesian multilevel regression models to estimate annual relative case notification rates (CNRs) during and after a mass screening intervention implemented over 5 weeks in 1957 compared to the counterfactual scenario where the intervention had not occurred. We additionally estimated case detection ratios and incidence. From 11 March 1957 to 12 April 1957, 714,915 people (622,349 of 819,301 [76.0%] resident adults ≥15 years) were screened with miniature chest X-ray; 2,369 (0.4%) were diagnosed with tuberculosis. Pre-intervention (1950 to 1956), pulmonary CNRs were declining at 2.3% per year from a CNR of 222/100,000 in 1950. With the intervention in 1957, there was a doubling in the pulmonary CNR (RR: 1.95, 95% uncertainty interval [UI] [1.81, 2.11]) and 35% decline in the year after (RR: 0.65, 95% UI [0.59, 0.71]). Post-intervention (1958 to 1963) annual rates of decline (5.4% per year) were greater (RR: 0.77, 95% UI [0.69, 0.85]), and there were an estimated 4,599 (95% UI [3,641, 5,683]) pulmonary case notifications averted due to the intervention. Effects were consistent across all city wards and notifications declined in young children (0 to 5 years) with the intervention. Limitations include the lack of data in historical reports on microbiological testing for tuberculosis, and uncertainty in contributory effects of other contemporaneous interventions including slum clearances, introduction of BCG vaccination programmes, and the ending of postwar food rationing. A single, rapid round of mass screening with chest X-ray (probably the largest ever conducted) likely resulted in a major and sustained reduction in tuberculosis case notifications. Synthesis of evidence from other historical tuberculosis screening programmes is needed to confirm findings from Glasgow and to provide insights into ongoing efforts to successfully implement ACF interventions in today's high tuberculosis burden countries and with new screening tools and technologies.

High-throughput screening and identification of lignin peroxidase based on spore surface display of Bacillus subtilis.

Lignin peroxidase is closely related to agriculture and food as it improves the quality of feedstuffs, facilitates the degradation of lignin in agricultural wastes, and degrades azo dyes that have similar complex structures to lignin. However, the current status of homologous or heterologous expression of lignin peroxidase is unsatisfactory and needs to be modified with the help of immobilization and directed evolution to maximize its potential. Directed evolution technology is an effective strategy for designing and improving enzyme characteristics, and Bacillus subtilis spore surface display technology is an efficient method for preparing immobilized enzymes. A colorimetric dye decolorization assay using Congo red as a substrate was developed and optimized for high-throughput screening of spore surface display in a 96-well plate. After two rounds of screening, a superior mutant strain was selected from 2700 mutants. Its highest catalytic activity was 196.36%. The amino acid substitution sites were identified as N120D and I242T. The mechanism for the enhanced catalytic activity was explained using protein modeling and functional analysis software. This study provides insights into the rational design of lignin peroxidase and its application in food and agriculture. © 2024 Society of Chemical Industry.

Blood microRNA testing in participants with suspicious low-dose CT findings: follow-up of the BioMILD lung cancer screening trial

The proper management of suspicious radiologic findings is crucial to optimize the effectiveness of low-dose computed tomography (LDCT) lung cancer screening trials. In the BioMILD study, we evaluated the utility of combining a plasma 24-microRNA signature classifier (MSC) and LDCT to define the individual risk and personalize screening strategies. Here we aim to assess the utility of repeated MSC testing during annual screening rounds in 1024 participants with suspicious LDCT findings. The primary outcome was two-year lung cancer incidence in relation to MSC test results, reported as relative risk (RR) with 95% confidence interval (CI). Lung cancer incidence and mortality were estimated using extended Cox models for time-dependent covariates, yielding the respective hazard ratios (HR). Clinicaltrials.gov ID: NCT02247453. With a median follow-up of 8.5 years, the full study set included 1403 indeterminate LDCT (CTind) and 584 positive LDCT (CT+) results. A lung cancer RR increase in MSC+compared to MSC- participants was observed in both the CTind (RR: 2.5; 95% CI: 1.4-4.32) and CT+ (RR: 2.6; 95% CI: 1.81-3.74) groups and was maintained when considering stage I or resectable tumors only. A 98% negative predictive value in CTind/MSC- and a 30% positive predictive value in CT+/MSC+ lesions were recorded. At seven years' follow-up, MSC+ participants had a cumulative HR of 4.4 (95% CI: 3.0-6.4) for lung cancer incidence and of 8.1 (95% CI: 2.7-24.5) for lung cancer mortality. Our study shows that MSC can be reliably performed during LDCT screening rounds to increase the accuracy of lung cancer risk and mortality prediction and supports its clinical utility in the management of LDCT findings of uncertain malignancy. Italian Association for Cancer Research; Italian Ministry of Health; Horizon2020; National Cancer Institute (NCI); Gensignia LifeScience.

Human papillomavirus-based cervical screening and long-term cervical cancer risk: a randomised health-care policy trial in Sweden.

Human papillomavirus (HPV)-based cervical screening is a globally recommended public health policy. Randomised clinical trials find superior performance of primary HPV-based screening compared with cytology for preventing cervical cancer. However, additional evidence from real-world public health policies is needed. In preplanned secondary analysis of a randomised health-care policy trial in Sweden we aimed to evaluate which policy provided better protection against invasive cervical cancer, after two full rounds of screening. The organised cervical screening programme in the capital region of Sweden invited all women aged 30-64 years and eligible for screening to a randomised health-care policy trial of HPV-based versus cytology-based screening. During 2014-16, 395 725 eligible women were randomly assigned (non-concealed) to either policy and the invasive cervical cancer incidences over 8 years of follow-up were compared. Intention-to-screen analyses included all invited women and per-protocol analyses the women that attended baseline screening according to protocol. This trial is registered with ClinicalTrials.gov, NCT01511328. Women invited to HPV-based cervical screening had a 17% lower invasive cervical cancer risk compared with women invited to cytology (hazard ratio [HR] 0·83, 95% CI 0·70-0·98). Women participating in HPV-based screening had a 28% lower invasive cervical cancer risk compared with women participating with cytology (HR 0·72, 95% CI 0·54-0·95). Adverse events were a higher number of referrals to colposcopy with biopsy in the HPV policy (15 832 [7·5%] of 212 199 in intention to screen analyses and 9968 [9·0%] of 110 176 per protocol at baseline) than in the cytology policy (12 650 [6·9%] of 183 120 in intention to screen analyses, and 7179 [7·9%] of 90 821 per protocol at baseline). Women who were HPV-negative at baseline had invasive cervical cancer risks of 1·3 (95% CI 0·6-2·4) per 100 000 person-years, whereas the risk for women with normal cytology was 9·1 (6·7-11·8) per 100 000 person-years. HPV-positive women with negative cytology triage had invasive cervical cancer risks of 79·2 per 100 000 person-years and HPV 16 or HPV 18-positive women with negative cytology triage had risks of 318·2 per 100 000 person-years. This randomised policy trial found HPV-based screening to be superior for preventing invasive cervical cancer in the real-world setting. A single baseline HPV-negative test was associated with a very low invasive cervical cancer risk after 8 years. However, HPV positivity with negative cytology triage was associated with high invasive cervical cancer risks. Region Stockholm, Swedish Cancer Society, and European Union Horizon 2020.

An updated systematic review of the risk factors for unplanned dialysis initiation

Abstract Background Previously, a comprehensive review of the risk factors for unplanned dialysis initiation (UDI) was conducted by Hassan et al. (2019), based on studies published up to end of 2017. They demonstrated that high quality data and well-designed studies on the subject are lacking. Thus, we updated their review to establish the modifiable factors associated with UDI. Methods MEDLINE and EMBASE were searched from January 2018 to August 2023. Following several rounds of screening, we identified 17 international studies (majority of which were based in Europe) that met the eligibility criteria. Results Many of the included studies were well designed, utilised very large datasets, and adopted multivariate analyses to examine associations between patient characteristics and UDI. Definitions of UDI varied across studies, i.e. timeliness of presentation, vascular access type, initiating dialysis as an inpatient/outpatient, or for life threatening indications. The most common risk factors reported were cardiovascular disease, increased age, cause of kidney disease, cancer, diabetes, lower serum albumin, increased rate of estimated glomerular filtration rate (eGFR) decline and fewer number of nephrology visits prior to dialysis start. These were in line with those reported by Hassan et al. However, our updated review revealed several other important predictors of UDI, i.e. worse coding of chronic kidney disease (CKD) in the GP health record, lower health literacy, and having an acute kidney injury (AKI). Conclusions Our review provides new insights into reasons why people start dialysis in an unplanned manner, many of which are modifiable, thus contributing to efforts in reducing the rate of UDI.

The Analysis Study of Prevalence, Diagnosis and Management of Bacterial Vaginosis: A Comprehensive Systematic Review

Background: Bacterial vaginosis (BV) is a prevalent condition among women of reproductive age, characterized by a disruption in the normal vaginal microbiota. The systematic review focused on analyzing the prevalence, diagnosis, and management of Bacterial vaginosis based on literature from the past decade. Methods: The study followed PRISMA 2020 guidelines, reviewing English-language publications from 2014 to 2024. Editorials, duplicate reviews from the same journal, and papers lacking a DOI were excluded. The literature search was conducted using PubMed, SagePub, SpringerLink, and Google Scholar. Result: A total of 630 articles were initially identified through online databases (PubMed, SagePub, SpringerLink, and Google Scholar). After three rounds of screening, eight relevant studies were selected for full-text analysis. Conclusion: Bacterial vaginosis remains a complex condition influenced by microbial diversity, contraceptive use, and co-infections. Improved diagnostic methods and innovative treatment strategies, including probiotics, are essential for effective management and prevention of BV and its associated complications.

The Analysis Study of Effect of Acupuncture on the Treatment of Atopic Itch: A Comprehensive Systematic Review

Background: Atopic dermatitis is a common inflammatory skin disorder characterized by recurrent eczematous lesions and severe itching. Given its chronic nature and association with persistent pruritus, exploring therapies like acupuncture may offer valuable relief and enhance patient outcomes. This systematic review aims to explore the efficacy and mechanisms of acupuncture as a treatment for atopic pruritus based on the literature of the last decade. Methods: The study followed PRISMA 2020 guidelines, reviewing English-language publications from 2014 to 2024. Editorials, duplicate reviews from the same journal, and papers lacking a DOI were excluded. The literature search was conducted using PubMed, SagePub, SpringerLink, and Google Scholar. Result: A total of 630 articles were initially identified through online databases (PubMed, SagePub, SpringerLink, and Google Scholar). After three rounds of screening, eight relevant studies were selected for full-text analysis. Conclusion: Acupuncture shows potential as a noninvasive and effective treatment for reducing pruritus and associated symptoms in patients with atopic dermatitis and other pruritic conditions. The observed benefits, such as decreased itch intensity, improved quality of life, and reduced medication use, underline its value as an adjunct therapy.

COMPARISON DIAGNOSTIC ACCURACY OF ULTRASONOGRAPHY ELASTOGRAPHY FOR DETECTING LIVER FIBROSIS COMPARED TO LIVER BIOPSY: A COMPREHENSIVE SYSTEMATIC REVIEW AND META-ANALYSIS STUDIES

Background: Liver fibrosis significantly impacts disease outcomes in chronic liver disease. While liver biopsy has long been the gold standard for assessing and staging fibrosis, non-invasive ultrasound-based methods are emerging as valuable alternatives. The aim of this study is to systematically review and conduct a meta-analysis to compare the diagnostic accuracy of ultrasound elastography with liver biopsy for detecting liver fibrosis based on literatures in the last 10 years. Method: A systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines using the PICO framework. Rigorous screening, data extraction, risk of bias assessment, and statistical analysis were performed to investigate diagnostic accuracy of ultrasonography elastography for detecting liver fibrosis compared to liver biopsy. Results: A total of 32 articles were retrieved from online databases (PubMed, SagePub, Nature and Cochrane). After three rounds of screening, seven articles directly relevant to the meta-analysis were selected for full-text reading and analysis. Conclusion: Liver fibrosis significantly impacts disease outcomes in chronic liver disease. While liver biopsy has long been the gold standard for assessing and staging fibrosis, non-invasive ultrasound-based methods like shear wave elastography are emerging as valuable alternatives.

An Analysis Study on the Effect of the Use of Electronic Medical Records on the Effectiveness and Efficiency of Services at Public Health Centers (Puskesmas) in Indonesia: A Systematic Review

Background: EMR utilize electronic systems to store, manage, and share patient health information more efficiently and accurately. Given the importance of using EMR in improving the quality and efficiency of health services in Indonesia, this study aims to systematically review the existing evidence related to the effectiveness of EMR implementation on the effectiveness and efficiency of services at Puskesmas in Indonesia. This study follows the PRISMA 2020 standard, examining English literature from 2014 to 2024. The study excluded editorials, reviews from the same journal, and submissions without DOI. PubMed, SagePub, SpringerLink, and Google Scholar are used as literary sources. Results: Initially getting 360 articles from online databases (PubMed, SagePub, SpringerLink, and Google Scholar), eight relevant papers were selected after three rounds of screening for full-text analysis. Conclusion: Overall, the use of Electronic Medical Records at primary healthcare in Indonesia provides many advantages in terms of the effectiveness and efficiency of health services, especially in accelerating queue waiting time, registration, service in the police, and drug taking. However, to achieve optimal implementation, efforts to improve technology infrastructure, training for health workers, and good network management are needed to overcome technical obstacles and ensure smooth service flow at the primary healthcare.

Improving Hydrolytic Activity and Enantioselectivity of Epoxide Hydrolase from Phanerochaete chrysosporium by Directed Evolution.

Epoxide hydrolases (EHs) catalyze the conversion of epoxides into vicinal diols. The epoxide hydrolase gene from P. chrysosporium was previously cloned and subjected to site-directed mutation to study its enzyme activity, but the results were unsatisfactory. This study used error prone PCR and DNA shuffling to construct a PchEHA mutation library. We performed mutation-site combinations on PchEHA based on enzyme activity measurement results combined with directed evolution technology. More than 15,000 mutants were randomly selected for the preliminary screening of PchEHA enzyme activity alongside 38 mutant strains with increased enzyme activity or enantioselectivity. Protein expression and purification were conducted to determine the hydrolytic activity of PchEHA, and three mutants increased their activity by more than 95% compared with that of the wt. After multiple rounds of screening and site-specific mutagenesis, we found that F3 offers the best enzyme activity and enantioselectivity; furthermore, the molecular docking results confirmed this result. Overall, this study uncovered novel mutants with potential value as industrial biocatalysts.

Streamlining RNA Aptamer Selection via Unique Molecular Identifiers and High-Throughput Sequencing.

Aptamers are valuable tools for applications such as cell imaging, drug delivery, and therapeutics. RNA aptamers, in particular, exhibit complex structural diversity and flexibility, affording higher affinity and specificity, broader target recognition, and easier chemical modification compared with DNA aptamers. However, traditional selection methods for RNA aptamers are time-consuming and involve numerous rounds of screening, thus limiting their widespread application. To overcome this challenge, we propose an efficient truncated selection approach termed ID-SELEX. This method incorporates a molecular identification marker whereby each template is labeled with a unique molecular identifier, or UMI. Such incorporation helps mitigate biases introduced by multiple polymerase chain reaction (PCR) amplification during high-throughput sequencing, ensuring accurate identification of aptamer candidates. Utilizing ID-SELEX, we successfully identified a panel of high-quality aptamers targeting the human colon cancer cell line HCT-8 in just 2 rounds of selection. Furthermore, we demonstrated the versatility of this strategy by selecting 6 RNA aptamers targeting mouse myoblast cell line C2C12 with only one round of selection. In summary, RNA aptamer selection based on ID-SELEX utilizes high-throughput sequencing and UMI labeling to enable the rapid screening of RNA aptamers across human and murine cell lines. As such, ID-SELEX has the potential to facilitate RNA aptamer discovery, providing a novel molecular tool for biomedical research, clinical applications, and precision medicine.

The Analysis Study of Prevalence, Diagnosis and Management of Chronic Obstructive Pulmonary Disease (COPD): A Comprehensive Systematic Review

Background: Chronic Obstructive Pulmonary Disease (COPD) is a debilitating respiratory condition that significantly contributes to global morbidity and mortality rates. This systematic review aims to evaluate prevalence, diagnostic challenges, and management strategies for COPD based on the literatures of the last 10 years. Methods: The study adhered to PRISMA 2020 standards, examining English literature from 2014 to 2024. It excluded editorials, reviews from the same journal, and submissions without a DOI. PubMed, SagePub, SpringerLink, and Google Scholar were utilized as literature sources. Result: Initially retrieving 360 articles from online databases (PubMed, SagePub, SpringerLink and Google Scholar) eight relevant papers were selected after three rounds of screening for full-text analysis. Conclusion: COPD is a major global health issue, significantly impacting quality of life due to prevalent comorbidities. This review emphasizes the necessity for targeted interventions and innovative management strategies, including home-based treatments, to enhance patient outcomes and reduce healthcare costs.

Harm-to-Benefit Ratio of Fecal Immunochemical Test–Based Screening for Colorectal Cancer Given Prior Fecal Hemoglobin Concentrations

This study aimed to provide evidence on the harm-to-benefit ratio of fecal immunochemical test (FIT)-based colorectal cancer (CRC) screening by previous fecal hemoglobin (f-Hb) concentrations, as reflected in the number needed to screen (NNS) and number needed to scope (NNSc). Participants in up to 4 FIT screening rounds of the Dutch CRC screening program were included. The main outcomes of this study were the NNS and NNSc to detect 1 CRC and/or advanced neoplasia (AN) in screening rounds 2, 3, or 4, conditional on previous f-Hb concentrations. Outcomes were compared between participants using chi-square tests and logistic regression. In total, 2,428,883 study participants completed at least 2 consecutive FITs, 1,308,684 completed 3 FITs, and 150,958 completed 4 FITs. There were 31,400, 16,060, and 2007 ANs detected by round, respectively. The NNS for individuals with vs without a history of detectable f-Hb differed significantly irrespective of screening round. Individuals without detectable f-Hb in previous negative FITs had almost 9 times the NNS to detect 1 AN compared with those with detectable f-Hb (odds ratio, 8.71; 95% confidence interval, 8.51-8.92). A similar directional pattern was observed for NNSc, although the differences were smaller (odds ratio, 2.7; 95% confidence interval, 2.7-2.8). The harm-to-benefit ratio of FIT-based screening is substantially greater in individuals without vs with prior detectable f-Hb. Less intensive screening should be considered for this lower-risk group.

Back to the Past: A Systematic Review of Immersive Narrative in Cultural Heritage Conservation

ABSTRACTImmersive narrative creates a vivid experiential environment that allows users to be participants rather than mere observers, holding immense potential in the field of cultural heritage. However, current research primarily focuses on technological applications and integration, lacking in‐depth exploration of the fusion between technology and content as well as limited user engagement. Following a systematic review methodology, this study conducted searches and two rounds of screening in 7 major databases, resulting in the inclusion of 176 studies on immersive narrative in cultural heritage conservation. The study summarizes and extracts the current state, development trajectory, trends, research methods, and key elements in this field, innovatively categorizing them into 6 core levels of research patterns while proposing corresponding optimization strategies. Additionally, this study identifies research gaps and suggests future directions, aiming to facilitate the enhancement of immersive narrative development and deepen user engagement in the cultural heritage field.

Self-management behavior preferences and influencing factors in Chinese patients with recurrent gout: A qualitative study

ObjectiveThis study aimed to explore the preferences and influencing factors of self-management behaviors in patients with recurrent gout and provide a theoretical basis for developing targeted strategies to improve self-management preferences. MethodsA total of 10 patients with recurrent gout were recruited from the gout specialist outpatient clinic at a tertiary hospital in Shenyang, Liaoning Province, China. Semi-structured interviews were conducted with these patients, and the Kawakita Jiro (KJ) method was used to analyze the interview data. ResultsAfter four rounds of screening by five researchers, 35 codes were selected from an initial 132. After three rounds of discussion and induction, the KJ method identified seven domains of self-management behavior preferences in patients with recurrent gout: 1) extensive knowledge of gout, yet difficulty in distinguishing between accurate and inaccurate information; 2) a passive attitude of “no pain, no management”; 3) the challenge of changing entrenched daily habits; 4) the optimistic but unrealistic belief of “self-delusion”; 5) a tendency to seek medical attention late due to hopelessness of cure and familiarity with recurrences; 6) preference for analgesics for gout recurrences while neglecting long-term urate-lowering therapy (ULT); and 7) gout-related stigma. ConclusionThe results of this study showed that the self-management behavior of patients with recurrent gout could be improved, especially in the aspects of medical seeking behavior, medication compliance, daily management and emotional management. At the same time, we found that gout stigma, difficulty in distinguishing true and false knowledge of gout and negative attitude of “ignoring pain” were significantly associated with self-management behavior.