Screening Data Research Articles

Navigating the dual role of physician and clinician investigator in end-of-life research

ABSTRACT The challenges of recruiting participants for end-of-life (EOL) research are multifaceted. The Last Gift study at the University of California San Diego, an observational study for people with HIV (PWH) with terminal illness, appeals to the altruism of potential participants and community of allied health providers. Involvement of the latter group highlights a potential ethical conundrum of a “dual role”, as primary care providers (PCPs) navigate between clinical responsibilities to their patients, along with opportunities to discuss clinical research. To explore this conundrum and better understand study recruitment dynamics of the Last Gift study, we analyzed screening and enrollment data for a 12-month period (2022–2023). We found that PCPs can play an important role in the recruitment of PWH into EOL research, as having PCPs discuss the study with potential participants yielded more successful enrollments than contact by the study team alone. Our manuscript proposes considerations to mitigate dual role conflicts, including ensuring ethical awareness, prioritizing clinical care and offering strategies to involve PCPs in recruitment without causing unnecessary burden or coercion. These insights aim to guide similar EOL research efforts, emphasizing the need for balanced, ethical recruitment processes in the sensitive context of terminal illness.

Functional genomics pipeline identifies CRL4 inhibition for the treatment of ovarian cancer.

The goal of precision oncology is to find effective therapeutics for every patient. Through the inclusion of emerging therapeutics in a high-throughput drug screening platform, our functional genomics pipeline inverts the common paradigm to identify patient populations that are likely to benefit from novel therapeutic strategies. Utilizing drug screening data across a panel of 46 cancer cell lines from 11 tumor lineages, we identified an ovarian cancer-specific sensitivity to the first-in-class CRL4 inhibitors KH-4-43 and 33-11. CRL4 (i.e., Cullin-4 RING E3 ubiquitin ligase) is known to be dysregulated in a variety of cancer contexts, making it an attractive therapeutic target. Unlike proteasome inhibitors that are associated with broad toxicity, CRL4 inhibition offers the potential for tumor-specific effects. We observed that CRL4 inhibition negatively regulates core gene signatures that are upregulated in ovarian tumors and significantly slowed tumor growth as compared to the standard of care, cisplatin, in OVCAR8 xenografts. Building on this, we performed combination drug screening in conjunction with proteomic and transcriptomic profiling to identify ways to improve the antitumor effects of CRL4 inhibition in ovarian cancer models. CRL4 inhibition consistently resulted in activation of the mitogen-activated protein kinase (MAPK) signaling cascade at both the transcriptomic and protein levels, suggesting that survival signaling is induced in response to CRL4 inhibition. These observations were concordant with the results of the combination drug screens in seven ovarian cancer cell lines that showed CRL4 inhibition cooperates with MEK inhibition. Preclinical studies in OVCAR8 and A2780 xenografts confirmed the therapeutic potential of the combination of KH-4-43 and trametinib, which extended overall survival and slowed tumor progression relative to either single agent or the standard of care. Together, these data demonstrate the prospective utility of functional modeling pipelines for therapeutic development and underscore the clinical potential of CRL4 inhibition in the ovarian cancer context. A precision medicine pipeline identifies ovarian cancer sensitivity to CRL4 inhibitors. CRL4 inhibition induces activation of MAPK signalling as identified by RNA sequencing, proteomics, and phosphoproteomics. Inhibitor combinations that target both CRL4 and this CRL4 inhibitor-induced survival signalling enhance ovarian cancer sensitivity to treatment.

CryoCrane: an open-source GUI for analyzing cryo-EM screening data sets.

Screening of cryo-EM samples is essential for the generation of high-resolution cryo-EM structures. Often, it is cumbersome to correlate the appearance of specific grid squares and micrograph quality. Here, CryoCrane (Correlate atlas and exposures), a visualization tool for cryo-EM screening data, is presented. It aims to provide an intuitive way to visualize micrographs and to speed up data analysis.

Development and experimental validation of a machine learning model for the prediction of new antimalarials

A large set of antimalarial molecules (N ~ 15k) was employed from ChEMBL to build a robust random forest (RF) model for the prediction of antiplasmodial activity. Rather than depending on high throughput screening (HTS) data, molecules tested at multiple doses against blood stages of Plasmodium falciparum were used for model development. The open-access and code-free KNIME platform was used to develop a workflow to train the model on 80% of data (N ~ 12k). The hyperparameter values were optimized to achieve the highest predictive accuracy with nine different molecular fingerprints (MFPs), among which Avalon MFPs (referred to as RF-1) provided the best results. RF-1 displayed 91.7% accuracy, 93.5% precision, 88.4% sensitivity and 97.3% area under the Receiver operating characteristic (AUROC) for the remaining 20% test set. The predictive performance of RF-1 was comparable to that of the malaria inhibitor prediction platform (MAIP), a recently reported consensus model based on a large proprietary dataset. However, hits obtained from RF-1 and MAIP from a commercial library did not overlap, suggesting that these two models are complementary. Finally, RF-1 was used to screen small molecules under clinical investigations for repurposing. Six molecules were purchased, out of which two human kinase inhibitors were identified to have single-digit micromolar antiplasmodial activity. One of the hits (compound 1) was a potent inhibitor of β-hematin, suggesting the involvement of parasite hemozoin (Hz) synthesis in the parasiticidal effect. The training and test sets are provided as supplementary information, allowing others to reproduce this work.

P-425. A Scoping Review of Data Systems for HPV Vaccination and HPV-Related Outcomes in China

Abstract Background Human papillomavirus (HPV) is a major cause of cervical cancer, the sixth most common cancer among women in China. In 2023, China launched a new government plan to facilitate the elimination of cervical, requiring reliable data systems for monitoring and evaluating progress. This study aimed to identify, understand, and summarize data systems that record HPV vaccination, cervical cancer screening, HPV infection, HPV-related cervical and non-cervical diseases, as well as sexual and life behaviors in China. Methods A scoping review of literature from PubMed and the China National Knowledge Infrastructure databases was conducted, covering publications from 2012 to 2023. Two reviewers independently reviewed articles in two rounds, and all disagreements were resolved by a third reviewer. Results From 234 studies, 146 data sources were identified, covering topics including HPV vaccination (n=2), HPV-related cervical and non-cervical diseases (n=121), cervical cancer screening and HPV infection (n=11), HPV-related knowledge, attitude, and belief (n=1), and sexual and life behaviors (n=7). The main source for HPV vaccination data is the National Immunization Program Information Management System, while HPV-related cancer data primarily come from the National Central Cancer Registry of China. Cervical screening and HPV infection data are recorded in clinical or laboratory databases, including KingMed Diagnostics Laboratory and the national “Two Cancer” Screening database. HPV knowledge, attitude and sexual behaviors are mainly collected from surveys of individuals registered in epidemiology registries. Notably, several cities, including Yinzhou, Chengdu, Suzhou, and Lecheng, have recently established population-level data systems linking vaccination, screening to cervical/other HPV outcomes; however, a national system linking HPV vaccination and cervical screening with HPV-related disease outcomes, health beliefs, and risk behaviors is lacking. Conclusion There is a clear need for comprehensive and integrated data systems in China to effectively monitor and evaluate the impact and progress of public health intervention for cervical cancer elimination. Disclosures Wei Wang, PhD, Merck: Stocks/Bonds (Public Company) Ruixuan Wang, MPP, Merck: Co-Op Ya-Ting Chen, PhD, Merck & Co., Inc: Stocks/Bonds (Private Company)

Association of red blood cell distribution width–coefficient of variation with cranial ultrasound abnormalities in neonatal hyperbilirubinemia: a retrospective cross-sectional study

BackgroundNeonatal hyperbilirubinemia frequently leads to severe neurological damage. Although cranial ultrasound (CUS) is crucial for assessing neonatal brain injury, the association between red blood cell distribution width-coefficient of variation (RDW-CV), a marker of red blood cell size variability, and cranial ultrasound abnormalities (CUAs) remains unclear.ObjectiveThe primary aim of this study was to explore the impact of RDW-CV on CUAs in neonatal hyperbilirubinemia and to elucidate the potential clinical implications of this relationship.MethodsThis retrospective cross-sectional study included 503 cases of neonatal hyperbilirubinemia at gestational age ≥35 weeks with available RDW-CV and CUS screening data at Nanjing Lishui People's Hospital. Multivariate logistic regression analysis and smooth curve fitting were used to estimate the association between RDW-CV and the risk of CUAs in neonatal hyperbilirubinemia.ResultsThis study found that the overall prevalence of CUAs in ultrasound images was 26.0%. Multivariate logistic regression analysis adjusted for risk factors revealed that a one-percent increase in RDW-CV increased the risk of CUAs by 23.0%. After conducting a sensitivity analysis of the three RDW-CV quantiles, the findings remained robust and consistent.ConclusionsThe study concluded that a higher RDW-CV was associated with a proportional increase in the risk of CUAs. These results demonstrate the importance of RDW-CV in neonatal hyperbilirubinemia. Clinicians should consider this association when managing patients with high RDW-CV.

The Otoacoustic Emissions in the Universal Neonatal Hearing Screening: A Scoping Review Update on the African Data (2004 to 2024)

Background: The reported data on African universal neonatal hearing screening (UNHS) practices tend to be quite scarce, despite the developments in hearing screening the last two decades. The objective of this systematic review was (a) to identify the most recent (in a 20-year span) literature information about NHS/UNHS programs in Africa and (b) to provide data on the procedures used to assess the population, the intervention policies, and on the estimated prevalence of congenital hearing loss with an emphasis on bilateral hearing loss cases. Methods: Queries were conducted via the PubMed, Scopus, and Google Scholar databases for the time window of 2004–2024. The mesh terms used were “OAE”, “universal neonatal hearing screening”, “congenital hearing loss”, “well babies”, and “Africa”. Only research articles and review papers were considered as good candidates. The standard English language filter was not used, to identify information from non-English-speaking scientific communities and groups. Results: Data from 15 papers were considered, reflecting the neonatal hearing practices of nine African states. No country-wide NHS programs were reported. The various screening realities are implemented within big urban centers, leaving the residents of rural areas unassisted. For the latter, proposals based on tele-medicine protocols have been suggested. The data on HL prevalence are also incomplete, but the available data refer to rates from 3 to 360 subjects per 1000. These data cannot be taken at face value but within the small sample size context in which they were acquired. Regarding the causes of HL, very few data have been reported; consanguinity is the most attributed factor, at least in the Sub-Saharan African states. For the majority of the programs, no data were reported on hearing loss prevalence/incidence or on any strategies to restore hearing. Conclusions: The information on the African neonatal hearing screening are quite scarce, and it is an urgent need to convince audiologists from the African localized programs to publish their hearing screening data.

Nonlinear association between liver fat content and lumbar bone mineral density in overweight and obese individuals: evidence from a large-scale health screening data in China.

The impact of fatty liver disease on lumbar bone mineral density (BMD) represents an intriguing area of study, particularly in light of established research linking obesity to bone metabolism. However, there remains limited investigation into the correlation between quantifying liver fat content (LFC) and lumbar BMD among overweight and obese populations, particularly within the Chinese demographic. This study aims to accurately quantify LFC and investigate its association with lumbar BMD in overweight or obese individuals. This cross-sectional study was conducted at the Health Management Center of Henan Provincial People's Hospital from January 2019 to February 2023, involving 6996 participants with a body mass index (BMI) of 24 kg/m² or higher. LFC and lumbar BMD were assessed using computed tomography. The study utilized one-way ANOVA, subgroup analysis, multifactor regression analysis, smooth curve fitting, and threshold and saturation effect analysis to explore the relationship between LFC and lumbar BMD. Furthermore, inflammatory cell analysis was included to investigate the potential mediating role of inflammatory cells in the association between LFC and lumbar BMD. After adjusting for confounding variables, multivariate regression analysis revealed a significant negative association between LFC and lumbar BMD (β = -0.323, 95% CI: -0.464 to -0.183, P < 0.001). Particularly, participants in the highest baseline LFC quartile (Q4 group) exhibited a more pronounced negative impact on lumbar BMD compared to those in the lowest quartile (Q1 group) (β = -5.026, 95% CI: -7.040 to -3.012, P < 0.001). Threshold saturation effect analysis identified a turning point in the LFC-BMD relationship (K = 5.4). Below this point, LFC showed a positive correlation with lumbar BMD (β = 0.962, 95% CI: 0.016-1.907, P < 0.05), whereas above it, LFC was significantly negatively correlated with lumbar BMD (β = -0.405, 95% CI: -0.558 to -0.253, P < 0.001). Additionally, mediation analysis indicated that leukocytes and monocytes potentially mediated the association between LFC and lumbar BMD, with mediation ratios of -5.78 and -6.68%, respectively. Among individuals categorized as overweight or obese, elevated levels of LFC were associated with reduced lumbar BMD, particularly noticeable above a threshold of 5.4%. Additionally, various types of inflammatory cells are presumed to exert a substantial mediating influence on the correlation between LFC and lumbar BMD.

Prioritizing performance and outcome indicators for quality assessment of cancer screening programs in the EU.

A key element in ensuring appropriate balance of harms and benefits in cancer screening is to develop a priority set of performance and outcome indicators to be used in screening data evaluation systems. These indicators need to be equity-focused, aligned to new screening approaches and broad-based to cover possible opportunistic screening, but at the same time as limited as possible. Indicators for breast, colorectal and cervical cancer screening programs were chosen through a consensus building Delphi methodology involving a panel of cancer screening experts. The list of indicators was developed using a multistage process. First, a systematic search was performed along with an extensive grey literature search to identify all potential existing indicators. Next, these indicators were refined by two expert groups, definitions and calculations were agreed upon, redundant indicators removed. A final list of 38 indicators was put forward into a Delphi study. 33 cancer screening experts were invited to take part. The Delphi study consisted of two rounds of an online survey and an online facilitated discussion between the cancer screening experts. 23 indicators were chosen covering 10 predefined indicator categories with detection rate, examination coverage and interval cancer rate deemed most important. Outcome indicators such as crude incidence rate and time from screen to result notification, while ultimately reaching consensus were deemed of less importance. 23 priority indicators cover the entire screening pathway including harms, barriers and inequalities. These indicators have been piloted by the CanScreen-ECIS project.

Predicting risk factors for Epstein-Barr virus reactivation using Bayesian network analysis: a population-based study of high-risk areas for nasopharyngeal cancer.

Nasopharyngeal carcinoma (NPC) is a rare disease in most parts of the world, but it is highly prevalent in South China. Epstein-Barr virus (EBV) is one of the major risk factors for NPC. Hence, understanding the factors associated with the reactivation of EBV from the latent stage is crucial for preventing NPC. This study aimed to investigate the risk factors for EBV reactivation associated with NPC in high-prevalence areas in China using a Bayesian network (BN) model combined with structural equation modeling tools. The baseline information for this study was derived from NPC screening data from a population-based prospective cohort in Sihui City, Guangdong Province, China. We divided the data into a training dataset and a test dataset. We then constructed an interaction networktionba BN prediction model to explore the risk factors for EBV reactivation, which was compared with a conventional logistic regression model. A total of 12,579 participants were included in the analyses, with 1596 participant pairs finally included after the use of a nested case-control study. The results of multivariable logistic regression showed that only being older than 60 years (OR = 1.718, 95% CI = 1.273,2.322) and being a current smoker (OR = 1.477, 95% CI = 1.167 - 1.872) were the risk factors for EBV reactivation. The results of the model constructed using BN showed that age and smoking were directly associated with EBV reactivation. In contrast, sex, education level, tea drinking, cooking, and family history of cancer were indirectly associated with EBV reactivation. Further, we predicted the risk of EBV reactivation using Bayesian inference and visualized the BN inference. Model prediction performance was evaluated using the test dataset. The results showed that the BN model slightly outperformed the traditional logistic regression model in all metrics. BN not only reflects the complex interaction between factors but also visualizes the prediction results. It has a promising application potential in the risk prediction of EBV reactivation associated with NPC.

Predictive Value of the DETECT Algorithm for Pulmonary Arterial Hypertension in Systemic Sclerosis: Findings from an Italian Observational Study.

Background/Objectives: Pulmonary arterial hypertension (PAH) is a complication of systemic sclerosis (SSc), and several screening algorithms have been proposed for the early detection of PAH in SSc. This study aimed to evaluate the predicting values of the DETECT algorithm for SSc-PAH screening in patients with SSc undergoing right heart catheterization (RHC) based on 2015 ESC/ERS echocardiographic criteria in a real-life setting. Methods: Patients fulfilling the 2013 ACR/EULAR classification criteria for SSc and with available data for PAH screening with the DETECT algorithm and the 2015 ESC/ERS echocardiographic criteria were retrospectively enrolled from January to June 2017 and then followed for 5 years. Baseline and annual clinical, laboratory, and instrumental data were collected. Results: A total of 33 out of 131 (25%) patients were selected based upon the ESC/ERS echocardiographic criteria, but 30 (23%) underwent RHC, while 51 (39%) patients with SSc were positive based on the DETECT algorithm. PAH diagnosis was confirmed in 28/30 cases (93.3%). The DETECT algorithm showed lower specificity and positive predictive value (PPV) (p < 0.0001) but higher sensitivity and negative predictive value (NPV) (p < 0.0001) than ESC/ERS criteria. Notably, patients with SSc with a negative DETECT screening at baseline had a low probability of developing PAH during a 5-year follow-up (OR 0.15, 95% CI 0.10-0.60-p < 0.0001). Conclusions: The DETECT algorithm has proven to be an easy, fast, and inexpensive tool for screening PAH in patients with SSc. Overall, a low probability of PAH using DETECT is highly predictive of a good prognosis.

Combined first-trimester screening for preterm small-for-gestational-age infants: Australian multicenter clinical feasibility study.

To assess the performance of the Fetal Medicine Foundation (FMF) first-trimester competing-risks screening model for small-for-gestational-age (SGA) fetuses requiring delivery at < 37 weeks' gestation, in a large cohort of women receiving maternity care in Australia. This was a retrospective analysis of prospectively collected data from a cohort of women attending one of two private multicenter fetal medicine practices for first-trimester screening for preterm pre-eclampsia (PE), defined as PE requiring delivery before 37 weeks' gestation. Risk for preterm SGA, defined as SGA requiring delivery before 37 weeks, was calculated but was not disclosed to the patient or referring physician. Screening data were matched to obstetric outcomes. The primary outcome was the efficacy of the FMF screening model in assessing the risk of preterm SGA. The potential effect on identifying other adverse pregnancy outcomes was also assessed. During the study period, 22841 women with a singleton pregnancy underwent combined first-trimester screening for preterm PE. These data were compared with those of 301721 women in the state of Victoria with a singleton pregnancy who did not undergo screening during the study period. Calculation of the risk for preterm SGA identified 3030 (13.3%) pregnancies as high risk. The sensitivity of the model was 48.6% (95% CI, 41.0-56.2%), specificity was 87.0% (95% CI, 86.6-87.5%) and positive and negative predictive values were 2.9% (95% CI, 2.7-3.1%) and 99.5% (95% CI, 99.4-99.6%) respectively. Pregnancies at high risk for preterm SGA were also more likely to have preterm PE (risk ratio (RR), 2.28 (95% CI, 1.72-3.03)) and preterm birth (RR, 1.46 (95% CI, 1.32-1.63)), compared with unscreened pregnancies. Pregnancies at low risk for preterm SGA were less likely to result in a stillbirth (RR, 0.64 (95% CI, 0.47-0.86)) compared with unscreened pregnancies. Combined first-trimester screening for preterm SGA shows moderate screening efficacy and therefore could help to inform pregnancy management and improve antenatal resource allocation. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.

Global disease burden of cervical cancer and the association of screening coverage with quality of disease management.

To analyze the global disease burden of cervical cancer and the association between screening coverage and the quality of disease management. The data of global burden of cervical cancer 2021 and the data of cervical cancer screening 2019 were obtained from IHME Global Burden of Disease (GBD) and the WHO Global Health Observatory (GHO), respectively. The age-standardized disease burden index was calculated, the Quality of Disease Management Index (QCI) was determined with principal component analysis, the correlation between QCI and cervical cancer screening coverage was examined with linear regression analysis by regions and populations. The burden of cervical cancer and the quality of its management exhibited significant variability across countries with differing levels of social development. The indicators of cervical cancer burden in China were close to the average level of countries with higher socia-demographic index (SDI). The global QCI was 22.22 (10.50, 35.43), and that of China was 26.30. The global screening coverage rate for cervical cancer was 42% (12%, 86%) and that in China was 31%. After adjusting for the social development level of countries, the coverage level of cervical cancer screening was associated with QCI (β=0.27, P<0.01), no matter in countries with low or high SDI (P>0.05). The association was significantly stronger among younger women (β=1.48, P<0.05). There are discrepancies in both the disease burden of cervical cancer and the quality of disease management among countries with different socioeconomic levels, and there is still considerable room for improvement in China. Expanding coverage of cervical cancer screening may be an effective strategy to enhance the management quality of cervical cancer, particularly among younger women where the screening benefits are most pronounced.

Rapid Development of High Concentration Protein Formulation Driven by High-Throughput Technologies.

High concentration protein formulation (HCPF) development needs to balance protein stability attributes such as conformational/colloidal stability, chemical stability, and solution properties such as viscosity and osmolality. A three-phase design is established in this work. In Phase 1, conformational and colloidal stability are measured by 384-well-based high-throughput (HT) biophysical screening while viscosity reduction screening is performed with HT viscosity screening. Collectively, the biophysical and viscosity screening data are leveraged to design the phase 2 of short-term stability study, executed using 96-well plates under thermal and freeze/thaw stresses. In phase 2, samples are analyzed by stability-indicating assays and processed with pair-wise Student's t-test analyses to choose the final formulations. In phase 3, the final formulations are then confirmed through a one-month accelerated stability in glass vials. Using a model antibody A (mAb-A), the initial HT screening successfully established the 384-well based platform. A lead formulation was chosen from the second round based on statistical analyses and subsequently tested against the commercial formulation of mAb-A as a control. Compared to the control, the lead formulation reduced the viscosity of mAb-A by 30% and decreased subvisible particles after thermal stress by 80%. HT biophysical screening in 384-well plates was demonstrated to effectively guide the rational design of a high-throughput stability screening study using 96-well plates. This platform enables the identification of a high concentration formulation within seven weeks within the first two phases of study that strategically balance stability with solution properties, thus achieving a rapid development of HCPF.

Recent Advances in Nontargeted Screening of Chemical Hazards in Foodstuffs.

The emergence of several chemical substances continues to enrich and facilitate the development of food science, but their irrational use also poses a threat to food safety and human health. Nontargeted screening (NTS) has become an important tool for rapid traceability and efficient identification of chemical hazards in food matrices. NTS in food analysis is highly integrated with sample pretreatment, instrumental analysis platforms, data acquisition and analysis, and toxicology. This article is a systemic review of current sample preparation, analytical platforms, and toxicity-guided NTS techniques and provides the latest advancements in workflows and innovative applications of the NTS process based on mass spectrometric techniques. High-throughput toxicity screening platforms play an important role in NTS of unknown chemical hazards of complex food matrices. Advanced machine learning and artificial intelligence are increasingly accessible fields that may effectively process large-scale screening data and advance food NTS research.

Two-layer homolog network approach for PFAS nontarget screening and retrospective data mining

The rapid increase of novel per- and polyfluoroalkyl substances (PFAS) raises concerns, while their identification remains challenging. Here, we develop a two-layer homolog network approach for PFAS nontarget screening using mass spectrometry. The first layer constructs networks between homologs, with evaluation showing that it filters 94% of false candidates. The second layer builds a network between classes to expedite the identification of PFAS. We detected 94 PFAS in twelve waterproof products and two related industrial sludges, including 36 novel PFAS not previously reported in any sample. A local dataset is constructed for retrospective analysis by re-analyzing our previous samples, revealing fifteen novel PFAS in samples collected in 2005. The retrieval of the public database MassIVE uncovers novel PFAS in samples from seven countries. Here, we reveal the historic and global presence of novel PFAS, providing guidance for the management and policy-making concerning persistent chemicals.

Screening for anxiety in patients with cancer: Diagnostic accuracy of GAD-7 items considering lowered GAD-7 cut-offs.

A standard questionnaire for generalized anxiety disorders is the GAD-7. Attempts to improve its screening capacity in oncological settings resulted in a discussion about lowering its cut-off. This study examines the diagnostic accuracy of the GAD-7 items depending on applied cut-offs and whether, similar to depressive symptoms, a distinction between somatic-emotional and cognitive items might be relevant. Screening data from 4705 patients with cancer who were treated at the outpatient clinic of the National Centre for Tumour Diseases in Heidelberg were analysed. For the individual GAD-7 items sensitivity, specificity, positive and negative predictive values, and Clinical Utility Index were determined for cut-off ≥ 7, ≥ 8, ≥ 10 and ≥ 15 in the GAD-7 questionnaire. The best overall diagnostic accuracy was found for a cut-off ≥ 8. The cognitive items had the best diagnostic accuracy for identifying severe GAD (cut-off ≥ 15), and the somatic-emotional items had the best diagnostic accuracy for identifying mild to moderate GAD (cut-off ≥ 7, ≥ 8 and ≥ 10). Our data support the recommendation of lowering the GAD-7 cut-off in oncology settings and suggest that in anxiety disorders, a symptom overlap between the physical illness and a possible mental disorder should be considered.

An Efficient Acute Lymphoblastic Leukemia Screen Framework Based on Multi-Modal Deep Neural Network.

Acute lymphoblastic leukemia (ALL) is a leading cause of death among pediatric malignancies. Early diagnosis of ALL is crucial for minimizing misdiagnosis, improving survival rates, and ensuring the implementation of precise treatment plans for patients. In this study, we propose a multi-modal deep neural network-based framework for early and efficient screening of ALL. Both white blood cell (WBC) scattergrams and complete blood count (CBC) are employed for ALL detection. The dataset comprises medical data from 233 patients with ALL, 283 patients with infectious mononucleosis (IM), and 183 healthy controls (HCs). The combination of CBC data with WBC scattergrams achieved an accuracy of 98.43% in fivefold cross-validation and a sensitivity of 96.67% in external validation, demonstrating the efficacy of our method. Additionally, the area under the curve (AUC) of this model surpasses 0.99, outperforming well-trained medical technicians. To the best of our knowledge, this framework is the first to incorporate WBC scattergrams with CBC data for ALL screening, proving to be an efficient method with enhanced sensitivity and specificity. Integrating this framework into the screening procedure shows promise for improving the early diagnosis of ALL and reducing the burden on medical technicians. The code and dataset are available at https://github.com/cvi-szu/ALL-Screening.

Mortality among older adults Jordanians with coronary heart disease: Intelligent algorithms prediction

&lt;b&gt;Background and aim: &lt;/b&gt;Worldwide, coronary heart disease (CHD) is the main cause of death. To prevent heart disease and save lives, this study uses a machine learning algorithm (MLA), a subfield of artificial intelligence, to predict death vs. life outcomes among older persons with CHD.&lt;br /&gt; &lt;b&gt;Methods: &lt;/b&gt;Large-scale data was retrieved from the electronic health records of 3,331 elderly patients with congestive heart failure retrospectively. Information was gathered on the population in Jordan who were hospitalized in public health hospitals between 2015 and 2021.&lt;br /&gt; &lt;b&gt;Results: &lt;/b&gt;Based on the accuracy level (91.4%) and area under the curve (71.7%) of the eight prediction models created, the Chi-square automatic interaction detector algorithm was chosen to predict death versus life among older adults with CHD. The sequence of death prediction algorithms began with the medical diagnosis, location, age, and pulse pressure.&lt;br /&gt; &lt;b&gt;Conclusion: &lt;/b&gt;Attempts should be made to use the expertise of many specialists and clinical screening data gathered from patient databases to speed up the diagnosis process with MLAs, which are thought to be a useful tool for identifying CHD patients who are at high risk of dying.

Insights From Minnesota on Newborn Screening for Adrenoleukodystrophy: A 5-Year Update.

Our objectives are to report on the outcomes of adrenal insufficiency (AI) and cerebral ALD (cALD) in children diagnosed with X-linked adrenoleukodystrophy (ALD) identified by newborn screening (NBS) in Minnesota in the first 5 years following initiation of NBS in 02/2017. A retrospective chart review was conducted for children diagnosed with ALD via Minnesota NBS from 02/06/2017 through 02/06/2022. Data reviewed included newborn screening data, diagnostic very long chain fatty acid levels, ABCD1 molecular testing results, serial measurements of ACTH and cortisol, and serial brain MRI results. Thirty-two boys and 11 girls were molecularly and/or biochemically confirmed to have ALD. Of these 32 boys, six (2-7 years; median age:18 months) developed AI. Two boys developed cALD and underwent stem cell transplantation, one of whom also has been diagnosed with AI. All the pathogenic/likely pathogenic variants detected during the first 5 years had initial C26:0 lysophosphatidylcholine (C26:0 lysoPC) values over 0.3 μmol/L at the time of newborn screening. The addition of ALD to NBS in Minnesota has allowed for early detection of asymptomatic AI in six young patients and asymptomatic cALD in two patients. Data from our study shows a positive correlation between high newborn screening LysoPC levels and variant pathogenicity.