Screening Sessions Research Articles

The acceptability of a novel seismocardiography device for measuring VO2 max in a workplace setting: a mixed methods approach

BackgroundWorkplace health screening rarely includes measures of cardiorespiratory fitness, despite it being a greater predictor of cardiovascular disease and all-cause mortality than other routinely measured risk factors. This study aimed to determine the comparative acceptability of using a novel seismocardiography device to measure cardiorespiratory fitness via VO2 max during a workplace health check.MethodsParticipants were invited to participate in workplace health screening sessions where VO2 max was assessed by both seismocardiography at rest and sub-maximal exercise testing, in order for acceptability of both to be compared across multiple domains. Questionnaires and focus group guides for participants and practitioners were developed based on the Theoretical Framework of Acceptability. Data were analysed using t-tests and deductive thematic analysis.ResultsThere was a significant difference in the acceptability domain of ‘affective attitude’ between the novel SCG device (M = 9.06 ± 1.14) and the sub-maximal exercise testing (M = 7.94 ± 1.79); t = 3.296, p = .001, d = 0.50, and in the domain of ‘burden’ between the novel SCG device (M = 9.16, ± 0.55) and the sub-maximal exercise testing (M = 7.41 ± 1.45); t = 7.033, p = < 0.001, d = 1.45. Practitioners and employees highlighted the potential of seismocardiography to create a more inclusive and accessible workplace offer, allowing those with restricted mobility or those with differing physical or emotional needs to participate in wellness testing; yet there was a lack of understanding in both groups around intervention effectiveness and coherence.ConclusionsSeismocardiography may offer an acceptable route to cardiorespiratory fitness testing in the workplace, due to the low effort requirement and simplicity of administration. This study suggests that practitioners delivering such services have a critical role to play in acceptability of health interventions at work, as employees will be heavily influenced by practitioner beliefs around coherence and effectiveness. Comprehensive delivery training is important for the adoption of new health-related technologies such as seismocardiography into workplace health screening.

Investigation of the rates of retinopathy of prematurity and other diseases in infants born late preterm: is routine ROP examination required?

The objective of this study was to ascertain the prevalence of ROP and other ocular diseases in late preterm infants and to evaluate the necessity of routine ROP examination in a tertiary hospital in Turkey. This retrospective cohort study included late preterm infants treated in the neonatal intensive care unit (NICU) and referred to the ROP outpatient clinic. Those who were discharged or died before the first screening and those who did not complete all screening sessions were excluded. The data set comprised demographic information, gestational age, birth weight, stages of ROP, treatments, and the presence of other ocular comorbidities. The study cohort comprised 600 late preterm infants, with a median gestational age of 35 weeks and a mean birth weight of 2392 ± 451 g. Of the infants included in the study, 3.3% developed ROP, with one infant requiring treatment. Furthermore, 4.8% of the subjects exhibited additional ocular comorbidities. The results indicated a statistically significant correlation between lower birth weight and gestational age with an increased prevalence of ROP and other ocular pathologies. ROP incidence in late preterm infants is relatively low, although comorbidities are notable. Infants born late preterm with lower birth weight and gestational age are at greater risk for ROP and additional pathologies. It is recommended that routine screening for ROP be conducted in order to ensure that ROP and other ocular conditions are diagnosed and treated in a timely manner, thus preventing severe visual impairments.

Prevalence of Malocclusion During Puberty Growth Spurt in Grade X Students of SMA Seven at Gunung Samarinda Health Center

Malocclusion is anabnormal position of the jaw or teeth. Malocclusion ranges in severity from low to high, reflecting biological differences across individuals. Human growth and development varies, including bone growth during the accelerated growth period during puberty. Individual identification of the pubertal growth spurt period is very important in orthodontic treatment, because the best growth changes are achieved during the pubertal growth spurt.Purpose: This Study aimed to describe the prevalence of Malocclusion in Pubertal growth Spurt at class 10 students of 7 Senior High School during networking at Gunung Samarinda Community Health Center, Balikpapan East Kalimantan.Methods: A descriptive observational study with a crosssectional design was conducted. There were 1339 students recruited in the screening session.

Abstract 4144566: Building CPR/AED Confidence through Community Volunteer Prevention Screening Sessions: The Impact of the Eric Paredes Save A Life Foundation

Introduction: Sudden cardiac arrest (SCA) remains a leading cause of death among young individuals, often occurring without prior symptoms. Public confidence in recognizing SCA warning signs, understanding risk factors, and using cardiopulmonary resuscitation (CPR) and Automated External Defibrillators (AEDs) is generally low. The Eric Paredes Save A Life Foundation addresses this gap by offering free cardiac screenings and educational sessions. This abstract evaluates the foundation's impact on participants' confidence in these critical areas. Goals: The primary objectives were to enhance participants' confidence in identifying SCA warning signs and risk factors, performing CPR, using AEDs during cardiac emergencies, and communicating youth heart health concerns to healthcare providers. Methods: Volunteer-led prevention screening sessions were conducted, incorporating educational components on SCA warning signs, risk factors, and hands-only CPR and AED training. Post-session surveys were administered to 1,123 participants to assess their confidence levels in these areas. Results: The screening sessions significantly increased participants' confidence. Specifically, 96% of participants reported heightened confidence in recognizing SCA warning signs and understanding risk factors. Additionally, 94% felt more assured in discussing youth heart health with providers. Confidence in performing CPR during a cardiac emergency rose to 92%, while confidence in using an AED reached 89%. These results demonstrate the effectiveness of the sessions in empowering individuals with essential life-saving skills. Conclusions: The Eric Paredes Save A Life Foundation's prevention screening sessions are highly effective in improving participants' confidence in recognizing SCA warning signs, understanding risk factors, and using CPR and AEDs. The substantial increase in confidence levels underscores the importance of community-based education and training programs in reducing SCA-related fatalities among youth. These findings support the need for ongoing and expanded initiatives to further enhance public health outcomes and preparedness for cardiac emergencies.

Cervical precancer screening using self-sampling, HPV DNA testing, and mobile colposcopy in a hard-to-reach community in Ghana: a pilot study

BackgroundThe World Health Organization has set ambitious goals to eliminate cervical cancer, necessitating evidence on increasing coverage and access to screening and treatment in high-burden areas. We implemented a pilot program to assess the feasibility of obtaining self-collected specimens for high-risk human papillomavirus (hr-HPV) testing in Nzulezo stilt village, a hard-to-reach community in Ghana, and inviting only hr-HPV-positive women to a central location for colposcopy and possible treatment. Subsequently, this study aimed to investigate the prevalence of hr-HPV infection and cervical lesions among the women and to explore factors potentially associated with hr-HPV infection among them.MethodsThis pilot community-based cross-sectional study utilized data from screening sessions held from 2 to 20 November 2021 with specimens collected by participants using Evalyn brushes. HPV DNA testing was performed using the Sansure MA-6000 platform, while visual inspection utilized the Enhanced Visual Assessment (EVA) mobile colposcope. Univariate and multivariable nominal logistic regression was employed to explore factors associated with hr-HPV positivity.ResultsAmong 100 women screened (mean age, 43.6 ± 14.5 years), the overall hr-HPV prevalence rate was 39.0% (95% CI, 29.4–49.3). The prevalence rates of hr-HPV genotypes were stratified as follows: HPV16–8.0% (95% CI, 3.5–15.2), HPV18–5.0% (95% CI, 1.6–11.2), and other genotype(s) – 31.0% (95% CI, 22.1–41.0). Single-genotype infections with HPV16 and HPV18 were found in 4.0% (95% CI, 1.1–9.9) and 3.0% (95% CI, 0.6–8.5) of women, respectively. Mixed infections were observed in 1.0% (95% CI, 0.0–5.4) for HPV16 + 18, 3.0% (95% CI, 0.6–8.5) for HPV16 + other type(s), and 1.0% (95% CI, 0.0–5.4) for HPV18 + other type(s). The prevalence of cervical lesions among hr-HPV-positive women screened via colposcopy was 11.4% (95% CI, 3.2–26.7). In the multivariable model, reliance on other sources for medical bill payment was associated with hr-HPV infection (aOR, 0.20; 95% CI, 0.04–0.93), whereas age was not (aOR, 1.02; 95% CI, 0.99–1.05).ConclusionsA high hr-HPV infection prevalence was recorded among the women. Utilizing technologies such as self-sampling, HPV DNA testing, and mobile colposcopy enables screening and treatment in remote and hard-to-reach communities where access to cervical cancer screening and treatment would otherwise be limited. Further research is warranted to assess the value and scalability of this approach in similar remote areas and its potential implementation in future programs.

Screening for compensated advanced chronic liver disease using transient elastography in outpatient addiction clinics.

Patients with substance use disorders present with many risk factors for liver disease-including alcohol, hepatitis C virus infection, and obesity-and should thus be screened for compensated advanced chronic liver disease (cACLD). Such screening could potentially be performed by outpatient addiction clinics. In this study, we aimed to assess the feasibility, acceptability, and results of cACLD screening using transient elastography (TE) among all patients attending routine follow-up visits at addiction clinics, regardless of their liver disease risk factors. Liver fibrosis evaluation using TE was offered to every patient consulting two different addiction clinics in France, between December 2020 and September 2021, during dedicated half-day screening sessions. The screening was proposed during the patient's routine care and was performed immediately after the scheduled consultation. Patients with a liver stiffness measurement over 8 kPa were referred to a hepatology visit in the addiction clinic within 2-4 weeks. Screening was offered to 227 patients and was accepted by 116 (51%) patients. Twelve patients had a liver stiffness over 8 kPa, and nine of these patients attended the recommended specialist hepatology visit. Five patients (4.3% of those screened) were diagnosed with cACLD. Patients' acceptance of the screening was associated with older age, being on one's own or professionally inactive, and presenting with alcohol use disorder. Overall, our results demonstrated that opportunistic cACLD screening using TE in outpatient addiction clinics was feasible and acceptable, with good results.

Evaluating the Feasibility of a Telescreening Program for Retinopathy of Prematurity (ROP) in Denmark.

Objectives: This study investigates the feasibility of implementing telescreening for retinopathy of prematurity (ROP) using the ICON GO® widefield camera operated by a non-physician healthcare professional (NPHP). We hypothesized that images captured by an NPHP are adequate to evaluate ROP changes without further examinations. Secondly, the level of agreement between independent ROP graders were evaluated based on the fundus photographs. Methods: National ROP screening criteria were gestational age (GA) < 32 weeks or birthweight (BW) < 1500 g. Exclusion criteria were children hospitalized and born outside the Capital Region and examinations not performed by an NPHP. The screenings were performed using the ICON GO®. The NPHP selected the best images for evaluation by an on-site ophthalmologist, regarding whether re-examination was necessary and if so, whether the re-examination was beneficial. Lastly, the images were re-evaluated by an independent off-site ophthalmologist. Results: A total of 415 screening sessions on 165 patients performed by an NPHP were included. Re-examination was necessary in three screening sessions and beneficial in two. The level of agreement between the on-site and off-site ophthalmologists regarding ROP screening outcome was k = 0.82, ROP stage k = 0.69, plus disease k = 0.69, and lastly ROP zone k = 0.37. Of the screened children, ninety-seven (58.8%) had no ROP at any time points, sixty-two (37.6%) had some stage of ROP not requiring treatment, and six (3.6%) received ROP treatment. Conclusions: Telemedicine screening for ROP with the ICON GO® camera performed by an NPHP was feasible with an almost-perfect agreement and negligible need for re-examinations. The approach effectively identified children needing treatment, supporting the use of telescreening in ROP management.

Efficiency and Workload Reduction of Semi-automated Citation Screening Software for Creating Clinical Practice Guidelines: A Prospective Observational Study

We evaluated the applicability of automated citation screening in developing clinical practice guidelines. We prospectively compared the efficiency of citation screening between the conventional (Rayyan) and semi-automated (ASReview software) methods. We searched the literature for five clinical questions (CQs) in the development of the Japanese Clinical Practice Guidelines for the Management of Sepsis and Septic Shock. Objective measurements of the time required to complete citation screening were recorded. Following the first screening round, in the primary analysis, the sensitivity, specificity, positive predictive value, and overall screening time were calculated for both procedures using the semi-automated tool as index and the results of the conventional method as standard reference. In the secondary analysis, the same parameters were compared between the two procedures using the final list of included studies after the second screening session as standard reference. Among the five CQs after the first screening session, the highest and lowest sensitivity, specificity, and positive predictive values were 0.241 and 0.795; 0.991 and 1.000; and 0.482 and 0.929, respectively. In the secondary analysis, the highest sensitivity and specificity in the semi-automated citation screening were 1.000 and 0.997, respectively. The overall screening time per 100 studies was significantly shorter with semi-automated than with conventional citation screening. The potential advantages of the semi-automated method (shorter screening time and higher discriminatory rate for the final list of studies) warrant further validation.

Viral Hepatitis and HIV Screening in Seasonal Mountain Workers: Feasibility and Results of a First French Experiment

Introduction: The Mobile Hepatitis Team (MHT) was set up in 2013, with main objective was to increase outreach screening care treatment access and cure of our target population. Target population was drugs users, prisoners, homeless, precarious people, migrants, and psychiatric patients. Seasonal workers working in mid-mountain ski resorts in the Eastern Pyrenees constitute a population at risk of viral hepatitis and HIV. This young population presents sexual risk behaviors and consumption of addictive products without regular access to care because of their mobility, moving from one workplace to another according to the seasons. They do not have a regular general practitioner, do not perform screening tests and there is no access to care other than the mandatory occupational medicine visit at the beginning of the season. In previous actions on the health aera of the high cantons of the department of Pyrénées-Orientales. We met with invested partners who referred us to this specific population of seasonal workers and their lack of access to screening and care, except for the occupational medicine hiring visit, organized before the beginning of the winter season, late November in early December. Objective: To detect viral hepatitis and HIV in a population at viral risk and far from care and offer them immediate treatment of the type of linkage to care “TEST TO CURE”. Methodology: 2-weeks HCV HBV and HIV finger sticks by trained nurses and orientation to the hepatology or the infectious units. Results: only 28 HCV finger sticks were completed. We also met 4 patients with known HCV serology. Three patients received DAA treatment and one patient spontaneous cured with negative RNA. One new patient had RNA C positive on balance sheet without social rights. We oriented him towards sour social worker to treat him later. Two patients had 2 real time HCV viral load not detected (including one post treatment follow-up) and one RNA negative without antiviral treatment, in case of HCV spontaneous clearance. For HBV, 16 finger sticks were completed, all negative. We did not meet as many seasonal workers as originally planned. This is why we conducted a second session over 2 days only targeted on these temporary accommodations. We realized 26 HCV and HIV finger sticks. One patient was HIV positive. HIV serology was unknow until our screening session. Nobody was HCV positive but 62% of screened people were drugs users or former drugs users. Discussion: our study was a success even the low number of people screened in the first 2-week session. The second 2-day session was more efficient. It was the first experience of hepatitis and HIV screening in this population of seasonal mountain workers. Conclusion: despite all limits, hepatitis and HIV screening among seasonal mountain workers was an innovative and efficient action. This action could be easily replicated in all populations of seasonal workers, whether in the mountains or by the sea.

Smoking data quality of primary care practices in comparison with smoking data from the New Zealand Māori and Pacific abdominal aortic aneurysm screening programme: an observational study

BackgroundQuality smoking data is crucial for assessing smoking-related health risk and eligibility for interventions related to that risk. Smoking information collected in primary care practices (PCPs) is a major data source; however, little is known about the PCP smoking data quality. This project compared PCP smoking data to that collected in the Māori and Pacific Abdominal Aortic Aneurysm (AAA) screening programme.MethodsA two stage review was conducted. In Stage 1, data quality was assessed by comparing the PCP smoking data recorded close to AAA screening episodes with the data collected from participants at the AAA screening session. Inter-rater reliability was analysed using Cohen’s kappa scores. In Stage 2, an audit of longitudinal smoking status was conducted, of a subset of participants potentially misclassified in Stage 1. Data were compared in three groups: current smoker (smoke at least monthly), ex-smoker (stopped > 1 month ago) and never smoker (smoked < 100 cigarettes in lifetime).ResultsOf the 1841 people who underwent AAA screening, 1716 (93%) had PCP smoking information. Stage 1 PCP smoking data showed 82% concordance with the AAA data (adjusted kappa 0.76). Fewer current or ex-smokers were recorded in PCP data. In the Stage 2 analysis of discordant and missing data (N = 313), 212 were enrolled in the 29 participating PCPs, and of these 13% were deceased and 41% had changed PCP. Of the 93 participants still enrolled in the participating PCPs, smoking status had been updated for 43%. Data on quantity, duration, or quit date of smoking were largely missing in PCP records. The AAA data of ex-smokers who were classified as never smokers in the Stage 2 PCP data (N = 27) showed a median smoking cessation duration of 32 years (range 0–50 years), with 85% (N = 23) having quit more than 15 years ago.ConclusionsPCP smoking data quality compared with the AAA data is consistent with international findings. PCP data captured fewer current and ex-smokers, suggesting ongoing improvement is important. Intervention programmes based on smoking status should consider complementary mechanisms to ensure eligible individuals are not missed from programme invitation.

EMinsight: a tool to capture cryoEM microscope configuration and experimental outcomes for analysis and deposition.

The widespread adoption of cryoEM technologies for structural biology has pushed the discipline to new frontiers. A significant worldwide effort has refined the single-particle analysis (SPA) workflow into a reasonably standardized procedure. Significant investments of development time have been made, particularly in sample preparation, microscope data-collection efficiency, pipeline analyses and data archiving. The widespread adoption of specific commercial microscopes, software for controlling them and best practices developed at facilities worldwide has also begun to establish a degree of standardization to data structures coming from the SPA workflow. There is opportunity to capitalize on this moment in the maturation of the field, to capture metadata from SPA experiments and correlate the metadata with experimental outcomes, which is presented here in a set of programs called EMinsight. This tool aims to prototype the framework and types of analyses that could lead to new insights into optimal microscope configurations as well as to define methods for metadata capture to assist with the archiving of cryoEM SPA data. It is also envisaged that this tool will be useful to microscope operators and facilities looking to rapidly generate reports on SPA data-collection and screening sessions.

Patients’ perspectives on adherence to cardiovascular screening consultation and lifestyle changes

BackgroundRheumatoid arthritis (RA) poses a significant health burden, with patients facing a twofold higher risk of cardiovascular diseases compared to the general population. As a results, the international recommendations set forth by the European Alliance of Associations for Rheumatology, advocate for a structured cardiovascular (CV) risk management and adherence to a healthy lifestyle for patients with RA. Unhealthy lifestyle factors not only impact overall health but also worsen inflammation and hinder treatment response in patients with RA Despite these recommendations, there remains a knowledge gap regarding patients’ attitudes towards screening participation and lifestyle changes. Therefore, the aims of this study were firstly to explore the perspectives of patients with rheumatoid arthritis on participation and adherence to cardiovascular screening. Secondly, to explore patients’ perspectives on lifestyle changes.MethodsSemi-structured interviews based on a hermeneutic approach were conducted. The analysis was guided by qualitative content analysis, employing an inductive approach.ResultsNine women and seven men, aged 47 to 76 years, diagnosed with RA, and who had attended at least one CV screening session, took part in the study. Two primary themes, along with four sub-themes, emerged from the analysis. The first main theme, Accepting an offer, encompassed the sub-themes of Engagement in the screening consultation and Risk awareness, reflecting participants' views on their involvement in, and commitment to, CV screening. The second theme pertained to participants' perspectives on lifestyle changes: Living with a chronic disease and embracing changes, described through the sub-themes of Motivation for lifestyle changes and Strategies to achieve lifestyle changes.ConclusionMotivations for taking part in the screening differed among the participants, ranging from simply accepting an invitation to joining as a proactive precaution. In general, there was unanimous agreement among the participants that the screening proved to be a positive encounter. While it may not have immediately prompted significant lifestyle alterations, it did enhance their awareness of risks and underscored the significance of maintaining a healthy lifestyle. Overall, the individual guidance and support for patients with rheumatoid arthritis should entail awareness of CV risk combined with support to lifestyle changes the participants want to pursue.

Functional analysis screening for inappropriate mealtime behavior

AbstractInappropriate mealtime behavior (IMB) is a class of food refusal behavior that is commonly observed in children with neurodevelopmental disorders or avoidant/restrictive food intake disorder. An abundance of research has demonstrated that IMB is commonly maintained by negative reinforcement in the form of escape from food or drink presentation. Given the common association between IMB and escape as a reinforcer, more efficient methods of conducting functional analyses have been called for. The present study examined the extent to which indirect assessments and a functional analysis screening process reliably predicted an escape function in three children with autism spectrum disorder who engaged in IMB. The results of the two assessments were then compared to a standard functional analysis. For all participants, the functional analysis identified an escape function, which corresponded with both the indirect assessment and screening. Additionally, within‐session analyses of screening sessions further validated the screening process. The functional analysis screening of IMB is discussed in terms of its efficiency, practicality, and experimental design. The results of this study offer a framework for efficiently assessing the function of IMB, while providing recommendations for future research.

Proof of concept of a sexual health outreach program led by community health workers in homeless hostels in the greater Paris region.

Homeless individuals face exacerbated risks of infectious diseases, including sexually transmitted infections (STIs). Programs led by Community Health Workers (CHWs) have demonstrated potential to enhance healthcare access for marginalized groups such as homeless families. This study aims to evaluate the feasibility and effectiveness of a novel CHW-based outreach program addressing sexual health issues among individuals residing in homeless hostels. Twelve social homeless hostels in the greater Paris region were selected as program implementation sites. An outreach program was developed consisting of two interventions: sexual health workshops and STI screening sessions (HIV and hepatitis B and C) accompanied by individual interviews, both conducted by CHWs within each hostel over an 8-week period and scheduled weekly. Feasibility, participation and engagement were evaluated using complementary methods including qualitative field observations, semi-structured interviews and focus groups with CHWs, satisfaction questionnaires for participants, and quantitative outcome data collection of each intervention. A total of 80 program activities (workshops and screening sessions) were conducted. Among the participants, 542 women and 30 men engaged in workshops. During the 30 Rapid Diagnostic Testing sessions, 150 individuals underwent testing for HIV, hepatitis B, and/or hepatitis C. Positivity rates were 6.7% for hepatitis B and 0.9% for hepatitis C. No HIV infections were detected. Participant satisfaction rates were consistently high (>76%) across workshops. Qualitative analysis unveiled two critical axes influencing program feasibility and effectiveness: program organization and CHW involvement. This assessment of the program highlights its feasibility among a population that is difficult to reach through conventional healthcare efforts. The intervention's potential effectiveness is suggested by self- and CHW-reported improvements in sexual health literacy and high rates of referral to the healthcare system, as well as holistic well-being considerations. CHW involvement is a vital determinant of program success, as are robust coordination among stakeholders, deep understanding of the target population, and strong partner engagement. This outreach program amplifies the voices of often-overlooked populations while empowering them to navigate health and social challenges. Although these workshops serve as lifelines for those frequently excluded from mainstream services, long-term improvements to the health and wellbeing of homeless populations will necessitate systemic governmental intervention.

Programmatic implementation of depression screening and remote mental health support sessions for persons recently diagnosed with TB in Lima, Peru during the COVID-19 pandemic.

Few studies have explored a stepped care model for delivering mental health care to persons with tuberculosis (TB). Here, we evaluated depression screening and remote low-intensity mental health interventions for persons initiating TB treatment in Lima, Peru during the COVID-19 pandemic. We used the Patient Health Questionnaire 9 (PHQ-9) to screen participants for depressive symptoms (PHQ-9≥5). Participants with PHQ-9, 5-14 received remote Psychological First Aid (PFA) or Problem Management Plus (PM+). Participants were reevaluated 6months after intervention completion. We then compared the change in median PHQ-9 scores before and after intervention completion. Those with PHQ-9≥15 were referred to higher-level care. We found that 62 (45.9%) of the 135 participants had PHQ-9≥5 at baseline. Then, 54 individuals with PHQ-9, 5-9 received PFA, of which 44 (81.5%) were reevaluated. We observed significant reductions in median PHQ-9 scores from 6 to 2 (r=0.98; p<0.001). Four participants with PHQ-9, 10-14 received PM+ but were unable to be reevaluated. Four participants with PHQ-9≥15 were referred to higher-level care. Depressive symptoms were common among persons recently diagnosed with TB. We observed improvements in depressive symptoms 6months later for most participants who received remote sessions of PFA.

Prevalence and factors associated with uncontrolled type 2 diabetes among patients in Kirehe District, Rwanda: a cross-sectional study.

the increase in type 2 diabetes mellitus (T2DM) is a major public health issue on a global scale. A continuous rise in blood sugar levels, even if there are no symptoms of diabetes, leads to tissue degeneration and, in certain cases, fatal diseases. in this cross-sectional study, the researcher examined the prevalence of uncontrolled type 2 diabetes mellitus among patients in Kirehe District Health Facilities from October 2023 to February 2024. The target population was 333 patients and the sample size was 201 patients who visited the non-communicable disease clinics throughout the time of data collection, those with T2DM diagnosis for at least a year, and non-pregnant women. the mean age was 57.23 years with an 11.06 standard deviation. Females represented 58.7% (n=118) while males were 41.3% (n=83). The prevalence of uncontrolled type 2 diabetes mellitus was 72.6% (n=146). Patients who had ever been lost to follow-up were more likely to have uncontrolled T2DM (AOR=3.24, 95% CI: 1.06-5.90, p=0.036) compared to those who regularly visited the health facility for care and follow-up. Patients who had comorbidities to diabetes were more likely to have uncontrolled T2DM (AOR=2.48, 95% CI: 1.31-4.68, p=0.005) compared to those who did not have comorbidities. the prevalence of uncontrolled T2DM is high; healthcare providers have a responsibility to perform home visits to reduce the lost to follow-up rate and to conduct regular screening sessions for diabetes comorbidities.

Cryo-Electron Microscopy Screening Automation across Multiple Grids using Smart Leginon.

Advancements in cryo-electron microscopy (cryoEM) techniques over the past decade have allowed structural biologists to routinely resolve macromolecular protein complexes to near-atomic resolution. The general workflow of the entire cryoEM pipeline involves iterating between sample preparation, cryoEM grid preparation, and sample/grid screening before moving on to high-resolution data collection. Iterating between sample/grid preparation and screening is typically a major bottleneck for researchers, as every iterative experiment must optimize for sample concentration, buffer conditions, grid material, grid hole size, ice thickness, and protein particle behavior in the ice, amongst other variables. Furthermore, once these variables are satisfactorily determined, grids prepared under identical conditions vary widely in whether they are ready for data collection, so additional screening sessions prior to selecting optimal grids for high-resolution data collection are recommended. This sample/grid preparation and screening process often consumes several dozen grids and days of operator time at the microscope. Furthermore, the screening process is limited to operator/microscope availability and microscope accessibility. Here, we demonstrate how to use Leginon and Smart Leginon Autoscreen to automate the majority of cryoEM grid screening. Autoscreen combines machine learning, computer vision algorithms, and microscope-handling algorithms to remove the need for constant manual operator input. Autoscreen can autonomously load and image grids with multi-scale imaging using an automated specimen-exchange cassette system, resulting in unattended grid screening for an entire cassette. As a result, operator time for screening 12 grids may be reduced to ~10 min with Autoscreen compared to ~6 h using previous methods which are hampered by their inability to account for high variability between grids. This protocol first introduces basic Leginon setup and functionality, then demonstrates Autoscreen functionality step-by-step from the creation of a template session to the end of a 12-grid automated screening session.

P147: Internet-delivered guided self-help Acceptance and Commitment Therapy for family carers of people with dementia (iACT4CARERS)

Background and objective:Despite the high prevalence of anxiety and depression, many family carers of people living with dementia are not able to access timely psychological support due to various barriers such as lack of respite care and a shortage of skilled therapists. Online treatments have the potential to improve access, and also scalability, reducing inequalities in access to care. This uncontrolled feasibility study aimed to evaluate whether it is feasible to deliver internet- delivered guided self-help Acceptance and Commitment Therapy (iACT4CARERS) within primary and secondary care services in the UK, and whether the intervention is acceptable to family carers of people living with dementia.Method:Family carers of people living with dementia presenting with mild to moderate anxiety or depression were recruited through healthcare services and public advertisements. Participants were offered eight, guided, self-help online ACT sessions adapted for the needs of family carers. Participants were also allocated a therapist who responded to questions to support their completion of each weekly session. Participants completed questionnaires assessing anxiety, depression and other outcomes before and after the intervention. They were also invited to attend an individual semi-structured interview to provide feedback on iACT4CARERSE at the end of the study.Results:Seventy-nine participants attended the screening session over six months, and 33 eligible participants (age range 47-85) received iACT4CARERS. Further, 70% of participants completed seven or all eight sessions, and 27% of participants were lost to follow-up, but none of the reasons for early withdrawal was related to the intervention. There was preliminary evidence of improvements in anxiety, depression and psychological flexibility, particularly in anxiety, which demonstrated an average reduction of 26% on the GAD7 anxiety scale. The results of qualitative interviews suggested that iACT4CARERS is acceptable to family carers. Positive carer experiences were particularly facilitated by the relatedness of the contents, increased feelings of connectedness and the user-friendliness of the online platform.Conclusion:The feasibility study provided evidence for the feasibility and acceptability of iACT4CARERS. This feasibility study led to an ongoing full-scale randomised controlled trial testing the clinical and cost effectiveness of iACT4CARERS. Recent developments of the iACT4CARERS project will be discussed.

Optimizing Noninvasive Vagus Nerve Stimulation for Systemic Lupus Erythematosus: Protocol for a Multicenter Randomized Controlled Trial.

Systemic lupus erythematosus is a chronic, multisystem, inflammatory disease of autoimmune etiology occurring predominantly in women. A major hurdle to the diagnosis, treatment, and therapeutic advancement of this disease is its heterogeneous nature, which presents as a wide range of symptoms such as fatigue, fever, musculoskeletal involvement, neuropsychiatric disorders, and cardiovascular involvement with varying severity. The current therapeutic approach to this disease includes the administration of immunomodulatory drugs that may produce unfavorable secondary effects. This study explores the known relationship between the autonomic nervous system and inflammatory pathways to improve patient outcomes by treating autonomic nervous system dysregulation in patients via noninvasive vagus nerve stimulation. In this study, data including biomarkers, physiological signals, patient outcomes, and patient quality of life are being collected and analyzed. After completion of the clinical trial, a computer model will be developed to identify the biomarkers and physiological signals related to lupus activity in order to understand how they change with different noninvasive vagus nerve stimulation frequency parameters. Finally, we propose building a decision support system with integrated noninvasive wearable technologies for continuous cardiovascular and peripheral physiological sensing for adaptive, patient-specific optimization of the noninvasive vagus nerve stimulation frequency parameters in real time. The protocol was designed to evaluate the efficacy and safety of transauricular vagus nerve stimulation in patients with systemic lupus erythematosus. This multicenter, national, randomized, double-blind, parallel-group, placebo-controlled study will recruit a minimum of 18 patients diagnosed with this disease. Evaluation and treatment of patients will be conducted in an outpatient clinic and will include 12 visits. Visit 1 consists of a screening session. Subsequent visits up to visit 6 involve mixing treatment and evaluation sessions. Finally, the remaining visits correspond with early and late posttreatment follow-ups. On November 2022, data collection was initiated. Of the 10 participants scheduled for their initial appointment, 8 met the inclusion criteria, and 6 successfully completed the entire protocol. Patient enrollment and data collection are currently underway and are expected to be completed in December 2023. The results of this study will advance patient-tailored vagus nerve stimulation therapies, providing an adjunctive treatment solution for systemic lupus erythematosus that will foster adoption of technology and, thus, expand the population with systemic lupus erythematosus who can benefit from improved autonomic dysregulation, translating into reduced costs and better quality of life. ClinicalTrials.gov NCT05704153; https://clinicaltrials.gov/study/NCT05704153. DERR1-10.2196/48387.

Development and validation of an artificial intelligence based screening tool for detection of retinopathy of prematurity in a South Indian population.

The primary objective of this study was to develop and validate an AI algorithm as a screening tool for the detection of retinopathy of prematurity (ROP). Images were collected from infants enrolled in the KIDROP tele-ROP screening program. We developed a deep learning (DL) algorithm with 227,326 wide-field images from multiple camera systems obtained from the KIDROP tele-ROP screening program in India over an 11-year period. 37,477 temporal retina images were utilized with the dataset split into train (n = 25,982, 69.33%), validation (n = 4,006, 10.69%), and an independent test set (n = 7,489, 19.98%). The algorithm consists of a binary classifier that distinguishes between the presence of ROP (Stages 1-3) and the absence of ROP. The image labels were retrieved from the daily registers of the tele-ROP program. They consist of per-eye diagnoses provided by trained ROP graders based on all images captured during the screening session. Infants requiring treatment and a proportion of those not requiring urgent referral had an additional confirmatory diagnosis from an ROP specialist. Of the 7,489 temporal images analyzed in the test set, 2,249 (30.0%) images showed the presence of ROP. The sensitivity and specificity to detect ROP was 91.46% (95% CI: 90.23%-92.59%) and 91.22% (95% CI: 90.42%-91.97%), respectively, while the positive predictive value (PPV) was 81.72% (95% CI: 80.37%-83.00%), negative predictive value (NPV) was 96.14% (95% CI: 95.60%-96.61%) and the AUROC was 0.970. The novel ROP screening algorithm demonstrated high sensitivity and specificity in detecting the presence of ROP. A prospective clinical validation in a real-world tele-ROP platform is under consideration. It has the potential to lower the number of screening sessions required to be conducted by a specialist for a high-risk preterm infant thus significantly improving workflow efficiency.