Specific Screening Research Articles

Increased Distress in Neurooncological Patients, a Monocentric Longitudinal Study: When to Screen Which Patient?

Neurooncological patients are well-known to experience an increased psycho-oncological burden with a negative impact on distress, therapy adherence, quality of life, and finally survival. But still, psycho-oncological screening and support is rare, with ongoing discussion about specific screening time points and impact factors. Therefore, we analysed the psycho-oncologic treatment demand at specific disease-related time points throughout therapy. In this longitudinal, prospective, single-centre study, patients with malignant brain tumours were screened for increased distress (using the Distress Thermometer), anxiety, depression (Hospital Anxiety and Depression Scale questionnaire), and health-related quality of life interference (EORTC QLQ C30-BN20 questionnaire) at specific longitudinal time points during therapy. The results were correlated with sociodemographic and clinical data. From 2013 to 2017, 2500 prospective screening data points from 512 malignant brain tumour patients were analysed. DT was identified as a significant predictor for psycho-oncological treatment demand (p < 0.001). Particularly significant time points concerning psycho-oncological burden were primary diagnosis and tumour recurrence. Next to these known factors, here, patients < 65 years old and female patients (p = 0.018 and p = 0.017) reflected increased screening results, whereas partnership and professional activity (p = 0.043; p = 0.017) were identified as contributing factors to a significantly decreased treatment demand. The increased need for psycho-oncological support for neurooncological patients is underlined. Psycho-oncological support should particularly be offered at the time points of primary diagnosis and tumour recurrence. To support the positive effect of caregivers, they should be involved at an early stage.

Moving forward in Rheumatoid Arthritis-Associated Interstitial Lung Disease Screening.

Patients with rheumatoid arthritis (RA) are at increased risk of developing interstitial lung disease compared to the general population, a complication that is associated with significant morbidity and high mortality. Given its frequency and severity, ILD should always be considered during both the initial assessment and follow-up of RA patients. However, there is currently no consensus on which RA patients should be screened for ILD. In recent years, several scientific societies have developed specific screening proposals. According to the recommendations of the Spanish, American, and Austrian rheumatology societies, it is not necessary to screen all individuals with RA, and it should be tailored to each patient based on clinical risk factors. In contrast, the Portuguese Societies of Rheumatology and Pulmonology advocate for systematic screening of all RA patients. Risk factors for the development of ILD in RA patients are well identified, and several screening tools for RA-ILD based on these risk factors have been developed. However, all of these tools still require further validation. To address this issue, the ANCHOR-RA study, a multinational cross-sectional initiative, has been launched to develop a multivariable model for predicting RA-ILD, which could provide valuable guidance for screening practices in clinical settings. In addition to certain biochemical and genetic predictive markers, lung ultrasound appears to be a useful screening tool. When combined with clinical evaluation and risk factor assessment, it can help identify which patients require a thoracic HRCT evaluation, which remains the gold standard for confirming an ILD diagnosis.

Screening Teachers Effectively Across Roles and Classrooms

A growing literature points to the conclusion that information collected while screening applicants has the potential to improve teacher hiring decisions. However, this work sheds little light on the extent to which the predictive validity of screening assessments varies across teacher types or teaching contexts. The author uses information on applicant teachers’ performance on prehire screening assessments in the Los Angeles Unified School District to see whether the relationship between performance on specific screening assessments and the outcomes of hired teachers varies across teacher types or student characteristics. The author finds little evidence that the predictive validity of screening instruments varies between elementary or single-subject teachers, or when teachers serve larger proportions of low-income students or English learners. However, the author finds suggestive evidence that screening instruments predict teachers’ outcomes somewhat differently in special education contexts. Taken as a whole, these results suggest teacher screening systems do not need to be highly differentiated to be useful or can be adapted relatively easily. This bolsters the case for using prehire screening to improve teacher quality and may also indicate the skills and attributes that define teacher quality are largely similar across roles and contexts.

Economic Evaluation of Cervical Cancer Screening by HPV DNA, VIA, and Pap smear Methods in Indonesia.

Cervical cancer occurs 80% in developing country including Indonesia and take place in the first rank of incidence rate and third rank in mortality rate in Asian Pacific. Natural history of cervical cancer gives a potential to get accurate screening method. Cervical cancer screening m in Indonesia use VIA and Pap smear method for women in age range 30 to 50 years old. Recently, HPV DNA test has been recommended in international and national policy as primary screening method for cervical cancer. This research aims to asses cost-effectiveness and economic implications of specific cervical cancer screening modalities. Cost-effectiveness analysis was conducted from societal perspective. Cost data was collected from four hospitals in Indonesia. Direct medical costs were derived from discussions with an expert panel and hospital billing data, aligning with current practice guidelines. Direct and indirect non-medical costs were estimated from patient interviews. Effectiveness data for the screening methods were extracted from a systematic review of existing literature. Markov model design was used for cost-effectiveness analysis. Budget impact analysis used healthcare perspective method from its billing for cervical cancer patients. Cervical cancer screening costs are calculated using direct medical, non-medical, and indirect expenses. Regarding to cost-effective analysis by incremental cost-effective ratio (ICER), pap smear for every 3 and 5 years is more cost-effective than VIA. HPV DNA also has the potential to be cost-effective. The budget impact analysis investigates scenarios, with a focus on negotiation-based cost reductions for HPV DNA testing. Controlling HPV DNA tariffs at USD 8.76 proves cost-effective. In conclusion, pap smear is the most cost-effective modality, while HPV DNA has the potential to be cost-effective by reducing the unit cost. Despite favorable outcomes, challenges in implementation suggest a phased approach for resource equalization before full deployment.

Translation and cultural adaptation of the Italian version of the Paediatric Palliative Screening Scale.

The Paediatric Palliative Screening Scale is a reliable tool that can assist in timely evaluating children who qualify for Paediatric Palliative Care. The tool can be used in Italian healthcare settings with its cultural adaptation. • Despite the lack of early diagnosis techniques, there is a significant increase in the number of children entitled to Paediatric Palliative Care. • A specific screening tool called the Paediatric Palliative Screening Scale determines a child's suitability for paediatric palliative treatment. • The Paediatric Palliative Screening Scale is necessary to assess the psychosocial needs of patients eligible for Paediatric Palliative Care. The Italian scale has good content and face validity ensuring equivalence between the original and target populations.

Routine cognitive screening for older people undergoing major elective surgery: Benefits, risks and costs.

Cognitive impairment and older age are major risk factors for postoperative delirium. Professional societies have advocated preoperative screening to identify at-risk individuals for implementation of interventions, which have moderate effectiveness in preventing delirium. However, it remains unclear from the guidelines whether screening should be completed routinely for all older individuals or targeted, and also which specific screening tool is preferred. In addition, the responsibility for screening remains undesignated in the guidelines provided. We reviewed the benefits and risks of routine screening. We also performed a cost-benefit analysis of routine screening (versus no screening). Furthermore, we summarised the sensitivities and specificities of commonly used screening tools and reviewed evolving screening tools that may have an increasing role in future practice. We concluded that routine screening is useful and appears to be cost-effective for reducing postoperative delirium, with a cost-benefit ratio of 2.89 (adjusted ratio of 2.34), and has additional advantages over other approaches such as targeted screening or routine intervention.

P115 CLINICAL PROFILE AND PREVALENCE OF OBSTRUCTIVE SLEEP APNEA IN A POPULATION OF YOUNG ADULTS REGISTERED IN A PRIMARY CARE UNIT IN RIO DE JANEIRO

Background: Obstructive Sleep Apnea (OSA) is strongly associated with high blood pressure (BP) and cardiovascular risk (CVR). There is a lack of studies and specific screening for younger populations, which could allow for early intervention and potentially reduce CVR. Objective: Analyze the prevalence and clinical profile of OSA, identifying the best screening method in a young population attended by a Family Health Strategy Unit in Rio de Janeiro. Methods: Cross-sectional population study of adults between 20 and 65 years old. Sociodemographic characteristics, anthropometric measures and CVR were obtained. Office BP was calculated using two measurements. The risk of OSA was assessed using STOP-BANG (SB) and Epworth Sleepiness Scale (ESS) questionnaires. All underwent home polysomnography. Result: 67 individuals included [38.9% men; average age of 38.9 ± 8 years]: 35 without OSA, 20 with mild OSA, 9 with moderate OSA and 3 with severe OSA. The prevalence of moderate/severe OSA was 18%. Individuals with moderate/severe OSA were older, more obese, had higher prevalence of increased neck circumference, dyslipidemia and heart rate. High risk for OSA in screening by SB, ESS and both questionnaires was respectively 55.2%, 44.8% and 19.4%. SB confirmed moderate/severe OSA in 30% in high-risk individuals, and excluded in 97% of low risk, with 60% accuracy. The sensitivity, specificity, PPV and NPV of SB to identify moderate/severe OSA were respectively 92%, 53%, 36% and 97%. In those with high risk according to the ESS, moderate/severe OSA was confirmed in 13%, while in those with low risk it was excluded in 78%. The accuracy of the ESS was 49%. The sensitivity, specificity, PPV and NPV of the ESS to identify moderate/severe OSA were respectively 33%, 53%, 13% and 78%. Conclusion: Moderate/severe OSA was more associated with an adverse metabolic profile than with high BP. The best screening questionnaire for this population is the STOP-BANG.

Differential Functional Changes in Visual Performance during Acute Exposure to Microgravity Analogue and Their Potential Links with Spaceflight-Associated Neuro-Ocular Syndrome.

Spaceflight-Associated Neuro-Ocular Syndrome (SANS) is a complex pathology threatening the health of astronauts, with incompletely understood causes and no current specific functional diagnostic or screening test. We investigated the use of the differential performance of the visual system (central vs. perimacular visual function) as a candidate marker of SANS-related pathology in a ground-based microgravity analogue. We used a simple reaction time (SRT) task to visual stimuli, presented in the central and perimacular field of view, as a measure of the overall performance of the visual function, during acute settings (first 10 min) of vertical, bed rest (BR), -6°, and -15° head-down tilt (HDT) presentations in healthy participants (n = 8). We built dose-response models linking the gravitational component to SRT distribution parameters in the central vs. perimacular areas. Acute exposure to microgravity induces detectable changes between SRT distributions in the perimacular vs. central retina (increased mean, standard deviation, and tau component of the ex-Gaussian function) in HDT compared with vertical presentation. Functional testing of the perimacular retina might be beneficial for the earlier detection of SANS-related ailments in addition to regular testing of the central vision. Future diagnostic tests should consider the investigation of the extra-macular areas, particularly towards the optic disc.

DNA-directed immobilization fluorescent immunoarray for multiplexed antibiotic residue determination in milk.

The presence of antibiotic residues in cow's milk entails high risk for consumers, the dairy industry, and the environment. Therefore, the development of highly specific and sensitive screening tools for the rapid and cost-effective identification of traces of these compounds is urgently needed. A multiplexed screening platform utilizing DNA-directed immobilization (DDI) was developed aiming to detect three classes of antibiotic residues (fluoroquinolones, sulfonamides, and tylosin) prevalently found in milk. Throughout this work, each oligonucleotide sequence was conjugated to a different hapten molecule, while the three complementary strands were immobilized in 24 independent microarray chips on a single glass slide. First, the array was incubated with the pool of hapten-oligonucleotide conjugate site encoded the signal through DNA hybridization. Next, commercial milk samples were incubated with the cocktail of monoclonal antibodies following a secondary fluorophore-labeled antibody which was required for fluorescent readout. Direct sample detection was achieved in milk diluting 20 times in assay buffer. The limits of detection (LODs) reached were 1.43µgkg-1, 1.67µgkg-1, and 0.89µgkg-1 for TYLA, STZ, and CIP, respectively, which represented in raw milk 7.15µgkg-1, 8.35µgkg-1, and 4.45µgkg-1 for TYLA, STZ, and CIP, respectively, that are below the EU regulatory limits. Cross-reactivity profiles were evaluated against the family of structurally related antibiotics in order to demonstrate the capability to detect antibiotics from the same family of compounds. A pre-validation study was performed by spiking 20 blind samples above and below the maximum residue limits established by the EU guidelines. The system was successfully implemented towards randomized sample classification as compliant or non-compliant. The proposed DDI-based immunoarray provides a fast and cost-effective alternative to obtain semi-quantitative information about the presence of three veterinary residues simultaneously in milk samples.

Machine learning analysis of oxidative stress-related phenotypes for specific gene screening in ovarian cancer.

Oxidative stress serves a crucial role in tumor development. However, the relationship between ovarian cancer and oxidative stress remains unknown. We aimed to create an oxidative stress-related prognostic signature to enhance the prognosis prediction of CC patients using bioinformatics. The genes differentially expressed and associated with oxidative stress were extracted with the help of "limma" packages. The model for prognosis was created using Multivariate Cox regression analysis to determine the risk related to the genes related to oxidative stress. Patients were categorized as low-risk or high-risk based on the median score. The receiver operation characteristic (ROC) and survival curves were used to evaluate the predictive effect of the prognostic signature. We utilized quantitative real-time PCR to assess the expression levels of key genes associated with oxidative stress in ovarian cancer cell lines (SKOV3, OVCAR3, and HeyA8) and normal ovarian epithelial cells (HOSEpiC). A signature comprising seven genes associated with oxidative stress was developed to prognosticate patients with ovarian cancer. Overall survival (OS) of the patient having CC was determined using Kaplan-Meier analysis. It was found that patient with a higher risk score had lower OS than the low-risk score. The signature of genes associated with oxidative stress was found to be independently prognostic for 1, 2, and 3 years. Further research found that the expression levels of nine hub genes had a strong association with patient outcomes. Our analysis revealed a higher expression of CX3CR1 in ovarian cancer cell lines compared with normal cells. To deploy a novel oxidative stress-related prognostic signature as an independent biomarker in cervical cancer, we developed and validated it.

Development and characterization of nanobody against envenomation by Naja naja oxiana

Snakebites are considered a significant health issue. Current antivenoms contain polyclonal antibodies, which vary in their specificity against different venom components. Development and characterization of next generation antivenoms including nanobodies against Naja naja oxiana was the main aim of this study. Crude venom was injected into the Sephadex G50 filtration gel chromatography column and then toxic fractions were obtained. Then the corresponding fraction was injected into the HPLC column and the toxic peaks were identified. N. naja oxiana venom was injected into a camel and specific nanobodies screening was performed against the toxic peak using phage display technique. The obtained results showed that among the 12 clones obtained, N24 nanobody was capable of neutralizing P1, the most toxic peak obtained from HPLC chromatography. The molecular weight of P1 was measured with a mass spectrometer and was found to be about seven kDa. The results of the neutralization test of crude N. naja oxiana venom with N24 nanobody showed that 250 μg of recombinant nanobody could neutralize the toxic effects of 20 μg equivalent to LD50 × 10 of crude venom in mice. The findings indicate the potential of the developed nanobody to serve as a novel antivenom therapy.

Use of protease substrate specificity screening in the rational design of selective protease inhibitors with unnatural amino acids: Application to HGFA, matriptase, and hepsin.

Inhibition of the proteolytic processing of hepatocyte growth factor (HGF) and macrophage stimulating protein (MSP) is an attractive approach for the drug discovery of novel anticancer therapeutics which prevent tumor progression and metastasis. Here, we utilized an improved and expanded version of positional scanning of substrate combinatorial libraries (PS-SCL) technique called HyCoSuL to optimize peptidomimetic inhibitors of the HGF/MSP activating serine proteases, HGFA, matriptase, and hepsin. These inhibitors have an electrophilic ketone serine trapping warhead and thus form a reversible covalent bond to the protease. We demonstrate that by varying the P2, P3, and P4 positions of the inhibitor with unnatural amino acids based on the protease substrate preferences learned from HyCoSuL, we can predictably modify the potency and selectivity of the inhibitor. We identified the tetrapeptide JH-1144 (8) as a single digit nM inhibitor of HGFA, matriptase and hepsin with excellent selectivity over Factor Xa and thrombin. These unnatural peptides have increased metabolic stability relative to natural peptides of similar structure. The tripeptide inhibitor PK-1-89 (2) has excellent pharmacokinetics in mice with good compound exposure out to 24 h. In addition, we obtained an X-ray structure of the inhibitor MM1132 (15) bound to matriptase revealing an interesting binding conformation useful for future inhibitor design.

Coordination-Driven Templated Synthesis of Hierarchically Porous Zeolitic Imidazolate Frameworks for Cascade Enzyme Cycle Amplification Coupled Immunoassay.

Although hierarchically porous zeolitic imidazolate frameworks (HPZIFs) not only inherit the intrinsic architectural and chemical stabilities of their microporous counterparts but also afford open space for the efficient mass diffusion of the macromolecules involved, their rational design and construction are still challenging. Herein, HPZIFs with tailorable pore sizes ranging from 18 to 54 nm were successfully fabricated by using a newly developed soft-template-directed strategy. Our success rooted in the fact that the screened PS81-PVP44-PEO113 triblock copolymer could effectively coordinate with the metal precursor for the directed crystallization of ZIFs along surfactant assemblies. The advantages of continuous large pores and open structures in such HPZIFs were fully taken into account to serve as a bioreactor for the efficient immunoassay. The expanded large pores provided not only a significantly vast surface area to enhance the density of capture antibodies but also enough space for accommodating multiple conjugated biomolecules in one pore channel. In combination with a cascade enzyme cycle amplification strategy, a model biomarker of prostate-specific antigen (PSA) at the femtomolar level was checked with a limit of detection of 92 fM using the developed immunosensor. Specific screening on patients with prostate cancer or even benign prostatic hyperplasia was exemplified through accurately quantifying small changes of PSA concentration in clinical serum samples, prefiguring the great potential of the developed HPZIF-8 immunosensor platform for the early monitoring and diagnostics of diseases.

Clinical performance of human papillomavirus based cervical cancer screening algorithm: The result of a large Danish implementation study.

In Denmark, where human papillomavirus (HPV) -based cervical cancer screening is being implemented, the aim of this pilot implementation study was to test a specific screening algorithm, assess follow-up examination attendance, and measure the proportion of precancer lesions found in relation to the number of women referred for colposcopy. From May 2017 to December 2020, 36 417 women in the uptake area of the Department of Pathology, Vejle Hospital, Region of Southern Denmark, were included in the HPV group. Women positive for HPV16/18 irrespective of cytology and women positive for other high-risk HPV (hrHPV) types having concomitant abnormal cytology were referred directly to colposcopy. Women positive for other hrHPV types and normal cytology were referred to repeat screening after 12 months, and hrHPV negative to routine screening after three years. We obtained information on screening results and subsequent histological diagnosis from the Danish Pathology Databank through September 2022. 3.6% of the women were referred to colposcopy after primary screening, 5% to repeat screening after 12 months, and 91.4% back to routine screening. High follow-up rates were observed: 96% attended colposcopy after primary screening, with 91% attending colposcopy after repeat screening. CIN3+ was detected at colposcopy following the primary screening in 28.1% of HPV16/18-positive women and 18.2% of those positive for other hrHPV types with concomitant abnormal cytology. Of the women with other hrHPV and simultaneous ASCUS/LSIL, 8% had CIN3+. At the repeat screening, 43% had become hrHPV negative, 55% were persistently positive for other hrHPV, and 2% had turned positive for HPV16/18. At the colposcopy following repeat screening, 10.1% of the women positive for other hrHPV were diagnosed with CIN3+, in comparison with 11.1% of the HPV16/18-positive women. In this pilot implementation study, an algorithm for HPV-based screening was evaluated in a Danish setting. The results demonstrated high attendance at follow-up examinations and provided insights into the number of colposcopy referrals and the detection of CIN2 and CIN3+ cases. The results suggest that women testing positive for other hrHPV in combination with ASCUS/LSIL at primary screening could potentially be referred to repeat screening instead of an immediate colposcopy.

Magnetic ligand fishing protocol combined with HPLC-FT-ICR-MS for screening potential α-Glucosidase inhibitors from UCG and in silico analysis

Uremic Clearance Granule (UCG) is a traditional Chinese medicines (TCMs) that has been recognized as potentially effective treatment for diabetic nephropathy (DN). However, the chemical composition and the hypoglycemic ingredients of UCG remain unclear. In this experiment, a magnetic ligand fishing protocol combined with HPLC coupled Fourier transform ion cyclotron resonance mass spectrometry (HPLC-FT-ICR-MS) technology was developed to screen and identify α-Glucosidase inhibitors from UCG. First, constituents of UCG was identified by HPLC-FT-ICR-MS. Next, α-Glucosidase coated Fe3O4@SiO2@NH2 (Fe3O4@SiO2@NH2@α-Glucosidase) nano composites was synthesized. The essential parameters (concentration of Glutaraldehyde (GA), ratio of Fe3O4@SiO2@NH2 to enzyme, crosslinking time and immobilization time) were optimized to obtain maximum enzyme activity and the performance of immobilized enzyme was compared with that of free enzyme. The α-Glucosidase inhibitory activities were then evaluated using autodock and the 4-Nitrophenyl-α-D-glucopyranoside (pNPG) method. As a result, 142 compounds were identified were identified by comparing the retention time, molecular ions and fragmentation behaviors with the reference compounds or the in-house database. 20 possible α-Glucosidase activity inhibitory components were identified using HPLC-FT-ICR-MS. Molecular docking and inhibition studies showed that 4 compuunds including Limonexic acid, Sanggenol A, Glabrone, Matrine were more likely to stronger α-Glucosidase inhibitory activities than acarbose. In conclusion, the proposed approach, which combined highly specific screening with HPLC-FT-ICR-MS, provided a powerful platform for discovering bioactive components from multi-component and multi-target traditional Chinese medicines (TCMs).

Tuberculin Skin Test Reactivity among Health Care Workers in the Abia State University Teaching Hospital, Aba South-east Nigeria

Background Tuberculosis is one of the infections targeted for eradication and is still under surveillance. Hospital workers in Nigeria take little or no precautions against tuberculosis while attending to patients. Objectives This research aimed to study the prevalence of the reactivity of positive Tuberculin Skin Tests among healthcare workers in a Nigerian University Teaching Hospital. Methods Ethical approval and informed consent were obtained from the participants. Two hundred and ten consented participants were recruited for this study, while 185 contributed till the end. The Tuberculin Skin Test was conducted following the standard operating procedures. The chi-square test was used to compare the variable at a significant level of P &lt; 0.05. Of those who received a BGC vaccine &lt; 3 years, 4.8% were excluded from the analyses. Results Mean ± SD of participants’ age was approximately 30 ± 8 years. Participants comprised 87 (47%) males and 98 (53%) females. The modal age group was 21-25 years. Most participants were clinical medical students, 93(50.3%), while doctors, 7 (3.8%), were second to least. The prevalence of positive reactivity to the Tuberculin Skin Test was 29.9%. There was no significant difference observed regarding sexes and positive reactivity. A significant difference was found in reactivity ≥ 10 mm between those who didn’t receive BCG and those who received BCG vaccine ≥ 10 years before the study. Conclusion Healthcare workers can be potential active TB patients and reservoirs. We recommend highly sensitive and specific periodic TB screening, prophylactic treatment, and re-vaccination of Health Care Workers in Nigeria.

Rapid Identification of the Spruce Bark Beetle &amp;lt;i&amp;gt;Ips typographus&amp;lt;/i&amp;gt; (Linnaeus) Basing on a New Amplification and Analysis Platform

Insects, one of the major disturbance agents, are regarded as a big challenge to forests. Bark beetles (Coleoptera: Curculionidae: Scolytinae) are among the most destructive pests around the world. The European spruce bark beetle &amp;lt;i&amp;gt;I. typographus &amp;lt;/i&amp;gt;(Linnaeus) is considered the most dangerous species to mature spruce forests throughout Eurasia. In order to improve efficiency, accuracy, and operability of identification, a rapid, simple, highly sensitive and specific screening method is in urgent need. In this study, a rapid classification approach for &amp;lt;i&amp;gt;I. typographus&amp;lt;/i&amp;gt; was established based on the enzyme-mediated duplex exponential amplification (EmDEA) amplification and analysis platform. The method development process consists of target gene selection, primer design, primer screening, and method validation. Parameter analysis demonstrated that this new method has a detection limit of 1.96×103 copies/μL, which is comparable to conventional molecular tools such as PCR. Stable repeatability and high specificity were confirmed by testing 5 samples of &amp;lt;i&amp;gt;I. typographus&amp;lt;/i&amp;gt; and 4 related beetles. Besides, this screening protocol was easy to use, and could be completed in 30 min. With the advantage of isothermal amplification, this method could be further applied in non-laboratory scenarios such as port rapid screening and wild survey. This rapid screening method for &amp;lt;i&amp;gt;I. typographus&amp;lt;/i&amp;gt; is believed to assist precise prediction and efficient prevention of exotic insect species.

Role of Lipocalin-2 Levels in Non-Alcoholic Fatty Pancreatic Disease and its Association with Non-Alcoholic Fatty Liver Disease

Abstract Background Lipocalin-2 (LCN2) is a 25-kDa secretory protein with great importance as a sensitive and specific screening and diagnostic biomarker for hepatic inflammation, acute hepatic injury, hepatic cancer, and radiation-induced early phase hepatic damage and lipid abnormalities. However, little is known about LCN2's functions in the homeostasis and metabolism of hepatic lipids or in the development of steatosis as well as its actual role in the event of inflammation. Aim and Objectives To establish a correlation between the levels of lipocalin as a useful biomarker with increasing severity of steatosis in NAFLD and NAFPD patients. Subjects and Methods This was observational prospective case–control study, was conducted at Hepatology Unit of Ain Shams University Hospital on 50 patients diagnosed with NAFPD and 50 healthy age and sex-matched volunteers without NAFPD during a period of 6 months. All patients were subjected to; Full history taking and thorough clinical examination, Anthropometric measurements, Laboratory investigations, and abdominal ultrasonography. Result There was a significant Positive correlation between Lipocalin 2, BMI, LDL (mg/dL), Cholesterol (mg/dL), Insulin (μU/mL) and HOMA-IR in patient group(P-value ≤ 0.001), Conclusion; lipocalin-2 is a good blood biomarker for detection of hepatic and Pancreatic steatosis. The lipocalin levels increase with increasing severity of steatosis. In addition to this, lipocalin will be useful for early diagnosis of NAFLD, NAFPD and convenient to do with other blood tests. The early intervention may prevent high morbidity and mortality and to manage the disease properly.

Imported schistosomiasis in travelers: Experience from a referral tropical medicine unit in Barcelona, Spain

BackgroundAcute schistosomiasis occurs most often in travelers to endemic regions. The aim of the study is to describe the epidemiological, clinical and parasitological characteristics of patients with schistosomiasis acquired during an international travel. MethodsObservational retrospective study including all travel-related schistosomiasis cases seen at the International Health Unit Vall d’Hebron-Drassanes (Barcelona, Spain) from 2009 to 2022. Diagnosis of schistosomiasis was defined by the presence of Schistosoma eggs in stools or urine or the positivity of a serological test. We collected demographic, epidemiological, clinical, parasitological, and therapeutic information. Results917 cases of schistosomiasis were diagnosed, from whom 96 (10.5 %) were travel-related. Mean age of the patients was 34.9 years, and 53.1 % were women. Median duration of the travel was 72 days, and geographical areas where travelers had contact with fresh water were Africa (82.3 %), Asia (12.5 %), and South America (5.2 %). Twenty (20.8 %) patients reported having had some clinical symptom, being gastrointestinal symptoms the most frequent. Two patients developed the classical Katayama syndrome. In eleven (11.5 %) cases eggs were observed in urine or feces samples, and 85 (88.5 %) cases were diagnosed by a positive serology. Ninety-one (94.8 %) patients received treatment with praziquantel with different therapeutic schemes. The two patients with Katayama syndrome received concomitant treatment with corticosteroids. ConclusionsSchistosomiasis in travelers represented 10 % of the overall schistosomiasis cases in our center. Increasing the awareness in the pre-travel advice and implementing specific screening in those travelers at risk (long travelers, contact with fresh water) could reduce the incidence and associated morbidity in this group.

DOES COVID-19 CAUSE STRUCTURAL CHANGES IN THE INDONESIAN STOCK MARKET BEHAVIOR? A COMPARISON OF ISLAMIC AND CONVENTIONAL STOCK

Introduction: Islamic stock is believed to be more stable and less risky than conventional stock due to specific screening based on Sharia principles, particularly during economic downturns. This research aims to investigate whether the Covid-19 outbreak caused a structural break in Indonesia's Islamic and conventional stock markets. Methods: This study covers the period from January 2007 to June 2022, divided into sub-periods before Covid-19 (January 2007 to February 2020) and during COVID-19 (March 2020 to June 2022). The study adopts the time series regression method to examine the predicting factors of Islamic and conventional stock indexes, followed by the application of the Chow Breakpoint Test method to determine whether there are structural changes in the Islamic and conventional stock markets due to Covid-19. Results: The results of this study suggest that, in comparison to the period preceding Covid-19, the Islamic stock index demonstrates heightened sensitivity to fluctuations in predicting factors during the pandemic. Additionally, there is an absence of any structural break observed in conventional indices. Consequently, Islamic stocks exhibit lower resistance during crisis periods than conventional stocks. Conclusion and suggestion: This finding prompts a comprehensive evaluation of the Sharia screening standards by policymakers to enhance the resilience of Islamic stocks during economic turmoil. Moreover, based on the results, it is suggested that investors cannot consider the Islamic stock index as a 'safe-haven' instrument during financial turmoil. The result of this research assist investors in adjusting their investment strategies more effectively, particularly in bearish market conditions.