目的对比人工智能宫颈癌实时筛查技术(TruScreen)联合高危人乳头瘤病毒(high-risk human papillomavirus,hr-HPV)检测与液基薄层细胞学检测(Thinprep cytologic test,TCT)联合hr-HPV在宫颈癌筛查中的临床价值。方法研究对象为2020年6月...目的对比人工智能宫颈癌实时筛查技术(TruScreen)联合高危人乳头瘤病毒(high-risk human papillomavirus,hr-HPV)检测与液基薄层细胞学检测(Thinprep cytologic test,TCT)联合hr-HPV在宫颈癌筛查中的临床价值。方法研究对象为2020年6月–2023年12月期间在攀枝花市中心医院接受宫颈癌筛查的297例女性,筛查项目包括HPV检测、TCT检测以及TruScreen检测。以病理结果为标准,评估TruScreen联合hr-HPV与TCT联合hr-HPV对宫颈低度鳞状上皮内病变(low-grade squamous intraepithelial lesion positive,LSIL^(+))及高度鳞状上皮内病变(high-grade squamous intraepithelial lesion positive,HSIL^(+))的诊断效果。结果在297例受试者中,病理确诊LSIL^(+)128例(43.10%),HSIL^(+)67例(22.56%)。HPV16/18阳性110例(37.04%),TCT检测≥未明确诊断意义的非典型鳞状细胞(atypical squamous cells of undetermined significance,ASC-US)177例(59.60%),176例(59.26%)TruScreen检测异常;TruScreen联合hr-HPV诊断LSIL^(+)及HSIL^(+)宫颈病变的曲线下面积(area under the curve,AUC)高于TCT联合hr-HPV(P<0.05)。结论TruScreen联合hr-HPV在宫颈癌筛查中的效果优于TCT联合hr-HPV,可作为传统细胞学检查的潜在替代方案,具有较高的临床应用价值。展开更多
Whitebacked planthopper (WBPH) -resistance in a japonica / indica doubled haploid (DH) rice population established from a cross between WBPH-resistant japonica Chun]iang 06 and susceptible indica TN1, was comparativel...Whitebacked planthopper (WBPH) -resistance in a japonica / indica doubled haploid (DH) rice population established from a cross between WBPH-resistant japonica Chun]iang 06 and susceptible indica TN1, was comparatively evaluated through a field experiment based on the WBPH immigrant density and standardized seedbox screening test (SSST). All the susceptible DH lines in the field experiment behaved accordingly in SSST. However, 35 of resistant 66 lines (53%) in the field, were categorized to susceptible groups in SSST. Likewise, there were no significant differences in WBPH immigrant densities among 70 DH lines that were highly resistant to susceptible in SSST. The results revealed that SSST could not evaluate properly WBPH resistance in the DH lines. Four QTLs for WBPH-resistance phenotyped by the immigrant density were detected on chromosomes 2, 3, 4, and 11. Of them, the QTL on chromosome 4 was the most effective (LOD 21.8, variance 78%). Five QTLs associated with seedling mortality were mapped on chromosomes 2, 3, 4, 5 and 6. In addition to the QTL (LOD 10.5, variance 68%) on chromosome 4, there was another major QTL (LOD 12.7, variance 71%) located on chromosome 5, which was SSST-specific but might be irrespective of the WBPH resistance traits.展开更多
BACKGROUND Cognitive decline is common among older patients with cardiovascular disease(CVD) and can decrease their self-management abilities. However, the instruments for identifying mild cognitive impairment(MCI) ar...BACKGROUND Cognitive decline is common among older patients with cardiovascular disease(CVD) and can decrease their self-management abilities. However, the instruments for identifying mild cognitive impairment(MCI) are not always feasible in clinical practice. Therefore, this study evaluated whether MCI could be detected using the Japanese version of the Rapid Dementia Screening Test(RDST-J), which is a simple screening tool for identifying cognitive decline.METHODS This retrospective single-center study included patients who were ≥ 65 years old and hospitalized because of CVD.Patients with a pre-hospitalization diagnosis of dementia were excluded. Each patient's cognitive function had been measured at discharge using the RDST-J and the Japanese version of the Montreal Cognitive Assessment(Mo CA-J), which is a standard tool for MCI screening. The correlation between the two scores was evaluated using Spearman's rank correlation coefficient. Receiver operating characteristic(ROC) analysis was also to evaluate whether the RDST-J could identify MCI, which was defined as a Mo CA-J score of ≤ 25 points.RESULTS The study included 78 patients(mean age: 77.2 ± 8.9 years). The RDST-J and Mo CA-J scores were strongly correlated(r = 0.835, P < 0.001). The ROC analysis revealed that an RDST-J score of ≤ 9 points provided 75.4% sensitivity and 95.2% specificity for identifying MCI, with an area under the curve of 0.899(95% CI: 0.835-0.964). The same cut-off value was identified when excluding patients with a high probability of dementia(RDST-J score of ≤ 4 points).CONCLUSIONS The RDST-J may be a simple and effective tool for identifying MCI in older patients with CVD.展开更多
Clinical movement screening tests are gaining popularity as a means to determine injury risk and to implement training programs to prevent sport injury. While these screens are being used readily in the clinical field...Clinical movement screening tests are gaining popularity as a means to determine injury risk and to implement training programs to prevent sport injury. While these screens are being used readily in the clinical field, it is only recently that some of these have started to gain attention from a research perspective. This limits applicability and poses questions to the validity, and in some cases the reliability, of the clinical movement tests as they relate to injury prediction, intervention, and prevention. This editorial will review the following clinical movement screening tests: Functional Movement Screen?, Star Excursion Balance Test, Y Balance Test, Drop Jump Screening Test, Landing Error Scoring System, and the Tuck Jump Analysis in regards to test administration, reliability, validity, factors that affect test performance, intervention programs, and usefulness for injury prediction. It is important to review the aforementioned factors for each of these clinical screening tests as this may help clinicians interpret the current body of literature. While each of these screening tests were developed by clinicians based on what appears to be clinical practice, this paper brings to light that this is a need for collaboration between clinicians and researchers to ensure validity of clinically meaningful tests so that they are used appropriately in future clinical practice. Further, this editorial may help to identify where the research is lacking and, thus, drive future research questions in regards to applicability and appropriateness of clinical movement screening tools.展开更多
Objective: Despite the high prevalence of CRC and the proven benefits of faecal sampling tests, participation rates in CRC screening are suboptimal. Literature has identified a number of barriers to participation, inc...Objective: Despite the high prevalence of CRC and the proven benefits of faecal sampling tests, participation rates in CRC screening are suboptimal. Literature has identified a number of barriers to participation, including faecal aversion. Emerging test technologies suggest blood-based molecular markers might provide an alternative, more acceptable option, for CRC screening tests. We aim to determine preference for blood compared to faeces as the sample for the screening test. Methods: A survey was mailed to 956 South Australians aged 50 to 74 years. Data were collected on sample preference, demographic variables, and ratings of screening test convenience and comfort. Results: The survey yielded a 43% response rate. The majority of participants preferred to provide a blood sample (78% v 22%, p < 0.001). Women were more likely to prefer blood than men (82% vs 74%, p = 0.05). Sample experience influenced preferences, with a significantly higher preference for faeces among participants with experience in faecal sampling (27% vs 17% with no experience, p < 0.05). Participants who preferred to provide a faecal sample rated it significantly more convenient (p < 0.001), more comfortable (p < 0.001), and more acceptable (p < 0.001) than those who preferred blood sampling. Conclusions: Survey participants overwhelmingly indicate a preference for the idea of a blood sample over a faecal sample for CRC screening. Preference was influenced by gender, experience with sampling method and the individual’s perception of sampling convenience, sampling comfort and sample acceptability. Our results suggest population participation rates are likely to improve with blood-based screening tests.展开更多
BACKGROUND Elderly patients aged at least 75 years old(Elderly_75),represent 45%of colorectal cancer(CRC)incidence.As others,the French Colorectal Cancer Screening Program(CRCSP)does not include Elderly_75.To date,the...BACKGROUND Elderly patients aged at least 75 years old(Elderly_75),represent 45%of colorectal cancer(CRC)incidence.As others,the French Colorectal Cancer Screening Program(CRCSP)does not include Elderly_75.To date,there is little evidence to justify stopping screening at 74 years of age.AIM To describe CRC fecal screening test completion after age 74,source(CRCSP/Provider ordered)and outcomes of these tests.METHODS The study concerned 18704 Elderly_75 residing in eleven French districts(Ain,Doubs,Essonne,Haute-Saone,Hauts-de-Seine,Jura,Seine-Saint-Denis,Territoire-de-Belfort,Val-de-Marne,Val-d'Oise,Yonne),having performed a CRC screening test between January 2008 and December 2017.The tests performed in a circumstance of delayed response to a solicitation(DRS)from the local cancer screening managing center(Managing-Center)were distinguished from the tests non-solicited by the Managing-Center,performed after a recommendation by a General Practitioner(GP)or other provider ordered(RGP).DRS was any test realized by an Elderly_75 following an initial invitation from the ManagingCenter with a maximum 24 mo after this invitation.Any Non-DRS test was considered RGP.The outcomes of these tests were described according to the circumstances of test completion.RESULTS Of 18995 screening-tests were performed at ages:75(83.5%),76-80(13.4%)and>80(3.1%)years old.Elderly_75 performed the screening test in a circumstance of DRS(71.9%)or RGP(28.1%).The proportion of the tests that could not be analyzed and not restarted was 13.2%.For these unanalyzed tests,the reason was age-related in 78.0%of cases,related to the laboratory's refusal to analyze the test of people aged≥77.Reported colonoscopy completion rate was 81.3%.For those575 people with reported colonoscopy,no complication was listed.18.0%of the366 Elderly_75 with lesions had no anteriority in the CRCSP.The neoplasia(124 Low-risk-polyps,159 High-risk-polyps,13 Unspecified-polyps and 70 CRCs)detection rate was 19.3/1000 Elderly_75 screened and the CRC detection rate was3.7/1000 Elderly_75 screened.CONCLUSION The high rate of colonoscopy completion after a positive test and the high proportion of screened lesions observed suggest that the lengthening of the screening period could allow significant detection of CRC and polyps that occur in Elderly_75 excluded from CRCSP.展开更多
There has been a growing interest in screening programs designed to detect chronic progressive cancers in the asymptomatic stage, with the expectation that early detection will result in a better prognosis. One key el...There has been a growing interest in screening programs designed to detect chronic progressive cancers in the asymptomatic stage, with the expectation that early detection will result in a better prognosis. One key element of early detection programs is a screening test. An accurate screening test is more effective in finding cases with early-stage diseases. Sensitivity, the conditional probability of getting a positive test result when one truly has a disease, represents one measure of accuracy for a screening test. Since the true disease status is unknown, it is not straightforward to estimate the sensitivity directly from observed data. Furthermore, the sensitivity is associated with other parameters related to the disease progression. This feature introduces additional numerical complexity and limitations, especially when the sensitivity depends on age. In this paper, we propose a new approach that, through combinatorial manipulation of probability statements, formulates the age-dependent sensitivity. This formulation has an exact and simple expression and can be estimated based on directly observable probabilities. This approach also helps evaluate other parameters associated with the natural history of disease more accurately. The proposed method was applied to estimate the mammography sensitivity for breast cancer using the data from the Health Insurance Plan trial.展开更多
To discuss whether the capillary whole blood glucose （CBG） test can be used in glucose screening test （GST） for gestational diabetes mellitus （GDM） compared to the venous plasma glucose （ VPG） method, and to d...To discuss whether the capillary whole blood glucose （CBG） test can be used in glucose screening test （GST） for gestational diabetes mellitus （GDM） compared to the venous plasma glucose （ VPG） method, and to determine the cutoff value of CBG. Methods This was a self-control test. The 50-g oral GST was conducted among 1 557 pregnant women between 24-28 weeks. Every woman was measured CBG and VPG at the same time and same arm. Three hundred and forty women underwent 100-g 3-h oral glucose tolerance test （OGTT）. Receiver operation curve （ROC） was used to determine the potential cutoff level of CBG and VPG. Diagnose criteria of GDM was based on NDDG criteria. OGTT diagnosed GDM and VPG ≥ 7. 8 mmol/L were used as golden standard for ROC. Results There was good relationship between CBG and VPG （ P 〈0.01 ）. Correlation coefficient was O. 86. The value of CBG was lower than VPG. The statistical and high-sensitivity cutoff values were 7. 4 mmol/L in CBG and 7. 8 mmol/L in VPG when GDM was used as golden standard. Cutoff value of CBG was 7. 0 mmol/L when VPG≥7. 8 mmol/L was used as golden standard. The pregnant outcomes of positive cases of three thresholds had no significant differences. But it was better in case of the pregnant woman when the CBG value was more than 7. 4 mmol/L. Conclusion CBG can be used in GST, the threshold of CBG was suggested as 7. 4 mmol/L. CBG test was more convenience and effective than VPG test.展开更多
According to the guidelines by the Japanese government, optical colonoscopy is the most strongly recommended diagnostic test after screening with the immunochemical fecal occult blood test (iFOBT), followed by double-...According to the guidelines by the Japanese government, optical colonoscopy is the most strongly recommended diagnostic test after screening with the immunochemical fecal occult blood test (iFOBT), followed by double-contrast barium enema (BE) or sigmoidoscopy. Our study was to assess patterns and trends of colorectal cancer (CRC) diagnostic testing within 2 years after iFOBT. We analyzed both iFOBT results and claims data provided by employee health insurance societies in Japan from 2005 to 2010. 25,596 enrollees underwent iFOBT screening. The positive rate was 5.1%. 32.3% of those positive underwent diagnostic tests and 1.0% (12 patients) were confirmed as having cancer. The most common test was optical colonoscopy (77.2% of total tests), followed by BE (16.2%). From 2006 to 2009, the rate of optical colonoscopy for females increased from 55% to 82% and that of BE declined from 36% to 12%, while no significant changes were seen for males. Only one-third of those who tested positive underwent diagnostic test in the 2 years following screening iFOBT. As official guidelines for diagnostic testing of CRC recommend, optical colonoscopy is now the most commonly used diagnostic test after positive iFOBT result for enrollees in employee health insurance societies in Japan.展开更多
Objective: to explore the role of alanine aminotransferase (ALT) primary screening test in the blood testing of Taiyuan Blood Center. Method: from January 2019 to December 2020, Taiyuan Blood Center laboratory of 2 ca...Objective: to explore the role of alanine aminotransferase (ALT) primary screening test in the blood testing of Taiyuan Blood Center. Method: from January 2019 to December 2020, Taiyuan Blood Center laboratory of 2 cases of 236628 blood type samples selected 1200 cases of unpaid blood donation samples as research samples, according to the random number method are divided into group A and B, group A routine screening blood test, group B in group plus alanine aminotransferase (ALT) early screening test. Comparative analysis of the test results between the two groups. Results: the scrap rate of group A blood samples was 0.33% higher than 1.67% in Group B (P <0.05);No laboratory review results and ALT (P> 0.05). Conclusion: the application of alanine aminotransferase (ALT) primary screening test in the blood test has high feasibility and has a significant role in reducing the blood scrap rate, which is worth recommended.展开更多
We submitted 437 patients with cytological alterations that suggest viral infections to HPV test. 154 patients (35.24%) resulted positive for HPV;among these, 128 (83.11%) with a low degree of infectivity, 19 (12.33%)...We submitted 437 patients with cytological alterations that suggest viral infections to HPV test. 154 patients (35.24%) resulted positive for HPV;among these, 128 (83.11%) with a low degree of infectivity, 19 (12.33%), with an average degree of infectivity and 7 (4.54%) with a high degree of infectivity).展开更多
A high risk population consisting of 3034 people with history of rectal polyps or ulcers were screened for colorectal neoplasia with Reverse Passive Hemagglutination Fecal Occult Blood Test (RPHA FOB) and 60 cm fibero...A high risk population consisting of 3034 people with history of rectal polyps or ulcers were screened for colorectal neoplasia with Reverse Passive Hemagglutination Fecal Occult Blood Test (RPHA FOB) and 60 cm fiberoptic colonoscopy. Among 2553 subjects (84.1%)who completed both tests, 11 cases of colorectal malignancies and 465 cases of polyps were detected.Using colonoscopic finding and histopathological examination as the 'gold standard' of diagnosis, results showed that FOB positivity of polyps was related to their size, macroscopic appearance and surface features but no correlation between bleeding of polyps and their location, numbers, pathological types were found. In this study the sensitivity of RPHA in screening of colorectal malignancy was 63.6% (7/11), while that for polyps was only 21.1% (98/465) . For screening of colorectal neoplasia (cancer+polyps) the overall sensitivity and specificity of RPHA FOB were 22.1% and 82.4%, the positive and negative predictive values were 22.3% and 82.2% respectively. Amoug 465 polyps there were 195 adenomas, further analysis showed that villous and tubulovillous adenomas had higher intestinal bleeding rate (FOB positive)than tubular type (45.5%,30.0% and 17.8% respectively, X2=5.8, p=0.05). The results indicate that although the sensitivity of RPHA FOB in screening for colorectal polyps was generally low, but about 40% (8/21) of villous and tubulovillous adenoma which present higher tendency of malignant transformation can be detected by RPHA FOB as a screening Procedure. So the authors suggest that screening of colorectal neoplasia be not only a procedure of secondary prevention but also a measure of primary prevention for colorectal cancer.Accepted March 22, 1994展开更多
AIM: To improve the interpretation of fecal immunochemical test (FIT) results in colorectal cancer (CRC) cases from screening and referral cohorts. METHODS: In this comparative observational study, two prospective coh...AIM: To improve the interpretation of fecal immunochemical test (FIT) results in colorectal cancer (CRC) cases from screening and referral cohorts. METHODS: In this comparative observational study, two prospective cohorts of CRC cases were compared. The first cohort was obtained from 10 322 average risk subjects invited for CRC screening with FIT, of which, only subjects with a positive FIT were referred for colonoscopy. The second cohort was obtained from 3637 subjects scheduled for elective colonoscopy with a positive FIT result. The same FIT and positivity threshold (OC sensor; ≥ 50 ng/mL) was used in both cohorts. Colonoscopy was performed in all referral subjects and in FIT positive screening subjects. All CRC cases were selected from both cohorts. Outcome measurements were mean FIT results and FIT scores per tissue tumor stage (T stage). RESULTS: One hundred and eighteen patients with CRC were included in the present study: 28 cases obtained from the screening cohort (64% male; mean age 65 years, SD 6.5) and 90 cases obtained from the referral cohort (58% male; mean age 69 years, SD 9.8). The mean FIT results found were higher in the referral cohort (829 ± 302 ng/mLvs 613 ± 368 ng/mL,P = 0.02). Tissue tumor stage (T stage) distribution was dif-ferent between both populations [screening population: 13 (46%) T1, eight (29%) T2, six (21%) T3, one (4%) T4 carcinoma; referral population: 12 (13%) T1, 22 (24%) T2, 52 (58%) T3, four (4%) T4 carcinoma], and higher T stage was significantly associated with higher FIT results (P < 0.001). Per tumor stage, no significant difference in mean FIT results was observed (screening vs referral: T1 498 ± 382 ng/mL vs 725 ± 374 ng/mL, P = 0.22; T2 787 ± 303 ng/mL vs 794 ± 341 ng/mL, P = 0.79; T3 563 ± 368 ng/mLvs 870 ± 258 ng/mL,P = 0.13; T4 not available). After correction for T stage in logistic regression analysis, no significant differences in mean FIT results were observed between both types of cohorts (P = 0.10). CONCLUSION: Differences in T stage distribution largely explain differences in FIT results between screening and referral cohorts. Therefore, FIT results should be reported according to T stage.展开更多
Background: Zimbabwe recorded a 55% increase in HIV testing from 2011 to 2018 but with decreasing HIV-testing yields from 20% to 6% respectively as we aim to identify the narrowing gap of undiagnosed people living wit...Background: Zimbabwe recorded a 55% increase in HIV testing from 2011 to 2018 but with decreasing HIV-testing yields from 20% to 6% respectively as we aim to identify the narrowing gap of undiagnosed people living with HIV. As such adoption of screening tools during targeted HIV testing services improves efficiency by identifying individuals who are likely to test positive. Effective utilization of screening tools requires an understanding of health care worker perception and willingness to use the tools. Methods: We conducted a qualitative study among healthcare workers at 8 selected primary healthcare facilities in Zimbabwe. Interviewer-guided, in-depth interviews were conducted with healthcare workers and their immediate supervisors. Thematic analysis was performed following a framework built around the grounded theory model to describe perspectives that influence the utilization of HIV screening tools and suggestions for improved eligibility screening. Results: Behavioural factors facilitating the utilisation of the screening tool included motivation to adhere to standard practice, awareness of screening in targeting testing, and its ability to manage workload through screening out ineligible clients. This was evident across service delivery levels. Barriers included limited healthcare capacity, confidentiality space, multiple screening tools and opaque screening in/out criteria and the potential of clients not responding to screening questions truthfully. Conclusions: Across geographical and service delivery levels, placing screening tools at HIV testing entry points, healthcare worker knowledge on screening in/out criteria emerged as enablers for correct and consistent utilization. Further, standardizing the tools and adopting a decision aid algorithm would improve the accurate utilisation of screening tools.展开更多
Shaker screen is one of important equipments in the industry of oil, metallurgy, coal and timbering. The movement locus of shaker screen affects the capacity and efficiency of shaker screen to split the solid particle...Shaker screen is one of important equipments in the industry of oil, metallurgy, coal and timbering. The movement locus of shaker screen affects the capacity and efficiency of shaker screen to split the solid particle from crude ore directly. To test movement of shaker locus, two eddy current transducers are employed. A discussion of the usage of these eddy current transducer to test and acceleration sensors will be made. The experiment results from a real elliptic shaker screen have good agree with the design requirements.展开更多
AIM: To measure the compliance of an Academic Hospital staff with a colorectal cancer(CRC) screening program using fecal immunochemical test(FIT).METHODS: All employees of 'Attikon' University General Hospital...AIM: To measure the compliance of an Academic Hospital staff with a colorectal cancer(CRC) screening program using fecal immunochemical test(FIT).METHODS: All employees of 'Attikon' University General Hospital aged over 50 years were thoroughly informed by a team of physicians and medical students about the study aims and they were invited to undergo CRC screening using two rounds of FIT(DyoniFOB~ Combo H, DyonMed SA, Athens, Greece). The tests were provided for free and subjects tested positive were subsequently referred for colonoscopy. One year after completing the two rounds, participants were asked to be re-screened by means of the same test.RESULTS: Among our target population consisted of 211 employees, 59(27.9%) consented to participate, but only 41(19.4%) and 24(11.4%) completed the first and the second FIT round, respectively. Female gender was significantly associated with higher initial participation(P = 0.005) and test completion- first and second round-(P = 0.004 and P = 0.05) rates, respectively. Phy sician’s(13.5% vs 70.2%, P < 0.0001) participation and test completion rates(7.5% vs 57.6%, P < 0.0001 for the first and 2.3% vs 34%, P < 0.0001 for the second round) were significantly lower compared to those of the administrative/technical staff. Similarly, nurses participated(25.8% vs 70.2%, P = 0.0002) and completed the first test round(19.3% vs 57.6%, P = 0.004) in a significant lower rate than the administrative/technical staff. One test proved false positive. No participant repeated the test one year later.CONCLUSION: Despite the well-organized, guided and supervised provision of the service, the compliance of the Academic Hospital personnel with a FIT-based CRC screening program was suboptimal, especially among physicians.展开更多
文摘Whitebacked planthopper (WBPH) -resistance in a japonica / indica doubled haploid (DH) rice population established from a cross between WBPH-resistant japonica Chun]iang 06 and susceptible indica TN1, was comparatively evaluated through a field experiment based on the WBPH immigrant density and standardized seedbox screening test (SSST). All the susceptible DH lines in the field experiment behaved accordingly in SSST. However, 35 of resistant 66 lines (53%) in the field, were categorized to susceptible groups in SSST. Likewise, there were no significant differences in WBPH immigrant densities among 70 DH lines that were highly resistant to susceptible in SSST. The results revealed that SSST could not evaluate properly WBPH resistance in the DH lines. Four QTLs for WBPH-resistance phenotyped by the immigrant density were detected on chromosomes 2, 3, 4, and 11. Of them, the QTL on chromosome 4 was the most effective (LOD 21.8, variance 78%). Five QTLs associated with seedling mortality were mapped on chromosomes 2, 3, 4, 5 and 6. In addition to the QTL (LOD 10.5, variance 68%) on chromosome 4, there was another major QTL (LOD 12.7, variance 71%) located on chromosome 5, which was SSST-specific but might be irrespective of the WBPH resistance traits.
文摘BACKGROUND Cognitive decline is common among older patients with cardiovascular disease(CVD) and can decrease their self-management abilities. However, the instruments for identifying mild cognitive impairment(MCI) are not always feasible in clinical practice. Therefore, this study evaluated whether MCI could be detected using the Japanese version of the Rapid Dementia Screening Test(RDST-J), which is a simple screening tool for identifying cognitive decline.METHODS This retrospective single-center study included patients who were ≥ 65 years old and hospitalized because of CVD.Patients with a pre-hospitalization diagnosis of dementia were excluded. Each patient's cognitive function had been measured at discharge using the RDST-J and the Japanese version of the Montreal Cognitive Assessment(Mo CA-J), which is a standard tool for MCI screening. The correlation between the two scores was evaluated using Spearman's rank correlation coefficient. Receiver operating characteristic(ROC) analysis was also to evaluate whether the RDST-J could identify MCI, which was defined as a Mo CA-J score of ≤ 25 points.RESULTS The study included 78 patients(mean age: 77.2 ± 8.9 years). The RDST-J and Mo CA-J scores were strongly correlated(r = 0.835, P < 0.001). The ROC analysis revealed that an RDST-J score of ≤ 9 points provided 75.4% sensitivity and 95.2% specificity for identifying MCI, with an area under the curve of 0.899(95% CI: 0.835-0.964). The same cut-off value was identified when excluding patients with a high probability of dementia(RDST-J score of ≤ 4 points).CONCLUSIONS The RDST-J may be a simple and effective tool for identifying MCI in older patients with CVD.
文摘Clinical movement screening tests are gaining popularity as a means to determine injury risk and to implement training programs to prevent sport injury. While these screens are being used readily in the clinical field, it is only recently that some of these have started to gain attention from a research perspective. This limits applicability and poses questions to the validity, and in some cases the reliability, of the clinical movement tests as they relate to injury prediction, intervention, and prevention. This editorial will review the following clinical movement screening tests: Functional Movement Screen?, Star Excursion Balance Test, Y Balance Test, Drop Jump Screening Test, Landing Error Scoring System, and the Tuck Jump Analysis in regards to test administration, reliability, validity, factors that affect test performance, intervention programs, and usefulness for injury prediction. It is important to review the aforementioned factors for each of these clinical screening tests as this may help clinicians interpret the current body of literature. While each of these screening tests were developed by clinicians based on what appears to be clinical practice, this paper brings to light that this is a need for collaboration between clinicians and researchers to ensure validity of clinically meaningful tests so that they are used appropriately in future clinical practice. Further, this editorial may help to identify where the research is lacking and, thus, drive future research questions in regards to applicability and appropriateness of clinical movement screening tools.
文摘Objective: Despite the high prevalence of CRC and the proven benefits of faecal sampling tests, participation rates in CRC screening are suboptimal. Literature has identified a number of barriers to participation, including faecal aversion. Emerging test technologies suggest blood-based molecular markers might provide an alternative, more acceptable option, for CRC screening tests. We aim to determine preference for blood compared to faeces as the sample for the screening test. Methods: A survey was mailed to 956 South Australians aged 50 to 74 years. Data were collected on sample preference, demographic variables, and ratings of screening test convenience and comfort. Results: The survey yielded a 43% response rate. The majority of participants preferred to provide a blood sample (78% v 22%, p < 0.001). Women were more likely to prefer blood than men (82% vs 74%, p = 0.05). Sample experience influenced preferences, with a significantly higher preference for faeces among participants with experience in faecal sampling (27% vs 17% with no experience, p < 0.05). Participants who preferred to provide a faecal sample rated it significantly more convenient (p < 0.001), more comfortable (p < 0.001), and more acceptable (p < 0.001) than those who preferred blood sampling. Conclusions: Survey participants overwhelmingly indicate a preference for the idea of a blood sample over a faecal sample for CRC screening. Preference was influenced by gender, experience with sampling method and the individual’s perception of sampling convenience, sampling comfort and sample acceptability. Our results suggest population participation rates are likely to improve with blood-based screening tests.
文摘BACKGROUND Elderly patients aged at least 75 years old(Elderly_75),represent 45%of colorectal cancer(CRC)incidence.As others,the French Colorectal Cancer Screening Program(CRCSP)does not include Elderly_75.To date,there is little evidence to justify stopping screening at 74 years of age.AIM To describe CRC fecal screening test completion after age 74,source(CRCSP/Provider ordered)and outcomes of these tests.METHODS The study concerned 18704 Elderly_75 residing in eleven French districts(Ain,Doubs,Essonne,Haute-Saone,Hauts-de-Seine,Jura,Seine-Saint-Denis,Territoire-de-Belfort,Val-de-Marne,Val-d'Oise,Yonne),having performed a CRC screening test between January 2008 and December 2017.The tests performed in a circumstance of delayed response to a solicitation(DRS)from the local cancer screening managing center(Managing-Center)were distinguished from the tests non-solicited by the Managing-Center,performed after a recommendation by a General Practitioner(GP)or other provider ordered(RGP).DRS was any test realized by an Elderly_75 following an initial invitation from the ManagingCenter with a maximum 24 mo after this invitation.Any Non-DRS test was considered RGP.The outcomes of these tests were described according to the circumstances of test completion.RESULTS Of 18995 screening-tests were performed at ages:75(83.5%),76-80(13.4%)and>80(3.1%)years old.Elderly_75 performed the screening test in a circumstance of DRS(71.9%)or RGP(28.1%).The proportion of the tests that could not be analyzed and not restarted was 13.2%.For these unanalyzed tests,the reason was age-related in 78.0%of cases,related to the laboratory's refusal to analyze the test of people aged≥77.Reported colonoscopy completion rate was 81.3%.For those575 people with reported colonoscopy,no complication was listed.18.0%of the366 Elderly_75 with lesions had no anteriority in the CRCSP.The neoplasia(124 Low-risk-polyps,159 High-risk-polyps,13 Unspecified-polyps and 70 CRCs)detection rate was 19.3/1000 Elderly_75 screened and the CRC detection rate was3.7/1000 Elderly_75 screened.CONCLUSION The high rate of colonoscopy completion after a positive test and the high proportion of screened lesions observed suggest that the lengthening of the screening period could allow significant detection of CRC and polyps that occur in Elderly_75 excluded from CRCSP.
文摘There has been a growing interest in screening programs designed to detect chronic progressive cancers in the asymptomatic stage, with the expectation that early detection will result in a better prognosis. One key element of early detection programs is a screening test. An accurate screening test is more effective in finding cases with early-stage diseases. Sensitivity, the conditional probability of getting a positive test result when one truly has a disease, represents one measure of accuracy for a screening test. Since the true disease status is unknown, it is not straightforward to estimate the sensitivity directly from observed data. Furthermore, the sensitivity is associated with other parameters related to the disease progression. This feature introduces additional numerical complexity and limitations, especially when the sensitivity depends on age. In this paper, we propose a new approach that, through combinatorial manipulation of probability statements, formulates the age-dependent sensitivity. This formulation has an exact and simple expression and can be estimated based on directly observable probabilities. This approach also helps evaluate other parameters associated with the natural history of disease more accurately. The proposed method was applied to estimate the mammography sensitivity for breast cancer using the data from the Health Insurance Plan trial.
基金Supported by grants from the Natrual Science Foundation of Shanghai, China (99ZB14071).
文摘To discuss whether the capillary whole blood glucose （CBG） test can be used in glucose screening test （GST） for gestational diabetes mellitus （GDM） compared to the venous plasma glucose （ VPG） method, and to determine the cutoff value of CBG. Methods This was a self-control test. The 50-g oral GST was conducted among 1 557 pregnant women between 24-28 weeks. Every woman was measured CBG and VPG at the same time and same arm. Three hundred and forty women underwent 100-g 3-h oral glucose tolerance test （OGTT）. Receiver operation curve （ROC） was used to determine the potential cutoff level of CBG and VPG. Diagnose criteria of GDM was based on NDDG criteria. OGTT diagnosed GDM and VPG ≥ 7. 8 mmol/L were used as golden standard for ROC. Results There was good relationship between CBG and VPG （ P 〈0.01 ）. Correlation coefficient was O. 86. The value of CBG was lower than VPG. The statistical and high-sensitivity cutoff values were 7. 4 mmol/L in CBG and 7. 8 mmol/L in VPG when GDM was used as golden standard. Cutoff value of CBG was 7. 0 mmol/L when VPG≥7. 8 mmol/L was used as golden standard. The pregnant outcomes of positive cases of three thresholds had no significant differences. But it was better in case of the pregnant woman when the CBG value was more than 7. 4 mmol/L. Conclusion CBG can be used in GST, the threshold of CBG was suggested as 7. 4 mmol/L. CBG test was more convenience and effective than VPG test.
文摘According to the guidelines by the Japanese government, optical colonoscopy is the most strongly recommended diagnostic test after screening with the immunochemical fecal occult blood test (iFOBT), followed by double-contrast barium enema (BE) or sigmoidoscopy. Our study was to assess patterns and trends of colorectal cancer (CRC) diagnostic testing within 2 years after iFOBT. We analyzed both iFOBT results and claims data provided by employee health insurance societies in Japan from 2005 to 2010. 25,596 enrollees underwent iFOBT screening. The positive rate was 5.1%. 32.3% of those positive underwent diagnostic tests and 1.0% (12 patients) were confirmed as having cancer. The most common test was optical colonoscopy (77.2% of total tests), followed by BE (16.2%). From 2006 to 2009, the rate of optical colonoscopy for females increased from 55% to 82% and that of BE declined from 36% to 12%, while no significant changes were seen for males. Only one-third of those who tested positive underwent diagnostic test in the 2 years following screening iFOBT. As official guidelines for diagnostic testing of CRC recommend, optical colonoscopy is now the most commonly used diagnostic test after positive iFOBT result for enrollees in employee health insurance societies in Japan.
文摘Objective: to explore the role of alanine aminotransferase (ALT) primary screening test in the blood testing of Taiyuan Blood Center. Method: from January 2019 to December 2020, Taiyuan Blood Center laboratory of 2 cases of 236628 blood type samples selected 1200 cases of unpaid blood donation samples as research samples, according to the random number method are divided into group A and B, group A routine screening blood test, group B in group plus alanine aminotransferase (ALT) early screening test. Comparative analysis of the test results between the two groups. Results: the scrap rate of group A blood samples was 0.33% higher than 1.67% in Group B (P <0.05);No laboratory review results and ALT (P> 0.05). Conclusion: the application of alanine aminotransferase (ALT) primary screening test in the blood test has high feasibility and has a significant role in reducing the blood scrap rate, which is worth recommended.
文摘We submitted 437 patients with cytological alterations that suggest viral infections to HPV test. 154 patients (35.24%) resulted positive for HPV;among these, 128 (83.11%) with a low degree of infectivity, 19 (12.33%), with an average degree of infectivity and 7 (4.54%) with a high degree of infectivity).
文摘A high risk population consisting of 3034 people with history of rectal polyps or ulcers were screened for colorectal neoplasia with Reverse Passive Hemagglutination Fecal Occult Blood Test (RPHA FOB) and 60 cm fiberoptic colonoscopy. Among 2553 subjects (84.1%)who completed both tests, 11 cases of colorectal malignancies and 465 cases of polyps were detected.Using colonoscopic finding and histopathological examination as the 'gold standard' of diagnosis, results showed that FOB positivity of polyps was related to their size, macroscopic appearance and surface features but no correlation between bleeding of polyps and their location, numbers, pathological types were found. In this study the sensitivity of RPHA in screening of colorectal malignancy was 63.6% (7/11), while that for polyps was only 21.1% (98/465) . For screening of colorectal neoplasia (cancer+polyps) the overall sensitivity and specificity of RPHA FOB were 22.1% and 82.4%, the positive and negative predictive values were 22.3% and 82.2% respectively. Amoug 465 polyps there were 195 adenomas, further analysis showed that villous and tubulovillous adenomas had higher intestinal bleeding rate (FOB positive)than tubular type (45.5%,30.0% and 17.8% respectively, X2=5.8, p=0.05). The results indicate that although the sensitivity of RPHA FOB in screening for colorectal polyps was generally low, but about 40% (8/21) of villous and tubulovillous adenoma which present higher tendency of malignant transformation can be detected by RPHA FOB as a screening Procedure. So the authors suggest that screening of colorectal neoplasia be not only a procedure of secondary prevention but also a measure of primary prevention for colorectal cancer.Accepted March 22, 1994
基金Supported by A Research Grant of Center for Translational Molecular Medicine, The Netherlands, to van Turenhout STGrant of Nycomed B.V., Hoofddorp to "the Amsterdam Gut-club", The Netherlands+1 种基金The Netherlands Organization for Health Research and Development, ZonMW, No. 50-50115-98-060,project 63000004The original trial was registered under IS-RCTN57917442 at Current Controlled Trials (www.controlled-trials.com)
文摘AIM: To improve the interpretation of fecal immunochemical test (FIT) results in colorectal cancer (CRC) cases from screening and referral cohorts. METHODS: In this comparative observational study, two prospective cohorts of CRC cases were compared. The first cohort was obtained from 10 322 average risk subjects invited for CRC screening with FIT, of which, only subjects with a positive FIT were referred for colonoscopy. The second cohort was obtained from 3637 subjects scheduled for elective colonoscopy with a positive FIT result. The same FIT and positivity threshold (OC sensor; ≥ 50 ng/mL) was used in both cohorts. Colonoscopy was performed in all referral subjects and in FIT positive screening subjects. All CRC cases were selected from both cohorts. Outcome measurements were mean FIT results and FIT scores per tissue tumor stage (T stage). RESULTS: One hundred and eighteen patients with CRC were included in the present study: 28 cases obtained from the screening cohort (64% male; mean age 65 years, SD 6.5) and 90 cases obtained from the referral cohort (58% male; mean age 69 years, SD 9.8). The mean FIT results found were higher in the referral cohort (829 ± 302 ng/mLvs 613 ± 368 ng/mL,P = 0.02). Tissue tumor stage (T stage) distribution was dif-ferent between both populations [screening population: 13 (46%) T1, eight (29%) T2, six (21%) T3, one (4%) T4 carcinoma; referral population: 12 (13%) T1, 22 (24%) T2, 52 (58%) T3, four (4%) T4 carcinoma], and higher T stage was significantly associated with higher FIT results (P < 0.001). Per tumor stage, no significant difference in mean FIT results was observed (screening vs referral: T1 498 ± 382 ng/mL vs 725 ± 374 ng/mL, P = 0.22; T2 787 ± 303 ng/mL vs 794 ± 341 ng/mL, P = 0.79; T3 563 ± 368 ng/mLvs 870 ± 258 ng/mL,P = 0.13; T4 not available). After correction for T stage in logistic regression analysis, no significant differences in mean FIT results were observed between both types of cohorts (P = 0.10). CONCLUSION: Differences in T stage distribution largely explain differences in FIT results between screening and referral cohorts. Therefore, FIT results should be reported according to T stage.
文摘Background: Zimbabwe recorded a 55% increase in HIV testing from 2011 to 2018 but with decreasing HIV-testing yields from 20% to 6% respectively as we aim to identify the narrowing gap of undiagnosed people living with HIV. As such adoption of screening tools during targeted HIV testing services improves efficiency by identifying individuals who are likely to test positive. Effective utilization of screening tools requires an understanding of health care worker perception and willingness to use the tools. Methods: We conducted a qualitative study among healthcare workers at 8 selected primary healthcare facilities in Zimbabwe. Interviewer-guided, in-depth interviews were conducted with healthcare workers and their immediate supervisors. Thematic analysis was performed following a framework built around the grounded theory model to describe perspectives that influence the utilization of HIV screening tools and suggestions for improved eligibility screening. Results: Behavioural factors facilitating the utilisation of the screening tool included motivation to adhere to standard practice, awareness of screening in targeting testing, and its ability to manage workload through screening out ineligible clients. This was evident across service delivery levels. Barriers included limited healthcare capacity, confidentiality space, multiple screening tools and opaque screening in/out criteria and the potential of clients not responding to screening questions truthfully. Conclusions: Across geographical and service delivery levels, placing screening tools at HIV testing entry points, healthcare worker knowledge on screening in/out criteria emerged as enablers for correct and consistent utilization. Further, standardizing the tools and adopting a decision aid algorithm would improve the accurate utilisation of screening tools.
文摘Shaker screen is one of important equipments in the industry of oil, metallurgy, coal and timbering. The movement locus of shaker screen affects the capacity and efficiency of shaker screen to split the solid particle from crude ore directly. To test movement of shaker locus, two eddy current transducers are employed. A discussion of the usage of these eddy current transducer to test and acceleration sensors will be made. The experiment results from a real elliptic shaker screen have good agree with the design requirements.
文摘AIM: To measure the compliance of an Academic Hospital staff with a colorectal cancer(CRC) screening program using fecal immunochemical test(FIT).METHODS: All employees of 'Attikon' University General Hospital aged over 50 years were thoroughly informed by a team of physicians and medical students about the study aims and they were invited to undergo CRC screening using two rounds of FIT(DyoniFOB~ Combo H, DyonMed SA, Athens, Greece). The tests were provided for free and subjects tested positive were subsequently referred for colonoscopy. One year after completing the two rounds, participants were asked to be re-screened by means of the same test.RESULTS: Among our target population consisted of 211 employees, 59(27.9%) consented to participate, but only 41(19.4%) and 24(11.4%) completed the first and the second FIT round, respectively. Female gender was significantly associated with higher initial participation(P = 0.005) and test completion- first and second round-(P = 0.004 and P = 0.05) rates, respectively. Phy sician’s(13.5% vs 70.2%, P < 0.0001) participation and test completion rates(7.5% vs 57.6%, P < 0.0001 for the first and 2.3% vs 34%, P < 0.0001 for the second round) were significantly lower compared to those of the administrative/technical staff. Similarly, nurses participated(25.8% vs 70.2%, P = 0.0002) and completed the first test round(19.3% vs 57.6%, P = 0.004) in a significant lower rate than the administrative/technical staff. One test proved false positive. No participant repeated the test one year later.CONCLUSION: Despite the well-organized, guided and supervised provision of the service, the compliance of the Academic Hospital personnel with a FIT-based CRC screening program was suboptimal, especially among physicians.
