An Examination of Sexual Orientation Group Patterns in Mammographic and Colorectal Screening in a Cohort of U.S. Women

PubMed Central

Austin, S. Bryn; Pazaris, Mathew J.; Nichols, Lauren P.; Bowen, Deborah; Wei, Esther K.; Spiegelman, Donna

2014-01-01

Purpose Underutilization of cancer screening has been found especially to affect socially marginalized groups. We investigated sexual orientation group patterns in breast and colorectal cancer screening adherence. Methods Data on breast and colorectal cancer screening, sexual orientation, and sociodemographics were gathered prospectively from 1989 through 2005 from 85,759 U.S. women in the Nurses' Health Study II. Publicly available data on state-level health care quality and sexual orientation-related legal protections were also gathered. Multivariable models were used to estimate sexual orientation-group differences in breast and colorectal cancer screening, controlling for sociodemographics and state-level health care quality and legal protections for sexual minorities. Results Receipt of a mammogram in the past two years was common though not universal and differed only slightly by sexual orientation: heterosexual 84%; bisexual 79%; lesbian 82%. Fewer than half of eligible women had ever received a colonoscopy or sigmoidoscopy, and rates did not differ by sexual orientation: heterosexual 39%; bisexual 39%; lesbian 42%. In fully adjusted models, state-level health care quality score, though not state-level legal protections for sexual minorities, was positively associated with likelihood of being screened for all women regardless of sexual orientation. Conclusions Concerns have been raised that unequal health care access for sexual orientation minorities may adversely affect cancer screening. We found small disparities in mammography and none in colorectal screening, though adherence to colorectal screening recommendations was uniformly very low. Interventions are needed to increase screening in women of all sexual orientation groups, particularly in areas with poor health care policies. PMID:22729931

Prediction of Chlamydia trachomatis infection to facilitate selective screening on population and individual level: a cross-sectional study of a population-based screening programme.

PubMed

van Klaveren, David; Götz, Hannelore M; Op de Coul, Eline Lm; Steyerberg, Ewout W; Vergouwe, Yvonne

2016-09-01

To develop prediction models for Chlamydia trachomatis (Ct) infection with different levels of detail in information, that is, from readily available data in registries and from additional questionnaires. All inhabitants of Rotterdam and Amsterdam aged 16-29 were invited yearly from 2008 until 2011 for home-based testing. Their registry data included gender, age, ethnicity and neighbourhood-level socioeconomic status (SES). Participants were asked to fill in a questionnaire on education, sexually transmitted infection history, symptoms, partner information and sexual behaviour. We developed prediction models for Ct infection using first-time participant data-including registry variables only and with additional questionnaire variables-by multilevel logistic regression analysis to account for clustering within neighbourhoods. We assessed the discriminative ability by the area under the receiver operating characteristic curve (AUC). Four per cent (3540/80 385) of the participants was infected. The strongest registry predictors for Ct infection were young age (especially for women) and Surinamese, Antillean or sub-Saharan African ethnicity. Neighbourhood-level SES was of minor importance. Strong questionnaire predictors were low to intermediate education level, ethnicity of the partner (non-Dutch) and having sex with casual partners. When using a prediction model including questionnaire risk factors (AUC 0.74, 95% CI 0.736 to 0.752) for selective screening, 48% of the participating population needed to be screened to find 80% (95% CI 78.4% to 81.0%) of Ct infections. The model with registry risk factors only (AUC 0.67, 95% CI 0.656 to 0.675) required 60% to be screened to find 78% (95% CI 76.6% to 79.4%) of Ct infections. A registry-based prediction model can facilitate selective Ct screening at population level, with further refinement at the individual level by including questionnaire risk factors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Organizational Factors Affecting the Likelihood of Cancer Screening Among VA Patients.

PubMed

Chou, Ann F; Rose, Danielle E; Farmer, Melissa; Canelo, Ismelda; Yano, Elizabeth M

2015-12-01

Preventive service delivery, including cancer screenings, continues to pose a challenge to quality improvement efforts. Although many studies have focused on person-level characteristics associated with screening, less is known about organizational influences on cancer screening. This study aims to understand the association between organizational factors and adherence to cancer screenings. This study employed a cross-sectional design using organizational-level, patient-level, and area-level data. Dependent variables included breast, cervical, and colorectal cancer screening. Organizational factors describing resource sufficiency were constructed using factor analyses from a survey of 250 Veterans Affairs primary care directors. We conducted random-effects logistic regression analyses, modeling cancer screening as a function of organizational factors, controlling for patient-level and area-level factors. Overall, 87% of the patients received mammograms, 92% received cervical and 78% had colorectal screening. Quality improvement orientation increased the odds of cervical [odds ratio (OR): 1.27; 95% confidence interval (CI), 1.03-1.57] and colorectal cancer screening (OR: 1.10; 95% CI, 1.00-1.20). Authority in determining primary care components increased the odds of mammography screening (OR: 1.23; 95% CI, 1.03-1.51). Sufficiency in clinical staffing increased the odds of mammography and cervical cancer screenings. Several patient-level factors, serving as control variables, were associated with achievement of screenings. Resource sufficiency led to increased odds of screening possibly because they promote excellence in patient care by conveying organizational goals and facilitate goal achievement with resources. Complementary to patient-level factors, our findings identified organizational processes associated with better performance, which offer concrete strategies in which facilities can evaluate their capabilities to implement best practices to foster and sustain a culture of quality care.

Cost-effectiveness analysis of a quantitative immunochemical test for colorectal cancer screening.

PubMed

Wilschut, Janneke A; Hol, Lieke; Dekker, Evelien; Jansen, Jan B; Van Leerdam, Monique E; Lansdorp-Vogelaar, Iris; Kuipers, Ernst J; Habbema, J Dik F; Van Ballegooijen, Marjolein

2011-11-01

Two European randomized trials (N = 30,000) compared guaiac fecal occult blood testing with quantitative fecal immunochemical testing (FIT) and showed better attendance rates and test characteristics for FIT. We aimed to identify the most cost-effective FIT cutoff level for referral to colonoscopy based on data from these trials and allowing for differences in screening ages. We used the validated MIcrosimulation SCreening ANalysis (MISCAN)-Colon microsimulation model to estimate costs and effects of different screening strategies for FIT cutoff levels of 50, 75, 100, 150, and 200 ng/mL hemoglobin. For each cutoff level, screening strategies were assessed with various age ranges and screening intervals. We assumed sufficient colonoscopy capacity for all strategies. At all cost levels, FIT screening was most effective with the 50 ng/mL cutoff level. The incremental cost-effectiveness ratio of biennial screening between ages 55 and 75 years using FIT at 50 ng/mL, for example, was 3900 euro per life year gained. Annual screening had an incremental cost-effectiveness ratio of 14,900 euro per life year gained, in combination with a wider age range (between ages 45 and 80 years). In the sensitivity analysis, 50 ng/mL remained the preferred cutoff level. FIT screening is more cost-effective at a cutoff level of 50 ng/mL than at higher cutoff levels. This supports the recommendation to use FIT at a cutoff level of 50 ng/mL, which is considerably lower than the values used in current practice. Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

Screening level risk assessment model for chemical fate and effects in the environment.

PubMed

Arnot, Jon A; Mackay, Don; Webster, Eva; Southwood, Jeanette M

2006-04-01

A screening level risk assessment model is developed and described to assess and prioritize chemicals by estimating environmental fate and transport, bioaccumulation, and exposure to humans and wildlife for a unit emission rate. The most sensitive risk endpoint is identified and a critical emission rate is then calculated as a result of that endpoint being reached. Finally, this estimated critical emission rate is compared with the estimated actual emission rate as a risk assessment factor. This "back-tracking" process avoids the use of highly uncertain emission rate data as model input. The application of the model is demonstrated in detail for three diverse chemicals and in less detail for a group of 70 chemicals drawn from the Canadian Domestic Substances List. The simple Level II and the more complex Level III fate calculations are used to "bin" substances into categories of similar probable risk. The essential role of the model is to synthesize information on chemical and environmental properties within a consistent mass balance framework to yield an overall estimate of screening level risk with respect to the defined endpoint. The approach may be useful to identify and prioritize those chemicals of commerce that are of greatest potential concern and require more comprehensive modeling and monitoring evaluations in actual regional environments and food webs.

A QSAR Model for Thyroperoxidase Inhibition and Screening ...

EPA Pesticide Factsheets

Thyroid hormones (THs) are critical modulators of a wide range of biological processes from neurodevelopment to metabolism. Well regulated levels of THs are critical during development and even moderate changes in maternal or fetal TH levels produce irreversible neurological deficits in children. The enzyme thyroperoxidase (TPO) plays a key role in the synthesis of THs. Inhibition of TPO by xenobiotics leads to decreased TH synthesis and, depending on the degree of synthesis inhibition, may result in adverse developmental outcomes. Recently, a high-throughput screening assay for TPO inhibition (AUR-TPO) was developed and used to screen the ToxCast Phase I and II chemicals. In the present study, we used the results from the AUR-TPO screening to develop a Quantitative Structure-Activity Relationship (QSAR) model for TPO inhibition in Leadscope®. The training set consisted of 898 discrete organic chemicals: 134 positive and 764 negative for TPO inhibition. A 10 times two-fold 50% cross-validation of the model was performed, yielding a balanced accuracy of 78.7% within its defined applicability domain. More recently, an additional ~800 chemicals from the US EPA Endocrine Disruption Screening Program (EDSP21) were screened using the AUR-TPO assay. This data was used for external validation of the QSAR model, demonstrating a balanced accuracy of 85.7% within its applicability domain. Overall, the cross- and external validations indicate a model with a high predictiv

Breast Cancer Screening in an Era of Personalized Regimens

PubMed Central

Onega, Tracy; Beaber, Elisabeth F.; Sprague, Brian L.; Barlow, William E.; Haas, Jennifer S.; Tosteson, Anna N.A.; Schnall, Mitchell D.; Armstrong, Katrina; Schapira, Marilyn M.; Geller, Berta; Weaver, Donald L.; Conant, Emily F.

2014-01-01

Breast cancer screening holds a prominent place in public health, health care delivery, policy, and women’s health care decisions. Several factors are driving shifts in how population-based breast cancer screening is approached, including advanced imaging technologies, health system performance measures, health care reform, concern for “overdiagnosis,” and improved understanding of risk. Maximizing benefits while minimizing the harms of screening requires moving from a “1-size-fits-all” guideline paradigm to more personalized strategies. A refined conceptual model for breast cancer screening is needed to align women’s risks and preferences with screening regimens. A conceptual model of personalized breast cancer screening is presented herein that emphasizes key domains and transitions throughout the screening process, as well as multilevel perspectives. The key domains of screening awareness, detection, diagnosis, and treatment and survivorship are conceptualized to function at the level of the patient, provider, facility, health care system, and population/policy arena. Personalized breast cancer screening can be assessed across these domains with both process and outcome measures. Identifying, evaluating, and monitoring process measures in screening is a focus of a National Cancer Institute initiative entitled PROSPR (Population-based Research Optimizing Screening through Personalized Regimens), which will provide generalizable evidence for a risk-based model of breast cancer screening, The model presented builds on prior breast cancer screening models and may serve to identify new measures to optimize benefits-to-harms tradeoffs in population-based screening, which is a timely goal in the era of health care reform. PMID:24830599

Independence screening for high dimensional nonlinear additive ODE models with applications to dynamic gene regulatory networks.

PubMed

Xue, Hongqi; Wu, Shuang; Wu, Yichao; Ramirez Idarraga, Juan C; Wu, Hulin

2018-05-02

Mechanism-driven low-dimensional ordinary differential equation (ODE) models are often used to model viral dynamics at cellular levels and epidemics of infectious diseases. However, low-dimensional mechanism-based ODE models are limited for modeling infectious diseases at molecular levels such as transcriptomic or proteomic levels, which is critical to understand pathogenesis of diseases. Although linear ODE models have been proposed for gene regulatory networks (GRNs), nonlinear regulations are common in GRNs. The reconstruction of large-scale nonlinear networks from time-course gene expression data remains an unresolved issue. Here, we use high-dimensional nonlinear additive ODEs to model GRNs and propose a 4-step procedure to efficiently perform variable selection for nonlinear ODEs. To tackle the challenge of high dimensionality, we couple the 2-stage smoothing-based estimation method for ODEs and a nonlinear independence screening method to perform variable selection for the nonlinear ODE models. We have shown that our method possesses the sure screening property and it can handle problems with non-polynomial dimensionality. Numerical performance of the proposed method is illustrated with simulated data and a real data example for identifying the dynamic GRN of Saccharomyces cerevisiae. Copyright © 2018 John Wiley & Sons, Ltd.

Dermal permeation data and models for the prioritization and screening-level exposure assessment of organic chemicals

EPA Science Inventory

High throughput screening (HTS) models are being developed and applied to prioritize chemicals for more comprehensive exposure and risk assessment. Dermal pathways are possible exposure routes to humans for thousands of chemicals found in personal care products and the indoor env...

Harms, benefits and costs of fecal immunochemical testing versus guaiac fecal occult blood testing for colorectal cancer screening.

PubMed

Goede, S Lucas; Rabeneck, Linda; van Ballegooijen, Marjolein; Zauber, Ann G; Paszat, Lawrence F; Hoch, Jeffrey S; Yong, Jean H E; Kroep, Sonja; Tinmouth, Jill; Lansdorp-Vogelaar, Iris

2017-01-01

The ColonCancerCheck screening program for colorectal cancer (CRC) in Ontario, Canada, is considering switching from biennial guaiac fecal occult blood test (gFOBT) screening between age 50-74 years to the more sensitive, but also less specific fecal immunochemical test (FIT). The aim of this study is to estimate whether the additional benefits of FIT screening compared to gFOBT outweigh the additional costs and harms. We used microsimulation modeling to estimate quality adjusted life years (QALYs) gained and costs of gFOBT and FIT, compared to no screening, in a cohort of screening participants. We compared strategies with various age ranges, screening intervals, and cut-off levels for FIT. Cost-efficient strategies were determined for various levels of available colonoscopy capacity. Compared to no screening, biennial gFOBT screening between age 50-74 years provided 20 QALYs at a cost of CAN$200,900 per 1,000 participants, and required 17 colonoscopies per 1,000 participants per year. FIT screening was more effective and less costly. For the same level of colonoscopy requirement, biennial FIT (with a high cut-off level of 200 ng Hb/ml) between age 50-74 years provided 11 extra QALYs gained while saving CAN$333,300 per 1000 participants, compared to gFOBT. Without restrictions in colonoscopy capacity, FIT (with a low cut-off level of 50 ng Hb/ml) every year between age 45-80 years was the most cost-effective strategy providing 27 extra QALYs gained per 1000 participants, while saving CAN$448,300. Compared to gFOBT screening, switching to FIT at a high cut-off level could increase the health benefits of a CRC screening program without considerably increasing colonoscopy demand.

Phenotypic screening of hepatocyte nuclear factor (HNF) 4-{gamma} receptor knockout mice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gerdin, Anna Karin; Surve, Vikas V.; Joensson, Marie

2006-10-20

Using the mouse as a model organism in pharmaceutical research presents unique advantages as its physiology in many ways resembles the human physiology, it also has a relatively short generation time, low breeding and maintenance costs, and is available in a wide variety of inbred strains. The ability to genetically modify mouse embryonic stem cells to generate mouse models that better mimic human disease is another advantage. In the present study, a comprehensive phenotypic screening protocol is applied to elucidate the phenotype of a novel mouse knockout model of hepatocyte nuclear factor (HNF) 4-{gamma}. HNF4-{gamma} is expressed in the kidneys,more » gut, pancreas, and testis. First level of the screen is aimed at general health, morphologic appearance, normal cage behaviour, and gross neurological functions. The second level of the screen looks at metabolic characteristics and lung function. The third level of the screen investigates behaviour more in-depth and the fourth level consists of a thorough pathological characterisation, blood chemistry, haematology, and bone marrow analysis. When compared with littermate wild-type mice (HNF4-{gamma}{sup +/+}), the HNF4-{gamma} knockout (HNF4-{gamma}{sup -/-}) mice had lowered energy expenditure and locomotor activity during night time that resulted in a higher body weight despite having reduced intake of food and water. HNF4-{gamma}{sup -/-} mice were less inclined to build nest and were found to spend more time in a passive state during the forced swim test.« less

FEATURES, EVENTS, AND PROCESSES: SYSTEM-LEVEL AND CRITICALITY

DOE Office of Scientific and Technical Information (OSTI.GOV)

D.L. McGregor

The primary purpose of this Analysis/Model Report (AMR) is to identify and document the screening analyses for the features, events, and processes (FEPs) that do not easily fit into the existing Process Model Report (PMR) structure. These FEPs include the 3 1 FEPs designated as System-Level Primary FEPs and the 22 FEPs designated as Criticality Primary FEPs. A list of these FEPs is provided in Section 1.1. This AMR (AN-WIS-MD-000019) documents the Screening Decision and Regulatory Basis, Screening Argument, and Total System Performance Assessment (TSPA) Disposition for each of the subject Primary FEPs. This AMR provides screening information and decisionsmore » for the TSPA-SR report and provides the same information for incorporation into a project-specific FEPs database. This AMR may also assist reviewers during the licensing-review process.« less

Physiologically-based Pharmacokinetic(PBPK) Models Application to Screen Environmental Hazards Related to Adverse Outcome Pathways(AOPs)

EPA Science Inventory

PBPK models are useful in estimating exposure levels based on in vitro to in vivo extrapolation (IVIVE) calculations. Linkage of large sets of chemically screened vitro signature effects to in vivo adverse outcomes using IVIVE is central to the concepts of toxicology in the 21st ...

Methodology for the Model-based Small Area Estimates of Cancer Risk Factors and Screening Behaviors - Small Area Estimates

Cancer.gov

This model-based approach uses data from both the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS) to produce estimates of the prevalence rates of cancer risk factors and screening behaviors at the state, health service area, and county levels.

Discrete Event Simulation for Decision Modeling in Health Care: Lessons from Abdominal Aortic Aneurysm Screening

PubMed Central

Jones, Edmund; Masconi, Katya L.; Sweeting, Michael J.; Thompson, Simon G.; Powell, Janet T.

2018-01-01

Markov models are often used to evaluate the cost-effectiveness of new healthcare interventions but they are sometimes not flexible enough to allow accurate modeling or investigation of alternative scenarios and policies. A Markov model previously demonstrated that a one-off invitation to screening for abdominal aortic aneurysm (AAA) for men aged 65 y in the UK and subsequent follow-up of identified AAAs was likely to be highly cost-effective at thresholds commonly adopted in the UK (£20,000 to £30,000 per quality adjusted life-year). However, new evidence has emerged and the decision problem has evolved to include exploration of the circumstances under which AAA screening may be cost-effective, which the Markov model is not easily able to address. A new model to handle this more complex decision problem was needed, and the case of AAA screening thus provides an illustration of the relative merits of Markov models and discrete event simulation (DES) models. An individual-level DES model was built using the R programming language to reflect possible events and pathways of individuals invited to screening v. those not invited. The model was validated against key events and cost-effectiveness, as observed in a large, randomized trial. Different screening protocol scenarios were investigated to demonstrate the flexibility of the DES. The case of AAA screening highlights the benefits of DES, particularly in the context of screening studies.

Health education for a breast and cervical cancer screening program: using the ecological model to assess local initiatives.

PubMed

Holden, D J; Moore, K S; Holliday, J L

1998-06-01

This study investigates the development and implementation of health education strategies at the local level for a statewide breast and cervical cancer control program. Baseline data on these initiatives were collected from 88 local screening programs in North Carolina. Using the ecological model as a framework, health education initiatives were assessed and analyzed to determine the level of activity occurring at the local level and the comprehensiveness of programs. Types and levels of interventions used are described and initial analysis is provided of the impact these strategies are having on recruiting women from target populations into these screening programs. Specific examples illustrating the variety of interventions used at the individual, network, organizational and community levels, and the impact of certain variables, such as the use of local health education staff, on the comprehensiveness of interventions utilized, are provided. The importance to practitioners of establishing process indicators in assessing local initiatives and challenges to conducting evaluations of these strategies are also discussed.

A Research into Evaluation of Basketball Athletes' Risk Perception Level

ERIC Educational Resources Information Center

Karatas, Ozgur

2016-01-01

The aim of this study is to compare the risk perception levels of Basketball athletes in Turkish League teams according to some variables. In this research the "general screening model," which is one of the descriptive screening methods, was used. While the population of the study consists of athletes actively engaged in the Turkish…

Readability, suitability, and health content assessment of web-based patient education materials on colorectal cancer screening.

PubMed

Tian, Chenlu; Champlin, Sara; Mackert, Michael; Lazard, Allison; Agrawal, Deepak

2014-08-01

Colorectal cancer (CRC) screening rates in the Unites States are still below target level. Web-based patient education materials are used by patients and providers to provide supplemental information on CRC screening. Low literacy levels and patient perceptions are significant barriers to screening. There are little data on the quality of these online materials from a health literacy standpoint or whether they address patients' perceptions. To evaluate the readability, suitability, and health content of web-based patient education materials on colon cancer screening. Descriptive study. Web-based patient materials. Twelve reputable and popular online patient education materials were evaluated. Readability was measured by using the Flesch-Kincaid Reading Grade Level, and suitability was determined by the Suitability Assessment of Materials, a scale that considers characteristics such as content, graphics, layout/typography, and learning stimulation. Health content was evaluated within the framework of the Health Belief Model, a behavioral model that relates patients' perceptions of susceptibility to disease, severity, and benefits and barriers to their medical decisions. Each material was scored independently by 3 reviewers. Flesch-Kincaid Reading Grade Level score, Suitability Assessment of Materials score, health content score. Readability for 10 of 12 materials surpassed the maximum recommended sixth-grade reading level. Five were 10th grade level and above. Only 1 of 12 materials received a superior suitability score; 3 materials received inadequate scores. Health content analysis revealed that only 50% of the resources discussed CRC risk in the general population and <25% specifically addressed patients at high risk, such as African Americans, smokers, patients with diabetes, and obese patients. For perceived barriers to screening, only 8.3% of resources discussed embarrassment, 25% discussed pain with colonoscopy, 25% addressed cost of colonoscopy, and none specifically mentioned the need to get colonoscopy when no symptoms are present. No material discussed the social benefits of screening. Descriptive design. Most online patient education materials for CRC screening are written beyond the recommended sixth-grade reading level, with suboptimal suitability. Health content is lacking in addressing key perceived risks, barriers, and benefits to CRC screening. Developing more appropriate and targeted patient education resources on CRC may improve patient understanding and promote screening. Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Development of a community cancer education program: the Forsyth County, NC cervical cancer prevention project.

PubMed

Michielutte, R; Dignan, M B; Wells, H B; Young, L D; Jackson, D S; Sharp, P C

1989-01-01

The authors outline the development and implementation of a public health education program for cervical cancer screening among black women in Forsyth County, NC. The educational program includes distributing electronic and printed information media messages, a program of direct education for women, and providing information on current issues in cervical screening to primary-care physicians. Program development was based on social marketing principles, the PRECEDE model, and the communication-behavior change (CBC) model. Since a true experimental design was not feasible, program evaluation is based on several complementary quasi-experimental designs. Analysis of baseline data indicate that the county where the intervention is taking place, and the control county, are similar with respect to both demographic characteristics and the current level of screening activity. Preliminary results indicate that the program has been successful in raising women's level of awareness of cervical cancer and cervical screening.

Telemedicine and Diabetic Retinopathy: Review of Published Screening Programs

PubMed Central

Tozer, Kevin; Woodward, Maria A.; Newman-Casey, Paula A.

2016-01-01

Background Diabetic Retinopathy (DR) is a leading cause of blindness worldwide even though successful treatments exist. Improving screening and treatment could avoid many cases of vision loss. However, due to an increasing prevalence of diabetes, traditional in-person screening for DR for every diabetic patient is not feasible. Telemedicine is one viable solution to provide high-quality and efficient screening to large number of diabetic patients. Purpose To provide a narrative review of large DR telemedicine screening programs. Methods Articles were identified through a comprehensive search of the English-language literature published between 2000 and 2014. Telemedicine screening programs were included for review if they had published data on at least 150 patients and had available validation studies supporting their model. Screening programs were then categorized according to their American Telemedicine Association Validation Level. Results Seven programs from the US and abroad were identified and included in the review. Three programs were Category 1 programs (Ophdiat, EyePacs, and Digiscope), two were Category 2 programs (Eye Check, NHS Diabetic Eye Screening Program), and two were Category 3 programs (Joslin Vision Network, Alberta Screening Program). No program was identified that claimed category 4 status. Programs ranged from community or city level programs to large nationwide programs including millions of individuals. The programs demonstrated a high level of clinical accuracy in screening for DR. There was no consensus amongst the programs regarding the need for dilation, need for stereoscopic images, or the level of training for approved image graders. Conclusion Telemedicine programs have been clinically validated and successfully implemented across the globe. They can provide a high-level of clinical accuracy for screening for DR while improving patient access in a cost-effective and scalable manner. PMID:27430019

Cost-effectiveness analysis of neonatal hearing screening program in China: should universal screening be prioritized?

PubMed

Huang, Li-Hui; Zhang, Luo; Tobe, Ruo-Yan Gai; Qi, Fang-Hua; Sun, Long; Teng, Yue; Ke, Qing-Lin; Mai, Fei; Zhang, Xue-Feng; Zhang, Mei; Yang, Ru-Lan; Tu, Lin; Li, Hong-Hui; Gu, Yan-Qing; Xu, Sai-Nan; Yue, Xiao-Yan; Li, Xiao-Dong; Qi, Bei-Er; Cheng, Xiao-Huan; Tang, Wei; Xu, Ling-Zhong; Han, De-Min

2012-04-17

Neonatal hearing screening (NHS) has been routinely offered as a vital component of early childhood care in developed countries, whereas such a screening program is still at the pilot or preliminary stage as regards its nationwide implementation in developing countries. To provide significant evidence for health policy making in China, this study aims to determine the cost-effectiveness of NHS program implementation in case of eight provinces of China. A cost-effectiveness model was conducted and all neonates annually born from 2007 to 2009 in eight provinces of China were simulated in this model. The model parameters were estimated from the established databases in the general hospitals or maternal and child health hospitals of these eight provinces, supplemented from the published literature. The model estimated changes in program implementation costs, disability-adjusted life years (DALYs), average cost-effectiveness ratio (ACER), and incremental cost-effectiveness ratio (ICER) for universal screening compared to targeted screening in eight provinces. A multivariate sensitivity analysis was performed to determine uncertainty in health effect estimates and cost-effectiveness ratios using a probabilistic modeling technique. Targeted strategy trended to be cost-effective in Guangxi, Jiangxi, Henan, Guangdong, Zhejiang, Hebei, Shandong, and Beijing from the level of 9%, 9%, 8%, 4%, 3%, 7%, 5%, and 2%, respectively; while universal strategy trended to be cost-effective in those provinces from the level of 70%, 70%, 48%, 10%, 8%, 28%, 15%, 4%, respectively. This study showed although there was a huge disparity in the implementation of the NHS program in the surveyed provinces, both universal strategy and targeted strategy showed cost-effectiveness in those relatively developed provinces, while neither of the screening strategy showed cost-effectiveness in those relatively developing provinces. This study also showed that both strategies especially universal strategy achieve a good economic effect in the long term costs. Universal screening might be considered as the prioritized implementation goal especially in those relatively developed provinces of China as it provides the best health and economic effects, while targeted screening might be temporarily more realistic than universal screening in those relatively developing provinces of China.

Does cholesterol screening result in negative labeling effects? Results of the Massachusetts Model Systems for Blood Cholesterol Screening Project.

PubMed

Havas, S; Reisman, J; Hsu, L; Koumjian, L

1991-01-01

Several previous studies that looked at the effects of labeling individuals as hypertensive found increases in psychosocial distress, diminished feelings of well-being, or absenteeism. Other studies found no such effects. Thus far, similar studies relating to labeling for high blood cholesterol levels have not been published. The Massachusetts Model Systems for Blood Cholesterol Screening Project investigated whether labeling effects occurred as a result of the community-based screening, education, and referral programs it conducted in Worcester and Lowell. Nine questions concerning perceptions of physical and psychological well-being were asked on a questionnaire given to screening participants. The same questions were asked as part of a follow-up questionnaire given to all individuals identified as having high blood cholesterol levels at one of the screenings. Comparison of the baseline and follow-up results did not demonstrate significant overall negative effects among any age, sex, racial, income, or educational groups. On the contrary, responses to many of the questions revealed small but statistically significant improvements in perceptions of physical and psychological well-being. The absence of negative labeling effects may be attributable to the positive, supportive approach to participant counseling taken by the project.

Experiential instruction in graduate-level preparation of speech-language pathology students in outer and middle ear screening.

PubMed

Serpanos, Yula C; Senzer, Deborah

2015-05-01

This study presents a piloted training model of experiential instruction in outer and middle ear (OE-ME) screening for graduate speech-language pathology students with peer teaching by doctor of audiology (AuD) students. Six individual experiential training sessions in screening otoscopy and tympanometry were conducted for 36 graduate-level speech-language pathology students led by a supervised AuD student. Postexperiential training, survey outcomes from 24 speech-language pathology students revealed a significant improvement (p = .01) in perceptions of attaining adequate knowledge and comfort in performing screening otoscopy (handheld and video otoscopy) and tympanometry. In a group of matched controls who did not receive experiential training in OE-ME screening (n = 24), ratings on the same learning outcomes survey in otoscopy and tympanometry were significantly poorer (p = .01) compared with students who did receive experiential training. A training model of experiential instruction for speech-language pathology students by AuD students improved learning outcomes, illustrating its promise in affecting clinical practices. The instructional model also meets the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA; American Speech-Language-Hearing Association, 2008) and American Speech-Language-Hearing Association (2014) Certificate of Clinical Competence (ASHA CCC) standards for speech-language pathology in OE-ME screening and CAA (2008) and ASHA (2012) CCC standards in the supervisory process for audiology.

Prevention, screening and treatment of colorectal cancer: a global and regional generalized cost effectiveness analysis

PubMed Central

2010-01-01

Background Regional generalized cost-effectiveness estimates of prevention, screening and treatment interventions for colorectal cancer are presented. Methods Standardised WHO-CHOICE methodology was used. A colorectal cancer model was employed to provide estimates of screening and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs. Results In regions characterised by high income, low mortality and high existing treatment coverage, the addition of screening to the current high treatment levels is very cost-effective, although no particular intervention stands out in cost-effectiveness terms relative to the others. In regions characterised by low income, low mortality with existing treatment coverage around 50%, expanding treatment with or without screening is cost-effective or very cost-effective. Abandoning treatment in favour of screening (no treatment scenario) would not be cost effective. In regions characterised by low income, high mortality and low treatment levels, the most cost-effective intervention is expanding treatment. Conclusions From a cost-effectiveness standpoint, screening programmes should be expanded in developed regions and treatment programmes should be established for colorectal cancer in regions with low treatment coverage. PMID:20236531

The Effects of Reading from the Screen on the Reading Motivation Levels of Elementary 5th Graders

ERIC Educational Resources Information Center

Aydemir, Zeynep; Ozturk, Ergun

2012-01-01

This study aims to explore the effects of reading from the screen on elementary 5th grade students' reading motivation levels. It used the randomized control-group pretest-posttest model, which is a true experimental design. The study group consisted of 60 students, 30 experimental and 30 control, who were attending the 5th grade of a public…

Screening for elevated levels of fear-avoidance beliefs regarding work or physical activities in people receiving outpatient therapy.

PubMed

Hart, Dennis L; Werneke, Mark W; George, Steven Z; Matheson, James W; Wang, Ying-Chih; Cook, Karon F; Mioduski, Jerome E; Choi, Seung W

2009-08-01

Screening people for elevated levels of fear-avoidance beliefs is uncommon, but elevated levels of fear could worsen outcomes. Developing short screening tools might reduce the data collection burden and facilitate screening, which could prompt further testing or management strategy modifications to improve outcomes. The purpose of this study was to develop efficient yet accurate screening methods for identifying elevated levels of fear-avoidance beliefs regarding work or physical activities in people receiving outpatient rehabilitation. A secondary analysis of data collected prospectively from people with a variety of common neuromusculoskeletal diagnoses was conducted. Intake Fear-Avoidance Beliefs Questionnaire (FABQ) data were collected from 17,804 people who had common neuromusculoskeletal conditions and were receiving outpatient rehabilitation in 121 clinics in 26 states (in the United States). Item response theory (IRT) methods were used to analyze the FABQ data, with particular emphasis on differential item functioning among clinically logical groups of subjects, and to identify screening items. The accuracy of screening items for identifying subjects with elevated levels of fear was assessed with receiver operating characteristic analyses. Three items for fear of physical activities and 10 items for fear of work activities represented unidimensional scales with adequate IRT model fit. Differential item functioning was negligible for variables known to affect functional status outcomes: sex, age, symptom acuity, surgical history, pain intensity, condition severity, and impairment. Items that provided maximum information at the median for the FABQ scales were selected as screening items to dichotomize subjects by high versus low levels of fear. The accuracy of the screening items was supported for both scales. This study represents a retrospective analysis, which should be replicated using prospective designs. Future prospective studies should assess the reliability and validity of using one FABQ item to screen people for high levels of fear-avoidance beliefs. The lack of differential item functioning in the FABQ scales in the sample tested in this study suggested that FABQ screening could be useful in routine clinical practice and allowed the development of single-item screening for fear-avoidance beliefs that accurately identified subjects with elevated levels of fear. Because screening was accurate and efficient, single IRT-based FABQ screening items are recommended to facilitate improved evaluation and care of heterogeneous populations of people receiving outpatient rehabilitation.

Health workforce planning and service expansion during an economic crisis: A case study of the national breast screening programme in Ireland.

PubMed

McHugh, S M; Tyrrell, E; Johnson, B; Healy, O; Perry, I J; Normand, C

2015-12-01

This article aims to estimate the workforce and resource implications of the proposed age extension of the national breast screening programme, under the economic constraints of reduced health budgets and staffing levels in the Irish health system. Using a mixed method design, a purposive sample of 20 participants were interviewed and data were analysed thematically (June-September 2012). Quantitative data (programme-level activity data, screening activity, staffing levels and screening plans) were used to model potential workload and resource requirements. The analysis indicates that over 90% operational efficiency was achieved throughout the first six months of 2012. Accounting for maternity leave (10%) and sick leave (3.5%), 16.1 additional radiographers (whole time equivalent) would be required for the workload created by the age extension of the screening programme, at 90% operational efficiency. The results suggest that service expansion is possible with relatively minimal additional radiography resources if the efficiency of the skill mix and the use of equipment are improved. Investing in the appropriate skill mix should not be limited to clinical groups but should also include administrative staff to manage and support the service. Workload modelling may contribute to improved health workforce planning and service efficiency. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Perceptions of Prostate Cancer Fatalism and Screening Behavior Between United States-Born and Caribbean-Born Black Males

PubMed Central

Cobran, Ewan K.; Wutoh, Anthony K.; Lee, Euni; Odedina, Folakemi T.; Ragin, Camille; Aiken, William; Godley, Paul A.

2013-01-01

Cancer fatalism is believed to be a major barrier for cancer screening in Black males. Therefore, the purpose of this study was to compare perceptions of prostate cancer (CaP) fatalism and predictors of CaP screening with Prostate Specific Antigen (PSA) testing between U.S.-born and Caribbean-born Black males. The Powe Fatalism Inventory and the Personal Integrative Model of CaP Disparity Survey were used to collect the following data from males in South Florida. Multivariate logistic regression models were constructed to examine the statistically significant predictors of CaP screening. A total of 211 U.S.-born and Caribbean-born Black males between ages 39–75 were recruited. Nativity was not a significant predictor of CaP screening with PSA testing within the last year (Odds ratio [OR] = 0.80, 95 % confidence interval [CI] = 0.26, 2.48, p = 0.70). Overall, higher levels of CaP fatalism were not a significant predictor of CaP screening with PSA testing within the last year (OR = 1.37, 95 % CI = 0.48, 3.91, p = 0.56). The study results suggest that nativity did not influence CaP screening with PSA testing. However, further studies are needed to evaluate the association between CaP screening behavior and levels of CaP fatalism. PMID:23576029

Area-level socioeconomic inequalities in the use of mammography screening: A multilevel analysis of the Health of Houston Survey

PubMed Central

Calo, William A.; Vernon, Sally W.; Lairson, David R.; Linder, Stephen H.

2015-01-01

Background An emerging literature reports that women who reside in socioeconomically deprived communities are less likely to adhere to mammography screening. This study explored associations between area-level socioeconomic measures and mammography screening among a racially and ethnically diverse sample of women in Texas. Methods We conducted a cross-sectional multilevel study linking individual-level data from the 2010 Health of Houston Survey and contextual data from the U.S. Census. Women ages 40–74 years (N=1,541) were included in the analyses. We examined tract-level poverty, unemployment, education, Hispanic and Black composition, female-headed householder families, and crowding as contextual measures. Using multilevel logistic regression modeling, we compared most disadvantaged tracts (quartiles 2–4) to the most advantaged tract (quartile 1). Results Overall, 64% of the sample was adherent to mammography screening. Screening rates were lower (P<.05) among Hispanics, those foreign born, women aged 40–49 years, and those with low educational attainment, unemployed, and without health insurance coverage. Women living in areas with high levels of poverty (quartile 2 vs. quartile 1: OR=0.50; 95% CI: 0.30–0.85), Hispanic composition (quartile 3 vs. quartile 1: OR=0.54; 95% CI: 0.32–0.90), and crowding (quartile 4 vs. quartile 1: OR=0.53; 95% CI: 0.29–0.96) were less likely to have up-to-date mammography screening, net of individual-level factors. Conclusion Our findings highlight the importance of examining area-level socioeconomic inequalities in mammography screening. The study represents an advance on previous research because we examined multiple area measures, controlled for key individual-level covariates, used data aggregated at the tract level, and accounted for the nested structure of the data. PMID:26809487

Selecting a mix of prevention strategies against cervical cancer for maximum efficiency with an optimization program.

PubMed

Demarteau, Nadia; Breuer, Thomas; Standaert, Baudouin

2012-04-01

Screening and vaccination against human papillomavirus (HPV) can protect against cervical cancer. Neither alone can provide 100% protection. Consequently it raises the important question about the most efficient combination of screening at specified time intervals and vaccination to prevent cervical cancer. Our objective was to identify the mix of cervical cancer prevention strategies (screening and/or vaccination against HPV) that achieves maximum reduction in cancer cases within a fixed budget. We assessed the optimal mix of strategies for the prevention of cervical cancer using an optimization program. The evaluation used two models. One was a Markov cohort model used as the evaluation model to estimate the costs and outcomes of 52 different prevention strategies. The other was an optimization model in which the results of each prevention strategy of the previous model were entered as input data. The latter model determined the combination of the different prevention options to minimize cervical cancer under budget, screening coverage and vaccination coverage constraints. We applied the model in two countries with different healthcare organizations, epidemiology, screening practices, resource settings and treatment costs: the UK and Brazil. 100,000 women aged 12 years and above across the whole population over a 1-year period at steady state were included. The intervention was papanicolaou (Pap) smear screening programmes and/or vaccination against HPV with the bivalent HPV 16/18 vaccine (Cervarix® [Cervarix is a registered trademark of the GlaxoSmithKline group of companies]). The main outcome measures were optimal distribution of the population between different interventions (screening, vaccination, screening plus vaccination and no screening or vaccination) with the resulting number of cervical cancer and associated costs. In the base-case analysis (= same budget as today), the optimal prevention strategy would be, after introducing vaccination with a coverage rate of 80% in girls aged 12 years and retaining screening coverage at pre-vaccination levels (65% in the UK, 50% in Brazil), to increase the screening interval to 6 years (from 3) in the UK and to 5 years (from 3) in Brazil. This would result in a reduction of cervical cancer by 41% in the UK and by 54% in Brazil from pre-vaccination levels with no budget increase. Sensitivity analysis shows that vaccination alone at 80% coverage with no screening would achieve a cervical cancer reduction rate of 20% in the UK and 43% in Brazil compared with the pre-vaccination situation with a budget reduction of 30% and 14%, respectively. In both countries, the sharp reduction in cervical cancer is seen when the vaccine coverage rate exceeds the maximum screening coverage rate, or when screening coverage rate exceeds the maximum vaccine coverage rate, while maintaining the budget. As with any model, there are limitations to the value of predictions depending upon the assumptions made in each model. Spending the same budget that was used for screening and treatment of cervical cancer in the pre-vaccination era, results of the optimization program show that it would be possible to substantially reduce the number of cases by implementing an optimal combination of HPV vaccination (80% coverage) and screening at pre-vaccination coverage (65% UK, 50% Brazil) while extending the screening interval to every 6 years in the UK and 5 years in Brazil.

Examination of Self-Efficacy and Burnout Dynamics of Preschool Teachers in Turkey and the United States

ERIC Educational Resources Information Center

Orçan, Maide

2013-01-01

This study aimed to comparatively examine the self-efficacy and burnout levels of preschool teachers in Turkey and the United States. Of the general screening models, the study uses the relational screening model. A total of 90 teachers participated in the study. 32 of the participants were from the United States and 58 were from Turkey. The…

An Organizational Informatics Analysis of Colorectal, Breast, and Cervical Cancer Screening Clinical Decision Support and Information Systems within Community Health Centers

ERIC Educational Resources Information Center

Carney, Timothy Jay

2012-01-01

A study design has been developed that employs a dual modeling approach to identify factors associated with facility-level cancer screening improvement and how this is mediated by the use of clinical decision support. This dual modeling approach combines principles of (1) Health Informatics, (2) Cancer Prevention and Control, (3) Health Services…

Multilevel predictors of colorectal cancer testing modality among publicly and privately insured people turning 50.

PubMed

Wheeler, Stephanie B; Kuo, Tzy-Mey; Meyer, Anne Marie; Martens, Christa E; Hassmiller Lich, Kristen M; Tangka, Florence K L; Richardson, Lisa C; Hall, Ingrid J; Smith, Judith Lee; Mayorga, Maria E; Brown, Paul; Crutchfield, Trisha M; Pignone, Michael P

2017-06-01

Understanding multilevel predictors of colorectal cancer (CRC) screening test modality can help inform screening program design and implementation. We used North Carolina Medicare, Medicaid, and private, commercially available, health plan insurance claims data from 2003 to 2008 to ascertain CRC test modality among people who received CRC screening around their 50th birthday, when guidelines recommend that screening should commence for normal risk individuals. We ascertained receipt of colonoscopy, fecal occult blood test (FOBT) and fecal immunochemical test (FIT) from billing codes. Person-level and county-level contextual variables were included in multilevel random intercepts models to understand predictors of CRC test modality, stratified by insurance type. Of 12,570 publicly-insured persons turning 50 during the study period who received CRC testing, 57% received colonoscopy, whereas 43% received FOBT/FIT, with significant regional variation. In multivariable models, females with public insurance had lower odds of colonoscopy than males (odds ratio [OR] = 0.68; p < 0.05). Of 56,151 privately-insured persons turning 50 years old who received CRC testing, 42% received colonoscopy, whereas 58% received FOBT/FIT, with significant regional variation. In multivariable models, females with private insurance had lower odds of colonoscopy than males (OR = 0.43; p < 0.05). People living 10-15 miles away from endoscopy facilities also had lower odds of colonoscopy than those living within 5 miles (OR = 0.91; p < 0.05). Both colonoscopy and FOBT/FIT are widely used in North Carolina among insured persons newly age-eligible for screening. The high level of FOBT/FIT use among privately insured persons and women suggests that renewed emphasis on FOBT/FIT as a viable screening alternative to colonoscopy may be important.

Women's Benefits and Harms Trade-Offs in Breast Cancer Screening: Results from a Discrete-Choice Experiment.

PubMed

Sicsic, Jonathan; Pelletier-Fleury, Nathalie; Moumjid, Nora

2018-01-01

Over the past decade, the benefits and harms balance of breast cancer (BC) screening has been widely debated. To elicit women's trade-offs between the benefits and harms of BC screening and to analyze the main determinants of these trade-offs. A discrete-choice experiment with seven attributes depicting BC screening programs including varying levels of BC mortality, overdiagnosis, and false-positive result was used. Eight hundred twelve women aged 40 to 74 years with no personal history of BC recruited by a survey institute and representative of the French general population (age, socioeconomic level, and geographical location) completed the discrete-choice experiment. Preference heterogeneity was investigated using generalized multinomial logit models from which individual trade-offs were derived, and their main determinants were assessed using generalized linear models. Screening acceptance rates under various benefits and harms ratios were simulated on the basis of the distribution of individual preferences. The women would be willing to accept on average 14.1 overdiagnosis cases (median = 9.6) and 47.8 false-positive results (median = 27.2) to avoid one BC-related death. After accounting for preference heterogeneity, less than 50% of women would be willing to accept 10 overdiagnosis cases for one BC-related death avoided. Screening acceptance rates were higher among women with higher socioeconomic level and lower among women with poor health. Women are sensitive to both the benefits and the harms of BC screening and their preferences are highly heterogeneous. Our study provides useful results for public health authorities and clinicians willing to improve their recommendations of BC screening on the basis of women's preferences. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Determinants of participation in colorectal cancer screening among community-dwelling Chinese older people: Testing a comprehensive model using a descriptive correlational study.

PubMed

Leung, Doris Y P; Wong, Eliza M L; Chan, Carmen W H

2016-04-01

The prevalence of colorectal cancer (CRC) among older people is high. Screening for CRC presents a cost-effective secondary prevention and control strategy which results in a significant reduction in mortality. This study aims to describe the prevalence of CRC screening and examine its risk factors among Chinese community-dwelling older people guided by a comprehensive model combining Health Belief Model and Extended Parallel Processing Model. A descriptive correlational study was conducted. A convenience sample of 240 community-dwelling adults aged ≥60 was recruited in May-July in 2012 in Hong Kong. Participants were asked to complete a questionnaire which collected information on demographic variables, CRC-related psychosocial variables and whether they had a CRC screening in the past 10 years. Among the participants, 25.4% reported having a CRC screening test. Results of logistic regression analyses indicated that participants with a higher level in cue to action, and lower perceived knowledge barriers and severity-fear were significantly associated with participation in CRC screening. But there were no significant associations between fatalism and cancer fear with screening. The prevalence of CRC screening was low in Hong Kong Chinese community-dwelling elders. A number of modifiable factors associated with CRC screening were identified which provides specific targets for interventions. This study also adds to the knowledge regarding the associations between fatalism and fear with CRC screening behaviors among Chinese older people. Copyright © 2015 Elsevier Ltd. All rights reserved.

Screening for Elevated Blood Lead Levels in Children: Assessment of Criteria and a Proposal for New Ones in France

PubMed Central

Etchevers, Anne; Glorennec, Philippe; Le Strat, Yann; Lecoffre, Camille; Bretin, Philippe; Le Tertre, Alain

2015-01-01

The decline in children’s Blood Lead Levels (BLL) raises questions about the ability of current lead poisoning screening criteria to identify those children most exposed. The objectives of the study were to evaluate the performance of current screening criteria in identifying children with blood lead levels higher than 50 µg/L in France, and to propose new criteria. Data from a national French survey, conducted among 3831 children aged 6 months to 6 years in 2008–2009 were used. The sensitivity and specificity of the current criteria in predicting blood lead levels higher than or equal to 50 µg/L were evaluated. Two predictive models of BLL above 44 µg/L (for lack of sufficient sample size at 50 µg/L) were built: the first using current criteria, and the second using newly identified risk factors. For each model, performance was studied by calculating the area under the ROC (Receiver Operating Characteristic) curve. The sensitivity of current criteria for detecting BLL higher than or equal to 50 µg/L was 0.51 (0.26; 0.75) and specificity was 0.66 (0.62; 0.70). The new model included the following criteria: foreign child newly arrived in France, mother born abroad, consumption of tap water in the presence of lead pipes, pre-1949 housing, period of construction of housing unknown, presence of peeling paint, parental smoking at home, occupancy rates for housing and child’s address in a cadastral municipality or census block comprising more than 6% of housing that is potentially unfit and built pre-1949. The area under the ROC curve was 0.86 for the new model, versus 0.76 for the current one. The lead poisoning screening criteria should be updated. The risk of industrial, occupational and hobby-related exposure could not be assessed in this study, but should be kept as screening criteria. PMID:26633457

Association of screen time with self-perceived attention problems and hyperactivity levels in French students: a cross-sectional study

PubMed Central

Guichard, Elie; Kurth, Tobias

2016-01-01

Objective To investigate whether high levels of screen time exposure are associated with self-perceived levels of attention problems and hyperactivity in higher education students. Design Cross-sectional study among participants of the i-Share cohort. Setting French-speaking students of universities and higher education institutions. Participants 4816 graduate students who were at least 18 years old. Exposure Screen time was assessed by self-report of the average time spent on five different screen activities on smartphone, television, computer and tablet and categorised into quartiles. Main outcome measure We used the Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS-v1.1) concerning students’ behaviour over the past 6 months to measure self-perceived levels of attention problems and hyperactivity. Responses were summarised into a global score as well as scores for attention problems and hyperactivity. Results The 4816 participants of this study had a mean age of 20.8 years and 75.5% were female. Multivariable ordinary regression models showed significant associations of screen time exposure with quintiles of the total score of self-perceived attention problems and hyperactivity levels as well as the individual domains. Compared to the lowest screen time exposure category, the ORs (95% CI) were 1.58 (1.37 to 1.82) for each increasing level of quintiles of the global score, 1.57 (1.36 to 1.81) for increasing quintiles of attention levels and 1.25 (1.09 to 1.44) for increasing quartiles of hyperactivity. Conclusions Results of this large cross-sectional study among French university and higher education students show dose-dependent associations between screen time and self-perceived levels of attention problems and hyperactivity. Further studies are warranted to evaluate whether interventions could positively influence these associations. PMID:26920440

Obesity and Insulin Resistance Screening Tools in American Adolescents: National Health and Nutrition Examination Survey (NHANES) 1999 to 2010.

PubMed

Lee, Joey A; Laurson, Kelly R

2016-08-01

To identify which feasible obesity and insulin resistance (IR) screening tools are most strongly associated in adolescents by using a nationally representative sample. Adolescents aged 12.0 to 18.9 years who were participating in the National Health and Nutrition Examination Survey (NHANES) (n=3584) and who were measured for height, weight, waist circumference (WC), triceps and subscapular skinfold thickness, glycated hemoglobin, fasting glucose (FG) and fasting insulin (FI) level were included. Adolescents were split by gender and grouped by body mass index (BMI) percentile. Age- and gender-specific classifications were constructed for each obesity screening tool measure to account for growth and maturation. General linear models were used to establish groups objectively for analysis based on when IR began to increase. Additional general linear models were used to identify when IR significantly increased for each IR measure as obesity group increased and to identify the variance accounted for among each obesity-IR screening tool relationship. As the obesity group increased, homeostasis model assessment-insulin resistance (HOMA-IR) and FI significantly increased, while FG increased only (above the referent) in groups with BMI percentiles ≥95.0, and glycated hemoglobin level did not vary across obesity groups. The most strongly associated screening tools were WC and FI in boys (R(2)=0.253) and girls (R(2)=0.257). FI had the strongest association with all of the obesity measures. BMI associations were slightly weaker than WC in each in relation to IR. Our findings show that WC and FI are the most strongly associated obesity and IR screening tool measures in adolescents. These feasible screening tools should be utilized in screening practices for at-risk adolescents. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Sensitivity of ecological soil-screening levels for metals to exposure model parameterization and toxicity reference values.

PubMed

Sample, Bradley E; Fairbrother, Anne; Kaiser, Ashley; Law, Sheryl; Adams, Bill

2014-10-01

Ecological soil-screening levels (Eco-SSLs) were developed by the United States Environmental Protection Agency (USEPA) for the purposes of setting conservative soil screening values that can be used to eliminate the need for further ecological assessment for specific analytes at a given site. Ecological soil-screening levels for wildlife represent a simplified dietary exposure model solved in terms of soil concentrations to produce exposure equal to a no-observed-adverse-effect toxicity reference value (TRV). Sensitivity analyses were performed for 6 avian and mammalian model species, and 16 metals/metalloids for which Eco-SSLs have been developed. The relative influence of model parameters was expressed as the absolute value of the range of variation observed in the resulting soil concentration when exposure is equal to the TRV. Rank analysis of variance was used to identify parameters with greatest influence on model output. For both birds and mammals, soil ingestion displayed the broadest overall range (variability), although TRVs consistently had the greatest influence on calculated soil concentrations; bioavailability in food was consistently the least influential parameter, although an important site-specific variable. Relative importance of parameters differed by trophic group. Soil ingestion ranked 2nd for carnivores and herbivores, but was 4th for invertivores. Different patterns were exhibited, depending on which parameter, trophic group, and analyte combination was considered. The approach for TRV selection was also examined in detail, with Cu as the representative analyte. The underlying assumption that generic body-weight-normalized TRVs can be used to derive protective levels for any species is not supported by the data. Whereas the use of site-, species-, and analyte-specific exposure parameters is recommended to reduce variation in exposure estimates (soil protection level), improvement of TRVs is more problematic. © 2014 The Authors. Environmental Toxicology and Chemistry Published by Wiley Periodicals, Inc.

Sensitivity of ecological soil-screening levels for metals to exposure model parameterization and toxicity reference values

PubMed Central

Sample, Bradley E; Fairbrother, Anne; Kaiser, Ashley; Law, Sheryl; Adams, Bill

2014-01-01

Ecological soil-screening levels (Eco-SSLs) were developed by the United States Environmental Protection Agency (USEPA) for the purposes of setting conservative soil screening values that can be used to eliminate the need for further ecological assessment for specific analytes at a given site. Ecological soil-screening levels for wildlife represent a simplified dietary exposure model solved in terms of soil concentrations to produce exposure equal to a no-observed-adverse-effect toxicity reference value (TRV). Sensitivity analyses were performed for 6 avian and mammalian model species, and 16 metals/metalloids for which Eco-SSLs have been developed. The relative influence of model parameters was expressed as the absolute value of the range of variation observed in the resulting soil concentration when exposure is equal to the TRV. Rank analysis of variance was used to identify parameters with greatest influence on model output. For both birds and mammals, soil ingestion displayed the broadest overall range (variability), although TRVs consistently had the greatest influence on calculated soil concentrations; bioavailability in food was consistently the least influential parameter, although an important site-specific variable. Relative importance of parameters differed by trophic group. Soil ingestion ranked 2nd for carnivores and herbivores, but was 4th for invertivores. Different patterns were exhibited, depending on which parameter, trophic group, and analyte combination was considered. The approach for TRV selection was also examined in detail, with Cu as the representative analyte. The underlying assumption that generic body-weight–normalized TRVs can be used to derive protective levels for any species is not supported by the data. Whereas the use of site-, species-, and analyte-specific exposure parameters is recommended to reduce variation in exposure estimates (soil protection level), improvement of TRVs is more problematic. Environ Toxicol Chem 2014;33:2386–2398. PMID:24944000

Analysis of crash proportion by vehicle type at traffic analysis zone level: A mixed fractional split multinomial logit modeling approach with spatial effects.

PubMed

Lee, Jaeyoung; Yasmin, Shamsunnahar; Eluru, Naveen; Abdel-Aty, Mohamed; Cai, Qing

2018-02-01

In traffic safety literature, crash frequency variables are analyzed using univariate count models or multivariate count models. In this study, we propose an alternative approach to modeling multiple crash frequency dependent variables. Instead of modeling the frequency of crashes we propose to analyze the proportion of crashes by vehicle type. A flexible mixed multinomial logit fractional split model is employed for analyzing the proportions of crashes by vehicle type at the macro-level. In this model, the proportion allocated to an alternative is probabilistically determined based on the alternative propensity as well as the propensity of all other alternatives. Thus, exogenous variables directly affect all alternatives. The approach is well suited to accommodate for large number of alternatives without a sizable increase in computational burden. The model was estimated using crash data at Traffic Analysis Zone (TAZ) level from Florida. The modeling results clearly illustrate the applicability of the proposed framework for crash proportion analysis. Further, the Excess Predicted Proportion (EPP)-a screening performance measure analogous to Highway Safety Manual (HSM), Excess Predicted Average Crash Frequency is proposed for hot zone identification. Using EPP, a statewide screening exercise by the various vehicle types considered in our analysis was undertaken. The screening results revealed that the spatial pattern of hot zones is substantially different across the various vehicle types considered. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluating the impacts of screening and smoking cessation programmes on lung cancer in a high-burden region of the USA: a simulation modelling study

PubMed Central

Tramontano, Angela C; Sheehan, Deirdre F; McMahon, Pamela M; Dowling, Emily C; Holford, Theodore R; Ryczak, Karen; Lesko, Samuel M; Levy, David T; Kong, Chung Yin

2016-01-01

Objective While the US Preventive Services Task Force has issued recommendations for lung cancer screening, its effectiveness at reducing lung cancer burden may vary at local levels due to regional variations in smoking behaviour. Our objective was to use an existing model to determine the impacts of lung cancer screening alone or in addition to increased smoking cessation in a US region with a relatively high smoking prevalence and lung cancer incidence. Setting Computer-based simulation model. Participants Simulated population of individuals 55 and older based on smoking prevalence and census data from Northeast Pennsylvania. Interventions Hypothetical lung cancer control from 2014 to 2050 through (1) screening with CT, (2) intensified smoking cessation or (3) a combination strategy. Primary and secondary outcome measures Primary outcomes were lung cancer mortality rates. Secondary outcomes included number of people eligible for screening and number of radiation-induced lung cancers. Results Combining lung cancer screening with increased smoking cessation would yield an estimated 8.1% reduction in cumulative lung cancer mortality by 2050. Our model estimated that the number of screening-eligible individuals would progressively decrease over time, indicating declining benefit of a screening-only programme. Lung cancer screening achieved a greater mortality reduction in earlier years, but was later surpassed by smoking cessation. Conclusions Combining smoking cessation programmes with lung cancer screening would provide the most benefit to a population, especially considering the growing proportion of patients ineligible for screening based on current recommendations. PMID:26928026

Inequalities in adoption of cancer screening from a diffusion of innovation perspective: identification of late adopters.

PubMed

Hahm, Myung-Il; Park, Eun-Cheol; Choi, Kui Son; Lee, Hoo-Yeon; Park, Jae-Hyun; Park, Sohee

2011-02-01

Although national-level organized cancer screening programs have reduced barriers to screening for people of low socioeconomic status, barriers to early screening remain. Our aim was to determine the diffusion pattern and identify the factors associated with early participation in stomach and breast cancer screening programs. The study population was derived from the Korean National Cancer Screening Survey, conducted in 2007. A stratified random sample of people aged 40 years and older from a nationwide population-based database was gathered in Korea (n=1,517) in 2007. Time of participation in early screening was defined as the number of years that had elapsed between the participant's 30th birthday and the age at first screening. Significant differences were observed in the probability of adopting stomach and breast cancer screening in relation to education, household income, and job level. Results from Cox's proportional hazard model indicated that higher household income was significantly associated with an increased probability of adopting stomach cancer screening earlier (p<0.05), and people with high household incomes were more likely to adopt breast cancer screening earlier than were those with incomes under US$1,500 per month (p<0.01). When considered at a significance level of 0.1, we found that the most highly educated women were more likely than the least educated to be screened early. Despite organized governmental screening programs, there are still inequalities in the early adoption of cancer screening. The results of this study also suggest that inequalities in early adoption may affect participation in regular screening. Copyright © 2010 Elsevier Ltd. All rights reserved.

COLA with scale-dependent growth: applications to screened modified gravity models

NASA Astrophysics Data System (ADS)

Winther, Hans A.; Koyama, Kazuya; Manera, Marc; Wright, Bill S.; Zhao, Gong-Bo

2017-08-01

We present a general parallelized and easy-to-use code to perform numerical simulations of structure formation using the COLA (COmoving Lagrangian Acceleration) method for cosmological models that exhibit scale-dependent growth at the level of first and second order Lagrangian perturbation theory. For modified gravity theories we also include screening using a fast approximate method that covers all the main examples of screening mechanisms in the literature. We test the code by comparing it to full simulations of two popular modified gravity models, namely f(R) gravity and nDGP, and find good agreement in the modified gravity boost-factors relative to ΛCDM even when using a fairly small number of COLA time steps.

Cancer literacy as a mediator for cancer screening behaviour in Korean adults.

PubMed

Lee, Hee Yun; Rhee, Taeho Greg; Kim, Nam Keol

2016-09-01

This study investigates the cancer literacy level in Korean adults and examines whether cancer literacy plays a mediating role in the relationship between population characteristics and cancer screening behaviours. We collected data from 585 community-dwelling adults in Korea using self-administered surveys and face-to-face interviews from October to December in 2009. Guided by Andersen's behavioural model, we used a structural equation model to estimate the effect of cancer literacy as a mediator and found that cancer literacy mediated cancer screening behaviour. In the individual path analysis models, cancer literacy played a significant mediating role for the use of eastern medicine, fatalism, health status and the number of chronic diseases. When controlling for other relevant covariates, we found that in the optimal path model, cancer literacy played a mediating role in the relationship between the use of eastern medicine and self-rated health status as well as cancer screening behaviour. Thus, developing community-based cancer education programmes and training clinical practitioners in eastern medicine clinics about the importance of informing their patients about regular cancer screening may be an option to boost cancer literacy and screening behaviour in Korea. © 2015 John Wiley & Sons Ltd.

Developing a Screening Model to Establish Human Risk from Glacial Meltwater Release of Legacy Organochlorine Pollutants at the Silvretta Glacier in the Swiss Alps

NASA Astrophysics Data System (ADS)

Miner, K. R.

2017-12-01

Organochlorine pollutants (OCPs) banned globally by the Stockholm Convention in 2004 are reemerging from melting glaciers in numerous alpine ecosystems. Despite the known OCP influx from glaciers, a study of human risk from uptake of pesticides in glacial meltwater has never been attempted. Our study qualifies human uptake routes and quantifies risk utilizing published meltwater data from the Silvretta Glacier in the Swiss Alps in combination with methodology established by the US Environmental Protection Agency (EPA). Relatively high concentrations of OCPs in Silvretta glacier meltwater reflect proximity to use near high density populations and provide the best estimate of a 95th percentile human risk scenario. This screening level model assesses direct PCB risk to humans through consumption of fish tissue and meltwater. Our model shows a risk for both cancer and non-cancer disease impacts to children with lifetime exposure to glacial meltwater and an average local fish consumption. For adults with an abbreviated 30 year exposure timeframe, the risk for non-cancer effects is negligible and cancer effects are only barely above screening level. Populations that consume higher quantities of local fish are at greater risk, with additional challenges borne by children. Further direct study into the individual level risk to Swiss residents from glacial meltwater pollution is deemed necessary by our screening study.

Significant variations in the cervical cancer screening rate in China by individual-level and geographical measures of socioeconomic status: a multilevel model analysis of a nationally representative survey dataset.

PubMed

Bao, Heling; Zhang, Lei; Wang, Limin; Zhang, Mei; Zhao, Zhenping; Fang, Liwen; Cong, Shu; Zhou, Maigeng; Wang, Linhong

2018-05-01

Variations in cervical cancer screening rates in China have rarely been studied in depth. This study aimed to investigate cervical cancer screening rates in relation to both individual-level and geographical measures of socioeconomic status (SES). Data were obtained from women aged 21 years or older by face-to-face interviews between August 2013 and July 2014 as part of the Chinese Chronic Diseases and Risk Factors Surveillance. The geographical variables were obtained from the 2010 Chinese population census. The cervical cancer screening rates and 95% confidence interval (CI) were estimated and mapped. Multilevel logistic regression models were fitted. Overall, only 21.4% (95% CI: 19.6-23.1%) of 91,816 women aged ≥21 years reported having ever been screened for cervical cancer and significant geographical variations at both province and county levels were identified (P < 0.01). The cervical cancer screening rates were the lowest among the poor [13.9% (95% CI: 12.1-15.7%)], uninsured [14.4% (95% CI: 10.3-18.4%)], less-educated [16.0% (95% CI: 14.3-17.6%)], and agricultural employment [18.1% (95% CI: 15.8-20.4%)] women along with those residing in areas of low economic status [15.0% (95% CI: 11.8-18.2%)], of low urbanization [15.6% (95% CI: 13.4-17.7%)], and of low education status [16.0% (95% CI: 14.0-18.1%)]. The multilevel analysis also indicated that women with lower individual-level measures of SES residing in areas with low geographical measures of SES were significantly less likely to receive cervical cancer screening (P < 0.0001). Despite the launch of an organized cancer screening program in China, cervical cancer screening rates remain alarmingly low and significant variations based on geographical regions and measures of SES still exist. It is therefore essential to adopt strategies to better direct limited available public resources to priority groups. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Cervical cancer risk levels in Turkey and compliance to the national cervical cancer screening standard.

PubMed

Açikgöz, Ayla; Ergör, Gül

2011-01-01

Cervical cancer screening with Pap smear test is a cost-effective method. The Ministry of Health in Turkey recommends that it be performed once every five years after age 35. The purpose of this study was to determine the cervical cancer risk levels of women between 35 and 69, and the intervals they have the Pap smear test, and to investigate the relation between the two. This study was performed on 227 women aged between 35 and 69 living in Balçova District of İzmir province. Using the cervical cancer risk index program of Harvard School of Public Health, the cervical cancer risk level of 70% of the women was found below average, 22.1% average, and 7.9% above average. Only 52% of the women have had Pap smear test at least once in their lives. The percentage screening regularly in conformity with the national screening standard was 39.2%. Women in the 40-49 age group, were married, conformed significantly more (p<0.05) to the national screening standard. Compliance also increased with the level of education and decreased with the cervical cancer risk level (p<0.05). A logistic regression model was constructed including age, education level, menstruation state of the women and the economic level of the family. Not having the Pap smear test in conformity with the national cervical cancer screening standard in 35-39 age group was 2.52 times more than 40-49 age group, while it was 3.26 times more in 60-69 age group (p< 0.05). Not having Pap smear test in 35-39 age group more than other groups might result from lack of information on the cervical cancer national screening standard and the necessity of having Pap smear test. As for 60-69 age group, the low education level might cause not having Pap smear test. Under these circumstances, the cervical cancer risk levels should be determined and the individuals should be informed. Providing Pap smear test screening service to individuals in the target group of national screening standard, as a public service may resolve the inequalities due to age and educational differences.

Screening tool to evaluate the vulnerability of down-gradient receptors to groundwater contaminants from uncapped landfills

USGS Publications Warehouse

Baker, Ronald J.; Reilly, Timothy J.; Lopez, Anthony R.; Romanok, Kristin M.; Wengrowski, Edward W

2015-01-01

A screening tool for quantifying levels of concern for contaminants detected in monitoring wells on or near landfills to down-gradient receptors (streams, wetlands and residential lots) was developed and evaluated. The tool uses Quick Domenico Multi-scenario (QDM), a spreadsheet implementation of Domenico-based solute transport, to estimate concentrations of contaminants reaching receptors under steady-state conditions from a constant-strength source. Unlike most other available Domenico-based model applications, QDM calculates the time for down-gradient contaminant concentrations to approach steady state and appropriate dispersivity values, and allows for up to fifty simulations on a single spreadsheet. Sensitivity of QDM solutions to critical model parameters was quantified. The screening tool uses QDM results to categorize landfills as having high, moderate and low levels of concern, based on contaminant concentrations reaching receptors relative to regulatory concentrations. The application of this tool was demonstrated by assessing levels of concern (as defined by the New Jersey Pinelands Commission) for thirty closed, uncapped landfills in the New Jersey Pinelands National Reserve, using historic water-quality data from monitoring wells on and near landfills and hydraulic parameters from regional flow models. Twelve of these landfills are categorized as having high levels of concern, indicating a need for further assessment. This tool is not a replacement for conventional numerically-based transport model or other available Domenico-based applications, but is suitable for quickly assessing the level of concern posed by a landfill or other contaminant point source before expensive and lengthy monitoring or remediation measures are taken. In addition to quantifying the level of concern using historic groundwater-monitoring data, the tool allows for archiving model scenarios and adding refinements as new data become available.

Estimating an area-level socioeconomic status index and its association with colonoscopy screening adherence.

PubMed

Wheeler, David C; Czarnota, Jenna; Jones, Resa M

2017-01-01

Socioeconomic status (SES) is often considered a risk factor for health outcomes. SES is typically measured using individual variables of educational attainment, income, housing, and employment variables or a composite of these variables. Approaches to building the composite variable include using equal weights for each variable or estimating the weights with principal components analysis or factor analysis. However, these methods do not consider the relationship between the outcome and the SES variables when constructing the index. In this project, we used weighted quantile sum (WQS) regression to estimate an area-level SES index and its effect in a model of colonoscopy screening adherence in the Minnesota-Wisconsin Metropolitan Statistical Area. We considered several specifications of the SES index including using different spatial scales (e.g., census block group-level, tract-level) for the SES variables. We found a significant positive association (odds ratio = 1.17, 95% CI: 1.15-1.19) between the SES index and colonoscopy adherence in the best fitting model. The model with the best goodness-of-fit included a multi-scale SES index with 10 variables at the block group-level and one at the tract-level, with home ownership, race, and income among the most important variables. Contrary to previous index construction, our results were not consistent with an assumption of equal importance of variables in the SES index when explaining colonoscopy screening adherence. Our approach is applicable in any study where an SES index is considered as a variable in a regression model and the weights for the SES variables are not known in advance.

Decomposing socio-economic inequality in colorectal cancer screening uptake in England.

PubMed

Solmi, Francesca; Von Wagner, Christian; Kobayashi, Lindsay C; Raine, Rosalind; Wardle, Jane; Morris, Stephen

2015-06-01

Colorectal cancer (CRC) is the second largest cause of cancer death in the UK. Since 2010, CRC screening based on Faecal Occult Blood testing has been offered by the NHS in England biennially to all persons age 60-69 years. Several studies have demonstrated a gradient in uptake using area-level markers of socio-economic status (SES), but few have examined the individual-level contributors to the gradient. We aimed to quantify the extent of SES inequality in CRC screening uptake in England using individual-level data, and to identify individual factors associated with this inequality. We used data from 1833 participants (aged 61-69) in Wave 5 (collected in years 2010/11) of the English Longitudinal Study of Ageing (ELSA) eligible for having been sent at least one CRC screening invitation. Uptake was defined by self-report of ever having been screened as part of the National Screening Programme. We assessed socio-economic inequality using the corrected concentration index of uptake against SES rank, which was derived by regressing a range of SES markers against net non-pension household wealth. Other demographic and health-related variables were included in the analysis. Factors associated with inequality were measured using concentration index decomposition. There was a significant pro-rich gradient in screening uptake (concentration index: 0.16, 95% CI:0.11-0.22), mostly explained within our model by differences in non-pension wealth (38.7%), partner screening status (15.9%), sickness/disability (13.5%), and health literacy (8.5%). Interventions aimed at reducing inequalities in CRC screening uptake should focus on improving acceptability of screening in populations with low levels of education and literacy barriers. Copyright © 2015 Elsevier Ltd. All rights reserved.

Toward a systems-level analysis of infection biology: a new method for conducting genetic screens in human cells.

PubMed

Stanley, Sarah A; Hung, Deborah T

2009-12-16

Loss-of-function genetic screens have facilitated great strides in our understanding of the biology of model organisms but have not been possible in diploid human cells. A recent report by Brummelkamp's group in Science describes the use of insertional mutagenesis to generate loss-of-function alleles in a largely haploid human cell line and demonstrates the versatility of this method in screens designed to investigate the host/pathogen interaction. This approach has strengths that are complementary to existing strategies and will facilitate progress toward a systems-level understanding of infectious disease and ultimately the development of new therapeutics.

Screening tool to evaluate the vulnerability of down-gradient receptors to groundwater contaminants from uncapped landfills

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baker, Ronald J.; Reilly, Timothy J.; Lopez, Anthony

2015-09-15

Highlights: • A spreadsheet-based risk screening tool for groundwater affected by landfills is presented. • Domenico solute transport equations are used to estimate downgradient contaminant concentrations. • Landfills are categorized as presenting high, moderate or low risks. • Analysis of parameter sensitivity and examples of the method’s application are given. • The method has value to regulators and those considering redeveloping closed landfills. - Abstract: A screening tool for quantifying levels of concern for contaminants detected in monitoring wells on or near landfills to down-gradient receptors (streams, wetlands and residential lots) was developed and evaluated. The tool uses Quick Domenicomore » Multi-scenario (QDM), a spreadsheet implementation of Domenico-based solute transport, to estimate concentrations of contaminants reaching receptors under steady-state conditions from a constant-strength source. Unlike most other available Domenico-based model applications, QDM calculates the time for down-gradient contaminant concentrations to approach steady state and appropriate dispersivity values, and allows for up to fifty simulations on a single spreadsheet. Sensitivity of QDM solutions to critical model parameters was quantified. The screening tool uses QDM results to categorize landfills as having high, moderate and low levels of concern, based on contaminant concentrations reaching receptors relative to regulatory concentrations. The application of this tool was demonstrated by assessing levels of concern (as defined by the New Jersey Pinelands Commission) for thirty closed, uncapped landfills in the New Jersey Pinelands National Reserve, using historic water-quality data from monitoring wells on and near landfills and hydraulic parameters from regional flow models. Twelve of these landfills are categorized as having high levels of concern, indicating a need for further assessment. This tool is not a replacement for conventional numerically-based transport model or other available Domenico-based applications, but is suitable for quickly assessing the level of concern posed by a landfill or other contaminant point source before expensive and lengthy monitoring or remediation measures are taken. In addition to quantifying the level of concern using historic groundwater-monitoring data, the tool allows for archiving model scenarios and adding refinements as new data become available.« less

Modeling Precheck Parallel Screening Process in the Face of Strategic Applicants with Incomplete Information and Screening Errors.

PubMed

Song, Cen; Zhuang, Jun

2018-01-01

In security check systems, tighter screening processes increase the security level, but also cause more congestion, which could cause longer wait times. Having to deal with more congestion in lines could also cause issues for the screeners. The Transportation Security Administration (TSA) Precheck Program was introduced to create fast lanes in airports with the goal of expediting passengers who the TSA does not deem to be threats. In this lane, the TSA allows passengers to enjoy fewer restrictions in order to speed up the screening time. Motivated by the TSA Precheck Program, we study parallel queueing imperfect screening systems, where the potential normal and adversary participants/applicants decide whether to apply to the Precheck Program or not. The approved participants would be assigned to a faster screening channel based on a screening policy determined by an approver, who balances the concerns of safety of the passengers and congestion of the lines. There exist three types of optimal normal applicant's application strategy, which depend on whether the marginal payoff is negative or positive, or whether the marginal benefit equals the marginal cost. An adversary applicant would not apply when the screening policy is sufficiently large or the number of utilized benefits is sufficiently small. The basic model is extended by considering (1) applicants' parameters to follow different distributions and (2) applicants to have risk levels, where the approver determines the threshold value needed to qualify for Precheck. This article integrates game theory and queueing theory to study the optimal screening policy and provides some insights to imperfect parallel queueing screening systems. © 2017 Society for Risk Analysis.

Cost Effectiveness of Screening Patients With Gastroesophageal Reflux Disease for Barrett's Esophagus With a Minimally Invasive Cell Sampling Device.

PubMed

Heberle, Curtis R; Omidvari, Amir-Houshang; Ali, Ayman; Kroep, Sonja; Kong, Chung Yin; Inadomi, John M; Rubenstein, Joel H; Tramontano, Angela C; Dowling, Emily C; Hazelton, William D; Luebeck, E Georg; Lansdorp-Vogelaar, Iris; Hur, Chin

2017-09-01

It is important to identify patients with Barrett's esophagus (BE), the precursor to esophageal adenocarcinoma (EAC). Patients with BE usually are identified by endoscopy, which is expensive. The Cytosponge, which collects tissue from the esophagus noninvasively, could be a cost-effective tool for screening individuals with gastroesophageal reflux disease (GERD) who are at increased risk for BE. We developed a model to analyze the cost effectiveness of using the Cytosponge in first-line screening of patients with GERD for BE with endoscopic confirmation, compared with endoscopy screening only. We incorporated data from a large clinical trial of Cytosponge performance into 2 validated microsimulation models of EAC progression (the esophageal adenocarcinoma model from Massachusetts General Hospital and the microsimulation screening analysis model from Erasmus University Medical Center). The models were calibrated for US Surveillance, Epidemiology and End Results data on EAC incidence and mortality. In each model, we simulated the effect of a 1-time screen for BE in male patients with GERD, 60 years of age, using endoscopy alone or Cytosponge collection of tissue, and analysis for the level of trefoil factor 3 with endoscopic confirmation of positive results. For each strategy we recorded the number of cases of EAC that developed, the number of EAC cases detected with screening by Cytosponge only or by subsequent targeted surveillance, and the number of endoscopies needed. In addition, we recorded the cumulative costs (including indirect costs) incurred and quality-adjusted years of life lived within each strategy, discounted at a rate of 3% per year, and computed incremental cost-effectiveness ratios (ICERs) among the 3 strategies. According to the models, screening patients with GERD by Cytosponge with follow-up confirmation of positive results by endoscopy would reduce the cost of screening by 27% to 29% compared with screening by endoscopy, but led to 1.8 to 5.5 (per 1000 patients) fewer quality-adjusted life years. The ICERs for Cytosponge screening compared with no screening ranged from $26,358 to $33,307. For screening patients by endoscopy compared with Cytosponge the ICERs ranged from $107,583 to $330,361. These results were sensitive to Cytosponge cost within a plausible range of values. In a comparative modeling analysis of screening strategies for BE in patients with GERD, we found Cytosponge screening with endoscopic confirmation to be a cost-effective strategy. The greatest benefit was achieved by endoscopic screening, but with an unfavorable cost margin. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Evaluating the impacts of screening and smoking cessation programmes on lung cancer in a high-burden region of the USA: a simulation modelling study.

PubMed

Tramontano, Angela C; Sheehan, Deirdre F; McMahon, Pamela M; Dowling, Emily C; Holford, Theodore R; Ryczak, Karen; Lesko, Samuel M; Levy, David T; Kong, Chung Yin

2016-02-29

While the US Preventive Services Task Force has issued recommendations for lung cancer screening, its effectiveness at reducing lung cancer burden may vary at local levels due to regional variations in smoking behaviour. Our objective was to use an existing model to determine the impacts of lung cancer screening alone or in addition to increased smoking cessation in a US region with a relatively high smoking prevalence and lung cancer incidence. Computer-based simulation model. Simulated population of individuals 55 and older based on smoking prevalence and census data from Northeast Pennsylvania. Hypothetical lung cancer control from 2014 to 2050 through (1) screening with CT, (2) intensified smoking cessation or (3) a combination strategy. Primary outcomes were lung cancer mortality rates. Secondary outcomes included number of people eligible for screening and number of radiation-induced lung cancers. Combining lung cancer screening with increased smoking cessation would yield an estimated 8.1% reduction in cumulative lung cancer mortality by 2050. Our model estimated that the number of screening-eligible individuals would progressively decrease over time, indicating declining benefit of a screening-only programme. Lung cancer screening achieved a greater mortality reduction in earlier years, but was later surpassed by smoking cessation. Combining smoking cessation programmes with lung cancer screening would provide the most benefit to a population, especially considering the growing proportion of patients ineligible for screening based on current recommendations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Psychological distress, television viewing, and physical activity in children aged 4 to 12 years.

PubMed

Hamer, Mark; Stamatakis, Emmanuel; Mishra, Gita

2009-05-01

Sedentary behavior and physical activity may be independent risk factors for psychological distress in adolescents, although there is no existing information for children. We examined the cross-sectional association between psychological distress, television and screen entertainment time, and physical activity levels among a representative sample of children aged 4 to 12 years from the 2003 Scottish Health Survey. Participants were 1486 boys and girls (mean age: 8.5 +/- 2.3 years). Parents answered on behalf of children who were required to be present. The parents completed the Strengths and Difficulties Questionnaire and information on television and screen entertainment time, physical activity, and dietary intake of their children. An abnormally high Strengths and Difficulties Questionnaire total difficulties score (20-40) was found in 4.2% of the sample. Approximately 25% of the children were exposed to television and screen entertainment at least 3 hours/day. In general linear models, television and screen entertainment time per week and physical activity levels were independently associated with the Strengths and Difficulties Questionnaire total difficulties score after adjustment for age, gender, area deprivation level, single-parent status, medical conditions, and various dietary intake indicators. There was also an additive interaction effect showing that the combination of high television and screen entertainment time and low physical activity was associated with the highest Strengths and Difficulties Questionnaire score. Higher television and screen entertainment exposure (>2.7 hours/day) alone resulted in a 24% increase in the Strengths and Difficulties Questionnaire score in comparison with lower television and screen entertainment exposure (<1.6 hours/day), although when combined with low physical activity this resulted in a 46% increase. Higher levels of television and screen entertainment time and low physical activity levels interact to increase psychological distress in young children.

Cost-Effectiveness of Screening Individuals With Cystic Fibrosis for Colorectal Cancer.

PubMed

Gini, Andrea; Zauber, Ann G; Cenin, Dayna R; Omidvari, Amir-Houshang; Hempstead, Sarah E; Fink, Aliza K; Lowenfels, Albert B; Lansdorp-Vogelaar, Iris

2017-12-27

Individuals with cystic fibrosis are at increased risk of colorectal cancer (CRC) compared to the general population, and risk is higher among those who received an organ transplant. We performed a cost-effectiveness analysis to determine optimal CRC screening strategies for patients with cystic fibrosis. We adjusted the existing Microsimulation Screening Analysis-Colon microsimulation model to reflect increased CRC risk and lower life expectancy in patients with cystic fibrosis. Modeling was performed separately for individuals who never received an organ transplant and patients who had received an organ transplant. We modeled 76 colonoscopy screening strategies that varied the age range and screening interval. The optimal screening strategy was determined based on a willingness to pay threshold of $100,000 per life-year gained. Sensitivity and supplementary analyses were performed, including fecal immunochemical test (FIT) as an alternative test, earlier ages of transplantation, and increased rates of colonoscopy complications, to assess whether optimal screening strategies would change. Colonoscopy every 5 years, starting at age 40 years, was the optimal colonoscopy strategy for patients with cystic fibrosis who never received an organ transplant; this strategy prevented 79% of deaths from CRC. Among patients with cystic fibrosis who had received an organ transplant, optimal colonoscopy screening should start at an age of 30 or 35 years, depending on the patient's age at time of transplantation. Annual FIT screening was predicted to be cost-effective for patients with cystic fibrosis. However, the level of accuracy of the FIT in population is not clear. Using a Microsimulation Screening Analysis-Colon microsimulation model, we found screening of patients with cystic fibrosis for CRC to be cost-effective. Due to the higher risk in these patients for CRC, screening should start at an earlier age with a shorter screening interval. The findings of this study (especially those on FIT screening) may be limited by restricted evidence available for patients with cystic fibrosis. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Cost Effectiveness of Screening Individuals With Cystic Fibrosis for Colorectal Cancer.

PubMed

Gini, Andrea; Zauber, Ann G; Cenin, Dayna R; Omidvari, Amir-Houshang; Hempstead, Sarah E; Fink, Aliza K; Lowenfels, Albert B; Lansdorp-Vogelaar, Iris

2018-02-01

Individuals with cystic fibrosis are at increased risk of colorectal cancer (CRC) compared with the general population, and risk is higher among those who received an organ transplant. We performed a cost-effectiveness analysis to determine optimal CRC screening strategies for patients with cystic fibrosis. We adjusted the existing Microsimulation Screening Analysis-Colon model to reflect increased CRC risk and lower life expectancy in patients with cystic fibrosis. Modeling was performed separately for individuals who never received an organ transplant and patients who had received an organ transplant. We modeled 76 colonoscopy screening strategies that varied the age range and screening interval. The optimal screening strategy was determined based on a willingness to pay threshold of $100,000 per life-year gained. Sensitivity and supplementary analyses were performed, including fecal immunochemical test (FIT) as an alternative test, earlier ages of transplantation, and increased rates of colonoscopy complications, to assess if optimal screening strategies would change. Colonoscopy every 5 years, starting at an age of 40 years, was the optimal colonoscopy strategy for patients with cystic fibrosis who never received an organ transplant; this strategy prevented 79% of deaths from CRC. Among patients with cystic fibrosis who had received an organ transplant, optimal colonoscopy screening should start at an age of 30 or 35 years, depending on the patient's age at time of transplantation. Annual FIT screening was predicted to be cost-effective for patients with cystic fibrosis. However, the level of accuracy of the FIT in this population is not clear. Using a Microsimulation Screening Analysis-Colon model, we found screening of patients with cystic fibrosis for CRC to be cost effective. Because of the higher risk of CRC in these patients, screening should start at an earlier age with a shorter screening interval. The findings of this study (especially those on FIT screening) may be limited by restricted evidence available for patients with cystic fibrosis. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

Using Computational Modeling to Assess the Impact of Clinical Decision Support on Cancer Screening within Community Health Centers

PubMed Central

Carney, Timothy Jay; Morgan, Geoffrey P.; Jones, Josette; McDaniel, Anna M.; Weaver, Michael; Weiner, Bryan; Haggstrom, David A.

2014-01-01

Our conceptual model demonstrates our goal to investigate the impact of clinical decision support (CDS) utilization on cancer screening improvement strategies in the community health care (CHC) setting. We employed a dual modeling technique using both statistical and computational modeling to evaluate impact. Our statistical model used the Spearman’s Rho test to evaluate the strength of relationship between our proximal outcome measures (CDS utilization) against our distal outcome measure (provider self-reported cancer screening improvement). Our computational model relied on network evolution theory and made use of a tool called Construct-TM to model the use of CDS measured by the rate of organizational learning. We employed the use of previously collected survey data from community health centers Cancer Health Disparities Collaborative (HDCC). Our intent is to demonstrate the added valued gained by using a computational modeling tool in conjunction with a statistical analysis when evaluating the impact a health information technology, in the form of CDS, on health care quality process outcomes such as facility-level screening improvement. Significant simulated disparities in organizational learning over time were observed between community health centers beginning the simulation with high and low clinical decision support capability. PMID:24953241

Optimizing colorectal cancer screening by race and sex: Microsimulation analysis II to inform the American Cancer Society colorectal cancer screening guideline.

PubMed

Meester, Reinier G S; Peterse, Elisabeth F P; Knudsen, Amy B; de Weerdt, Anne C; Chen, Jennifer C; Lietz, Anna P; Dwyer, Andrea; Ahnen, Dennis J; Siegel, Rebecca L; Smith, Robert A; Zauber, Ann G; Lansdorp-Vogelaar, Iris

2018-05-30

Colorectal cancer (CRC) risk varies by race and sex. This study, 1 of 2 microsimulation analyses to inform the 2018 American Cancer Society CRC screening guideline, explored the influence of race and sex on optimal CRC screening strategies. Two Cancer Intervention and Surveillance Modeling Network microsimulation models, informed by US incidence data, were used to evaluate a variety of screening methods, ages to start and stop, and intervals for 4 demographic subgroups (black and white males and females) under 2 scenarios for the projected lifetime CRC risk for 40-year-olds: 1) assuming that risk had remained stable since the early screening era and 2) assuming that risk had increased proportionally to observed incidence trends under the age of 40 years. Model-based screening recommendations were based on the predicted level of benefit (life-years gained) and burden (required number of colonoscopies), the incremental burden-to-benefit ratio, and the relative efficiency in comparison with strategies with similar burdens. When lifetime CRC risk was assumed to be stable over time, the models differed in the recommended age to start screening for whites (45 vs 50 years) but consistently recommended screening from the age of 45 years for blacks. When CRC risk was assumed to be increased, the models recommended starting at the age of 45 years, regardless of race and sex. Strategies recommended under both scenarios included colonoscopy every 10 or 15 years, annual fecal immunochemical testing, and computed tomographic colonography every 5 years through the age of 75 years. Microsimulation modeling suggests that CRC screening should be considered from the age of 45 years for blacks and for whites if the lifetime risk has increased proportionally to the incidence for younger adults. Cancer 2018. © 2018 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. © 2018 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Reduction of Nuak1 Decreases Tau and Reverses Phenotypes in a Tauopathy Mouse Model.

PubMed

Lasagna-Reeves, Cristian A; de Haro, Maria; Hao, Shuang; Park, Jeehye; Rousseaux, Maxime W C; Al-Ramahi, Ismael; Jafar-Nejad, Paymaan; Vilanova-Velez, Luis; See, Lauren; De Maio, Antonia; Nitschke, Larissa; Wu, Zhenyu; Troncoso, Juan C; Westbrook, Thomas F; Tang, Jianrong; Botas, Juan; Zoghbi, Huda Y

2016-10-19

Many neurodegenerative proteinopathies share a common pathogenic mechanism: the abnormal accumulation of disease-related proteins. As growing evidence indicates that reducing the steady-state levels of disease-causing proteins mitigates neurodegeneration in animal models, we developed a strategy to screen for genes that decrease the levels of tau, whose accumulation contributes to the pathology of both Alzheimer disease (AD) and progressive supranuclear palsy (PSP). Integrating parallel cell-based and Drosophila genetic screens, we discovered that tau levels are regulated by Nuak1, an AMPK-related kinase. Nuak1 stabilizes tau by phosphorylation specifically at Ser356. Inhibition of Nuak1 in fruit flies suppressed neurodegeneration in tau-expressing Drosophila, and Nuak1 haploinsufficiency rescued the phenotypes of a tauopathy mouse model. These results demonstrate that decreasing total tau levels is a valid strategy for mitigating tau-related neurodegeneration and reveal Nuak1 to be a novel therapeutic entry point for tauopathies. Copyright © 2016 Elsevier Inc. All rights reserved.

Modeling Preventative Strategies against HPV-Related Disease in Developed Countries

PubMed Central

Canfell, Karen; Chesson, Harrell; Kulasingam, Shalini L.; Berkhof, Johannes; Diaz, Mireia; Kim, Jane J.

2013-01-01

Over the last five years, prophylactic vaccination against Human Papillomavirus (HPV) in pre-adolescent females has been introduced in most developed countries, supported by modeled evaluations which have almost universally found vaccination of pre-adolescent females to be cost-effective. Studies to date suggest that vaccination of pre-adolescent males may also be cost-effective at a cost per vaccinated individual ~US$400–500 if vaccination coverage in females cannot be increased above ~50%; but if it is possible, increasing coverage in females appears to be a better return on investment. Comparative evaluation of the quadrivalent (HPV16,18,6,11) and bivalent (HPV16,18) vaccines centers around the potential tradeoff between protection against anogenital warts and vaccine-specific levels of cross-protection against infections not targeted by the vaccines. Future evaluations will also need to consider the cost-effectiveness of a next generation nonavalent vaccine designed to protect against ~90% of cervical cancers. The timing of the effect of vaccination on cervical screening programs will be country-specific and will depend on vaccination catch-up age range and coverage and the age at which screening starts. Initial evaluations suggest that if screening remains unchanged it will be less cost-effective in vaccinated compared to unvaccinated women but, in the context of current vaccines, will remain an important prevention method. Comprehensive evaluation of new approaches to screening will need to consider the population-level effects of vaccination over time. New screening strategies of particular interest include delaying the start age of screening, increasing the screening interval and switching to primary HPV screening. Future evaluations of screening will also need to focus on the effects of disparities in screening and vaccination uptake, the potential effects of vaccination on screening participation, and the effects of imperfect compliance with screening recommendations. PMID:23199959

Nonbleeding adenomas: Evidence of systematic false-negative fecal immunochemical test results and their implications for screening effectiveness-A modeling study.

PubMed

van der Meulen, Miriam P; Lansdorp-Vogelaar, Iris; van Heijningen, Else-Mariëtte B; Kuipers, Ernst J; van Ballegooijen, Marjolein

2016-06-01

If some adenomas do not bleed over several years, they will cause systematic false-negative fecal immunochemical test (FIT) results. The long-term effectiveness of FIT screening has been estimated without accounting for such systematic false-negativity. There are now data with which to evaluate this issue. The authors developed one microsimulation model (MISCAN [MIcrosimulation SCreening ANalysis]-Colon) without systematic false-negative FIT results and one model that allowed a percentage of adenomas to be systematically missed in successive FIT screening rounds. Both variants were adjusted to reproduce the first-round findings of the Dutch CORERO FIT screening trial. The authors then compared simulated detection rates in the second screening round with those observed, and adjusted the simulated percentage of systematically missed adenomas to those data. Finally, the authors calculated the impact of systematic false-negative FIT results on the effectiveness of repeated FIT screening. The model without systematic false-negativity simulated higher detection rates in the second screening round than observed. These observed rates could be reproduced when assuming that FIT systematically missed 26% of advanced and 73% of nonadvanced adenomas. To reduce the false-positive rate in the second round to the observed level, the authors also had to assume that 30% of false-positive findings were systematically false-positive. Systematic false-negative FIT testing limits the long-term reduction of biennial FIT screening in the incidence of colorectal cancer (35.6% vs 40.9%) and its mortality (55.2% vs 59.0%) in participants. The results of the current study provide convincing evidence based on the combination of real-life and modeling data that a percentage of adenomas are systematically missed by repeat FIT screening. This impairs the efficacy of FIT screening. Cancer 2016;122:1680-8. © 2016 American Cancer Society. © 2016 American Cancer Society.

Mathematical models for the early detection and treatment of colorectal cancer.

PubMed

Harper, P R; Jones, S K

2005-05-01

Colorectal cancer is a major cause of death for men and women in the Western world. When the cancer is detected through an awareness of the symptoms by a patient, typically it is at an advanced stage. It is possible to detect cancer at an early stage through screening and the marked differences in survival for early and late stages provide the incentive for the primary prevention or early detection of colorectal cancer. This paper considers mathematical models for colorectal cancer screening together with models for the treatment of patients. Illustrative results demonstrate that detailed attention to the processes involved in diseases, interventions and treatment enable us to combine data and expert knowledge from various sources. Thus a detailed operational model is a very useful tool in helping to make decisions about screening at national and local levels.

To Screen or Not to Screen? A Decision Analysis of the Utility of Screening for Developmental Dysplasia of the Hip

PubMed Central

Mahan, Susan T.; Katz, Jeffrey N.; Kim, Young-Jo

2009-01-01

Background: The United States Preventive Services Task Force recently determined that they could not recommend any screening strategies for developmental dysplasia of the hip. Disparate findings in the literature and treatment-related problems have led to confusion about whether or not to screen for this disorder. The purpose of the present study was to determine, with use of expected-value decision analysis, which of the following three strategies leads to the best chance of having a non-arthritic hip by the age of sixty years: (1) no screening for developmental dysplasia of the hip, (2) universal screening of newborns with both physical examination and ultrasonography, or (3) universal screening with physical examination but only selective use of ultrasonography for neonates considered to be at high risk. Methods: Developmental dysplasia of the hip, avascular necrosis, and the treatment algorithm were carefully defined. The outcome was determined as the probability of any neonate having a non-arthritic hip through the age of sixty years. A decision tree was then built with decision nodes as described above, and chance node probabilities were determined from a thorough review of the literature. Foldback analysis and sensitivity analyses were performed. Results: The expected value of a favorable hip outcome was 0.9590 for the strategy of screening all neonates with physical examination and selective use of ultrasonography, 0.9586 for screening all neonates with physical examination and ultrasonography, and 0.9578 for no screening. A lower expected value implies a greater risk for the development of osteoarthritis as a result of developmental dysplasia of the hip or avascular necrosis; thus, the optimum strategy was selective screening. This model was robust to sensitivity analysis, except when the rate of missed dysplasia rose as high as 4/1000 or the rate of treated hip subluxation/dislocation was the same; then, the optimum strategy was to screen all neonates with both physical examination and ultrasonography. Conclusions: Our decision analytic model indicated that the optimum strategy, associated with the highest probability of having a non-arthritic hip at the age of sixty years, was to screen all neonates for hip dysplasia with a physical examination and to use ultrasonography selectively for infants who are at high risk. Additional data on the costs and cost-effectiveness of these screening policies are needed to guide policy recommendations. Level of Evidence: Economic and decision analysis Level II. See Instructions to Authors for a complete description of levels of evidence. PMID:19571094

Serum factors and clinical characteristics associated with serum E-Screen activity

PubMed Central

Wang, Jue; Trentham-Dietz, Amy; Hemming, Jocelyn D. C.; Hedman, Curtis J.; Sprague, Brian L.

2013-01-01

Background The E-Screen bioassay can measure the mitogenicity of human serum and thus may be useful as a biomarker in epidemiologic studies of breast cancer. While the assay’s MCF-7 cells are known to proliferate in response to estrogen, the specific determinants of variation in E-Screen activity in human serum samples are poorly understood. We sought to identify serum molecules and patient characteristics associated with serum E-Screen activity among postmenopausal women. Methods Postmenopausal women (N=219) aged 55–70 with no history of postmenopausal hormone use or breast cancer completed a questionnaire and provided a blood sample. Serum was analyzed for E-Screen activity and a variety of molecules including sex hormones, growth factors, and environmental chemicals. Stepwise selection procedures were used to identify correlates of E-Screen activity. Results Serum samples from all women had detectable E-Screen activity, with a median estradiol equivalents value of 0.027 ng/mL and interquartile range of 0.018–0.036 ng/mL. In the final multivariable-adjusted model, serum E-Screen activity was positively associated with serum estradiol, estrone, IGFBP-3, and testosterone levels (p<0.05), as well as body mass index (p=0.03). Serum E-Screen activity was lower among women with higher SHBG (p<0.0001) and progesterone levels (p=0.03). Conclusion Serum E-Screen activity varies according to levels of endogenous estrogens and other serum molecules. Obesity appears to confer additional serum mitogenicity beyond its impact on the measured hormones and growth factors. Impact By capturing mitogenicity due to a variety of patient and serum factors, the E-Screen may provide advantages for use as a biomarker in breast cancer studies. PMID:23588007

Multistate transitional models for measuring adherence to breast cancer screening: A population-based longitudinal cohort study with over two million women.

PubMed

Sutradhar, R; Gu, S; Paszat, L F

2017-06-01

Objective Prior work on the disparities among women in breast cancer screening adherence has been methodologically limited. This longitudinal study determines and examines the factors associated with becoming adherent. Methods In a cohort of Canadian women aged 50-74, a three-state transitional model was used to examine adherence to screening for breast cancer. The proportion of time spent being non-adherent with screening was calculated for each woman during her observation window. Using age as the time scale, a relative rate multivariable regression was implemented under the three-state transitional model, to examine the association between covariates (all time-varying) and the rate of becoming adherent. Results The cohort consisted of 2,537,960 women with a median follow-up of 8.46 years. Nearly 31% of women were continually up-to-date with breast screening. Once a woman was non-adherent, the rate of becoming adherent was higher among longer term residents (relative rate = 1.289, 95% confidence interval 1.275-1.302), those from wealthier neighbourhoods, and those who had an identifiable primary care provider who was female or had graduated in Canada. Conclusion Individual and physician-level characteristics play an important role in a woman's adherence to screening. This work improves the quality of evidence regarding disparities among women in adherence to breast cancer screening and provides a novel methodological foundation to investigate adherence for other types of screening, including cervix and colorectal cancer screening.

The Association Between Primary Source of Healthcare Coverage and Colorectal Cancer Screening Among US Veterans.

PubMed

May, Folasade P; Yano, Elizabeth M; Provenzale, Dawn; Neil Steers, W; Washington, Donna L

2017-08-01

Colorectal cancer (CRC) is a deadly but largely preventable disease. Screening improves outcomes, but screening rates vary across healthcare coverage models. In the Veterans Health Administration (VA), screening rates are high; however, it is unknown how CRC screening rates compare for Veterans with other types of healthcare coverage. To determine whether Veterans with Veteran-status-related coverage (VA, military, TRICARE) have higher rates of CRC screening than Veterans with alternate sources of healthcare coverage. We conducted a cross-sectional analysis of Veterans 50-75 years from the 2014 Behavioral Risk Factor Surveillance System survey. We examined CRC screening rates and screening modalities. We performed multivariable logistic regression to identify the role of coverage type, demographics, and clinical factors on screening status. The cohort included 22,138 Veterans. Of these, 76.7% reported up-to-date screening. Colonoscopy was the most common screening modality (83.7%). Screening rates were highest among Veterans with Veteran-status-related coverage (82.3%), as was stool-based screening (10.8%). The adjusted odds of up-to-date screening among Veterans with Veteran-status-related coverage were 83% higher than among Veterans with private coverage (adjusted OR = 1.83, 95% CI = 1.52-2.22). Additional predictors of screening included older age, black race, high income, access to medical care, frequent medical visits, and employed or married status. CRC screening rates were highest among Veterans with Veteran-status-related coverage. High CRC screening rates among US Veterans may be related to system-level characteristics of VA and military care. Insight to these system-level characteristics may inform mechanisms to improve CRC screening in non-VA settings.

Frequency of Evidence-Based Screening for Retinopathy in Type 1 Diabetes.

PubMed

Nathan, David M; Bebu, Ionut; Hainsworth, Dean; Klein, Ronald; Tamborlane, William; Lorenzi, Gayle; Gubitosi-Klug, Rose; Lachin, John M

2017-04-20

In patients who have had type 1 diabetes for 5 years, current recommendations regarding screening for diabetic retinopathy include annual dilated retinal examinations to detect proliferative retinopathy or clinically significant macular edema, both of which require timely intervention to preserve vision. During 30 years of the Diabetes Control and Complications Trial (DCCT) and its longitudinal follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study, retinal photography was performed at intervals of 6 months to 4 years. We used retinal photographs from the DCCT/EDIC study to develop a rational screening frequency for retinopathy. Markov modeling was used to determine the likelihood of progression to proliferative diabetic retinopathy or clinically significant macular edema in patients with various initial retinopathy levels (no retinopathy or mild, moderate, or severe nonproliferative diabetic retinopathy). The models included recognized risk factors for progression of retinopathy. Overall, the probability of progression to proliferative diabetic retinopathy or clinically significant macular edema was limited to approximately 5% between retinal screening examinations at 4 years among patients who had no retinopathy, 3 years among those with mild retinopathy, 6 months among those with moderate retinopathy, and 3 months among those with severe nonproliferative diabetic retinopathy. The risk of progression was also closely related to mean glycated hemoglobin levels. The risk of progression from no retinopathy to proliferative diabetic retinopathy or clinically significant macular edema was 1.0% over 5 years among patients with a glycated hemoglobin level of 6%, as compared with 4.3% over 3 years among patients with a glycated hemoglobin level of 10%. Over a 20-year period, the frequency of eye examinations was 58% lower with our practical, evidence-based schedule than with routine annual examinations, which resulted in substantial cost savings. Our model for establishing an individualized schedule for retinopathy screening on the basis of the patient's current state of retinopathy and glycated hemoglobin level reduced the frequency of eye examinations without delaying the diagnosis of clinically significant disease. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; DCCT/EDIC ClinicalTrials.gov numbers, NCT00360893 and NCT00360815 .).

Student, teacher, and classroom predictors of between-teacher variance of students' teacher-rated behavior.

PubMed

Splett, Joni W; Smith-Millman, Marissa; Raborn, Anthony; Brann, Kristy L; Flaspohler, Paul D; Maras, Melissa A

2018-03-08

The current study examined between-teacher variance in teacher ratings of student behavioral and emotional risk to identify student, teacher and classroom characteristics that predict such differences and can be considered in future research and practice. Data were taken from seven elementary schools in one school district implementing universal screening, including 1,241 students rated by 68 teachers. Students were mostly African America (68.5%) with equal gender (female 50.1%) and grade-level distributions. Teachers, mostly White (76.5%) and female (89.7%), completed both a background survey regarding their professional experiences and demographic characteristics and the Behavior Assessment System for Children (Second Edition) Behavioral and Emotional Screening System-Teacher Form for all students in their class, rating an average of 17.69 students each. Extant student data were provided by the district. Analyses followed multilevel linear model stepwise model-building procedures. We detected a significant amount of variance in teachers' ratings of students' behavioral and emotional risk at both student and teacher/classroom levels with student predictors explaining about 39% of student-level variance and teacher/classroom predictors explaining about 20% of between-teacher differences. The final model fit the data (Akaike information criterion = 8,687.709; pseudo-R2 = 0.544) significantly better than the null model (Akaike information criterion = 9,457.160). Significant predictors included student gender, race ethnicity, academic performance and disciplinary incidents, teacher gender, student-teacher gender interaction, teacher professional development in behavior screening, and classroom academic performance. Future research and practice should interpret teacher-rated universal screening of students' behavioral and emotional risk with consideration of the between-teacher variance unrelated to student behavior detected. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Public health genomics and personalized prevention: lessons from the COGS project.

PubMed

Pashayan, N; Hall, A; Chowdhury, S; Dent, T; Pharoah, P D P; Burton, H

2013-11-01

Using the principles of public health genomics, we examined the opportunities and challenges of implementing personalized prevention programmes for cancer at the population level. Our model-based estimates indicate that polygenic risk stratification can potentially improve the effectiveness and cost-effectiveness of screening programmes. However, compared with 'one-size-fits-all' screening programmes, personalized screening adds further layers of complexity to the organization of screening services and raises ethical, legal and social challenges. Before polygenic inheritance is translated into population screening strategy, evidence from empirical research and engagement with and education of the public and the health professionals are needed. © 2013 The Association for the Publication of the Journal of Internal Medicine.

Screening for hypercholesterolaemia versus case finding for familial hypercholesterolaemia: a systematic review and cost-effectiveness analysis.

PubMed

Marks, D; Wonderling, D; Thorogood, M; Lambert, H; Humphries, S E; Neil, H A

2000-01-01

In the majority of people with familial hypercholesterolaemia (FH) the disorder is caused by a mutation of the low-density lipoprotein receptor gene that impairs its proper function, resulting in very high levels of plasma cholesterol. Such levels result in early and severe atherosclerosis, and hence substantial excess mortality from coronary heart disease. Most people with FH are undiagnosed or only diagnosed after their first coronary event, but early detection and treatment with hydroxymethylglutaryl-coenzyme (HMG CoA) reductase inhibitors (statins) can reduce morbidity and mortality. The prevalence of FH in the UK population is estimated to be 1 in 500, which means that approximately 110,000 people are affected. To evaluate whether screening for FH is appropriate. To determine which system of screening is most acceptable and cost-effective. To assess the deleterious psychosocial effects of genetic and clinical screening for an asymptomatic treatable inherited condition. To assess whether the risks of screening outweigh potential benefits. Relevant papers were identified through a search of the electronic databases. Additional papers referenced in the search material were identified and collected. Known researchers in the field were contacted and asked to supply information on unpublished or ongoing studies. INCLUSION/EXCLUSION CRITERIA: SCREENING AND TREATMENT: The review included studies of the mortality and morbidity associated with FH, the effectiveness and cost of treatment (ignoring pre-statin therapies in adults), and of the effectiveness or cost of possible screening strategies for FH. PSYCHOSOCIAL EFFECTS OF SCREENING: The search for papers on the psychological and social effects of screening for a treatable inherited condition was limited to the last 5 years because recent developments in genetic testing have changed the nature and implications of such screening tests. Papers focusing on genetic testing for FH and breast cancer were included. Papers relating to the risk of coronary heart disease with similarly modifiable outcome (non-FH) were also included. DATA EXTRACTION AND ASSESSMENT OF VALIDITY: A data assessment tool was designed to assess the quality and validity of the papers which reported primary data for the social and psychological effects of screening. Available guidelines for systematically reviewing papers concentrated on quantitative methods, and were of limited relevance. An algorithm was developed which could be used for both the qualitative and quantitative literature. MODELLING METHODS: A model was constructed to investigate the relative cost and effectiveness of various forms of population screening (universal or opportunistic) and case-finding screening (screening relatives of known FH cases). All strategies involved a two-stage process: first, identifying those people with cholesterol levels sufficiently elevated to be compatible with a diagnosis of FH, and then either making the diagnosis based on clinical signs and a family history of coronary disease or carrying out genetic tests. Cost-effectiveness has been measured in terms of incremental cost per year of life gained. MODELLING COST-EFFECTIVENESS: FH is a life-threatening condition with a long presymptomatic state. Diagnostic tests are reasonably reliable and acceptable, and treatment with statins substantially improves prognosis. Therefore, it is appropriate to consider systematic screening for this condition. Case finding amongst relatives of FH cases was the most cost-effective strategy, and universal systematic screening the least cost-effective. However, when targeted at young people (16 year olds) universal screening was also cost-effective. Screening patients admitted to hospital with premature myocardial infarction was also relatively cost-effective. Screening is least cost-effective in men aged over 35 years, because the gains in life expectancy are small. (ABSTRACT TRUNCA

Utilization of breast cancer screening methods in a developing nation: results from a nationally representative sample of Malaysian households.

PubMed

Dunn, Richard A; Tan, Andrew K G

2011-01-01

As is the case in many developing nations, previous studies of breast cancer screening behavior in Malaysia have used relatively small samples that are not nationally representative, thereby limiting the generalizability of results. Therefore, this study uses nationally representative data from the Malaysia Non-Communicable Disease Surveillance-1 to investigate the role of socio-economic status on breast cancer screening behavior in Malaysia, particularly differences in screening behaviour between ethnic groups. The decisions of 816 women above age 40 in Malaysia to screen for breast cancer using mammography, clinical breast exams (CBE), and breast self-exams (BSE) are modeled using logistic regression. Results indicate that after adjusting for differences in age, education, household income, marital status, and residential location, Malay women are less likely than Chinese and Indian women to utilize mammography, but more likely to perform BSE. Education level and urban residence are positively associated with utilization of each method, but these relationships vary across ethnicity. Higher education levels are strongly related to using each screening method among Chinese women, but have no statistically significant relationship to screening among Malays. © 2011 Wiley Periodicals, Inc.

Systematic review: cultural adaptation and feasibility of screening for autism in non-English speaking countries.

PubMed

Al Maskari, Turkiya S; Melville, Craig A; Willis, Diane S

2018-01-01

Screening children for autism has gained wider acceptance within clinical practice, and early intervention has improved outcomes. Increasingly, adapting an existing screening instrument is a common, fast method to create a usable screening tool, especially for countries with limited resources and/or expertise. However, concerns have been raised regarding adaptation adequacy and the feasibility of screening across cultural groups. This study systematically examined the levels of cultural adaptation and feasibility aspects considered when screening for autism in non-English speaking countries to build upon the sparse knowledge that exists on this topic in the literature. Nineteen studies, obtained from five electronic databases, were examined. PRISMA guidance was used for this review. The Ecological Validity Framework model, and Bowen Recommendations for Feasibility were adopted to extract relevant data, which was synthesised narratively. Cultural adaptation within the included studies mostly involved language translation with little information offered to enable conclusions on how the processes were guided and maintained. Few cultural adjustments involved modifying screening methods; clarifying difficult concepts and changing instrument content were employed to address the core values, competence, beliefs, and norms of the adapted culture. However, less attention was given to adapt the screening goals within the context of cultural values, and customs or to consider interactional match between the clients and assessors. The review also highlighted an acceptable level of practicality to screen for autism but did not encourage integrating autism screening within routine practice or beyond the study context for different cultures. Concurring with previous literature, we agree that knowledge on cultural adaptation for autism screening instruments is limited and not sufficiently documented to establish adaptation levels (process and/or contents), and prove adequacy. However, this review provides an infrastructure to improve future adaptation processes. Integrating autism screening as routine medical practice is not encouraged and warrants further feasibility studies to minimize wasted resources and improve screening effectiveness in various health care systems.

Addressing Unmet Basic Resource Needs as Part of Chronic Cardiometabolic Disease Management.

PubMed

Berkowitz, Seth A; Hulberg, Amy Catherine; Standish, Sara; Reznor, Gally; Atlas, Steven J

2017-02-01

It is unclear if helping patients meet resource needs, such as difficulty affording food, housing, or medications, improves clinical outcomes. To determine the effectiveness of the Health Leads program on improvement in systolic and diastolic blood pressure (SBP and DBP, respectively), low-density lipoprotein cholesterol (LDL-C) level, and hemoglobin A1c (HbA1c) level. A difference-in-difference evaluation of the Health Leads program was conducted from October 1, 2012, through September 30, 2015, at 3 academic primary care practices. Health Leads consists of screening for unmet needs at clinic visits, and offering those who screen positive to meet with an advocate to help obtain resources, or receive brief information provision. Changes in SBP, DBP, LDL-C level, and HbA1c level. We compared those who screened positive for unmet basic needs (Health Leads group) with those who screened negative, using intention-to-treat, and, secondarily, between those who did and did not enroll in Health Leads, using linear mixed modeling, examining the period before and after screening. A total of 5125 people were screened, using a standardized form, for unmet basic resource needs; 3351 screened negative and 1774 screened positive. For those who screened positive, the mean age was 57.6 years and 1811 (56%) were women. For those who screened negative, the mean age was 56.7 years and 909 (57%) were women. Of 5125 people screened, 1774 (35%) reported at least 1 unmet need, and 1021 (58%) of those enrolled in Health Leads. Median follow-up for those who screened positive and negative was 34 and 32 months, respectively. In unadjusted intention-to-treat analyses of 1998 participants with hypertension, the Health Leads group experienced greater reduction in SBP (differential change, -1.2; 95% CI, -2.1 to -0.4) and DBP (differential change, -1.0; 95% CI, -1.5 to -0.5). For 2281 individuals with an indication for LDL-C level lowering, results also favored the Health Leads group (differential change, -3.7; 95% CI -6.7 to -0.6). For 774 individuals with diabetes, the Health Leads group did not show HbA1c level improvement (differential change, -0.04%; 95% CI, -0.17% to 0.10%). Results adjusted for baseline demographic and clinical differences were not qualitatively different. Among those who enrolled in Health Leads program, there were greater BP and LDL-C level improvements than for those who declined (SBP differential change -2.6; 95% CI,-3.5 to -1.7; SBP differential change, -1.4; 95% CI, -1.9 to -0.9; LDL-C level differential change, -6.3; 95% CI, -9.7 to -2.8). Screening for and attempting to address unmet basic resource needs in primary care was associated with modest improvements in blood pressure and lipid, but not blood glucose, levels.

Exploring the Distance Education Students' Cyberbullying, Cybervictimization and Cyberbullying Sensibility Levels

ERIC Educational Resources Information Center

Ozgur, Hasan

2015-01-01

The purpose of present research is to detect cyberbullying, cybervictimization and cyberbullying sensibility levels of distance education students and analyze these levels with respect to several variables. The research has been patterned on relational screening model. Study group consisted of 297 distance education students studying at university…

Youth Screen Time and Behavioral Health Problems: The Role of Sleep Duration and Disturbances.

PubMed

Parent, Justin; Sanders, Wesley; Forehand, Rex

2016-05-01

The purpose of this study was to examine the indirect effect of youth screen time (e.g., television, computers, smartphones, video games, and tablets) on behavioral health problems (i.e., internalizing, externalizing, and peer problems) through sleep duration and disturbances. The authors assessed a community sample of parents with a child in one of the following three developmental stages: young childhood (3-7 yrs; N = 209), middle childhood (8-12 yrs; N = 202), and adolescence (13-17 yrs; N = 210). Path analysis was used to test the hypothesized indirect effect model. Findings indicated that, regardless of the developmental stage of the youth, higher levels of youth screen time were associated with more sleep disturbances, which, in turn, were linked to higher levels of youth behavioral health problems. Children who have increased screen time are more likely to have poor sleep quality and problem behaviors.

Industrial Waste Management Evaluation Model Version 3.1

EPA Pesticide Factsheets

IWEM is a screening level ground water model designed to simulate contaminant fate and transport. IWEM v3.1 is the latest version of the IWEM software, which includes additional tools to evaluate the beneficial use of industrial materials

MULTIMEDIA HUMAN EXPOSURE AND RISK ASSESSMENT MODELING

EPA Science Inventory

Exposures and health risk comparisons from different sites may be used for allocating limited resources available for remedial action. It is important that comparisons between different sites use similar levels of site-specific data and/or screening level data. Risk assessment c...

Screening with an NMNAT2-MSD platform identifies small molecules that modulate NMNAT2 levels in cortical neurons.

PubMed

Ali, Yousuf O; Bradley, Gillian; Lu, Hui-Chen

2017-03-07

Nicotinamide mononucleotide adenylyl transferase 2 (NMNAT2) is a key neuronal maintenance factor and provides potent neuroprotection in numerous preclinical models of neurological disorders. NMNAT2 is significantly reduced in Alzheimer's, Huntington's, Parkinson's diseases. Here we developed a Meso Scale Discovery (MSD)-based screening platform to quantify endogenous NMNAT2 in cortical neurons. The high sensitivity and large dynamic range of this NMNAT2-MSD platform allowed us to screen the Sigma LOPAC library consisting of 1280 compounds. This library had a 2.89% hit rate, with 24 NMNAT2 positive and 13 negative modulators identified. Western analysis was conducted to validate and determine the dose-dependency of identified modulators. Caffeine, one identified NMNAT2 positive-modulator, when systemically administered restored NMNAT2 expression in rTg4510 tauopathy mice to normal levels. We confirmed in a cell culture model that four selected positive-modulators exerted NMNAT2-specific neuroprotection against vincristine-induced cell death while four selected NMNAT2 negative modulators reduced neuronal viability in an NMNAT2-dependent manner. Many of the identified NMNAT2 positive modulators are predicted to increase cAMP concentration, suggesting that neuronal NMNAT2 levels are tightly regulated by cAMP signaling. Taken together, our findings indicate that the NMNAT2-MSD platform provides a sensitive phenotypic screen to detect NMNAT2 in neurons.

Screening with an NMNAT2-MSD platform identifies small molecules that modulate NMNAT2 levels in cortical neurons

PubMed Central

Ali, Yousuf O.; Bradley, Gillian; Lu, Hui-Chen

2017-01-01

Nicotinamide mononucleotide adenylyl transferase 2 (NMNAT2) is a key neuronal maintenance factor and provides potent neuroprotection in numerous preclinical models of neurological disorders. NMNAT2 is significantly reduced in Alzheimer’s, Huntington’s, Parkinson’s diseases. Here we developed a Meso Scale Discovery (MSD)-based screening platform to quantify endogenous NMNAT2 in cortical neurons. The high sensitivity and large dynamic range of this NMNAT2-MSD platform allowed us to screen the Sigma LOPAC library consisting of 1280 compounds. This library had a 2.89% hit rate, with 24 NMNAT2 positive and 13 negative modulators identified. Western analysis was conducted to validate and determine the dose-dependency of identified modulators. Caffeine, one identified NMNAT2 positive-modulator, when systemically administered restored NMNAT2 expression in rTg4510 tauopathy mice to normal levels. We confirmed in a cell culture model that four selected positive-modulators exerted NMNAT2-specific neuroprotection against vincristine-induced cell death while four selected NMNAT2 negative modulators reduced neuronal viability in an NMNAT2-dependent manner. Many of the identified NMNAT2 positive modulators are predicted to increase cAMP concentration, suggesting that neuronal NMNAT2 levels are tightly regulated by cAMP signaling. Taken together, our findings indicate that the NMNAT2-MSD platform provides a sensitive phenotypic screen to detect NMNAT2 in neurons. PMID:28266613

Many-body perturbation theory and non-perturbative approaches: screened interaction as the key ingredient

NASA Astrophysics Data System (ADS)

Tarantino, Walter; Mendoza, Bernardo S.; Romaniello, Pina; Berger, J. A.; Reining, Lucia

2018-04-01

Many-body perturbation theory is often formulated in terms of an expansion in the dressed instead of the bare Green’s function, and in the screened instead of the bare Coulomb interaction. However, screening can be calculated on different levels of approximation, and it is important to define what is the most appropriate choice. We explore this question by studying a zero-dimensional model (so called ‘one-point model’) that retains the structure of the full equations. We study both linear and non-linear response approximations to the screening. We find that an expansion in terms of the screening in the random phase approximation is the most promising way for an application in real systems. Moreover, by making use of the nonperturbative features of the Kadanoff-Baym equation for the one-body Green’s function, we obtain an approximate solution in our model that is very promising, although its applicability to real systems has still to be explored.

Tier 1 Rice Model for Estimating Pesticide Concentrations in Rice Paddies

EPA Science Inventory

The Tier 1 Rice Model estimates screening level aquatic concentrations of pesticides in rice paddies. It is a simple pesticide soil:water partitioning model with default values for water volume, soil mass, and organic carbon. Pesticide degradation is not considered in the mode...

How Levels of Interactivity in Tutorials Affect Students' Learning of Modeling Transportation Problems in a Spreadsheet

ERIC Educational Resources Information Center

Seal, Kala Chand; Przasnyski, Zbigniew H.; Leon, Linda A.

2010-01-01

Do students learn to model OR/MS problems better by using computer-based interactive tutorials and, if so, does increased interactivity in the tutorials lead to better learning? In order to determine the effect of different levels of interactivity on student learning, we used screen capture technology to design interactive support materials for…

A Study of Curriculum Literacy and Information Literacy Levels of Teacher Candidates in Department of Social Sciences Education

ERIC Educational Resources Information Center

Sural, Serhat; Dedebali, Nurhak Cem

2018-01-01

The present study aims to investigate information literacy and curriculum literacy levels of teacher candidates and to identify the relationship between them through their course of study at Faculty of Education. The research model was designed as quantitative one and general screening model was employed. The study group is 895 students, who were…

Unscreening Modified Gravity in the Matter Power Spectrum.

PubMed

Lombriser, Lucas; Simpson, Fergus; Mead, Alexander

2015-06-26

Viable modifications of gravity that may produce cosmic acceleration need to be screened in high-density regions such as the Solar System, where general relativity is well tested. Screening mechanisms also prevent strong anomalies in the large-scale structure and limit the constraints that can be inferred on these gravity models from cosmology. We find that by suppressing the contribution of the screened high-density regions in the matter power spectrum, allowing a greater contribution of unscreened low densities, modified gravity models can be more readily discriminated from the concordance cosmology. Moreover, by variation of density thresholds, degeneracies with other effects may be dealt with more adequately. Specializing to chameleon gravity as a worked example for screening in modified gravity, employing N-body simulations of f(R) models and the halo model of chameleon theories, we demonstrate the effectiveness of this method. We find that a percent-level measurement of the clipped power at k<0.3h/Mpc can yield constraints on chameleon models that are more stringent than what is inferred from Solar System tests or distance indicators in unscreened dwarf galaxies. Finally, we verify that our method is also applicable to the Vainshtein mechanism.

Feasible economic strategies to improve screening compliance for colorectal cancer in Korea

PubMed Central

Park, Sang Min; Yun, Young Ho; Kwon, Soonman

2005-01-01

AIM: While colorectal cancer (CRC) is an ideal target for population screening, physician and patient attitudes contribute to low levels of screening uptake. This study was carried out to find feasible economic strategies to improve the CRC screening compliance in Korea. METHODS: The natural history of a simulated cohort of 50-year-old Korean in the general population was modeled with CRC screening until the age of 80 years. Cases of positive results were worked up with colonoscopy. After polypectomy, colonoscopy was repeated every 3 years. Baseline screening compliance without insurance coverage by the national health insurance (NHI) was assumed to be 30%. If NHI covered the CRC screening or the reimbursement of screening to physicians increased, the compliance was assumed to increase. We evaluated 16 different CRC screening strategies based on Markov model. RESULTS: When the NHI did not cover the screening and compliance was 30%, non-dominated strategies were colonoscopy every 5 years (COL5) and colonoscopy every 3 years (COL3). In all scenarios of various compliance rates with raised coverage of the NHI and increased reimbursement of colonoscopy, COL10, COL5 and COL3 were non-dominated strategies, and COL10 had lower or minimal incremental medical cost and financial burden on the NHI than the strategy of no screening. These results were stable with sensitivity analyses. CONCLUSION: Economic strategies for promoting screening compliance can be accompanied by expanding insurance coverage by the NHI and by increasing reimbursement for CRC screening to providers. COL10 was a cost-effective and cost saving screening strategy for CRC in Korea. PMID:15786532

Cost-effectiveness of one versus two sample faecal immunochemical testing for colorectal cancer screening.

PubMed

Goede, S Lucas; van Roon, Aafke H C; Reijerink, Jacqueline C I Y; van Vuuren, Anneke J; Lansdorp-Vogelaar, Iris; Habbema, J Dik F; Kuipers, Ernst J; van Leerdam, Monique E; van Ballegooijen, Marjolein

2013-05-01

The sensitivity and specificity of a single faecal immunochemical test (FIT) are limited. The performance of FIT screening can be improved by increasing the screening frequency or by providing more than one sample in each screening round. This study aimed to evaluate if two-sample FIT screening is cost-effective compared with one-sample FIT. The MISCAN-colon microsimulation model was used to estimate costs and benefits of strategies with either one or two-sample FIT screening. The FIT cut-off level varied between 50 and 200 ng haemoglobin/ml, and the screening schedule was varied with respect to age range and interval. In addition, different definitions for positivity of the two-sample FIT were considered: at least one positive sample, two positive samples, or the mean of both samples being positive. Within an exemplary screening strategy, biennial FIT from the age of 55-75 years, one-sample FIT provided 76.0-97.0 life-years gained (LYG) per 1000 individuals, at a cost of € 259,000-264,000 (range reflects different FIT cut-off levels). Two-sample FIT screening with at least one sample being positive provided 7.3-12.4 additional LYG compared with one-sample FIT at an extra cost of € 50,000-59,000. However, when all screening intervals and age ranges were considered, intensifying screening with one-sample FIT provided equal or more LYG at lower costs compared with two-sample FIT. If attendance to screening does not differ between strategies it is recommended to increase the number of screening rounds with one-sample FIT screening, before considering increasing the number of FIT samples provided per screening round.

Constructing and Validating High-Performance MIEC-SVM Models in Virtual Screening for Kinases: A Better Way for Actives Discovery

PubMed Central

Sun, Huiyong; Pan, Peichen; Tian, Sheng; Xu, Lei; Kong, Xiaotian; Li, Youyong; Dan Li; Hou, Tingjun

2016-01-01

The MIEC-SVM approach, which combines molecular interaction energy components (MIEC) derived from free energy decomposition and support vector machine (SVM), has been found effective in capturing the energetic patterns of protein-peptide recognition. However, the performance of this approach in identifying small molecule inhibitors of drug targets has not been well assessed and validated by experiments. Thereafter, by combining different model construction protocols, the issues related to developing best MIEC-SVM models were firstly discussed upon three kinase targets (ABL, ALK, and BRAF). As for the investigated targets, the optimized MIEC-SVM models performed much better than the models based on the default SVM parameters and Autodock for the tested datasets. Then, the proposed strategy was utilized to screen the Specs database for discovering potential inhibitors of the ALK kinase. The experimental results showed that the optimized MIEC-SVM model, which identified 7 actives with IC50 < 10 μM from 50 purchased compounds (namely hit rate of 14%, and 4 in nM level) and performed much better than Autodock (3 actives with IC50 < 10 μM from 50 purchased compounds, namely hit rate of 6%, and 2 in nM level), suggesting that the proposed strategy is a powerful tool in structure-based virtual screening. PMID:27102549

Constructing and Validating High-Performance MIEC-SVM Models in Virtual Screening for Kinases: A Better Way for Actives Discovery.

PubMed

Sun, Huiyong; Pan, Peichen; Tian, Sheng; Xu, Lei; Kong, Xiaotian; Li, Youyong; Dan Li; Hou, Tingjun

2016-04-22

The MIEC-SVM approach, which combines molecular interaction energy components (MIEC) derived from free energy decomposition and support vector machine (SVM), has been found effective in capturing the energetic patterns of protein-peptide recognition. However, the performance of this approach in identifying small molecule inhibitors of drug targets has not been well assessed and validated by experiments. Thereafter, by combining different model construction protocols, the issues related to developing best MIEC-SVM models were firstly discussed upon three kinase targets (ABL, ALK, and BRAF). As for the investigated targets, the optimized MIEC-SVM models performed much better than the models based on the default SVM parameters and Autodock for the tested datasets. Then, the proposed strategy was utilized to screen the Specs database for discovering potential inhibitors of the ALK kinase. The experimental results showed that the optimized MIEC-SVM model, which identified 7 actives with IC50 < 10 μM from 50 purchased compounds (namely hit rate of 14%, and 4 in nM level) and performed much better than Autodock (3 actives with IC50 < 10 μM from 50 purchased compounds, namely hit rate of 6%, and 2 in nM level), suggesting that the proposed strategy is a powerful tool in structure-based virtual screening.

Can screening and brief intervention lead to population-level reductions in alcohol-related harm?

PubMed Central

2012-01-01

A distinction is made between the clinical and public health justifications for screening and brief intervention (SBI) against hazardous and harmful alcohol consumption. Early claims for a public health benefit of SBI derived from research on general medical practitioners’ (GPs’) advice on smoking cessation, but these claims have not been realized, mainly because GPs have not incorporated SBI into their routine practice. A recent modeling exercise estimated that, if all GPs in England screened every patient at their next consultation, 96% of the general population would be screened over 10 years, with 70-79% of excessive drinkers receiving brief interventions (BI); assuming a 10% success rate, this would probably amount to a population-level effect of SBI. Thus, a public health benefit for SBI presupposes widespread screening; but recent government policy in England favors targeted versus universal screening, and in Scotland screening is based on new registrations and clinical presentation. A recent proposal for a national screening program was rejected by the UK National Health Service’s National Screening Committee because 1) there was no good evidence that SBI led to reductions in mortality or morbidity, and 2) a safe, simple, precise, and validated screening test was not available. Even in countries like Sweden and Finland, where expensive national programs to disseminate SBI have been implemented, only a minority of the population has been asked about drinking during health-care visits, and a minority of excessive drinkers has been advised to cut down. Although there has been research on the relationship between treatment for alcohol problems and population-level effects, there has been no such research for SBI, nor have there been experimental investigations of its relationship with population-level measures of alcohol-related harm. These are strongly recommended. In this article, conditions that would allow a population-level effect of SBI to occur are reviewed, including their political acceptability. It is tentatively concluded that widespread dissemination of SBI, without the implementation of alcohol control measures, might have indirect influences on levels of consumption and harm but would be unlikely on its own to result in public health benefits. However, if and when alcohol control measures were introduced, SBI would still have an important role in the battle against alcohol-related harm. PMID:23186309

Global Sensitivity Analysis of Environmental Models: Convergence, Robustness and Validation

NASA Astrophysics Data System (ADS)

Sarrazin, Fanny; Pianosi, Francesca; Khorashadi Zadeh, Farkhondeh; Van Griensven, Ann; Wagener, Thorsten

2015-04-01

Global Sensitivity Analysis aims to characterize the impact that variations in model input factors (e.g. the parameters) have on the model output (e.g. simulated streamflow). In sampling-based Global Sensitivity Analysis, the sample size has to be chosen carefully in order to obtain reliable sensitivity estimates while spending computational resources efficiently. Furthermore, insensitive parameters are typically identified through the definition of a screening threshold: the theoretical value of their sensitivity index is zero but in a sampling-base framework they regularly take non-zero values. There is little guidance available for these two steps in environmental modelling though. The objective of the present study is to support modellers in making appropriate choices, regarding both sample size and screening threshold, so that a robust sensitivity analysis can be implemented. We performed sensitivity analysis for the parameters of three hydrological models with increasing level of complexity (Hymod, HBV and SWAT), and tested three widely used sensitivity analysis methods (Elementary Effect Test or method of Morris, Regional Sensitivity Analysis, and Variance-Based Sensitivity Analysis). We defined criteria based on a bootstrap approach to assess three different types of convergence: the convergence of the value of the sensitivity indices, of the ranking (the ordering among the parameters) and of the screening (the identification of the insensitive parameters). We investigated the screening threshold through the definition of a validation procedure. The results showed that full convergence of the value of the sensitivity indices is not necessarily needed to rank or to screen the model input factors. Furthermore, typical values of the sample sizes that are reported in the literature can be well below the sample sizes that actually ensure convergence of ranking and screening.

Hypothesis generation using network structures on community health center cancer-screening performance.

PubMed

Carney, Timothy Jay; Morgan, Geoffrey P; Jones, Josette; McDaniel, Anna M; Weaver, Michael T; Weiner, Bryan; Haggstrom, David A

2015-10-01

Nationally sponsored cancer-care quality-improvement efforts have been deployed in community health centers to increase breast, cervical, and colorectal cancer-screening rates among vulnerable populations. Despite several immediate and short-term gains, screening rates remain below national benchmark objectives. Overall improvement has been both difficult to sustain over time in some organizational settings and/or challenging to diffuse to other settings as repeatable best practices. Reasons for this include facility-level changes, which typically occur in dynamic organizational environments that are complex, adaptive, and unpredictable. This study seeks to understand the factors that shape community health center facility-level cancer-screening performance over time. This study applies a computational-modeling approach, combining principles of health-services research, health informatics, network theory, and systems science. To investigate the roles of knowledge acquisition, retention, and sharing within the setting of the community health center and to examine their effects on the relationship between clinical decision support capabilities and improvement in cancer-screening rate improvement, we employed Construct-TM to create simulated community health centers using previously collected point-in-time survey data. Construct-TM is a multi-agent model of network evolution. Because social, knowledge, and belief networks co-evolve, groups and organizations are treated as complex systems to capture the variability of human and organizational factors. In Construct-TM, individuals and groups interact by communicating, learning, and making decisions in a continuous cycle. Data from the survey was used to differentiate high-performing simulated community health centers from low-performing ones based on computer-based decision support usage and self-reported cancer-screening improvement. This virtual experiment revealed that patterns of overall network symmetry, agent cohesion, and connectedness varied by community health center performance level. Visual assessment of both the agent-to-agent knowledge sharing network and agent-to-resource knowledge use network diagrams demonstrated that community health centers labeled as high performers typically showed higher levels of collaboration and cohesiveness among agent classes, faster knowledge-absorption rates, and fewer agents that were unconnected to key knowledge resources. Conclusions and research implications: Using the point-in-time survey data outlining community health center cancer-screening practices, our computational model successfully distinguished between high and low performers. Results indicated that high-performance environments displayed distinctive network characteristics in patterns of interaction among agents, as well as in the access and utilization of key knowledge resources. Our study demonstrated how non-network-specific data obtained from a point-in-time survey can be employed to forecast community health center performance over time, thereby enhancing the sustainability of long-term strategic-improvement efforts. Our results revealed a strategic profile for community health center cancer-screening improvement via simulation over a projected 10-year period. The use of computational modeling allows additional inferential knowledge to be drawn from existing data when examining organizational performance in increasingly complex environments. Copyright © 2015 Elsevier Inc. All rights reserved.

Public Databases Supporting Computational Toxicology

EPA Science Inventory

A major goal of the emerging field of computational toxicology is the development of screening-level models that predict potential toxicity of chemicals from a combination of mechanistic in vitro assay data and chemical structure descriptors. In order to build these models, resea...

Two level approach to safety planning incorporating the Highway Safety Manual (HSM) network screening : [summary].

DOT National Transportation Integrated Search

2014-04-01

In this project, University of Central Florida researchers combined two types of safety analysis, microscopic and macroscopic, to overcome their limitations. Microscopic models focus on traffic flows and related parameters. Macroscopic models are bas...

Met Éireann high resolution reanalysis for Ireland

NASA Astrophysics Data System (ADS)

Gleeson, Emily; Whelan, Eoin; Hanley, John

2017-03-01

The Irish Meteorological Service, Met Éireann, has carried out a 35-year very high resolution (2.5 km horizontal grid) regional climate reanalysis for Ireland using the ALADIN-HIRLAM numerical weather prediction system. This article provides an overview of the reanalysis, called MÉRA, as well as a preliminary analysis of surface parameters including screen level temperature, 10 m wind speeds, mean sea-level pressure (MSLP), soil temperatures, soil moisture and 24 h rainfall accumulations. The quality of the 3-D variational data assimilation used in the reanalysis is also assessed. Preliminary analysis shows that it takes almost 12 months to spin up the deep soil in terms of moisture, justifying the choice of running year-long spin up periods. Overall, the model performed consistently over the time period. Small biases were found in screen-level temperatures (less than -0.5 °C), MSLP (within 0.5 hPa) and 10 m wind speed (up to 0.5 m s-1) Soil temperatures are well represented by the model. 24 h accumulations of precipitation generally exhibit a small positive bias of ˜ 1 mm per day and negative biases over mountains due to a mismatch between the model orography and the geography of the region. MÉRA outperforms the ERA-Interim reanalysis, particularly in terms of standard deviations in screen-level temperatures and surface winds. This dataset is the first of its kind for Ireland that will be made publically available during spring 2017.

SIMULATING RADIONUCLIDE FATE AND TRANSPORT IN THE UNSATURATED ZONE: EVALUATION AND SENSITIVITY ANALYSES OF SELECT COMPUTER MODELS

EPA Science Inventory

Numerical, mathematical models of water and chemical movement in soils are used as decision aids for determining soil screening levels (SSLs) of radionuclides in the unsaturated zone. Many models require extensive input parameters which include uncertainty due to soil variabil...

Polygenic susceptibility to testicular cancer: implications for personalised health care.

PubMed

Litchfield, Kevin; Mitchell, Jonathan S; Shipley, Janet; Huddart, Robert; Rajpert-De Meyts, Ewa; Skakkebæk, Niels E; Houlston, Richard S; Turnbull, Clare

2015-11-17

The increasing incidence of testicular germ cell tumour (TGCT) combined with its strong heritable basis suggests that stratified screening for the early detection of TGCT may be clinically useful. We modelled the efficiency of such a personalised screening approach, based on genetic risk profiling in combination with other diagnostic tools. We compared the number of cases potentially detectable in the population under a number of screening models. The polygenic risk scoring (PRS) model was assumed to have a log-normal relative risk distribution across the 19 currently known TGCT susceptibility variants. The diagnostic performance of testicular biopsy and non-invasive semen analysis was also assessed, within a simulated combined screening programme. The area under the curve for the TGCT PRS model was 0.72 with individuals in the top 1% of the PRS having a nine-fold increased TGCT risk compared with the population median. Results from population-screening simulations only achieved a maximal positive predictive value (PPV) of 60%, highlighting broader clinical factors that challenge such strategies, not least the rare nature of TGCT. In terms of future improvements, heritability estimates suggest that a significant number of additional genetic risk factors for TGCT remain to be discovered, identification of which would potentially yield improvement of the PPV to 80-90%. While personalised screening models may offer enhanced TGCT risk discrimination, presently the case for population-level testing is not compelling. However, future advances, such as more routine generation of whole genome data is likely to alter the landscape. More targeted screening programs may plausibly then offer clinical benefit, particularly given the significant survivorship issues associated with the successful treatment of TGCT.

Variation in cervical and breast cancer screening coverage in England: a cross-sectional analysis to characterise districts with atypical behaviour

PubMed Central

Massat, Nathalie J; Douglas, Elaine; Waller, Jo; Wardle, Jane; Duffy, Stephen W

2015-01-01

Objectives Reducing cancer screening inequalities in England is a major focus of the 2011 Department of Health cancer outcome strategy. Screening coverage requires regular monitoring in order to implement targeted interventions where coverage is low. This study aimed to characterise districts with atypical coverage levels for cervical or breast screening. Design Observational study of district-level coverage in the English Cervical and Breast screening programmes in 2012. Setting England, UK. Participants All English women invited to participate in the cervical (age group 25–49 and 50–64) and breast (age group 50–64) screening programmes. Outcomes Risk adjustment models for coverage were developed based on district-level characteristics. Funnel plots of adjusted coverage were constructed, and atypical districts examined by correlation analysis. Results Variability in coverage was primarily explained by population factors, whereas general practice characteristics had little independent effect. Deprivation and ethnicity other than white, Asian, black or mixed were independently associated with poorer coverage in both screening programmes, with ethnicity having the strongest effect; by comparison, the influence of Asian, black or mixed ethnic minority was limited. Deprivation, ethnicity and urbanisation largely accounted for the lower cervical screening coverage in London. However, for breast screening, being located in London remained a strong negative predictor. A subset of districts was identified as having atypical coverage across programmes. Correlates of deprivation in districts with relatively low adjusted coverage were substantially different from overall correlates of deprivation. Discussion These results inform the continuing drive to reduce avoidable cancer deaths in England, and encourage implementation of targeted interventions in communities residing in districts identified as having atypically low coverage. Sequential implementation to monitor the impact of local interventions would help accrue evidence on ‘what works’. PMID:26209119

Model tracking system for low-level radioactive waste disposal facilities: License application interrogatories and responses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Benbennick, M.E.; Broton, M.S.; Fuoto, J.S.

This report describes a model tracking system for a low-level radioactive waste (LLW) disposal facility license application. In particular, the model tracks interrogatories (questions, requests for information, comments) and responses. A set of requirements and desired features for the model tracking system was developed, including required structure and computer screens. Nine tracking systems were then reviewed against the model system requirements and only two were found to meet all requirements. Using Kepner-Tregoe decision analysis, a model tracking system was selected.

Cost-effectiveness and population outcomes of general population screening for hepatitis C.

PubMed

Coffin, Phillip O; Scott, John D; Golden, Matthew R; Sullivan, Sean D

2012-05-01

Current US guidelines recommend limiting hepatitis C virus (HCV) screening to high-risk individuals, and 50%-75% of infected persons remain unaware of their status. To estimate the cost-effectiveness and population-level impact of adding one-time HCV screening of US population aged 20-69 years to current guidelines, we developed a decision analytic model for the screening intervention and Markov model with annual transitions to estimate natural history. Subanalyses included protease inhibitor therapy and screening those at highest risk of infection (birth year 1945-1965). We relied on published literature and took a lifetime, societal perspective. Compared to current guidelines, incremental cost per quality-adjusted life year gained (ICER) was $7900 for general population screening and $4200 for screening by birth year, which dominated general population screening if cost, clinician uptake, and median age of diagnoses were assumed equivalent. General population screening remained cost-effective in all one-way sensitivity analyses, 30 000 Monte Carlo simulations, and scenarios in which background mortality was doubled, all genotype 1 patients were treated with protease inhibitors, and most parameters were set unfavorable to increased screening. ICER was lowest if screening was applied to a population with liver fibrosis similar to 2010 estimates. Approximately 1% of liver-related deaths would be averted per 15% of the general population screened; the impact would be greater with improved referral, treatment uptake, and cure. Broader screening for HCV would likely be cost-effective, but significantly reducing HCV-related morbidity and mortality would also require improved rates of referral, treatment, and cure.

Investigation of Job Satisfaction Levels of School Administrators and Teachers

ERIC Educational Resources Information Center

Sener, Gönül; Boydak Özan, Mukadder

2017-01-01

The main purpose of the research is to determine the job satisfaction levels of school administrators and teachers. The descriptive method based on screening model for revealing the existing situation was used in the study. An attempt to determine the job satisfaction levels of administrators and teachers in educational organizations was made in…

Cervical cancer screening behavior and associated factors among women of Ugrachandi Nala, Kavre, Nepal.

PubMed

Acharya Pandey, Radha; Karmacharya, Era

2017-09-19

Cervical cancer in Nepal ranks as the first most frequent cancer among women. Primary prevention measures, such as prophylactic vaccines against high risk HPV, are now available. Over time, vaccination will decrease the prevalence of the disease among younger women; however, screening will still be needed. The objective of the study was to assess the cervical cancer screening behavior and its associated factors among women of Nala Village Development Committee (VDC), Kavre. A descriptive cross-sectional study was done to assess the cervical cancer screening behavior among women in 2014. Systematic Random sampling was used to collect the data from a sample of 180 women residing in Nala VDC. A structured interview questionnaire and health belief model scale was used to collect data. Descriptive and inferential statistics (Chi-square test) was used for data analysis using SPSS version 16 program. Minority (18.3%) of the respondents had cervical cancer screening behavior. Education level of the respondents was significantly associated with cervical cancer screening behavior (p < 0.05). Age, parity, perceived susceptibility, perceived benefits, and perceived barriers had no significant association with cervical cancer screening behavior. This study shows that cervical cancer screening behavior was satisfactory. The findings of the study indicate a significant association between cervical cancer screening behavior and education level of the participants. Awareness campaigns targeting illiterate groups can be conducted in community so that they become motivated towards cervical cancer screening.

Comparison of screening-level and Monte Carlo approaches for wildlife food web exposure modeling

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pastorok, R.; Butcher, M.; LaTier, A.

1995-12-31

The implications of using quantitative uncertainty analysis (e.g., Monte Carlo) and site-specific tissue residue data for wildlife exposure modeling were examined with data on trace elements at the Clark Fork River Superfund Site. Exposure of white-tailed deer, red fox, and American kestrel was evaluated using three approaches. First, a screening-level exposure model was based on conservative estimates of exposure parameters, including estimates of dietary residues derived from bioconcentration factors (BCFs) and soil chemistry. A second model without Monte Carlo was based on site-specific data for tissue residues of trace elements (As, Cd, Cu, Pb, Zn) in key dietary species andmore » plausible assumptions for habitat spatial segmentation and other exposure parameters. Dietary species sampled included dominant grasses (tufted hairgrass and redtop), willows, alfalfa, barley, invertebrates (grasshoppers, spiders, and beetles), and deer mice. Third, the Monte Carlo analysis was based on the site-specific residue data and assumed or estimated distributions for exposure parameters. Substantial uncertainties are associated with several exposure parameters, especially BCFS, such that exposure and risk may be greatly overestimated in screening-level approaches. The results of the three approaches are compared with respect to realism, practicality, and data gaps. Collection of site-specific data on trace elements concentrations in plants and animals eaten by the target wildlife receptors is a cost-effective way to obtain realistic estimates of exposure. Implications of the results for exposure and risk estimates are discussed relative to use of wildlife exposure modeling and evaluation of remedial actions at Superfund sites.« less

Pesticides exposure assessment of kettleman city using the industrial source complex short-term model version 3.

PubMed

Tao, Jing; Barry, Terrell; Segawa, Randy; Neal, Rosemary; Tuli, Atac

2013-01-01

Kettleman City, California, reported a higher than expected number of birth defect cases between 2007 and 2010, raising the concern of community and government agencies. A pesticide exposure evaluation was conducted as part of a complete assessment of community chemical exposure. Nineteen pesticides that potentially cause birth defects were investigated. The Industrial Source Complex Short-Term Model Version 3 (ISCST3) was used to estimate off-site air concentrations associated with pesticide applications within 8 km of the community from late 2006 to 2009. The health screening levels were designed to indicate potential health effects and used for preliminary health evaluations of estimated air concentrations. A tiered approach was conducted. The first tier modeled simple, hypothetical worst-case situations for each of 19 pesticides. The second tier modeled specific applications of the pesticides with estimated concentrations exceeding health screening levels in the first tier. The pesticide use report database of the California Department of Pesticide Regulation provided application information. Weather input data were summarized from the measurements of a local weather station in the California Irrigation Management Information System. The ISCST3 modeling results showed that during the target period, only two application days of one pesticide (methyl isothiocyanate) produced air concentration estimates above the health screening level for developmental effects at the boundary of Kettleman City. These results suggest that the likelihood of birth defects caused by pesticide exposure was low. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Mesoscale carbon sequestration site screening and CCS infrastructure analysis.

PubMed

Keating, Gordon N; Middleton, Richard S; Stauffer, Philip H; Viswanathan, Hari S; Letellier, Bruce C; Pasqualini, Donatella; Pawar, Rajesh J; Wolfsberg, Andrew V

2011-01-01

We explore carbon capture and sequestration (CCS) at the meso-scale, a level of study between regional carbon accounting and highly detailed reservoir models for individual sites. We develop an approach to CO(2) sequestration site screening for industries or energy development policies that involves identification of appropriate sequestration basin, analysis of geologic formations, definition of surface sites, design of infrastructure, and analysis of CO(2) transport and storage costs. Our case study involves carbon management for potential oil shale development in the Piceance-Uinta Basin, CO and UT. This study uses new capabilities of the CO(2)-PENS model for site screening, including reservoir capacity, injectivity, and cost calculations for simple reservoirs at multiple sites. We couple this with a model of optimized source-sink-network infrastructure (SimCCS) to design pipeline networks and minimize CCS cost for a given industry or region. The CLEAR(uff) dynamical assessment model calculates the CO(2) source term for various oil production levels. Nine sites in a 13,300 km(2) area have the capacity to store 6.5 GtCO(2), corresponding to shale-oil production of 1.3 Mbbl/day for 50 years (about 1/4 of U.S. crude oil production). Our results highlight the complex, nonlinear relationship between the spatial deployment of CCS infrastructure and the oil-shale production rate.

Screening, prevention and treatment of cervical cancer -- a global and regional generalized cost-effectiveness analysis.

PubMed

Ginsberg, Gary Michael; Edejer, Tessa Tan-Torres; Lauer, Jeremy A; Sepulveda, Cecilia

2009-10-09

The paper calculates regional generalized cost-effectiveness estimates of screening, prevention, treatment and combined interventions for cervical cancer. Using standardised WHO-CHOICE methodology, a cervical cancer model was employed to provide estimates of screening, vaccination and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs. In regions characterized by high income, low mortality and high existing treatment coverage, the addition of any screening programme to the current high treatment levels is very cost-effective. However, based on projections of the future price per dose (representing the economic costs of the vaccination excluding monopolistic rents and vaccine development cost) vaccination is the most cost-effective intervention. In regions characterized by low income, low mortality and existing treatment coverage around 50%, expanding treatment with or without combining it with screening appears to be cost-effective or very cost-effective. Abandoning treatment in favour of screening in a no-treatment scenario would not be cost-effective. Vaccination is usually the most cost-effective intervention. Penta or tri-annual PAP smears appear to be cost-effective, though when combined with HPV-DNA testing they are not cost-effective. In regions characterized by low income, high mortality and low treatment levels, expanding treatment with or without adding screening would be very cost-effective. A one off vaccination plus expanding treatment was usually very cost-effective. One-off PAP or VIA screening at age 40 are more cost-effective than other interventions though less effective overall. From a cost-effectiveness perspective, consideration should be given to implementing vaccination (depending on cost per dose and longevity of efficacy) and screening programmes on a worldwide basis to reduce the burden of disease from cervical cancer. Treatment should also be increased where coverage is low.

Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis.

PubMed

Arrospide, Arantzazu; Rue, Montserrat; van Ravesteyn, Nicolien T; Comas, Merce; Soto-Gordoa, Myriam; Sarriugarte, Garbiñe; Mar, Javier

2016-06-01

Breast cancer screening in the Basque Country has shown 20 % reduction of the number of BC deaths and an acceptable overdiagnosis level (4 % of screen detected BC). The aim of this study was to evaluate the breast cancer early detection programme in the Basque Country in terms of retrospective cost-effectiveness and budget impact from 1996 to 2011. A discrete event simulation model was built to reproduce the natural history of breast cancer (BC). We estimated for lifetime follow-up the total cost of BC (screening, diagnosis and treatment), as well as quality-adjusted life years (QALY), for women invited to participate in the evaluated programme during the 15-year period in the actual screening scenario and in a hypothetical unscreened scenario. An incremental cost-effectiveness ratio was calculated with the use of aggregated costs. Besides, annual costs were considered for budget impact analysis. Both population level and single-cohort analysis were performed. A probabilistic sensitivity analysis was applied to assess the impact of parameters uncertainty. The actual screening programme involved a cost of 1,127 million euros and provided 6.7 million QALYs over the lifetime of the target population, resulting in a gain of 8,666 QALYs for an additional cost of 36.4 million euros, compared with the unscreened scenario. Thus, the incremental cost-effectiveness ratio was 4,214€/QALY. All the model runs in the probabilistic sensitivity analysis resulted in an incremental cost-effectiveness ratio lower than 10,000€/QALY. The screening programme involved an increase of the annual budget of the Basque Health Service by 5.2 million euros from year 2000 onwards. The BC screening programme in the Basque Country proved to be cost-effective during the evaluated period and determined an affordable budget impact. These results confirm the epidemiological benefits related to the centralised screening system and support the continuation of the programme.

Chemical-specific screening criteria for interpretation of biomonitoring data for volatile organic compounds (VOCs)--application of steady-state PBPK model solutions.

PubMed

Aylward, Lesa L; Kirman, Chris R; Blount, Ben C; Hays, Sean M

2010-10-01

The National Health and Nutrition Examination Survey (NHANES) generates population-representative biomonitoring data for many chemicals including volatile organic compounds (VOCs) in blood. However, no health or risk-based screening values are available to evaluate these data from a health safety perspective or to use in prioritizing among chemicals for possible risk management actions. We gathered existing risk assessment-based chronic exposure reference values such as reference doses (RfDs), reference concentrations (RfCs), tolerable daily intakes (TDIs), cancer slope factors, etc. and key pharmacokinetic model parameters for 47 VOCs. Using steady-state solutions to a generic physiologically-based pharmacokinetic (PBPK) model structure, we estimated chemical-specific steady-state venous blood concentrations across chemicals associated with unit oral and inhalation exposure rates and with chronic exposure at the identified exposure reference values. The geometric means of the slopes relating modeled steady-state blood concentrations to steady-state exposure to a unit oral dose or unit inhalation concentration among 38 compounds with available pharmacokinetic parameters were 12.0 microg/L per mg/kg-d (geometric standard deviation [GSD] of 3.2) and 3.2 microg/L per mg/m(3) (GSD=1.7), respectively. Chemical-specific blood concentration screening values based on non-cancer reference values for both oral and inhalation exposure range from 0.0005 to 100 microg/L; blood concentrations associated with cancer risk-specific doses at the 1E-05 risk level ranged from 5E-06 to 6E-02 microg/L. The distribution of modeled steady-state blood concentrations associated with unit exposure levels across VOCs may provide a basis for estimating blood concentration screening values for VOCs that lack chemical-specific pharmacokinetic data. The screening blood concentrations presented here provide a tool for risk assessment-based evaluation of population biomonitoring data for VOCs and are most appropriately applied to central tendency estimates for such datasets. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Integrating Oral and General Health Screening at Senior Centers for Minority Elders

PubMed Central

Cheng, Bin; Northridge, Mary E.; Kunzel, Carol; Huang, Catherine; Lamster, Ira B.

2013-01-01

Racial/ethnic and socioeconomic disparities regarding untreated oral disease exist for older adults, and poor oral health diminishes quality of life. The ElderSmile program integrated screening for diabetes and hypertension into its community-based oral health activities at senior centers in northern Manhattan. The program found a willingness among minority seniors (aged ≥ 50 years) to be screened for primary care sensitive conditions by dental professionals and a high level of unrecognized disease (7.8% and 24.6% of ElderSmile participants had positive screening results for previously undiagnosed diabetes and hypertension, respectively). Dental professionals may screen for primary care–sensitive conditions and refer patients to health care providers for definitive diagnosis and treatment. The ElderSmile program is a replicable model for community-based oral and general health screening. PMID:23597378

76 FR 5691 - Cyprodinil; Pesticide Tolerances

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-02

....'' This includes exposure through drinking water and in residential settings, but does not include... exposure from drinking water. The Agency used screening level water exposure models in the dietary exposure analysis and risk assessment for cyprodinil in drinking water. These simulation models take into account...

75 FR 17579 - Aminopyralid; Pesticide Tolerances

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-07

... exposure through drinking water and in residential settings, but does not include occupational exposure... from drinking water. The Agency used screening level water exposure models in the dietary exposure analysis and risk assessment for aminopyralid in drinking water. These simulation models take into account...

Association between background parenchymal enhancement of breast MRI and BIRADS rating change in the subsequent screening

NASA Astrophysics Data System (ADS)

Aghaei, Faranak; Mirniaharikandehei, Seyedehnafiseh; Hollingsworth, Alan B.; Stoug, Rebecca G.; Pearce, Melanie; Liu, Hong; Zheng, Bin

2018-03-01

Although breast magnetic resonance imaging (MRI) has been used as a breast cancer screening modality for high-risk women, its cancer detection yield remains low (i.e., <= 3%). Thus, increasing breast MRI screening efficacy and cancer detection yield is an important clinical issue in breast cancer screening. In this study, we investigated association between the background parenchymal enhancement (BPE) of breast MRI and the change of diagnostic (BIRADS) status in the next subsequent breast MRI screening. A dataset with 65 breast MRI screening cases was retrospectively assembled. All cases were rated BIRADS-2 (benign findings). In the subsequent screening, 4 cases were malignant (BIRADS-6), 48 remained BIRADS-2 and 13 were downgraded to negative (BIRADS-1). A computer-aided detection scheme was applied to process images of the first set of breast MRI screening. Total of 33 features were computed including texture feature and global BPE features. Texture features were computed from either a gray-level co-occurrence matrix or a gray level run length matrix. Ten global BPE features were also initially computed from two breast regions and bilateral difference between the left and right breasts. Box-plot based analysis shows positive association between texture features and BIRADS rating levels in the second screening. Furthermore, a logistic regression model was built using optimal features selected by a CFS based feature selection method. Using a leave-one-case-out based cross-validation method, classification yielded an overall 75% accuracy in predicting the improvement (or downgrade) of diagnostic status (to BIRAD-1) in the subsequent breast MRI screening. This study demonstrated potential of developing a new quantitative imaging marker to predict diagnostic status change in the short-term, which may help eliminate a high fraction of unnecessary repeated breast MRI screenings and increase the cancer detection yield.

Nonlocal screening effects on core-level photoemission spectra investigated by large-cluster models

DOE Office of Scientific and Technical Information (OSTI.GOV)

Okada, K.; Kotani, A.

1995-08-15

The copper 2{ital p} core-level x-ray photoemission spectrum in CuO{sub 2} plane systems is calculated by means of large-cluster models to investigate in detail the nonlocal screening effects, which were pointed out by van Veenendaal {ital et} {ital al}. [Phys. Rev. B 47, 11 462 (1993)]. Calculating the hole distributions for the initial and final states of photoemission, we show that the atomic coordination in a cluster strongly affects accessible final states. Accordingly, we point out that the interpretation for Cu{sub 3}O{sub 10} given by van Veenendaal {ital et} {ital al}. is not always general. Moreover, it is shown thatmore » the spectrum can be remarkably affected by whether or not the O 2{ital p}{sub {pi}} orbits are taken into account in the calculations. We also introduce a Hartree-Fock approximation in order to treat much larger-cluster models.« less

Associations between factors within the home setting and screen time among children aged 0–5 years: a cross-sectional study

PubMed Central

2012-01-01

Background Excessive engagement in screen time has several immediate and long-term health implications among pre-school children. However, little is known about the factors that influence screen time in this age group. Therefore, the purpose of this study was to use the Ecologic Model of Sedentary Behavior as a guide to examine associations between intrapersonal, interpersonal, and physical environment factors within the home setting and screen time among pre-school children. Methods Participants were 746 pre-school children (≤ 5 years old) from the Kingston, Ontario, Canada area. From May to September, 2011, parents completed a questionnaire regarding several intrapersonal (child demographics), interpersonal (family demographics, parental cognitions, parental behavior), and physical environment (television, computer, or video games in the bedroom) factors within the home setting. Parents also reported the average amount of time per day their child spent watching television and playing video/computer games. Associations were examined using linear and logistic regression models. Results Most participants (93.7%) watched television and 37.9% played video/computer games. Several intrapersonal, interpersonal, and physical environment factors within the home setting were associated with screen time. More specifically, age, parental attitudes, parental barriers, parental descriptive norms, parental screen time, and having a television in the bedroom were positive predictors of screen time; whereas, parental education, parental income, and parental self-efficacy were negative predictors of screen time in the linear regression analysis. Collectively these variables explained 64.2% of the variance in screen time. Parental cognitive factors (self-efficacy, attitudes, barriers, descriptive norms) at the interpersonal level explained a large portion (37.9%) of this variance. Conclusions A large proportion of screen time in pre-school children was explained by factors within the home setting. Parental cognitive factors at the interpersonal level were of particular relevance. These findings suggest that interventions aiming to foster appropriate screen time habits in pre-school children may be most effective if they target parents for behavioral change. PMID:22823887

Colorectal cancer screening in Korean workers: using a stage model approach to examine the ecological predictors of behavior.

PubMed

Park, Su Ho; Kim, Gwang Suk

2014-01-01

Early detection is important for reducing mortality by colorectal cancer. Workplaces have access to a large number of people, approximately half of the Korean population. For cancer prevention, it is necessary to approach cancer screening through the workplace. In this cross-sectional study, we aimed to identify colorectal cancer screening (CRCS) stages and to predict factors that affect the respective stages. Data were collected from 314 manual workers at 32 medium-sized and small workplaces located in Korea. The dependent variable was the stage of CRCS, and independent variables were intrapersonal, interpersonal, and organizational levels. At the intrapersonal level, workers who increased work hours per week or who felt stress were less likely to be in the acting/maintenance stage than in the decided to act stage of CRCS. At the organizational level, workers in medium-sized workplaces, those whose administrators secured health checkup and cancer screening budget for their workplace, and those considering health checkup and cancer screening were more likely to be in the acting/maintenance stage, compared with the decided to act stage. Our findings suggest that the respective stages are affected by different intrapersonal, interpersonal, and organizational factors. The workplace environment and organizational predictors before the implementation of CRCS promotion programs may produce better results.

3D geometric modeling and simulation of laser propagation through turbulence with plenoptic functions

NASA Astrophysics Data System (ADS)

Wu, Chensheng; Nelson, William; Davis, Christopher C.

2014-10-01

Plenoptic functions are functions that preserve all the necessary light field information of optical events. Theoretical work has demonstrated that geometric based plenoptic functions can serve equally well in the traditional wave propagation equation known as the "scalar stochastic Helmholtz equation". However, in addressing problems of 3D turbulence simulation, the dominant methods using phase screen models have limitations both in explaining the choice of parameters (on the transverse plane) in real-world measurements, and finding proper correlations between neighboring phase screens (the Markov assumption breaks down). Though possible corrections to phase screen models are still promising, the equivalent geometric approach based on plenoptic functions begins to show some advantages. In fact, in these geometric approaches, a continuous wave problem is reduced to discrete trajectories of rays. This allows for convenience in parallel computing and guarantees conservation of energy. Besides the pairwise independence of simulated rays, the assigned refractive index grids can be directly tested by temperature measurements with tiny thermoprobes combined with other parameters such as humidity level and wind speed. Furthermore, without loss of generality one can break the causal chain in phase screen models by defining regional refractive centers to allow rays that are less affected to propagate through directly. As a result, our work shows that the 3D geometric approach serves as an efficient and accurate method in assessing relevant turbulence problems with inputs of several environmental measurements and reasonable guesses (such as Cn 2 levels). This approach will facilitate analysis and possible corrections in lateral wave propagation problems, such as image de-blurring, prediction of laser propagation over long ranges, and improvement of free space optic communication systems. In this paper, the plenoptic function model and relevant parallel algorithm computing will be presented, and its primary results and applications are demonstrated.

Endotoxin molecule lipopolysaccharide-induced zebrafish inflammation model: a novel screening method for anti-inflammatory drugs.

PubMed

Yang, Li-Ling; Wang, Guo-Quan; Yang, Li-Mei; Huang, Zhi-Bing; Zhang, Wen-Qing; Yu, Lin-Zhong

2014-02-21

Lipopolysaccharide (LPS), an endotoxin molecule, has been used to induce inflammatory responses. In this study, LPS was used to establish an in vivo inflammation model in zebrafish for drug screening. We present an experimental method that conveniently and rapidly assesses the anti-inflammatory properties of drugs. The yolks of 3-day post-fertilization (dpf) larvae were injected with 0.5 mg/mL LPS to induce fatal inflammation. After LPS stimulation, macrophages were tracked by NR and SB staining and neutrophil migration was observed using the MPO:GFP line. Larval mortality was used as the primary end-point. Expression levels of key cytokines involved in the inflammatory response including IL-1β, IL-6, and TNF-α, were measured using quantitative reverse transcription polymerase chain reaction (RT-PCR). Macrophages and neutrophils were both recruited to the LPS-injected site during the inflammatory response. Mortality was increased by LPS in a dose-dependent manner within 48 h. Analyses of IL-1β, IL-6, and TNF-α expression levels revealed the upregulation of the inflammatory response in the LPS-injected larvae. Further, the anti-inflammatory activity of chlorogenic acid (CA) was evaluated in this zebrafish model to screen for anti-inflammatory drugs. A preliminary result showed that CA revealed a similar effect as the corticosteroid dexamethasone (DEX), which was used as a positive control, by inhibiting macrophage and neutrophil recruitment to the LPS site and improving survival. Our results suggest that this zebrafish screening model could be applied to study inflammation-mediated diseases. Moreover, the Traditional Chinese Medicine CA displays potential anti-inflammatory activity.

Implementation challenges and successes of a population-based colorectal cancer screening program: a qualitative study of stakeholder perspectives.

PubMed

Liles, Elizabeth G; Schneider, Jennifer L; Feldstein, Adrianne C; Mosen, David M; Perrin, Nancy; Rosales, Ana Gabriela; Smith, David H

2015-03-29

Few studies describe system-level challenges or facilitators to implementing population-based colorectal cancer (CRC) screening outreach programs. Our qualitative study explored viewpoints of multilevel stakeholders before, during, and after implementation of a centralized outreach program. Program implementation was part of a broader quality-improvement initiative. During 2008-2010, we conducted semi-structured, open-ended individual interviews and focus groups at Kaiser Permanente Northwest (KPNW), a not-for-profit group model health maintenance organization using the practical robust implementation and sustainability model to explore external and internal barriers to CRC screening. We interviewed 55 stakeholders: 8 health plan leaders, 20 primary care providers, 4 program managers, and 23 endoscopy specialists (15 gastroenterologists, 8 general surgeons), and analyzed interview transcripts to identify common as well as divergent opinions expressed by stakeholders. The majority of stakeholders at various levels consistently reported that an automated telephone-reminder system to contact patients and coordinate mailing fecal tests alleviated organizational constraints on staff's time and resources. Changing to a single-sample fecal immunochemical test (FIT) lessened patient and provider concerns about feasibility and accuracy of fecal testing. The centralized telephonic outreach program did, however, result in some screening duplication and overuse. Higher rates of FIT completion and a higher proportion of positive results with FIT required more colonoscopies. Addressing barriers at multiple levels of a health system by changing the delivery system design to add a centralized outreach program, switching to a more accurate and easier-to-use fecal test, and providing educational and electronic support had both benefits and problematic consequences. Other health care organizations can use our results to understand the complexities of implementing centralized screening programs.

Generic Degraded Congiguration Probability Analysis for DOE Codisposal Waste Package

DOE Office of Scientific and Technical Information (OSTI.GOV)

S.F.A. Deng; M. Saglam; L.J. Gratton

2001-05-23

In accordance with the technical work plan, ''Technical Work Plan For: Department of Energy Spent Nuclear Fuel Work Packages'' (CRWMS M&O 2000c), this Analysis/Model Report (AMR) is developed for the purpose of screening out degraded configurations for U.S. Department of Energy (DOE) spent nuclear fuel (SNF) types. It performs the degraded configuration parameter and probability evaluations of the overall methodology specified in the ''Disposal Criticality Analysis Methodology Topical Report'' (YMP 2000, Section 3) to qualifying configurations. Degradation analyses are performed to assess realizable parameter ranges and physical regimes for configurations. Probability calculations are then performed for configurations characterized by k{submore » eff} in excess of the Critical Limit (CL). The scope of this document is to develop a generic set of screening criteria or models to screen out degraded configurations having potential for exceeding a criticality limit. The developed screening criteria include arguments based on physical/chemical processes and probability calculations and apply to DOE SNF types when codisposed with the high-level waste (HLW) glass inside a waste package. The degradation takes place inside the waste package and is long after repository licensing has expired. The emphasis of this AMR is on degraded configuration screening and the probability analysis is one of the approaches used for screening. The intended use of the model is to apply the developed screening criteria to each DOE SNF type following the completion of the degraded mode criticality analysis internal to the waste package.« less

Geographic variation and effect of area-level poverty rate on colorectal cancer screening.

PubMed

Lian, Min; Schootman, Mario; Yun, Shumei

2008-10-16

With a secular trend of increasing colorectal cancer (CRC) screening, concerns about disparities in CRC screening also have been rising. It is unclear if CRC screening varies geographically, if area-level poverty rate affects CRC screening, and if individual-level characteristics mediate the area-level effects on CRC screening. Using 2006 Missouri Behavioral Risk Factor Surveillance System (BRFSS) data, a multilevel study was conducted to examine geographic variation and the effect of area-level poverty rate on CRC screening use among persons age 50 or older. Individuals were nested within ZIP codes (ZIP5 areas), which in turn, were nested within aggregations of ZIP codes (ZIP3 areas). Six groups of individual-level covariates were considered as potential mediators. An estimated 51.8% of Missourians aged 50 or older adhered to CRC screening recommendations. Nearly 15% of the total variation in CRC screening lay between ZIP5 areas. Persons residing in ZIP5 areas with > or = 10% of poverty rate had lower odds of CRC screening use than those residing in ZIP5 areas with <10% poverty rate (unadjusted odds ratio [OR], 0.69; 95% confidence interval [95% CI], 0.58-0.81; adjusted OR, 0.81; 95% CI, 0.67-0.98). Persons who resided in ZIP3 areas with > or = 20% poverty rate also had lower odds of following CRC screening guidelines than those residing in ZIP3 areas with <20% poverty rate (unadjusted OR, 0.66; 95% CI, 0.52-0.83; adjusted OR, 0.64; 95% CI, 0.50-0.83). Obesity, history of depression/anxiety and access to care were associated with CRC screening, but did not mediate the effect of area-level poverty on CRC screening. Large geographic variation of CRC screening exists in Missouri. Area-level poverty rate, independent of individual-level characteristics, is a significant predictor of CRC screening, but it only explains a small portion of the geographic heterogeneity of CRC screening. Individual-level factors we examined do not mediate the effect of the area-level poverty rate on CRC screening. Future studies should identify other area- and individual-level characteristics associated with CRC screening in Missouri.

An Electronic Health Record Data-driven Model for Identifying Older Adults at Risk of Unintentional Falls

PubMed Central

Baus, Adam; Coben, Jeffrey; Zullig, Keith; Pollard, Cecil; Mullett, Charles; Taylor, Henry; Cochran, Jill; Jarrett, Traci; Long, Dustin

2017-01-01

Screening for risk of unintentional falls remains low in the primary care setting because of the time constraints of brief office visits. National studies suggest that physicians caring for older adults provide recommended fall risk screening only 30 to 37 percent of the time. Given prior success in developing methods for repurposing electronic health record data for the identification of fall risk, this study involves building a model in which electronic health record data could be applied for use in clinical decision support to bolster screening by proactively identifying patients for whom screening would be beneficial and targeting efforts specifically to those patients. The final model, consisting of priority and extended measures, demonstrates moderate discriminatory power, indicating that it could prove useful in a clinical setting for identifying patients at risk of falls. Focus group discussions reveal important contextual issues involving the use of fall-related data and provide direction for the development of health systems–level innovations for the use of electronic health record data for fall risk identification. PMID:29118679

Incremental Value of Repeated Risk Factor Measurements for Cardiovascular Disease Prediction in Middle-Aged Korean Adults: Results From the NHIS-HEALS (National Health Insurance System-National Health Screening Cohort).

PubMed

Cho, In-Jeong; Sung, Ji Min; Chang, Hyuk-Jae; Chung, Namsik; Kim, Hyeon Chang

2017-11-01

Increasing evidence suggests that repeatedly measured cardiovascular disease (CVD) risk factors may have an additive predictive value compared with single measured levels. Thus, we evaluated the incremental predictive value of incorporating periodic health screening data for CVD prediction in a large nationwide cohort with periodic health screening tests. A total of 467 708 persons aged 40 to 79 years and free from CVD were randomly divided into development (70%) and validation subcohorts (30%). We developed 3 different CVD prediction models: a single measure model using single time point screening data; a longitudinal average model using average risk factor values from periodic screening data; and a longitudinal summary model using average values and the variability of risk factors. The development subcohort included 327 396 persons who had 3.2 health screenings on average and 25 765 cases of CVD over 12 years. The C statistics (95% confidence interval [CI]) for the single measure, longitudinal average, and longitudinal summary models were 0.690 (95% CI, 0.682-0.698), 0.695 (95% CI, 0.687-0.703), and 0.752 (95% CI, 0.744-0.760) in men and 0.732 (95% CI, 0.722-0.742), 0.735 (95% CI, 0.725-0.745), and 0.790 (95% CI, 0.780-0.800) in women, respectively. The net reclassification index from the single measure model to the longitudinal average model was 1.78% in men and 1.33% in women, and the index from the longitudinal average model to the longitudinal summary model was 32.71% in men and 34.98% in women. Using averages of repeatedly measured risk factor values modestly improves CVD predictability compared with single measurement values. Incorporating the average and variability information of repeated measurements can lead to great improvements in disease prediction. URL: https://www.clinicaltrials.gov. Unique identifier: NCT02931500. © 2017 American Heart Association, Inc.

Inference on cancer screening exam accuracy using population-level administrative data.

PubMed

Jiang, H; Brown, P E; Walter, S D

2016-01-15

This paper develops a model for cancer screening and cancer incidence data, accommodating the partially unobserved disease status, clustered data structures, general covariate effects, and dependence between exams. The true unobserved cancer and detection status of screening participants are treated as latent variables, and a Markov Chain Monte Carlo algorithm is used to estimate the Bayesian posterior distributions of the diagnostic error rates and disease prevalence. We show how the Bayesian approach can be used to draw inferences about screening exam properties and disease prevalence while allowing for the possibility of conditional dependence between two exams. The techniques are applied to the estimation of the diagnostic accuracy of mammography and clinical breast examination using data from the Ontario Breast Screening Program in Canada. Copyright © 2015 John Wiley & Sons, Ltd.

78 FR 3328 - Fluroxypyr; Pesticide Tolerances

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-16

... drinking water and in residential settings, but does not include occupational exposure. Section 408(b)(2)(C... from drinking water. The Agency used screening level water exposure models in the dietary exposure analysis and risk assessment for fluroxypyr in drinking water. These simulation models take into account...

Cost-effectiveness of prenatal screening strategies for congenital heart disease.

PubMed

Pinto, N M; Nelson, R; Puchalski, M; Metz, T D; Smith, K J

2014-07-01

The economic implications of strategies to improve prenatal screening for congenital heart disease (CHD) in low-risk mothers have not been explored. The aim was to perform a cost-effectiveness analysis of different screening methods. We constructed a decision analytic model of CHD prenatal screening strategies (four-chamber screen (4C), 4C + outflow, nuchal translucency (NT) or fetal echocardiography) populated with probabilities from the literature. The model included whether initial screens were interpreted by a maternal-fetal medicine (MFM) specialist and different referral strategies if they were read by a non-MFM specialist. The primary outcome was the incremental cost per defect detected. Costs were obtained from Medicare National Fee estimates. A probabilistic sensitivity analysis was undertaken on model variables commensurate with their degree of uncertainty. In base-case analysis, 4C + outflow referred to an MFM specialist was the least costly strategy per defect detected. The 4C screen and the NT screen were dominated by other strategies (i.e. were more costly and less effective). Fetal echocardiography was the most effective, but most costly. On simulation of 10 000 low-risk pregnancies, 4C + outflow screen referred to an MFM specialist remained the least costly per defect detected. For an additional $580 per defect detected, referral to cardiology after a 4C + outflow was the most cost-effective for the majority of iterations, increasing CHD detection by 13 percentage points. The addition of examination of the outflow tracts to second-trimester ultrasound increases detection of CHD in the most cost-effective manner. Strategies to improve outflow-tract imaging and to refer with the most efficiency may be the best way to improve detection at a population level. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

Relationship between Legible Handwriting and Level of Success of Third Grade Students in Written Expression

ERIC Educational Resources Information Center

Bayat, Seher; Küçükayar, Hasan

2016-01-01

This study aims to identify third-grade students' performance levels for written expression and handwriting and to find the relationship between these performances. The study is based on relational screening model. It is carried out with 110 third grade students. Students' levels of success in handwriting and in written expression are evaluated…

Analyzing the Classroom Teachers' Levels of Creating a Constructivist Learning Environments in Terms of Various Variables: A Mersin Case

ERIC Educational Resources Information Center

Üredi, Lütfi

2014-01-01

In this research, it was aimed to analyze the classroom teachers' level of creating a constructivist learning environment in terms of various variables. For that purpose, relational screening model was used in the research. Classroom teachers' level of creating a constructivist learning environment was determined using the "constructivist…

Predictors of heart failure self-care in patients who screened positive for mild cognitive impairment.

PubMed

Davis, Karen K; Himmelfarb, Cheryl R Dennison; Szanton, Sarah L; Hayat, Matthew J; Allen, Jerilyn K

2015-01-01

Heart failure (HF) is associated with cognitive impairment, which could negatively affect a patient's abilities to carry out self-care, potentially resulting in higher hospital readmission rates. Factors associated with self-care in patients experiencing mild cognitive impairment (MCI) are not known. This descriptive correlation study aimed to assess levels of HF self-care and knowledge and to determine the predictors of self-care in HF patients who screen positive for MCI. The Montreal Cognitive Assessment was used to screen for MCI. In 125 patients with MCI hospitalized with HF, self-care (Self-care of Heart Failure Index) and HF knowledge (Dutch Heart Failure Knowledge Scale) were assessed. We used multiple regression analysis to test a model of variables hypothesized to predict self-care maintenance, management, and confidence. Mean (SD) HF knowledge scores (11.24 [1.84]) were above the level considered to be adequate (defined as >10). Mean (SD) scores for self-care maintenance (63.57 [19.12]), management (68.35 [20.24]), and confidence (64.99 [16.06]) were consistent with inadequate self-care (defined as scores <70). In multivariate analysis, HF knowledge, race, greater disease severity, and social support explained 22% of the variance in self-care maintenance (P < .001); age, education level, and greater disease severity explained 19% of the variance in self-care management (P < .001); and younger age and higher social support explained 20% of the variance in self-care confidence scores (P < .001). Blacks, on average, scored significantly lower in self-care maintenance (P = .03). In this sample, patients who screened positive for MCI, on average, had adequate HF knowledge yet inadequate self-care scores. These models show the influence of modifiable and nonmodifiable predictors for patients who screened positive for MCI across the domains of self-care. Health professionals should consider screening for MCI and identifying interventions that address HF knowledge and social support. Further research is needed to explain the racial differences in self-care.

Using Weighted Entropy to Rank Chemicals in Quantitative High Throughput Screening Experiments

PubMed Central

Shockley, Keith R.

2014-01-01

Quantitative high throughput screening (qHTS) experiments can simultaneously produce concentration-response profiles for thousands of chemicals. In a typical qHTS study, a large chemical library is subjected to a primary screen in order to identify candidate hits for secondary screening, validation studies or prediction modeling. Different algorithms, usually based on the Hill equation logistic model, have been used to classify compounds as active or inactive (or inconclusive). However, observed concentration-response activity relationships may not adequately fit a sigmoidal curve. Furthermore, it is unclear how to prioritize chemicals for follow-up studies given the large uncertainties that often accompany parameter estimates from nonlinear models. Weighted Shannon entropy can address these concerns by ranking compounds according to profile-specific statistics derived from estimates of the probability mass distribution of response at the tested concentration levels. This strategy can be used to rank all tested chemicals in the absence of a pre-specified model structure or the approach can complement existing activity call algorithms by ranking the returned candidate hits. The weighted entropy approach was evaluated here using data simulated from the Hill equation model. The procedure was then applied to a chemical genomics profiling data set interrogating compounds for androgen receptor agonist activity. PMID:24056003

Chlamydia screening is not cost-effective at low participation rates: evidence from a repeated register-based implementation study in The Netherlands.

PubMed

de Wit, G Ardine; Over, Eelco A B; Schmid, Boris V; van Bergen, Jan E A M; van den Broek, Ingrid V F; van der Sande, Marianne A B; Welte, Robert; Op de Coul, Eline L M; Kretzschmar, Mirjam E

2015-09-01

In three pilot regions of The Netherlands, all 16-29 year olds were invited to participate in three annual rounds of Chlamydia screening. The aim of the present study is to evaluate the cost-effectiveness of repeated Chlamydia screening, based on empirical data. A mathematical model was employed to estimate the influence of repeated screening on prevalence and incidence of Chlamydial infection. A model simulating the natural history of Chlamydia was combined with cost and utility data to estimate the number of major outcomes and quality-adjusted life-years (QALYs) associated with Chlamydia. Six screening scenarios (16-29 years annually; 16-24 years annually; women only; biennial screening; biennial screening women only; screening every five years) were compared with no screening in two sexual networks, representing both lower ('national network') and higher ('urban network') baseline prevalence. Incremental cost-effectiveness ratios (ICERs) for the different screening scenarios were estimated. Uncertainty and sensitivity analyses were performed. In all scenarios and networks, cost per major outcome averted are above €5000. Cost per QALY are at least €50,000. The default scenario as piloted in the Netherlands was least cost-effective, with ICERs of €232,000 in the national and €145,000 in the urban sexual network. Results were robust in sensitivity analyses. It is unlikely that repeated rounds of Chlamydia screening will be cost-effective. Only at high levels of willingness to pay for a QALY (>€50,000) screening may be more cost-effective than no screening. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Socioeconomic and Physician Supply Determinants of Racial Disparities in Colorectal Cancer Screening

PubMed Central

Soneji, Samir; Armstrong, Katrina; Asch, David A.

2012-01-01

Purpose: Causes of racial disparities in colorectal cancer (CRC) screening may extend beyond individual-level characteristics. We examined how physician density, beyond socioeconomic factors, affected observed racial disadvantages in recent CRC screening for blacks and Hispanics. Methods: We obtained socioeconomic and CRC screening information on adults age ≥ 50 years from the Behavioral Risk Factor Surveillance System (1997 to 2008) and information on the number of primary care physicians and gastroenterologists from the American Medical Association Masterfile (1997 to 2008). We used fixed-effect multivariate logistic regression to model the probability of receiving a fecal occult blood test within the past year or endoscopic screening within the past 5 years as a function of individual-level socioeconomic factors and state-level physician supply. Results: In 2008, 60.6% of whites were current on CRC screening (95% CI, 60.6% to 61.0%) compared with 57.9% of blacks (95% CI, 56.7% to 59.2%) and 42.9% of Hispanics (95% CI, 41.0% to 44.8%). Inclusion of socioeconomic variables reversed black-white disparities (odds ratio [OR], 1.17; 95% CI, 1.15 to 1.19) but did not explain disadvantage for Hispanics (OR, 0.89; 95% CI, 0.87 to 0.92). Once interaction of race and physician supply was considered, likelihood of recent CRC screening became statistically indistinguishable for Hispanics and whites of similar socioeconomic status residing in states with high physician supplies. Conclusion: Socioeconomic factors and physician supply are key predictors of CRC screening. Adjustment for socioeconomic determinants explained black-white disparities; further adjustment for physician supply explained Hispanic-white disparities. Physician distribution is a potentially remediable contributor to ethnic/racial disparities in CRC screening. Whether the United States is able to equitably meet future demand for screening may depend on access, physician supply, and organization of the health care system. PMID:23277775

Socioeconomic and physician supply determinants of racial disparities in colorectal cancer screening.

PubMed

Soneji, Samir; Armstrong, Katrina; Asch, David A

2012-09-01

Causes of racial disparities in colorectal cancer (CRC) screening may extend beyond individual-level characteristics. We examined how physician density, beyond socioeconomic factors, affected observed racial disadvantages in recent CRC screening for blacks and Hispanics. We obtained socioeconomic and CRC screening information on adults age ≥ 50 years from the Behavioral Risk Factor Surveillance System (1997 to 2008) and information on the number of primary care physicians and gastroenterologists from the American Medical Association Masterfile (1997 to 2008). We used fixed-effect multivariate logistic regression to model the probability of receiving a fecal occult blood test within the past year or endoscopic screening within the past 5 years as a function of individual-level socioeconomic factors and state-level physician supply. In 2008, 60.6% of whites were current on CRC screening (95% CI, 60.6% to 61.0%) compared with 57.9% of blacks (95% CI, 56.7% to 59.2%) and 42.9% of Hispanics (95% CI, 41.0% to 44.8%). Inclusion of socioeconomic variables reversed black-white disparities (odds ratio [OR], 1.17; 95% CI, 1.15 to 1.19) but did not explain disadvantage for Hispanics (OR, 0.89; 95% CI, 0.87 to 0.92). Once interaction of race and physician supply was considered, likelihood of recent CRC screening became statistically indistinguishable for Hispanics and whites of similar socioeconomic status residing in states with high physician supplies. Socioeconomic factors and physician supply are key predictors of CRC screening. Adjustment for socioeconomic determinants explained black-white disparities; further adjustment for physician supply explained Hispanic-white disparities. Physician distribution is a potentially remediable contributor to ethnic/racial disparities in CRC screening. Whether the United States is able to equitably meet future demand for screening may depend on access, physician supply, and organization of the health care system.

Breast cancer screening utilization among women from Muslim majority countries in Ontario, Canada.

PubMed

Vahabi, Mandana; Lofters, Aisha; Kim, Eliane; Wong, Josephine Pui-Hing; Ellison, Lisa; Graves, Erin; Glazier, Richard H

2017-12-01

Breast cancer screening disparities continue to prevail with immigrant women being at the forefront of the under screened population. There is a paucity of knowledge about the role of religious affiliation or cultural orientation on immigrant women's cancer screening uptake. This study examined differences in uptake of breast cancer screening among women from Muslim and non- Muslim majority countries in Ontario, Canada. A cohort of 1,851,834 screening-eligible women living in Ontario during April 1, 2013 to March 31, 2015 was created using linked health and social administrative databases. The study found that being born in a Muslim majority country was associated with lower breast cancer screening uptake after adjusting for region of origin, neighbourhood income, and primary care-related factors. However, screening uptake in Muslim majority countries varied by world region with the greatest differences found in Sub-Saharan Africa and South Asia. Screening uptake was lower for women who had no primary care provider, were in a traditional fee-for service model of primary care, had a male physician, had an internationally trained physician, resided in a low income neighbourhood, and entered Canada under the family class of immigration. Religion may play a role in screening uptake, however, the variation in rates by regions of origin, immigration class, and access to primary care providers alludes to confluence of socio-demographic, cultural beliefs and practices, immigration trajectories and system level factors. Facilitating access for immigrant women to regular primary care providers, particularly female providers and enrollment in primary care models could enhance screening uptake. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of large magnetic islands on screening of external magnetic perturbation fields at slow plasma flow

NASA Astrophysics Data System (ADS)

Li, L.; Liu, Y. Q.; Huang, X.; Luan, Q.; Zhong, F. C.

2017-02-01

A toroidal resistive magneto-hydrodynamic plasma response model, involving large magnetic islands, is proposed and numerically investigated, based on local flattening of the equilibrium pressure profile near a rational surface. It is assumed that such islands can be generated near the edge of the tokamak plasma, due to the penetration of the resonant magnetic perturbations, used for the purpose of controlling the edge localized mode. Within this model, it is found that the local flattening of the equilibrium pressure helps to mitigate the toroidal curvature induced screening effect [Glasser et al., Phys. Fluids 7, 875 (1975)]—the so called Glasser-Greene-Johnson screening, when the local toroidal flow near the mode rational surface is very slow (for example, as a result of mode locking associated with the field penetration). The saturation level of the plasma response amplitude is computed, as the plasma rotation frequency approaches zero. The local modification of the plasma resistivity inside the magnetic island is found to also affect the saturation level of the plasma response at vanishing flow.

Prevalence of Failure due to Adverse Reaction to Metal Debris in Modern, Medium and Large Diameter Metal-on-Metal Hip Replacements – The Effect of Novel Screening Methods: Systematic Review and Metaregression Analysis

PubMed Central

Reito, Aleksi; Lainiala, Olli; Elo, Petra; Eskelinen, Antti

2016-01-01

Metal-on-metal (MoM) hip replacements were used for almost a decade before adverse reactions to metal debris (ARMD) were found to be a true clinical problem. Currently, there is a paucity of evidence regarding the usefulness of systematic screening for ARMD. We implemented a systematic review and meta-analysis to establish the prevalence of revision confirmed ARMD stratified by the use of different screening protocols in patients with MoM hip replacements. Five levels of screening were identified: no screening (level 0), targeted blood metal ion measurement and/or cross-sectional imaging (level 1), metal ion measurement without imaging (level 2), metal ion measurement with targeted imaging (level 3) and comprehensive screening (both metal ions and imaging for all; level 4). 122 studies meeting our eligibility criteria were included in analysis. These studies included 144 study arms: 100 study arms with hip resurfacings, 33 study arms with large-diameter MoM total hip replacements (THR), and 11 study arms with medium-diameter MoM THRs. For hip resurfacing, the lowest prevalence of ARMD was seen with level 0 screening (pooled prevalence 0.13%) and the highest with level 4 screening (pooled prevalace 9.49%). Pooled prevalence of ARMD with level 0 screening was 0.29% and with level 4 screening 21.3% in the large-diameter MoM THR group. In metaregression analysis of hip resurfacings, level 4 screening was superior with regard to prevalence of ARMD when compared with other levels. In the large diameter THR group level 4 screening was superior to screening 0,2 and 3. These outcomes were irrespective of follow-up time or study publication year. With hip resurfacings, routine cross-sectional imaging regardless of clinical findings is advisable. It is clear, however, that targeted metal ion measurement and/or imaging is not sufficient in the screening for ARMD in any implant concepts. However, economic aspects should be weighed when choosing the preferred screening level. PMID:26930057

A QSAR Model for Thyroperoxidase Inhibition and Screening of a Large Set of Environmental Chemicals (SOT)

EPA Science Inventory

Thyroid hormones (THs) are critical modulators of a wide range of biological processes from neurodevelopment to metabolism. Well regulated levels of THs are critical during development and even moderate changes in maternal or fetal TH levels produce irreversible neurological defi...

77 FR 26954 - 1-Naphthaleneacetic acid; Pesticide Tolerances

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-08

... for which there is reliable information.'' This includes exposure through drinking water and in... exposure from drinking water. The Agency used screening level water exposure models in the dietary exposure analysis and risk assessment for NAA in drinking water. These simulation models take into account data on...

Severity of iron overload of proband determines serum ferritin levels in families with HFE-related hemochromatosis: the HEmochromatosis FAmily Study.

PubMed

Jacobs, Esther M G; Hendriks, Jan C M; van Deursen, Cees Th B M; Kreeftenberg, Herman G; de Vries, Richard A; Marx, Joannes J M; Stalenhoef, Anton F H; Verbeek, André L M; Swinkels, Dorine W

2009-01-01

In families of patients with clinically detected hereditary hemochromatosis (HH) early screening has been suggested to prevent morbidity and mortality. Here, we aim to identify determinants for iron overload in first-degree family members of C282Y homozygous probands with clinically detected HH. Data on HFE-genotype, iron parameters, demographics, lifestyle factors and health, were collected from 224 Dutch C282Y homozygous patients with clinically diagnosed HH and 735 of their first-degree family members (FDFM), all participating in the HEmochromatosis FAmily Study (HEFAS). The best predictive multivariable model forecasted 45% of variation of the serum ferritin levels. In this model severity of iron overload in the proband significantly predicted serum ferritin levels in FDFM. Other significant determinants in this model consisted of C282Y homozygosity, compound heterozygosity, age at testing for serum ferritin and supplemental iron intake, whereas a low body mass index showed a protective effect. This study provides a model to assess the risk of development of iron overload for relatives of probands with HH. These results might be instrumental in the development of an optimal strategy for future family screening programs.

Do HMO market level factors lead to racial/ethnic disparities in colorectal cancer screening? A comparison between high-risk Asian and Pacific Islander Americans and high-risk whites.

PubMed

Ponce, Ninez A; Huh, Soonim; Bastani, Roshan

2005-11-01

Few studies have explored health care market structure and colorectal cancer (CRC) screening test use, and little is known whether market factors contribute to racial/ethnic screening disparities. We investigated whether HMO market level factors, controlling for individual covariates, differentially impact Asian American and Pacific Islander (AAPI) subjects' access to CRC screening compared with white subjects. We used random intercept hierarchical models to predict CRC test use. Individual-level survey data was linked to market data by metropolitan statistical areas from InterStudy. Insured first-degree relatives, ages 40-80, of a random sample of colorectal cancer cases identified from the California Cancer Registry: 515 white subjects and 396 AAPI subjects residing in 36 metropolitan statistical areas (MSAs). Dependent variables were receipt of (1) annual fecal occult blood test only; (2) sigmoidoscopy in the past 5 years; (3) colonoscopy in the past 10 years; and (4) any of these tests over the recommended time interval. Market characteristics were HMO penetration, HMO competition, and proportion of staff/group/network HMOs. Market characteristics were as important as individual-level characteristics for AAPI but not for white subjects. Among AAPI subjects, a 10% increase in the percent of group/staff/network model HMO was associated with a reduction in colonoscopy use (28.9% to 20.5%) and in receipt of any of the CRC tests (53.2% to 45.4%). The prevailing organizational structure of a health care market confers a penalty on access to CRC test use among high-risk AAPI subjects but not among high-risk white subjects. Identifying the differential effect of market structure on race/ethnicity can potentially reduce the cancer burden among disadvantaged racial groups.

Which strategies reduce breast cancer mortality most? Collaborative modeling of optimal screening, treatment, and obesity prevention.

PubMed

Mandelblatt, Jeanne; van Ravesteyn, Nicolien; Schechter, Clyde; Chang, Yaojen; Huang, An-Tsun; Near, Aimee M; de Koning, Harry; Jemal, Ahmedin

2013-07-15

US breast cancer mortality is declining, but thousands of women still die each year. Two established simulation models examine 6 strategies that include increased screening and/or treatment or elimination of obesity versus continuation of current patterns. The models use common national data on incidence and obesity prevalence, competing causes of death, mammography characteristics, treatment effects, and survival/cure. Parameters are modified based on obesity (defined as BMI  ≥  30 kg/m(2) ). Outcomes are presented for the year 2025 among women aged 25+ and include numbers of cases, deaths, mammograms and false-positives; age-adjusted incidence and mortality; breast cancer mortality reduction and deaths averted; and probability of dying of breast cancer. If current patterns continue, the models project that there would be about 50,100-57,400 (range across models) annual breast cancer deaths in 2025. If 90% of women were screened annually from ages 40 to 54 and biennially from ages 55 to 99 (or death), then 5100-6100 fewer deaths would occur versus current patterns, but incidence, mammograms, and false-positives would increase. If all women received the indicated systemic treatment (with no screening change), then 11,400-14,500 more deaths would be averted versus current patterns, but increased toxicity could occur. If 100% received screening plus indicated therapy, there would be 18,100-20,400 fewer deaths. Eliminating obesity yields 3300-5700 fewer breast cancer deaths versus continuation of current obesity levels. Maximal reductions in breast cancer deaths could be achieved through optimizing treatment use, followed by increasing screening use and obesity prevention. © 2013 American Cancer Society.

Go big or go home: impact of screening coverage on syphilis infection dynamics.

PubMed

Tuite, Ashleigh; Fisman, David

2016-02-01

Syphilis outbreaks in urban men who have sex with men (MSM) are an ongoing public health challenge in many high-income countries, despite intensification of efforts to screen and treat at-risk individuals. We sought to understand how population-level coverage of asymptomatic screening impacts the ability to control syphilis transmission. We developed a risk-structured deterministic compartmental mathematical model of syphilis transmission in a population of sexually active MSM. We assumed a baseline level of treatment of syphilis cases due to seeking medical care in all scenarios. We evaluated the impact of sustained annual population-wide screening coverage ranging from 0% to 90% on syphilis incidence over the short term (20 years) and at endemic equilibrium. The relationship between screening coverage and equilibrium syphilis incidence displayed an inverted U-shape relationship, with peak equilibrium incidence occurring with 20-30% annual screening coverage. Annual screening of 62% of the population was required for local elimination (incidence <1 case per 100 000 population). Results were qualitatively similar in the face of differing programmatic, behavioural and natural history assumptions, although the screening thresholds for local elimination differed. With 6-monthly or 3-monthly screening, the population coverage required to achieve local elimination was reduced to 39% or 23%, respectively. Although screening has the potential to control syphilis outbreaks, suboptimal coverage may paradoxically lead to a higher equilibrium infection incidence than that observed in the absence of intervention. Suboptimal screening programme design should be considered as a possible contributor to unsuccessful syphilis control programmes in the context of the current epidemic. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

DOE Office of Scientific and Technical Information (OSTI.GOV)

M. L. Abbott; K. N. Keck; R. E. Schindler

This screening level risk assessment evaluates potential adverse human health and ecological impacts resulting from continued operations of the calciner at the New Waste Calcining Facility (NWCF) at the Idaho Nuclear Technology and Engineering Center (INTEC), Idaho National Engineering and Environmental Laboratory (INEEL). The assessment was conducted in accordance with the Environmental Protection Agency (EPA) report, Guidance for Performing Screening Level Risk Analyses at Combustion Facilities Burning Hazardous Waste. This screening guidance is intended to give a conservative estimate of the potential risks to determine whether a more refined assessment is warranted. The NWCF uses a fluidized-bed combustor to solidifymore » (calcine) liquid radioactive mixed waste from the INTEC Tank Farm facility. Calciner off volatilized metal species, trace organic compounds, and low-levels of radionuclides. Conservative stack emission rates were calculated based on maximum waste solution feed samples, conservative assumptions for off gas partitioning of metals and organics, stack gas sampling for mercury, and conservative measurements of contaminant removal (decontamination factors) in the off gas treatment system. Stack emissions were modeled using the ISC3 air dispersion model to predict maximum particulate and vapor air concentrations and ground deposition rates. Results demonstrate that NWCF emissions calculated from best-available process knowledge would result in maximum onsite and offsite health and ecological impacts that are less then EPA-established criteria for operation of a combustion facility.« less

Prediction of cervical cancer incidence in England, UK, up to 2040, under four scenarios: a modelling study.

PubMed

Castanon, Alejandra; Landy, Rebecca; Pesola, Francesca; Windridge, Peter; Sasieni, Peter

2018-01-01

In the next 25 years, the epidemiology of cervical cancer in England, UK, will change: human papillomavirus (HPV) screening will be the primary test for cervical cancer. Additionally, the proportion of women screened regularly is decreasing and women who received the HPV vaccine are due to attend screening for the first time. Therefore, we aimed to estimate how vaccination against HPV, changes to the screening test, and falling screening coverage will affect cervical cancer incidence in England up to 2040. We did a data modelling study that combined results from population modelling of incidence trends, observable data from the individual level with use of a generalised linear model, and microsimulation of unobservable disease states. We estimated age-specific absolute risks of cervical cancer in the absence of screening (derived from individual level data). We used an age period cohort model to estimate birth cohort effects. We multiplied the absolute risks by the age cohort effects to provide absolute risks of cervical cancer for unscreened women in different birth cohorts. We obtained relative risks (RRs) of cervical cancer by screening history (never screened, regularly screened, or lapsed attender) using data from a population-based case-control study for unvaccinated women, and using a microsimulation model for vaccinated women. RRs of primary HPV screening were relative to cytology. We used the proportion of women in each 5-year age group (25-29 years to 75-79 years) and 5-year period (2016-20 to 2036-40) who have a combination of screening and vaccination history, and weighted to estimate the population incidence. The primary outcome was the number of cases and rates per 100 000 women under four scenarios: no changes to current screening coverage or vaccine uptake and HPV primary testing from 2019 (status quo), changing the year in which HPV primary testing is introduced, introduction of the nine-valent vaccine, and changes to cervical screening coverage. The status quo scenario estimated that the peak age of cancer diagnosis will shift from the ages of 25-29 years in 2011-15 to 55-59 years in 2036-40. Unvaccinated women born between 1975 and 1990 were predicted to have a relatively high risk of cervical cancer throughout their lives. Introduction of primary HPV screening from 2019 could reduce age-standardised rates of cervical cancer at ages 25-64 years by 19%, from 15·1 in 2016 to 12·2 per 100 000 women as soon as 2028. Vaccination against HPV types 16 and 18 (HPV 16/18) could see cervical cancer rates in women aged 25-29 years decrease by 55% (from 20·9 in 2011-15 to 9·5 per 100 000 women by 2036-40), and introduction of nine-valent vaccination from 2019 compared with continuing vaccination against HPV 16/18 will reduce rates by a further 36% (from 9·5 to 6·1 per 100 000 women) by 2036-40. Women born before 1991 will not benefit directly from vaccination; therefore, despite vaccination and primary HPV screening with current screening coverage, European age-standardised rates of cervical cancer at ages 25-79 years will decrease by only 10% (from 12·8 in 2011-15 to 11·5 per 100 000 women in 2036-40). If screening coverage fell to 50%, European age-standardised rates could increase by 27% (from 12·8 to 16·3 per 100 000 by 2036-40). Going forward, focus should be placed on scenarios that offer less intensive screening for vaccinated women and more on increasing coverage and incorporation of new technologies to enhance current cervical screening among unvaccinated women. Jo's Cervical Cancer Trust and Cancer Research UK. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

An Evaluation of the Addition of Critical Congenital Heart Defect Screening in Georgia Newborn Screening Procedures.

PubMed

Rentmeester, Shelby T; Pringle, Johanna; Hogue, Carol R

2017-11-01

Objectives Each year in the U.S., approximately 7200 infants are born with a critical congenital heart defect (CCHD). The Georgia Department of Public Health (DPH) mandated routine screening for CCHD starting January 2015. The current study evaluated hospital performance of the mandated CCHD screenings in Georgia. Methods Utilizing the DPH newborn screening surveillance system, data from 6 months before and after the mandate were analyzed for reports submitted and positive CCHD screening results. Chi square tests of independence were performed to examine the association between reporting of results for CCHD screening after the mandate and hospital nursery level [level I (well-baby/newborn); level II (special care); level III (neonatal intensive care unit-NICU)] and NICU submissions. Results In the 6 months following implementation, reports of the screening increased, but the DPH had not received information for approximately 40% of newborns. Hospitals with level III nurseries had poorer reporting rates compared to hospitals with level I or II nurseries. Newborn screening (NBS) cards submitted by NICUs were less likely to contain the CCHD screening results compared to cards submitted by regular Labor and Delivery units. Conclusions for Practice Further attention should focus on improving both CCHD screening and reporting of screening results within hospitals with level III nurseries and from NICUs at all hospital levels. Identifying and addressing the root of the issue, whether it be hospital compliance with CCHD screening or reporting of the results, will help to improve screening rates for all newborns, especially those most vulnerable.

MODELING FLUX PATHWAYS TO VEGETATION FOR VOLATILE AND SEMI-VOLATILE ORGANIC COMPOUNDS IN A MULTIMEDIA ENVIRONMENT

EPA Science Inventory

This study evaluates the treatment of gas-phase atmospheric deposition in a screening level model of the multimedia environmental distribution of toxics (MEND-TOX). Recent algorithmic additions to MEND-TOX for the estimation of gas-phase deposition velocity over vegetated surf...

Framework for a Quantitative Systemic Toxicity Model (FutureToxII)

EPA Science Inventory

EPA’s ToxCast program profiles the bioactivity of chemicals in a diverse set of ~700 high throughput screening (HTS) assays. In collaboration with L’Oreal, a quantitative model of systemic toxicity was developed using no effect levels (NEL) from ToxRefDB for 633 chemicals with HT...

Web-based depression screening and psychiatric consultation for college students: a feasibility and acceptability study.

PubMed

Williams, Aya; Larocca, Rachel; Chang, Trina; Trinh, Nhi-Ha; Fava, Maurizio; Kvedar, Joseph; Yeung, Albert

2014-01-01

Background. A steady rise in the prevalence of depression among college students has negatively affected student quality of life. This study investigates the feasibility and acceptability of a Web-based model, including Skype, to screen and provide psychiatric consultation to depressed college students. Methods. Students completed the 9-item Patient Health Questionnaire (PHQ-9) online; those who screened positive (PHQ-9 ≥ 10) or endorsed any level of suicidal ideation were offered Web-based psychiatric consultation using Skype. After the consultation, students filled out a 7-item satisfaction questionnaire to report on the acceptability of this Web-based method. Results. A total of 972 students consented to the online depression screening and 285 screened positive. Of those, 69 students consented and 17 students successfully completed the psychiatric consultation via Skype. Thirteen (76.4%) students found the interview useful in helping them understand their depression. Fifteen (88.2%) students thought that psychologists and psychiatrists could successfully see patients via videoconferencing. Conclusions. Current online technologies can provide depression screening and psychiatric consultation to college students; those who participated reported a positive experience. Future studies will need to address the low levels of participation among college students and attract students who are underserved, as well as use a videoconferencing platform that adequately protects data confidentiality.

Web-Based Depression Screening and Psychiatric Consultation for College Students: A Feasibility and Acceptability Study

PubMed Central

Williams, Aya; LaRocca, Rachel; Chang, Trina; Trinh, Nhi-Ha; Fava, Maurizio

2014-01-01

Background. A steady rise in the prevalence of depression among college students has negatively affected student quality of life. This study investigates the feasibility and acceptability of a Web-based model, including Skype, to screen and provide psychiatric consultation to depressed college students. Methods. Students completed the 9-item Patient Health Questionnaire (PHQ-9) online; those who screened positive (PHQ-9 ≥ 10) or endorsed any level of suicidal ideation were offered Web-based psychiatric consultation using Skype. After the consultation, students filled out a 7-item satisfaction questionnaire to report on the acceptability of this Web-based method. Results. A total of 972 students consented to the online depression screening and 285 screened positive. Of those, 69 students consented and 17 students successfully completed the psychiatric consultation via Skype. Thirteen (76.4%) students found the interview useful in helping them understand their depression. Fifteen (88.2%) students thought that psychologists and psychiatrists could successfully see patients via videoconferencing. Conclusions. Current online technologies can provide depression screening and psychiatric consultation to college students; those who participated reported a positive experience. Future studies will need to address the low levels of participation among college students and attract students who are underserved, as well as use a videoconferencing platform that adequately protects data confidentiality. PMID:24799895

The cost-effectiveness of screening for colorectal cancer.

PubMed

Telford, Jennifer J; Levy, Adrian R; Sambrook, Jennifer C; Zou, Denise; Enns, Robert A

2010-09-07

Published decision analyses show that screening for colorectal cancer is cost-effective. However, because of the number of tests available, the optimal screening strategy in Canada is unknown. We estimated the incremental cost-effectiveness of 10 strategies for colorectal cancer screening, as well as no screening, incorporating quality of life, noncompliance and data on the costs and benefits of chemotherapy. We used a probabilistic Markov model to estimate the costs and quality-adjusted life expectancy of 50-year-old average-risk Canadians without screening and with screening by each test. We populated the model with data from the published literature. We calculated costs from the perspective of a third-party payer, with inflation to 2007 Canadian dollars. Of the 10 strategies considered, we focused on three tests currently being used for population screening in some Canadian provinces: low-sensitivity guaiac fecal occult blood test, performed annually; fecal immunochemical test, performed annually; and colonoscopy, performed every 10 years. These strategies reduced the incidence of colorectal cancer by 44%, 65% and 81%, and mortality by 55%, 74% and 83%, respectively, compared with no screening. These strategies generated incremental cost-effectiveness ratios of $9159, $611 and $6133 per quality-adjusted life year, respectively. The findings were robust to probabilistic sensitivity analysis. Colonoscopy every 10 years yielded the greatest net health benefit. Screening for colorectal cancer is cost-effective over conventional levels of willingness to pay. Annual high-sensitivity fecal occult blood testing, such as a fecal immunochemical test, or colonoscopy every 10 years offer the best value for the money in Canada.

School Locations and Traffic Emissions — Environmental (In)Justice Findings Using a New Screening Method

PubMed Central

Gaffron, Philine; Niemeier, Deb

2015-01-01

It has been shown that the location of schools near heavily trafficked roads can have detrimental effects on the health of children attending those schools. It is therefore desirable to screen both existing school locations and potential new school sites to assess either the need for remedial measures or suitability for the intended use. Current screening tools and public guidance on school siting are either too coarse in their spatial resolution for assessing individual sites or are highly resource intensive in their execution (e.g., through dispersion modeling). We propose a new method to help bridge the gap between these two approaches. Using this method, we also examine the public K-12 schools in the Sacramento Area Council of Governments Region, California (USA) from an environmental justice perspective. We find that PM2.5 emissions from road traffic affecting a school site are significantly positively correlated with the following metrics: percent share of Black, Hispanic and multi-ethnic students, percent share of students eligible for subsidized meals. The emissions metric correlates negatively with the schools’ Academic Performance Index, the share of White students and average parental education levels. Our PM2.5 metric also correlates with the traffic related, census tract level screening indicators from the California Communities Environmental Health Screening Tool and the tool’s tract level rate of asthma related emergency department visits. PMID:25679341

Understanding the Low Level of Cervical Cancer Screening in Masaka Uganda Using the ASE Model: A Community-Based Survey.

PubMed

Twinomujuni, Cyprian; Nuwaha, Fred; Babirye, Juliet Ndimwibo

2015-01-01

Cervical cancer is one of the leading causes of cancer deaths among women globally and its impact is mostly felt in developing countries like Uganda where its prevalence is higher and utilization of cancer screening services is low. This study aimed to identify factors associated with intention to screen for cervical cancer among women of reproductive age in Masaka Uganda using the attitude, social influence and self efficacy (ASE) model. A descriptive community based survey was conducted among 416 women. A semi-structured interviewer administered questionnaire was used to collect data. Unadjusted and adjusted prevalence ratios (PR) were computed using a generalized linear model with Poisson family and a log link using STATA 12. Only 7% (29/416) of our study respondents had ever screened for cervical cancer although a higher proportion (63%, 262/416) reported intention to screen for cervical cancer. The intention to screen for cervical cancer was higher among those who said they were at risk of developing cervical cancer (Adjusted prevalence ratio [PR] 2.0, 95% CI 1.60-2.58), those who said they would refer other women for screening (Adjusted PR 1.4, 95% CI 1.06-1.88) and higher among those who were unafraid of being diagnosed with cervical cancer (Adjusted PR 1.6, 95% CI 1.36-1.93). Those who reported discussions on cervical cancer with health care providers (Adjusted PR 1.2, 95% CI 1.05-1.44), those living with a sexual partner (Adjusted PR 1.4, 95% CI 1.11-1.68), and those who were formally employed (Adjusted PR 1.2, 95% CI 1.03-1.35) more frequently reported intention to screen for cervical cancer. In conclusion, health education to increase risk perception, improve women's attitudes towards screening for cervical cancer and address the fears held by the women would increase intention to screen for cervical cancer. Interventions should also target increased discussions with health workers.

Tailoring Breast Cancer Screening Intervals by Breast Density and Risk for Women Aged 50 Years or Older: Collaborative Modeling of Screening Outcomes.

PubMed

Trentham-Dietz, Amy; Kerlikowske, Karla; Stout, Natasha K; Miglioretti, Diana L; Schechter, Clyde B; Ergun, Mehmet Ali; van den Broek, Jeroen J; Alagoz, Oguzhan; Sprague, Brian L; van Ravesteyn, Nicolien T; Near, Aimee M; Gangnon, Ronald E; Hampton, John M; Chandler, Young; de Koning, Harry J; Mandelblatt, Jeanne S; Tosteson, Anna N A

2016-11-15

Biennial screening is generally recommended for average-risk women aged 50 to 74 years, but tailored screening may provide greater benefits. To estimate outcomes for various screening intervals after age 50 years based on breast density and risk for breast cancer. Collaborative simulation modeling using national incidence, breast density, and screening performance data. United States. Women aged 50 years or older with various combinations of breast density and relative risk (RR) of 1.0, 1.3, 2.0, or 4.0. Annual, biennial, or triennial digital mammography screening from ages 50 to 74 years (vs. no screening) and ages 65 to 74 years (vs. biennial digital mammography from ages 50 to 64 years). Lifetime breast cancer deaths, life expectancy and quality-adjusted life-years (QALYs), false-positive mammograms, benign biopsy results, overdiagnosis, cost-effectiveness, and ratio of false-positive results to breast cancer deaths averted. Screening benefits and overdiagnosis increase with breast density and RR. False-positive mammograms and benign results on biopsy decrease with increasing risk. Among women with fatty breasts or scattered fibroglandular density and an RR of 1.0 or 1.3, breast cancer deaths averted were similar for triennial versus biennial screening for both age groups (50 to 74 years, median of 3.4 to 5.1 vs. 4.1 to 6.5 deaths averted; 65 to 74 years, median of 1.5 to 2.1 vs. 1.8 to 2.6 deaths averted). Breast cancer deaths averted increased with annual versus biennial screening for women aged 50 to 74 years at all levels of breast density and an RR of 4.0, and those aged 65 to 74 years with heterogeneously or extremely dense breasts and an RR of 4.0. However, harms were almost 2-fold higher. Triennial screening for the average-risk subgroup and annual screening for the highest-risk subgroup cost less than $100 000 per QALY gained. Models did not consider women younger than 50 years, those with an RR less than 1, or other imaging methods. Average-risk women with low breast density undergoing triennial screening and higher-risk women with high breast density receiving annual screening will maintain a similar or better balance of benefits and harms than average-risk women receiving biennial screening. National Cancer Institute.

Parental modelling, media equipment and screen-viewing among young children: cross-sectional study

PubMed Central

Jago, Russell; Sebire, Simon J; Lucas, Patricia J; Turner, Katrina M; Bentley, Georgina F; Goodred, Joanna K; Stewart-Brown, Sarah; Fox, Kenneth R

2013-01-01

Objective To examine whether parental screen-viewing, parental attitudes or access to media equipment were associated with the screen-viewing of 6-year-old to 8-year-old children. Design Cross-sectional survey. Setting Online survey. Main outcome Parental report of the number of hours per weekday that they and, separately, their 6-year-old to 8-year-old child spent watching TV, using a games console, a smart-phone and multiscreen viewing. Parental screen-viewing, parental attitudes and pieces of media equipment were exposures. Results Over 75% of the parents and 62% of the children spent more than 2 h/weekday watching TV. Over two-thirds of the parents and almost 40% of the children spent more than an hour per day multiscreen viewing. The mean number of pieces of media equipment in the home was 5.9 items, with 1.3 items in the child's bedroom. Children who had parents who spent more than 2 h/day watching TV were over 7.8 times more likely to exceed the 2 h threshold. Girls and boys who had a parent who spent an hour or more multiscreen viewing were 34 times more likely to also spend more than an hour per day multiscreen viewing. Media equipment in the child's bedroom was associated with higher TV viewing, computer time and multiscreen viewing. Each increment in the parental agreement that watching TV was relaxing for their child was associated with a 49% increase in the likelihood that the child spent more than 2 h/day watching TV. Conclusions Children who have parents who engage in high levels of screen-viewing are more likely to engage in high levels of screen-viewing. Access to media equipment, particularly in the child's bedroom, was associated with higher levels of screen-viewing. Family-based strategies to reduce screen-viewing and limit media equipment access may be important ways to reduce child screen-viewing. PMID:23619088

Utilisation of preventative health check-ups in the UK: findings from individual-level repeated cross-sectional data from 1992 to 2008

PubMed Central

Labeit, Alexander; Peinemann, Frank; Baker, Richard

2013-01-01

Objectives To analyse and compare the determinants of screening uptake for different National Health Service (NHS) health check-ups in the UK. Design Individual-level analysis of repeated cross-sectional surveys with balanced panel data. Setting The UK. Participants Individuals taking part in the British Household Panel Survey (BHPS), 1992–2008. Outcome measure Uptake of NHS health check-ups for cervical cancer screening, breast cancer screening, blood pressure checks, cholesterol tests, dental screening and eyesight tests. Methods Dynamic panel data models (random effects panel probit with initial conditions). Results Having had a health check-up 1 year before, and previously in accordance with the recommended schedule, was associated with higher uptake of health check-ups. Individuals who visited a general practitioner (GP) had a significantly higher uptake in 5 of the 6 health check-ups. Uptake was highest in the recommended age group for breast and cervical cancer screening. For all health check-ups, age had a non-linear relationship. Lower self-rated health status was associated with increased uptake of blood pressure checks and cholesterol tests; smoking was associated with decreased uptake of 4 health check-ups. The effects of socioeconomic variables differed for the different health check-ups. Ethnicity did not have a significant influence on any health check-up. Permanent household income had an influence only on eyesight tests and dental screening. Conclusions Common determinants for having health check-ups are age, screening history and a GP visit. Policy interventions to increase uptake should consider the central role of the GP in promoting screening examinations and in preserving a high level of uptake. Possible economic barriers to access for prevention exist for dental screening and eyesight tests, and could be a target for policy intervention. Trial registration This observational study was not registered. PMID:24366576

Variation in cervical and breast cancer screening coverage in England: a cross-sectional analysis to characterise districts with atypical behaviour.

PubMed

Massat, Nathalie J; Douglas, Elaine; Waller, Jo; Wardle, Jane; Duffy, Stephen W

2015-07-24

Reducing cancer screening inequalities in England is a major focus of the 2011 Department of Health cancer outcome strategy. Screening coverage requires regular monitoring in order to implement targeted interventions where coverage is low. This study aimed to characterise districts with atypical coverage levels for cervical or breast screening. Observational study of district-level coverage in the English Cervical and Breast screening programmes in 2012. England, UK. All English women invited to participate in the cervical (age group 25-49 and 50-64) and breast (age group 50-64) screening programmes. Risk adjustment models for coverage were developed based on district-level characteristics. Funnel plots of adjusted coverage were constructed, and atypical districts examined by correlation analysis. Variability in coverage was primarily explained by population factors, whereas general practice characteristics had little independent effect. Deprivation and ethnicity other than white, Asian, black or mixed were independently associated with poorer coverage in both screening programmes, with ethnicity having the strongest effect; by comparison, the influence of Asian, black or mixed ethnic minority was limited. Deprivation, ethnicity and urbanisation largely accounted for the lower cervical screening coverage in London. However, for breast screening, being located in London remained a strong negative predictor. A subset of districts was identified as having atypical coverage across programmes. Correlates of deprivation in districts with relatively low adjusted coverage were substantially different from overall correlates of deprivation. These results inform the continuing drive to reduce avoidable cancer deaths in England, and encourage implementation of targeted interventions in communities residing in districts identified as having atypically low coverage. Sequential implementation to monitor the impact of local interventions would help accrue evidence on 'what works'. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Evaluating a De-Centralized Regional Delivery System for Breast Cancer Screening and Patient Navigation for the Rural Underserved.

PubMed

Inrig, Stephen J; Tiro, Jasmin A; Melhado, Trisha V; Argenbright, Keith E; Craddock Lee, Simon J

2014-01-01

Providing breast cancer screening services in rural areas is challenging due to the fractured nature of healthcare delivery systems and complex reimbursement mechanisms that create barriers to access for the under- and uninsured. Interventions that reduce structural barriers to mammography, like patient navigation programs, are effective and recommended, especially for minority and underserved women. Although the literature on rural healthcare is significant, the field lacks studies of adaptive service delivery models and rigorous evaluation of evidence-based programs that facilitate routine screening and appropriate follow-up across large geographic areas. To better understand how to implement a decentralized regional delivery "hub & spoke" model for rural breast cancer screening and patient navigation, we have designed a rigorous, structured, multi-level and mixed-methods evaluation based on Glasgow's RE-AIM model (Reach, Effectiveness, Adoption, Implementation, and Maintenance). The program is comprised of three core components: 1) Outreach to underserved women by partnering with county organizations; 2) Navigation to guide patients through screening and appropriate follow-up; and 3) Centralized Reimbursement to coordinate funding for screening services through a central contract with Medicaid Breast and Cervical Cancer Services (BCCS). Using Glasgow's RE-AIM model, we will: 1) assess which counties have the resources and capacity to implement outreach and/or navigation components, 2) train partners in each county on how to implement components, and 3) monitor process and outcome measures in each county at regular intervals, providing booster training when needed. This evaluation strategy will elucidate how the heterogeneity of rural county infrastructure impacts decentralized service delivery as a navigation program expands. In addition to increasing breast cancer screening access, our model improves and maintains time to diagnostic resolution and facilitates timely referral to local cancer treatment services. We offer this evaluation approach as an exemplar for scientific methods to evaluate the translation of evidence-based federal policy into sustainable health services delivery in a rural setting.

Evaluating a De-Centralized Regional Delivery System for Breast Cancer Screening and Patient Navigation for the Rural Underserved

PubMed Central

Inrig, Stephen J.; Tiro, Jasmin A.; Melhado, Trisha V.; Argenbright, Keith E.; Craddock Lee, Simon J.

2017-01-01

Providing breast cancer screening services in rural areas is challenging due to the fractured nature of healthcare delivery systems and complex reimbursement mechanisms that create barriers to access for the under- and uninsured. Interventions that reduce structural barriers to mammography, like patient navigation programs, are effective and recommended, especially for minority and underserved women. Although the literature on rural healthcare is significant, the field lacks studies of adaptive service delivery models and rigorous evaluation of evidence-based programs that facilitate routine screening and appropriate follow-up across large geographic areas. Objectives To better understand how to implement a decentralized regional delivery “hub & spoke” model for rural breast cancer screening and patient navigation, we have designed a rigorous, structured, multi-level and mixed-methods evaluation based on Glasgow’s RE-AIM model (Reach, Effectiveness, Adoption, Implementation, and Maintenance). Methods and Design The program is comprised of three core components: 1) Outreach to underserved women by partnering with county organizations; 2) Navigation to guide patients through screening and appropriate follow-up; and 3) Centralized Reimbursement to coordinate funding for screening services through a central contract with Medicaid Breast and Cervical Cancer Services (BCCS). Using Glasgow’s RE-AIM model, we will: 1) assess which counties have the resources and capacity to implement outreach and/or navigation components, 2) train partners in each county on how to implement components, and 3) monitor process and outcome measures in each county at regular intervals, providing booster training when needed. Discussion This evaluation strategy will elucidate how the heterogeneity of rural county infrastructure impacts decentralized service delivery as a navigation program expands. In addition to increasing breast cancer screening access, our model improves and maintains time to diagnostic resolution and facilitates timely referral to local cancer treatment services. We offer this evaluation approach as an exemplar for scientific methods to evaluate the translation of evidence-based federal policy into sustainable health services delivery in a rural setting. PMID:28713882

Using Collaborative Simulation Modeling to Develop a Web-Based Tool to Support Policy-Level Decision Making About Breast Cancer Screening Initiation Age

PubMed Central

Burnside, Elizabeth S.; Lee, Sandra J.; Bennette, Carrie; Near, Aimee M.; Alagoz, Oguzhan; Huang, Hui; van den Broek, Jeroen J.; Kim, Joo Yeon; Ergun, Mehmet A.; van Ravesteyn, Nicolien T.; Stout, Natasha K.; de Koning, Harry J.; Mandelblatt, Jeanne S.

2017-01-01

Background There are no publicly available tools designed specifically to assist policy makers to make informed decisions about the optimal ages of breast cancer screening initiation for different populations of US women. Objective To use three established simulation models to develop a web-based tool called Mammo OUTPuT. Methods The simulation models use the 1970 US birth cohort and common parameters for incidence, digital screening performance, and treatment effects. Outcomes include breast cancers diagnosed, breast cancer deaths averted, breast cancer mortality reduction, false-positive mammograms, benign biopsies, and overdiagnosis. The Mammo OUTPuT tool displays these outcomes for combinations of age at screening initiation (every year from 40 to 49), annual versus biennial interval, lifetime versus 10-year horizon, and breast density, compared to waiting to start biennial screening at age 50 and continuing to 74. The tool was piloted by decision makers (n = 16) who completed surveys. Results The tool demonstrates that benefits in the 40s increase linearly with earlier initiation age, without a specific threshold age. Likewise, the harms of screening increase monotonically with earlier ages of initiation in the 40s. The tool also shows users how the balance of benefits and harms varies with breast density. Surveys revealed that 100% of users (16/16) liked the appearance of the site; 94% (15/16) found the tool helpful; and 94% (15/16) would recommend the tool to a colleague. Conclusions This tool synthesizes a representative subset of the most current CISNET (Cancer Intervention and Surveillance Modeling Network) simulation model outcomes to provide policy makers with quantitative data on the benefits and harms of screening women in the 40s. Ultimate decisions will depend on program goals, the population served, and informed judgments about the weight of benefits and harms. PMID:29376135

Development and Interlaboratory Validation of a Simple Screening Method for Genetically Modified Maize Using a ΔΔC(q)-Based Multiplex Real-Time PCR Assay.

PubMed

Noguchi, Akio; Nakamura, Kosuke; Sakata, Kozue; Sato-Fukuda, Nozomi; Ishigaki, Takumi; Mano, Junichi; Takabatake, Reona; Kitta, Kazumi; Teshima, Reiko; Kondo, Kazunari; Nishimaki-Mogami, Tomoko

2016-04-19

A number of genetically modified (GM) maize events have been developed and approved worldwide for commercial cultivation. A screening method is needed to monitor GM maize approved for commercialization in countries that mandate the labeling of foods containing a specified threshold level of GM crops. In Japan, a screening method has been implemented to monitor approved GM maize since 2001. However, the screening method currently used in Japan is time-consuming and requires generation of a calibration curve and experimental conversion factor (C(f)) value. We developed a simple screening method that avoids the need for a calibration curve and C(f) value. In this method, ΔC(q) values between the target sequences and the endogenous gene are calculated using multiplex real-time PCR, and the ΔΔC(q) value between the analytical and control samples is used as the criterion for determining analytical samples in which the GM organism content is below the threshold level for labeling of GM crops. An interlaboratory study indicated that the method is applicable independently with at least two models of PCR instruments used in this study.

Vainshtein screening in scalar-tensor theories before and after GW170817: Constraints on theories beyond Horndeski

NASA Astrophysics Data System (ADS)

Dima, Alexandru; Vernizzi, Filippo

2018-05-01

Screening mechanisms are essential features of dark energy models mediating a fifth force on large scales. We study the regime of strong scalar field nonlinearities, known as Vainshtein screening, in the most general scalar-tensor theories propagating a single scalar degree of freedom. We first develop an effective approach to parametrize cosmological perturbations beyond linear order for these theories. In the quasistatic limit, the fully nonlinear effective Lagrangian contains six independent terms, one of which starts at cubic order in perturbations. We compute the two gravitational potentials around a spherical body. Outside and near the body, screening reproduces standard gravity, with a modified gravitational coupling. Inside the body, the two potentials are different and depend on the density profile, signalling the breaking of the Vainshtein screening. We provide the most general expressions for these modifications, revising and extending previous results. We apply our findings to show that the combination of the GW170817 event, the Hulse-Taylor pulsar and stellar structure physics, constrain the parameters of these general theories at the level of 10-1, and of Gleyzes-Langlois-Piazza-Vernizzi theories at the level of 10-2.

Quantum probability ranking principle for ligand-based virtual screening.

PubMed

Al-Dabbagh, Mohammed Mumtaz; Salim, Naomie; Himmat, Mubarak; Ahmed, Ali; Saeed, Faisal

2017-04-01

Chemical libraries contain thousands of compounds that need screening, which increases the need for computational methods that can rank or prioritize compounds. The tools of virtual screening are widely exploited to enhance the cost effectiveness of lead drug discovery programs by ranking chemical compounds databases in decreasing probability of biological activity based upon probability ranking principle (PRP). In this paper, we developed a novel ranking approach for molecular compounds inspired by quantum mechanics, called quantum probability ranking principle (QPRP). The QPRP ranking criteria would make an attempt to draw an analogy between the physical experiment and molecular structure ranking process for 2D fingerprints in ligand based virtual screening (LBVS). The development of QPRP criteria in LBVS has employed the concepts of quantum at three different levels, firstly at representation level, this model makes an effort to develop a new framework of molecular representation by connecting the molecular compounds with mathematical quantum space. Secondly, estimate the similarity between chemical libraries and references based on quantum-based similarity searching method. Finally, rank the molecules using QPRP approach. Simulated virtual screening experiments with MDL drug data report (MDDR) data sets showed that QPRP outperformed the classical ranking principle (PRP) for molecular chemical compounds.

Quantum probability ranking principle for ligand-based virtual screening

NASA Astrophysics Data System (ADS)

Al-Dabbagh, Mohammed Mumtaz; Salim, Naomie; Himmat, Mubarak; Ahmed, Ali; Saeed, Faisal

2017-04-01

Chemical libraries contain thousands of compounds that need screening, which increases the need for computational methods that can rank or prioritize compounds. The tools of virtual screening are widely exploited to enhance the cost effectiveness of lead drug discovery programs by ranking chemical compounds databases in decreasing probability of biological activity based upon probability ranking principle (PRP). In this paper, we developed a novel ranking approach for molecular compounds inspired by quantum mechanics, called quantum probability ranking principle (QPRP). The QPRP ranking criteria would make an attempt to draw an analogy between the physical experiment and molecular structure ranking process for 2D fingerprints in ligand based virtual screening (LBVS). The development of QPRP criteria in LBVS has employed the concepts of quantum at three different levels, firstly at representation level, this model makes an effort to develop a new framework of molecular representation by connecting the molecular compounds with mathematical quantum space. Secondly, estimate the similarity between chemical libraries and references based on quantum-based similarity searching method. Finally, rank the molecules using QPRP approach. Simulated virtual screening experiments with MDL drug data report (MDDR) data sets showed that QPRP outperformed the classical ranking principle (PRP) for molecular chemical compounds.

Calculation of Quasi-Particle Energies of Aromatic Self-Assembled Monolayers on Au(111).

PubMed

Li, Yan; Lu, Deyu; Galli, Giulia

2009-04-14

We present many-body perturbation theory calculations of the electronic properties of phenylene diisocyanide self-assembled monolayers (SAMs) on a gold surface. Using structural models obtained within density functional theory (DFT), we have investigated how the SAM molecular energies are modified by self-energy corrections and how they are affected by the presence of the surface. We have employed a combination of GW (G = Green's function; W = screened Coulomb interaction) calculations of the SAM quasi-particle energies and a semiclassical image potential model to account for surface polarization effects. We find that it is essential to include both quasi-particle corrections and surface screening in order to provide a reasonable estimate of the energy level alignment at a SAM-metal interface. In particular, our results show that within the GW approximation the energy distance between phenylene diisocyanide SAM energy levels and the gold surface Fermi level is much larger than that found within DFT, e.g., more than double in the case of low packing densities of the SAM.

Development of a Decision Support Model for Screening Attention-deficit Hyperactivity Disorder with Actigraph-based Measurements of Classroom Activity

PubMed Central

Kam, H.J.; Shin, Y.M.; Cho, S.M.; Kim, S.Y.; Kim, K.W.; Park, R.W.

2010-01-01

Objective Questionnaire-based ADHD screening tests may not always be objective or accurate, owing to both subjectivity and prejudice. Despite attempts to develop objective measures to characterize ADHD, no widely applicable index currently exists. The principal aim of this study was to develop a decision support model for ADHD screening by monitoring children’s school activities using a 3-axial actigraph. Methods Actigraphs were placed on the non-dominant wrists of 153 children for 3 hours, while they were at school. Children who scored high on the questionnaires were clinically examined by child psychiatrists, who then confirmed ADHD. Mean, variance, and ratios of low-level (0.5-1.0G) and high-level (1.6-3.2G) activity were extracted as activity features from 142 children (10 ADHD, 132 non-ADHD). Two decision-tree models were constructed using the C5.0 algorithm: [A] from whole hours (class + playtime) and [B] during classes. Accuracy, sensitivity, and specificity were evaluated. PPV, NPV, likelihood ratio, and AUC were also calculated for evaluation. Results [Model A] One child without ADHD was misclassified, resulting in an accuracy score of 99.30%. Sensitivity and NPV were 1.0000. Specificity and PPV were 0.992 and 0.803-0.909, respectively. [Model B] Two children without ADHD were misclassified, resulting in an accuracy score of 98.59%. Specificity and PPV were scored at 0.985 and 0.671-0.832, respectively. Conclusion The selected features were consistent with the findings of previous studies. Objective screening of latent patients with ADHD can be accomplished with a simple watch-like sensor, which is worn for just a few hours while the child attends school. The model proposed herein can be applied to a great many children without heavy cost in time and manpower cost, and would generate valuable results from a public health perspective. PMID:23616848

Metacognitive Theory and Levels of History Department Students, Karabuk University

ERIC Educational Resources Information Center

Candan, Ahmet Sait

2012-01-01

This paper aims to study the levels of metacognition of students of History Department of Karabuk University and whether they differ according to their variables terms. Screening model was used in this study. Basic information about the concept of metacognition and metacognitive theory from movement of national and international literature were…

The Alcohol Use Disorders Identification Test and carbohydrate-deficient transferrin in alcohol-related sickness absence.

PubMed

Hermansson, Ulric; Helander, Anders; Brandt, Lena; Huss, Anders; Rönnberg, Sten

2002-01-01

Previous studies have shown that elevated, risky levels of alcohol consumption may lead to higher rates of sickness absence. However, no studies have examined the Alcohol Use Disorders Identification Test (AUDIT) or serum carbohydrate-deficient transferrin (CDT) in relation to sickness absence in the workplace. The purpose of this study was to examine the relationship between sick-days, 12 months before screening, and the AUDIT and CDT (CDTect kit). Serum gamma-glutamyltransferase also was used for comparison. The study was carried out over 36 months in a large workplace and formed part of an ongoing controlled study. In conjunction with a routine health examination, employees were offered the opportunity to undergo an alcohol screening. Absence data were obtained from the company payroll system, and sickness absence was analyzed by using a three-ordinal level cumulative logistic model on the number of sick-days. Odds ratios (OR) and 95% confidence intervals (CI) are reported. Of the 989 subjects who participated in the study, 193 (19.5%) screened positive in relation to either the AUDIT (>or=8 points) or CDT (<20 units/liter for men, and <27 units/liter for women), or both. Employees who screened positive with the AUDIT had a significantly higher proportion of sick-days (p = 0.047) compared with those who screened negative (OR = 1.4, CI 1.0-1.9). Neither long, continuous periods of sickness absence nor absence on Mondays or Fridays gave a clear indication of individuals who screened positive on the AUDIT or CDT test. Our data indicate that individuals with moderately elevated or risky levels of alcohol consumption show an increase in sick-days. Accordingly, workplaces have a good reason for using a more systematic approach to alcohol screening in routine workplace health examinations.

Screening and vaccination as determined by the Social Ecological Model and the Theory of Triadic Influence: a systematic review.

PubMed

Nyambe, Anayawa; Van Hal, Guido; Kampen, Jarl K

2016-11-17

Vaccination and screening are forms of primary and secondary prevention methods. These methods are recommended for controlling the spread of a vast number of diseases and conditions. To determine the most effective preventive methods to be used by a society, multi-level models have shown to be more effective than models that focus solely on individual level characteristics. The Social Ecological Model (SEM) and the Theory of Triadic Influence (TTI) are such models. The purpose of this systematic review was to identify main differences and similarities of SEM and TTI regarding screening and vaccination in order to prepare potentially successful prevention programs for practice. A systematic review was conducted. Separate literature searches were performed during January and February 2015 using Medline, Ovid, Proquest, PubMed, University of Antwerp Discovery Service and Web of Science, for articles that apply the SEM and TTI. A Data Extraction Form with mostly closed-end questions was developed to assist with data extraction. Aggregate descriptive statistics were utilized to summarize the general characteristics of the SEM and TTI as documented in the scientific literature. A total of 290 potentially relevant articles referencing the SEM were found. As for the TTI, a total of 131 potentially relevant articles were found. After strict evaluation for inclusion and exclusion criteria, 40 SEM studies and 46 TTI studies were included in the systematic review. The SEM and TTI are theoretical frameworks that share many theoretical concepts and are relevant for several types of health behaviors. However, they differ in the structure of the model, and in how the variables are thought to interact with each other, the TTI being a matrix while the SEM has a ring structure. The main difference consists of the division of the TTI into levels of causation (ultimate, distal and proximal) which are not considered within the levels of the SEM. It was further found that in the articles studied in this systematic review, both models are often considered effective, while the empirical basis of these (and other) conclusions reached by their authors is in many cases unclear or incompletely specified.

Effects of Application of Social Marketing Theory and the Health Belief Model in Promoting Cervical Cancer Screening among Targeted Women in Sisaket Province, Thailand.

PubMed

Wichachai, Suparp; Songserm, Nopparat; Akakul, Theerawut; Kuasiri, Chanapong

2016-01-01

Cervical cancer is a major public health problem in Thailand, being ranked second only to breast cancer. Thai women have been reported to have a low rate of cervical cancer screening (27.7% of the 80% goal of WHO). We therefore aimed to apply the social marketing theory and health belief model in promoting cervical cancer screening in Kanthararom District, Sisaket Province. A total of 92 from 974 targeted women aged 3060 years were randomly divided into two groups. The experimental group underwent application of social marketing theory and a health belief model program promoting cervical cancer screening while the control group received normal services. Two research tools were used: (1) application of social marketing theory and health belief model program and (2) questionnaire used to evaluate perceptions of cervical cancer. Descriptive and inferential statistics including paired sample ttest and independent ttest were used to analyze the data. After the program had been used, the mean score of perception of cervical cancer of experimental group was at a higher level (x=4.09; S.D. =0.30), than in the control group (x=3.82; S.D. =0.20) with statistical significance (p<0.001). This research demonstrated an appropriate communication process in behavioral modification to prevent cervical cancer. It can be recommended that this program featuring social marketing and the health belief model be used to promote cervical cancer screening in targeted women and it can be promoted as a guideline for other health services, especially in health promotion and disease prevention.

Microfluidic Devices for Drug Delivery Systems and Drug Screening

PubMed Central

Kompella, Uday B.; Damiati, Safa A.

2018-01-01

Microfluidic devices present unique advantages for the development of efficient drug carrier particles, cell-free protein synthesis systems, and rapid techniques for direct drug screening. Compared to bulk methods, by efficiently controlling the geometries of the fabricated chip and the flow rates of multiphase fluids, microfluidic technology enables the generation of highly stable, uniform, monodispersed particles with higher encapsulation efficiency. Since the existing preclinical models are inefficient drug screens for predicting clinical outcomes, microfluidic platforms might offer a more rapid and cost-effective alternative. Compared to 2D cell culture systems and in vivo animal models, microfluidic 3D platforms mimic the in vivo cell systems in a simple, inexpensive manner, which allows high throughput and multiplexed drug screening at the cell, organ, and whole-body levels. In this review, the generation of appropriate drug or gene carriers including different particle types using different configurations of microfluidic devices is highlighted. Additionally, this paper discusses the emergence of fabricated microfluidic cell-free protein synthesis systems for potential use at point of care as well as cell-, organ-, and human-on-a-chip models as smart, sensitive, and reproducible platforms, allowing the investigation of the effects of drugs under conditions imitating the biological system. PMID:29462948

Determinants of individuals' participation in integrated chronic disease screening in Singapore.

PubMed

Venkataraman, Kavita; Wee, Hwee Lin; Ng, Sheryl Hui Xian; Rebello, Salome; Tai, E Shyong; Lee, Jeannette; Tan, Chuen Seng

2016-06-10

A large pool of patients with chronic diseases remains undiagnosed globally and in Singapore. We explored factors associated with participation in a health screening exercise, using revealed preference, that is, actual attendance, to understand why people remain undiagnosed with chronic diseases. A cross-sectional, community-based sample of Singapore residents was invited to participate in home interviews, and subsequently to attend centre-based health screening, between 2004 and 2007. Determinants of health screening participation were identified using logistic regression models based on Andersen's Behavioral Model. Of the 6366 participants who completed health interview, 4092 attended the health screening, while 2274 did not. Older age, Chinese or Indian ethnicity, higher education levels, greater intake of monounsaturated fat, greater transport and leisure-time physical activity were the key predisposing factors associated with greater health screening participation. Greater family cohesion was the key associated enabling factor, while previous diagnosis of dyslipidaemia or musculoskeletal conditions, absence of previously diagnosed diabetes or hypertension and lower perceived physical health were the associated need factors. Our study suggests that ethnicity, education, family cohesion, healthy behaviour patterns and perceived physical health status were key determinants of health screening participation. Enhancing the cultural competence of preventive health services may help increase participation of these groups in screening efforts and reduce the proportions of undiagnosed chronic disease in the community. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Predicting the risk for colorectal cancer with personal characteristics and fecal immunochemical test.

PubMed

Li, Wen; Zhao, Li-Zhong; Ma, Dong-Wang; Wang, De-Zheng; Shi, Lei; Wang, Hong-Lei; Dong, Mo; Zhang, Shu-Yi; Cao, Lei; Zhang, Wei-Hua; Zhang, Xi-Peng; Zhang, Qing-Huai; Yu, Lin; Qin, Hai; Wang, Xi-Mo; Chen, Sam Li-Sheng

2018-05-01

We aimed to predict colorectal cancer (CRC) based on the demographic features and clinical correlates of personal symptoms and signs from Tianjin community-based CRC screening data.A total of 891,199 residents who were aged 60 to 74 and were screened in 2012 were enrolled. The Lasso logistic regression model was used to identify the predictors for CRC. Predictive validity was assessed by the receiver operating characteristic (ROC) curve. Bootstrapping method was also performed to validate this prediction model.CRC was best predicted by a model that included age, sex, education level, occupations, diarrhea, constipation, colon mucosa and bleeding, gallbladder disease, a stressful life event, family history of CRC, and a positive fecal immunochemical test (FIT). The area under curve (AUC) for the questionnaire with a FIT was 84% (95% CI: 82%-86%), followed by 76% (95% CI: 74%-79%) for a FIT alone, and 73% (95% CI: 71%-76%) for the questionnaire alone. With 500 bootstrap replications, the estimated optimism (<0.005) shows good discrimination in validation of prediction model.A risk prediction model for CRC based on a series of symptoms and signs related to enteric diseases in combination with a FIT was developed from first round of screening. The results of the current study are useful for increasing the awareness of high-risk subjects and for individual-risk-guided invitations or strategies to achieve mass screening for CRC.

Homology modeling and virtual screening of inhibitors against TEM- and SHV-type-resistant mutants: A multilayer filtering approach.

PubMed

Baig, Mohammad H; Balaramnavar, Vishal M; Wadhwa, Gulshan; Khan, Asad U

2015-01-01

TEM and SHV are class-A-type β-lactamases commonly found in Escherichia coli and Klebsiella pneumoniae. Previous studies reported S130G and K234R mutations in SHVs to be 41- and 10-fold more resistant toward clavulanic acid than SHV-1, respectively, whereas TEM S130G and R244S also showed the same level of resistance. These selected mutants confer higher level of resistance against clavulanic acid. They also show little susceptibility against other commercially available β-lactamase inhibitors. In this study, we have used docking-based virtual screening approach in order to screen potential inhibitors against some of the major resistant mutants of SHV and TEM types β-lactamase. Two different inhibitor-resistant mutants from SHV and TEM were selected. Moreover, we have retained the active site water molecules within each enzyme. Active site water molecules were placed within modeled structure of the mutant whose structure was unavailable with protein databank. The novelty of this work lies in the use of multilayer virtual screening approach for the prediction of best and accurate results. We are reporting five inhibitors on the basis of their efficacy against all the selected resistant mutants. These inhibitors were selected on the basis of their binding efficacies and pharmacophore features. © 2015 International Union of Biochemistry and Molecular Biology, Inc.

Identifying depression severity risk factors in persons with traumatic spinal cord injury.

PubMed

Williams, Ryan T; Wilson, Catherine S; Heinemann, Allen W; Lazowski, Linda E; Fann, Jesse R; Bombardier, Charles H

2014-02-01

Examine the relationship between demographic characteristics, health-, and injury-related characteristics, and substance misuse across multiple levels of depression severity. 204 persons with traumatic spinal cord injury (SCI) volunteered as part of screening efforts for a randomized controlled trial of venlafaxine extended release for major depressive disorder (MDD). Instruments included the Patient Health Questionnaire-9 (PHQ-9) depression scale, the Alcohol Use Disorders Identification Test (AUDIT), and the Substance Abuse in Vocational Rehabilitation-Screener (SAVR-S), which contains 3 subscales: drug misuse, alcohol misuse, and a subtle items scale. Each of the SAVR-S subscales contributes to an overall substance use disorder (SUD) outcome. Three proportional odds models were specified, varying the substance misuse measure included in each model. 44% individuals had no depression symptoms, 31% had mild symptoms, 16% had moderate symptoms, 6% had moderately severe symptoms, and 3% had severe depression symptoms. Alcohol misuse, as indicated by the AUDIT and the SAVR-S drug misuse subscale scores were significant predictors of depression symptom severity. The SAVR-S substance use disorder (SUD) screening outcome was the most predictive variable. Level of education was only significantly predictive of depression severity in the model using the AUDIT alcohol misuse indicator. Likely SUD as measured by the SAVR-S was most predictive of depression symptom severity in this sample of persons with traumatic SCI. Drug and alcohol screening are important for identifying individuals at risk for depression, but screening for both may be optimal. Further research is needed on risk and protective factors for depression, including psychosocial characteristics. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Tetrandrine identified in a small molecule screen to activate mesenchymal stem cells for enhanced immunomodulation.

PubMed

Yang, Zijiang; Concannon, John; Ng, Kelvin S; Seyb, Kathleen; Mortensen, Luke J; Ranganath, Sudhir; Gu, Fangqi; Levy, Oren; Tong, Zhixiang; Martyn, Keir; Zhao, Weian; Lin, Charles P; Glicksman, Marcie A; Karp, Jeffrey M

2016-07-26

Pre-treatment or priming of mesenchymal stem cells (MSC) prior to transplantation can significantly augment the immunosuppressive effect of MSC-based therapies. In this study, we screened a library of 1402 FDA-approved bioactive compounds to prime MSC. We identified tetrandrine as a potential hit that activates the secretion of prostaglandin E2 (PGE2), a potent immunosuppressive agent, by MSC. Tetrandrine increased MSC PGE2 secretion through the NF-κB/COX-2 signaling pathway. When co-cultured with mouse macrophages (RAW264.7), tetrandrine-primed MSC attenuated the level of TNF-α secreted by RAW264.7. Furthermore, systemic transplantation of primed MSC into a mouse ear skin inflammation model significantly reduced the level of TNF-α in the inflamed ear, compared to unprimed cells. Screening of small molecules to pre-condition cells prior to transplantation represents a promising strategy to boost the therapeutic potential of cell therapy.

Use of probability analysis to establish routine bioassay screening levels

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carbaugh, E.H.; Sula, M.J.; McFadden, K.M.

1990-09-01

Probability analysis was used by the Hanford Internal Dosimetry Program to establish bioassay screening levels for tritium and uranium in urine. Background environmental levels of these two radionuclides are generally detectable by the highly sensitive urine analysis procedures routinely used at Hanford. Establishing screening levels requires balancing the impact of false detection with the consequence of potentially undetectable occupation dose. To establish the screening levels, tritium and uranium analyses were performed on urine samples collected from workers exposed only to environmental sources. All samples were collected at home using a simulated 12-hour protocol for tritium and a simulated 24-hour collectionmore » protocol for uranium. Results of the analyses of these samples were ranked according to tritium concentration or total sample uranium. The cumulative percentile was calculated and plotted using log-probability coordinates. Geometric means and screening levels corresponding to various percentiles were estimated by graphical interpolation and standard calculations. The potentially annual internal dose associated with a screening level was calculated. Screening levels were selected corresponding to the 99.9 percentile, implying that, on the average, 1 out of 1000 samples collected from an unexposed worker population would be expected to exceed the screening level. 4 refs., 2 figs.« less

Resources Required for Cervical Cancer Prevention in Low- and Middle-Income Countries.

PubMed

Campos, Nicole G; Sharma, Monisha; Clark, Andrew; Kim, Jane J; Resch, Stephen C

2016-01-01

Cervical cancer is the fourth leading cause of cancer death in women, with 85% of cases and deaths occurring in developing countries. While organized screening programs have reduced cervical cancer incidence in high-income countries through detection and treatment of precancerous lesions, the implementation of organized screening has not been effective in low-resource settings due to lack of infrastructure and limited budgets. Our objective was to estimate the cost of comprehensive primary and secondary cervical cancer prevention in low- and middle-income countries. We performed a modeling analysis to estimate 1) for girls aged 10 years, the cost of 2-dose human papillomavirus (HPV) vaccination; and 2) for women aged 30 to 49 years, the cost of cervical cancer screening (with visual inspection with acetic acid (VIA), HPV testing, or cytology) and preventive treatment in 102 low- and middle-income countries from 2015 to 2024. We used an Excel-based costing and service utilization model to estimate financial costs (2013 US$) based on prevalence of HPV, prevalence of precancerous lesions, and screening test performance. Where epidemiologic data were unavailable, we extrapolated from settings with data using an individual-based microsimulation model of cervical carcinogenesis (calibrated to 20 settings) and multivariate regression. Total HPV vaccination costs ranged from US$8.6 billion to US$24.2 billion for all scenarios considered (immediate, 5-year, or 10-year roll-out; price per dose US$4.55-US$70 by country income level). The total cost of screening and preventive treatment ranged from US$5.1 billion (10-year roll-out, screening once at age 35 years) to US$42.3 billion (immediate roll-out, high intensity screening). Limitations of this analysis include the assumption of standardized protocols by country income level that did not account for the potential presence of multiple screening modalities or management strategies within a country, and extrapolation of cost and epidemiologic data to settings where data were limited. The estimated cost of comprehensive cervical cancer prevention with 2-dose HPV vaccination of 10-year-old girls and screening of women aged 30 to 49 years ranges from US$13.7 billion to US$66.5 billion, depending on speed of roll-out, vaccine price per dose, and screening test and frequency. Findings demonstrate the substantial impact of vaccine price in middle-income countries that are not eligible for assistance from Gavi, the Vaccine Alliance. Replacing routine cytology with HPV-based screening may reduce total costs. Data on the health impact and relative cost-effectiveness of strategies are needed to determine the best value for public health dollars.

Resources Required for Cervical Cancer Prevention in Low- and Middle-Income Countries

PubMed Central

Campos, Nicole G.; Sharma, Monisha; Clark, Andrew; Kim, Jane J.; Resch, Stephen C.

2016-01-01

Background Cervical cancer is the fourth leading cause of cancer death in women, with 85% of cases and deaths occurring in developing countries. While organized screening programs have reduced cervical cancer incidence in high-income countries through detection and treatment of precancerous lesions, the implementation of organized screening has not been effective in low-resource settings due to lack of infrastructure and limited budgets. Our objective was to estimate the cost of comprehensive primary and secondary cervical cancer prevention in low- and middle-income countries. Methods and Findings We performed a modeling analysis to estimate 1) for girls aged 10 years, the cost of 2-dose human papillomavirus (HPV) vaccination; and 2) for women aged 30 to 49 years, the cost of cervical cancer screening (with visual inspection with acetic acid (VIA), HPV testing, or cytology) and preventive treatment in 102 low- and middle-income countries from 2015 to 2024. We used an Excel-based costing and service utilization model to estimate financial costs (2013 US$) based on prevalence of HPV, prevalence of precancerous lesions, and screening test performance. Where epidemiologic data were unavailable, we extrapolated from settings with data using an individual-based microsimulation model of cervical carcinogenesis (calibrated to 20 settings) and multivariate regression. Total HPV vaccination costs ranged from US$8.6 billion to US$24.2 billion for all scenarios considered (immediate, 5-year, or 10-year roll-out; price per dose US$4.55-US$70 by country income level). The total cost of screening and preventive treatment ranged from US$5.1 billion (10-year roll-out, screening once at age 35 years) to US$42.3 billion (immediate roll-out, high intensity screening). Limitations of this analysis include the assumption of standardized protocols by country income level that did not account for the potential presence of multiple screening modalities or management strategies within a country, and extrapolation of cost and epidemiologic data to settings where data were limited. Conclusions The estimated cost of comprehensive cervical cancer prevention with 2-dose HPV vaccination of 10-year-old girls and screening of women aged 30 to 49 years ranges from US$13.7 billion to US$66.5 billion, depending on speed of roll-out, vaccine price per dose, and screening test and frequency. Findings demonstrate the substantial impact of vaccine price in middle-income countries that are not eligible for assistance from Gavi, the Vaccine Alliance. Replacing routine cytology with HPV-based screening may reduce total costs. Data on the health impact and relative cost-effectiveness of strategies are needed to determine the best value for public health dollars. PMID:27711124

The High-Throughput Stochastic Human Exposure and Dose Simulation Model (SHEDS-HT) & The Chemical and Products Database (CPDat)

EPA Science Inventory

The Stochastic Human Exposure and Dose Simulation Model – High-Throughput (SHEDS-HT) is a U.S. Environmental Protection Agency research tool for predicting screening-level (low-tier) exposures to chemicals in consumer products. This course will present an overview of this m...

Quantitative Model of Systemic Toxicity Using ToxCast and ToxRefDB (SOT)

EPA Science Inventory

EPA’s ToxCast program profiles the bioactivity of chemicals in a diverse set of ~700 high throughput screening (HTS) assays. In collaboration with L’Oreal, a quantitative model of systemic toxicity was developed using no effect levels (NEL) from ToxRefDB for 633 chemicals with HT...

ESR/ERS white paper on lung cancer screening

PubMed Central

Bonomo, Lorenzo; Gaga, Mina; Nackaerts, Kristiaan; Peled, Nir; Prokop, Mathias; Remy-Jardin, Martine; von Stackelberg, Oyunbileg; Sculier, Jean-Paul

2015-01-01

Lung cancer is the most frequently fatal cancer, with poor survival once the disease is advanced. Annual low dose computed tomography has shown a survival benefit in screening individuals at high risk for lung cancer. Based on the available evidence, the European Society of Radiology and the European Respiratory Society recommend lung cancer screening in comprehensive, quality-assured, longitudinal programmes within a clinical trial or in routine clinical practice at certified multidisciplinary medical centres. Minimum requirements include: standardised operating procedures for low dose image acquisition, computer-assisted nodule evaluation, and positive screening results and their management; inclusion/exclusion criteria; expectation management; and smoking cessation programmes. Further refinements are recommended to increase quality, outcome and cost-effectiveness of lung cancer screening: inclusion of risk models, reduction of effective radiation dose, computer-assisted volumetric measurements and assessment of comorbidities (chronic obstructive pulmonary disease and vascular calcification). All these requirements should be adjusted to the regional infrastructure and healthcare system, in order to exactly define eligibility using a risk model, nodule management and quality assurance plan. The establishment of a central registry, including biobank and image bank, and preferably on a European level, is strongly encouraged. PMID:25929956

Stages of syphilis in South China - a multilevel analysis of early diagnosis.

PubMed

Wong, Ngai Sze; Huang, Shujie; Zheng, Heping; Chen, Lei; Zhao, Peizhen; Tucker, Joseph D; Yang, Li Gang; Goh, Beng Tin; Yang, Bin

2017-01-31

Early diagnosis of syphilis and timely treatment can effectively reduce ongoing syphilis transmission and morbidity. We examined the factors associated with the early diagnosis of syphilis to inform syphilis screening strategic planning. In an observational study, we analyzed reported syphilis cases in Guangdong Province, China (from 2014 to mid-2015) accessed from the national case-based surveillance system. We categorized primary and secondary syphilis cases as early diagnosis and categorized latent and tertiary syphilis as delayed diagnosis. Univariate analyses and multivariable logistic regressions were performed to identify the factors associated with early diagnosis. We also examined the factors associated with early diagnosis at the individual and city levels in multilevel logistic regression models with cases nested by city (n = 21), adjusted for age at diagnosis and gender. Among 83,944 diagnosed syphilis cases, 22% were early diagnoses. The city-level early diagnosis rate ranged from 7 to 46%, consistent with substantial geographic variation as shown in the multilevel model. Early diagnosis was associated with cases presenting to specialist clinics for screening, being male and attaining higher education level. Cases received syphilis testing in institutions and hospitals, and diagnosed in hospitals were less likely to be in early diagnosis. At the city-level, cases living in a city equipped with more hospitals per capita were less likely to be early diagnosis. To enhance early diagnosis of syphilis, city-specific syphilis screening strategies with a mix of passive and client/provider-initiated testing might be a useful approach.

Discovery of Antibiotics-derived Polymers for Gene Delivery using Combinatorial Synthesis and Cheminformatics Modeling

PubMed Central

Potta, Thrimoorthy; Zhen, Zhuo; Grandhi, Taraka Sai Pavan; Christensen, Matthew D.; Ramos, James; Breneman, Curt M.; Rege, Kaushal

2014-01-01

We describe the combinatorial synthesis and cheminformatics modeling of aminoglycoside antibiotics-derived polymers for transgene delivery and expression. Fifty-six polymers were synthesized by polymerizing aminoglycosides with diglycidyl ether cross-linkers. Parallel screening resulted in identification of several lead polymers that resulted in high transgene expression levels in cells. The role of polymer physicochemical properties in determining efficacy of transgene expression was investigated using Quantitative Structure-Activity Relationship (QSAR) cheminformatics models based on Support Vector Regression (SVR) and ‘building block’ polymer structures. The QSAR model exhibited high predictive ability, and investigation of descriptors in the model, using molecular visualization and correlation plots, indicated that physicochemical attributes related to both, aminoglycosides and diglycidyl ethers facilitated transgene expression. This work synergistically combines combinatorial synthesis and parallel screening with cheminformatics-based QSAR models for discovery and physicochemical elucidation of effective antibiotics-derived polymers for transgene delivery in medicine and biotechnology. PMID:24331709

Breast, prostate, and thyroid cancer screening tests and overdiagnosis.

PubMed

Jung, Minsoo

The purpose of this study was to examine overdiagnosis and overtreatment related to cancer screening and to review relevant reports and studies. A comprehensive search of peer-reviewed and gray literature was conducted for relevant studies published between January 2000 and December 2015 reporting breast, prostate, and thyroid cancer screening tests and overdiagnosis. This study revealed no dichotomy on where screening would lower risk or cause overdiagnosis and overtreatment. Many screening tests did both, that is, at population level, there were both benefit (decreased disease-specific mortality) and harm (overdiagnosis and overtreatment). Therefore, we need to consider a balanced argument with citations for the potential benefits of screening along with the harms associated with screening. Although the benefits and harms can only be tested through randomized trials, important data from cohort studies, diagnostic accuracy studies, and modeling work can help define the extent of benefits and harms in the population. The health care cycle that prompt patients to undergo periodic screening tests is self-reinforcing. In most developed countries, screening test recommendations encourage periodic testing. Therefore, patients are continuing their screening. It is necessary for patients to become wise consumers of screening tests and make decisions with their physicians regarding further testing and treatments. Copyright © 2017 Elsevier Inc. All rights reserved.

Road screening and distribution route multi-objective robust optimization for hazardous materials based on neural network and genetic algorithm.

PubMed

Ma, Changxi; Hao, Wei; Pan, Fuquan; Xiang, Wang

2018-01-01

Route optimization of hazardous materials transportation is one of the basic steps in ensuring the safety of hazardous materials transportation. The optimization scheme may be a security risk if road screening is not completed before the distribution route is optimized. For road screening issues of hazardous materials transportation, a road screening algorithm of hazardous materials transportation is built based on genetic algorithm and Levenberg-Marquardt neural network (GA-LM-NN) by analyzing 15 attributes data of each road network section. A multi-objective robust optimization model with adjustable robustness is constructed for the hazardous materials transportation problem of single distribution center to minimize transportation risk and time. A multi-objective genetic algorithm is designed to solve the problem according to the characteristics of the model. The algorithm uses an improved strategy to complete the selection operation, applies partial matching cross shift and single ortho swap methods to complete the crossover and mutation operation, and employs an exclusive method to construct Pareto optimal solutions. Studies show that the sets of hazardous materials transportation road can be found quickly through the proposed road screening algorithm based on GA-LM-NN, whereas the distribution route Pareto solutions with different levels of robustness can be found rapidly through the proposed multi-objective robust optimization model and algorithm.

Interventions to Improve Follow-Up of Abnormal Findings in Cancer Screening

PubMed Central

Bastani, Roshan; Yabroff, K. Robin; Myers, Ronald E.; Glenn, Beth

2006-01-01

The potential reduction in morbidity and mortality through cancer screening cannot be realized without receipt of appropriate follow-up care for abnormalities identified via screening. In this paper, the authors critically examine the existing literature on correlates of receipt of appropriate follow-up care for screen-detected abnormalities, as well as the literature on interventions designed to increase rates of receipt of follow-up care. Lessons learned describe what is known and not known about factors that are related to or predict receipt of follow-up care. Similarly, effective interventions to increase follow-up are described and gaps identified. A conceptual model is developed that categorizes the health care system in the United States as comprising four levels: policy, practice, provider, and patient. Some patient-level factors that influence follow-up receipt are identified, but the lack of data severely limit the understanding of provider, practice, and policy-level correlates. The majority of intervention studies to increase follow-up receipt have focused on patient-level factors and have targeted follow-up of abnormal Papanicolaou smears. Insufficient information is available regarding the effectiveness of provider, practice, or policy-level interventions. Standard definitions of what constitutes appropriate follow-up are lacking, which severely limit comparability of findings across studies. The validity of various methods of obtaining outcome data has not been clearly established. More research is needed on interventions targeting provider, system, and policy-level factors, particularly interventions focusing on follow-up of colorectal and breast abnormalities. Standardization of definitions and measures is needed to facilitate comparisons across studies. PMID:15316914

Grid Gap Measurement for an NSTAR Ion Thruster

NASA Technical Reports Server (NTRS)

Diaz, Esther M.; Soulas, George C.

2006-01-01

The change in gap between the screen and accelerator grids of an engineering model NSTAR ion optics assembly was measured during thruster operation with beam extraction. The molybdenum ion optics assembly was mounted onto an engineering model NSTAR ion thruster. The measurement technique consisted of measuring the difference in height of an alumina pin relative to the downstream accelerator grid surface. The alumina pin was mechanically attached to the center aperture of the screen grid and protruded through the center aperture of the accelerator grid. The change in pin height was monitored using a long distance microscope coupled to a digital imaging system. Transient and steady-state hot grid gaps were measured at three power levels: 0.5, 1.5 and 2.3 kW. Also, the change in grid gap was measured during the transition between power levels, and during the startup with high voltage applied just prior to discharge ignition. Performance measurements, such as perveance, electron backstreaming limit and screen grid ion transparency, were also made to confirm that this ion optics assembly performed similarly to past testing. Results are compared to a prior test of 30 cm titanium ion optics.

The Impact of the University Students' Level of Alienation on Their Perception of General Satistaction

ERIC Educational Resources Information Center

Kaçire, Ilhan

2016-01-01

The purpose of this study is to investigate the impact of university students' level of alienation on their general satisfaction. The study was carried out using rational screening model. The total participants of this study were 551 Dicle University students, studying at Medical, Technology, and Ziya Gökalp Education Faculty departments. The…

University Students' Early Maladaptive Schemas' Prediction of Their Mindfulness Levels

ERIC Educational Resources Information Center

Yalcin, S.Barbaros; Kavakli, Mehmet; Kesici, Sahin; Ak, Mehmet

2017-01-01

Purpose: The aim of this study is to determine whether university students' early maladaptive schemas predict their mindfulness levels or not. Methods: The study was carried out in the relational screening model. The study group consisted of 293 university students; 237 (80,9%) females and 56 (19,1%) males. "Mindful Attention Awareness Scale…

Item Analysis and Differential Item Functioning of a Brief Conduct Problem Screen

ERIC Educational Resources Information Center

Wu, Johnny; King, Kevin M.; Witkiewitz, Katie; Racz, Sarah Jensen; McMahon, Robert J.

2012-01-01

Research has shown that boys display higher levels of childhood conduct problems than girls, and Black children display higher levels than White children, but few studies have tested for scalar equivalence of conduct problems across gender and race. The authors conducted a 2-parameter item response theory (IRT) model to examine item…

Investigating the Relationship between Job Satisfaction Levels of the Teachers in Educational Institutions and Their Attitudes towards Teaching Profession

ERIC Educational Resources Information Center

Üredi, Lütfi

2017-01-01

The basic purpose of this research was to investigate the relationship between job satisfaction levels of the teachers in educational institutions and their attitudes towards teaching profession. Obtained results provided significant contributions for improving the quality of educational activities. Relational screening model as one of the…

Determinants of breast cancer screening uptake in Kurdish women of Iran.

PubMed

Aminisani, Nayyereh; Fattahpour, Roujin; Dastgiri, Saeed; Asghari-Jafarabadi, Mohammad; Allahverdipour, Hamid

2016-01-01

Recently, a national breast cancer screening program has been introduced in Iran.The aim of this study was to examine the determinants of breast cancer screening uptake among Kurdish women, in order to identify those characteristics that may be potentially associated with the screening uptake. Through a cross sectional study, in 2014, a random sample of 561 women aged 40 years and older without the history of breast cancer and identified with Kurdish background in Baneh county, Iran, were recruited and interviewed by two trained interviewers. Data were collected using a valid and reliable researcher made questionnaire. Univariate and multivariate logistic regression models with self-reported screening history as the dependent variable were used to estimate the odds ratios (ORs) with 95% of CI. The mean age of women was 43.64 (SD = 5.17). The participation rate in the mammography program was 16.8% (95% CI: 13.7-19.8%). The lowest level of participation was found among women aged 60 and older (OR = 0.30, 95% CI: 0.14-0.69), illiterate (OR = 0.63,95% CI: 0.40-0.99) and post-menopausal (OR = 0.56, 95% CI: 0.35-0.91) women. It was found that the level of breast screening uptake was low among Kurdish women compared to those reported in the previous studies. Designing participation enhancing interventions with a specific focus on older, illiterate and post-menopausal women are recommended.

iPSC-based drug screening for Huntington's disease.

PubMed

Zhang, Ningzhe; Bailus, Barbara J; Ring, Karen L; Ellerby, Lisa M

2016-05-01

Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder, caused by an expansion of the CAG repeat in exon 1 of the huntingtin gene. The disease generally manifests in middle age with both physical and mental symptoms. There are no effective treatments or cures and death usually occurs 10-20 years after initial symptoms. Since the original identification of the Huntington disease associated gene, in 1993, a variety of models have been created and used to advance our understanding of HD. The most recent advances have utilized stem cell models derived from HD-patient induced pluripotent stem cells (iPSCs) offering a variety of screening and model options that were not previously available. The discovery and advancement of technology to make human iPSCs has allowed for a more thorough characterization of human HD on a cellular and developmental level. The interaction between the genome editing and the stem cell fields promises to further expand the variety of HD cellular models available for researchers. In this review, we will discuss the history of Huntington's disease models, common screening assays, currently available models and future directions for modeling HD using iPSCs-derived from HD patients. This article is part of a Special Issue entitled SI: PSC and the brain. Copyright © 2015 Elsevier B.V. All rights reserved.

Screening and Intervention for Comorbid Substance Disorders, PTSD, Depression, and Suicide: A Trauma Center Survey.

PubMed

Love, Jeff; Zatzick, Douglas

2014-07-01

Few investigations have examined screening and intervention procedures for comorbid substance use and mental disorders at trauma centers in the United States, although these disorders are endemic among survivors of traumatic injury. In 2006, the American College of Surgeons (ACS) mandated that level I and level II trauma centers screen for alcohol use problems and that level I centers provide brief intervention for those who screen positive. The ACS is expected to recommend best practice policy guidelines for screening for drug use problems and posttraumatic stress disorder (PTSD). This study examined screening and intervention procedures for the full spectrum of comorbid mental and substance use disorders at U.S. trauma centers. Respondents at all level I and level II trauma centers (N=518) in the United States were asked to complete a survey describing screening and intervention procedures for alcohol and drug use problems, suicidality, depression, and PTSD. There were 391 (75%) respondents. Over 80% of trauma centers routinely screened for alcohol and drug use problems. Routine screening and intervention for suicidality, depression, and PTSD were markedly less common; in fact, only 7% of centers reported routine screening for PTSD. Consistent with ACS policy, level I centers were significantly more likely than level II centers to provide alcohol intervention. Alcohol screening and intervention occurred frequently at U.S. trauma centers and appeared to be responsive to ACS mandates. In the future, efforts to orchestrate clinical investigation and policy could enhance screening and intervention procedures for highly prevalent, comorbid mental disorders.

Interest in health screening as a predictor of long-term overall mortality: multilevel analysis of a Japanese national cohort study.

PubMed

Fujino, Yoshihisa; Tanabe, Naohito; Honjo, Kaori; Suzuki, Sadao; Iso, Hiroyasu; Tamakoshi, Akiko

2011-01-01

In Japan, screening programmes have been widely implemented as a public health practice. We investigated the effect of the area-level interest in health screening on mortality using data from a large cohort in Japan. A baseline survey was conducted between 1988 and 1990 among 110,792 residents of 45 areas, aged 40-79 years. Area-level interest in health screening was defined as the proportion of people with high and moderate interest in health screening in an area. Multilevel Poisson regression was employed in a two-level structure of individuals nested within the areas. During 15 years of follow-up (1,035,617 person-years), 13,184 deaths were observed. The reduction in mortality rate was (a) 2% in both men (p=0.009) and women (p=0.038) for each percent increase in area-level interest in screening, and (b) 10% in men (p=0.001) and 9% in women (p=0.001) for individual attendance to screening in the year before follow-up. There was no interaction between area-level interest in screening, individual-level attendance at screening and overall mortality. Area-level and individual interest for health screening appear to be independent predictor of 15-year mortality in this national Japanese study. The present findings may support public health practices to promote knowledge and participation in screening programmes. Copyright © 2010 Elsevier Inc. All rights reserved.

Influence of semiclassical plasma on the energy levels and radiative transitions in highly charged ions★

NASA Astrophysics Data System (ADS)

Hu, Hong-Wei; Chen, Zhan-Bin; Chen, Wen-Cong; Liu, Xiao-Bin; Fu, Nian; Wang, Kai

2017-11-01

Considering the quantum effects of diffraction and the collective screening effects, the potential of test charge in semiclassical plasmas is derived. It is generalized exponential screened Coulomb potential. Using the Ritz variational method incorporating this potential, the effects of semiclassical plasma on the energy levels and radiative transitions are investigated systematically, taking highly charged H-like ion as an example. The Debye plasma model is also employed for comparison purposes. Comparisons and analysis are made between these two sets of results and the differences are discussed. Contribution to the Topical Issue "Atomic and Molecular Data and their Applications", edited by Gordon W.F. Drake, Jung-Sik Yoon, Daiji Kato, Grzegorz Karwasz.

Youth Justice staff attitudes towards screening for self-harm.

PubMed

Knowles, Sarah E; Townsend, Ellen; Anderson, Martin P

2012-09-01

Young offenders are recognised as a high-risk group for suicidal behaviour. It is essential that the screening used to identify those at risk and refer them to mental health services is effective, especially in community settings where service utilisation is low. Staff attitudes towards screening for suicide and self-harm are likely to influence how a young offender engages with the screening process. Our study is the first to explore community youth justice staff attitudes towards, and perceptions of, screening for self-harmful behaviour. Eight semi-structured interviews were conducted at an English Youth Offending Team in June 2006 with staff who had used the suicide screening tool with young offenders. Data were analysed using Interpretative Phenomenological Analysis. Staff attitudes towards working within the screening system varied along two dimensions. The first 'active/passive' dimension related to perceived confidence in dealing with self-harm. The second 'positive/negative' dimension related to perceptions of the benefits of screening and the effectiveness of mental health provision for young offenders. Results indicate that barriers to effective screening must be tackled at both individual and organisational levels. The model of attitudes presented here could be used to increase understanding of how staff can be supported to engage effectively with the screening system. © 2012 Blackwell Publishing Ltd.

CRISPR/Cas9-Directed Gene Editing for the Generation of Loss-of-Function Mutants in High-Throughput Zebrafish F0 Screens.

PubMed

Shankaran, Sunita S; Dahlem, Timothy J; Bisgrove, Brent W; Yost, H Joseph; Tristani-Firouzi, Martin

2017-07-05

The ability to perform reverse genetics in the zebrafish model organism has been greatly advanced with the advent of the CRISPR (clustered regularly interspaced short palindromic repeats)/Cas9 (CRISPR-associated) system. The high level of efficiency in generating mutations when using the CRISPR/Cas9 system combined with the rapid generation time of the zebrafish model organism has made the possibility of performing F 0 screens in this organism a reality. This unit describes a detailed protocol for performing an F 0 screen using the CRISPR/Cas9 system in zebrafish starting with the design and production of custom CRISPR/Cas9 reagents for injection. Next, two approaches for determining the efficiency of mutation induction by the custom CRISPR/Cas9 reagents that are easily performed using standard molecular biology protocols are detailed. Finally, screening for F 0 induced phenotypes using the zebrafish flh gene as an example is discussed. © 2017 by John Wiley & Sons, Inc. Copyright © 2017 John Wiley & Sons, Inc.

Characterization of three human cell line models for high-throughput neuronal cytotoxicity screening.

PubMed

Tong, Zhi-Bin; Hogberg, Helena; Kuo, David; Sakamuru, Srilatha; Xia, Menghang; Smirnova, Lena; Hartung, Thomas; Gerhold, David

2017-02-01

More than 75 000 man-made chemicals contaminate the environment; many of these have not been tested for toxicities. These chemicals demand quantitative high-throughput screening assays to assess them for causative roles in neurotoxicities, including Parkinson's disease and other neurodegenerative disorders. To facilitate high throughput screening for cytotoxicity to neurons, three human neuronal cellular models were compared: SH-SY5Y neuroblastoma cells, LUHMES conditionally-immortalized dopaminergic neurons, and Neural Stem Cells (NSC) derived from human fetal brain. These three cell lines were evaluated for rapidity and degree of differentiation, and sensitivity to 32 known or candidate neurotoxicants. First, expression of neural differentiation genes was assayed during a 7-day differentiation period. Of the three cell lines, LUHMES showed the highest gene expression of neuronal markers after differentiation. Both in the undifferentiated state and after 7 days of neuronal differentiation, LUHMES cells exhibited greater cytotoxic sensitivity to most of 32 suspected or known neurotoxicants than SH-SY5Y or NSCs. LUHMES cells were also unique in being more susceptible to several compounds in the differentiating state than in the undifferentiated state; including known neurotoxicants colchicine, methyl-mercury (II), and vincristine. Gene expression results suggest that differentiating LUHMES cells may be susceptible to apoptosis because they express low levels of anti-apoptotic genes BCL2 and BIRC5/survivin, whereas SH-SY5Y cells may be resistant to apoptosis because they express high levels of BCL2, BIRC5/survivin, and BIRC3 genes. Thus, LUHMES cells exhibited favorable characteristics for neuro-cytotoxicity screening: rapid differentiation into neurons that exhibit high level expression neuronal marker genes, and marked sensitivity of LUHMES cells to known neurotoxicants. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

High drug loading self-microemulsifying/micelle formulation: design by high-throughput formulation screening system and in vivo evaluation.

PubMed

Sakai, Kenichi; Obata, Kouki; Yoshikawa, Mayumi; Takano, Ryusuke; Shibata, Masaki; Maeda, Hiroyuki; Mizutani, Akihiko; Terada, Katsuhide

2012-10-01

To design a high drug loading formulation of self-microemulsifying/micelle system. A poorly-soluble model drug (CH5137291), 8 hydrophilic surfactants (HS), 10 lipophilic surfactants (LS), 5 oils, and PEG400 were used. A high loading formulation was designed by a following stepwise approach using a high-throughput formulation screening (HTFS) system: (1) an oil/solvent was selected by solubility of the drug; (2) a suitable HS for highly loading was selected by the screenings of emulsion/micelle size and phase stability in binary systems (HS, oil/solvent) with increasing loading levels; (3) a LS that formed a broad SMEDDS/micelle area on a phase diagram containing the HS and oil/solvent was selected by the same screenings; (4) an optimized formulation was selected by evaluating the loading capacity of the crystalline drug. Aqueous solubility behavior and oral absorption (Beagle dog) of the optimized formulation were compared with conventional formulations (jet-milled, PEG400). As an optimized formulation, d-α-tocopheryl polyoxyethylene 1000 succinic ester: PEG400 = 8:2 was selected, and achieved the target loading level (200 mg/mL). The formulation formed fine emulsion/micelle (49.1 nm), and generated and maintained a supersaturated state at a higher level compared with the conventional formulations. In the oral absorption test, the area under the plasma concentration-time curve of the optimized formulation was 16.5-fold higher than that of the jet-milled formulation. The high loading formulation designed by the stepwise approach using the HTFS system improved the oral absorption of the poorly-soluble model drug.

APPLICATION AND EVALUATION OF AN AGGREGATE PHYSICALLY-BASED TWO-STAGE MONTE CARLO PROBABILISTIC MODEL FOR QUANTIFYING CHILDREN'S RESIDENTIAL EXPOSURE AND DOSE TO CHLORPYRIFOS

EPA Science Inventory

Critical voids in exposure data and models lead risk assessors to rely on conservative assumptions. Risk assessors and managers need improved tools beyond the screening level analysis to address aggregate exposures to pesticides as required by the Food Quality Protection Act o...

Promoting Breast Cancer Screening in Rural, African American Communities: The "Science and Art" of Community Health Promotion.

ERIC Educational Resources Information Center

Altpeter, Mary; Earp, Jo Anne L.; Shopler, Janice H.

1998-01-01

Social ecological theory, social-work community organization models, and health-promotion models are brought together to address ways to generate change at the individual and policy levels, and to provide guidance for community health-promotion programs. An eight-year cancer-prevention project is presented as a case study. (EMK)

Estimating radiation risk induced by CT screening for Korean population

NASA Astrophysics Data System (ADS)

Yang, Won Seok; Yang, Hye Jeong; Min, Byung In

2017-02-01

The purposes of this study are to estimate the radiation risks induced by chest/abdomen computed tomography (CT) screening for healthcare and to determine the cancer risk level of the Korean population compared to other populations. We used an ImPACT CT Patient Dosimetry Calculator to compute the organ effective dose induced by CT screening (chest, low-dose chest, abdomen/pelvis, and chest/abdomen/pelvis CT). A risk model was applied using principles based on the BEIR VII Report in order to estimate the lifetime attributable risk (LAR) using the Korean Life Table 2010. In addition, several countries including Hong Kong, the United States (U.S.), and the United Kingdom, were selected for comparison. Herein, each population exposed radiation dose of 100 mSv was classified according to country, gender and age. For each CT screening the total organ effective dose calculated by ImPACT was 6.2, 1.5, 5.2 and 11.4 mSv, respectively. In the case of Korean female LAR, it was similar to Hong Kong female but lower than those of U.S. and U.K. females, except for those in their twenties. The LAR of Korean males was the highest for all types of CT screening. However, the difference of the risk level was negligible because of the quite low value.

Many-body formulation of carriers capture time in quantum dots applicable in device simulation codes

NASA Astrophysics Data System (ADS)

Vallone, Marco

2010-03-01

We present an application of Green's functions formalism to calculate in a simplified but rigorous way electrons and holes capture time in quantum dots in closed form as function of carrier density, levels confinement potential, and temperature. Carrier-carrier (Auger) scattering and single LO-phonon emission are both addressed accounting for dynamic effects of the potential screening in the single plasmon pole approximation of the dielectric function. Regarding the LO-phonons interaction, the formulation evidences the role of the dynamic screening from wetting-layer carriers in comparison with its static limit, describes the interplay between screening and Fermi band filling, and offers simple expressions for capture time, suitable for modeling implementation.

Evaluation and Application of Gridded Snow Water Equivalent Products for Improving Snowmelt Flood Predictions in the Red River Basin of the North

NASA Astrophysics Data System (ADS)

Schroeder, R.; Jacobs, J. M.; Vuyovich, C.; Cho, E.; Tuttle, S. E.

2017-12-01

Each spring the Red River basin (RRB) of the North, located between the states of Minnesota and North Dakota and southern Manitoba, is vulnerable to dangerous spring snowmelt floods. Flat terrain, low permeability soils and a lack of satisfactory ground observations of snow pack conditions make accurate predictions of the onset and magnitude of major spring flood events in the RRB very challenging. This study investigated the potential benefit of using gridded snow water equivalent (SWE) products from passive microwave satellite missions and model output simulations to improve snowmelt flood predictions in the RRB using NOAA's operational Community Hydrologic Prediction System (CHPS). Level-3 satellite SWE products from AMSR-E, AMSR2 and SSM/I, as well as SWE computed from Level-2 brightness temperatures (Tb) measurements, including model output simulations of SWE from SNODAS and GlobSnow-2 were chosen to support the snowmelt modeling exercises. SWE observations were aggregated spatially (i.e. to the NOAA North Central River Forecast Center forecast basins) and temporally (i.e. by obtaining daily screened and weekly unscreened maximum SWE composites) to assess the value of daily satellite SWE observations relative to weekly maximums. Data screening methods removed the impacts of snow melt and cloud contamination on SWE and consisted of diurnal SWE differences and a temperature-insensitive polarization difference ratio, respectively. We examined the ability of the satellite and model output simulations to capture peak SWE and investigated temporal accuracies of screened and unscreened satellite and model output SWE. The resulting SWE observations were employed to update the SNOW-17 snow accumulation and ablation model of CHPS to assess the benefit of using temporally and spatially consistent SWE observations for snow melt predictions in two test basins in the RRB.

Clinical and economic impact of various strategies for varicella immunity screening and vaccination of health care personnel.

PubMed

Baracco, G J; Eisert, S; Saavedra, S; Hirsch, P; Marin, M; Ortega-Sanchez, I R

2015-10-01

Exposure to patients with varicella or herpes zoster causes considerable disruption to a health care facility's operations and has a significant health and economic impact. However, practices related to screening for immunity and immunization of health care personnel (HCP) for varicella vary widely. A decision tree model was built to evaluate the cost-effectiveness of 8 different strategies of screening and vaccinating HCP for varicella. The outcomes are presented as probability of acquiring varicella, economic impact of varicella per employee per year, and cost to prevent additional cases of varicella. Monte Carlo simulations and 1-way sensitivity analyses were performed to address the uncertainties inherent to the model. Alternative epidemiologic and technologic scenarios were also analyzed. Performing a clinical screening followed by serologic testing of HCP with negative history diminished the cost impact of varicella by >99% compared with not having a program. Vaccinating HCP with negative screen cost approximately $50,000 per case of varicella prevented at the current level of U.S. population immunity, but was projected to be cost-saving at 92% or lower immunity prevalence. Improving vaccine acceptance rates and using highly sensitive assays also optimize cost-effectiveness. Strategies relying on screening and vaccinating HCP for varicella on employment were shown to be cost-effective for health care facilities and are consistent with current national guidelines for varicella prevention. Published by Elsevier Inc.

Associations between Screen-Based Sedentary Behaviour and Anxiety Symptoms in Mothers with Young Children

PubMed Central

Teychenne, Megan; Hinkley, Trina

2016-01-01

Objectives Anxiety is a serious illness and women (including mothers with young children) are at particular risk. Although physical activity (PA) may reduce anxiety risk, little research has investigated the link between sedentary behaviour and anxiety risk. The aim of this study was to examine the association between screen-based sedentary behaviour and anxiety symptoms, independent of PA, amongst mothers with young children. Methods During 2013–2014, 528 mothers with children aged 2–5 years completed self-report measures of recreational screen-based sedentary behaviour (TV/DVD/video viewing, computer/e-games/hand held device use) and anxiety symptoms (using the Hospital Anxiety and Depression Scale, HADS-A). Linear regression analyses examined the cross-sectional association between screen-based sedentary behaviour and anxiety symptoms. Results In models that adjusted for key demographic and behavioural covariates (including moderate- to vigorous-intensity PA, MVPA), computer/device use (B = 0.212; 95% CI = 0.048, 0.377) and total screen time (B = 0.109; 95% CI = 0.014, 0.205) were positively associated with heightened anxiety symptoms. TV viewing was not associated with anxiety symptoms in either model. Conclusions Higher levels of recreational computer or handheld device use and overall screen time may be linked to higher risk of anxiety symptoms in mothers with young children, independent of MVPA. Further longitudinal and intervention research is required to determine temporal associations. PMID:27191953

Financial Incentives and Cervical Cancer Screening Participation in Ontario's Primary Care Practice Models.

PubMed

Pendrith, Ciara; Thind, Amardeep; Zaric, Gregory S; Sarma, Sisira

2016-08-01

The primary objective of this paper is to compare cervical cancer screening rates of family physicians in Ontario's two dominant reformed practice models, Family Health Group (FHG) and Family Health Organization (FHO), and traditional fee-for-service (FFS) model. Both reformed models formally enrol patients and offer extensive pay-for-performance incentives; however, they differ by remuneration for core services (FHG is FFS; FHO is capitated). The secondary objective is to estimate the average and marginal costs of screening in each model. Using administrative data on 7,298 family physicians and their 2,083,633 female patients aged 35-69 eligible for cervical cancer screening in 2011, we assessed screening rates after adjusting for patient and physician characteristics. Predicted screening rates, fees and bonus payments were used to estimate the average and marginal costs of cervical cancer screening. Adjusted screening rates were highest in the FHG (81.9%), followed by the FHO (79.6%), and then the traditional FFS model (74.2%). The cost of a cervical cancer screening was $18.30 in the FFS model. The estimated average cost of screening in the FHGs and FHOs were $29.71 and $35.02, respectively, while the corresponding marginal costs were $33.05 and $39.06. We found significant differences in cervical cancer screening rates across Ontario's primary care practice models. Cervical screening rates were significantly higher in practice models eligible for incentives (FHGs and FHOs) than the traditional FFS model. However, the average and marginal cost of screening were lowest in the traditional FFS model and highest in the FHOs. Copyright © 2016 Longwoods Publishing.

Preparticipation Screening of Athletic Officials: SEC Football Referees at Risk.

PubMed

Turner, John L; Walters, Rod; Leski, Mark J; Saywell, Robert M; Wooldridge, J Scott

2003-03-01

Although preparticipation screening for athletes is commonplace, few studies have addressed the issue for those officiating at games. To review current data on physiologic stress on sports officials, to obtain prevalence data on health parameters for football officials, and to determine the outcomes when screening criteria are applied in preseason exams. A protocol was established using health history questionnaires and physical exams with laboratory screening to assess the health of all football officials working in the Southeastern Conference (SEC) from 1997 to 2000. The main outcome measure was the prevalence of cardiac risk factors as determined by American College of Sports Medicine guidelines. Initial screening of 102 football officials revealed that 10.1% of SEC referees had elevated systolic blood pressure, 13.9% had elevated diastolic blood pressure, and 3.8% had resting tachycardia. Average body mass index (BMI) was 28.6 kg/m2, with 87.3% having a BMI that exceeded 25 (overweight). About one-third (31.6%) had a BMI greater than 30 (obese). Total fasting cholesterol exceeded 200 mg/dL in 44.2%, HDL levels were below 35 mg/dL in 34.3%, and LDL levels were above 120 mg/dL in 62.3%. Compared with age-adjusted national data, there were more overweight and more obese officials, but they had lower systolic and diastolic blood pressures and lower mean total cholesterol levels. Using the Framingham Study prediction model to estimate coronary heart disease (CHD) risk, analysis revealed that referees had a lower risk than the national 10-year CHD risk but a higher risk compared with that of the low-risk population. These data reveal a greater need for graded exercise testing. The higher rates of obesity among officials will promote further screening for CHD risk factors.

Perceived Family Functioning Predicts Baseline Psychosocial Characteristics in U.S. Participants of a Family Focused Grief Therapy Trial.

PubMed

Schuler, Tammy A; Zaider, Talia I; Li, Yuelin; Masterson, Melissa; McDonnell, Glynnis A; Hichenberg, Shira; Loeb, Rebecca; Kissane, David W

2017-07-01

Screening and baseline data on 170 American families (620 individuals), selected by screening from a palliative care population for inclusion in a randomized controlled trial of family-focused grief therapy, were examined to determine whether family dysfunction conferred higher levels of psychosocial morbidity. We hypothesized that greater family dysfunction would, indeed, be associated with poorer psychosocial outcomes among palliative care patients and their family members. Screened families were classified according to their functioning on the Family Relationships Index (FRI) and consented families completed baseline assessments. Mixed-effects modeling with post hoc tests compared individuals' baseline psychosocial outcomes (psychological distress, social functioning, and family functioning on a different measure) according to the classification of their family on the FRI. Covariates were included in all models as appropriate. For those who completed baseline measures, 191 (30.0%) individuals were in low-communicating families, 313 (50.5%) in uninvolved families, and 116 (18.7%) in conflictual families. Family class was significantly associated (at ps ≤ 0.05) with increased psychological distress (Beck Depression Inventory and Brief Symptom Inventory) and poorer social adjustment (Social Adjustment Scale) for individual family members. The family assessment device supported the concurrent accuracy of the FRI. As predicted, significantly greater levels of individual psychosocial morbidity were present in American families whose functioning as a group was poorer. Support was generated for a clinical approach that screens families to identify those at high risk. Overall, these baseline data point to the importance of a family-centered model of care. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Winther, Hans A.; Koyama, Kazuya; Wright, Bill S.

We present a general parallelized and easy-to-use code to perform numerical simulations of structure formation using the COLA (COmoving Lagrangian Acceleration) method for cosmological models that exhibit scale-dependent growth at the level of first and second order Lagrangian perturbation theory. For modified gravity theories we also include screening using a fast approximate method that covers all the main examples of screening mechanisms in the literature. We test the code by comparing it to full simulations of two popular modified gravity models, namely f ( R ) gravity and nDGP, and find good agreement in the modified gravity boost-factors relative tomore » ΛCDM even when using a fairly small number of COLA time steps.« less

Modeling of luminance distribution in CAVE-type virtual reality systems

NASA Astrophysics Data System (ADS)

Meironke, Michał; Mazikowski, Adam

2017-08-01

At present, one of the most advanced virtual reality systems are CAVE-type (Cave Automatic Virtual Environment) installations. Such systems are usually consisted of four, five or six projection screens and in case of six screens arranged in form of a cube. Providing the user with a high level of immersion feeling in such systems is largely dependent of optical properties of the system. The modeling of physical phenomena plays nowadays a huge role in the most fields of science and technology. It allows to simulate work of device without a need to make any changes in the physical constructions. In this paper distribution of luminance in CAVE-type virtual reality systems were modelled. Calculations were performed for the model of 6-walled CAVE-type installation, based on Immersive 3D Visualization Laboratory, situated at the Faculty of Electronics, Telecommunications and Informatics at the Gdańsk University of Technology. Tests have been carried out for two different scattering distribution of the screen material in order to check how these characteristicinfluence on the luminance distribution of the whole CAVE. The basis assumption and simplification of modeled CAVE-type installation and results were presented. The brief discussion about the results and usefulness of developed model were also carried out.

Examining the Relation between Social Values Perception and Moral Maturity Level of Folk Dancers

ERIC Educational Resources Information Center

Dogan, Pinar Karacan

2018-01-01

The purpose of the present study is to examine the relation between social values perceptions and moral maturity levels of folk dancers, and evaluate this relation in terms of some variables. The relational screening model was used in the study. The "Multi-dimensional Social Values Scale," which was developed by Bolat (2013), and the…

Trajectories of cognitive function in dementia-free subjects: Radiation Effects Research Foundation Adult Health Study.

PubMed

Yamada, Michiko; Landes, Reid D; Mimori, Yasuyo; Nagano, Yoshito; Sasaki, Hideo

2015-04-15

To investigate associations between age, sex, education, and birth cohort and global cognitive decline among a population that would most likely not progress to dementia. A total of 1538 dementia-free subjects aged 60 to 80years in 1992 were followed up through 2011 without dementia occurrence. We assessed cognitive function using the Cognitive Ability Screening Instrument (CASI). Using stepwise-like model selection procedure, we built mixed-effects models for initial cognition and longitudinal cognition. Initial CASI scores for younger age and more years of formal education were higher than those for older and less education. Sex did not show a significant effect. In the longitudinal analysis, cognitive decline became more rapid with increasing age. Sex and education did not modify the degree of deterioration with age. CASI scores were higher for younger cohorts and men due to differences in education levels. Among dementia-free subjects, age is an important predictor of cognitive function level and cognitive decline. Education level affects cognitive function level, but did not affect cognitive decline. The results have implications not only for elucidation of the aging process, but also for reference in dementia screening. Copyright © 2015 Elsevier B.V. All rights reserved.

Design checkpoint kinase 2 inhibitors by pharmacophore modeling and virtual screening techniques.

PubMed

Wang, Yen-Ling; Lin, Chun-Yuan; Shih, Kuei-Chung; Huang, Jui-Wen; Tang, Chuan-Yi

2013-12-01

Damage to DNA is caused by ionizing radiation, genotoxic chemicals or collapsed replication forks. When DNA is damaged or cells fail to respond, a mutation that is associated with breast or ovarian cancer may occur. Mammalian cells control and stabilize the genome using a cell cycle checkpoint to prevent damage to DNA or to repair damaged DNA. Checkpoint kinase 2 (Chk2) is one of the important kinases, which strongly affects DNA-damage and plays an important role in the response to the breakage of DNA double-strands and related lesions. Therefore, this study concerns Chk2. Its purpose is to find potential inhibitors using the pharmacophore hypotheses (PhModels) and virtual screening techniques. PhModels can identify inhibitors with high biological activities and virtual screening techniques are used to screen the database of the National Cancer Institute (NCI) to retrieve compounds that exhibit all of the pharmacophoric features of potential inhibitors with high interaction energy. Ten PhModels were generated using the HypoGen best algorithm. The established PhModel, Hypo01, was evaluated by performing a cost function analysis of its correlation coefficient (r), root mean square deviation (RMSD), cost difference, and configuration cost, with the values 0.955, 1.28, 192.51, and 16.07, respectively. The result of Fischer's cross-validation test for the Hypo01 model yielded a 95% confidence level, and the correlation coefficient of the testing set (rtest) had a best value of 0.81. The potential inhibitors were then chosen from the NCI database by Hypo01 model screening and molecular docking using the cdocker docking program. Finally, the selected compounds exhibited the identified pharmacophoric features and had a high interaction energy between the ligand and the receptor. Eighty-three potential inhibitors for Chk2 are retrieved for further study. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cost-effectiveness analysis of cervical cancer prevention based on a rapid human papillomavirus screening test in a high-risk region of China.

PubMed

Levin, Carol E; Sellors, John; Shi, Ju-Fang; Ma, Li; Qiao, You-lin; Ortendahl, Jesse; O'Shea, Meredith K H; Goldie, Sue J

2010-09-01

This study assessed the cost-effectiveness of a new, rapid human papillomavirus (HPV)-DNA screening test for cervical cancer prevention in the high-risk region of Shanxi, China. Using micro-costing methods, we estimated the resources needed to implement preventive strategies using cervical cytology or HPV-DNA testing, including the Hybrid Capture 2 (hc2) test (QIAGEN Corp., Gaithersburg, MD) and the rapid HPV-DNA careHPV test (QIAGEN). Data were used in a previously published model and empirically calibrated to country-specific epidemiological data. Strategies differed by initial test, targeted age, frequency of screening, number of clinic visits required (1, 2 or 3) and service delivery setting (national, county and township levels). Outcomes included lifetime risk of cancer, years of life saved (YLS), lifetime costs and incremental cost-effectiveness ratios (cost per YLS). For all screening frequencies, the most efficient strategy used 2-visit rapid HPV-DNA testing at the county level, including screening and diagnostics in the first visit, and treatment in the second visit. Screening at ages 35, 40 and 45 reduced cancer risk by 50% among women compliant with all 3 screening rounds, and was US$ 150 per YLS, compared with this same strategy applied twice per lifetime. This would be considered very cost-effective evaluated against China's per-capita gross domestic product (US$ 1,702). By enhancing the linkage between screening and treatment through a reduced number of visits, rapid HPV-DNA testing 3 times per lifetime is more effective than traditional cytology, and is likely to be cost-effective in high-risk regions of China.

Maternal glucose level and body mass index measured at gestational diabetes mellitus screening and the risk of macrosomia: results from a perinatal cohort study.

PubMed

Liu, Jian; Leng, Junhong; Tang, Chen; Liu, Gongshu; Hay, John; Wang, Jing; Wen, Shiwu; Li, Zhenling; She, Ye

2014-05-20

To examine the impact of maternal blood glucose (BG) level and body mass index (BMI) measured at gestational diabetes mellitus (GDM) screening on the risk of macrosomia. A perinatal cohort of women were followed up from receiving perinatal healthcare to giving birth. Beichen District, Tianjin, China between June 2011 and October 2012. 1951 women aged 19-42 years with valid values of BMI and BG level at GDM screening (24-28 weeks gestation), singleton birth and birth weight (BW)>2500 g. Primary outcome was macrosomia (BW>4000 g). BG level and BMI were measured at GDM screening. 191 (9.7%) newborns were macrosomia. The ORs (95% CIs) of macrosomia from multiple logistic regression were 1.14 (1.10 to 1.19, p<0.0001) for BMI and 1.11 (1.01 to 1.23, p=0.03) for BG. When BMI and BG levels (continuous) were modelled simultaneously, the OR for BMI was similar, but significantly attenuated for BG. Areas of receiver operating characteristics (ROC) were 0.6530 (0.6258 to 0.6803) for BMI and 0.5548 (0.5248 to 0.5848) for BG (χ(2)=26.17, p<0.0001). BG (mmol/L, <6.7, 6.7-7.8 or ≥7.8) and BMI in quintiles (Q1-Q5) were evaluated with BG <6.7 and Q2 BMI as the reference group. The ORs of macrosomia were not statistically different for mothers in Q1 or Q2 of BMI regardless of the BG levels; the ORs for ≥Q3 of BMI were elevated significantly with the highest OR observed in Q5 of BMI and BG levels ≥7.8 (6.93 (2.61 to 18.43), p<0.0001). High BMI measured at GDM screening was the most important determinant for risk of macrosomia. These findings suggest that GDM screening may be a critical gestational time point to initiate maternal weight control oriented intervention strategy to lower the risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Long-term evaluation of benefits, harms, and cost-effectiveness of the National Bowel Cancer Screening Program in Australia: a modelling study.

PubMed

Lew, Jie-Bin; St John, D James B; Xu, Xiang-Ming; Greuter, Marjolein J E; Caruana, Michael; Cenin, Dayna R; He, Emily; Saville, Marion; Grogan, Paul; Coupé, Veerle M H; Canfell, Karen

2017-07-01

No assessment of the National Bowel Screening Program (NBCSP) in Australia, which considers all downstream benefits, costs, and harms, has been done. We aimed to use a comprehensive natural history model and the most recent information about cancer treatment costs to estimate long-term benefits, costs, and harms of the NBCSP (2 yearly immunochemical faecal occult blood testing screening at age 50-74 years) and evaluate the incremental effect of improved screening participation under different scenarios. In this modelling study, a microsimulation model, Policy1-Bowel, which simulates the development of colorectal cancer via both the conventional adenoma-carcinoma and serrated pathways was used to simulate the NBCSP in 2006-40, taking into account the gradual rollout of NBCSP in 2006-20. The base-case scenario assumed 40% screening participation (currently observed behaviour) and two alternative scenarios assuming 50% and 60% participation by 2020 were modelled. Aggregate year-by-year screening, diagnosis, treatment and surveillance-related costs, resource utilisation (number of screening tests and colonoscopies), and health outcomes (incident colorectal cancer cases and colorectal cancer deaths) were estimated, as was the cost-effectiveness of the NBCSP. With current levels of participation (40%), the NBCSP is expected to prevent 92 200 cancer cases and 59 000 deaths over the period 2015-40; an additional 24 300 and 37 300 cases and 16 800 and 24 800 deaths would be prevented if participation was increased to 50% and 60%, respectively. In 2020, an estimated 101 000 programme-related colonoscopies will be done, associated with about 270 adverse events; an additional 32 500 and 49 800 colonoscopies and 88 and 134 adverse events would occur if participation was increased to 50% and 60%, respectively. The overall number needed to screen (NNS) is 647-788 per death prevented, with 52-59 colonoscopies per death prevented. The programme is cost-effective due to the cancer treatment costs averted (cost-effectiveness ratio compared with no screening at current participation, AUS$3014 [95% uncertainty interval 1807-5583] per life-year saved) in the cost-effectiveness analysis. In the budget impact analysis, reduced annual expenditure on colorectal cancer control is expected by 2030, with expenditure reduced by a cumulative AUS$1·7 billion, AUS$2·0 billion, and AUS$2·1 billion (2015 prices) between 2030 and 2040, at participation rates of 40%, 50%, and 60%, respectively. The NBCSP has potential to save 83 800 lives over the period 2015-40 if coverage rates can be increased to 60%. By contrast, the associated harms, although an important consideration, are at a smaller magnitude at the population level. The programme is highly cost-effective and within a decade of full roll-out, there will be reduced annual health systems expenditure on colorectal cancer control due to the impact of screening. Australia Postgraduate Award PhD Scholarship, Translational Cancer Research Network Top-up scholarship (supported by Cancer Institute NSW) and Cancer Council NSW. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

A SCREENING-LEVEL MODEL EVALUATION OF ATRAZINE IN THE LAKE MICHIGAN BASIN

EPA Science Inventory

Atrazine, a widely used herbicide in the agricultural regions of the Lake Michigan basin, was selected as a priority toxic chemical study in the United States Environmental Protection Agency (U.S. EPA) - sponsored Lake Michigan Mass Balance Project.

Conceptual Framework for Trait-Based Ecological Risk Assessment for Wildlife Populations Exposed to Pesticides

EPA Science Inventory

Between screening level risk assessments and complex ecological models, a need exists for practical identification of risk based on general information about species, chemicals, and exposure scenarios. Several studies have identified demographic, biological, and toxicological fa...

Screening-level estimates of mass discharge uncertainty from point measurement methods

EPA Science Inventory

The uncertainty of mass discharge measurements associated with point-scale measurement techniques was investigated by deriving analytical solutions for the mass discharge coefficient of variation for two simplified, conceptual models. In the first case, a depth-averaged domain w...

siRNA screen identifies QPCT as a druggable target for Huntington's disease.

PubMed

Jimenez-Sanchez, Maria; Lam, Wun; Hannus, Michael; Sönnichsen, Birte; Imarisio, Sara; Fleming, Angeleen; Tarditi, Alessia; Menzies, Fiona; Dami, Teresa Ed; Xu, Catherine; Gonzalez-Couto, Eduardo; Lazzeroni, Giulia; Heitz, Freddy; Diamanti, Daniela; Massai, Luisa; Satagopam, Venkata P; Marconi, Guido; Caramelli, Chiara; Nencini, Arianna; Andreini, Matteo; Sardone, Gian Luca; Caradonna, Nicola P; Porcari, Valentina; Scali, Carla; Schneider, Reinhard; Pollio, Giuseppe; O'Kane, Cahir J; Caricasole, Andrea; Rubinsztein, David C

2015-05-01

Huntington's disease (HD) is a currently incurable neurodegenerative condition caused by an abnormally expanded polyglutamine tract in huntingtin (HTT). We identified new modifiers of mutant HTT toxicity by performing a large-scale 'druggable genome' siRNA screen in human cultured cells, followed by hit validation in Drosophila. We focused on glutaminyl cyclase (QPCT), which had one of the strongest effects on mutant HTT-induced toxicity and aggregation in the cell-based siRNA screen and also rescued these phenotypes in Drosophila. We found that QPCT inhibition induced the levels of the molecular chaperone αB-crystallin and reduced the aggregation of diverse proteins. We generated new QPCT inhibitors using in silico methods followed by in vitro screening, which rescued the HD-related phenotypes in cell, Drosophila and zebrafish HD models. Our data reveal a new HD druggable target affecting mutant HTT aggregation and provide proof of principle for a discovery pipeline from druggable genome screen to drug development.

Genome-Wide RNAi Ionomics Screen Reveals New Genes and Regulation of Human Trace Element Metabolism

PubMed Central

Malinouski, Mikalai; Hasan, Nesrin M.; Zhang, Yan; Seravalli, Javier; Lin, Jie; Avanesov, Andrei; Lutsenko, Svetlana; Gladyshev, Vadim N.

2017-01-01

Trace elements are essential for human metabolism and dysregulation of their homeostasis is associated with numerous disorders. Here we characterize mechanisms that regulate trace elements in human cells by designing and performing a genome-wide high-throughput siRNA/ionomics screen, and examining top hits in cellular and biochemical assays. The screen reveals high stability of the ionomes, especially the zinc ionome, and yields known regulators and novel candidates. We further uncover fundamental differences in the regulation of different trace elements. Specifically, selenium levels are controlled through the selenocysteine machinery and expression of abundant selenoproteins; copper balance is affected by lipid metabolism and requires machinery involved in protein trafficking and posttranslational modifications; and the iron levels are influenced by iron import and expression of the iron/heme-containing enzymes. Our approach can be applied to a variety of disease models and/or nutritional conditions, and the generated dataset opens new directions for studies of human trace element metabolism. PMID:24522796

Functional single-cell hybridoma screening using droplet-based microfluidics.

PubMed

El Debs, Bachir; Utharala, Ramesh; Balyasnikova, Irina V; Griffiths, Andrew D; Merten, Christoph A

2012-07-17

Monoclonal antibodies can specifically bind or even inhibit drug targets and have hence become the fastest growing class of human therapeutics. Although they can be screened for binding affinities at very high throughput using systems such as phage display, screening for functional properties (e.g., the inhibition of a drug target) is much more challenging. Typically these screens require the generation of immortalized hybridoma cells, as well as clonal expansion in microtiter plates over several weeks, and the number of clones that can be assayed is typically no more than a few thousand. We present here a microfluidic platform allowing the functional screening of up to 300,000 individual hybridoma cell clones within less than a day. This approach should also be applicable to nonimmortalized primary B-cells, as no cell proliferation is required: Individual cells are encapsulated into aqueous microdroplets and assayed directly for the release of antibodies inhibiting a drug target based on fluorescence. We used this system to perform a model screen for antibodies that inhibit angiotensin converting enzyme 1, a target for hypertension and congestive heart failure drugs. When cells expressing these antibodies were spiked into an unrelated hybridoma cell population in a ratio of 1:10,000 we observed a 9,400-fold enrichment after fluorescence activated droplet sorting. A wide variance in antibody expression levels at the single-cell level within a single hybridoma line was observed and high expressors could be successfully sorted and recultivated.

Determinants of breast cancer screening uptake in Kurdish women of Iran

PubMed Central

Aminisani, Nayyereh; Fattahpour, Roujin; Dastgiri, Saeed; Asghari-Jafarabadi, Mohammad; Allahverdipour, Hamid

2016-01-01

Background: Recently, a national breast cancer screening program has been introduced in Iran.The aim of this study was to examine the determinants of breast cancer screening uptake among Kurdish women, in order to identify those characteristics that may be potentially associated with the screening uptake. Methods: Through a cross sectional study, in 2014, a random sample of 561 women aged 40 years and older without the history of breast cancer and identified with Kurdish background in Baneh county, Iran, were recruited and interviewed by two trained interviewers. Data were collected using a valid and reliable researcher made questionnaire. Univariate and multivariate logistic regression models with self-reported screening history as the dependent variable were used to estimate the odds ratios (ORs) with 95% of CI. Results: The mean age of women was 43.64 (SD = 5.17). The participation rate in the mammography program was 16.8% (95% CI: 13.7-19.8%). The lowest level of participation was found among women aged 60 and older (OR = 0.30, 95% CI: 0.14-0.69), illiterate (OR = 0.63,95% CI: 0.40-0.99) and post-menopausal (OR = 0.56, 95% CI: 0.35-0.91) women. Conclusion: It was found that the level of breast screening uptake was low among Kurdish women compared to those reported in the previous studies. Designing participation enhancing interventions with a specific focus on older, illiterate and post-menopausal women are recommended. PMID:27123436

Development of Peritoneal Tumor-Targeting Vector by In Vivo Screening with a Random Peptide-Displaying Adenovirus Library

PubMed Central

Yoshida, Kimiko; Goto, Naoko; Ohnami, Shumpei; Aoki, Kazunori

2012-01-01

The targeting of gene transfer at the cell-entry level is one of the most attractive challenges in vector development. However, attempts to redirect adenovirus vectors to alternative receptors by engineering the capsid-coding region have shown limited success, because the proper targeting ligands on the cells of interest are generally unknown. To overcome this limitation, we have constructed a random peptide library displayed on the adenoviral fiber knob, and have successfully selected targeted vectors by screening the library on cancer cell lines in vitro. The infection of targeted vectors was considered to be mediated by specific receptors on target cells. However, the expression levels and kinds of cell surface receptors may be substantially different between in vitro culture and in vivo tumor tissue. Here, we screened the peptide display-adenovirus library in the peritoneal dissemination model of AsPC-1 pancreatic cancer cells. The vector displaying a selected peptide (PFWSGAV) showed higher infectivity in the AsPC-1 peritoneal tumors but not in organs and other peritoneal tumors as compared with a non-targeted vector. Furthermore, the infectivity of the PFWSGAV-displaying vector for AsPC-1 peritoneal tumors was significantly higher than that of a vector displaying a peptide selected by in vitro screening, indicating the usefulness of in vivo screening in exploring the targeting vectors. This vector-screening system can facilitate the development of targeted adenovirus vectors for a variety of applications in medicine. PMID:23029088

Copper homeostasis gene discovery in Drosophila melanogaster.

PubMed

Norgate, Melanie; Southon, Adam; Zou, Sige; Zhan, Ming; Sun, Yu; Batterham, Phil; Camakaris, James

2007-06-01

Recent studies have shown a high level of conservation between Drosophila melanogaster and mammalian copper homeostasis mechanisms. These studies have also demonstrated the efficiency with which this species can be used to characterize novel genes, at both the cellular and whole organism level. As a versatile and inexpensive model organism, Drosophila is also particularly useful for gene discovery applications and thus has the potential to be extremely useful in identifying novel copper homeostasis genes and putative disease genes. In order to assess the suitability of Drosophila for this purpose, three screening approaches have been investigated. These include an analysis of the global transcriptional response to copper in both adult flies and an embryonic cell line using DNA microarray analysis. Two mutagenesis-based screens were also utilized. Several candidate copper homeostasis genes have been identified through this work. In addition, the results of each screen were carefully analyzed to identify any factors influencing efficiency and sensitivity. These are discussed here with the aim of maximizing the efficiency of future screens and the most suitable approaches are outlined. Building on this information, there is great potential for the further use of Drosophila for copper homeostasis gene discovery.

Developing and testing lay literature about breast cancer screening for African American women.

PubMed

Coleman, Elizabeth Ann; Coon, Sharon; Mohrmann, Carolyn; Hardin, Susan; Stewart, Beth; Gibson, Regina Shoate; Cantrell, Mary; Lord, Janet; Heard, Jeanne

2003-01-01

Written materials about breast cancer screening for African American women with low literacy skills are needed. Available materials were not at or below third-grade reading levels, were not culturally sensitive, and were not accurate in illustrating correct breast self-examination (BSE) techniques. Focus groups representing the target population helped the authors design a pamphlet describing how to perform BSE and a motivational picture book to help women overcome barriers to screening. The authors chose a food theme for the cover of the pamphlet written at a third-grade level and suggested a photographic version. In the motivational book, two women address barriers to screening and replace myths and fears with facts and actions. Data from 162 women showed that they learned from both the photographic and illustrated versions. Women in the photographic group found significantly more lumps in the silicone models, so the authors chose that version to use in final testing. Finally, nurses pretested a group of patients before they reviewed the materials and post-tested another group after they reviewed them. The group who had reviewed the materials had greater knowledge of and intent to follow the guidelines and received higher scores on BSE techniques.

Perceived Neighborhood Quality and Cancer Screening Behavior: Evidence from the Survey of the Health of Wisconsin.

PubMed

Beyer, Kirsten M M; Malecki, Kristen M; Hoormann, Kelly A; Szabo, Aniko; Nattinger, Ann B

2016-02-01

Socioeconomic disparities in colorectal and breast cancer screening persist, partially accounting for disparities in cancer outcomes. Some neighborhood characteristics--particularly area level socioeconomic factors--have been linked to cancer screening behavior, but few studies have examined the relationship between perceived neighborhood quality and screening behavior, which may provide more insight into the ways in which neighborhood environments shape cancer related behaviors. This study examines the relationship between several aspects of the perceived neighborhood environment and breast and colorectal cancer screening behavior among a population-based sample of Wisconsin residents. A sub-goal was to compare the relevance of different perceived neighborhood factors for different screening tests. This is a cross-sectional study of 2008-2012 data from the Survey of the Health of Wisconsin, a population-based annual survey of Wisconsin residents. An average risk sample of Black, Hispanic and White women age 50 and older (n = 1265) were selected. Survey regression analyses examined predictors of screening, as well as adherence to screening guidelines. Models controlled for individual socio-demographic information and insurance status. Perceptions of social and physical disorder, including fear of crime and visible garbage, were associated with screening rates. Findings emphasize the particular importance of these factors for colorectal cancer screening, indicating the necessity of improving screening rates in areas characterized by social disorganization, crime, and physical disorder. Additional work should be done to further investigate the pathways that explain the linkage between neighborhood conditions, perceived neighborhood risks and cancer screening behavior.

Fe en Accion/Faith in Action: Design and implementation of a church-based randomized trial to promote physical activity and cancer screening among churchgoing Latinas

PubMed Central

Arredondo, Elva M.; Haughton, Jessica; Ayala, Guadalupe X.; Slymen, Donald J.; Sallis, James F.; Burke, Kari; Holub, Christina; Chanson, Dayana; Perez, Lilian G.; Valdivia, Rodrigo; Ryan, Sherry; Elder, John

2015-01-01

Objectives To describe both conditions of a two-group randomized trial, one that promotes physical activity and one that promotes cancer screening, among churchgoing Latinas. The trial involves promotoras (community health workers) targeting multiple levels of the Ecological Model. This trial builds on formative and pilot research findings. Design Sixteen churches were randomly assigned to either the physical activity intervention or cancer screening comparison condition (approximately 27 women per church). In both conditions, promotoras from each church intervened at the individual- (e.g., beliefs), interpersonal- (e.g., social support), and environmental- (e.g., park features and access to health care) levels to affect change on target behaviors. Measurements The study’s primary outcome is min/wk of moderate-to-vigorous physical activity (MVPA) at baseline and 12 and 24 months following implementation of intervention activities. We enrolled 436 Latinas (aged 18–65 years) who engaged in less than 250 min/wk of MVPA at baseline as assessed by accelerometer, attended church at least four times per month, lived near their church, and did not have a health condition that could prevent them from participating in physical activity. Participants were asked to complete measures assessing physical activity and cancer screening as well as their correlates at 12- and 24-months. Summary Findings from the current study will address gaps in research by showing the long term effectiveness of multi-level faith-based interventions promoting physical activity and cancer screening among Latino communities. PMID:26358535

Characterization of Human Cancer Cell Lines by Reverse-phase Protein Arrays* | Office of Cancer Genomics

Cancer.gov

Cancer cell lines are major model systems for mechanistic investigation and drug development. However, protein expression data linked to high-quality DNA, RNA, and drug-screening data have not been available across a large number of cancer cell lines. Using reverse-phase protein arrays, we measured expression levels of ∼230 key cancer-related proteins in >650 independent cell lines, many of which have publically available genomic, transcriptomic, and drug-screening data.

Two-component scattering model and the electron density spectrum

NASA Astrophysics Data System (ADS)

Zhou, A. Z.; Tan, J. Y.; Esamdin, A.; Wu, X. J.

2010-02-01

In this paper, we discuss a rigorous treatment of the refractive scintillation caused by a two-component interstellar scattering medium and a Kolmogorov form of density spectrum. It is assumed that the interstellar scattering medium is composed of a thin-screen interstellar medium (ISM) and an extended interstellar medium. We consider the case that the scattering of the thin screen concentrates in a thin layer represented by a δ function distribution and that the scattering density of the extended irregular medium satisfies the Gaussian distribution. We investigate and develop equations for the flux density structure function corresponding to this two-component ISM geometry in the scattering density distribution and compare our result with the observations. We conclude that the refractive scintillation caused by this two-component ISM scattering gives a more satisfactory explanation for the observed flux density variation than does the single extended medium model. The level of refractive scintillation is strongly sensitive to the distribution of scattering material along the line of sight (LOS). The theoretical modulation indices are comparatively less sensitive to the scattering strength of the thin-screen medium, but they critically depend on the distance from the observer to the thin screen. The logarithmic slope of the structure function is sensitive to the scattering strength of the thin-screen medium, but is relatively insensitive to the thin-screen location. Therefore, the proposed model can be applied to interpret the structure functions of flux density observed in pulsar PSR B2111 + 46 and PSR B0136 + 57. The result suggests that the medium consists of a discontinuous distribution of plasma turbulence embedded in the interstellar medium. Thus our work provides some insight into the distribution of the scattering along the LOS to the pulsar PSR B2111 + 46 and PSR B0136 + 57.

Zebrafish in the sea of mineral (iron, zinc, and copper) metabolism

PubMed Central

Zhao, Lu; Xia, Zhidan; Wang, Fudi

2014-01-01

Iron, copper, zinc, and eight other minerals are classified as essential trace elements because they present in minute in vivo quantities and are essential for life. Because either excess or insufficient levels of trace elements can be detrimental to life (causing human diseases such as iron-deficiency anemia, hemochromatosis, Menkes syndrome and Wilson's disease), the endogenous levels of trace minerals must be tightly regulated. Many studies have demonstrated the existence of systems that maintain trace element homeostasis, and these systems are highly conserved in multiple species ranging from yeast to mice. As a model for studying trace mineral metabolism, the zebrafish is indispensable to researchers. Several large-scale mutagenesis screens have been performed in zebrafish, and these screens led to the identification of a series of metal transporters and the generation of several mutagenesis lines, providing an in-depth functional analysis at the system level. Moreover, because of their developmental advantages, zebrafish have also been used in mineral metabolism-related chemical screens and toxicology studies. Here, we systematically review the major findings of trace element homeostasis studies using the zebrafish model, with a focus on iron, zinc, copper, selenium, manganese, and iodine. We also provide a homology analysis of trace mineral transporters in fish, mice and humans. Finally, we discuss the evidence that zebrafish is an ideal experimental tool for uncovering novel mechanisms of trace mineral metabolism and for improving approaches to treat mineral imbalance-related diseases. PMID:24639652

Development of a chronic noncancer oral reference dose and drinking water screening level for sulfolane using benchmark dose modeling.

PubMed

Thompson, Chad M; Gaylor, David W; Tachovsky, J Andrew; Perry, Camarie; Carakostas, Michael C; Haws, Laurie C

2013-12-01

Sulfolane is a widely used industrial solvent that is often used for gas treatment (sour gas sweetening; hydrogen sulfide removal from shale and coal processes, etc.), and in the manufacture of polymers and electronics, and may be found in pharmaceuticals as a residual solvent used in the manufacturing processes. Sulfolane is considered a high production volume chemical with worldwide production around 18 000-36 000 tons per year. Given that sulfolane has been detected as a contaminant in groundwater, an important potential route of exposure is tap water ingestion. Because there are currently no federal drinking water standards for sulfolane in the USA, we developed a noncancer oral reference dose (RfD) based on benchmark dose modeling, as well as a tap water screening value that is protective of ingestion. Review of the available literature suggests that sulfolane is not likely to be mutagenic, clastogenic or carcinogenic, or pose reproductive or developmental health risks except perhaps at very high exposure concentrations. RfD values derived using benchmark dose modeling were 0.01-0.04 mg kg(-1) per day, although modeling of developmental endpoints resulted in higher values, approximately 0.4 mg kg(-1) per day. The lowest, most conservative, RfD of 0.01 mg kg(-1) per day was based on reduced white blood cell counts in female rats. This RfD was used to develop a tap water screening level that is protective of ingestion, viz. 365 µg l(-1). It is anticipated that these values, along with the hazard identification and dose-response modeling described herein, should be informative for risk assessors and regulators interested in setting health-protective drinking water guideline values for sulfolane. Copyright © 2012 John Wiley & Sons, Ltd.

Thermal Integration of a Liquid Acquisition Device into a Cryogenic Feed System

NASA Technical Reports Server (NTRS)

Hastings, L. J.; Bolshinskiy, L. G.; Schunk, R. G.; Martin, A. K.; Eskridge, R. H.; Frenkel, A.; Grayson, G.; Pendleton, M. L.

2011-01-01

Primary objectives of this effort were to define the following: (1) Approaches for quantification of the accumulation of thermal energy within a capillary screen liquid acquisition device (LAD) for a lunar lander upper stage during periods of up to 210 days on the lunar surface, (2) techniques for mitigating heat entrapment, and (3) perform initial testing, data evaluation. The technical effort was divided into the following categories: (1) Detailed thermal modeling of the LAD/feed system interactions using both COMSOL computational fluid device and standard codes, (2) FLOW-3D modeling of bulk liquid to provide interfacing conditions for the LAD thermal modeling, (3) condensation conditioning of capillary screens to stabilize surface tension retention capability, and (4) subscale testing of an integrated LAD/feed system. Substantial progress was achieved in the following technical areas: (1) Thermal modeling and experimental approaches for evaluating integrated cryogen LAD/feed systems, at both the system and component levels, (2) reduced gravity pressure control analyses, (3) analytical modeling and testing for capillary screen conditioning using condensation and wicking, and (4) development of rapid turnaround testing techniques for evaluating LAD/feed system thermal and fluid integration. A comprehensive effort, participants included a diverse cross section of representatives from academia, contractors, and multiple Marshall Space Flight Center organizations.

The role of area-level deprivation and gender in participation in population-based faecal immunochemical test (FIT) colorectal cancer screening.

PubMed

Clarke, Nicholas; McNamara, Deirdre; Kearney, Patricia M; O'Morain, Colm A; Shearer, Nikki; Sharp, Linda

2016-12-01

This study aimed to investigate the effects of sex and deprivation on participation in a population-based faecal immunochemical test (FIT) colorectal cancer screening programme. The study population included 9785 individuals invited to participate in two rounds of a population-based biennial FIT-based screening programme, in a relatively deprived area of Dublin, Ireland. Explanatory variables included in the analysis were sex, deprivation category of area of residence and age (at end of screening). The primary outcome variable modelled was participation status in both rounds combined (with "participation" defined as having taken part in either or both rounds of screening). Poisson regression with a log link and robust error variance was used to estimate relative risks (RR) for participation. As a sensitivity analysis, data were stratified by screening round. In both the univariable and multivariable models deprivation was strongly associated with participation. Increasing affluence was associated with higher participation; participation was 26% higher in people resident in the most affluent compared to the most deprived areas (multivariable RR=1.26: 95% CI 1.21-1.30). Participation was significantly lower in males (multivariable RR=0.96: 95%CI 0.95-0.97) and generally increased with increasing age (trend per age group, multivariable RR=1.02: 95%CI, 1.01-1.02). No significant interactions between the explanatory variables were found. The effects of deprivation and sex were similar by screening round. Deprivation and male gender are independently associated with lower uptake of population-based FIT colorectal cancer screening, even in a relatively deprived setting. Development of evidence-based interventions to increase uptake in these disadvantaged groups is urgently required. Copyright © 2016. Published by Elsevier Inc.

Association of eHealth Literacy With Colorectal Cancer Knowledge and Screening Practice Among Internet Users in Japan

PubMed Central

2012-01-01

Background In rapidly developing Internet-user societies, eHealth literacy has become important in promoting wellness. Although previous studies have observed that poor health literacy is associated with less knowledge and screening practice of colorectal cancer (CRC), little is known about whether eHealth literacy is associated with these variables. Objective The present study examined associations between eHealth literacy, knowledge of CRC, and CRC screening practices. Methods Data were analyzed for 2970 Japanese adults (men, 49.9%; mean age ± SD, 39.7 ± 10.9 years) who responded to an Internet-based cross-sectional survey. Knowledge of the definition of CRC, its risk factors and screening practice, previous experience of CRC screening, score on the Japanese version of the eHEALS (J-eHEALS), sociodemographic attributes (sex, age, marital status, educational attainment, and household income level), and frequency of Internet usage were obtained. Sociodemographic attributes and frequency of Internet usage were used as control variables in the multiple regression and logistic regression models. Results eHealth literacy was positively associated with CRC knowledge (β = .116, < .001), when the covariables of both eHealth literacy and CRC knowledge were used in the multiple regression model. Moreover, after controlling for sociodemographic factors, which were significantly associated with eHealth literacy and CRC screening practice, an increase of 1 point in the eHEALS score signified that participants were 1.03 times (95% CI = 1.01–1.05) more likely to undergo CRC screening. Conclusions Internet users with high eHealth literacy are more likely to have knowledge and previous screening practice related to CRC compared to those with low eHealth literacy. PMID:23149453

Association of eHealth literacy with colorectal cancer knowledge and screening practice among internet users in Japan.

PubMed

Mitsutake, Seigo; Shibata, Ai; Ishii, Kaori; Oka, Koichiro

2012-11-13

In rapidly developing Internet-user societies, eHealth literacy has become important in promoting wellness. Although previous studies have observed that poor health literacy is associated with less knowledge and screening practice of colorectal cancer (CRC), little is known about whether eHealth literacy is associated with these variables. The present study examined associations between eHealth literacy, knowledge of CRC, and CRC screening practices. Data were analyzed for 2970 Japanese adults (men, 49.9%; mean age±SD, 39.7±10.9 years) who responded to an Internet-based cross-sectional survey. Knowledge of the definition of CRC, its risk factors and screening practice, previous experience of CRC screening, score on the Japanese version of the eHEALS (J-eHEALS), sociodemographic attributes (sex, age, marital status, educational attainment, and household income level), and frequency of Internet usage were obtained. Sociodemographic attributes and frequency of Internet usage were used as control variables in the multiple regression and logistic regression models. eHealth literacy was positively associated with CRC knowledge (β=.116, <.001), when the covariables of both eHealth literacy and CRC knowledge were used in the multiple regression model. Moreover, after controlling for sociodemographic factors, which were significantly associated with eHealth literacy and CRC screening practice, an increase of 1 point in the eHEALS score signified that participants were 1.03 times (95% CI=1.01-1.05) more likely to undergo CRC screening. Internet users with high eHealth literacy are more likely to have knowledge and previous screening practice related to CRC compared to those with low eHealth literacy.

Collective screening tools for early identification of dyslexia

PubMed Central

Andrade, Olga V. C. A.; Andrade, Paulo E.; Capellini, Simone A.

2015-01-01

Current response to intervention models (RTIs) favor a three-tier system. In general, Tier 1 consists of evidence-based, effective reading instruction in the classroom and universal screening of all students at the beginning of the grade level to identify children for early intervention. Non-responders to Tier 1 receive small-group tutoring in Tier 2. Non-responders to Tier 2 are given still more intensive, individual intervention in Tier 3. Limited time, personnel and financial resources derail RTI’s implementation in Brazilian schools because this approach involves procedures that require extra time and extra personnel in all three tiers, including screening tools which normally consist of tasks administered individually. We explored the accuracy of collectively and easily administered screening tools for the early identification of second graders at risk for dyslexia in a two-stage screening model. A first-stage universal screening based on collectively administered curriculum-based measurements was used in 45 7 years old early Portuguese readers from 4 second-grade classrooms at the beginning of the school year and identified an at-risk group of 13 academic low-achievers. Collectively administered tasks based on phonological judgments by matching figures and figures to spoken words [alternative tools for educators (ATE)] and a comprehensive cognitive-linguistic battery of collective and individual assessments were both administered to all children and constituted the second-stage screening. Low-achievement on ATE tasks and on collectively administered writing tasks (scores at the 25th percentile) showed good sensitivity (true positives) and specificity (true negatives) to poor literacy status defined as scores ≤1 SD below the mean on literacy abilities at the end of fifth grade. These results provide implications for the use of a collectively administered screening tool for the early identification of children at risk for dyslexia in a classroom setting. PMID:25667575

The Effect of Classroom Teachers' Attitudes toward Constructivist Approach on Their Level of Establishing a Constructivist Learning Environment: A Case of Mersin

ERIC Educational Resources Information Center

Uredi, Lutfi

2013-01-01

This study aims to determine the attitudes of classroom teachers towards constructivist approach and to analyze the effect of their attitudes towards constructivist approach on their level of creating a constructivist learning environment. For that purpose, relational screening model was used in the research. The research sample included 504…

Screening Mammography: Patient Perceptions and Preferences Regarding Communication of Estimated Breast Cancer Risk.

PubMed

Amornsiripanitch, Nita; Mangano, Mark; Niell, Bethany L

2017-05-01

Many models exist to estimate a woman's risk of development of breast cancer. At screening mammography, many imaging centers collect data required for these models to identify women who may benefit from supplemental screening and referral for cancer risk assessment. The purpose of this study was to discern perceptions and preferences of screening mammography patients regarding communication of estimated breast cancer risk. An anonymous survey was distributed to screening and surveillance mammography patients between April and June 2015. Survey questions were designed to assess patient preferences regarding the receipt and complexity of risk estimate communication, including hypothetical scenarios with and without > 20% estimated risk of breast cancer. The McNemar test and the Wilcoxon signed rank test were used with p ≤ 0.05 considered statistically significant. The survey was distributed to 1061 screening and surveillance mammography patients, and 503 patients responded (response rate, 47%). Although 86% (431/503) of patients expressed interest in learning their estimated risk, only 8% (38/503) had undergone formal risk assessment. The preferred method (241 respondents [26%]) of communication of risk < 20% was a mailed letter accompanying annual mammogram results. For risk > 20%, patients preferred oral communication and were 10-fold as likely to choose only oral communication (p < 0.000001). For risk < 20% and > 20%, patients preferred to learn their estimated risk in great detail (69% and 85%), although women were significantly more likely to choose greater detail for risk > 20% (p < 0.00001). Screening mammography patients expressed interest in learning their estimated risk of breast cancer regardless of their level of hypothetical risk.

Mental health screening and evaluation within prisons.

PubMed

Metzner, J L; Miller, R D; Kleinsasser, D

1994-01-01

Current national standards and/or guidelines for correctional mental health care programs emphasize the importance of various levels of mental health screening and evaluation that should be performed by qualified personnel on all inmates as part of the admission process to a prison. The authors describe the results of a study that included data from all 50 state departments of corrections regarding prison mental health screening and evaluation models. The vast majority of states appear to have adopted some variation of the most recognized guidelines and/or standards (e.g., American Psychiatric Association, National Commission on Correctional Health Care, American Public Health Association) concerning correctional health care systems. Results are also provided concerning the use of standardized psychological tests and informed consent issues.

Recalibration of indium foil for personnel screening in criticality accidents.

PubMed

Takada, C; Tsujimura, N; Mikami, S

2011-03-01

At the Nuclear Fuel Cycle Engineering Laboratories of the Japan Atomic Energy Agency (JAEA), small pieces of indium foil incorporated into personal dosemeters have been used for personnel screening in criticality accidents. Irradiation tests of the badges were performed using the SILENE reactor to verify the calibration of the indium activation that had been made in the 1980s and to recalibrate them for simulated criticalities that would be the most likely to occur in the solution process line. In addition, Monte Carlo calculations of the indium activation using the badge model were also made to complement the spectral dependence. The results lead to a screening level of 15 kcpm being determined that corresponds to a total dose of 0.25 Gy, which is also applicable in posterior-anterior exposure. The recalibration based on the latest study will provide a sounder basis for the screening procedure in the event of a criticality accident.

Expansion of electronic health record-based screening, prevention, and management of diabetes in New York City.

PubMed

Albu, Jeanine; Sohler, Nancy; Matti-Orozco, Brenda; Sill, Jordan; Baxter, Daniel; Burke, Gary; Young, Edwin

2013-01-01

To address the increasing burden of diabetes in New York City, we designed 2 electronic health records (EHRs)-facilitated diabetes management systems to be implemented in 6 primary care practices on the West Side of Manhattan, a standard system and an enhanced system. The standard system includes screening for diabetes. The enhanced system includes screening and ensures close patient follow-up; it applies principles of the chronic care model, including community-clinic linkages, to the management of patients newly diagnosed with diabetes and prediabetes through screening. We will stagger implementation of the enhanced system across the 6 clinics allowing comparison, through a quasi-experimental design (pre-post difference with a control group), of patients treated in the enhanced system with similar patients treated in the standard system. The findings could inform health system practices at multiple levels and influence the integration of community resources into routine diabetes care.

Relating memory to functional performance in normal aging to dementia using hierarchical Bayesian cognitive processing models.

PubMed

Shankle, William R; Pooley, James P; Steyvers, Mark; Hara, Junko; Mangrola, Tushar; Reisberg, Barry; Lee, Michael D

2013-01-01

Determining how cognition affects functional abilities is important in Alzheimer disease and related disorders. A total of 280 patients (normal or Alzheimer disease and related disorders) received a total of 1514 assessments using the functional assessment staging test (FAST) procedure and the MCI Screen. A hierarchical Bayesian cognitive processing model was created by embedding a signal detection theory model of the MCI Screen-delayed recognition memory task into a hierarchical Bayesian framework. The signal detection theory model used latent parameters of discriminability (memory process) and response bias (executive function) to predict, simultaneously, recognition memory performance for each patient and each FAST severity group. The observed recognition memory data did not distinguish the 6 FAST severity stages, but the latent parameters completely separated them. The latent parameters were also used successfully to transform the ordinal FAST measure into a continuous measure reflecting the underlying continuum of functional severity. Hierarchical Bayesian cognitive processing models applied to recognition memory data from clinical practice settings accurately translated a latent measure of cognition into a continuous measure of functional severity for both individuals and FAST groups. Such a translation links 2 levels of brain information processing and may enable more accurate correlations with other levels, such as those characterized by biomarkers.

EVALUATING THE SENSITIVITY OF SCREENING-LEVEL VAPOR INTRUSTION MODELS

EPA Science Inventory

Vapor intrusion is defined as the migration of volatile chemicals from the subsurface into overlying buildings. Volatile organic contaminants (VOCs) in soil or ground water can volatilize into soil gas and be transported towards the land surface where it can enter homes or busin...

RFC 18001 – Regional Screening Level Tables – Anthraquinone

EPA Pesticide Factsheets

9,10-Anthraquinone (CASRN 84-65-1) in Provisional Peer-Reviewed Toxicity Values, EPA/690/R-11/007F, Final 2-17-2011, and EPA Regional Screening Level (RSL) Tables at: https://www.epa.gov/risk/regional-screening-levels-rsls-generic-tables-november-2017

Cost-Effectiveness of Osteoporosis Screening Strategies for Men

PubMed Central

Nayak, Smita; Greenspan, Susan L.

2016-01-01

Osteoporosis affects many men, with significant morbidity and mortality. However, the best osteoporosis screening strategies for men are unknown. We developed an individual-level state-transition cost-effectiveness model with a lifetime time horizon to identify the cost-effectiveness of different osteoporosis screening strategies for U.S. men involving various screening tests (dual-energy x-ray absorptiometry (DXA); the Osteoporosis Self-Assessment Tool (OST); or a fracture risk assessment strategy using age, femoral neck bone mineral density (BMD), and Vertebral Fracture Assessment (VFA)); screening initiation ages (50, 60, 70, or 80); and repeat screening intervals (5 years or 10 years). In base-case analysis, no screening was a less effective option than all other strategies evaluated; furthermore, no screening was more expensive than all strategies that involved screening with DXA or the OST risk assessment instrument, and thus no screening was “dominated” by screening with DXA or OST at all evaluated screening initiation ages and repeat screening intervals. Screening strategies that most frequently appeared as most cost-effective in base-case analysis and one-way sensitivity analyses when assuming willingness-to-pay of $50,000/QALY or $100,000/QALY included screening initiation at age 50 with the fracture risk assessment strategy and repeat screening every 10 years; screening initiation at age 50 with fracture risk assessment and repeat screening every 5 years; and screening initiation at age 50 with DXA and repeat screening every 5 years. In conclusion, expansion of osteoporosis screening for U.S. men to initiate routine screening at age 50 or 60 would be expected to be effective and of good value for improving health outcomes. A fracture risk assessment strategy using variables of age, femoral neck BMD, and VFA is likely to be the most effective of the evaluated strategies within accepted cost-effectiveness parameters. DXA and OST are also reasonable screening options, albeit likely slightly less effective than the evaluated fracture risk assessment strategy. PMID:26751984

Studying circadian rhythm and sleep using genetic screens in Drosophila.

PubMed

Axelrod, Sofia; Saez, Lino; Young, Michael W

2015-01-01

The power of Drosophila melanogaster as a model organism lies in its ability to be used for large-scale genetic screens with the capacity to uncover the genetic basis of biological processes. In particular, genetic screens for circadian behavior, which have been performed since 1971, allowed researchers to make groundbreaking discoveries on multiple levels: they discovered that there is a genetic basis for circadian behavior, they identified the so-called core clock genes that govern this process, and they started to paint a detailed picture of the molecular functions of these clock genes and their encoded proteins. Since the discovery that fruit flies sleep in 2000, researchers have successfully been using genetic screening to elucidate the many questions surrounding this basic animal behavior. In this chapter, we briefly recall the history of circadian rhythm and sleep screens and then move on to describe techniques currently employed for mutagenesis and genetic screening in the field. The emphasis lies on comparing the newer approaches of transgenic RNA interference (RNAi) to classical forms of mutagenesis, in particular in their application to circadian behavior and sleep. We discuss the different screening approaches in light of the literature and published and unpublished sleep and rhythm screens utilizing ethyl methanesulfonate mutagenesis and transgenic RNAi from our lab. © 2015 Elsevier Inc. All rights reserved.

Development of a Clinical Forecasting Model to Predict Comorbid Depression Among Diabetes Patients and an Application in Depression Screening Policy Making.

PubMed

Jin, Haomiao; Wu, Shinyi; Di Capua, Paul

2015-09-03

Depression is a common but often undiagnosed comorbid condition of people with diabetes. Mass screening can detect undiagnosed depression but may require significant resources and time. The objectives of this study were 1) to develop a clinical forecasting model that predicts comorbid depression among patients with diabetes and 2) to evaluate a model-based screening policy that saves resources and time by screening only patients considered as depressed by the clinical forecasting model. We trained and validated 4 machine learning models by using data from 2 safety-net clinical trials; we chose the one with the best overall predictive ability as the ultimate model. We compared model-based policy with alternative policies, including mass screening and partial screening, on the basis of depression history or diabetes severity. Logistic regression had the best overall predictive ability of the 4 models evaluated and was chosen as the ultimate forecasting model. Compared with mass screening, the model-based policy can save approximately 50% to 60% of provider resources and time but will miss identifying about 30% of patients with depression. Partial-screening policy based on depression history alone found only a low rate of depression. Two other heuristic-based partial screening policies identified depression at rates similar to those of the model-based policy but cost more in resources and time. The depression prediction model developed in this study has compelling predictive ability. By adopting the model-based depression screening policy, health care providers can use their resources and time better and increase their efficiency in managing their patients with depression.

Effective screening length and quasiuniversality for the restricted primitive model of an electrolyte solution.

PubMed

Janecek, Jirí; Netz, Roland R

2009-02-21

Monte Carlo simulations for the restricted primitive model of an electrolyte solution above the critical temperature are performed at a wide range of concentrations and temperatures. Thermodynamic properties such as internal energy, osmotic coefficient, activity coefficient, as well as spatial correlation functions are determined. These observables are used to investigate whether quasiuniversality in terms of an effective screening length exists, similar to the role played by the effective electron mass in solid-state physics. To that end, an effective screening length is extracted from the asymptotic behavior of the Fourier-transformed charge-correlation function and plugged into the Debye-Huckel limiting expressions for various thermodynamic properties. Comparison with numerical results is favorable, suggesting that correlation and other effects not captured on the Debye-Huckel limiting level can be successfully incorporated by a single effective parameter while keeping the functional form of Debye-Huckel expressions. We also compare different methods to determine mean ionic activity coefficient in molecular simulations and check the internal consistency of the numerical data.

Blood-brain-barrier spheroids as an in vitro screening platform for brain-penetrating agents.

PubMed

Cho, Choi-Fong; Wolfe, Justin M; Fadzen, Colin M; Calligaris, David; Hornburg, Kalvis; Chiocca, E Antonio; Agar, Nathalie Y R; Pentelute, Bradley L; Lawler, Sean E

2017-06-06

Culture-based blood-brain barrier (BBB) models are crucial tools to enable rapid screening of brain-penetrating drugs. However, reproducibility of in vitro barrier properties and permeability remain as major challenges. Here, we report that self-assembling multicellular BBB spheroids display reproducible BBB features and functions. The spheroid core is comprised mainly of astrocytes, while brain endothelial cells and pericytes encase the surface, acting as a barrier that regulates transport of molecules. The spheroid surface exhibits high expression of tight junction proteins, VEGF-dependent permeability, efflux pump activity and receptor-mediated transcytosis of angiopep-2. In contrast, the transwell co-culture system displays comparatively low levels of BBB regulatory proteins, and is unable to discriminate between the transport of angiopep-2 and a control peptide. Finally, we have utilized the BBB spheroids to screen and identify BBB-penetrant cell-penetrating peptides (CPPs). This robust in vitro BBB model could serve as a valuable next-generation platform for expediting the development of CNS therapeutics.

Risk-Screening Environmental Indicators (RSEI)

EPA Pesticide Factsheets

EPA's Risk-Screening Environmental Indicators (RSEI) is a geographically-based model that helps policy makers and communities explore data on releases of toxic substances from industrial facilities reporting to EPA??s Toxics Release Inventory (TRI). By analyzing TRI information together with simplified risk factors, such as the amount of chemical released, its fate and transport through the environment, each chemical??s relative toxicity, and the number of people potentially exposed, RSEI calculates a numeric score, which is designed to only be compared to other scores calculated by RSEI. Because it is designed as a screening-level model, RSEI uses worst-case assumptions about toxicity and potential exposure where data are lacking, and also uses simplifying assumptions to reduce the complexity of the calculations. A more refined assessment is required before any conclusions about health impacts can be drawn. RSEI is used to establish priorities for further investigation and to look at changes in potential impacts over time. Users can save resources by conducting preliminary analyses with RSEI.

Modeling the Dynamics of High-Grade Serous Ovarian Cancer Progression for Transvaginal Ultrasound-Based Screening and Early Detection

PubMed Central

Lee, Jung-Min; Levy, Doron

2016-01-01

High-grade serous ovarian cancer (HGSOC) represents the majority of ovarian cancers and accounts for the largest proportion of deaths from the disease. A timely detection of low volume HGSOC should be the goal of any screening studies. However, numerous transvaginal ultrasound (TVU) detection-based population studies aimed at detecting low-volume disease have not yielded reduced mortality rates. A quantitative invalidation of TVU as an effective HGSOC screening strategy is a necessary next step. Herein, we propose a mathematical model for a quantitative explanation on the reported failure of TVU-based screening to improve HGSOC low-volume detectability and overall survival.We develop a novel in silico mathematical assessment of the efficacy of a unimodal TVU monitoring regimen as a strategy aimed at detecting low-volume HGSOC in cancer-positive cases, defined as cases for which the inception of the first malignant cell has already occurred. Our findings show that the median window of opportunity interval length for TVU monitoring and HGSOC detection is approximately 1.76 years. This does not translate into reduced mortality levels or improved detection accuracy in an in silico cohort across multiple TVU monitoring frequencies or detection sensitivities. We demonstrate that even a semiannual, unimodal TVU monitoring protocol is expected to miss detectable HGSOC. Lastly, we find that circa 50% of the simulated HGSOC growth curves never reach the baseline detectability threshold, and that on average, 5–7 infrequent, rate-limiting stochastic changes in the growth parameters are associated with reaching HGSOC detectability and mortality thresholds respectively. Focusing on a malignancy poorly studied in the mathematical oncology community, our model captures the dynamic, temporal evolution of HGSOC progression. Our mathematical model is consistent with recent case reports and prospective TVU screening population studies, and provides support to the empirical recommendation against frequent HGSOC screening. PMID:27257824

Models of Community-Based Hepatitis B Surface Antigen Screening Programs in the U.S. and Their Estimated Outcomes and Costs

PubMed Central

Rein, David B.; Lesesne, Sarah B.; Smith, Bryce D.; Weinbaum, Cindy M.

2011-01-01

Objectives Information on the process and method of service delivery is sparse for hepatitis B surface antigen (HBsAg) testing, and no systematic study has evaluated the relative effectiveness or cost-effectiveness of different HBsAg screening models. To address this need, we compared five specific community-based screening programs. Methods We funded five HBsAg screening programs to collect information on their design, costs, and outcomes of participants during a six-month observation period. We categorized programs into four types of models. For each model, we calculated the number screened, the number screened as per Centers for Disease Control and Prevention (CDC) recommendations, and the cost per screening. Results The models varied by cost per person screened and total number of people screened, but they did not differ meaningfully in the proportion of people screened following CDC recommendations, the proportion of those screened who tested positive, or the proportion of those who newly tested positive. Conclusions Integrating screening into outpatient service settings is the most cost-effective method but may not reach all people needing to be screened. Future research should examine cost-effective methods that expand the reach of screening into communities in outpatient settings. PMID:21800750

A PATO-compliant zebrafish screening database (MODB): management of morpholino knockdown screen information.

PubMed

Knowlton, Michelle N; Li, Tongbin; Ren, Yongliang; Bill, Brent R; Ellis, Lynda Bm; Ekker, Stephen C

2008-01-07

The zebrafish is a powerful model vertebrate amenable to high throughput in vivo genetic analyses. Examples include reverse genetic screens using morpholino knockdown, expression-based screening using enhancer trapping and forward genetic screening using transposon insertional mutagenesis. We have created a database to facilitate web-based distribution of data from such genetic studies. The MOrpholino DataBase is a MySQL relational database with an online, PHP interface. Multiple quality control levels allow differential access to data in raw and finished formats. MODBv1 includes sequence information relating to almost 800 morpholinos and their targets and phenotypic data regarding the dose effect of each morpholino (mortality, toxicity and defects). To improve the searchability of this database, we have incorporated a fixed-vocabulary defect ontology that allows for the organization of morpholino affects based on anatomical structure affected and defect produced. This also allows comparison between species utilizing Phenotypic Attribute Trait Ontology (PATO) designated terminology. MODB is also cross-linked with ZFIN, allowing full searches between the two databases. MODB offers users the ability to retrieve morpholino data by sequence of morpholino or target, name of target, anatomical structure affected and defect produced. MODB data can be used for functional genomic analysis of morpholino design to maximize efficacy and minimize toxicity. MODB also serves as a template for future sequence-based functional genetic screen databases, and it is currently being used as a model for the creation of a mutagenic insertional transposon database.

A Pre-Screening Questionnaire to Predict Non-24-Hour Sleep-Wake Rhythm Disorder (N24HSWD) among the Blind

PubMed Central

Flynn-Evans, Erin E.; Lockley, Steven W.

2016-01-01

Study Objectives: There is currently no questionnaire-based pre-screening tool available to detect non-24-hour sleep-wake rhythm disorder (N24HSWD) among blind patients. Our goal was to develop such a tool, derived from gold standard, objective hormonal measures of circadian entrainment status, for the detection of N24HSWD among those with visual impairment. Methods: We evaluated the contribution of 40 variables in their ability to predict N24HSWD among 127 blind women, classified using urinary 6-sulfatoxymelatonin period, an objective marker of circadian entrainment status in this population. We subjected the 40 candidate predictors to 1,000 bootstrapped iterations of a logistic regression forward selection model to predict N24HSWD, with model inclusion set at the p < 0.05 level. We removed any predictors that were not selected at least 1% of the time in the 1,000 bootstrapped models and applied a second round of 1,000 bootstrapped logistic regression forward selection models to the remaining 23 candidate predictors. We included all questions that were selected at least 10% of the time in the final model. We subjected the selected predictors to a final logistic regression model to predict N24SWD over 1,000 bootstrapped models to calculate the concordance statistic and adjusted optimism of the final model. We used this information to generate a predictive model and determined the sensitivity and specificity of the model. Finally, we applied the model to a cohort of 1,262 blind women who completed the survey, but did not collect urine samples. Results: The final model consisted of eight questions. The concordance statistic, adjusted for bootstrapping, was 0.85. The positive predictive value was 88%, the negative predictive value was 79%. Applying this model to our larger dataset of women, we found that 61% of those without light perception, and 27% with some degree of light perception, would be referred for further screening for N24HSWD. Conclusions: Our model has predictive utility sufficient to serve as a pre-screening questionnaire for N24HSWD among the blind. Citation: Flynn-Evans EE, Lockley SW. A pre-screening questionnaire to predict non-24-hour sleep-wake rhythm disorder (N24HSWD) among the blind. J Clin Sleep Med 2016;12(5):703–710. PMID:26951421

Conceptual Framework To Extend Life Cycle Assessment Using Near-Field Human Exposure Modeling and High-Throughput Tools for Chemicals.

PubMed

Csiszar, Susan A; Meyer, David E; Dionisio, Kathie L; Egeghy, Peter; Isaacs, Kristin K; Price, Paul S; Scanlon, Kelly A; Tan, Yu-Mei; Thomas, Kent; Vallero, Daniel; Bare, Jane C

2016-11-01

Life Cycle Assessment (LCA) is a decision-making tool that accounts for multiple impacts across the life cycle of a product or service. This paper presents a conceptual framework to integrate human health impact assessment with risk screening approaches to extend LCA to include near-field chemical sources (e.g., those originating from consumer products and building materials) that have traditionally been excluded from LCA. A new generation of rapid human exposure modeling and high-throughput toxicity testing is transforming chemical risk prioritization and provides an opportunity for integration of screening-level risk assessment (RA) with LCA. The combined LCA and RA approach considers environmental impacts of products alongside risks to human health, which is consistent with regulatory frameworks addressing RA within a sustainability mindset. A case study is presented to juxtapose LCA and risk screening approaches for a chemical used in a consumer product. The case study demonstrates how these new risk screening tools can be used to inform toxicity impact estimates in LCA and highlights needs for future research. The framework provides a basis for developing tools and methods to support decision making on the use of chemicals in products.

Implications of Nine Risk Prediction Models for Selecting Ever-Smokers for Computed Tomography Lung Cancer Screening.

PubMed

Katki, Hormuzd A; Kovalchik, Stephanie A; Petito, Lucia C; Cheung, Li C; Jacobs, Eric; Jemal, Ahmedin; Berg, Christine D; Chaturvedi, Anil K

2018-05-15

Lung cancer screening guidelines recommend using individualized risk models to refer ever-smokers for screening. However, different models select different screening populations. The performance of each model in selecting ever-smokers for screening is unknown. To compare the U.S. screening populations selected by 9 lung cancer risk models (the Bach model; the Spitz model; the Liverpool Lung Project [LLP] model; the LLP Incidence Risk Model [LLPi]; the Hoggart model; the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Model 2012 [PLCOM2012]; the Pittsburgh Predictor; the Lung Cancer Risk Assessment Tool [LCRAT]; and the Lung Cancer Death Risk Assessment Tool [LCDRAT]) and to examine their predictive performance in 2 cohorts. Population-based prospective studies. United States. Models selected U.S. screening populations by using data from the National Health Interview Survey from 2010 to 2012. Model performance was evaluated using data from 337 388 ever-smokers in the National Institutes of Health-AARP Diet and Health Study and 72 338 ever-smokers in the CPS-II (Cancer Prevention Study II) Nutrition Survey cohort. Model calibration (ratio of model-predicted to observed cases [expected-observed ratio]) and discrimination (area under the curve [AUC]). At a 5-year risk threshold of 2.0%, the models chose U.S. screening populations ranging from 7.6 million to 26 million ever-smokers. These disagreements occurred because, in both validation cohorts, 4 models (the Bach model, PLCOM2012, LCRAT, and LCDRAT) were well-calibrated (expected-observed ratio range, 0.92 to 1.12) and had higher AUCs (range, 0.75 to 0.79) than 5 models that generally overestimated risk (expected-observed ratio range, 0.83 to 3.69) and had lower AUCs (range, 0.62 to 0.75). The 4 best-performing models also had the highest sensitivity at a fixed specificity (and vice versa) and similar discrimination at a fixed risk threshold. These models showed better agreement on size of the screening population (7.6 million to 10.9 million) and achieved consensus on 73% of persons chosen. No consensus on risk thresholds for screening. The 9 lung cancer risk models chose widely differing U.S. screening populations. However, 4 models (the Bach model, PLCOM2012, LCRAT, and LCDRAT) most accurately predicted risk and performed best in selecting ever-smokers for screening. Intramural Research Program of the National Institutes of Health/National Cancer Institute.

Human Systems Integration Design Environment (HSIDE)

DTIC Science & Technology

2012-04-09

quality of the resulting HSI products. 15. SUBJECT TERMS HSI , Manning Estimation and Validation , Risk Assessment, I POE, PLM, BPMN , Workflow...business process model in Business Process Modeling Notation ( BPMN ) or the actual workflow template associated with the specific functional area, again...as filtered by the user settings in the high level interface. Figure 3 shows the initial screen which allows the user to select either the BPMN or

Cost and effects of different admission screening strategies to control the spread of methicillin-resistant Staphylococcus aureus.

PubMed

Gurieva, Tanya; Bootsma, Martin C J; Bonten, Marc J M

2013-01-01

Nosocomial infection rates due to antibiotic-resistant bacteriae, e.g., methicillin-resistant Staphylococcus aureus (MRSA) remain high in most countries. Screening for MRSA carriage followed by barrier precautions for documented carriers (so-called screen and isolate (S&I)) has been successful in some, but not all settings. Moreover, different strategies have been proposed, but comparative studies determining their relative effects and costs are not available. We, therefore, used a mathematical model to evaluate the effect and costs of different S&I strategies and to identify the critical parameters for this outcome. The dynamic stochastic simulation model consists of 3 hospitals with general wards and intensive care units (ICUs) and incorporates readmission of carriers of MRSA. Patient flow between ICUs and wards was based on real observations. Baseline prevalence of MRSA was set at 20% in ICUs and hospital-wide at 5%; ranges of costs and infection rates were based on published data. Four S&I strategies were compared to a do-nothing scenario: S&I of previously documented carriers ("flagged" patients); S&I of flagged patients and ICU admissions; S&I of flagged and group of "frequent" patients; S&I of all hospital admissions (universal screening). Evaluated levels of efficacy of S&I were 10%, 25%, 50% and 100%. Our model predicts that S&I of flagged and S&I of flagged and ICU patients are the most cost-saving strategies with fastest return of investment. For low isolation efficacy universal screening and S&I of flagged and "frequent" patients may never become cost-saving. Universal screening is predicted to prevent hardly more infections than S&I of flagged and "frequent" patients, albeit at higher costs. Whether an intervention becomes cost-saving within 10 years critically depends on costs per infection in ICU, costs of screening and isolation efficacy.

Cost and Effects of Different Admission Screening Strategies to Control the Spread of Methicillin-resistant Staphylococcus aureus

PubMed Central

Gurieva, Tanya; Bootsma, Martin C. J.; Bonten, Marc J. M.

2013-01-01

Nosocomial infection rates due to antibiotic-resistant bacteriae, e.g., methicillin-resistant Staphylococcus aureus (MRSA) remain high in most countries. Screening for MRSA carriage followed by barrier precautions for documented carriers (so-called screen and isolate (S&I)) has been successful in some, but not all settings. Moreover, different strategies have been proposed, but comparative studies determining their relative effects and costs are not available. We, therefore, used a mathematical model to evaluate the effect and costs of different S&I strategies and to identify the critical parameters for this outcome. The dynamic stochastic simulation model consists of 3 hospitals with general wards and intensive care units (ICUs) and incorporates readmission of carriers of MRSA. Patient flow between ICUs and wards was based on real observations. Baseline prevalence of MRSA was set at 20% in ICUs and hospital-wide at 5%; ranges of costs and infection rates were based on published data. Four S&I strategies were compared to a do-nothing scenario: S&I of previously documented carriers (“flagged” patients); S&I of flagged patients and ICU admissions; S&I of flagged and group of “frequent” patients; S&I of all hospital admissions (universal screening). Evaluated levels of efficacy of S&I were 10%, 25%, 50% and 100%. Our model predicts that S&I of flagged and S&I of flagged and ICU patients are the most cost-saving strategies with fastest return of investment. For low isolation efficacy universal screening and S&I of flagged and “frequent” patients may never become cost-saving. Universal screening is predicted to prevent hardly more infections than S&I of flagged and “frequent” patients, albeit at higher costs. Whether an intervention becomes cost-saving within 10 years critically depends on costs per infection in ICU, costs of screening and isolation efficacy. PMID:23436984

Response: Reading between the lines of cancer screening trials: using modeling to understand the evidence.

PubMed

Etzioni, Ruth; Gulati, Roman

2013-04-01

In our article about limitations of basing screening policy on screening trials, we offered several examples of ways in which modeling, using data from large screening trials and population trends, provided insights that differed somewhat from those based only on empirical trial results. In this editorial, we take a step back and consider the general question of whether randomized screening trials provide the strongest evidence for clinical guidelines concerning population screening programs. We argue that randomized trials provide a process that is designed to protect against certain biases but that this process does not guarantee that inferences based on empirical results from screening trials will be unbiased. Appropriate quantitative methods are key to obtaining unbiased inferences from screening trials. We highlight several studies in the statistical literature demonstrating that conventional survival analyses of screening trials can be misleading and list a number of key questions concerning screening harms and benefits that cannot be answered without modeling. Although we acknowledge the centrality of screening trials in the policy process, we maintain that modeling constitutes a powerful tool for screening trial interpretation and screening policy development.

Development of small scale cell culture models for screening poloxamer 188 lot-to-lot variation.

PubMed

Peng, Haofan; Hall, Kaitlyn M; Clayton, Blake; Wiltberger, Kelly; Hu, Weiwei; Hughes, Erik; Kane, John; Ney, Rachel; Ryll, Thomas

2014-01-01

Shear protectants such as poloxamer 188 play a critical role in protecting cells during cell culture bioprocessing. Lot-to-lot variation of poloxamer 188 was experienced during a routine technology transfer across sites of similar scale and equipment. Cell culture medium containing a specific poloxamer 188 lot resulted in an unusual drop in cell growth, viability, and titer during manufacturing runs. After switching poloxamer lots, culture performance returned to the expected level. In order to control the quality of poloxamer 188 and thus maintain better consistency in manufacturing, multiple small scale screening models were developed. Initially, a 5L bioreactor model was established to evaluate cell damage by high sparge rates with different poloxamer 188 lots. Subsequently, a more robust, simple, and efficient baffled shake flask model was developed. The baffled shake flask model can be performed in a high throughput manner to investigate the cell damage in a bubbling environment. The main cause of the poor performance was the loss of protection, rather than toxicity. It was also suggested that suspicious lots can be identified using different cell line and media. The screening methods provide easy, yet remarkable models for understanding and controlling cell damage due to raw material lot variation as well as studying the interaction between poloxamer 188 and cells. © 2014 American Institute of Chemical Engineers.

Chemical structure-based predictive model for methanogenic anaerobic biodegradation potential.

PubMed

Meylan, William; Boethling, Robert; Aronson, Dallas; Howard, Philip; Tunkel, Jay

2007-09-01

Many screening-level models exist for predicting aerobic biodegradation potential from chemical structure, but anaerobic biodegradation generally has been ignored by modelers. We used a fragment contribution approach to develop a model for predicting biodegradation potential under methanogenic anaerobic conditions. The new model has 37 fragments (substructures) and classifies a substance as either fast or slow, relative to the potential to be biodegraded in the "serum bottle" anaerobic biodegradation screening test (Organization for Economic Cooperation and Development Guideline 311). The model correctly classified 90, 77, and 91% of the chemicals in the training set (n = 169) and two independent validation sets (n = 35 and 23), respectively. Accuracy of predictions of fast and slow degradation was equal for training-set chemicals, but fast-degradation predictions were less accurate than slow-degradation predictions for the validation sets. Analysis of the signs of the fragment coefficients for this and the other (aerobic) Biowin models suggests that in the context of simple group contribution models, the majority of positive and negative structural influences on ultimate degradation are the same for aerobic and methanogenic anaerobic biodegradation.

A model-based cost-effectiveness analysis of osteoporosis screening and treatment strategy for postmenopausal Japanese women.

PubMed

Yoshimura, M; Moriwaki, K; Noto, S; Takiguchi, T

2017-02-01

Although an osteoporosis screening program has been implemented as a health promotion project in Japan, its cost-effectiveness has yet to be elucidated fully. We performed a cost-effectiveness analysis and found that osteoporosis screening and treatment would be cost-effective for Japanese women over 60 years. The purpose of this study was to estimate the cost-effectiveness of osteoporosis screening and drug therapy in the Japanese healthcare system for postmenopausal women with no history of fracture. A patient-level state transition model was developed to predict the outcomes of Japanese women with no previous fracture. Lifetime costs and quality-adjusted life years (QALYs) were estimated for women who receive osteoporosis screening and alendronate therapy for 5 years and those who do not receive the screening and treatments. The incremental cost-effectiveness ratio (ICER) of the screening option compared with the no screening option was estimated. Sensitivity analyses were performed to examine the influence of parameter uncertainty on the base case results. The ICERs of osteoporosis screening and treatments for Japanese women aged 50-54, 55-59, 60-64, 65-69, 70-74, and 75-79 years were estimated to be $89,242, $64,010, $40,596, $27,697, $17,027, and $9771 per QALY gained, respectively. Deterministic sensitivity analyses showed that several parameters such as the disutility due to vertebral fracture had a significant influence on the base case results. Applying a willingness to pay of $50,000 per QALY gained, the probability that the screening option became cost-effectiveness estimated to 50.9, 56.3, 59.1, and 64.7 % for women aged 60-64, 65-69, 70-74, and 75-79 years, respectively. Scenario analyses showed that the ICER for women aged 55-59 years with at least one clinical risk factor was below $50,000 per QALY. In conclusion, dual energy X-ray absorptiometry (DXA) screening and alendronate therapy for osteoporosis would be cost-effective for postmenopausal Japanese women over 60 years. In terms of cost-effectiveness, the individual need for osteoporosis screening should be determined by age and clinical risk factors.

Establishment of apoptotic regulatory network for genetic markers of colorectal cancer.

PubMed

Hao, Yibin; Shan, Guoyong; Nan, Kejun

2017-03-01

Our purpose is to screen out genetic markers applicable to early diagnosis for colorectal cancer and to establish apoptotic regulatory network model for colorectal cancer, thereby providing theoretical evidence and targeted therapy for early diagnosis of colorectal cancer. Taking databases including CNKI, VIP, Wanfang data, Pub Med, and MEDLINE as main sources of literature retrieval, literatures associated with genetic markers applied to early diagnosis of colorectal cancer were searched to perform comprehensive and quantitative analysis by Meta analysis, hence screening genetic markers used in early diagnosis of colorectal cancer. Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were employed to establish apoptotic regulatory network model based on screened genetic markers, and then verification experiment was conducted. Through Meta analysis, seven genetic markers were screened out, including WWOX, K-ras, COX-2, p53, APC, DCC and PTEN, among which DCC shows highest diagnostic efficiency. GO analysis of genetic markers found that six genetic markers played role in biological process, molecular function and cellular component. It was indicated in apoptotic regulatory network built by KEGG analysis and verification experiment that WWOX could promote tumor cell apoptotic in colorectal cancer and elevate expression level of p53. The apoptotic regulatory model of colorectal cancer established in this study provides clinically theoretical evidence and targeted therapy for early diagnosis of colorectal cancer.

Incidence and risk factors for preoperative deep venous thrombosis in 314 consecutive patients undergoing surgery for spinal metastasis.

PubMed

Zacharia, Brad E; Kahn, Sweena; Bander, Evan D; Cederquist, Gustav Y; Cope, William P; McLaughlin, Lily; Hijazi, Alexa; Reiner, Anne S; Laufer, Ilya; Bilsky, Mark

2017-08-01

OBJECTIVE The authors of this study aimed to identify the incidence of and risk factors for preoperative deep venous thrombosis (DVT) in patients undergoing surgical treatment for spinal metastases. METHODS Univariate analysis of patient age, sex, ethnicity, laboratory values, comorbidities, preoperative ambulatory status, histopathological classification, spinal level, and surgical details was performed. Factors significantly associated with DVT univariately were entered into a multivariate logistic regression model. RESULTS The authors identified 314 patients, of whom 232 (73.9%) were screened preoperatively for a DVT. Of those screened, 22 (9.48%) were diagnosed with a DVT. The screened patients were older (median 62 vs 55 years, p = 0.0008), but otherwise similar in baseline characteristics. Nonambulatory status, previous history of DVT, lower partial thromboplastin time, and lower hemoglobin level were statistically significant and independent factors associated with positive results of screening for a DVT. Results of screening were positive in only 6.4% of ambulatory patients in contrast to 24.4% of nonambulatory patients, yielding an odds ratio of 4.73 (95% CI 1.88-11.90). All of the patients who had positive screening results underwent preoperative placement of an inferior vena cava filter. CONCLUSIONS Patients requiring surgery for spinal metastases represent a population with unique risks for venous thromboembolism. This study showed a 9.48% incidence of DVT in patients screened preoperatively. The highest rates of preoperative DVT were identified in nonambulatory patients, who were found to have a 4-fold increase in the likelihood of harboring a DVT. Understanding the preoperative thrombotic status may provide an opportunity for early intervention and risk stratification in this critically ill population.

Prostate-specific antigen screening impacts on biochemical recurrence in patients with clinically localized prostate cancer.

PubMed

Hashimoto, Takeshi; Ohori, Makoto; Shimodaira, Kenji; Kaburaki, Naoto; Hirasawa, Yosuke; Satake, Naoya; Gondo, Tatsuo; Nakagami, Yoshihiro; Namiki, Kazunori; Ohno, Yoshio

2018-06-01

To clarify the impact of prostate-specific antigen screening on surgical outcomes of prostate cancer. Patients who underwent radical prostatectomy were divided into two groups according to prostate-specific antigen testing opportunity (group 1, prostate-specific antigen screening; group 2, non-prostate-specific antigen screening). Perioperative clinical characteristics were compared using the Wilcoxon rank-sum and χ 2 -tests. Cox proportional hazards models were used to identify independent predictors of postoperative biochemical recurrence-free survival. In total, 798 patients (63.2%) and 464 patients (36.8%) were categorized into groups 1 and 2, respectively. Group 2 patients were more likely to have a higher prostate-specific antigen level and age at diagnosis and larger prostate volume. Clinical T stage, percentage of positive cores and pathological Gleason score did not differ between the groups. The 5-year biochemical recurrence-free survival rate was 83.9% for group 1 and 71.0% for group 2 (P < 0.001). On multivariate analysis, prostate-specific antigen testing opportunity (hazard ratio 2.530; P < 0.001) was an independent predictive factor for biochemical recurrence after surgery, as well as pathological T stage, pathological Gleason score, positive surgical margin and lymphovascular invasion. Additional analyses showed that prostate-specific antigen screening had a greater impact on biochemical recurrence in a younger patients, patients with a high prostate-specific antigen level, large prostate volume and D'Amico high risk, and patients meeting the exclusion criteria of the Prostate Cancer Research International Active Surveillance study. Detection by screening results in favorable outcomes after surgery. Prostate-specific antigen screening might contribute to reducing biochemical recurrence in patients with localized prostate cancer. © 2018 The Japanese Urological Association.

Cost-effectiveness of different screening strategies for osteoporosis in postmenopausal women.

PubMed

Nayak, Smita; Roberts, Mark S; Greenspan, Susan L

2011-12-06

The best strategies to screen postmenopausal women for osteoporosis are not clear. To identify the cost-effectiveness of various screening strategies. Individual-level state-transition cost-effectiveness model. Published literature. U.S. women aged 55 years or older. Lifetime. Payer. Screening strategies composed of alternative tests (central dual-energy x-ray absorptiometry [DXA], calcaneal quantitative ultrasonography [QUS], and the Simple Calculated Osteoporosis Risk Estimation [SCORE] tool) initiation ages, treatment thresholds, and rescreening intervals. Oral bisphosphonate treatment was assumed, with a base-case adherence rate of 50% and a 5-year on/off treatment pattern. Incremental cost-effectiveness ratios (2010 U.S. dollars per quality-adjusted life-year [QALY] gained). At all evaluated ages, screening was superior to not screening. In general, quality-adjusted life-days gained with screening tended to increase with age. At all initiation ages, the best strategy with an incremental cost-effectiveness ratio (ICER) of less than $50,000 per QALY was DXA screening with a T-score threshold of -2.5 or less for treatment and with follow-up screening every 5 years. Across screening initiation ages, the best strategy with an ICER less than $50,000 per QALY was initiation of screening at age 55 years by using DXA -2.5 with rescreening every 5 years. The best strategy with an ICER less than $100,000 per QALY was initiation of screening at age 55 years by using DXA with a T-score threshold of -2.0 or less for treatment and then rescreening every 10 years. No other strategy that involved treatment of women with osteopenia had an ICER less than $100,000 per QALY. Many other strategies, including strategies with SCORE or QUS prescreening, were also cost-effective, and in general the differences in effectiveness and costs between evaluated strategies was small. Probabilistic sensitivity analysis did not reveal a consistently superior strategy. Data were primarily from white women. Screening initiation at ages younger than 55 years were not examined. Only osteoporotic fractures of the hip, vertebrae, and wrist were modeled. Many strategies for postmenopausal osteoporosis screening are effective and cost-effective, including strategies involving screening initiation at age 55 years. No strategy substantially outperforms another. National Center for Research Resources.

Ionomic screening of field-grown soybeans identifies mutants with altered seed elemental composition

USDA-ARS?s Scientific Manuscript database

Soybean seeds contain high levels of mineral nutrients essential for human and animal nutrition. High throughput elemental profiling (ionomics) has identified mutants in model plant species grown in controlled environments. Here, we describe a method for identifying potential soybean ionomics mutant...

Screening-level assays for potentially human-infectious environmental Legionella spp.

EPA Science Inventory

In spite of the fact that Legionella species can be isolated from nonclinical settings, there is no standard method to determine whether environmental legionellae may be infectious to humans. In this study, an in vivo murine model of pneumonia and three in vitro proliferation as...

USE OF ELECTRICAL RESISTIVITY PROBE WITH MODFLOW FOR SCREENING LEVEL DETERMINATION OF PARAFLUVIAL HYPORHEIC FLOW

EPA Science Inventory

The hyporheic zone can provide significant nutrient attenuation in watersheds. Conceptual models describe the behavior of nutrients and biota for the hyporheic ecotone, but site characterization is needed to quantify these effects at the restoration reach scale (hundreds of meter...

78 FR 29049 - Streptomycin; Pesticide Tolerances for Emergency Exemptions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-17

... exposures for which there is reliable information.'' This includes exposure through drinking water and in... commodities. 2. Dietary exposure from drinking water. The Agency used screening level water exposure models in the dietary exposure analysis and risk assessment for streptomycin in drinking water. These simulation...

The Relationship between Principals' Cultural Intelligence Levels and Their Cultural Leadership Behaviors

ERIC Educational Resources Information Center

Göksoy, Süleyman

2017-01-01

This study aimed to identify school administrators' views on school administrators' cultural intelligence and cultural leadership behaviors. The study employed relational screening model, a descriptive research method, since it set out to determine the existing situation. "Cultural Intelligence Scale" and "Cultural Leadership…

Community Near-Port Modeling System (C-PORT): Briefing for Environmental Defense Fund

EPA Science Inventory

What C-PORT is: Screening level tool for assessing port activities and exploring the range of potential impacts that changes to port operations might have on local air quality; Analysis of decision alternatives through mapping of the likely pattern of potential pollutant dispersi...

Implementing a court diversion and liaison scheme in a remand prison by systematic screening of new receptions: a 6 year participatory action research study of 20,084 consecutive male remands

PubMed Central

2013-01-01

Background A mental health needs assessment in the Irish prison population confirmed findings from other jurisdictions showing high prevalence of severe mental illness, including psychosis amongst those newly committed. We implemented a participatory action research approach in order to provide an integrated mental health prison in-reach and court liaison service for this population. Results Following extensive consultation, a two stage screening process was developed which was supplemented by an inter-agency referral management system. During the six years 2006–2011, all 20,084 new remands to the main remand prison serving 58% of the national population were screened. Following the first stage screen, 3,195 received a comprehensive psychiatric assessment. Of these 561 (2.8%) had symptoms of psychosis – corresponding to the prior research finding – and 572 were diverted from the criminal justice system to mental health services (89 to a secure forensic hospital, 164 to community mental health hospitals and 319 to other community mental health services). Conclusions We have shown that it is possible to match research findings in clinical practice by systematic screening, to sustain this over a long period and to achieve consistent levels of diversion from the criminal justice system to appropriate mental health services. The sustained and consistent performance of the model used is likely to reflect the use of participatory action research both to find the most effective model and to achieve wide ownership and cooperation with the model of care. PMID:23800103

Unifying Screening Processes Within the PROSPR Consortium: A Conceptual Model for Breast, Cervical, and Colorectal Cancer Screening

PubMed Central

Kim, Jane J.; Schapira, Marilyn M.; Tosteson, Anna N. A.; Zauber, Ann G.; Geiger, Ann M.; Kamineni, Aruna; Weaver, Donald L.; Tiro, Jasmin A.

2015-01-01

General frameworks of the cancer screening process are available, but none directly compare the process in detail across different organ sites. This limits the ability of medical and public health professionals to develop and evaluate coordinated screening programs that apply resources and population management strategies available for one cancer site to other sites. We present a trans-organ conceptual model that incorporates a single screening episode for breast, cervical, and colorectal cancers into a unified framework based on clinical guidelines and protocols; the model concepts could be expanded to other organ sites. The model covers four types of care in the screening process: risk assessment, detection, diagnosis, and treatment. Interfaces between different provider teams (eg, primary care and specialty care), including communication and transfer of responsibility, may occur when transitioning between types of care. Our model highlights across each organ site similarities and differences in steps, interfaces, and transitions in the screening process and documents the conclusion of a screening episode. This model was developed within the National Cancer Institute–funded consortium Population-based Research Optimizing Screening through Personalized Regimens (PROSPR). PROSPR aims to optimize the screening process for breast, cervical, and colorectal cancer and includes seven research centers and a statistical coordinating center. Given current health care reform initiatives in the United States, this conceptual model can facilitate the development of comprehensive quality metrics for cancer screening and promote trans-organ comparative cancer screening research. PROSPR findings will support the design of interventions that improve screening outcomes across multiple cancer sites. PMID:25957378

Comparison of Loneliness and Social Skill Levels of Children with Specific Learning Disabilities in Terms of Participation in Sports

ERIC Educational Resources Information Center

Yilmaz, Atike; Kirimoglu, Hüseyin; Soyer, Fikret

2018-01-01

This study was conducted in order to compare loneliness and social skill levels of children with specific learning disabilities in terms of participation in sports. For this study, a screening model was used. The study group was composed of 56 children who were aged between 7 and 14 years and diagnosed with a specific learning disability (30 boys…

Classification of CITES-listed and other neotropical Meliaceae wood images using convolutional neural networks.

PubMed

Ravindran, Prabu; Costa, Adriana; Soares, Richard; Wiedenhoeft, Alex C

2018-01-01

The current state-of-the-art for field wood identification to combat illegal logging relies on experienced practitioners using hand lenses, specialized identification keys, atlases of woods, and field manuals. Accumulation of this expertise is time-consuming and access to training is relatively rare compared to the international demand for field wood identification. A reliable, consistent and cost effective field screening method is necessary for effective global scale enforcement of international treaties such as the Convention on the International Trade in Endagered Species (CITES) or national laws (e.g. the US Lacey Act) governing timber trade and imports. We present highly effective computer vision classification models, based on deep convolutional neural networks, trained via transfer learning, to identify the woods of 10 neotropical species in the family Meliaceae, including CITES-listed Swietenia macrophylla , Swietenia mahagoni , Cedrela fissilis , and Cedrela odorata . We build and evaluate models to classify the 10 woods at the species and genus levels, with image-level model accuracy ranging from 87.4 to 97.5%, with the strongest performance by the genus-level model. Misclassified images are attributed to classes consistent with traditional wood anatomical results, and our species-level accuracy greatly exceeds the resolution of traditional wood identification. The end-to-end trained image classifiers that we present discriminate the woods based on digital images of the transverse surface of solid wood blocks, which are surfaces and images that can be prepared and captured in the field. Hence this work represents a strong proof-of-concept for using computer vision and convolutional neural networks to develop practical models for field screening timber and wood products to combat illegal logging.

The Use of Mathematical Models of Chlamydia Transmission to Address Public Health Policy Questions: A Systematic Review.

PubMed

Rönn, Minttu M; Wolf, Emory E; Chesson, Harrell; Menzies, Nicolas A; Galer, Kara; Gorwitz, Rachel; Gift, Thomas; Hsu, Katherine; Salomon, Joshua A

2017-05-01

Mathematical models of chlamydia transmission can help inform disease control policy decisions when direct empirical evaluation of alternatives is impractical. We reviewed published chlamydia models to understand the range of approaches used for policy analyses and how the studies have responded to developments in the field. We performed a literature review by searching Medline and Google Scholar (up to October 2015) to identify publications describing dynamic chlamydia transmission models used to address public health policy questions. We extracted information on modeling methodology, interventions, and key findings. We identified 47 publications (including two model comparison studies), which reported collectively on 29 distinct mathematical models. Nine models were individual-based, and 20 were deterministic compartmental models. The earliest studies evaluated the benefits of national-level screening programs and predicted potentially large benefits from increased screening. Subsequent trials and further modeling analyses suggested the impact might have been overestimated. Partner notification has been increasingly evaluated in mathematical modeling, whereas behavioral interventions have received relatively limited attention. Our review provides an overview of chlamydia transmission models and gives a perspective on how mathematical modeling has responded to increasing empirical evidence and addressed policy questions related to prevention of chlamydia infection and sequelae.

Perceived Neighborhood Quality and Cancer Screening Behavior: Evidence from the Survey of the Health of Wisconsin

PubMed Central

Beyer, Kirsten M. M.; Malecki, Kristen M.; Hoormann, Kelly A.; Szabo, Aniko; Nattinger, Ann B.

2016-01-01

Socioeconomic disparities in colorectal and breast cancer screening persist, partially accounting for disparities in cancer outcomes. Some neighborhood characteristics – particularly area level socioeconomic factors – have been linked to cancer screening behavior, but few studies have examined the relationship between perceived neighborhood quality and screening behavior, which may provide more insight into the ways in which neighborhood environments shape cancer related behaviors. This study examines the relationship between several aspects of the perceived neighborhood environment and breast and colorectal cancer screening behavior among a population-based sample of Wisconsin residents. A sub-goal was to compare the relevance of different perceived neighborhood factors for different screening tests. This is a cross-sectional study of 2008–2012 data from the Survey of the Health of Wisconsin (SHOW), a population-based annual survey of Wisconsin residents. An average risk sample of Black, Hispanic and White women age 50 and older (n=1265) were selected. Survey regression analyses examined predictors of screening, as well as adherence to screening guidelines. Models controlled for individual socio-demographic information and insurance status. Perceptions of social and physical disorder, including fear of crime and visible garbage, were associated with screening rates. Findings emphasize the particular importance of these factors for colorectal cancer screening, indicating the necessity of improving screening rates in areas characterized by social disorganization, crime, and physical disorder. Additional work should be done to further investigate the pathways that explain the linkage between neighborhood conditions, perceived neighborhood risks and cancer screening behavior. PMID:26275881

Colorectal Cancer Screening Initiation After Age 50 Years in an Organized Program.

PubMed

Fedewa, Stacey A; Corley, Douglas A; Jensen, Christopher D; Zhao, Wei; Goodman, Michael; Jemal, Ahmedin; Ward, Kevin C; Levin, Theodore R; Doubeni, Chyke A

2017-09-01

Recent studies report racial disparities among individuals in organized colorectal cancer (CRC) programs; however, there is a paucity of information on CRC screening utilization by race/ethnicity among newly age-eligible adults in such programs. This was a retrospective cohort study among Kaiser Permanente Northern California enrollees who turned age 50 years between 2007 and 2012 (N=138,799) and were served by a systemwide outreach and facilitated in-reach screening program based primarily on mailed fecal immunochemical tests to screening-eligible people. Kaplan-Meier and Cox model analyses were used to estimate differences in receipt of CRC screening in 2015-2016. Cumulative probabilities of CRC screening within 1 and 2 years of subjects' 50th birthday were 51% and 73%, respectively. Relative to non-Hispanic whites, the likelihood of completing any CRC screening was similar in blacks (hazard ratio, 0.98; 95% CI=0.96, 1.00); 5% lower in Hispanics (hazard ratio, 0.95; 95% CI=0.93, 0.96); and 13% higher in Asians (hazard ratio, 1.13; 95% CI=1.11, 1.15) in adjusted analyses. Fecal immunochemical testing was the most common screening modality, representing 86% of all screening initiations. Blacks and Hispanics had lower receipt of fecal immunochemical testing in adjusted analyses. CRC screening uptake was high among newly screening-eligible adults in an organized CRC screening program, but Hispanics were less likely to initiate screening near age 50 years than non-Hispanic whites, suggesting that cultural and other individual-level barriers not addressed within the program likely contribute. Future studies examining the influences of culturally appropriate and targeted efforts for screening initiation are needed. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

10 CFR 26.131 - Cutoff levels for validity screening and initial validity tests.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Cutoff levels for validity screening and initial validity tests. 26.131 Section 26.131 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.131 Cutoff levels for validity screening and initial validity tests. (a) Each...

10 CFR 26.131 - Cutoff levels for validity screening and initial validity tests.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Cutoff levels for validity screening and initial validity tests. 26.131 Section 26.131 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.131 Cutoff levels for validity screening and initial validity tests. (a) Each...

Comparison of optometry vs digital photography screening for diabetic retinopathy in a single district.

PubMed

Tu, K L; Palimar, P; Sen, S; Mathew, P; Khaleeli, A

2004-01-01

To compare (a). the clinical effectiveness and (b). cost effectiveness of the two models in screening for diabetic retinopathy. (a). Retrospective analysis of referral diagnoses of each screening model in their first respective years of operation and an audit of screen positive patients and a sample of screen negatives referred to the hospital eye service from both screening programmes. (b). Cost effectiveness study. (1). A total of 1643 patients screened in the community and in digital photography clinics; (2). 109 consecutive patients referred to the Diabetic Eye Clinic through the two existing models of diabetic retinopathy screening; (3). 55 screen negative patients from the optometry model; (4). 68 screen negative patients audited from the digital photography model. The compliance rate was 45% for optometry (O) vs 50% for the digital imaging system (I). Background retinopathy was recorded at screening in 22% (O) vs 17% (I) (P=0.03) and maculopathy in 3.8% (O) vs 1.7% (I) (P=0.02). Hospital referral rates were 3.8% (O) vs 4.2% (I) Sensitivity (75% for optometry, 80% for digital photography) and specificity (98% for optometry and digital photography) were similar in both models. The cost of screening each patient was pound 23.99 (O) vs pound 29.29 (I). The cost effectiveness was pound 832 (O) vs pound 853(I) in the first year. The imaging system was not always able to detect early retinopathy and maculopathy; it was equally specific in identifying sight-threatening disease. Cost effectiveness was poor in both models, in their first operational year largely as a result of poor compliance rates in the newly introduced screening programme. Cost effectiveness of the imaging model should further improve with falling costs of imaging systems. Until then, it is essential to continue any existing well-coordinated optometry model.

QSAR Accelerated Discovery of Potent Ice Recrystallization Inhibitors

NASA Astrophysics Data System (ADS)

Briard, Jennie G.; Fernandez, Michael; de Luna, Phil; Woo, Tom. K.; Ben, Robert N.

2016-05-01

Ice recrystallization is the main contributor to cell damage and death during the cryopreservation of cells and tissues. Over the past five years, many small carbohydrate-based molecules were identified as ice recrystallization inhibitors and several were shown to reduce cryoinjury during the cryopreservation of red blood cells (RBCs) and hematopoietic stems cells (HSCs). Unfortunately, clear structure-activity relationships have not been identified impeding the rational design of future compounds possessing ice recrystallization inhibition (IRI) activity. A set of 124 previously synthesized compounds with known IRI activities were used to calibrate 3D-QSAR classification models using GRid INdependent Descriptors (GRIND) derived from DFT level quantum mechanical calculations. Partial least squares (PLS) model was calibrated with 70% of the data set which successfully identified 80% of the IRI active compounds with a precision of 0.8. This model exhibited good performance in screening the remaining 30% of the data set with 70% of active additives successfully recovered with a precision of ~0.7 and specificity of 0.8. The model was further applied to screen a new library of aryl-alditol molecules which were then experimentally synthesized and tested with a success rate of 82%. Presented is the first computer-aided high-throughput experimental screening for novel IRI active compounds.

QSAR Accelerated Discovery of Potent Ice Recrystallization Inhibitors

PubMed Central

Briard, Jennie G.; Fernandez, Michael; De Luna, Phil; Woo, Tom. K.; Ben, Robert N.

2016-01-01

Ice recrystallization is the main contributor to cell damage and death during the cryopreservation of cells and tissues. Over the past five years, many small carbohydrate-based molecules were identified as ice recrystallization inhibitors and several were shown to reduce cryoinjury during the cryopreservation of red blood cells (RBCs) and hematopoietic stems cells (HSCs). Unfortunately, clear structure-activity relationships have not been identified impeding the rational design of future compounds possessing ice recrystallization inhibition (IRI) activity. A set of 124 previously synthesized compounds with known IRI activities were used to calibrate 3D-QSAR classification models using GRid INdependent Descriptors (GRIND) derived from DFT level quantum mechanical calculations. Partial least squares (PLS) model was calibrated with 70% of the data set which successfully identified 80% of the IRI active compounds with a precision of 0.8. This model exhibited good performance in screening the remaining 30% of the data set with 70% of active additives successfully recovered with a precision of ~0.7 and specificity of 0.8. The model was further applied to screen a new library of aryl-alditol molecules which were then experimentally synthesized and tested with a success rate of 82%. Presented is the first computer-aided high-throughput experimental screening for novel IRI active compounds. PMID:27216585

QSAR Accelerated Discovery of Potent Ice Recrystallization Inhibitors.

PubMed

Briard, Jennie G; Fernandez, Michael; De Luna, Phil; Woo, Tom K; Ben, Robert N

2016-05-24

Ice recrystallization is the main contributor to cell damage and death during the cryopreservation of cells and tissues. Over the past five years, many small carbohydrate-based molecules were identified as ice recrystallization inhibitors and several were shown to reduce cryoinjury during the cryopreservation of red blood cells (RBCs) and hematopoietic stems cells (HSCs). Unfortunately, clear structure-activity relationships have not been identified impeding the rational design of future compounds possessing ice recrystallization inhibition (IRI) activity. A set of 124 previously synthesized compounds with known IRI activities were used to calibrate 3D-QSAR classification models using GRid INdependent Descriptors (GRIND) derived from DFT level quantum mechanical calculations. Partial least squares (PLS) model was calibrated with 70% of the data set which successfully identified 80% of the IRI active compounds with a precision of 0.8. This model exhibited good performance in screening the remaining 30% of the data set with 70% of active additives successfully recovered with a precision of ~0.7 and specificity of 0.8. The model was further applied to screen a new library of aryl-alditol molecules which were then experimentally synthesized and tested with a success rate of 82%. Presented is the first computer-aided high-throughput experimental screening for novel IRI active compounds.

Predictive models of prenatal developmental toxicity from ToxCast high-throughput screening data

EPA Science Inventory

EPA's ToxCast™ project is profiling the in vitro bioactivity of chemicals to assess pathway-level and cell-based signatures that correlate with observed in vivo toxicity. We hypothesized that developmental toxicity in guideline animal studies captured in the ToxRefDB database wou...

Development of a QSAR Model for Thyroperoxidase Inhbition and Screening of 72,524 REACH substances - (Eurotox 2016)

EPA Science Inventory

hyroid hormones (THs) are involved in multiple biological processes and are critical modulators of fetal development. Even moderate changes in maternal or fetal TH levels can produce irreversible neurological deficits in children, such as lower IQ. The enzyme thyroperoxidase (TPO...

Cultural Context and Modification of Behavior Change Theory

ERIC Educational Resources Information Center

Sanders Thompson, Vetta L.

2009-01-01

Although social and cultural contexts act on each level of the multilevel ecologic model to affect cancer risk, health behavior, and cancer screening and promotion in health behavior research, people have yet to develop theories that sufficiently integrate the social and environmental context with group and individual behavior. The "Behavioral…

Climate Change Impacts on Harmful Algal Blooms in U.S. Freshwaters: A Screening-Level Assessment

EPA Science Inventory

Cyanobacterial harmful algal blooms have serious adverse effects on human and environmental health. Herein, we develop a modeling framework that predicts the effect of climate change on cyanobacteria concentrations in reservoirs in the contiguous U.S. The framework, which uses cl...

Effective Hamiltonian approach to bright and dark excitons in single-walled carbon nanotubes

NASA Astrophysics Data System (ADS)

Choi, Sangkook; Deslippe, Jack; Louie, Steven G.

2009-03-01

Recently, excitons in single-walled carbon nanotubes (SWCNTs) have generated great research interest due to the large binding energies and unique screening properties associated with one-dimensional (1D) materials. Considerable progress in their theoretical understanding has been achieved by studies employing the ab initio GW-Bethe-Salpeter equation methodology. For example, the presence of bright and dark excitons with binding energies of a large fraction of an eV has been predicted and subsequently verified by experiment. Some of these results have also been quantitatively reproduced by recent model calculations using a spatially dependent screened Coulomb interaction between the excited electron and hole, an approach that would be useful for studying large diameter and chiral nanotubes with many atoms per unit cell. However, this previous model neglects the degeneracy of the band states and hence the dark excitons. We present an extension of this exciton model for the SWCNT, incorporating the screened Coulomb interaction as well as state degeneracy, to understand and compute the characteristics of the bright and dark excitons, such as the bright and dark level splittings. Supported by NSF #DMR07-05941, DOE #De-AC02-05CH11231 and computational resources from Teragrid and NERSC.

Unifying screening processes within the PROSPR consortium: a conceptual model for breast, cervical, and colorectal cancer screening.

PubMed

Beaber, Elisabeth F; Kim, Jane J; Schapira, Marilyn M; Tosteson, Anna N A; Zauber, Ann G; Geiger, Ann M; Kamineni, Aruna; Weaver, Donald L; Tiro, Jasmin A

2015-06-01

General frameworks of the cancer screening process are available, but none directly compare the process in detail across different organ sites. This limits the ability of medical and public health professionals to develop and evaluate coordinated screening programs that apply resources and population management strategies available for one cancer site to other sites. We present a trans-organ conceptual model that incorporates a single screening episode for breast, cervical, and colorectal cancers into a unified framework based on clinical guidelines and protocols; the model concepts could be expanded to other organ sites. The model covers four types of care in the screening process: risk assessment, detection, diagnosis, and treatment. Interfaces between different provider teams (eg, primary care and specialty care), including communication and transfer of responsibility, may occur when transitioning between types of care. Our model highlights across each organ site similarities and differences in steps, interfaces, and transitions in the screening process and documents the conclusion of a screening episode. This model was developed within the National Cancer Institute-funded consortium Population-based Research Optimizing Screening through Personalized Regimens (PROSPR). PROSPR aims to optimize the screening process for breast, cervical, and colorectal cancer and includes seven research centers and a statistical coordinating center. Given current health care reform initiatives in the United States, this conceptual model can facilitate the development of comprehensive quality metrics for cancer screening and promote trans-organ comparative cancer screening research. PROSPR findings will support the design of interventions that improve screening outcomes across multiple cancer sites. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Integrating cervical cancer with HIV healthcare services: A systematic review

PubMed Central

Sigfrid, Louise; Murphy, Georgina; Haldane, Victoria; Chuah, Fiona Leh Hoon; Ong, Suan Ee; Cervero-Liceras, Francisco; Watt, Nicola; Alvaro, Alconada; Otero-Garcia, Laura; Balabanova, Dina; Hogarth, Sue; Maimaris, Will; Buse, Kent; Mckee, Martin; Piot, Peter; Perel, Pablo

2017-01-01

Background Cervical cancer is a major public health problem. Even though readily preventable, it is the fourth leading cause of death in women globally. Women living with HIV are at increased risk of invasive cervical cancer, highlighting the need for access to screening and treatment for this population. Integration of services has been proposed as an effective way of improving access to cervical cancer screening especially in areas of high HIV prevalence as well as lower resourced settings. This paper presents the results of a systematic review of programs integrating cervical cancer and HIV services globally, including feasibility, acceptability, clinical outcomes and facilitators for service delivery. Methods This is part of a larger systematic review on integration of services for HIV and non-communicable diseases. To be considered for inclusion studies had to report on programs to integrate cervical cancer and HIV services at the level of service delivery. We searched multiple databases including Global Health, Medline and Embase from inception until December 2015. Articles were screened independently by two reviewers for inclusion and data were extracted and assessed for risk of bias. Main results 11,057 records were identified initially. 7,616 articles were screened by title and abstract for inclusion. A total of 21 papers reporting interventions integrating cervical cancer care and HIV services met the criteria for inclusion. All but one study described integration of cervical cancer screening services into existing HIV services. Most programs also offered treatment of minor lesions, a ‘screen-and-treat’ approach, with some also offering treatment of larger lesions within the same visit. Three distinct models of integration were identified. One model described integration within the same clinic through training of existing staff. Another model described integration through co-location of services, with the third model describing programs of integration through complex coordination across the care pathway. The studies suggested that integration of cervical cancer services with HIV services using all models was feasible and acceptable to patients. However, several barriers were reported, including high loss to follow up for further treatment, limited human-resources, and logistical and chain management support. Using visual screening methods can facilitate screening and treatment of minor to larger lesions in a single ‘screen-and-treat’ visit. Complex integration in a single-visit was shown to reduce loss to follow up. The use of existing health infrastructure and funding together with comprehensive staff training and supervision, community engagement and digital technology were some of the many other facilitators for integration reported across models. Conclusions This review shows that integration of cervical cancer screening and treatment with HIV services using different models of service delivery is feasible as well as acceptable to women living with HIV. However, the descriptive nature of most papers and lack of data on the effect on long-term outcomes for HIV or cervical cancer limits the inference on the effectiveness of the integrated programs. There is a need for strengthening of health systems across the care continuum and for high quality studies evaluating the effect of integration on HIV as well as on cervical cancer outcomes. PMID:28732037

Screening for Infectious Diseases among Newly Arrived Migrants in EU/EEA Countries—Varying Practices but Consensus on the Utility of Screening

PubMed Central

Kärki, Tommi; Napoli, Christian; Riccardo, Flavia; Fabiani, Massimo; Dente, Maria Grazia; Carballo, Manuel; Noori, Teymur; Declich, Silvia

2014-01-01

Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, practices and usefulness of these programmes. We conducted a survey among country experts from EU/EEA countries and Switzerland, asking whether their countries had implemented screening programmes. We also estimated the association between the implementation of these programmes and the rate of asylum-seekers in the population. Of the countries, 16 (59%) had implemented screening programmes and 15 (56%) had national guidelines. The rate of asylum-seekers was associated with implementation of screening programmes (p = 0.014). Screening was performed most often for tuberculosis; most commonly on holding level, and was targeted to specific migrant groups in over half of the countries performing screening. Twenty-five of all the country experts (96%) considered screening among migrants useful, and 24 (92%) would welcome EU level guidelines for screening. The implementation of screening programmes varied, and the practices were different among countries. Our survey suggests, that establishing EU level guidelines for screening would be useful, although they would have to take into account differences between individual countries. PMID:25337945

The German cervical cancer screening model: development and validation of a decision-analytic model for cervical cancer screening in Germany.

PubMed

Siebert, Uwe; Sroczynski, Gaby; Hillemanns, Peter; Engel, Jutta; Stabenow, Roland; Stegmaier, Christa; Voigt, Kerstin; Gibis, Bernhard; Hölzel, Dieter; Goldie, Sue J

2006-04-01

We sought to develop and validate a decision-analytic model for the natural history of cervical cancer for the German health care context and to apply it to cervical cancer screening. We developed a Markov model for the natural history of cervical cancer and cervical cancer screening in the German health care context. The model reflects current German practice standards for screening, diagnostic follow-up and treatment regarding cervical cancer and its precursors. Data for disease progression and cervical cancer survival were obtained from the literature and German cancer registries. Accuracy of Papanicolaou (Pap) testing was based on meta-analyses. We performed internal and external model validation using observed epidemiological data for unscreened women from different German cancer registries. The model predicts life expectancy, incidence of detected cervical cancer cases, lifetime cervical cancer risks and mortality. The model predicted a lifetime cervical cancer risk of 3.0% and a lifetime cervical cancer mortality of 1.0%, with a peak cancer incidence of 84/100,000 at age 51 years. These results were similar to observed data from German cancer registries, German literature data and results from other international models. Based on our model, annual Pap screening could prevent 98.7% of diagnosed cancer cases and 99.6% of deaths due to cervical cancer in women completely adherent to screening and compliant to treatment. Extending the screening interval from 1 year to 2, 3 or 5 years resulted in reduced screening effectiveness. This model provides a tool for evaluating the long-term effectiveness of different cervical cancer screening tests and strategies.

Lung cancer risk prediction to select smokers for screening CT--a model based on the Italian COSMOS trial.

PubMed

Maisonneuve, Patrick; Bagnardi, Vincenzo; Bellomi, Massimo; Spaggiari, Lorenzo; Pelosi, Giuseppe; Rampinelli, Cristiano; Bertolotti, Raffaella; Rotmensz, Nicole; Field, John K; Decensi, Andrea; Veronesi, Giulia

2011-11-01

Screening with low-dose helical computed tomography (CT) has been shown to significantly reduce lung cancer mortality but the optimal target population and time interval to subsequent screening are yet to be defined. We developed two models to stratify individual smokers according to risk of developing lung cancer. We first used the number of lung cancers detected at baseline screening CT in the 5,203 asymptomatic participants of the COSMOS trial to recalibrate the Bach model, which we propose using to select smokers for screening. Next, we incorporated lung nodule characteristics and presence of emphysema identified at baseline CT into the Bach model and proposed the resulting multivariable model to predict lung cancer risk in screened smokers after baseline CT. Age and smoking exposure were the main determinants of lung cancer risk. The recalibrated Bach model accurately predicted lung cancers detected during the first year of screening. Presence of nonsolid nodules (RR = 10.1, 95% CI = 5.57-18.5), nodule size more than 8 mm (RR = 9.89, 95% CI = 5.84-16.8), and emphysema (RR = 2.36, 95% CI = 1.59-3.49) at baseline CT were all significant predictors of subsequent lung cancers. Incorporation of these variables into the Bach model increased the predictive value of the multivariable model (c-index = 0.759, internal validation). The recalibrated Bach model seems suitable for selecting the higher risk population for recruitment for large-scale CT screening. The Bach model incorporating CT findings at baseline screening could help defining the time interval to subsequent screening in individual participants. Further studies are necessary to validate these models.

Development of a keratinocyte-based screening model for antipsoriatic drugs using green fluorescent protein under the control of an endogenous promoter.

PubMed

Pol, Arno; van Ruissen, Fred; Schalkwijk, Joost

2002-08-01

Inflamed epidermis (psoriasis, wound healing, ultraviolet-irradiated skin) harbors keratinocytes that are hyperproliferative and display an abnormal differentiation program. A distinct feature of this so-called regenerative maturation pathway is the expression of proteins such as the cytokeratins CK6, CK16, and CK17 and the antiinflammatory protein SKALP/elafin. These proteins are absent in normal skin but highly induced in lesional psoriatic skin. Expression of these genes can be used as a surrogate marker for psoriasis in drug-screening procedures of large compound libraries. The aim of this study was to develop a keratinocyte cell line that contained a reporter gene under the control of a psoriasis-associated endogenous promoter and demonstrate its use in an assay suitable for screening. We generated a stably transfected keratinocyte cell line that expresses enhanced green fluorescent protein (EGFP), under the control of a 0.8-kb fragment derived from the promoter of the SKALP/elafin gene, which confers high levels of tissue-specific expression at the mRNA level. Induction of the SKALP promoter by tumor necrosis factor-alpha resulted in increased expression levels of the secreted SKALP-EGFP fusion protein as assessed by direct readout of fluorescence and fluorescence polarization in 96-well cell culture plates. The fold stimulation of the reporter gene was comparable to that of the endogenous SKALP gene as assessed by enzyme-linked immunosorbent assay. Although the dynamic range of the screening system is limited, the small standard deviation yields a Z factor of 0.49. This indicates that the assay is suitable as a high-throughput screen, and provides proof of the concept that a secreted EGFP fusion protein under the control of a physiologically relevant endogenous promoter can be used as a fluorescence-based high-throughput screen for differentiation-modifying or antiinflammatory compounds that act via the keratinocyte.

Rigorous Screening Technology for Identifying Suitable CO2 Storage Sites II

DOE Office of Scientific and Technical Information (OSTI.GOV)

George J. Koperna Jr.; Vello A. Kuuskraa; David E. Riestenberg

2009-06-01

This report serves as the final technical report and users manual for the 'Rigorous Screening Technology for Identifying Suitable CO2 Storage Sites II SBIR project. Advanced Resources International has developed a screening tool by which users can technically screen, assess the storage capacity and quantify the costs of CO2 storage in four types of CO2 storage reservoirs. These include CO2-enhanced oil recovery reservoirs, depleted oil and gas fields (non-enhanced oil recovery candidates), deep coal seems that are amenable to CO2-enhanced methane recovery, and saline reservoirs. The screening function assessed whether the reservoir could likely serve as a safe, long-term CO2more » storage reservoir. The storage capacity assessment uses rigorous reservoir simulation models to determine the timing, ultimate storage capacity, and potential for enhanced hydrocarbon recovery. Finally, the economic assessment function determines both the field-level and pipeline (transportation) costs for CO2 sequestration in a given reservoir. The screening tool has been peer reviewed at an Electrical Power Research Institute (EPRI) technical meeting in March 2009. A number of useful observations and recommendations emerged from the Workshop on the costs of CO2 transport and storage that could be readily incorporated into a commercial version of the Screening Tool in a Phase III SBIR.« less

The Relationship Between Education and Prostate-Specific Antigen Testing Among Urban African American Medicare Beneficiaries

PubMed Central

Pollack, Craig Evan; Garza, Mary A.; Yeh, Hsin-Chieh; Markakis, Diane; Phelan-Emrick, Darcy F.; Wenzel, Jennifer; Shapiro, Gary R.; Bone, Lee; Johnson, Lawrence

2017-01-01

Purpose We examined the association between socioeconomic status (SES) and prostate-specific antigen (PSA) cancer screening among older African American men. Methods We analyzed baseline data from a sample of 485 community-dwelling African American men who participated in the Cancer Prevention and Treatment Demonstration Trial. The outcome was receipt of PSA screening within the past year. SES was measured using income and educational attainment. Sequential multivariate logistic regression models were performed to study whether health care access, patient–provider relationship, and cancer fatalism mediated the relationship between SES and PSA screening. Results Higher educational attainment was significantly associated with higher odds of PSA screening in the past year (odds ratio (OR) 2.08 for college graduate compared to less than high school graduate, 95 % confidence interval (CI) 1.03–4.24); income was not. Health care access and patient–provider communication did not alter the relationship between education and screening; however, beliefs regarding cancer fatalism partially mediated the observed relationship. Conclusion Rates of prostate cancer screening among African American men vary by level of educational attainment; beliefs concerning cancer fatalism help explain this gradient. Understanding the determinants of cancer fatalism is a critical next step in building interventions that seek to ensure equitable access to prostate cancer screening. PMID:26863336

The Relationship Between Education and Prostate-Specific Antigen Testing Among Urban African American Medicare Beneficiaries.

PubMed

Hararah, Mohammad Khalid; Pollack, Craig Evan; Garza, Mary A; Yeh, Hsin-Chieh; Markakis, Diane; Phelan-Emrick, Darcy F; Wenzel, Jennifer; Shapiro, Gary R; Bone, Lee; Johnson, Lawrence; Ford, Jean G

2015-06-01

We examined the association between socioeconomic status (SES) and prostate-specific antigen (PSA) cancer screening among older African American men. We analyzed baseline data from a sample of 485 community-dwelling African American men who participated in the Cancer Prevention and Treatment Demonstration Trial. The outcome was receipt of PSA screening within the past year. SES was measured using income and educational attainment. Sequential multivariate logistic regression models were performed to study whether health care access, patient-provider relationship, and cancer fatalism mediated the relationship between SES and PSA screening. Higher educational attainment was significantly associated with higher odds of PSA screening in the past year (odds ratio (OR) 2.08 for college graduate compared to less than high school graduate, 95 % confidence interval (CI) 1.03-4.24); income was not. Health care access and patient-provider communication did not alter the relationship between education and screening; however, beliefs regarding cancer fatalism partially mediated the observed relationship. Rates of prostate cancer screening among African American men vary by level of educational attainment; beliefs concerning cancer fatalism help explain this gradient. Understanding the determinants of cancer fatalism is a critical next step in building interventions that seek to ensure equitable access to prostate cancer screening.

Blood glucose screening among elderly Malaysians: Who to target?

PubMed

Cheah, Yong Kang; Goh, Kim-Leng

2017-01-01

Early detection of raised blood glucose can reduce the risk of developing diabetes. Despite being a high-risk group, a significant proportion of the elderly population does not undergo blood glucose screening. The aim of the present study was to examine the factors affecting blood glucose screening among the elderly. Data from a sample of 2463 respondents in the National Health and Morbidity Survey 2011 were used. Pearson Chi-squared tests were conducted to find factors associated with screening behavior. A logit model was used to analyze the likelihood of screening. Income, age, education, ethnicity, employment status, availability of medical coverage, and smoking behavior were significantly associated with blood glucose screening. The likelihood of blood glucose screening was positively correlated with available monthly income and was higher in those aged 60-69 years, those attaining higher education, Malays, and elderly who are medically covered. The findings of the present study provide insights for health policy formulation for the elderly. As part of their efforts to reduce national health costs, governments should pay particular attention to the elderly, who are likely to be unscreened for blood glucose levels, because they face even larger risk exposure. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Parental Intentions to Enroll Children in a Voluntary Expanded Newborn Screening Program

PubMed Central

Paquin, Ryan S.; Peay, Holly L.; Gehtland, Lisa M.; Lewis, Megan A.; Bailey, Donald B.

2016-01-01

Background and Objectives Nearly all babies in the United States are tested at birth for rare, serious, and treatable disorders through mandatory state newborn screening (NBS). Recently, there have been calls for an expanded, voluntary model to facilitate early diagnosis and treatment of a wider range of disorders. We applied the reasoned action framework to examine parental intentions to participate in voluntary expanded screening. Methods We recruited a national cohort of recent and expectant parents living in the U.S. who completed a self-administered online survey (N = 1,001). Using a mixed-level fractional factorial experiment, we studied parental participation intentions and preferences for timing of consent, cost, consent format, and testing options. Results We conducted a hierarchical regression analysis assessing parental intentions to participate in voluntary expanded NBS. Attitudes, perceived normative influence, and perceived behavioral control explained substantial variance in intention, with perceived normative influence emerging as the strongest predictor. We found no evidence that the manipulated program features altered mean levels of intention, but timing of parental permission, cost, and permission format moderated the relative importance of reasoned action constructs on intention. Conclusion Program design features may impact the psychological mechanisms underlying parental decision making for voluntary expanded screening. These results have important implications for parent education, outreach, and informed parental permission procedures. PMID:27526258

Design of a breath analysis system for diabetes screening and blood glucose level prediction.

PubMed

Yan, Ke; Zhang, David; Wu, Darong; Wei, Hua; Lu, Guangming

2014-11-01

It has been reported that concentrations of several biomarkers in diabetics' breath show significant difference from those in healthy people's breath. Concentrations of some biomarkers are also correlated with the blood glucose levels (BGLs) of diabetics. Therefore, it is possible to screen for diabetes and predict BGLs by analyzing one's breath. In this paper, we describe the design of a novel breath analysis system for this purpose. The system uses carefully selected chemical sensors to detect biomarkers in breath. Common interferential factors, including humidity and the ratio of alveolar air in breath, are compensated or handled in the algorithm. Considering the intersubject variance of the components in breath, we build subject-specific prediction models to improve the accuracy of BGL prediction. A total of 295 breath samples from healthy subjects and 279 samples from diabetic subjects were collected to evaluate the performance of the system. The sensitivity and specificity of diabetes screening are 91.51% and 90.77%, respectively. The mean relative absolute error for BGL prediction is 21.7%. Experiments show that the system is effective and that the strategies adopted in the system can improve its accuracy. The system potentially provides a noninvasive and convenient method for diabetes screening and BGL monitoring as an adjunct to the standard criteria.

Incorporating thyroid markers in Down syndrome screening protocols.

PubMed

Dhaifalah, Ishraq; Salek, Tomas; Langova, Dagmar; Cuckle, Howard

2017-05-01

The article aimed to assess the benefit of incorporating maternal serum thyroid disease marker levels (thyroid-stimulating hormone and free thyroxine) into first trimester Down syndrome screening protocols. Statistical modelling was used to predict performance with and without the thyroid markers. Two protocols were considered: the combined test and the contingent cell-free DNA (cfDNA) test, where 15-40% women are selected for cfDNA because of increased risk based on combined test results. Published parameters were used for the combined test, cfDNA and the Down syndrome means for thyroid-stimulating hormone and free thyroxine; other parameters were derived from a series of 5230 women screened for both thyroid disease and Down syndrome. Combined test: For a fixed 85% detection rate, the predicted false positive rate was reduced from 5.3% to 3.6% with the addition of the thyroid markers. Contingent cfDNA test: For a fixed 95% detection rate, the proportion of women selected for cfDNA was reduced from 25.6% to 20.2%. When screening simultaneously for maternal thyroid disease and Down syndrome, thyroid marker levels should be used in the calculation of Down syndrome risk. The benefit is modest but can be achieved with no additional cost. © 2017 John Wiley & Sons, Ltd. © 2017 John Wiley & Sons, Ltd.

Screening for adolescents' internalizing symptoms in primary care: item response theory analysis of the behavior health screen depression, anxiety, and suicidal risk scales.

PubMed

Bevans, Katherine B; Diamond, Guy; Levy, Suzanne

2012-05-01

To apply a modern psychometric approach to validate the Behavioral Health Screen (BHS) Depression, Anxiety, and Suicidal Risk Scales among adolescents in primary care. Psychometric analyses were conducted using data collected from 426 adolescents aged 12 to 21 years (mean = 15.8, SD = 2.2). Rasch-Masters partial credit models were fit to the data to determine whether items supported the comprehensive measurement of internalizing symptoms with minimal gaps and redundancies. Scales were reduced to ensure that they measured singular dimensions of generalized anxiety, depressed affect, and suicidal risk both comprehensively and efficiently. Although gender bias was observed for some depression and anxiety items, differential item functioning did not impact overall subscale scores. Future revisions to the BHS should include additional items that assess low-level internalizing symptoms. The BHS is an accurate and efficient tool for identifying adolescents with internalizing symptoms in primary care settings. Access to psychometrically sound and cost-effective behavioral health screening tools is essential for meeting the increasing demands for adolescent behavioral health screening in primary/ambulatory care.

The Long-Term Effectiveness and Cost Effectiveness of Organized versus Opportunistic Screening for Breast Cancer in Austria.

PubMed

Schiller-Fruehwirth, Irmgard; Jahn, Beate; Einzinger, Patrick; Zauner, Günther; Urach, Christoph; Siebert, Uwe

2017-09-01

In 2014, Austrian health authorities implemented an organized breast cancer screening program. Until then, there has been a long-standing tradition of opportunistic screening. To evaluate the cost-effectiveness of organized screening compared with opportunistic screening, as well as to identify factors influencing the clinical and economic outcomes. We developed and validated an individual-level state-transition model and assessed the health outcomes and costs of organized and opportunistic screening for 40-year-old asymptomatic women. The base-case analysis compared a scenario involving organized biennial screening with a scenario reflecting opportunistic screening practice for an average-risk woman aged 45 to 69 years. We applied an annual discount rate of 3% and estimated the incremental cost-effectiveness ratio in terms of the cost (2012 euros) per life-year gained (LYG) from a health care perspective. Deterministic and probabilistic sensitivity analyses were performed to assess uncertainty. Compared with opportunistic screening, an organized program yielded on average additional 0.0118 undiscounted life-years (i.e., 4.3 days) and cost savings of €41 per woman. In the base-case analysis, the incremental cost-effectiveness ratio of organized screening was approximately €20,000 per LYG compared with no screening. Assuming a willingness-to-pay threshold of €50,000 per LYG, there was a 70% probability that organized screening would be considered cost-effective. The attendance rate, but not the test accuracy of mammography, was an influential factor for the cost-effectiveness. The decision to adopt organized screening is likely an efficient use of limited health care resources in Austria. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Validation of the Identification and Intervention for Dementia in Elderly Africans (IDEA) cognitive screen in Nigeria and Tanzania.

PubMed

Paddick, Stella-Maria; Gray, William K; Ogunjimi, Luqman; Lwezuala, Bingileki; Olakehinde, Olaide; Kisoli, Aloyce; Kissima, John; Mbowe, Godfrey; Mkenda, Sarah; Dotchin, Catherine L; Walker, Richard W; Mushi, Declare; Collingwood, Cecilia; Ogunniyi, Adesola

2015-04-25

We have previously described the development of the Identification and Intervention for Dementia in Elderly Africans (IDEA) cognitive screen for use in populations with low levels of formal education. The IDEA cognitive screen was developed and field-tested in an elderly, community-based population in rural Tanzania with a relatively high prevalence of cognitive impairment. The aim of this study was to validate the IDEA cognitive screen as an assessment of major cognitive impairment in hospital settings in Nigeria and Tanzania. In Nigeria, 121 consecutive elderly medical clinic outpatients reviewed at the University College Hospital, Ibadan were screened using the IDEA cognitive screen. In Tanzania, 97 consecutive inpatients admitted to Mawenzi Regional Hospital (MRH), Moshi, and 108 consecutive medical clinic outpatients attending the geriatric medicine clinic at MRH were screened. Inter-rater reliability was assessed in Tanzanian outpatients attending St Joseph's Hospital in Moshi using three raters. A diagnosis of dementia or delirium (DSM-IV criteria) was classified as major cognitive impairment and was provided independently by a physician blinded to the results of the screening assessment. The area under the receiver operating characteristic (AUROC) curve in Nigerian outpatients, Tanzanian outpatients and Tanzanian inpatients was 0.990, 0.919 and 0.917 respectively. Inter-rater reliability was good (intra-class correlation coefficient 0.742 to 0.791). In regression models, the cognitive screen did not appear to be educationally biased. The IDEA cognitive screen performed well in these populations and should prove useful in screening for dementia and delirium in other areas of sub-Saharan Africa.

Invitation coverage and participation in Italian cervical, breast and colorectal cancer screening programmes.

PubMed

Giorgi Rossi, Paolo; Carrozzi, Giuliano; Federici, Antonio; Mancuso, Pamela; Sampaolo, Letizia; Zappa, Marco

2018-03-01

Objectives In Italy, regional governments organize cervical, breast and colorectal cancer screening programmes, but there are difficulties in regularly inviting all the target populations and participation remains low. We analysed the determinants associated with invitation coverage of and participation in these programmes. Methods We used data on screening programmes from annual Ministry of Health surveys, 1999-2012 for cervical, 1999-2011 for breast and 2005-2011 for colorectal cancer. For recent years, we linked these data to the results of the national routine survey on preventive behaviours to evaluate the effect of spontaneous screening at Province level. Invitation and participation relative risk were calculated using Generalized Linear Models. Results There is a strong decreasing trend in invitation coverage and participation in screening programmes from North to South Italy. In metropolitan areas, both invitation coverage (rate ratio 0.35-0.96) and participation (rate ratio 0.63-0.88) are lower. An inverse association exists between spontaneous screening and both screening invitation coverage (1-3% decrease in invitation coverage per 1% spontaneous coverage increase) and participation (2% decrease in participation per 1% spontaneous coverage increase) for the three programmes. High recall rate has a negative effect on invitation coverage in the next round for breast cancer (1% decrease in invitation per 1% recall increase). Conclusions Organizational and cultural changes are needed to better implement cancer screening in southern Italy.

Impact of socioeconomic deprivation on screening for cardiovascular disease risk in a primary prevention population: a cross-sectional study.

PubMed

Lang, Sarah-Jane; Abel, Gary A; Mant, Jonathan; Mullis, Ricky

2016-03-21

Investigate the association between socioeconomic deprivation and completeness of cardiovascular disease (CVD) risk factor recording in primary care, uptake of screening in people with incomplete risk factor recording and with actual CVD risk within the screened subgroup. Cross-sectional study. Nine UK general practices. 7987 people aged 50-74 years with no CVD diagnosis. CVD risk was estimated using the Framingham equation from data extracted from primary care electronic health records. Where there was insufficient information to calculate risk, patients were invited to attend a screening assessment. Proportion of patients for whom clinical data were sufficiently complete to enable CVD risk to be calculated; proportion of patients invited to screening who attended; proportion of patients who attended screening whose 10-year risk of a cardiovascular event was high (>20%). For each outcome, a set of logistic regression models were run. Crude and adjusted ORs were estimated for person-level deprivation, age, gender and smoking status. We included practice-level deprivation as a continuous variable and practice as a random effect to account for clustering. People who had lower Indices of Multiple Deprivation (IMD) scores (less deprived) had significantly worse routine CVD risk factor recording (adjusted OR 0.97 (0.95 to 1.00) per IMD decile; p=0.042). Screening attendance was poorer in those with more deprivation (adjusted OR 0.89 (0.86 to 0.91) per IMD decile; p<0.001). Among those who attended screening, the most deprived were more likely to have CVD risk >20% (OR 1.09 (1.03 to 1.15) per IMD decile; p=0.004). Our data suggest that those who had the most to gain from screening were least likely to attend, potentially exacerbating existing health inequalities. Future research should focus on tailoring the delivery of CVD screening to ensure engagement of socioeconomically deprived groups. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Liquid Acquisition Device Design Sensitivity Study

NASA Technical Reports Server (NTRS)

VanDyke, M. K.; Hastings, L. J.

2012-01-01

In-space propulsion often necessitates the use of a capillary liquid acquisition device (LAD) to assure that gas-free liquid propellant is available to support engine restarts in microgravity. If a capillary screen-channel device is chosen, then the designer must determine the appropriate combination screen mesh and channel geometry. A screen mesh selection which results in the smallest LAD width when compared to any other screen candidate (for a constant length) is desirable; however, no best screen exists for all LAD design requirements. Flow rate, percent fill, and acceleration are the most influential drivers for determining screen widths. Increased flow rates and reduced percent fills increase the through-the-screen flow pressure losses, which drive the LAD to increased widths regardless of screen choice. Similarly, increased acceleration levels and corresponding liquid head pressures drive the screen mesh selection toward a higher bubble point (liquid retention capability). After ruling out some screens on the basis of acceleration requirements alone, candidates can be identified by examining screens with small flow-loss-to-bubble point ratios for a given condition (i.e., comparing screens at certain flow rates and fill levels). Within the same flow rate and fill level, the screen constants inertia resistance coefficient, void fraction, screen pore or opening diameter, and bubble point can become the driving forces in identifying the smaller flow-loss-to-bubble point ratios.

Knowledge about cervical cancer and barriers of screening program among women in Wufeng County, a high-incidence region of cervical cancer in China.

PubMed

Jia, Yao; Li, Shuang; Yang, Ru; Zhou, Hang; Xiang, Qunying; Hu, Ting; Zhang, Qinghua; Chen, Zhilan; Ma, Ding; Feng, Ling

2013-01-01

Cervical cancer screening is an effective method for reducing the incidence and mortality of cervical cancer, but the screening attendance rate in developing countries is far from satisfactory, especially in rural areas. Wufeng is a region of high cervical cancer incidence in China. This study aimed to investigate the issues that concern cervical cancer and screening and the factors that affect women's willingness to undergo cervical cancer screening in the Wufeng area. A cross-sectional survey of women was conducted to determine their knowledge about cervical cancer and screening, demographic characteristics and the barriers to screening. Women who were willing to undergo screenings had higher knowledge levels. "Anxious feeling once the disease was diagnosed" (47.6%), "No symptoms/discomfort" (34.1%) and "Do not know the benefits of cervical cancer screening" (13.4%) were the top three reasons for refusing cervical cancer screening. Women who were younger than 45 years old or who had lower incomes, positive family histories of cancer, secondary or higher levels of education, higher levels of knowledge and fewer barriers to screening were more willing to participate in cervical cancer screenings than women without these characteristics. Efforts are needed to increase women's knowledge about cervical cancer, especially the screening methods, and to improve their perceptions of the screening process for early detection to reduce cervical cancer incidence and mortality rates.

A refined ecological risk assessment for California red-legged frog, Delta smelt, and California tiger salamander exposed to malathion.

PubMed

Clemow, Yvonne H; Manning, Gillian E; Breton, Roger L; Winchell, Michael F; Padilla, Lauren; Rodney, Sara I; Hanzas, John P; Estes, Tammara L; Budreski, Katherine; Toth, Brent N; Hill, Katie L; Priest, Colleen D; Teed, R Scott; Knopper, Loren D; Moore, Dwayne Rj; Stone, Christopher T; Whatling, Paul

2018-03-01

The California red-legged frog (CRLF), Delta smelt (DS), and California tiger salamander (CTS) are 3 species listed under the United States Federal Endangered Species Act (ESA), all of which inhabit aquatic ecosystems in California. The US Environmental Protection Agency (USEPA) has conducted deterministic screening-level risk assessments for these species potentially exposed to malathion, an organophosphorus insecticide and acaricide. Results from our screening-level analyses identified potential risk of direct effects to DS as well as indirect effects to all 3 species via reduction in prey. Accordingly, for those species and scenarios in which risk was identified at the screening level, we conducted a refined probabilistic risk assessment for CRLF, DS, and CTS. The refined ecological risk assessment (ERA) was conducted using best available data and approaches, as recommended by the 2013 National Research Council (NRC) report "Assessing Risks to Endangered and Threatened Species from Pesticides." Refined aquatic exposure models including the Pesticide Root Zone Model (PRZM), the Vegetative Filter Strip Modeling System (VFSMOD), the Variable Volume Water Model (VVWM), the Exposure Analysis Modeling System (EXAMS), and the Soil and Water Assessment Tool (SWAT) were used to generate estimated exposure concentrations (EECs) for malathion based on worst-case scenarios in California. Refined effects analyses involved developing concentration-response curves for fish and species sensitivity distributions (SSDs) for fish and aquatic invertebrates. Quantitative risk curves, field and mesocosm studies, surface-water monitoring data, and incident reports were considered in a weight-of-evidence approach. Currently, labeled uses of malathion are not expected to result in direct effects to CRLF, DS or CTS, or indirect effects due to effects on fish and invertebrate prey. Integr Environ Assess Manag 2018;14:224-239. © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Television screen time, but not computer use and reading time, is associated with cardio-metabolic biomarkers in a multiethnic Asian population: a cross-sectional study.

PubMed

Nang, Ei Ei Khaing; Salim, Agus; Wu, Yi; Tai, E Shyong; Lee, Jeannette; Van Dam, Rob M

2013-05-30

Recent evidence shows that sedentary behaviour may be an independent risk factor for cardiovascular diseases, diabetes, cancers and all-cause mortality. However, results are not consistent and different types of sedentary behaviour might have different effects on health. Thus the aim of this study was to evaluate the association between television screen time, computer/reading time and cardio-metabolic biomarkers in a multiethnic urban Asian population. We also sought to understand the potential mediators of this association. The Singapore Prospective Study Program (2004-2007), was a cross-sectional population-based study in a multiethnic population in Singapore. We studied 3305 Singaporean adults of Chinese, Malay and Indian ethnicity who did not have pre-existing diseases and conditions that could affect their physical activity. Multiple linear regression analysis was used to assess the association of television screen time and computer/reading time with cardio-metabolic biomarkers [blood pressure, lipids, glucose, adiponectin, C reactive protein and homeostasis model assessment of insulin resistance (HOMA-IR)]. Path analysis was used to examine the role of mediators of the observed association. Longer television screen time was significantly associated with higher systolic blood pressure, total cholesterol, triglycerides, C reactive protein, HOMA-IR, and lower adiponectin after adjustment for potential socio-demographic and lifestyle confounders. Dietary factors and body mass index, but not physical activity, were potential mediators that explained most of these associations between television screen time and cardio-metabolic biomarkers. The associations of television screen time with triglycerides and HOMA-IR were only partly explained by dietary factors and body mass index. No association was observed between computer/ reading time and worse levels of cardio-metabolic biomarkers. In this urban Asian population, television screen time was associated with worse levels of various cardio-metabolic risk factors. This may reflect detrimental effects of television screen time on dietary habits rather than replacement of physical activity.

Stressing Escherichia coli to educate students about research: A CURE to investigate multiple levels of gene regulation.

PubMed

McDonough, Janet; Goudsouzian, Lara K; Papaj, Agllai; Maceli, Ashley R; Klepac-Ceraj, Vanja; Peterson, Celeste N

2017-09-01

Course-based undergraduate research experiences (CUREs) have been shown to increase student retention and learning in the biological sciences. Most CURES cover only one aspect of gene regulation, such as transcriptional control. Here we present a new inquiry-based lab that engages understanding of gene expression from multiple perspectives. Students carry out a forward genetic screen to identify regulators of the stationary phase master regulator RpoS in the model organism Escherichia coli and then use a series of reporter fusions to determine if the regulation is at the level of transcription or the post-transcription level. This easy-to-implement course has been run both as a 9-week long project and a condensed 5-6 week version in three different schools and types of courses. A majority of the genes found in the screen are novel, thus giving students the opportunity to contribute to original findings to the field. Assessments of this CURE show student gains in learning in many knowledge areas. In addition, attitudinal surveys suggest the students are enthusiastic about the screen and their learning about gene regulation. In summary, this lab would be an appropriate addition to an intermediate or advanced level Molecular Biology, Genetics, or Microbiology curriculum. © 2017 by The International Union of Biochemistry and Molecular Biology, 45(5):449-458, 2017. © 2017 The International Union of Biochemistry and Molecular Biology.

Development and validation of risk models to select ever-smokers for CT lung-cancer screening

PubMed Central

Katki, Hormuzd A.; Kovalchik, Stephanie A.; Berg, Christine D.; Cheung, Li C.; Chaturvedi, Anil K.

2016-01-01

Importance The US Preventive Services Task Force (USPSTF) recommends computed-tomography (CT) lung-cancer screening for ever-smokers ages 55-80 years who smoked at least 30 pack-years with no more than 15 years since quitting. However, selecting ever-smokers for screening using individualized lung-cancer risk calculations may be more effective and efficient than current USPSTF recommendations. Objective Comparison of modeled outcomes from risk-based CT lung-screening strategies versus USPSTF recommendations. Design/Setting/Participants Empirical risk models for lung-cancer incidence and death in the absence of CT screening using data on ever-smokers from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO; 1993-2009) control group. Covariates included age, education, sex, race, smoking intensity/duration/quit-years, Body Mass Index, family history of lung-cancer, and self-reported emphysema. Model validation in the chest radiography groups of the PLCO and the National Lung Screening Trial (NLST; 2002-2009), with additional validation of the death model in the National Health Interview Survey (NHIS; 1997-2001), a representative sample of the US. Models applied to US ever-smokers ages 50-80 (NHIS 2010-2012) to estimate outcomes of risk-based selection for CT lung-screening, assuming screening for all ever-smokers yields the percent changes in lung-cancer detection and death observed in the NLST. Exposure Annual CT lung-screening for 3 years. Main Outcomes and Measures Model validity: calibration (number of model-predicted cases divided by number of observed cases (Estimated/Observed)) and discrimination (Area-Under-Curve (AUC)). Modeled screening outcomes: estimated number of screen-avertable lung-cancer deaths, estimated screening effectiveness (number needed to screen (NNS) to prevent 1 lung-cancer death). Results Lung-cancer incidence and death risk models were well-calibrated in PLCO and NLST. The lung-cancer death model calibrated and discriminated well for US ever-smokers ages 50-80 (NHIS 1997-2001: Estimated/Observed=0.94, 95%CI=0.84-1.05; AUC=0.78, 95%CI=0.76-0.80). Under USPSTF recommendations, the models estimated 9.0 million US ever-smokers would qualify for lung-cancer screening and 46,488 (95%CI=43,924-49,053) lung-cancer deaths were estimated as screen-avertable over 5 years (estimated NNS=194, 95%CI=187-201). In contrast, risk-based selection screening the same number of ever-smokers (9.0 million) at highest 5-year lung-cancer risk (≥1.9%), was estimated to avert 20% more deaths (55,717; 95%CI=53,033-58,400) and was estimated to reduce the estimated NNS by 17% (NNS=162, 95%CI=157-166). Conclusions and Relevance Among a cohort of US ever-smokers age 50-80 years, application of a risk-based model for CT screening for lung cancer compared with a model based on USPSTF recommendations was estimated to be associated with a greater number of lung-cancer deaths prevented over 5 years along with a lower NNS to prevent 1 lung-cancer death. PMID:27179989

Development and Validation of Risk Models to Select Ever-Smokers for CT Lung Cancer Screening.

PubMed

Katki, Hormuzd A; Kovalchik, Stephanie A; Berg, Christine D; Cheung, Li C; Chaturvedi, Anil K

2016-06-07

The US Preventive Services Task Force (USPSTF) recommends computed tomography (CT) lung cancer screening for ever-smokers aged 55 to 80 years who have smoked at least 30 pack-years with no more than 15 years since quitting. However, selecting ever-smokers for screening using individualized lung cancer risk calculations may be more effective and efficient than current USPSTF recommendations. Comparison of modeled outcomes from risk-based CT lung-screening strategies vs USPSTF recommendations. Empirical risk models for lung cancer incidence and death in the absence of CT screening using data on ever-smokers from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO; 1993-2009) control group. Covariates included age; education; sex; race; smoking intensity, duration, and quit-years; body mass index; family history of lung cancer; and self-reported emphysema. Model validation in the chest radiography groups of the PLCO and the National Lung Screening Trial (NLST; 2002-2009), with additional validation of the death model in the National Health Interview Survey (NHIS; 1997-2001), a representative sample of the United States. Models were applied to US ever-smokers aged 50 to 80 years (NHIS 2010-2012) to estimate outcomes of risk-based selection for CT lung screening, assuming screening for all ever-smokers, yield the percent changes in lung cancer detection and death observed in the NLST. Annual CT lung screening for 3 years beginning at age 50 years. For model validity: calibration (number of model-predicted cases divided by number of observed cases [estimated/observed]) and discrimination (area under curve [AUC]). For modeled screening outcomes: estimated number of screen-avertable lung cancer deaths and estimated screening effectiveness (number needed to screen [NNS] to prevent 1 lung cancer death). Lung cancer incidence and death risk models were well calibrated in PLCO and NLST. The lung cancer death model calibrated and discriminated well for US ever-smokers aged 50 to 80 years (NHIS 1997-2001: estimated/observed = 0.94 [95%CI, 0.84-1.05]; AUC, 0.78 [95%CI, 0.76-0.80]). Under USPSTF recommendations, the models estimated 9.0 million US ever-smokers would qualify for lung cancer screening and 46,488 (95% CI, 43,924-49,053) lung cancer deaths were estimated as screen-avertable over 5 years (estimated NNS, 194 [95% CI, 187-201]). In contrast, risk-based selection screening of the same number of ever-smokers (9.0 million) at highest 5-year lung cancer risk (≥1.9%) was estimated to avert 20% more deaths (55,717 [95% CI, 53,033-58,400]) and was estimated to reduce the estimated NNS by 17% (NNS, 162 [95% CI, 157-166]). Among a cohort of US ever-smokers aged 50 to 80 years, application of a risk-based model for CT screening for lung cancer compared with a model based on USPSTF recommendations was estimated to be associated with a greater number of lung cancer deaths prevented over 5 years, along with a lower NNS to prevent 1 lung cancer death.

Climate Change Impacts on Harmful Algal Blooms in U.S. Freshwaters: A Screening-Level Assessment.

PubMed

Chapra, Steven C; Boehlert, Brent; Fant, Charles; Bierman, Victor J; Henderson, Jim; Mills, David; Mas, Diane M L; Rennels, Lisa; Jantarasami, Lesley; Martinich, Jeremy; Strzepek, Kenneth M; Paerl, Hans W

2017-08-15

Cyanobacterial harmful algal blooms (CyanoHABs) have serious adverse effects on human and environmental health. Herein, we developed a modeling framework that predicts the effect of climate change on cyanobacteria concentrations in large reservoirs in the contiguous U.S. The framework, which uses climate change projections from five global circulation models, two greenhouse gas emission scenarios, and two cyanobacterial growth scenarios, is unique in coupling climate projections with a hydrologic/water quality network model of the contiguous United States. Thus, it generates both regional and nationwide projections useful as a screening-level assessment of climate impacts on CyanoHAB prevalence as well as potential lost recreation days and associated economic value. Our projections indicate that CyanoHAB concentrations are likely to increase primarily due to water temperature increases tempered by increased nutrient levels resulting from changing demographics and climatic impacts on hydrology that drive nutrient transport. The combination of these factors results in the mean number of days of CyanoHAB occurrence ranging from about 7 days per year per waterbody under current conditions, to 16-23 days in 2050 and 18-39 days in 2090. From a regional perspective, we find the largest increases in CyanoHAB occurrence in the Northeast U.S., while the greatest impacts to recreation, in terms of costs, are in the Southeast.

The cost effectiveness of radon mitigation in existing German dwellings--a decision theoretic analysis.

PubMed

Haucke, Florian

2010-11-01

Radon is a naturally occurring inert radioactive gas found in soils and rocks that can accumulate in dwellings, and is associated with an increased risk of lung cancer. This study aims to analyze the cost effectiveness of different intervention strategies to reduce radon concentrations in existing German dwellings. The cost effectiveness analysis (CEA) was conducted as a scenario analysis, where each scenario represents a specific regulatory regime. A decision theoretic model was developed, which reflects accepted recommendations for radon screening and mitigation and uses most up-to-date data on radon distribution and relative risks. The model was programmed to account for compliance with respect to the single steps of radon intervention, as well as data on the sensitivity/specificity of radon tests. A societal perspective was adopted to calculate costs and effects. All scenarios were calculated for different action levels. Cost effectiveness was measured in costs per averted case of lung cancer, costs per life year gained and costs per quality adjusted life year (QALY) gained. Univariate and multivariate deterministic and probabilistic sensitivity analyses (SA) were performed. Probabilistic sensitivity analyses were based on Monte Carlo simulations with 5000 model runs. The results show that legal regulations with mandatory screening and mitigation for indoor radon levels >100 Bq/m(3) are most cost effective. Incremental cost effectiveness compared to the no mitigation base case is 25,181 euro (95% CI: 7371 euro-90,593 euro) per QALY gained. Other intervention strategies focussing primarily on the personal responsibility for screening and/or mitigative actions show considerably worse cost effectiveness ratios. However, targeting radon intervention to radon-prone areas is significantly more cost effective. Most of the uncertainty that surrounds the results can be ascribed to the relative risk of radon exposure. It can be concluded that in the light of international experience a legal regulation requiring radon screening and, if necessary, mitigation is justifiable under the terms of CEA. Copyright 2010 Elsevier Ltd. All rights reserved.

An Evaluation of Teachers' Attitudes and Beliefs Levels on Classroom Control in Terms of Teachers' Sense of Efficacy (The Sample of Biology Teachers in Turkey)

ERIC Educational Resources Information Center

Kurt, Hakan

2014-01-01

The aim of this study is to evaluate biology teachers' attitudes and belief levels on classroom control in terms of teachers' sense of efficacy. The screening model was used in the study. The study group was comprised of 135 biology teachers. In this study, Teachers' Sense of Efficacy Scale (TSES) and The Attitudes and Beliefs on Classroom Control…

Examining the Behavior and Thinking Levels of Secondary School Students (6th-8th Grades) towards the Environment According to Gender

ERIC Educational Resources Information Center

Durkan, Nazmi

2017-01-01

The aim of this study is to examine the behavior and thinking levels of secondary school students towards the environment according to grade and gender. Relational screening model was used for the study. The sample includes a total of 958 (512 females and 446 males) secondary school students. Of the participants, 261 (27.2%) are in 6th grade, 461…

Using Human iPSC-Derived Neurons to Model TAU Aggregation

PubMed Central

Verheyen, An; Diels, Annick; Dijkmans, Joyce; Oyelami, Tutu; Meneghello, Giulia; Mertens, Liesbeth; Versweyveld, Sofie; Borgers, Marianne; Buist, Arjan; Peeters, Pieter; Cik, Miroslav

2015-01-01

Alzheimer’s disease and frontotemporal dementia are amongst the most common forms of dementia characterized by the formation and deposition of abnormal TAU in the brain. In order to develop a translational human TAU aggregation model suitable for screening, we transduced TAU harboring the pro-aggregating P301L mutation into control hiPSC-derived neural progenitor cells followed by differentiation into cortical neurons. TAU aggregation and phosphorylation was quantified using AlphaLISA technology. Although no spontaneous aggregation was observed upon expressing TAU-P301L in neurons, seeding with preformed aggregates consisting of the TAU-microtubule binding repeat domain triggered robust TAU aggregation and hyperphosphorylation already after 2 weeks, without affecting general cell health. To validate our model, activity of two autophagy inducers was tested. Both rapamycin and trehalose significantly reduced TAU aggregation levels suggesting that iPSC-derived neurons allow for the generation of a biologically relevant human Tauopathy model, highly suitable to screen for compounds that modulate TAU aggregation. PMID:26720731

Disease modeling and phenotypic drug screening for diabetic cardiomyopathy using human induced pluripotent stem cells.

PubMed

Drawnel, Faye M; Boccardo, Stefano; Prummer, Michael; Delobel, Frédéric; Graff, Alexandra; Weber, Michael; Gérard, Régine; Badi, Laura; Kam-Thong, Tony; Bu, Lei; Jiang, Xin; Hoflack, Jean-Christophe; Kiialainen, Anna; Jeworutzki, Elena; Aoyama, Natsuyo; Carlson, Coby; Burcin, Mark; Gromo, Gianni; Boehringer, Markus; Stahlberg, Henning; Hall, Benjamin J; Magnone, Maria Chiara; Kolaja, Kyle; Chien, Kenneth R; Bailly, Jacques; Iacone, Roberto

2014-11-06

Diabetic cardiomyopathy is a complication of type 2 diabetes, with known contributions of lifestyle and genetics. We develop environmentally and genetically driven in vitro models of the condition using human-induced-pluripotent-stem-cell-derived cardiomyocytes. First, we mimic diabetic clinical chemistry to induce a phenotypic surrogate of diabetic cardiomyopathy, observing structural and functional disarray. Next, we consider genetic effects by deriving cardiomyocytes from two diabetic patients with variable disease progression. The cardiomyopathic phenotype is recapitulated in the patient-specific cells basally, with a severity dependent on their original clinical status. These models are incorporated into successive levels of a screening platform, identifying drugs that preserve cardiomyocyte phenotype in vitro during diabetic stress. In this work, we present a patient-specific induced pluripotent stem cell (iPSC) model of a complex metabolic condition, showing the power of this technique for discovery and testing of therapeutic strategies for a disease with ever-increasing clinical significance. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

The impact of level of education on adherence to breast and cervical cancer screening: Evidence from a systematic review and meta-analysis.

PubMed

Damiani, Gianfranco; Basso, Danila; Acampora, Anna; Bianchi, Caterina B N A; Silvestrini, Giulia; Frisicale, Emanuela M; Sassi, Franco; Ricciardi, Walter

2015-12-01

To assess the inequalities in adherence to breast and cervical cancer screening according to educational level. A systematic review was carried out between 2000 and 2013 by querying an electronic database using specific keywords. Studies published in English reporting an estimation of the association between level of education and adherence to breast and/or cervical cancer screening were included in the study. Two different meta-analyses were carried out for adherence to breast and cervical cancer screening, respectively: women with the highest level of education and women with the lowest level of education were compared. The level of heterogeneity was investigated and subgroup analyses were carried out. Of 1231 identified articles, 10 cross-sectional studies were included in the analysis. The meta-analyses showed that women with the highest level of education were more likely to have both screenings with an overall OR=1.61 (95% CI 1.36-1.91; I(2)=71%) for mammography and OR=1.96 (95% CI 1.79-2.16; I(2)=0%) for Pap test, respectively. Stratified meta-analysis for breast cancer screening included only studies that reported guidelines with target age of population ≥50 years and showed a reduction in the level of heterogeneity and an increase of 36% in the adherence (95% CI 1.19-1.55; I(2)=0%). This study confirms and reinforces evidence of inequalities in breast and cervical cancer screening adherence according to educational level. Copyright © 2015 Elsevier Inc. All rights reserved.

Socioeconomic disparity in cervical cancer screening among Korean women: 1998–2010

PubMed Central

2013-01-01

Background Cervical cancer is the sixth most common cause of cancer among Korean women and is one of the most preventable cancers in the world. This study aimed to investigate the change in cervical cancer screening rates, the level of socioeconomic disparities in cervical cancer screening participation, and whether there was a reduction in these disparities between 1998 and 2010. Methods Using the Korean Health and Nutrition Examination Survey, women 30 years or older without a history of cervical cancer and who completed a health questionnaire, physical examination, and nutritional survey were included (n = 17,105). Information about participation in cervical cancer screening was collected using a self-administered questionnaire. Multiple logistic regression analysis was performed to investigate the relationship between cervical cancer screening participation and the socioeconomic status of the women. Results The cervical cancer screening rate increased from 40.5% in 1998 to 52.5% in 2010. Socioeconomic disparities influenced participation, and women with lower educational levels and lower household income were less likely to be screened. Compared with the lowest educational level, the adjusted odds ratios (ORs) for screening in women with the highest educational level were 1.56 (95% confidence interval (CI): 1.05–2.30) in 1998, and 1.44 (95% CI: 1.12–1.87) in 2010. Compared with women with the lowest household income level, the adjusted ORs for screening in women with the highest household income level were 1.80 (95% CI: 1.22–2.68), 2.82 (95% CI: 2.01–3.96), and 1.45 (95% CI: 1.08–1.94) in 2001, 2005, and 2010, respectively. Conclusion Although population-wide progress has been made in participation in cervical cancer screening over the 12-year period, socioeconomic status remained an important factor in reducing compliance with cancer screening. PMID:23742100

Impact of a public cholesterol screening program.

PubMed

Fischer, P M; Guinan, K H; Burke, J J; Karp, W B; Richards, J W

1990-12-01

The National Cholesterol Education Program (NCEP) has endorsed physician case finding as the primary method to detect individuals with elevated cholesterol levels. Despite this recommendation, promotional and for-profit public screening programs have flourished. We surveyed participants of a mall-based cholesterol screening program 1 year after their screening. Sixty-four percent of those screened had not previously known their cholesterol levels. Those who were newly screened were less likely to benefit from this testing than the general public, since they were older (mean age, 55.3 years), more likely to be female (67.4%), and nonsmokers (88%). Screenees had excellent recall of their cholesterol level (mean absolute reporting error, 0.24 mmol/L [9 mg/dL]) and a good understanding of cholesterol as a coronary heart disease risk. Those with elevated cholesterol levels reported high distress from screening but no reduction in overall psychosocial well-being and an actual decrease in absenteeism. Only 53.7% of all who were advised to seek follow-up because of an elevated screening value had done so within the year following the screening program. However, of those with values greater than 6.2 mmol/L (240 mg/dL), 68% had sought follow-up. Many of those who participate in public screening programs have been previously tested, fall into low-benefit groups, or fail to comply with recommended follow-up. We therefore conclude that cholesterol screening programs of the type now commonly offered are unlikely to contribute greatly to the national efforts to further reduce coronary heart disease.

Does access to a colorectal cancer screening website and/or a nurse-managed telephone help line provided to patients by their family physician increase fecal occult blood test uptake?: A pragmatic cluster randomized controlled trial study protocol.

PubMed

Clouston, Kathleen; Katz, Alan; Martens, Patricia J; Sisler, Jeff; Turner, Donna; Lobchuk, Michelle; McClement, Susan

2012-05-17

Fecal occult blood test screening in Canada is sub-optimal. Family physicians play a central role in screening and are limited by the time constraints of clinical practice. Patients face multiple barriers that further reduce completion rates. Tools that support family physicians in providing their patients with colorectal cancer information and that support uptake may prove useful. The primary objective of the study is to evaluate the efficacy of a patient decision aid (nurse-managed telephone support line and/or colorectal cancer screening website) distributed by community-based family physicians, in improving colorectal cancer screening rates. Secondary objectives include evaluation of (dis)incentives to patient FOBT uptake and internet use among 50 to 74 year old males and females for health-related questions. Challenges faced by family physicians in engaging in collaborative partnerships with primary healthcare researchers will be documented. A pragmatic, two-arm, randomized cluster controlled trial conducted in 22 community-based family practice clinics (36 clusters) with 76 fee-for-service family physicians in Winnipeg, Manitoba, Canada. Each physician will enroll 30 patients attending their periodic health examination and at average risk for colorectal cancer. All physicians will follow their standard clinical practice for screening. Intervention group physicians will provide a fridge magnet to each patient that contains information facilitating access to the study-specific colorectal cancer screening decision aids (telephone help-line and website). The primary endpoint is patient fecal occult blood test completion rate after four months (intention to treat model). Multi-level analysis will include clinic, physician and patient level variables. Patient Personal Health Identification Numbers will be collected from those providing consent to facilitate analysis of repeat screening behavior. Secondary outcome data will be obtained through the Clinic Characterization Form, Patient Tracking Form, In-Clinic Patient Survey, Post-Study Follow-Up Patient Survey, and Family Physician Survey. Study protocol approved by The University of Manitoba Health Research Ethics Board. The study intervention has the potential to increase patient fecal occult blood test uptake, decrease colorectal cancer mortality and morbidity, and improve the health of Manitobans. If utilization of the website and/or telephone support line result in clinically significant increases in colorectal cancer screening uptake, changes in screening at the policy- and system-level may be warranted. Clinical trials.gov identifier NCT01026753.

The relationship between hours of sleep, screen time and frequency of food and drink consumption in Spain in the 2011 and 2013 ALADINO: a cross-sectional study.

PubMed

Pérez-Farinós, Napoleón; Villar-Villalba, Carmen; López Sobaler, Ana María; Dal Re Saavedra, María Ángeles; Aparicio, Aránzazu; Santos Sanz, Sara; Robledo de Dios, Teresa; Castrodeza-Sanz, José Javier; Ortega Anta, Rosa María

2017-01-06

The frequency of intake of food and beverages depends on a number of ill-defined behaviour patterns. The objectives of this study were to evaluate the effects of screen time and sleep duration on food consumption frequency, and to describe frequencies and types of food consumption according to BMI category and parents' level of education. We studied 6287 and 2806 children drawn from the 2011 and 2013 cross-sectional ALADINO studies respectively. Data were collected on number of hours of sleep, screen time, and weekly frequency of consumption of 17 food groups. Weight status was measured, and information was also collected on parents' educational level. Average food consumption frequencies were calculated by reference to hours of sleep and hours of screen time, and were defined as ≥4 times or <4 times per week (once per week for soft drinks and diet soft drinks). Differences in frequency were evaluated for screen times of more and less than 2 h per day, and for sleep durations longer or shorter than the daily average. We fitted logistic regression models to evaluate the independent association between screen exposure and hours of sleep on the one hand, and food consumption frequency on the other. Consumption of fruit and vegetables was lower among children who had parents with no formal or only primary school education. High levels of screen time were associated with a greater frequency of consumption of energy-dense, micronutrient-poor products and a lower frequency of consumption of fruit and vegetables. Sleeping a sufficient number of hours was associated with a higher consumption of fruit and vegetables. The results for 2011 were concordant with those for 2013. If efforts to ensure healthier eating habits among children are to be at all successful, they should focus on promoting a sufficient amount of sleep for children, limiting the time they spend watching television and/or playing with computers or video games, and educating parents accordingly.

A screening-level modeling approach to estimate nitrogen ...

EPA Pesticide Factsheets

This paper presents a screening-level modeling approach that can be used to rapidly estimate nutrient loading and assess numerical nutrient standard exceedance risk of surface waters leading to potential classification as impaired for designated use. It can also be used to explore best management practice (BMP) implementation to reduce loading. The modeling framework uses a hybrid statistical and process based approach to estimate source of pollutants, their transport and decay in the terrestrial and aquatic parts of watersheds. The framework is developed in the ArcGIS environment and is based on the total maximum daily load (TMDL) balance model. Nitrogen (N) is currently addressed in the framework, referred to as WQM-TMDL-N. Loading for each catchment includes non-point sources (NPS) and point sources (PS). NPS loading is estimated using export coefficient or event mean concentration methods depending on the temporal scales, i.e., annual or daily. Loading from atmospheric deposition is also included. The probability of a nutrient load to exceed a target load is evaluated using probabilistic risk assessment, by including the uncertainty associated with export coefficients of various land uses. The computed risk data can be visualized as spatial maps which show the load exceedance probability for all stream segments. In an application of this modeling approach to the Tippecanoe River watershed in Indiana, USA, total nitrogen (TN) loading and risk of standard exce

Modeling Individual Patient Preferences for Colorectal Cancer Screening Based on Their Tolerance for Complications Risk.

PubMed

Taksler, Glen B; Perzynski, Adam T; Kattan, Michael W

2017-04-01

Recommendations for colorectal cancer screening encourage patients to choose among various screening methods based on individual preferences for benefits, risks, screening frequency, and discomfort. We devised a model to illustrate how individuals with varying tolerance for screening complications risk might decide on their preferred screening strategy. We developed a discrete-time Markov mathematical model that allowed hypothetical individuals to maximize expected lifetime utility by selecting screening method, start age, stop age, and frequency. Individuals could choose from stool-based testing every 1 to 3 years, flexible sigmoidoscopy every 1 to 20 years with annual stool-based testing, colonoscopy every 1 to 20 years, or no screening. We compared the life expectancy gained from the chosen strategy with the life expectancy available from a benchmark strategy of decennial colonoscopy. For an individual at average risk of colorectal cancer who was risk neutral with respect to screening complications (and therefore was willing to undergo screening if it would actuarially increase life expectancy), the model predicted that he or she would choose colonoscopy every 10 years, from age 53 to 73 years, consistent with national guidelines. For a similar individual who was moderately averse to screening complications risk (and therefore required a greater increase in life expectancy to accept potential risks of colonoscopy), the model predicted that he or she would prefer flexible sigmoidoscopy every 12 years with annual stool-based testing, with 93% of the life expectancy benefit of decennial colonoscopy. For an individual with higher risk aversion, the model predicted that he or she would prefer 2 lifetime flexible sigmoidoscopies, 20 years apart, with 70% of the life expectancy benefit of decennial colonoscopy. Mathematical models may formalize how individuals with different risk attitudes choose between various guideline-recommended colorectal cancer screening strategies.

Cancer screening delivery in persistent poverty rural counties.

PubMed

Bennett, Kevin J; Pumkam, Chaiporn; Bellinger, Jessica D; Probst, Janice C

2011-10-01

Rural populations are diagnosed with cancer at different rate and stages than nonrural populations, and race/ethnicity as well as the area-level income exacerbates the differences. The purpose of this analysis was to explore cancer screening rates across persistent poverty rural counties, with emphasis on nonwhite populations. The 2008 Behavioral Risk Factor Surveillance System was used, combined with data from the Area Resource File (analytic n = 309 937 unweighted, 196 344 347 weighted). Unadjusted analysis estimated screening rates for breast, cervical, and colorectal cancer. Multivariate analysis estimated the odds of screening, controlling for individual and county-level effects. Rural residents, particularly those in persistent poverty counties, were less likely to be screened than urban residents. More African Americans in persistent poverty rural counties reported not having mammography screening (18.3%) compared to 15.9% of urban African Americans. Hispanics had low screening rates across all service types. Multivariate analysis continued to find disparities in screening rates, after controlling for individual and county-level factors. African Americans in persistent poverty rural counties were more likely to be screened for both breast cancer (odds ratio, 1.44; 95% confidence interval, 1.12-1.85) and cervical cancer (1.46; 1.07-1.99) when compared with urban whites. Disparities in cancer screening rates exist across not only race/ethnicity but also county type. These disparities cannot be fully explained by either individual or county-level effects. Programs have been successful in improving screening rates for African American women and should be expanded to target other vulnerable women as well as other services such as colorectal cancer screening.

Knowledge and Acceptability of Anal Cytology Screening Among Women.

PubMed

Blankenship, Stephanie A; Debnath, Priyanka; Szlachta-McGinn, Alec W; Maguire, Karla; Garcia, Jorge J; Aserlind, Alexandra; Lipshultz, Emma; Potter, JoNell E

2016-01-01

Medical providers have initiated anal cytology screening among women to detect anal neoplasia early. Lack of knowledge of the human papillomavirus (HPV) and anticipated screening discomfort may limit patient acceptance. This study investigates attitudes toward anal cytology screening among women. Women seen for gynecologic care at an urban university medical center were invited to complete an anonymous survey assessing their understanding of HPV and interest in anal cytology screening. Subjects reported the level of pain, discomfort, and embarrassment they expected from screening on a 100-mm visual analog scale. Four hundred four women with mean (SD) age 36 (13) years met criteria for participation. Three hundred thirty-five women reported their race: 52% were white and 36% were African American. Three hundred forty-eight women reported their ethnicities: 76% were Hispanic and 12% were Haitian. Twenty-two percent had never heard of HPV, 57% were not familiar with anal cytology screening, 67% acknowledged that screening was very helpful in detecting anal neoplasia early, and 28% were very interested in undergoing screening. Mean (SD) level of anticipated pain, discomfort, and embarrassment during screening was 62 (32), 68 (30), and 58 (34) mm, respectively. Level of familiarity with anal cytology screening (p < .001), belief in its utility in detecting anal neoplasia (p < .001), and level of anticipated pain (p = .004) were significant predictors of acceptability. Medical providers should improve counseling about anal cytology screening among at-risk women to familiarize them with the procedure, describe its role in detecting anal neoplasia, and address expectations surrounding pain to increase its acceptability.

Integrating cardiovascular diseases, hypertension, and diabetes with HIV services: a systematic review.

PubMed

Haldane, Victoria; Legido-Quigley, Helena; Chuah, Fiona Leh Hoon; Sigfrid, Louise; Murphy, Georgina; Ong, Suan Ee; Cervero-Liceras, Francisco; Watt, Nicola; Balabanova, Dina; Hogarth, Sue; Maimaris, Will; Buse, Kent; McKee, Martin; Piot, Peter; Perel, Pablo

2018-01-01

Non-communicable diseases (NCDs), including cardiovascular diseases (CVD), hypertension and diabetes together with HIV infection are among the major public health concerns worldwide. Health services for HIV and NCDs require health systems that provide for people's chronic care needs, which present an opportunity to coordinate efforts and create synergies between programs to benefit people living with HIV and/or AIDS and NCDs. This review included studies that reported service integration for HIV and/or AIDS with coronary heart diseases, chronic CVD, cerebrovascular diseases (stroke), hypertension or diabetes. We searched multiple databases from inception until October 2015. Articles were screened independently by two reviewers and assessed for risk of bias. 11,057 records were identified with 7,616 after duplicate removal. After screening titles and abstracts, 14 papers addressing 17 distinct interventions met the inclusion criteria. We categorized integration models by diseases (HIV with diabetes, HIV with hypertension and diabetes, HIV with CVD and finally HIV with hypertension and CVD and diabetes). Models also looked at integration from micro (patient focused integration) to macro (system level integrations). Most reported integration of hypertension and diabetes with HIV and AIDS services and described multidisciplinary collaboration, shared protocols, and incorporating screening activities into community campaigns. Integration took place exclusively at the meso-level, with no micro- or macro-level integrations described. Most were descriptive studies, with one cohort study reporting evaluative outcomes. Several innovative initiatives were identified and studies showed that CVD and HIV service integration is feasible. Integration should build on existing protocols and use the community as a locus for advocacy and health services, while promoting multidisciplinary teams, including greater involvement of pharmacists. There is a need for robust and well-designed studies at all levels - particularly macro-level studies, research looking at long-term outcomes of integration, and research in a more diverse range of countries.

Validation of Association of Genetic Variants at 10q with PSA Levels in Men at High Risk for Prostate Cancer

PubMed Central

Chang, Bao-Li; Hughes, Lucinda; Chen, David Y. T.; Gross, Laura; Ruth, Karen; Giri, Veda N.

2013-01-01

Objectives Men with a family history of prostate cancer and African American men are at increased risk for prostate cancer and stand to benefit from individualized interpretation of PSA to guide screening strategies. The purpose of this study was to validate six previously identified markers among high-risk men enrolled in the Prostate Cancer Risk Assessment Program - a prostate cancer screening study. Patients and Methods Eligibility for PRAP includes men ages 35–69 years with a family history of prostate cancer, any African American male regardless of family history, and men with known BRCA gene mutations. GWAS markers assessed included rs2736098 (5p15.33), rs10993994 (10q11), rs10788160 (10q26), rs11067228 (12q24), rs4430796 (17q12), and rs17632542 (19q13.33). Genotyping methods included either Taqman® SNP Genotyping Assay (Applied Biosystems) or pyrosequencing. Linear regression models were used to evaluate the association between individual markers and log-transformed baseline PSA levels, while adjusting for potential confounders. Results 707 participants (37% Caucasian, 63% African American) with clinical and genotype data were included in the analysis. Rs10788160 (10q26) strongly associated with PSA levels among high-risk Caucasian participants (p<0.01), with a 33.2% increase in PSA level with each A-allele carried. Furthermore, rs10993994 (10q11) demonstrated an association to PSA level (p=0.03) in high-risk Caucasian men, with a 15% increase in PSA with each T-allele carried. A PSA adjustment model based on allele carrier status at rs10788160 and rs10993994 is proposed specific to high-risk Caucasian men. Conclusion Genetic variation at 10q may be particularly important in personalizing interpretation of PSA for high-risk Caucasian men. Such information may have clinical relevance in shared decision-making and individualized prostate cancer screening strategies for high-risk Caucasian men. Further study is warranted. PMID:23937305

Scheme for the selection of measurement uncertainty models in blood establishments' screening immunoassays.

PubMed

Pereira, Paulo; Westgard, James O; Encarnação, Pedro; Seghatchian, Jerard; de Sousa, Gracinda

2015-02-01

Blood establishments routinely perform screening immunoassays to assess safety of the blood components. As with any other screening test, results have an inherent uncertainty. In blood establishments the major concern is the chance of false negatives, due to its possible impact on patients' health. This article briefly reviews GUM and diagnostic accuracy models for screening immunoassays, recommending a scheme to support the screening laboratories' staffs on the selection of a model considering the intended use of the screening results (i.e., post-transfusion safety). The discussion is grounded on a "risk-based thinking", risk being considered from the blood donor selection to the screening immunoassays. A combination of GUM and diagnostic accuracy models to evaluate measurement uncertainty in blood establishments is recommended. Copyright © 2014 Elsevier Ltd. All rights reserved.

Conceptual Framework To Extend Life Cycle Assessment ...

EPA Pesticide Factsheets

Life Cycle Assessment (LCA) is a decision-making tool that accounts for multiple impacts across the life cycle of a product or service. This paper presents a conceptual framework to integrate human health impact assessment with risk screening approaches to extend LCA to include near-field chemical sources (e.g., those originating from consumer products and building materials) that have traditionally been excluded from LCA. A new generation of rapid human exposure modeling and high-throughput toxicity testing is transforming chemical risk prioritization and provides an opportunity for integration of screening-level risk assessment (RA) with LCA. The combined LCA and RA approach considers environmental impacts of products alongside risks to human health, which is consistent with regulatory frameworks addressing RA within a sustainability mindset. A case study is presented to juxtapose LCA and risk screening approaches for a chemical used in a consumer product. The case study demonstrates how these new risk screening tools can be used to inform toxicity impact estimates in LCA and highlights needs for future research. The framework provides a basis for developing tools and methods to support decision making on the use of chemicals in products. This paper presents a conceptual framework for including near-field exposures into Life Cycle Assessment using advanced human exposure modeling and high-throughput tools

Development and verification of a model for estimating the screening utility in the detection of PCBs in transformer oil.

PubMed

Terakado, Shingo; Glass, Thomas R; Sasaki, Kazuhiro; Ohmura, Naoya

2014-01-01

A simple new model for estimating the screening performance (false positive and false negative rates) of a given test for a specific sample population is presented. The model is shown to give good results on a test population, and is used to estimate the performance on a sampled population. Using the model developed in conjunction with regulatory requirements and the relative costs of the confirmatory and screening tests allows evaluation of the screening test's utility in terms of cost savings. Testers can use the methods developed to estimate the utility of a screening program using available screening tests with their own sample populations.

Effect of acculturation and access to care on colorectal cancer screening in low-income Latinos.

PubMed

Savas, Lara S; Vernon, Sally W; Atkinson, John S; Fernández, Maria E

2015-06-01

Latinos have lower colorectal cancer screening (CRCS) and survival rates compared to other race/ethnic groups. This cross-sectional study examines relationships between acculturation, access to and utilization of healthcare services, and CRCS in low-income Latinos. Bilingual data collectors conducted structured interviews with 544 Latino men and women (>50 years) residing in the Texas-Mexico border area. Using a hierarchical logistic regression model, we examined the relationship between lifetime history of any CRCS test and indicators of acculturation, healthcare utilization and access to care, adjusting for socio-demographic characteristics. Survey results revealed a 34% prevalence of CRCS. Participants reporting a provider recommendation for screening, regular check-ups, higher acculturation level, and health insurance had significantly increased odds of CRCS. Findings indicate CRCS intervention research in Latinos should focus on (1) increasing physicians' recommendations for screening, (2) promoting regular check-ups, (3) and increasing CRC prevention efforts on less acculturated and uninsured groups.

Genome-scale CRISPR-Cas9 knockout screening in human cells.

PubMed

Shalem, Ophir; Sanjana, Neville E; Hartenian, Ella; Shi, Xi; Scott, David A; Mikkelson, Tarjei; Heckl, Dirk; Ebert, Benjamin L; Root, David E; Doench, John G; Zhang, Feng

2014-01-03

The simplicity of programming the CRISPR (clustered regularly interspaced short palindromic repeats)-associated nuclease Cas9 to modify specific genomic loci suggests a new way to interrogate gene function on a genome-wide scale. We show that lentiviral delivery of a genome-scale CRISPR-Cas9 knockout (GeCKO) library targeting 18,080 genes with 64,751 unique guide sequences enables both negative and positive selection screening in human cells. First, we used the GeCKO library to identify genes essential for cell viability in cancer and pluripotent stem cells. Next, in a melanoma model, we screened for genes whose loss is involved in resistance to vemurafenib, a therapeutic RAF inhibitor. Our highest-ranking candidates include previously validated genes NF1 and MED12, as well as novel hits NF2, CUL3, TADA2B, and TADA1. We observe a high level of consistency between independent guide RNAs targeting the same gene and a high rate of hit confirmation, demonstrating the promise of genome-scale screening with Cas9.

[Study of Cervical Exfoliated Cell's DNA Quantitative Analysis Based on Multi-Spectral Imaging Technology].

PubMed

Wu, Zheng; Zeng, Li-bo; Wu, Qiong-shui

2016-02-01

The conventional cervical cancer screening methods mainly include TBS (the bethesda system) classification method and cellular DNA quantitative analysis, however, by using multiple staining method in one cell slide, which is staining the cytoplasm with Papanicolaou reagent and the nucleus with Feulgen reagent, the study of achieving both two methods in the cervical cancer screening at the same time is still blank. Because the difficulty of this multiple staining method is that the absorbance of the non-DNA material may interfere with the absorbance of DNA, so that this paper has set up a multi-spectral imaging system, and established an absorbance unmixing model by using multiple linear regression method based on absorbance's linear superposition character, and successfully stripped out the absorbance of DNA to run the DNA quantitative analysis, and achieved the perfect combination of those two kinds of conventional screening method. Through a series of experiment we have proved that between the absorbance of DNA which is calculated by the absorbance unmixxing model and the absorbance of DNA which is measured there is no significant difference in statistics when the test level is 1%, also the result of actual application has shown that there is no intersection between the confidence interval of the DNA index of the tetraploid cells which are screened by using this paper's analysis method when the confidence level is 99% and the DNA index's judging interval of cancer cells, so that the accuracy and feasibility of the quantitative DNA analysis with multiple staining method expounded by this paper have been verified, therefore this analytical method has a broad application prospect and considerable market potential in early diagnosis of cervical cancer and other cancers.

Income Disparities in the Use of Health Screening Services Among University Students in Korea: A Cross-Sectional Study of 2479 Participants in a University.

PubMed

Lee, Su Hyun; Joh, Hee-Kyung; Kim, Soojin; Oh, Seung-Won; Lee, Cheol Min; Kwon, Hyuktae

2016-05-01

Public health insurance coverage for preventive care in young adults is incomplete in Korea. Few studies have focused on young adults' socioeconomic disparities in preventive care utilization. We aimed to explore household income disparities in the use of different types of health screening services among university students in Korea.This cross-sectional study used a web-based self-administered survey of students at a university in Korea from January to February 2013. To examine the associations between household income levels and health screening service use within the past 2 years, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression with adjustment for various covariables.Of 2479 participants, 45.5% reported using health screening services within 2 years (university-provided screening 32.9%, private sector screening 16.7%, and both 4.1%). Household income levels were not significantly associated with overall rates of health screening service use with a multivariable-adjusted OR (95% CI) in the lowest versus highest income group of 1.12 (0.87-1.45, Ptrend = 0.35). However, we found significantly different associations in specific types of utilized screening services by household income levels. The multivariable-adjusted OR (95% CI) of university-provided health screening service use in the lowest versus highest income level was 1.74 (1.30-2.34; Ptrend < 0.001), whereas the multivariable-adjusted OR (95% CI) of private sector service use in the lowest versus highest income level was 0.45 (0.31-0.66; Ptrend < 0.001).This study demonstrated significant disparities in the types of utilized health screening services by income groups among university students in Korea, although overall rates of health screening service use were similar across income levels. Low-income students were more likely to use university-provided health screening services, and less likely to use private sector screening services. To ensure appropriate preventive care delivery for young adults and to address disparities in disadvantaged groups, the expansion of medical insurance coverage for preventive health care, establishment of a usual source of care, focusing on vulnerable groups, and the development of evidence-based standardized health screening guidelines for young adults are needed.

Income Disparities in the Use of Health Screening Services Among University Students in Korea

PubMed Central

Lee, Su Hyun; Joh, Hee-Kyung; Kim, Soojin; Oh, Seung-Won; Lee, Cheol Min; Kwon, Hyuktae

2016-01-01

Abstract Public health insurance coverage for preventive care in young adults is incomplete in Korea. Few studies have focused on young adults’ socioeconomic disparities in preventive care utilization. We aimed to explore household income disparities in the use of different types of health screening services among university students in Korea. This cross-sectional study used a web-based self-administered survey of students at a university in Korea from January to February 2013. To examine the associations between household income levels and health screening service use within the past 2 years, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression with adjustment for various covariables. Of 2479 participants, 45.5% reported using health screening services within 2 years (university-provided screening 32.9%, private sector screening 16.7%, and both 4.1%). Household income levels were not significantly associated with overall rates of health screening service use with a multivariable-adjusted OR (95% CI) in the lowest versus highest income group of 1.12 (0.87–1.45, Ptrend = 0.35). However, we found significantly different associations in specific types of utilized screening services by household income levels. The multivariable-adjusted OR (95% CI) of university-provided health screening service use in the lowest versus highest income level was 1.74 (1.30–2.34; Ptrend < 0.001), whereas the multivariable-adjusted OR (95% CI) of private sector service use in the lowest versus highest income level was 0.45 (0.31–0.66; Ptrend < 0.001). This study demonstrated significant disparities in the types of utilized health screening services by income groups among university students in Korea, although overall rates of health screening service use were similar across income levels. Low-income students were more likely to use university-provided health screening services, and less likely to use private sector screening services. To ensure appropriate preventive care delivery for young adults and to address disparities in disadvantaged groups, the expansion of medical insurance coverage for preventive health care, establishment of a usual source of care, focusing on vulnerable groups, and the development of evidence-based standardized health screening guidelines for young adults are needed. PMID:27196475

The role of acculturation and collectivism in cancer screening for Vietnamese American women.

PubMed

Nguyen, Anh B; Clark, Trenette T

2014-01-01

The aim of this study was to examine the influence of demographic variables and the interplay between collectivism and acculturation on breast and cervical cancer screening outcomes among Vietnamese American women. Convenience sampling was used to recruit 111 Vietnamese women from the Richmond, VA, metropolitan area, who participated in a larger cancer screening intervention. All participants completed measures on demographic variables, collectivism, acculturation, and cancer-screening-related variables (i.e., attitudes, self-efficacy, and screening behavior). Findings indicated that collectivism predicted both positive attitudes and higher levels of self-efficacy with regard to breast and cervical cancer screening. Collectivism also moderated the relationship between acculturation and attitudes toward breast cancer screening such that for women with low levels of collectivistic orientation, increasing acculturation predicted less positive attitudes towards breast cancer screening. This relationship was not found for women with high levels of collectivistic orientation. The current findings highlight the important roles that sociodemographic and cultural variables play in affecting health attitudes, self-efficacy, and behavior among Vietnamese women. The findings potentially inform screening programs that rely on culturally relevant values in helping increase Vietnamese women's motivation to screen.

The Role of Acculturation and Collectivism in Cancer Screening for Vietnamese American Women

PubMed Central

NGUYEN, ANH B.; CLARK, TRENETTE T.

2017-01-01

The aim of this study was to examine the influence of demographic variables and the interplay between collectivism and acculturation on breast and cervical cancer screening outcomes among Vietnamese American women. Convenience sampling was used to recruit 111 Vietnamese women from the Richmond, VA, metropolitan area, who participated in a larger cancer screening intervention. All participants completed measures on demographic variables, collectivism, acculturation, and cancer-screening-related variables (i.e., attitudes, self-efficacy, and screening behavior). Findings indicated that collectivism predicted both positive attitudes and higher levels of self-efficacy with regard to breast and cervical cancer screening. Collectivism also moderated the relationship between acculturation and attitudes toward breast cancer screening such that for women with low levels of collectivistic orientation, increasing acculturation predicted less positive attitudes towards breast cancer screening. This relationship was not found for women with high levels of collectivistic orientation. The current findings highlight the important roles that sociodemographic and cultural variables play in affecting health attitudes, self-efficacy, and behavior among Vietnamese women. The findings potentially inform screening programs that rely on culturally relevant values in helping increase Vietnamese women’s motivation to screen. PMID:24313445

Characterization of Differentiated SH-SY5Y as Neuronal Screening Model Reveals Increased Oxidative Vulnerability

PubMed Central

Forster, J. I.; Köglsberger, S.; Trefois, C.; Boyd, O.; Baumuratov, A. S.; Buck, L.; Balling, R.; Antony, P. M. A.

2016-01-01

The immortalized and proliferative cell line SH-SY5Y is one of the most commonly used cell lines in neuroscience and neuroblastoma research. However, undifferentiated SH-SY5Y cells share few properties with mature neurons. In this study, we present an optimized neuronal differentiation protocol for SH-SY5Y that requires only two work steps and 6 days. After differentiation, the cells present increased levels of ATP and plasma membrane activity but reduced expression of energetic stress response genes. Differentiation results in reduced mitochondrial membrane potential and decreased robustness toward perturbations with 6-hydroxydopamine. We are convinced that the presented differentiation method will leverage genetic and chemical high-throughput screening projects targeting pathways that are involved in the selective vulnerability of neurons with high energetic stress levels. PMID:26738520

Optimal healthcare decision making under multiple mathematical models: application in prostate cancer screening.

PubMed

Bertsimas, Dimitris; Silberholz, John; Trikalinos, Thomas

2018-03-01

Important decisions related to human health, such as screening strategies for cancer, need to be made without a satisfactory understanding of the underlying biological and other processes. Rather, they are often informed by mathematical models that approximate reality. Often multiple models have been made to study the same phenomenon, which may lead to conflicting decisions. It is natural to seek a decision making process that identifies decisions that all models find to be effective, and we propose such a framework in this work. We apply the framework in prostate cancer screening to identify prostate-specific antigen (PSA)-based strategies that perform well under all considered models. We use heuristic search to identify strategies that trade off between optimizing the average across all models' assessments and being "conservative" by optimizing the most pessimistic model assessment. We identified three recently published mathematical models that can estimate quality-adjusted life expectancy (QALE) of PSA-based screening strategies and identified 64 strategies that trade off between maximizing the average and the most pessimistic model assessments. All prescribe PSA thresholds that increase with age, and 57 involve biennial screening. Strategies with higher assessments with the pessimistic model start screening later, stop screening earlier, and use higher PSA thresholds at earlier ages. The 64 strategies outperform 22 previously published expert-generated strategies. The 41 most "conservative" ones remained better than no screening with all models in extensive sensitivity analyses. We augment current comparative modeling approaches by identifying strategies that perform well under all models, for various degrees of decision makers' conservativeness.

Virtual screening of integrase inhibitors by large scale binding free energy calculations: the SAMPL4 challenge

PubMed Central

Gallicchio, Emilio; Deng, Nanjie; He, Peng; Wickstrom, Lauren; Perryman, Alexander L.; Santiago, Daniel N.; Forli, Stefano; Olson, Arthur J.; Levy, Ronald M.

2014-01-01

As part of the SAMPL4 blind challenge, filtered AutoDock Vina ligand docking predictions and large scale binding energy distribution analysis method binding free energy calculations have been applied to the virtual screening of a focused library of candidate binders to the LEDGF site of the HIV integrase protein. The computational protocol leveraged docking and high level atomistic models to improve enrichment. The enrichment factor of our blind predictions ranked best among all of the computational submissions, and second best overall. This work represents to our knowledge the first example of the application of an all-atom physics-based binding free energy model to large scale virtual screening. A total of 285 parallel Hamiltonian replica exchange molecular dynamics absolute protein-ligand binding free energy simulations were conducted starting from docked poses. The setup of the simulations was fully automated, calculations were distributed on multiple computing resources and were completed in a 6-weeks period. The accuracy of the docked poses and the inclusion of intramolecular strain and entropic losses in the binding free energy estimates were the major factors behind the success of the method. Lack of sufficient time and computing resources to investigate additional protonation states of the ligands was a major cause of mispredictions. The experiment demonstrated the applicability of binding free energy modeling to improve hit rates in challenging virtual screening of focused ligand libraries during lead optimization. PMID:24504704

Lung Cancer Screening Participation: Developing a Conceptual Model to Guide Research

PubMed Central

Carter-Harris, Lisa; Davis, Lorie L.; Rawl, Susan M.

2017-01-01

Purpose To describe the development of a conceptual model to guide research focused on lung cancer screening participation from the perspective of the individual in the decision-making process. Methods Based on a comprehensive review of empirical and theoretical literature, a conceptual model was developed linking key psychological variables (stigma, medical mistrust, fatalism, worry, and fear) to the health belief model and precaution adoption process model. Results Proposed model concepts have been examined in prior research of either lung or other cancer screening behavior. To date, a few studies have explored a limited number of variables that influence screening behavior in lung cancer specifically. Therefore, relationships among concepts in the model have been proposed and future research directions presented. Conclusion This proposed model is an initial step to support theoretically based research. As lung cancer screening becomes more widely implemented, it is critical to theoretically guide research to understand variables that may be associated with lung cancer screening participation. Findings from future research guided by the proposed conceptual model can be used to refine the model and inform tailored intervention development. PMID:28304262

Lung Cancer Screening Participation: Developing a Conceptual Model to Guide Research.

PubMed

Carter-Harris, Lisa; Davis, Lorie L; Rawl, Susan M

2016-11-01

To describe the development of a conceptual model to guide research focused on lung cancer screening participation from the perspective of the individual in the decision-making process. Based on a comprehensive review of empirical and theoretical literature, a conceptual model was developed linking key psychological variables (stigma, medical mistrust, fatalism, worry, and fear) to the health belief model and precaution adoption process model. Proposed model concepts have been examined in prior research of either lung or other cancer screening behavior. To date, a few studies have explored a limited number of variables that influence screening behavior in lung cancer specifically. Therefore, relationships among concepts in the model have been proposed and future research directions presented. This proposed model is an initial step to support theoretically based research. As lung cancer screening becomes more widely implemented, it is critical to theoretically guide research to understand variables that may be associated with lung cancer screening participation. Findings from future research guided by the proposed conceptual model can be used to refine the model and inform tailored intervention development.

Exploring the Relationship between School Principals' Burnout Situation and Life Satisfaction

ERIC Educational Resources Information Center

Karakose, Turgut; Kocabas, Ibrahim; Yirci, Ramazan; Esen, Coskun; Celik, Mustafa

2016-01-01

The purpose of this study is to explore school administrations' burnout situation and life satisfaction levels and the relationship between burnout and life satisfaction. The study was designed with the screening model. The research sample consists of 92 school principals and vice principals. Research data was collected with "Maslach Burnout…

Improving ecological risk assessment of persistent, bioaccumulative, and toxic (PBT) chemicals by using an integrated modeling system - An example assessing chloroparaffins in riverine environments.

EPA Science Inventory

Chemical risk assessment (CRA) is primarily carried out at the screening level relying on empirical relationships between chemical properties and tested toxicity effects. Ultimately, risk to aquatic ecosystems is strongly dependent on actual exposure, which depends on chemical pr...

Relationship between High School Students' Facebook Addiction and Loneliness Status

ERIC Educational Resources Information Center

Karakose, Turgut; Yirci, Ramazan; Uygun, Harun; Ozdemir, Tuncay Yavuz

2016-01-01

This study was conducted in order to analyze the relation between high school students' Facebook addiction and loneliness levels. The study was conducted with the relational screening model. The sample of the study consists of 712 randomly selected high school students. The data was collected using the Bergen Facebook Addiction Scale (BFAS) to…

The Relationship between Good Readers' Attention, Reading Fluency and Reading Comprehension

ERIC Educational Resources Information Center

Yildiz, Mustafa; Çetinkaya, Ezgi

2017-01-01

This study aimed to examine the relationship between fourth-graders' reading fluency, reading comprehension and attention. It was conducted using the relational screening model and included 132 fourth-graders with grade level adequate reading skills. The study results showed that good readers' attention had significant effects on reading speed,…

Health and economic impact of human papillomavirus 16 and 18 vaccination of preadolescent girls and cervical cancer screening of adult women in Peru.

PubMed

Goldie, Sue J; Levin, Carol; Mosqueira-Lovón, N Rocio; Ortendahl, Jesse; Kim, Jane; O'Shea, Meredith; Diaz Sanchez, Mireia; Mendoza Araujo, Maria Ana

2012-12-01

To estimate the benefits, cost-effectiveness (i.e., value for money), and required financial costs (e.g., affordability) of adding human papillomavirus (HPV) vaccination to Peru's cervical cancer screening program. Evidence (e.g., coverage, delivery costs) from an HPV vaccination demonstration project conducted in Peru was combined with epidemiological data in an empirically calibrated mathematical model to assess screening (HPV DNA testing three to five times per lifetime) and HPV vaccination under different cost, coverage, and efficacy assumptions. Model outcomes included lifetime risk of cancer reduction, cancer cases averted, lives saved, average life expectancy gains, short-term financial costs, and discounted long-term economic costs. Status quo low levels of screening (e.g., cytologic screening at 10.0% coverage) reduced lifetime risk of cervical cancer by 11.9%, compared to not screening. Adding vaccination of preadolescent girls at a coverage achieved in the demonstration program (82.0%) produced an additional 46.1% reduction, and would cost less than US$ 500 per year of life saved (YLS) at ~US$ 7/dose or ~US$ 1 300 at ~US$ 20/dose. One year of vaccination was estimated to cost ~US$ 5 million at ~US$ 5/dose or ~US$ 16 million at ~US$ 20/dose, including programmatic costs. Enhanced screening in adult women combined with preadolescent vaccination had incremental cost-effectiveness ratios lower than Peru's 2005 per capita gross domestic product (GDP; US$ 2 852, in 2009 US$), and would be considered cost-effective. Preadolescent HPV vaccination, followed by enhanced HPV DNA screening in adult women, could prevent two out of three cervical cancer deaths. Several strategies would be considered "good value" for resources invested, provided vaccine prices are low. While financial costs imply substantial immediate investments, the high-value payoff should motivate creative mechanisms for financing and scale-up of delivery programs.

SUDOQU: a new dose model to derive criteria for surface contamination of non-food (consumer) goods, containers and conveyances.

PubMed

van Dillen, Teun

2015-04-01

The Fukushima nuclear accident (Japan, 11 March 2011) revealed the need for well-founded criteria for surface contamination and associated screening levels related to the import of non-food (consumer) goods, containers and conveyances. The only available European-harmonised criteria are those laid down in the IAEA transport regulations, but these criteria date back from the early 1960s and only apply to the safe transport of radioactive materials. The main problem is that a generic dose-assessment model for consumer products is missing. Therefore, RIVM (National Institute for Public Health and the Environment) developed a new methodology entitled SUDOQU (SUrface DOse QUantification) to calculate the annual effective dose for both consumers and non-radiological workers, addressing issues of removability of surface contamination. The methodology can be used to derive criteria and screening levels for surface contamination and could serve as a useful tool for policy-makers and radiation-protection specialists. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Tackling Heterogeneity: A Leaf Disc-Based Assay for the High-Throughput Screening of Transient Gene Expression in Tobacco

PubMed Central

Piotrzkowski, Natalia; Schillberg, Stefan; Rasche, Stefan

2012-01-01

Transient Agrobacterium-mediated gene expression assays for Nicotiana tabacum (N. tabacum) are frequently used because they facilitate the comparison of multiple expression constructs regarding their capacity for maximum recombinant protein production. However, for three model proteins, we found that recombinant protein accumulation (rpa) was significantly influenced by leaf age and leaf position effects. The ratio between the highest and lowest amount of protein accumulation (max/min ratio) was found to be as high as 11. Therefore, construct-based impacts on the rpa level that are less than 11-fold will be masked by background noise. To address this problem, we developed a leaf disc-based screening assay and infiltration device that allows the rpa level in a whole tobacco plant to be reliably and reproducibly determined. The prototype of the leaf disc infiltration device allows 14 Agrobacterium-mediated infiltration events to be conducted in parallel. As shown for three model proteins, the average max/min rpa ratio was reduced to 1.4 using this method, which allows for a sensitive comparison of different genetic elements affecting recombinant protein expression. PMID:23029251

Public stated preferences and predicted uptake for genome-based colorectal cancer screening

PubMed Central

2014-01-01

Background Emerging developments in nanomedicine allow the development of genome-based technologies for non-invasive and individualised screening for diseases such as colorectal cancer. The main objective of this study was to measure user preferences for colorectal cancer screening using a nanopill. Methods A discrete choice experiment was used to estimate the preferences for five competing diagnostic techniques including the nanopill and iFOBT. Alternative screening scenarios were described using five attributes namely: preparation involved, sensitivity, specificity, complication rate and testing frequency. Fourteen random and two fixed choice tasks, each consisting of three alternatives, were offered to 2225 individuals. Data were analysed using the McFadden conditional logit model. Results Thirteen hundred and fifty-six respondents completed the questionnaire. The most important attributes (and preferred levels) were the screening technique (nanopill), sensitivity (100%) and preparation (no preparation). Stated screening uptake for the nanopill was 79%, compared to 76% for iFOBT. In the case of screening with the nanopill, the percentage of people preferring not to be screened would be reduced from 19.2% (iFOBT) to 16.7%. Conclusions Although the expected benefits of nanotechnology based colorectal cancer screening are improved screening uptake, assuming more accurate test results and less preparation involved, the relative preference of the nanopill is only slightly higher than the iFOBT. Estimating user preferences during the development of diagnostic technologies could be used to identify relative performance, including perceived benefits and harms compared to competitors allowing for significant changes to be made throughout the process of development. PMID:24642027

Adequacy of published screening criteria for retinopathy of prematurity.

PubMed

Taranath, Deepa A; Oh, Dickson D-S; Keane, Miriam C; Fabel, Helen; Marshall, Peter

2016-03-01

Criteria for screening preterm infants for retinopathy of prematurity vary around the world. We aimed to analyse the efficacy of alternative screening criteria. We collected retrospective data at a tertiary level neonatal nursery. Our participants were 1007 babies, born between 1997 and 2011, at <32 weeks gestational age or <1500 g birth weight (as recommended by the National Health and Medical Research Council in 1996), who had completed follow-up to full retinal vascularization, with defined presence or absence of retinopathy of prematurity. We determined whether disease would be detected using an alternative Australian screening model (gestational age <30 weeks or birth weight <1250 g) or screening criteria utilized in developed countries with similar standards of neonatal care. Detection of retinopathy of prematurity is our main outcome. Using several of the alternative criteria, two neonates with clinically significant retinopathy of prematurity, one of whom required laser treatment to preserve sight, would not have been screened, and their disease may have gone undetected. Use of <30 weeks gestational age or <1500 g birth weight as the criteria would still have screened these infants but would have reduced the number of infants screened by 24.9%. Some commonly utilized international screening criteria for retinopathy of prematurity may risk clinically significant cases being missed and others may screen babies unnecessarily. Alternative criteria should be considered and '<30 weeks gestational age and/or <1500 g birth weight' appears a viable option. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

To expand coverage, or increase frequency: Quantifying the tradeoffs between equity and efficiency facing cervical cancer screening programs in low‐resource settings

PubMed Central

Tsu, Vivien; Jeronimo, Jose; Mvundura, Mercy; Lee, Kyueun; Kim, Jane J.

2017-01-01

Cervical cancer is a leading cause of cancer death worldwide, with 85% of the disease burden residing in less developed regions. To inform evidence‐based decision‐making as cervical cancer screening programs are planned, implemented, and scaled in low‐ and middle‐income countries, we used cost and test performance data from the START‐UP demonstration project in Uganda and a microsimulation model of HPV infection and cervical carcinogenesis to quantify the health benefits, distributional equity, cost‐effectiveness, and financial impact of either (1) improving access to cervical cancer screening or (2) increasing the number of lifetime screening opportunities for women who already have access. We found that when baseline screening coverage was low (i.e., 30%), expanding coverage of screening once in a lifetime to 50% can yield comparable reductions in cancer risk to screening two or three times in a lifetime at 30% coverage, lead to greater reductions in health disparities, and cost 150 international dollars (I$) per year of life saved (YLS). At higher baseline screening coverage levels (i.e., 70%), screening three times in a lifetime yielded greater health benefits than expanding screening once in a lifetime to 90% coverage, and would have a cost‐effectiveness ratio (I$590 per YLS) below Uganda's per capita GDP. Given very low baseline coverage at present, we conclude that a policy focus on increasing access for previously unscreened women appears to be more compatible with improving both equity and efficiency than a focus on increasing frequency for a small subset of women. PMID:27925175

Monitoring well utility in a heterogeneous DNAPL source zone area: Insights from proximal multilevel sampler wells and sampling capture-zone modelling

NASA Astrophysics Data System (ADS)

McMillan, Lindsay A.; Rivett, Michael O.; Wealthall, Gary P.; Zeeb, Peter; Dumble, Peter

2018-03-01

Groundwater-quality assessment at contaminated sites often involves the use of short-screen (1.5 to 3 m) monitoring wells. However, even over these intervals considerable variation may occur in contaminant concentrations in groundwater adjacent to the well screen. This is especially true in heterogeneous dense non-aqueous phase liquid (DNAPL) source zones, where cm-scale contamination variability may call into question the effectiveness of monitoring wells to deliver representative data. The utility of monitoring wells in such settings is evaluated by reference to high-resolution multilevel sampler (MLS) wells located proximally to short-screen wells, together with sampling capture-zone modelling to explore controls upon well sample provenance and sensitivity to monitoring protocols. Field data are analysed from the highly instrumented SABRE research site that contained an old trichloroethene source zone within a shallow alluvial aquifer at a UK industrial facility. With increased purging, monitoring-well samples tend to a flow-weighted average concentration but may exhibit sensitivity to the implemented protocol and degree of purging. Formation heterogeneity adjacent to the well-screen particularly, alongside pump-intake position and water level, influence this sensitivity. Purging of low volumes is vulnerable to poor reproducibility arising from concentration variability predicted over the initial 1 to 2 screen volumes purged. Marked heterogeneity may also result in limited long-term sample concentration stabilization. Development of bespoke monitoring protocols, that consider screen volumes purged, alongside water-quality indicator parameter stabilization, is recommended to validate and reduce uncertainty when interpreting monitoring-well data within source zone areas. Generalised recommendations on monitoring well based protocols are also developed. A key monitoring well utility is their proportionately greater sample draw from permeable horizons constituting a significant contaminant flux pathway and hence representative fraction of source mass flux. Acquisition of complementary, high-resolution, site monitoring data, however, vitally underpins optimal interpretation of monitoring-well datasets and appropriate advancement of a site conceptual model and remedial implementation.

Reducing Periconceptional Methylmercury Exposure: Cost–Utility Analysis for a Proposed Screening Program for Women Planning a Pregnancy in Ontario, Canada

PubMed Central

Rennie, Colin; Coyle, Doug

2015-01-01

Background The assessment of neurodevelopmental effects in children associated with prenatal methylmercury exposure, from contaminated fish and seafood in the maternal diet, has recently been strengthened by adjustment for the negative confounding resulting from co-exposure to beneficial polyunsaturated fatty acids (PUFAs). Objectives We aimed to determine the cost-effectiveness of a periconceptional screening program of blood mercury concentration for women planning to become pregnant in Ontario, Canada. Fish intake recommendations would be provided for those found to have blood mercury levels above the intervention threshold. Methods Analysis was conducted using a combined decision tree/Markov model to compare the proposed screening intervention with standard care from a societal perspective over a lifetime horizon. We used the national blood mercury distributions of women 20–49 years of age reported in the Canadian Health Measures Survey from 2009 through 2011 to determine the cognitive deficits associated with prenatal methylmercury exposure for successful planned pregnancies. Outcomes modeled included the loss in quality of life and the remedial education costs. Value of information analysis was conducted to assess the underlying uncertainty around the model results and to identify which parameters contribute most to this uncertainty. Results The incremental cost per quality-adjusted life year (QALY) gained for the proposed screening intervention was estimated to be Can$18,051, and the expected value for a willingness to pay of Can$50,000/QALY to be Can$0.61. Conclusions Our findings suggest that the proposed periconceptional blood mercury screening program for women planning a pregnancy would be highly cost-effective from a societal perspective. The results of a value of information analysis confirm the robustness of the study’s conclusions. Citation Gaskin J, Rennie C, Coyle D. 2015. Reducing periconceptional methylmercury exposure: cost–utility analysis for a proposed screening program for women planning a pregnancy in Ontario, Canada. Environ Health Perspect 123:1337–1344; http://dx.doi.org/10.1289/ehp.1409034 PMID:26024213

Phenotypic and genomic comparison of Mycobacterium aurum and surrogate model species to Mycobacterium tuberculosis: implications for drug discovery.

PubMed

Namouchi, Amine; Cimino, Mena; Favre-Rochex, Sandrine; Charles, Patricia; Gicquel, Brigitte

2017-07-13

Tuberculosis (TB) is caused by Mycobacterium tuberculosis and represents one of the major challenges facing drug discovery initiatives worldwide. The considerable rise in bacterial drug resistance in recent years has led to the need of new drugs and drug regimens. Model systems are regularly used to speed-up the drug discovery process and circumvent biosafety issues associated with manipulating M. tuberculosis. These include the use of strains such as Mycobacterium smegmatis and Mycobacterium marinum that can be handled in biosafety level 2 facilities, making high-throughput screening feasible. However, each of these model species have their own limitations. We report and describe the first complete genome sequence of Mycobacterium aurum ATCC23366, an environmental mycobacterium that can also grow in the gut of humans and animals as part of the microbiota. This species shows a comparable resistance profile to that of M. tuberculosis for several anti-TB drugs. The aims of this study were to (i) determine the drug resistance profile of a recently proposed model species, Mycobacterium aurum, strain ATCC23366, for anti-TB drug discovery as well as Mycobacterium smegmatis and Mycobacterium marinum (ii) sequence and annotate the complete genome sequence of this species obtained using Pacific Bioscience technology (iii) perform comparative genomics analyses of the various surrogate strains with M. tuberculosis (iv) discuss how the choice of the surrogate model used for drug screening can affect the drug discovery process. We describe the complete genome sequence of M. aurum, a surrogate model for anti-tuberculosis drug discovery. Most of the genes already reported to be associated with drug resistance are shared between all the surrogate strains and M. tuberculosis. We consider that M. aurum might be used in high-throughput screening for tuberculosis drug discovery. We also highly recommend the use of different model species during the drug discovery screening process.

The value of models in informing resource allocation in colorectal cancer screening – 1 the case of the Netherlands

PubMed Central

van Hees, Frank; Zauber, Ann G.; van Veldhuizen, Harriët; Heijnen, Marie-Louise A.; Penning, Corine; de Koning, Harry J.; van Ballegooijen, Marjolein; Lansdorp-Vogelaar, Iris

2015-01-01

In May 2011, the Dutch government decided to implement a national programme for colorectal cancer (CRC) screening using biennial faecal immunochemical test (FIT) screening between ages 55 and 75.[1] Decision modelling played an important role in informing this decision, as well as in the planning and implementation of the programme afterwards. In this overview, we illustrate the value of models in informing resource allocation in CRC screening, using the role that decision modelling has played in the Dutch CRC screening programme as an example. PMID:26063755

Transcutaneous bilirubin levels in newborns <35 weeks' gestation.

PubMed

Maisels, M J; Coffey, M P; Kring, E

2015-09-01

In infants <35 weeks' gestation, we sought to define the transcutaneous bilirubin (TcB) levels at which a total serum bilirubin (TSB) level suggesting the need for phototherapy is unlikely to occur and a TSB measurement can, therefore, be avoided. Nursing staff performed 896 TcB measurements within 1 h of a TSB on 225 neonates 26 0/7-34 6/7 weeks' postmenstrual age (PMA). Generalized linear models were fit with generalized estimating equations (GEEs) to model the probability of having a TSB level at or above the phototherapy initiation cutpoint as a function of the TcB; these methods allow for multiple tests per infant. The mean difference between TcB and TSB measurements was <1 mg dl(-1) for each PMA category. When the TcB was at least 3 mg dl(-1) below the TSB cutpoint for phototherapy, there was a ⩾98% probability that the TSB was not at, or above, the recommended phototherapy level. The single exception to this was a phototherapy level of 6 mg dl(-1) for infants of 28 0/7-29 6/7 weeks' PMA, where a TcB of 4 mg dl(-1) below the phototherapy level (ie a TcB ⩽2 mg dl(-1)) was necessary to achieve ⩾98% probability. Our data support the use of routine TcB screening for infants 28-34 6/7 weeks' gestation. TcB screening in the neonatal intensive care unit can identify infants who require a TSB to confirm or exclude the need for phototherapy.

Optimal Screening of Children with Acute Malnutrition Requires a Change in Current WHO Guidelines as MUAC and WHZ Identify Different Patient Groups

PubMed Central

Laillou, Arnaud; Prak, Sophonneary; de Groot, Richard; Whitney, Sophie; Conkle, Joel; Horton, Lindsey; Un, Sam Oeurn; Dijkhuizen, Marjoleine A.; Wieringa, Frank T.

2014-01-01

Background Timely treatment of acute malnutrition in children <5 years of age could prevent >500,000 deaths annually. Screening at community level is essential to identify children with malnutrition. Current WHO guidelines for community screening for malnutrition recommend a Mid Upper Arm Circumference (MUAC) of <115 mm to identify severe acute malnutrition (SAM). However, it is currently unclear how MUAC relates to the other indicator used to define acute malnutrition: weight-for-height Z-score (WHZ). Methods Secondary data from >11,000 Cambodian children, obtained by different surveys between 2010 and 2012, was used to calculate sensitivity and ROC curves for MUAC and WHZ. Findings The secondary analysis showed that using the current WHO cut-off of 115 mm for screening for severe acute malnutrition over 90% of children with a weight-for-height z-score (WHZ) <−3 would have been missed. Reversely, WHZ<−3 missed 80% of the children with a MUAC<115 mm. Conclusions The current WHO cut-off for screening for SAM should be changed upwards from the current 115 mm. In the Cambodian data-set, a cut-off of 133 mm would allow inclusion of >65% of children with a WHZ<−3. Importantly, MUAC and WHZ identified different sub-groups of children with acute malnutrition, therefore these 2 indicators should be regarded as independent from each other. We suggest a 2-step model with MUAC used a screening at community level, followed by MUAC and WHZ measured at a primary health care unit, with both indicators used independently to diagnose severe acute malnutrition. Current guidelines should be changed to reflect this, with treatment initiated when either MUAC <115 mm or WHZ<−3. PMID:24983995

What helps children to be more active and less sedentary? Perceptions of mothers living in disadvantaged neighbourhoods.

PubMed

Veitch, J; Hume, C; Salmon, J; Crawford, D; Ball, K

2013-01-01

  Increasing children's participation in physical activity and decreasing time spent in sedentary behaviours is of great importance to public health. Despite living in disadvantaged neighbourhoods, some children manage to engage in health-promoting physical activity and avoid high levels of screen-based activities (i.e. watching TV, computer use and playing electronic games). Understanding how these children manage to do well and whether there are unique features of their home or neighbourhood that explain their success is important for informing strategies targeting less active and more sedentary children. The aim of this qualitative study was to gain in-depth insights from mothers regarding their child's resilience to low physical activity and high screen-time.   Semi-structured face-to-face interviews were conducted with 38 mothers of children who lived in disadvantaged neighbourhoods in urban and rural areas of Victoria, Australia. The interviews were designed to gain in-depth insights about perceived individual, social and physical environmental factors influencing resilience to low physical activity and high screen-time.   Themes relating to physical activity that emerged from the interviews included: parental encouragement, support and modelling; sports culture in a rural town; the physical home and neighbourhood environment; child's individual personality; and dog ownership. Themes relating to screen-time behaviours encompassed: parental control; and child's individual preferences.   The results offer important insights into potential avenues for developing 'resilience' and increasing physical activity and reducing screen-time among children living in disadvantaged neighbourhoods. In light of the negative effects of low physical activity and high levels of screen-time on children's health, this evidence is urgently needed. © 2011 Blackwell Publishing Ltd.

Optimal screening of children with acute malnutrition requires a change in current WHO guidelines as MUAC and WHZ identify different patient groups.

PubMed

Laillou, Arnaud; Prak, Sophonneary; de Groot, Richard; Whitney, Sophie; Conkle, Joel; Horton, Lindsey; Un, Sam Oeurn; Dijkhuizen, Marjoleine A; Wieringa, Frank T

2014-01-01

Timely treatment of acute malnutrition in children <5 years of age could prevent >500,000 deaths annually. Screening at community level is essential to identify children with malnutrition. Current WHO guidelines for community screening for malnutrition recommend a Mid Upper Arm Circumference (MUAC) of <115 mm to identify severe acute malnutrition (SAM). However, it is currently unclear how MUAC relates to the other indicator used to define acute malnutrition: weight-for-height Z-score (WHZ). Secondary data from >11,000 Cambodian children, obtained by different surveys between 2010 and 2012, was used to calculate sensitivity and ROC curves for MUAC and WHZ. The secondary analysis showed that using the current WHO cut-off of 115 mm for screening for severe acute malnutrition over 90% of children with a weight-for-height z-score (WHZ) <-3 would have been missed. Reversely, WHZ<-3 missed 80% of the children with a MUAC<115 mm. The current WHO cut-off for screening for SAM should be changed upwards from the current 115 mm. In the Cambodian data-set, a cut-off of 133 mm would allow inclusion of >65% of children with a WHZ<-3. Importantly, MUAC and WHZ identified different sub-groups of children with acute malnutrition, therefore these 2 indicators should be regarded as independent from each other. We suggest a 2-step model with MUAC used a screening at community level, followed by MUAC and WHZ measured at a primary health care unit, with both indicators used independently to diagnose severe acute malnutrition. Current guidelines should be changed to reflect this, with treatment initiated when either MUAC <115 mm or WHZ<-3.

Pressure dependence of effective Coulomb interaction parameters in BaFe2As2 by first-principle calculation

NASA Astrophysics Data System (ADS)

Aghajani, M.; Hadipour, H.; Akhavan, M.

2018-05-01

Pressure dependence of the onsite Coulomb interactions of the BaFe2As2 has been studied by employing the constrained random phase approximation within first-principle calculations. Analyzing total and projected density of states, a pseudogap is found for dxy band at the energy roughly 0.25 eV higher than the Fermi level. Also, by applying pressure the spectral weight of the dxy orbital vanishes while other orbitals remain metallic. The different screening channels, as discussed in four different models, affect significantly on the Hubbard U while the Hund J remains almost unchanged. The average onsite bare and partially and fully screened Coulomb interactions increase with different rates upon compression. These different rates can be explained by competition between the electronic screening and reduction of bond lengths.

Colorectal Cancer Deaths Attributable to Nonuse of Screening in the United States

PubMed Central

Meester, Reinier G.S.; Doubeni, Chyke A.; Lansdorp-Vogelaar, Iris; Goede, S.L.; Levin, Theodore R.; Quinn, Virginia P.; van Ballegooijen, Marjolein; Corley, Douglas A.; Zauber, Ann G.

2015-01-01

Purpose Screening is a major contributor to colorectal cancer (CRC) mortality reductions in the U.S., but is underutilized. We estimated the fraction of CRC deaths attributable to nonuse of screening to demonstrate the potential benefits from targeted interventions. Methods The established MISCAN-colon microsimulation model was used to estimate the population attributable fraction (PAF) in people aged ≥50 years. The model incorporates long-term patterns and effects of screening by age and type of screening test. PAF for 2010 was estimated using currently available data on screening uptake; PAF was also projected assuming constant future screening rates to incorporate lagged effects from past increases in screening uptake. We also computed PAF using Levin's formula to gauge how this simpler approach differs from the model-based approach. Results There were an estimated 51,500 CRC deaths in 2010, about 63% (N∼32,200) of which were attributable to non-screening. The PAF decreases slightly to 58% in 2020. Levin's approach yielded a considerably more conservative PAF of 46% (N∼23,600) for 2010. Conclusions The majority of current U.S. CRC deaths are attributable to non-screening. This underscores the potential benefits of increasing screening uptake in the population. Traditional methods of estimating PAF underestimated screening effects compared with model-based approaches. PMID:25721748

The relationship between religiosity and cancer screening among Vietnamese women in the United States: the moderating role of acculturation.

PubMed

Nguyen, Anh B; Hood, Kristina B; Belgrave, Faye Z

2012-01-01

In this study the authors explore the relationship between intrinsic, personal extrinsic, and social extrinsic religiosity to breast and cervical cancer screening efficacy and behavior among Vietnamese women recruited from a Catholic Vietnamese church and a Buddhist temple in the Richmond, Virginia metropolitan area. The potential moderating effect of acculturation was of interest. Participants were 111 Vietnamese women who participated in a larger cancer screening intervention. Data collection began early fall of 2010 and ended in late spring 2011. High levels of acculturation were associated with increased self-efficacy for Pap tests and having received a Pap test. Acculturation moderated the relationships between religiosity and self-efficacy for breast and cervical cancer screening. Higher levels of social extrinsic religiosity were associated with increased efficacy for cancer screening among less acculturated women. Acculturation also moderated the relationship between religiosity and breast cancer screening. Specifically, for less acculturated women, increasing levels of intrinsic religiosity and personal extrinsic religiosity were associated with lower likelihood probability of Pap testing. For highly acculturated women, increasing levels of intrinsic religiosity and personal extrinsic religiosity were associated with higher likelihood probability of Pap testing. The authors' findings demonstrate the need for further investigation of the dynamic interplay of multi-level factors that influence cancer screening.

Prostate cancer screening

MedlinePlus

Prostate cancer screening - PSA; Prostate cancer screening - digital rectal exam; Prostate cancer screening - DRE ... level of PSA could mean you have prostate cancer. But other conditions can also cause a high ...

[Evaluating the effectiveness of child lead poisoning prevention programs].

PubMed

Ginot, L; Fontaine, A; Cheymol, J; Peyr, C

2003-09-01

A multi annual screening and prevention program against lead poisoning was implemented in a suburb of the Paris area. We attempted to assess the effectiveness of this program based on data available from children screening and follow-up. Indicators of effectiveness included the evolution of blood lead levels at screening and the frequency of secondary increases in blood lead levels. Buildings inclusion dates were used to control for the increasing selection of less exposed children. A total of 3,660 children were screened between 1992 and 2000. We observed a regular decrease in blood lead levels at screening, in the highest blood lead levels obtained for each child and in the proportion of children whose blood lead levels increased after screening: the proportion of children with initial blood lead levels >=15 micro g/dl fell from 17.4% in the 1992-1996 period to 4.1% in the 1997-2000 period. A multivariate analysis taking into account the first year that children were screened in a given building showed that less exposed children were included over time, but found also an additional independent decrease in blood lead levels that can be related to the effectiveness of prevention efforts. A "building by building" analysis of 30 buildings where more than 20 children were located over the whole study period confirmed that the incidence of lead poisoning decreased within most of these buildings. Taking into account buildings'inclusion dates makes it possible to distinguish program effectiveness from the consequences of including less exposed children The effectiveness of preventive actions is associated with several interacting factors, including the participation of families and the active involvement of local technical staff and policy makers. The finding that the decrease in blood lead levels leveled off after 1997 calls for further actions.

High-throughput screening and small animal models, where are we?

PubMed Central

Giacomotto, Jean; Ségalat, Laurent

2010-01-01

Current high-throughput screening methods for drug discovery rely on the existence of targets. Moreover, most of the hits generated during screenings turn out to be invalid after further testing in animal models. To by-pass these limitations, efforts are now being made to screen chemical libraries on whole animals. One of the most commonly used animal model in biology is the murine model Mus musculus. However, its cost limit its use in large-scale therapeutic screening. In contrast, the nematode Caenorhabditis elegans, the fruit fly Drosophila melanogaster, and the fish Danio rerio are gaining momentum as screening tools. These organisms combine genetic amenability, low cost and culture conditions that are compatible with large-scale screens. Their main advantage is to allow high-throughput screening in a whole-animal context. Moreover, their use is not dependent on the prior identification of a target and permits the selection of compounds with an improved safety profile. This review surveys the versatility of these animal models for drug discovery and discuss the options available at this day. PMID:20423335

Macro-level vulnerable road users crash analysis: A Bayesian joint modeling approach of frequency and proportion.

PubMed

Cai, Qing; Abdel-Aty, Mohamed; Lee, Jaeyoung

2017-10-01

This study aims at contributing to the literature on pedestrian and bicyclist safety by building on the conventional count regression models to explore exogenous factors affecting pedestrian and bicyclist crashes at the macroscopic level. In the traditional count models, effects of exogenous factors on non-motorist crashes were investigated directly. However, the vulnerable road users' crashes are collisions between vehicles and non-motorists. Thus, the exogenous factors can affect the non-motorist crashes through the non-motorists and vehicle drivers. To accommodate for the potentially different impact of exogenous factors we convert the non-motorist crash counts as the product of total crash counts and proportion of non-motorist crashes and formulate a joint model of the negative binomial (NB) model and the logit model to deal with the two parts, respectively. The formulated joint model is estimated using non-motorist crash data based on the Traffic Analysis Districts (TADs) in Florida. Meanwhile, the traditional NB model is also estimated and compared with the joint model. The result indicates that the joint model provides better data fit and can identify more significant variables. Subsequently, a novel joint screening method is suggested based on the proposed model to identify hot zones for non-motorist crashes. The hot zones of non-motorist crashes are identified and divided into three types: hot zones with more dangerous driving environment only, hot zones with more hazardous walking and cycling conditions only, and hot zones with both. It is expected that the joint model and screening method can help decision makers, transportation officials, and community planners to make more efficient treatments to proactively improve pedestrian and bicyclist safety. Published by Elsevier Ltd.

Enhancing HIV Testing and Treatment among Men Who Have Sex with Men in China: A Pilot Model with Two-Rapid Tests, Single Blood Draw Session, and Intensified Case Management in Six Cities in 2013.

PubMed

Zhang, Dapeng; Lu, Hongyan; Zhuang, Minghua; Wu, Guohui; Yan, Hongjing; Xu, Jun; Wei, Xiaoli; Li, Chengmei; Meng, Sining; Fu, Xiaojing; Qi, Jinlei; Wang, Peng; Luo, Mei; Dai, Min; Yip, Ray; Sun, Jiangping; Wu, Zunyou

2016-01-01

To explore models to improve HIV testing, linkage to care and treatment among men who have sex with men (MSM) in cooperation with community-based organizations (CBOs) in China. We introduced a new model for HIV testing services targeting MSM in six cities in 2013.These models introduced provision of rapid HIV testing by CBO staff and streamlined processes for HIV screening, confirmation of initial reactive screening results, and linkage to care among diagnosed people. We monitored attrition along each step of the continuum of care from screening to treatment and compared program performance between 2012 and 2013. According to the providers of two rapid tests (HIV screening), four different services delivery models were examined in 2013: Model A = first screen at CDC, second at CDC (Model A = CDC+CDC), Model B = first and second screens at CBOs (Model B = CBO+CBO), Model C = first screen at CBO, second at Hospital (Model C = CBO+Hosp), and Model D = first screen at CBO, second at CDC (Model D = CBO+CDC). Logistic regressions were performed to assess advantages of different screening models of case finding and case management. Compared to 2012, the number of HIV screening tests performed for MSM increased 35.8% in 2013 (72,577 in 2013 vs. 53,455 in 2012). We observed a 5.6% increase in proportion of cases screened reactive receiving HIV confirmatory tests (93.9% in 2013 vs. 89.2% in 2012, χ2 = 48.52, p<0.001) and 65% reduction in loss to CD4 cell count tests (15% in 2013 vs. 43% in 2012, χ2 = 628.85, p<0.001). Regarding linkage to care and treatment, the 2013 pilot showed that the Model D had the highest rate of loss between screening reactive and confirmatory test among the four models, with 18.1% fewer receiving a second screening test and a further 5.9% loss among those receiving HIV confirmatory tests. The Model B and the Model C showed lower losses (0.8% and 1.3%) for newly diagnosed HIV positives receiving CD4 cell count tests, and higher rates of HIV positives referred to designated ART hospitals (88.0% and 93.3%) than the Model A and Model D (4.6% and 5.7% for CD4 cell count test, and 68.9% and 64.4% for referring to designated ART hospitals). The proportion of cases where the screening test was reactive that were commenced on ART was highest in Model C; 52.8% of cases commenced on ART compared to 38.9%, 34.2% and 21.1% in Models A, B and D respectively. Using Model A as a reference group, the multivariate logistic regression results also showed the advantages of Models B, C and D, which increased CD4 cell count test, referral to designated ART hospitals and initiation of ART, when controlling for program city and other factors. This study has demonstrated that involvement of CBOs in HIV rapid testing provision, streamlining testing and care procedures and early hospital case management can improve testing, linkage to, and retention in care and treatment among MSM in China.

Classifying the Indication for Colonoscopy Procedures: A Comparison of NLP Approaches in a Diverse National Healthcare System.

PubMed

Patterson, Olga V; Forbush, Tyler B; Saini, Sameer D; Moser, Stephanie E; DuVall, Scott L

2015-01-01

In order to measure the level of utilization of colonoscopy procedures, identifying the primary indication for the procedure is required. Colonoscopies may be utilized not only for screening, but also for diagnostic or therapeutic purposes. To determine whether a colonoscopy was performed for screening, we created a natural language processing system to identify colonoscopy reports in the electronic medical record system and extract indications for the procedure. A rule-based model and three machine-learning models were created using 2,000 manually annotated clinical notes of patients cared for in the Department of Veterans Affairs. Performance of the models was measured and compared. Analysis of the models on a test set of 1,000 documents indicates that the rule-based system performance stays fairly constant as evaluated on training and testing sets. However, the machine learning model without feature selection showed significant decrease in performance. Therefore, rule-based classification system appears to be more robust than a machine-learning system in cases when no feature selection is performed.

10-year cumulative and bidirectional associations of domain-specific physical activity and sedentary behaviour with health-related quality of life in French adults: Results from the SU.VI.MAX studies.

PubMed

Omorou, Abdou Y; Vuillemin, Anne; Menai, Medhi; Latarche, Clotilde; Kesse-Guyot, Emmanuelle; Galan, Pilar; Hercberg, Serge; Oppert, Jean-Michel; Briançon, Serge

2016-07-01

The directionality of the associations of domain-specific physical activity (PA) and sedentary behaviour (SB) with health-related quality of life (HRQoL) in adults remain insufficiently known. This study investigated the longitudinal associations of 10-year cumulative levels of PA and SB with HRQoL and the reverse associations. A sample of 2093 (47.8% men) participants from a cohort of French adult (SU.VI.MAX) was included. Data were collected at 3 time points (1998, 2001 and 2007) using the Modifiable Activity Questionnaire (MAQ) for PA (leisure-time and occupational) and SB (screen-viewing, reading and total sitting time) and the DUKE Health Profile for HRQoL. The cumulative level (from 0 to 3) referred to the number of time points where a high PA level, high SB or good HRQoL was reported. Regression models examined the 10-year cumulative level of PA, SB as predictors of HRQoL and reverse associations. The 10-year cumulative level of high PA, both leisure-time and occupational, predicted a higher HRQoL while the 10-year cumulative level of high screen-viewing time and high total sitting time was associated with lower HRQoL. For the reverse association, cumulative level of good HRQoL predicted more leisure-time PA, less screen-viewing time and less total sitting time but was not related to occupational PA. Relationships between PA, SB and HRQoL are complex and should not be oversimplified in one or the other direction. Taking into account domain-specific PA and SB in health promotion programs appears of prime importance to design interventions aiming at improving HRQoL. Copyright © 2016 Elsevier Inc. All rights reserved.

Is prostate cancer screening cost-effective? A microsimulation model of prostate-specific antigen-based screening for British Columbia, Canada

PubMed Central

Pataky, Reka; Gulati, Roman; Etzioni, Ruth; Black, Peter; Chi, Kim N.; Coldman, Andrew J.; Pickles, Tom; Tyldesley, Scott; Peacock, Stuart

2015-01-01

Prostate-specific antigen (PSA) screening for prostate cancer may reduce mortality, but it incurs considerable risk of overdiagnosis and potential harm to quality of life. Our objective was to evaluate the cost-effectiveness of PSA screening, with and without adjustment for quality of life, for the British Columbia (BC) population. We adapted an existing natural history model using BC incidence, treatment, cost and mortality patterns. The modeled mortality benefit of screening derives from a stage-shift mechanism, assuming mortality reduction consistent with the European Study of Randomized Screening for Prostate Cancer. The model projected outcomes for 40 year-old men under 14 combinations of screening ages and frequencies. Cost and utility estimates were explored with deterministic sensitivity analysis. The incremental cost-effectiveness of regular screening ranged from $36,300/LYG, for screening every four years from ages 55-69, to $588,300/LYG, for screening every two years from ages 40-74. The marginal benefits of increasing screening frequency to two years or starting screening at age 40 were small and came at significant cost. After utility adjustment, all screening strategies resulted in a loss of QALYs; however, this result was very sensitive to utility estimates. Plausible outcomes under a range of screening strategies inform discussion of prostate cancer screening policy in BC and similar jurisdictions. Screening may be cost-effective but the sensitivity of results to utility values suggests individual preferences for quality versus quantity of life should be a key consideration. PMID:24443367

Predicting the stage shift as a result of breast cancer screening in low- and middle-income countries: a proof of concept.

PubMed

Zelle, Sten G; Baltussen, Rob; Otten, Johannes D M; Heijnsdijk, Eveline A M; van Schoor, Guido; Broeders, Mireille J M

2015-03-01

To provide proof of concept for a simple model to estimate the stage shift as a result of breast cancer screening in low- and middle-income countries (LMICs). Stage shift is an essential early detection indicator and an important proxy for the performance and possible further impact of screening programmes. Our model could help LIMCs to choose appropriate control strategies. We assessed our model concept in three steps. First, we calculated the proportional performance rates (i.e. index number Z) based on 16 screening rounds of the Nijmegen Screening Program (384,884 screened women). Second, we used linear regression to assess the association between Z and the amount of stage shift observed in the programme. Third, we hypothesized how Z could be used to estimate the stage shift as a result of breast cancer screening in LMICs. Stage shifts can be estimated by the proportional performance rates (Zs) using linear regression. Zs calculated for each screening round are highly associated with the observed stage shifts in the Nijmegen Screening Program (Pearson's R: 0.798, R square: 0.637). Our model can predict the stage shifts in the Nijmegen Screening Program, and could be applied to settings with different characteristics, although it should not be straightforwardly used to estimate the impact on mortality. Further research should investigate the extrapolation of our model to other settings. As stage shift is an essential screening performance indicator, our model could provide important information on the performance of breast cancer screening programmes that LMICs consider implementing. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

ESTIMATION OF ADULT PATIENT DOSES FOR CHEST X-RAY EXAMINATIONS AND COMPARISON WITH DIAGNOSTIC REFERENCE LEVELS (DRLs).

PubMed

Bas Mor, H; Altinsoy, N; Söyler, I

2018-05-08

The aim of this study was to evaluate the radiation doses to patient during chest (posterior anterior/and lateral) examinations. The study was performed in three public hospitals of İstanbul province with a total of 300 adult patients. Entrance surface dose (ESD) measurements were conducted on computed radiography, digital radiography and screen film system. ESD was estimated by using International Atomic Energy Agency (IAEA) model and Davies model which are the common indirect models. Results were compared with diagnostic reference levels from the European Commission, IAEA and National Radiological Protection Board. Although the results are compatible with the international diagnostic reference levels, they present variations between the hospitals. Dose variations for the same type of X-ray examination support the idea that further optimization is possible.

Analysis of the Determinants of Low Cervical Cancer Screening Uptake Among Nigerian Women.

PubMed

Nwobodo, Humphrey; Ba-Break, Maryam

2015-08-17

Cervical cancer causes an estimated 266,000 deaths globally, 85% of which occurs in developing countries. It is a preventable disease, if detected and treated early via screen and treat , yet its burden is still huge in Nigeria. In 2012, 21.8% cases of cervical cancer and 20.3% deaths due to cervical cancer were recorded in Nigeria. This review, therefore, aims at indentifying the determinants of low cervical cancer screening in Nigeria in order to contribute in reducing the burden of the disease. Literature were obtained from Global Health, Popline and PubMed databases; WHO and other relevant websites using Eldis search engine; and from libraries in the University of Leeds and WHO in Geneva. Conceptual framework for analyzing the determinants of cervical cancer screening uptake among Nigerian women was formed by inserting service delivery component of the WHO health system framework into a modified Health Belief Model. Wrong perception of cervical cancer and cervical cancer screening due to low level of knowledge about the disease and inadequate cervical cancer prevention were identified as the major determinants of low cervical cancer screening uptake in Nigeria. Among women, belief in being at risk and/or severity of cervical cancer was low just as belief on benefits of cervical cancer screening, unlike high belief in barriers to screening. Support from the community and screening skills among health-workers were inadequate. Improving uptake of cervical cancer screening will reduce the burden of the disease. Therefore, researchers and other stakeholders interested in prevention of cervical cancer should carryout studies to identify interventions that could address the key determinants of low cervical cancer screening among Nigerian women.

The impact of socioeconomic factors on the efficiency of voluntary toxoplasmosis screening during pregnancy: a population-based study.

PubMed

Lange, A E; Thyrian, J R; Wetzka, S; Flessa, S; Hoffmann, W; Zygmunt, M; Fusch, C; Lode, H N; Heckmann, M

2016-07-29

Congenital toxoplasmosis is associated with severe complications. German state health insurance covers rubella, but not toxoplasmosis, immunity screening. We analysed the effect of socioeconomic factors on the efficiency of private toxoplasmosis screening during pregnancy. Toxoplasmosis and rubella screening data (n = 5402 mothers) were collected within the population-based Survey of Neonates in Pomerania (SNiP). At the first-trimester screening, 34.4 % (88.1 %) of expecting mothers were immune to toxoplasmosis (rubella). Susceptibility for toxoplasmosis (rubella) was observed in 39.6 % (8.9 %) and 25.8 % (2.95 %) were not tested. Data on a 2(nd) screening were available in a subgroup of women with negative immunity showing less than 45 % participation rate. Active toxoplasmosis (no rubella) infection was observed in 0.3 % (n = 17) of pregnant women. A multiple logistic regression model (AIC = 719.67; AUC = 0.725) revealed that the likelihood of participating in a second toxoplasmosis screening increased among women with a good level of education and a steady partnership and decreased with paternal unemployment and the absence of breastfeeding. The highest probability of non-participation in toxoplasmosis screening was found among women with temporal burden and family responsibilities. A cost-benefit analysis showed that covering general screening for toxoplasmosis with health insurance saved costs. Toxoplasmosis carried a substantial risk of infection during pregnancy. Although increased socioeconomic status was positively associated with the participation in toxoplasmosis screening, this was not the case when pregnant women had strong temporal burden and family responsibilities. This data supports the need for toxoplasmosis screening among pregnant women as a general healthcare benefit covered by insurance.

Projected future impact of HPV vaccination and primary HPV screening on cervical cancer rates from 2017-2035: Example from Australia.

PubMed

Hall, Michaela T; Simms, Kate T; Lew, Jie-Bin; Smith, Megan A; Saville, Marion; Canfell, Karen

2018-01-01

Many countries are transitioning from cytology-based to longer-interval HPV screening. Trials comparing HPV-based screening to cytology report an increase in CIN2/3 detection at the first screen, and longer-term reductions in CIN3+; however, population level year-to-year transitional impacts are poorly understood. We undertook a comprehensive evaluation of switching to longer-interval primary HPV screening in the context of HPV vaccination. We used Australia as an example setting, since Australia will make this transition in December 2017. Using a model of HPV vaccination, transmission, natural history and cervical screening, Policy1-Cervix, we simulated the planned transition from recommending cytology every two years for sexually-active women aged 18-20 to 69, to recommending HPV screening every five years for women aged 25-74 years. We estimated rates of CIN2/3, cervical cancer incidence, and mortality for each year from 2005 to 2035, considering ranges for HPV test accuracy and screening compliance in the context of HPV vaccination (current coverage ~82% in females; ~76% in males). Transient increases are predicted to occur in rates of CIN2/3 detection and invasive cervical cancer in the first two to three years following the screening transition (of 16-24% and 11-14% in respectively, compared to 2017 rates). However, by 2035, CIN2/3 and invasive cervical cancer rates are predicted to fall by 40-44% and 42-51%, respectively, compared to 2017 rates. Cervical cancer mortality rates are predicted to remain unchanged until ~2020, then decline by 34-45% by 2035. Over the period 2018-2035, switching to primary HPV screening in Australia is expected to avert 2,006 cases of invasive cervical cancer and save 587 lives. Transient increases in detected CIN2/3 and invasive cancer, which may be detectable at the population level, are predicted following a change to primary HPV screening. This is due to improved test sensitivity bringing forward diagnoses, resulting in longer term reductions in both cervical cancer incidence and mortality. Fluctuations in health outcomes due to the transition to a longer screening interval are predicted to occur for 10-15 years, but cervical cancer rates will be significantly reduced thereafter due to the impact of HPV vaccination and HPV screening. In order to maintain confidence in primary HPV screening through the transitional phase, it is important to widely communicate that an initial increase in CIN2/3 and perhaps even invasive cervical cancer is expected after a national transition to primary HPV screening, that this phenomenon is due to increased prevalent disease detection, and that this effect represents a marker of screening success.

Knowledge about Cervical Cancer and Barriers of Screening Program among Women in Wufeng County, a High-Incidence Region of Cervical Cancer in China

PubMed Central

Zhou, Hang; Xiang, Qunying; Hu, Ting; Zhang, Qinghua; Chen, Zhilan; Ma, Ding; Feng, Ling

2013-01-01

Purpose Cervical cancer screening is an effective method for reducing the incidence and mortality of cervical cancer, but the screening attendance rate in developing countries is far from satisfactory, especially in rural areas. Wufeng is a region of high cervical cancer incidence in China. This study aimed to investigate the issues that concern cervical cancer and screening and the factors that affect women’s willingness to undergo cervical cancer screening in the Wufeng area. Participants and Methods A cross-sectional survey of women was conducted to determine their knowledge about cervical cancer and screening, demographic characteristics and the barriers to screening. Results Women who were willing to undergo screenings had higher knowledge levels. “Anxious feeling once the disease was diagnosed” (47.6%), “No symptoms/discomfort” (34.1%) and “Do not know the benefits of cervical cancer screening” (13.4%) were the top three reasons for refusing cervical cancer screening. Women who were younger than 45 years old or who had lower incomes, positive family histories of cancer, secondary or higher levels of education, higher levels of knowledge and fewer barriers to screening were more willing to participate in cervical cancer screenings than women without these characteristics. Conclusion Efforts are needed to increase women’s knowledge about cervical cancer, especially the screening methods, and to improve their perceptions of the screening process for early detection to reduce cervical cancer incidence and mortality rates. PMID:23843976

Modeling the cost-benefit of nerve conduction studies in pre-employment screening for carpal tunnel syndrome.

PubMed

Evanoff, Bradley; Kymes, Steve

2010-06-01

The aim of this study was to evaluate the costs associated with pre-employment nerve conduction testing as a screening tool for carpal tunnel syndrome (CTS) in the workplace. We used a Markov decision analysis model to compare the costs associated with a strategy of screening all prospective employees for CTS and not hiring those with abnormal nerve conduction, versus a strategy of not screening for CTS. The variables included in our model included employee turnover rate, the incidence of CTS, the prevalence of median nerve conduction abnormalities, the relative risk of developing CTS conferred by abnormal nerve conduction screening, the costs of pre-employment screening, and the worker's compensation costs to the employer for each case of CTS. In our base case, total employer costs for CTS from the perspective of the employer (cost of screening plus costs for workers' compensation associated with CTS) were higher when screening was used. Median costs per employee position over five years were US$503 for the screening strategy versus US$200 for a no-screening strategy. A sensitivity analysis showed that a strategy of screening was cost-beneficial from the perspective of the employer only under a few circumstances. Using Monte Carlo simulation varying all parameters, we found a 30% probability that screening would be cost-beneficial. A strategy of pre-employment screening for CTS should be carefully evaluated for yield and social consequences before being implemented. Our model suggests such screening is not appropriate for most employers.

Differences in knowledge of breast cancer screening among African American, Arab American, and Latina women.

PubMed

Williams, Karen Patricia; Mabiso, Athur; Todem, David; Hammad, Adnan; Hill-Ashford, Yolanda; Hamade, Hiam; Palamisono, Gloria; Robinson-Lockett, Murlisa; Zambrana, Ruth E

2011-01-01

We examined differences in knowledge and socioeconomic factors associated with 3 types of breast cancer screening (breast self-examination, clinical breast examination, and mammogram) among African American, Arab, and Latina women. Community health workers used a community-based intervention to recruit 341 women (112 Arab, 113 Latina, and 116 African American) in southeastern Michigan to participate in a breast cancer prevention intervention from August through October 2006. Before and after the intervention, women responded to a previously validated 5-item multiple-choice test on breast cancer screening (possible score range: 0 to 5) in their language of preference (English, Spanish, or Arabic). We used generalized estimating equations to analyze data and to account for family-level and individual correlations. Although African American women knew more about breast cancer screening at the baseline (pretest median scores were 4 for African American, 3 for Arab and 3 for Latina women), all groups significantly increased their knowledge after participating in the breast cancer prevention intervention (posttest median scores were 5 for African American and 4 for Arab and Latina women). Generalized estimating equations models show that Arab and Latina women made the most significant gains in posttest scores (P < .001). Racial/ethnic differences in knowledge of breast cancer screening highlight the need for tailored information on breast cancer screening for African American, Arab, and Latina women to promote adherence to breast cancer screening guidelines.

Breast cancer risk from different mammography screening practices.

PubMed

Bijwaard, Harmen; Brenner, Alina; Dekkers, Fieke; van Dillen, Teun; Land, Charles E; Boice, John D

2010-09-01

Mammography screening is an accepted procedure for early detection of breast tumors among asymptomatic women. Since this procedure involves the use of X rays, it is itself potentially carcinogenic. Although there is general consensus about the benefit of screening for older women, screening practices differ between countries. In this paper radiation risks for these different practices are estimated using a new approach. We model breast cancer induction by ionizing radiation in a cohort of patients exposed to frequent X-ray examinations. The biologically based, mechanistic model provides a better foundation for the extrapolation of risks to different mammography screening practices than empirical models do. The model predicts that the excess relative risk (ERR) doubles when screening starts at age 40 instead of 50 and that a continuation of screening at ages 75 and higher carries little extra risk. The number of induced fatal breast cancers is estimated to be considerably lower than derived from epidemiological studies and from internationally accepted radiation protection risks. The present findings, if used in a risk-benefit analysis for mammography screening, would be more favorable to screening than estimates currently recommended for radiation protection. This has implications for the screening ages that are currently being reconsidered in several countries.

Improving participation by Aboriginal children in blood lead screening services in Broken Hill, NSW.

PubMed

Thomas, Susan L; Boreland, Frances; Lyle, David M

2013-03-01

Lead poses a health risk to young children with detrimental effects on their intellectual development. Attendance rates for Aboriginal children at routine blood lead screening and at follow-up appointments in Broken Hill, NSW, have declined in recent years. This study sought to identify strategies to improve the participation of Aboriginal children aged 1-4 years in blood lead screening services in Broken Hill. Attendance rates during the period 2000-2010 were determined using the Broken Hill Lead Management database. From June to August 2011, Aboriginal community members, service providers and public health staff were invited to interviews and focus groups to explore barriers, enablers and suggestions for improving participation. In 2009, 27% of Aboriginal children aged 1-4 years attended blood lead screening and 29% of these children with blood lead levels over 15 µg/dL attended follow-up appointments. Barriers to participation in lead screening services included community perceptions, reduced service capacity, socio-economic and interorganisational factors. Enablers included using a culturally acceptable model, linking lead screening with routine health checks and using the finger-prick method of testing. The final report for the study included recommendations to improve participation rates of Aboriginal children including using social marketing, formalising collaboration between health services, supporting disadvantaged families and employing an Aboriginal Health Worker.

Physician Nonadherence With a Hepatitis C Screening Program

PubMed Central

Southern, William N.; Drainoni, Mari-Lynn; Smith, Bryce D.; Koppelman, Elisa; McKee, M. Diane; Christiansen, Cindy L.; Gifford, Allen L.; Weinbaum, Cindy M.; Litwin, Alain H.

2017-01-01

Background Testing for patients at risk for hepatitis C virus (HCV) infection is recommended, but it is unclear whether providers adhere to testing guidelines. We aimed to measure adherence to an HCV screening protocol during a multifaceted continuous intervention. Subjects and Methods Prospective cohort design to examine the associations between patient-level, physician-level, and visit-level characteristics and adherence to an HCV screening protocol. Study participants included all patients with a visit to 1 of the 3 study clinics and the physicians who cared for them. Adherence to the HCV screening protocol and patient-level, physician-level, and visit-level predictors of adherence were measured. Results A total of 8981 patients and 154 physicians were examined. Overall protocol adherence rate was 36.1%. In multivariate analysis, patient male sex (odds ratio [OR] = 1.18), new patient (OR = 1.23), morning visit (OR = 1.32), and patients’ preferred language being non-English (OR = 0.87) were significantly associated with screening adherence. There was a wide variation in overall adherence among physicians (range, 0%–92.4%). Screening adherence continuously declined from 59.1% in week 1 of the study to 13.7% in week 15 (final week). When implementing complex clinical practice guidelines, planners should address physician attitudinal barriers as well as gaps in knowledge to maximize adherence. PMID:24368717

Anticounterfeiting features of artistic screening

NASA Astrophysics Data System (ADS)

Ostromoukhov, Victor; Rudaz, Nicolas; Amidror, Isaac; Emmel, Patrick; Hersch, Roger D.

1996-12-01

In a recent publication (Ostromoukhov95), a new image reproduction technique, artistic screening, was presented. It incorporates freely created artistic screen elements for generating halftones. Fixed predefined dot contours associated with given intensity levels determine the screen dot shape's growing behavior. Screen dot contours associated with each intensity level are obtained by interpolation between the fixed predefined dot contours. A user-defined mapping transforms screen elements from screen element definition space to screen element rendition space. This mapping can be tuned to produce various effects such as dilatations, contractions and non-linear deformations of the screen element grid. Although artistic screening has been designed mainly for performing the creation of graphic designs of high artistic quality, it also incorporates several important anti-counterfeiting features. For example, bank notes or other valuable printed matters produced with artistic screening may incorporate both full size and microscopic letters of varying shape into the image halftoning process. Furthermore, artistic screening can be used for generating screen dots at varying frequencies and orientations, which are well known for inducing strong moire effects when scanned by a digital color copier or a desktop scanner. However, it is less known that frequency-modulated screen dots have at each screen element size a different reproduction behavior (dot gain). When trying to reproduce an original by analog means, such as a photocopier, the variations in dot gain induce strong intensity variations at the same original intensity levels. In this paper, we present a method for compensating such variations for the target printer, on which the original security document is to be printed. Potential counterfeiters who would like to reproduce the original with a photocopying device may only be able to adjust the dot gain for the whole image and will therefore be unable to eliminate the undesired intensity variations produced by variable frequency screen elements.

Mathematic model analysis of Gaussian beam propagation through an arbitrary thickness random phase screen.

PubMed

Tian, Yuzhen; Guo, Jin; Wang, Rui; Wang, Tingfeng

2011-09-12

In order to research the statistical properties of Gaussian beam propagation through an arbitrary thickness random phase screen for adaptive optics and laser communication application in the laboratory, we establish mathematic models of statistical quantities, which are based on the Rytov method and the thin phase screen model, involved in the propagation process. And the analytic results are developed for an arbitrary thickness phase screen based on the Kolmogorov power spectrum. The comparison between the arbitrary thickness phase screen and the thin phase screen shows that it is more suitable for our results to describe the generalized case, especially the scintillation index.

RNAi Screen for NRF2 Inducers Identifies Targets That Rescue Primary Lung Epithelial Cells from Cigarette Smoke Induced Radical Stress

PubMed Central

Schumacher, Frances-Rose; Schubert, Steffen; Hannus, Michael; Sönnichsen, Birte; Ittrich, Carina; Kreideweiss, Stefan; Rippmann, Jörg F.

2016-01-01

Chronic Obstructive Pulmonary Disease (COPD) is a highly prevalent condition characterized by inflammation and progressive obstruction of the airways. At present, there is no treatment that suppresses the chronic inflammation of the disease, and COPD patients often succumb to the condition. Excessive oxidative stress caused by smoke inhalation is a major driving force of the disease. The transcription factor NRF2 is a critical player in the battle against oxidative stress and its function is impaired in COPD. Increasing NRF2 activity may therefore be a viable therapeutic option for COPD treatment. We show that down regulation of KEAP1, a NRF2 inhibitor, protects primary human lung epithelial cells from cigarette-smoke-extract (CSE) induced cell death in an established in vitro model of radical stress. To identify new potential drug targets with a similar effect, we performed a siRNA screen of the ‘druggable’ genome using a NRF2 transcriptional reporter cell line. This screen identified multiple genes that when down regulated increased NRF2 transcriptional activity and provided a survival benefit in the in vitro model. Our results suggest that inhibiting components of the ubiquitin-proteasome system will have the strongest effects on NRF2 transcriptional activity by increasing NRF2 levels. We also find that down regulation of the small GTPase Rab28 or the Estrogen Receptor ESRRA provide a survival benefit. Rab28 knockdown increased NRF2 protein levels, indicating that Rab28 may regulate NRF2 proteolysis. Conversely ESRRA down regulation increased NRF2 transcriptional activity without affecting NRF2 levels, suggesting a proteasome-independent mechanism. PMID:27832175

Investigating the disparities in cervical cancer screening among Namibian women.

PubMed

Kangmennaang, Joseph; Thogarapalli, Nandini; Mkandawire, Paul; Luginaah, Isaac

2015-08-01

We examined the influence of knowledge and information, health care access and different socio-economic variables on women's decision to screen for cervical cancer using a nationally representative dataset. We use hierarchical binary logit regression models to explore the determinants of screening for cervical cancer among women who reported hearing about cervical cancer. This enabled us to include the effect of unobserved heterogeneity at the cluster level that may affect screening behaviors. Among women who have heard about cervical cancer (N=6542), only 39% of them did undergo screening with a mean age of 33 years. The univariate results reveal that women who are educated, insured, can afford money needed for treatment and reported distance not a barrier to accessing healthcare were more likely to screen. Our multivariate results indicate that insured women (OR=1.89, p=0.001) and women who had access to information through education and contact with a health worker (OR=1.41, p=0.001) were more likely to undertake screening compared to uninsured women and those with no contact with a health personnel, after controlling for relevant variables. The adoption of a universal health insurance scheme that ensures equity in access to health care and extension of public health information targeting women in rural communities especially within the Caprivi region may be needed for a large scale increase in cervical cancer screening in Namibia. Copyright © 2015 Elsevier Inc. All rights reserved.

Disparities in HIV Screening among Pregnant Women – El Salvador, 2011

PubMed Central

El Bcheraoui, Charbel; Nieto Gómez, Ana I.; Dubón Abrego, María A.; Gagnier, Marielle C.; Sutton, Madeline Y.; Mokdad, Ali H.

2013-01-01

Objectives To provide an accurate estimate of antenatal HIV screening and its determinants among pregnant women in El Salvador and help local authorities make informed decisions for targeted interventions around mother-to-child transmission (MTCT). Methods A total sample of 4,730 women aged 15-49 years were interviewed from a random sample of 3,625 households. We collected data on antenatal care services, including HIV screening, during last pregnancy through a pre-established questionnaire. We used a backward elimination multivariate logistic regression model to examine the association between HIV screening and sociodemographic and health care-related factors. Results A total of 2,929 women were included in this analysis. About 98% of participants reported receiving antenatal care, but only 83% of these reported being screened for HIV. Screening was lower in geographic areas with higher HIV incidence and ranged from 69.1% among women who were not seen by a physician during antenatal care, to 93.7% among those who attended or completed college. Odds for screening varied also by age, employment status, household economic expenditure, possession of health care coverage, health care settings, and number of antenatal care visits. Conclusions We found disparities in HIV screening during antenatal care at the environmental, social, demographic, and structural levels despite a high uptake of antenatal care in El Salvador. Our findings should urge health authorities to tailor and enhance current strategies implemented to eliminate MTCT and reduce inequities and HIV morbidity among women in El Salvador. PMID:24349356

Neighborhood Screening in Communities Throughout the Nation for Children with Elevated Blood Lead Levels

PubMed Central

Anderson, Dudley G.; Clark, John L.

1974-01-01

From the spring of 1971 to September 1973, neighborhood surveys were conducted in 58 communities throughout the nation to determine whether children with confirmed elevated blood lead levels could be identified. Another purpose of these screenings was to assist communities in identifying children with elevated blood lead levels and thereby demonstrate to community officials that such children do exist in communities screened. The children screened were not a random sample. In those communities where the initial elevated blood levels were confirmed all but seven had one or more children requiring followup and/or treatment. Of those children screened, black children had an elevated rate about three times as great as nonblack children. With few exceptions, the homes in the neighborhoods had at least one interior surface with sufficient quantities of lead paint to be dangerous if the paint were ingested. PMID:4831146

Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans

PubMed Central

Thompson, Caroline A.; Gomez, Scarlett Lin; Chan, Albert; Chan, John K.; McClellan, Sean R.; Chung, Sukyung; Olson, Cliff; Nimbal, Vani; Palaniappan, Latha P.

2014-01-01

BACKGROUND Routinely recommended screening for breast, cervical, and colorectal cancers can significantly reduce mortality from these types of cancer, yet screening is underutilized among Asians. Surveys rely on self-report and often are underpowered for analysis by Asian ethnicities. Electronic health records include validated (as opposed to recall-based) rates of cancer screening. In this paper we seek to better understand cancer screening patterns in a population of insured Asian Americans. METHODS We calculated rates of compliance with cervical, breast, and colorectal cancer screening among Asians from an EHR population, and compared them to non-Hispanic whites. We performed multivariable modeling to evaluate potential predictors (at the provider- and patient- level) of screening completion among Asian patients. RESULTS Aggregation of Asian subgroups masked heterogeneity in screening rates. Asian Indians and Native Hawaiians and Pacific Islanders had the lowest rates of screening in our sample, well below that of non-Hispanic whites. In multivariable analyses, screening completion was negatively associated with patient-physician language discordance for mammography (OR:0.81 95% CI:0.71–0.92) and colorectal cancer screening (OR:0.79 CI:0.72–0.87) and positively associated with patient-provider gender concordance for mammography (OR:1.16 CI:1.00–1.34) and cervical cancer screening (OR:1.66 CI:1.51–1.82). Additionally, patient enrollment in online health services increased mammography (OR:1.32 CI:1.20–1.46) and cervical cancer screening (OR:1.31 CI:1.24–1.37). CONCLUSIONS Language- and gender- concordant primary care providers, and culturally tailored online health resources may help improve preventive cancer screening in Asian patient populations. IMPACT This study demonstrates how use of EHR data can inform investigations of primary prevention practices within the healthcare delivery setting. PMID:25368396

Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.

PubMed

Thompson, Caroline A; Gomez, Scarlett Lin; Chan, Albert; Chan, John K; McClellan, Sean R; Chung, Sukyung; Olson, Cliff; Nimbal, Vani; Palaniappan, Latha P

2014-11-01

Routinely recommended screening for breast, cervical, and colorectal cancers can significantly reduce mortality from these types of cancer, yet screening is underutilized among Asians. Surveys rely on self-report and often are underpowered for analysis by Asian ethnicities. Electronic health records (EHR) include validated (as opposed to recall-based) rates of cancer screening. In this article, we seek to better understand cancer screening patterns in a population of insured Asian Americans. We calculated rates of compliance with cervical, breast, and colorectal cancer screening among Asians from an EHR population and compared them with non-Hispanic whites. We performed multivariable modeling to evaluate potential predictors (at the provider- and patient-level) of screening completion among Asian patients. Aggregation of Asian subgroups masked heterogeneity in screening rates. Asian Indians and native Hawaiians and Pacific Islanders had the lowest rates of screening in our sample, well below that of non-Hispanic whites. In multivariable analyses, screening completion was negatively associated with patient-physician language discordance for mammography [OR, 0.81; 95% confidence interval (CI), 0.71-0.92] and colorectal cancer screening (OR, 0.79; CI, 0.72-0.87) and positively associated with patient-provider gender concordance for mammography (OR, 1.16; CI, 1.00-1.34) and cervical cancer screening (OR, 1.66; CI, 1.51-1.82). In addition, patient enrollment in online health services increased mammography (OR, 1.32; CI, 1.20-1.46) and cervical cancer screening (OR, 1.31; CI, 1.24-1.37). Language- and gender-concordant primary care providers and culturally tailored online health resources may help improve preventive cancer screening in Asian patient populations. This study demonstrates how the use of EHR data can inform investigations of primary prevention practices within the healthcare delivery setting. ©2014 American Association for Cancer Research.

Socio-Economic and Health Access Determinants of Breast and Cervical Cancer Screening in Low-Income Countries: Analysis of the World Health Survey

PubMed Central

Akinyemiju, Tomi F.

2012-01-01

Background Breast and Cervical cancer are the two most common cancers among women in developing countries. Regular screening is the most effective way of ensuring that these cancers are detected at early stages; however few studies have assessed factors that predict cancer screening in developing countries. Purpose To assess the influence of household socio-economic status (SES), healthcare access and country level characteristics on breast and cervical cancer screening among women in developing countries. Methods Women ages 18–69 years (cervical cancer screening) and 40–69 years (breast cancer screening) from 15 developing countries who participated in the 2003 World Health Survey provided data for this study. Household SES and healthcare access was assessed based on self-reported survey responses. SAS survey procedures (SAS, Version 9.2) were used to assess determinants of breast and cervical cancer screening in separate models. Results 4.1% of women ages 18–69 years had received cervical cancer screening in the past three years, while only 2.2% of women ages 40–69 years had received breast cancer screening in the past 5 years in developing countries. Cancer screening rates varied by country; cervical cancer screening ranged from 1.1% in Bangladesh to 57.6% in Congo and breast cancer screening ranged from 0% in Mali to 26% in Congo. Significant determinants of cancer screening were household SES, rural residence, country health expenditure (as a percent of GDP) as well as healthcare access. Discussion A lot more needs to be done to improve screening rates for breast and cervical cancer in developing countries, such as increasing health expenditure (especially in rural areas), applying the increased funds towards the provision of more, better educated health providers as well as improved infrastructure. PMID:23155413

A Systematic Review of the Factors Influencing Ethnic Minority Women's Cervical Cancer Screening Behavior: From Intrapersonal to Policy Level.

PubMed

Chan, Dorothy N S; So, Winnie K W

Cervical cancer can be prevented by effective screening using Papanicolaou tests, but the utilization rate is lower among ethnic minorities than in the general population. Understanding the factors influencing minorities' use of such screening can aid the design of an appropriate intervention to increase their uptake rate. The aims of this study were to examine the factors that influence ethnic minority women in using cervical cancer screening and the similarities and differences in associated factors across different groups and to explore the interrelationships between the factors identified. A literature search was conducted using Ovid MEDLINE, Cumulative Index to Nursing and Allied Health Literature Plus, Scopus, PsycINFO, and PubMed. Furthermore, 1390 articles were retrieved, of which 24 met the inclusion criteria. Critical appraisal was performed by means of a quality assessment tool. The findings were summarized in tabular and narrative forms. The findings showed that certain factors commonly affected ethnic minority women's screening behavior, including knowledge, attitude and perceptions, physician's recommendation, quality of care and service, language, and acculturation. Culture-related factors, religion, and acculturation exhibited close interrelationships with the attitude and perceptions factor, resulting in behavioral change. The review sheds light on how common or unique are the factors across ethnic minorities and how these factors interact to influence behavior. Further studies are warranted to develop and test empirically a comprehensive model leading to a better understanding of the interrelationships between multiple factors. The model should be useful in informing policy makers about appropriate resource allocation and in guiding the development of culturally relevant programs to increase screening uptake.

Maximally efficient two-stage screening: Determining intellectual disability in Taiwanese military conscripts.

PubMed

Chien, Chia-Chang; Huang, Shu-Fen; Lung, For-Wey

2009-01-27

The purpose of this study was to apply a two-stage screening method for the large-scale intelligence screening of military conscripts. We collected 99 conscripted soldiers whose educational levels were senior high school level or lower to be the participants. Every participant was required to take the Wisconsin Card Sorting Test (WCST) and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) assessments. Logistic regression analysis showed the conceptual level responses (CLR) index of the WCST was the most significant index for determining intellectual disability (ID; FIQ ≤ 84). We used the receiver operating characteristic curve to determine the optimum cut-off point of CLR. The optimum one cut-off point of CLR was 66; the two cut-off points were 49 and 66. Comparing the two-stage window screening with the two-stage positive screening, the area under the curve and the positive predictive value increased. Moreover, the cost of the two-stage window screening decreased by 59%. The two-stage window screening is more accurate and economical than the two-stage positive screening. Our results provide an example for the use of two-stage screening and the possibility of the WCST to replace WAIS-R in large-scale screenings for ID in the future.

Maximally efficient two-stage screening: Determining intellectual disability in Taiwanese military conscripts

PubMed Central

Chien, Chia-Chang; Huang, Shu-Fen; Lung, For-Wey

2009-01-01

Objective: The purpose of this study was to apply a two-stage screening method for the large-scale intelligence screening of military conscripts. Methods: We collected 99 conscripted soldiers whose educational levels were senior high school level or lower to be the participants. Every participant was required to take the Wisconsin Card Sorting Test (WCST) and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) assessments. Results: Logistic regression analysis showed the conceptual level responses (CLR) index of the WCST was the most significant index for determining intellectual disability (ID; FIQ ≤ 84). We used the receiver operating characteristic curve to determine the optimum cut-off point of CLR. The optimum one cut-off point of CLR was 66; the two cut-off points were 49 and 66. Comparing the two-stage window screening with the two-stage positive screening, the area under the curve and the positive predictive value increased. Moreover, the cost of the two-stage window screening decreased by 59%. Conclusion: The two-stage window screening is more accurate and economical than the two-stage positive screening. Our results provide an example for the use of two-stage screening and the possibility of the WCST to replace WAIS-R in large-scale screenings for ID in the future. PMID:21197345

Comparative economic evaluation of data from the ACRIN National CT Colonography Trial with three cancer intervention and surveillance modeling network microsimulations.

PubMed

Vanness, David J; Knudsen, Amy B; Lansdorp-Vogelaar, Iris; Rutter, Carolyn M; Gareen, Ilana F; Herman, Benjamin A; Kuntz, Karen M; Zauber, Ann G; van Ballegooijen, Marjolein; Feuer, Eric J; Chen, Mei-Hsiu; Johnson, C Daniel

2011-11-01

To estimate the cost-effectiveness of computed tomographic (CT) colonography for colorectal cancer (CRC) screening in average-risk asymptomatic subjects in the United States aged 50 years. Enrollees in the American College of Radiology Imaging Network National CT Colonography Trial provided informed consent, and approval was obtained from the institutional review board at each site. CT colonography performance estimates from the trial were incorporated into three Cancer Intervention and Surveillance Modeling Network CRC microsimulations. Simulated survival and lifetime costs for screening 50-year-old subjects in the United States with CT colonography every 5 or 10 years were compared with those for guideline-concordant screening with colonoscopy, flexible sigmoidoscopy plus either sensitive unrehydrated fecal occult blood testing (FOBT) or fecal immunochemical testing (FIT), and no screening. Perfect and reduced screening adherence scenarios were considered. Incremental cost-effectiveness and net health benefits were estimated from the U.S. health care sector perspective, assuming a 3% discount rate. CT colonography at 5- and 10-year screening intervals was more costly and less effective than FOBT plus flexible sigmoidoscopy in all three models in both 100% and 50% adherence scenarios. Colonoscopy also was more costly and less effective than FOBT plus flexible sigmoidoscopy, except in the CRC-SPIN model assuming 100% adherence (incremental cost-effectiveness ratio: $26,300 per life-year gained). CT colonography at 5- and 10-year screening intervals and colonoscopy were net beneficial compared with no screening in all model scenarios. The 5-year screening interval was net beneficial over the 10-year interval except in the MISCAN model when assuming 100% adherence and willingness to pay $50,000 per life-year gained. All three models predict CT colonography to be more costly and less effective than non-CT colonographic screening but net beneficial compared with no screening given model assumptions. RSNA, 2011

Using an Ocean of Data, Researchers Model Real-Life Benefits of Cancer Screening

Cancer.gov

Using the results of screening trials, the NCI Cancer Intervention and Surveillance Modeling Network is trying to estimate the true benefit of cancer screening in the general population and identify the optimal way to implement screening within the health care system.

Screening the Hanford tanks for trapped gas

DOE Office of Scientific and Technical Information (OSTI.GOV)

Whitney, P.

1995-10-01

The Hanford Site is home to 177 large, underground nuclear waste storage tanks. Hydrogen gas is generated within the waste in these tanks. This document presents the results of a screening of Hanford`s nuclear waste storage tanks for the presence of gas trapped in the waste. The method used for the screening is to look for an inverse correlation between waste level measurements and ambient atmospheric pressure. If the waste level in a tank decreases with an increase in ambient atmospheric pressure, then the compressibility may be attributed to gas trapped within the waste. In this report, this methodology ismore » not used to estimate the volume of gas trapped in the waste. The waste level measurements used in this study were made primarily to monitor the tanks for leaks and intrusions. Four measurement devices are widely used in these tanks. Three of these measure the level of the waste surface. The remaining device measures from within a well embedded in the waste, thereby monitoring the liquid level even if the liquid level is below a dry waste crust. In the past, a steady rise in waste level has been taken as an indicator of trapped gas. This indicator is not part of the screening calculation described in this report; however, a possible explanation for the rise is given by the mathematical relation between atmospheric pressure and waste level used to support the screening calculation. The screening was applied to data from each measurement device in each tank. If any of these data for a single tank indicated trapped gas, that tank was flagged by this screening process. A total of 58 of the 177 Hanford tanks were flagged as containing trapped gas, including 21 of the 25 tanks currently on the flammable gas watch list.« less

The Evonik-Mainz Eye Care-Study (EMECS): Development of an Expert System for Glaucoma Risk Detection in a Working Population

PubMed Central

Wahl, Jochen; Barleon, Lorenz; Morfeld, Peter; Lichtmeß, Andrea; Haas-Brähler, Sibylle; Pfeiffer, Norbert

2016-01-01

Purpose To develop an expert system for glaucoma screening in a working population based on a human expert procedure using images of optic nerve head (ONH), visual field (frequency doubling technology, FDT) and intraocular pressure (IOP). Methods 4167 of 13037 (32%) employees between 40 and 65 years of Evonik Industries were screened. An experienced glaucoma expert (JW) assessed papilla parameters and evaluated all individual screening results. His classification into “no glaucoma”, “possible glaucoma” and “probable glaucoma” was defined as “gold standard”. A screening model was developed which was tested versus the gold-standard. This model took into account the assessment of the ONH. Values and relationships of CDR and IOP and the FDT were considered additionally and a glaucoma score was generated. The structure of the screening model was specified a priori whereas values of the parameters were chosen post-hoc to optimize sensitivity and specificity of the algorithm. Simple screening models based on IOP and / or FDT were investigated for comparison. Results 111 persons (2.66%) were classified as glaucoma suspects, thereof 13 (0.31%) as probable and 98 (2.35%) as possible glaucoma suspects by the expert. Re-evaluation by the screening model revealed a sensitivity of 83.8% and a specificity of 99.6% for all glaucoma suspects. The positive predictive value of the model was 80.2%, the negative predictive value 99.6%. Simple screening models showed insufficient diagnostic accuracy. Conclusion Adjustment of ONH and symmetry parameters with respect to excavation and IOP in an expert system produced sufficiently satisfying diagnostic accuracy. This screening model seems to be applicable in such a working population with relatively low age and low glaucoma prevalence. Different experts should validate the model in different populations. PMID:27479301

The Evonik-Mainz Eye Care-Study (EMECS): Development of an Expert System for Glaucoma Risk Detection in a Working Population.

PubMed

Wahl, Jochen; Barleon, Lorenz; Morfeld, Peter; Lichtmeß, Andrea; Haas-Brähler, Sibylle; Pfeiffer, Norbert

2016-01-01

To develop an expert system for glaucoma screening in a working population based on a human expert procedure using images of optic nerve head (ONH), visual field (frequency doubling technology, FDT) and intraocular pressure (IOP). 4167 of 13037 (32%) employees between 40 and 65 years of Evonik Industries were screened. An experienced glaucoma expert (JW) assessed papilla parameters and evaluated all individual screening results. His classification into "no glaucoma", "possible glaucoma" and "probable glaucoma" was defined as "gold standard". A screening model was developed which was tested versus the gold-standard. This model took into account the assessment of the ONH. Values and relationships of CDR and IOP and the FDT were considered additionally and a glaucoma score was generated. The structure of the screening model was specified a priori whereas values of the parameters were chosen post-hoc to optimize sensitivity and specificity of the algorithm. Simple screening models based on IOP and / or FDT were investigated for comparison. 111 persons (2.66%) were classified as glaucoma suspects, thereof 13 (0.31%) as probable and 98 (2.35%) as possible glaucoma suspects by the expert. Re-evaluation by the screening model revealed a sensitivity of 83.8% and a specificity of 99.6% for all glaucoma suspects. The positive predictive value of the model was 80.2%, the negative predictive value 99.6%. Simple screening models showed insufficient diagnostic accuracy. Adjustment of ONH and symmetry parameters with respect to excavation and IOP in an expert system produced sufficiently satisfying diagnostic accuracy. This screening model seems to be applicable in such a working population with relatively low age and low glaucoma prevalence. Different experts should validate the model in different populations.

Effects of Social Injustice on Breast Health–Seeking Behaviors of Low-Income Women

PubMed Central

Bowen, Shelly-Ann; Williams, Edith M.; Stoneberg-Cooper, Chayah M.; Glover, Saundra H.; Williams, Michelle S.; Byrd, Michael D.

2014-01-01

Purpose The study uses qualitative research to gain a better understanding of what occurs after low-income women receive an abnormal breast screening and the factors that influence their decisions and behavior. A heuristic model is presented for understanding this complexity. Design Qualitative research methods used to elicited social and cultural themes related to breast cancer screening follow-up. Setting Individual telephone interviews were conducted with 16 women with confirmed breast anomaly. Participants Low-income women screened through a national breast cancer early detection program. Method Grounded theory using selective coding was employed to elicit factors that influenced the understanding and follow-up of an abnormal breast screening result. Interviews were digitally recorded, transcribed, and uploaded into NVivo 8, a qualitative management and analysis software package. Results For women (16, or 72% of case management referrals) below 250% of the poverty level, the impact of social and economic inequities creates a psychosocial context underlined by structural and cultural barriers to treatment that forecasts the mechanism that generates differences in health outcomes. The absence of insurance due to underemployment and unemployment and inadequate public infrastructure intensified emotional stress impacting participants’ health decisions. Conclusion The findings that emerged offer explanations of how consistent patterns of social injustice impact treatment decisions in a high-risk vulnerable population that have implications for health promotion research and systems-level program improvement and development. PMID:23448411

Development and application of a screening model for simulating regional ground-water flow in the St. Croix River basin, Minnesota and Wisconsin

USGS Publications Warehouse

Feinstein, Daniel T.; Buchwald, Cheryl A.; Dunning, Charles P.; Hunt, Randall J.

2006-01-01

A series of databases and an accompanying screening model were constructed by the U.S. Geological Survey, in cooperation with the National Park Service, to better understand the regional ground-water-flow system and its relation to stream drainage in the St. Croix River Basin. The St. Croix River and its tributaries drain about 8,000 square miles in northeastern Minnesota and northwestern Wisconsin. The databases contain information for the entire St. Croix River Basin pertaining to well logs, lithology, thickness of lithologic groups, ground-water levels, streamflow, and well pumpage. Maps and generalized cross sections created from the compiled data show the lithologic groups, extending from the water table to the crystalline bedrock, through which ground water flows. These lithologic groups are: fine-grained unconsolidated deposits; coarse-grained unconsolidated deposits; sandstone bedrock; carbonate bedrock; and other bedrock lithologies including shale, siltstone, conglomerate, and igneous intrusions. The steady-state screening model treats the ground-water-flow system as a single layer with transmissivity zones that reflect the distribution of lithologic groups, and with recharge zones that correspond to general areas of high or low evapotranspiration. The model includes representation of second- and higher-order streams and municipal and other high-capacity production wells. The analytic-element model code GFLOW was used to simulate the regional ground-water flow, the water-table surface across the St. Croix River Basin, and base-flow contributions from ground water to streams. In addition, the model routes tributary base flow through the stream network to the St. Croix River. The parameter-estimation inverse model UCODE was linked to the GFLOW model to select the combination of parameter values best able to match over 5,000 water-level measurements and base-flow estimates at 22 streamflow-gaging stations. Results from the calibrated screening model show ground-water contributing areas for selected stream reaches within the basin. The delineation of these areas is useful to water-resource managers concerned with protection of fisheries and other resources. The model results also identify the areas of the basin where ground-water travel time from the water table to streams and wells is relatively short (less than 50 years). Ninety percent of the simulated ground-water pathlines require travel times between 3 and 260 years. The median pathline distance traversed and the median pathline velocity were 1.7 mi and 177 ft/y, respectively. It is important to recognize the limitations of this screening model. Heterogeneities in subsurface properties and in recharge rates are considered only at a very broad scale (miles to tens of miles). No account is taken of vertical variations in properties or pumping rates, and no provision is made to account for stacked ground-water-flow systems that have different flow patterns at different depths. Small-scale (hundreds to thousands of feet) flow systems associated with minor water bodies are neglected, and as a result, the model is not useful for simulating typical site-specific problems. Despite its limitations, the model serves as a framework for understanding the regional pattern of ground-water flow and as a starting point for a generation of more targeted and detailed ground-water models that would be needed to address emerging water-supply and water-quality concerns in the St. Croix River Basin.

Prioritizing Chemicals and Data Requirements for Screening-Level Exposure and Risk Assessment

PubMed Central

Brown, Trevor N.; Wania, Frank; Breivik, Knut; McLachlan, Michael S.

2012-01-01

Background: Scientists and regulatory agencies strive to identify chemicals that may cause harmful effects to humans and the environment; however, prioritization is challenging because of the large number of chemicals requiring evaluation and limited data and resources. Objectives: We aimed to prioritize chemicals for exposure and exposure potential and obtain a quantitative perspective on research needs to better address uncertainty in screening assessments. Methods: We used a multimedia mass balance model to prioritize > 12,000 organic chemicals using four far-field human exposure metrics. The propagation of variance (uncertainty) in key chemical information used as model input for calculating exposure metrics was quantified. Results: Modeled human concentrations and intake rates span approximately 17 and 15 orders of magnitude, respectively. Estimates of exposure potential using human concentrations and a unit emission rate span approximately 13 orders of magnitude, and intake fractions span 7 orders of magnitude. The actual chemical emission rate contributes the greatest variance (uncertainty) in exposure estimates. The human biotransformation half-life is the second greatest source of uncertainty in estimated concentrations. In general, biotransformation and biodegradation half-lives are greater sources of uncertainty in modeled exposure and exposure potential than chemical partition coefficients. Conclusions: Mechanistic exposure modeling is suitable for screening and prioritizing large numbers of chemicals. By including uncertainty analysis and uncertainty in chemical information in the exposure estimates, these methods can help identify and address the important sources of uncertainty in human exposure and risk assessment in a systematic manner. PMID:23008278

Biomimetic three-dimensional tissue models for advanced high-throughput drug screening

PubMed Central

Nam, Ki-Hwan; Smith, Alec S.T.; Lone, Saifullah; Kwon, Sunghoon; Kim, Deok-Ho

2015-01-01

Most current drug screening assays used to identify new drug candidates are 2D cell-based systems, even though such in vitro assays do not adequately recreate the in vivo complexity of 3D tissues. Inadequate representation of the human tissue environment during a preclinical test can result in inaccurate predictions of compound effects on overall tissue functionality. Screening for compound efficacy by focusing on a single pathway or protein target, coupled with difficulties in maintaining long-term 2D monolayers, can serve to exacerbate these issues when utilizing such simplistic model systems for physiological drug screening applications. Numerous studies have shown that cell responses to drugs in 3D culture are improved from those in 2D, with respect to modeling in vivo tissue functionality, which highlights the advantages of using 3D-based models for preclinical drug screens. In this review, we discuss the development of microengineered 3D tissue models which accurately mimic the physiological properties of native tissue samples, and highlight the advantages of using such 3D micro-tissue models over conventional cell-based assays for future drug screening applications. We also discuss biomimetic 3D environments, based-on engineered tissues as potential preclinical models for the development of more predictive drug screening assays for specific disease models. PMID:25385716

Barriers to antenatal psychosocial assessment and depression screening in private hospital settings.

PubMed

Connell, Tanya; Barnett, Bryanne; Waters, Donna

2017-10-11

The evidence of benefit for antenatal psychosocial assessment and depression screening has been sufficient to lead the implementation of screening in public hospitals in all states of Australia. Details of the implementation of perinatal screening in private obstetric settings is less well known. As any successful implementation relies on the identification of local barriers, we aimed to determine what perceived or actual barriers may exist for the implementation of evidence-based perinatal screening interventions in private obstetric care, and specifically within small private hospitals. The integrative literature review method offers a structured systematic approach to organise, synthesize and critique research from a range of sources. This method was used to determine what barriers have been identified in implementing psychosocial assessment and depression screening with women receiving obstetric care in private hospital settings. The integrative review findings suggest that barriers to implementing psychosocial screening in the private sector are similar to those experienced in the public sector but may also be influenced by the corporate focus of private services. Barriers were identified among health professionals, within the personal and psychosocial context of women and their families, and at provider or system level. Once identified, barriers can be systematically addressed to enhance the success of implementing psychosocial and depression screening in the private sector. Screening is likely to be influenced by the business models and operating systems of private service providers. Health professionals working within this environment need more support to conduct perinatal assessment within this context. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Optimal screening interval for men with low baseline prostate-specific antigen levels (≤1.0 ng/mL) in a prostate cancer screening program.

PubMed

Urata, Satoko; Kitagawa, Yasuhide; Matsuyama, Satoko; Naito, Renato; Yasuda, Kenji; Mizokami, Atsushi; Namiki, Mikio

2017-04-01

To optimize the rescreening schedule for men with low baseline prostate-specific antigen (PSA) levels, we evaluated men with baseline PSA levels of ≤1.0 ng/mL in PSA-based population screening. We enrolled 8086 men aged 55-69 years with baseline PSA levels of ≤1.0 ng/mL, who were screened annually. The relationships of baseline PSA and age with the cumulative risks and clinicopathological features of screening-detected cancer were investigated. Among the 8086 participants, 28 (0.35 %) and 18 (0.22 %) were diagnosed with prostate cancer and cancer with a Gleason score (GS) of ≥7 during the observation period, respectively. The cumulative probabilities of prostate cancer at 12 years were 0.42, 1.0, 3.4, and 4.3 % in men with baseline PSA levels of 0.0-0.4, 0.5-0.6, 0.7-0.8, and 0.9-1.0 ng/mL, respectively. Those with GS of ≥7 had cumulative probabilities of 0.42, 0.73, 2.8, and 1.9 %, respectively. The cumulative probabilities of prostate cancer were significantly lower when baseline PSA levels were 0.0-0.6 ng/mL compared with 0.7-1.0 ng/mL. Prostate cancer with a GS of ≥7 was not detected during the first 10 years of screening when baseline PSA levels were 0.0-0.6 ng/mL and was not detected during the first 2 years when baseline PSA levels were 0.7-1.0 ng/mL. Our study demonstrated that men with baseline PSA levels of 0.0-0.6 ng/mL might benefit from longer screening intervals than those recommended in the guidelines of the Japanese Urological Association. Further investigation is needed to confirm the optimal screening interval for men with low baseline PSA levels.

"Chair Stand Test" as Simple Tool for Sarcopenia Screening in Elderly Women.

PubMed

Pinheiro, P A; Carneiro, J A O; Coqueiro, R S; Pereira, R; Fernandes, M H

2016-01-01

To investigate the association between sarcopenia and "chair stand test" performance, and evaluate this test as a screening tool for sarcopenia in community-dwelling elderly women. Cross-sectional Survey. 173 female individuals, aged ≥ 60 years and living in the urban area of the municipality of Lafaiete Coutinho, Bahia's inland, Brazil. The association between sarcopenia (defined by muscle mass, strength and/or performance loss) and performance in the "chair stand test" was tested by binary logistic regression technique. The ROC curve parameters were used to evaluate the diagnostic power of the test in sarcopenia screening. The significance level was set at 5 %. The model showed that the time spent for the "chair stand test" was positively associated (OR = 1.08; 95% CI = 1.01 - 1.16, p = 0.024) to sarcopenia, indicating that, for each 1 second increment in the test performance, the sarcopenia's probability increased by 8% in elderly women. The cut-off point that showed the best balance between sensitivity and specificity was 13 seconds. The performance of "chair stand test" showed predictive ability for sarcopenia, being an effective and simple screening tool for sarcopenia in elderly women. This test could be used for screening sarcopenic elderly women, allowing early interventions.

Using the direct-injection model of early uveal melanoma hepatic metastasis to identify TPS as a potentially useful serum biomarker.

PubMed

Barak, Vivian; Frenkel, Shahar; Valyi-Nagy, Klara; Leach, Lu; Apushkin, Marsha A; Lin, Amy Y; Kalickman, Inna; Baumann, Nikola A; Pe'er, Jacob; Maniotis, Andrew J; Folberg, Robert

2007-10-01

To develop a method to screen for serum biomarkers of early hepatic metastasis from uveal melanoma. Cytokeratin 18 (TPS) was identified from gene expression profiles as protein generated by highly invasive uveal melanoma cells. Sera were collected from two groups of 15 SCID mice 2 weeks after injection of either tissue culture medium or MUM2B human metastatic uveal melanoma cells into the mouse liver. Serum TPS levels were assayed in 53 healthy human controls, 64 uveal melanoma patients who were disease free for at least 10 years, and 37 patients with metastatic uveal melanoma. After 2 weeks, small hepatic nodules (0.1-2.8 mm; mean, 0.80 mm) developed in 11 of 15 mice injected with MUM2B cells. Serum TPS levels in media-injected mice (84.7 U/L) were substantially lower than levels in MUM2B-injected mice (601 mug/L). TPS levels were significantly higher (P < 0.0001) in patients with metastatic uveal melanoma (139.63 +/- 22.20) than in healthy controls (54.23 +/- 0.01) or in patients free of disease (69.29 +/- 9.76). Significant differences were found between TPS levels before and after the development of hepatic metastases (P < 0.01), and serum TPS levels became elevated in four patients at least 6 months before the detection of hepatic metastases by abdominal ultrasonography. The direct-injection model of uveal melanoma in the mouse liver may be used to screen for potential serum biomarkers of metastatic uveal melanoma.

Automatic Classification of Users’ Health Information Need Context: Logistic Regression Analysis of Mouse-Click and Eye-Tracker Data

PubMed Central

Pian, Wenjing; Khoo, Christopher SG

2017-01-01

Background Users searching for health information on the Internet may be searching for their own health issue, searching for someone else’s health issue, or browsing with no particular health issue in mind. Previous research has found that these three categories of users focus on different types of health information. However, most health information websites provide static content for all users. If the three types of user health information need contexts can be identified by the Web application, the search results or information offered to the user can be customized to increase its relevance or usefulness to the user. Objective The aim of this study was to investigate the possibility of identifying the three user health information contexts (searching for self, searching for others, or browsing with no particular health issue in mind) using just hyperlink clicking behavior; using eye-tracking information; and using a combination of eye-tracking, demographic, and urgency information. Predictive models are developed using multinomial logistic regression. Methods A total of 74 participants (39 females and 35 males) who were mainly staff and students of a university were asked to browse a health discussion forum, Healthboards.com. An eye tracker recorded their examining (eye fixation) and skimming (quick eye movement) behaviors on 2 types of screens: summary result screen displaying a list of post headers, and detailed post screen. The following three types of predictive models were developed using logistic regression analysis: model 1 used only the time spent in scanning the summary result screen and reading the detailed post screen, which can be determined from the user’s mouse clicks; model 2 used the examining and skimming durations on each screen, recorded by an eye tracker; and model 3 added user demographic and urgency information to model 2. Results An analysis of variance (ANOVA) analysis found that users’ browsing durations were significantly different for the three health information contexts (P<.001). The logistic regression model 3 was able to predict the user’s type of health information context with a 10-fold cross validation mean accuracy of 84% (62/74), followed by model 2 at 73% (54/74) and model 1 at 71% (52/78). In addition, correlation analysis found that particular browsing durations were highly correlated with users’ age, education level, and the urgency of their information need. Conclusions A user’s type of health information need context (ie, searching for self, for others, or with no health issue in mind) can be identified with reasonable accuracy using just user mouse clicks that can easily be detected by Web applications. Higher accuracy can be obtained using Google glass or future computing devices with eye tracking function. PMID:29269342

Hydrodynamic model of screen channel liquid acquisition devices for in-space cryogenic propellant management

NASA Astrophysics Data System (ADS)

Darr, Samuel Ryan

Technologies that enable the storage and transfer of cryogenic propellants in space will be needed for the next generation vehicles that will carry humans to Mars. One of the candidate technologies is the screen channel liquid acquisition device (LAD), which uses a metal woven wire mesh to separate the liquid and vapor phases so that single-phase liquid propellant can be transferred in microgravity. The purpose of this work is to provide an accurate hydrodynamic model of the liquid flow through a screen channel LAD. Chapter 2 provides a derivation of the flow-through-screen (FTS) boundary condition. The final boundary condition more accurately represents the complex geometry of metal woven wire mesh than the current model used in the literature. The effect of thermal contraction on the screen geometry due to large temperature changes common in cryogenic systems is quantified in this chapter as well. Chapter 3 provides a two-dimensional (2-D) analytical solution of the velocity and pressure fields in a screen channel LAD. This solution, which accounts for non-uniform injection through the screen, is compared with the traditional 1-D model which assumes a constant, uniform injection velocity. Chapter 4 describes the setup and results of an experiment that measures both the velocity and pressure fields in a screen channel LAD in order to validate the 2-D model. Results show that the 2-D model performs best against the new data and historical data. With the improved FTS boundary condition and the 2-D model, the pressure drop of a screen channel LAD is described with excellent accuracy. The result of this work is a predictive tool that will instill confidence in the design of screen channel LADs for future in-space propulsion systems.

Computed tomography screening for lung cancer: results of ten years of annual screening and validation of cosmos prediction model.

PubMed

Veronesi, G; Maisonneuve, P; Rampinelli, C; Bertolotti, R; Petrella, F; Spaggiari, L; Bellomi, M

2013-12-01

It is unclear how long low-dose computed tomographic (LDCT) screening should continue in populations at high risk of lung cancer. We assessed outcomes and the predictive ability of the COSMOS prediction model in volunteers screened for 10 years. Smokers and former smokers (>20 pack-years), >50 years, were enrolled over one year (2000-2001), receiving annual LDCT for 10 years. The frequency of screening-detected lung cancers was compared with COSMOS and Bach risk model estimates. Among 1035 recruited volunteers (71% men, mean age 58 years) compliance was 65% at study end. Seventy-one (6.95%) lung cancers were diagnosed, 12 at baseline. Disease stage was: IA in 48 (66.6%); IB in 6; IIA in 5; IIB in 2; IIIA in 5; IIIB in 1; IV in 5; and limited small cell cancer in 3. Five- and ten-year survival were 64% and 57%, respectively, 84% and 65% for stage I. Ten (12.1%) received surgery for a benign lesion. The number of lung cancers detected during the first two screening rounds was close to that predicted by the COSMOS model, while the Bach model accurately predicted frequency from the third year on. Neither cancer frequency nor proportion at stage I decreased over 10 years, indicating that screening should not be discontinued. Most cancers were early stage, and overall survival was high. Only a limited number of invasive procedures for benign disease were performed. The Bach model - designed to predict symptomatic cancers - accurately predicted cancer frequency from the third year, suggesting that overdiagnosis is a minor problem in lung cancer screening. The COSMOS model - designed to estimate screening-detected lung cancers - accurately predicted cancer frequency at baseline and second screening round. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The KIDROP model of combining strategies for providing retinopathy of prematurity screening in underserved areas in India using wide-field imaging, tele-medicine, non-physician graders and smart phone reporting

PubMed Central

Vinekar, Anand; Gilbert, Clare; Dogra, Mangat; Kurian, Mathew; Shainesh, Gangadharan; Shetty, Bhujang; Bauer, Noel

2014-01-01

Aim: To report the Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity (KIDROP) program for retinopathy of prematurity (ROP) screening in underserved rural areas using an indigenously developed tele-ROP model. Materials and Methods: KIDROP currently provides ROP screening and treatment services in three zones and 81 neonatal units in Karnataka, India. Technicians were trained to use a portable Retcam Shuttle (Clarity, USA) and validated against ROP experts performing indirect ophthalmoscopy. An indigenously developed 20-point score (STAT score) graded their ability (Level I to III) to image and decide follow-up based on a three-way algorithm. Images were also uploaded on a secure tele-ROP platform and accessed and reported by remote experts on their smart phones (iPhone, Apple). Results: 6339 imaging sessions of 1601 infants were analyzed. A level III technician agreed with 94.3% of all expert decisions. The sensitivity, specificity, positive predictive value and negative predictive value for treatment grade disease were 95.7, 93.2, 81.5 and 98.6 respectively. The kappa for technicians to decide discharge of babies was 0.94 (P < 0.001). Only 0.4% of infants needing treatment were missed. The kappa agreement of experts reporting on the iPhone vs Retcam for treatment requiring and mild ROP were 0.96 and 0.94 (P < 0.001) respectively. Conclusions: This is the first and largest real-world program to employ accredited non-physicians to grade and report ROP. The KIDROP tele-ROP model demonstrates that ROP services can be delivered to the outreach despite lack of specialists and may be useful in other middle-income countries with similar demographics. PMID:24492500

ACCEPTABILITY OF A FUNCTIONAL-COSMETIC ARTIFICIAL HAND FOR YOUNG CHILDREN.

ERIC Educational Resources Information Center

FISHMAN, SIDNEY; KAY, HECTOR W.

SEVENTY-SEVEN CHILDREN, AGED 4 YEARS TO 12 YEARS, 4 MONTHS AND EXEMPLIFYING ALL LEVELS OF UPPER EXTREMITY AMPUTATION (PROSTHETIC TYPE) FROM WRIST-DISARTICULATION TO SHOULDER-DISARTICULATION, WORE THE APRL-SIERRA CHILD SIZE MODEL NUMBER 1 HAND FOR APPROXIMATELY 4 MONTHS. CHILD AND PARENTS MADE FOUR CLINIC VISITS FOR INITIAL SCREENING, FITTING, 2…

Preservice Teachers' Level of Web Pedagogical Content Knowledge: Assessment by Individual Innovativeness

ERIC Educational Resources Information Center

Gökçearslan, Sahin; Karademir, Tugra; Korucu, Agah Tugrul

2017-01-01

Technological Pedagogical Content Knowledge, one of the frameworks proposed in order to popularize the use of technology in a classroom environment, has been customized and has taken the form of Web Pedagogical Content Knowledge. The Relational Screening Model was used in this study. It aims to determine whether a profile of preservice teachers…

The Predictive Role of Values and Perceived Social Support Variables in Marital Adjustment

ERIC Educational Resources Information Center

Mert, Abdullah

2018-01-01

The aim of this study was to examine the predictive role of values and perceived social support variables in marital adjustment level among married individuals. A total of 422 (211 pairs) married individuals who agreed to participate voluntarily were included. The study was conducted in accordance with the relational screening model. "Dyadic…

Supervision Anxiety as a Predictor for Organizational Cynicism in Teachers

ERIC Educational Resources Information Center

Gündüz, Hasan Basri; Ömür, Yunus Emre

2016-01-01

The purpose of this is study is to reveal how the anxiety that the teachers who work in the Beyoglu district of Istanbul experience, due to the supervision process, predict their organizational cynicism levels. With this respect, the study was conducted on 274 teachers with the relational screening model. The "Supervision Anxiety Scale"…

DEVELOPMENT AND TEST APPLICATION A SCREENING-LEVEL MERCURY FATE MODEL AND TOOL FOR EVALUATING WILDLIFE EXPOSURE RISK FOR SURFACE WATERS WITH MERCURY-CONTAMINATED SEDIMENTS (SERAFM)

EPA Science Inventory

Complex chemical cycling of mercury in aquatic ecosystems means that tracing the linkage between anthropogenic and natural loadings of mercury to watersheds and water bodies and associated concentrations in the environment are difficult to establish without the assistance of nume...

The Effect of Teachers' Shared Leadership Perception on Academic Optimism and Organizational Citizenship Behaviour: A Turkish Case

ERIC Educational Resources Information Center

Akin Kösterelioglu, Meltem

2017-01-01

Purpose: The present study investigates the capability of high school teachers' shared leadership perception to predict the academic optimism and organizational citizenship levels. Research methods: The population of the current descriptive study, which was conducted via screening model, consists of 321 high school teachers working for Amasya…

Examination of Job Satisfaction of the Medical Vocational High School Teachers

ERIC Educational Resources Information Center

Bayraktar, Hatice Vatansever; Güney, Burcu

2016-01-01

The aim of this study is to determine the job satisfaction level of Medical Vocational High School teachers and whether it differs according to different variables. The research was organized in accordance with the screening model. The population of the research was composed of vocational course teachers who worked in Medical Vocational High…

Performance indicators evaluation of the population-based breast cancer screening programme in Northern Portugal using the European Guidelines.

PubMed

Bento, Maria José; Gonçalves, Guilherme; Aguiar, Ana; Castro, Clara; Veloso, Vitor; Rodrigues, Vítor

2015-10-01

To evaluate the first 10 years of operation of the population-based breast cancer screening programme implemented in the Northern Region of Portugal, using selected recommended standard performance indicators. Data from women aged 50-69 screened with two-view mammography, biennially, in the period 2000-2009, were included. Main performance indicators were compared with the recommended levels of the European Guidelines. A total of 202,039 screening examinations were performed, 71,731 (35.5%) in the initial screening and 130,308 (64.5%) in the subsequent screening. Coverage rate by examination reached 74.3% of the target population, in the last period evaluated. Recall rates were 8.1% and 2.4% and cancer detection rates were 4.4/1000 and 2.9/1000 respectively, for initial and subsequent screenings. The breast cancer detection rate, expressed as a multiple of the background expected incidence was 3.1 in initial screen and 2.2 in subsequent screen. The incidence of invasive interval cancers met the desirable recommended levels both the first and second years since last screening examination, in the initial and subsequent screenings. Invasive tumours <15mm were 50.4% and 53.8% of the invasive cancers detected in initial and subsequent screenings. Less favourable size, grading and biomarkers expression were found in interval cancers compared to screen-detected cancers. Breast cancer screening programme in the Northern Region of Portugal was well accepted by the population. Most of the performance indicators were consistent with the desirable levels of the European Guidelines, which indicate an effective screening programme. Future research should verify the consistency of some of these results by using updated information from a larger population. Copyright © 2015 Elsevier Ltd. All rights reserved.

The utility of Google Trends data to examine interest in cancer screening

PubMed Central

Schootman, M; Toor, A; Cavazos-Rehg, P; Jeffe, D B; McQueen, A; Eberth, J; Davidson, N O

2015-01-01

Objectives We examined the utility of January 2004 to April 2014 Google Trends data from information searches for cancer screenings and preparations as a complement to population screening data, which are traditionally estimated through costly population-level surveys. Setting State-level data across the USA. Participants Persons who searched for terms related to cancer screening using Google, and persons who participated in the Behavioral Risk Factor Surveillance System (BRFSS). Primary and secondary outcome measures (1) State-level Google Trends data, providing relative search volume (RSV) data scaled to the highest search proportion per week (RSV100) for search terms over time since 2004 and across different geographical locations. (2) RSV of new screening tests, free/low-cost screening for breast and colorectal cancer, and new preparations for colonoscopy (Prepopik). (3) State-level breast, cervical, colorectal and prostate cancer screening rates. Results Correlations between Google Trends and BRFSS data ranged from 0.55 for ever having had a colonoscopy to 0.14 for having a Pap smear within the past 3 years. Free/low-cost mammography and colonoscopy showed higher RSV during their respective cancer awareness months. RSV for Miralax remained stable, while interest in Prepopik increased over time. RSV for lung cancer screening, virtual colonoscopy and three-dimensional mammography was low. Conclusions Google Trends data provides enormous scientific possibilities, but are not a suitable substitute for, but may complement, traditional data collection and analysis about cancer screening and related interests. PMID:26056120

Analysis of Parametric Adaptive Signal Detection with Applications to Radars and Hyperspectral Imaging

DTIC Science & Technology

2010-02-01

98 8.4.5 Training Screening ............................. .................................................................99 8.5 Experimental...associated with the proposed parametric model. Several im- portant issues are discussed, including model order selection, training screening , and time...parameters associated with the NS-AR model. In addition, we develop model order selection, training screening , and time-series based whitening and

A Prototype Model for Automating Nursing Diagnosis, Nurse Care Planning and Patient Classification.

DTIC Science & Technology

1986-03-01

Each diagnosis has an assessment level. Assessment levels are defining characteristics observed by the nurse or subjectively stated by the patient... characteristics of this order line. Select IV Order (Figure 4.l.1.le] is the first screen of a series of three. Select IV Order has up to 10 selections...For I F Upatient orders. Input Files Used: IVC.Scr and Procfile.Prg * Output Files Used: None Calling Routine: IUB.Prg * Routine Called: None

What are GPs' preferences for financial and non-financial incentives in cancer screening? Evidence for breast, cervical, and colorectal cancers.

PubMed

Sicsic, Jonathan; Krucien, Nicolas; Franc, Carine

2016-10-01

General practitioners (GPs) play a key role in the delivery of preventive and screening services for breast, cervical, and colorectal cancers. In practice, GPs' involvement varies considerably across types of cancer and among GPs, raising important questions about the determinants of GPs' implication in screening activities: what is the relative impact of financial and non-financial incentives? Are GPs' preferences for financial and non-financial incentives cancer-specific? Is there preference heterogeneity and how much does it differ according to the screening context? This study investigates the determinants of GPs' involvement in cancer screening activities using the discrete choice experiment (DCE) methodology. A representative sample of 402 GPs' was recruited in France between March and April 2014. Marginal rates of substitution were used to compare GPs' preferences for being involved in screening activities across three types of cancers: breast, cervical, and colorectal. Variability of preferences was investigated using Hierarchical Bayes mixed logit models. The results indicate that GPs are sensitive to both financial and non-financial incentives, such as a compensated training and systematic transmission of information about screened patients, aimed to facilitate communication between doctors and patients. There is also evidence that the level and variability of preferences differ across screening contexts, although the variations are not statistically significant on average. GPs appear to be relatively more sensitive to financial incentives for being involved in colorectal cancer screening, whereas they have higher and more heterogeneous preferences for non-financial incentives in breast and cervical cancers. Our study provides new findings for policymakers interested in prioritizing levers to increase the supply of cancer screening services in general practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

Factors Associated with Breast Cancer Screening in a Country with National Health Insurance: Did We Succeed in Reducing Healthcare Disparities?

PubMed

Hayek, Samah; Enav, Teena; Shohat, Tamy; Keinan-Boker, Lital

2017-02-01

The effectiveness of breast cancer screening programs in reducing mortality is well established in the scientific literature. The National Breast Cancer Screening Program in Israel provides biennial mammograms for women of average risk aged 50-74 and annual mammograms for women aged 40-49 at higher risk. Compliance is high, but differential. This study explores different factors associated with breast cancer screening attendance among women aged 40-74 years. Two main outcomes were studied: ever been screened and been screened in the 2 years preceding the study, using the cross-sectional Knowledge, Attitudes and Practices (KAP) Survey conducted in 2010-2012 among 2575 Israeli women aged 21+ years. The independent variables were sociodemographic characteristics, perceived health status, lifestyle habits, and healthcare fund membership. Bivariate and multivariable logistic regressions were conducted. Of the 943 participants aged 50-74, 87% had ever been screened and 74.8% had attended screening for breast cancer in the last 2 years. In multivariable models, Jewish compared to Arab women (adjusted prevalence ratio [APR] = 2.09, 95% confidence interval [CI]: 1.02-4.32), and unmarried compared to married women (APR = 2.9, 95% CI: 1.2-7.2), were more likely to have ever been screened. The only factor associated with breast cancer screening in the 2 years preceding the study was healthcare fund membership. In women aged 40-49 years, ethnicity was the only contributing factor associated with breast cancer screening, with higher screening rates in the 2 years preceding the study in Jewish versus Arab women (APR = 3.7, 95% CI: 1.52-9.3). Breast cancer screening attendance in Israel is high. However, significant differences are observed by membership of healthcare fund and by ethnicity, calling for better targeted outreach programs at this level.

Screening-Level Ecological Risk Assessment Methods, Revision 3

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mirenda, Richard J.

2012-08-16

This document provides guidance for screening-level assessments of potential adverse impacts to ecological resources from release of environmental contaminants at the Los Alamos National Laboratory (LANL or the Laboratory). The methods presented are based on two objectives, namely: to provide a basis for reaching consensus with regulators, managers, and other interested parties on how to conduct screening-level ecological risk investigations at the Laboratory; and to provide guidance for ecological risk assessors under the Environmental Programs (EP) Directorate. This guidance promotes consistency, rigor, and defensibility in ecological screening investigations and in reporting those investigation results. The purpose of the screening assessmentmore » is to provide information to the risk managers so informed riskmanagement decisions can be made. This document provides examples of recommendations and possible risk-management strategies.« less

Screening fifth forces in k-essence and DBI models

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brax, Philippe; Burrage, Clare; Davis, Anne-Christine, E-mail: Philippe.Brax@cea.fr, E-mail: Clare.Burrage@nottingham.ac.uk, E-mail: A.C.Davis@damtp.cam.ac.uk

New fifth forces have not yet been detected in the laboratory or in the solar system, hence it is typically difficult to introduce new light scalar fields that would mediate such forces. In recent years it has been shown that a number of non-linear scalar field theories allow for a dynamical mechanism, such as the Vainshtein and chameleon ones, that suppresses the strength of the scalar fifth force in experimental environments. This is known as screening, however it is unclear how common screening is within non-linear scalar field theories. k-essence models are commonly studied examples of non-linear models, with DBImore » as the best motivated example, and so we ask whether these non-linearities are able to screen a scalar fifth force. We find that a Vainshtein-like screening mechanism exists for such models although with limited applicability. For instance, we cannot find a screening mechanism for DBI models. On the other hand, we construct a large class of k-essence models which lead to the acceleration of the Universe in the recent past for which the fifth force mediated by the scalar can be screened.« less

Assessing the Key Attributes of Low Utilization of Mammography Screening and Breast-self Exam among African-American Women

PubMed Central

Chowdhury, Rupak; David, Nganwa; Bogale, Asseged; Nandy, Shami; Habtemariam, T.; Tameru, Berhanu

2016-01-01

PURPOSE: African-American (AA) women living in four Black Belt Counties (BBC) of Alabama; consisting of Barbour, Macon, Green and Wilcox are known to have lower mammogram utilization and breast self-exam rates when compared to their white female counterparts. The influence of socioeconomic and demographic factors on these disparities has not been clearly defined so far. Our study was designed to determine whether these observed disparities can be predicted with the socioeconomic and other demographic attributes. METHODS: Health Disparity Questionnaires data (n = 516) for BBC of Alabama was analyzed using a logistic regression model to examine the association of breast cancer screening rates and breast self-exam with income, the level of education, family doctor, type of health insurance, obesity, and age. RESULTS: Income, education, family doctor, age and health insurance were independent predictors for the low utilization rate of mammography and breast self-exam (BSE). CONCLUSION: Improving socioeconomic conditions such as level of education and availability of health care are essential to increase the rates of breast cancer screening test and breast self-exam in the BBC of Alabama. PMID:26958089

A Comparison of Parallel and Integrated Models for Implementation of Routine HIV Screening in a Large, Urban Emergency Department.

PubMed

Hankin, Abigail; Freiman, Heather; Copeland, Brittney; Travis, Natasha; Shah, Bijal

2016-01-01

This study compared two approaches for implementation of non-targeted HIV screening in the emergency department (ED): (1) designated HIV counselors screening in parallel with ED care and (2) nurse-based screening integrated into patient triage. A retrospective analysis was performed to compare parallel and integrated screening models using data from the first 12 months of each program. Data for the parallel screening model were extracted from information collected by HIV test counselors and the electronic medical record (EMR). Integrated screening model data were extracted from the EMR and supplemented by data collected by HIV social workers during patient interaction. For both programs, data included demographics, HIV test offer, test acceptance or declination, and test result. A Z-test between two proportions was performed to compare screening frequencies and results. During the first 12 months of parallel screening, approximately 120,000 visits were made to the ED, with 3,816 (3%) HIV tests administered and 65 (2%) new diagnoses of HIV infection. During the first 12 months of integrated screening, 111,738 patients were triaged in the ED, with 16,329 (15%) patients tested and 190 (1%) new diagnoses. Integrated screening resulted in an increased frequency of HIV screening compared with parallel screening (0.15 tests per ED patient visit vs. 0.03 tests per ED patient visit, p<0.001) and an increase in the absolute number of new diagnoses (190 vs. 65), representing a slight decrease in the proportion of new diagnoses (1% vs. 2%, p=0.007). Non-targeted, integrated HIV screening, with test offer and order by ED nurses during patient triage, is feasible and resulted in an increased frequency of HIV screening and a threefold increase in the absolute number of newly identified HIV-positive patients.

[Cost-effectiveness analysis of universal screening for thyroid disease in pregnant women in Spain].

PubMed

Donnay Candil, Sergio; Balsa Barro, José Antonio; Álvarez Hernández, Julia; Crespo Palomo, Carlos; Pérez-Alcántara, Ferrán; Polanco Sánchez, Carlos

2015-01-01

To assess the cost-effectiveness of universal screening for thyroid disease in pregnant women in Spain as compared to high risk screening and no screening. A decision-analytic model comparing the incremental cost per quality-adjusted life year (QALY) of universal screening versus high risk screening and versus no screening. was used for the pregnancy and postpartum period. Probabilities from randomized controlled trials were considered for adverse obstetrical outcomes. A Markov model was used to assess the lifetime period after the first postpartum year and account for development of overt hypothyroidism. The main assumptions in the model and use of resources were assessed by local clinical experts. The analysis considered direct healthcare costs only. Universal screening gained .011 QALYs over high risk screening and .014 QALYS over no screening. Total direct costs per patient were €5,786 for universal screening, €5,791 for high risk screening, and €5,781 for no screening. Universal screening was dominant compared to risk-based screening and a very cost-effective alternative as compared to no screening. Use of universal screening instead of high risk screening would result in €2,653,854 annual savings for the Spanish National Health System. Universal screening for thyroid disease in pregnant women in the first trimester is dominant in Spain as compared to risk-based screening, and is cost-effective as compared to no screening (incremental cost-effectiveness ratio of €374 per QALY). Moreover, it allows diagnosing and treating cases of clinical and subclinical hypothyroidism that may not be detected when only high-risk women are screened. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

High-throughput screening (HTS) and modeling of the retinoid ...

EPA Pesticide Factsheets

Presentation at the Retinoids Review 2nd workshop in Brussels, Belgium on the application of high throughput screening and model to the retinoid system Presentation at the Retinoids Review 2nd workshop in Brussels, Belgium on the application of high throughput screening and model to the retinoid system

Regional Screening Levels (RSLs)

EPA Pesticide Factsheets

Regional Screening Level RSL Home Page introduces risk assessors to Chemical Risk Assessment preliminary remediation goals PRG risk based concentration RBC and risk calculations for the assessment of human Health.

Modeling the Cost-Effectiveness of Alternative Upper Age Limits for Breast Cancer Screening in England and Wales.

PubMed

Rafia, Rachid; Brennan, Alan; Madan, Jason; Collins, Karen; Reed, Malcolm W R; Lawrence, Gill; Robinson, Thompson; Greenberg, David; Wyld, Lynda

2016-06-01

Currently in the United Kingdom, the National Health Service (NHS) Breast Screening Programme invites all women for triennial mammography between the ages of 47 and 73 years (the extension to 47-50 and 70-73 years is currently examined as part of a randomized controlled trial). The benefits and harms of screening in women 70 years and older, however, are less well documented. The aim of this study was to examine whether extending screening to women older than 70 years would represent a cost-effective use of NHS resources and to identify the upper age limit at which screening mammography should be extended in England and Wales. A mathematical model that allows the impact of screening policies on cancer diagnosis and subsequent management to be assessed was built. The model has two parts: a natural history model of the progression of breast cancer up to discovery and a postdiagnosis model of treatment, recurrence, and survival. The natural history model was calibrated to available data and compared against published literature. The management of breast cancer at diagnosis was taken from registry data and valued using official UK tariffs. The model estimated that screening would lead to overdiagnosis in 6.2% of screen-detected women at the age of 72 years, increasing up to 37.9% at the age of 90 years. Under commonly quoted willingness-to-pay thresholds in the United Kingdom, our study suggests that an extension to screening up to the age of 78 years represents a cost-effective strategy. This study provides encouraging findings to support the extension of the screening program to older ages and suggests that further extension of the UK NHS Breast Screening Programme up to age 78 years beyond the current upper age limit of 73 years could be potentially cost-effective according to current NHS willingness-to-pay thresholds. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Development of an objective tool for the diagnosis of myxedema coma.

PubMed

Chiong, Yien V; Bammerlin, Elaine; Mariash, Cary N

2015-09-01

Myxedema coma, a rare entity, with a reported 25%-65% mortality had no objective criteria for making the diagnosis when we began our study. We developed an objective screening tool for myxedema coma to more easily identify patients and examine the best treatment method in future prospective studies to reduce the mortality of this entity. We conducted a retrospective chart review to find all patients aged ≥18 years admitted with myxedema coma from January 1, 2005 through June 13, 2010 at Indiana University Health Methodist Hospital. On the basis of both our retrospective chart review and on literature accounts, we identified 6 criteria to diagnose myxedema coma. We identified 10 patients initially diagnosed with myxedema coma and established a control group consisting of 13 patients identified with altered mental status and increased thyroid-stimulating hormone (TSH) levels. The 6 variables we created for the screening tool were heart rate, temperature, Glasgow coma scale, TSH, free thyroxine, and precipitating factors. The screening tool has a sensitivity and specificity of about 80%. We ran a logistic regression model using the 10 study patients and 13 controls with the 6 variables. No variables alone significantly contributed to the model. However, the overall model was highly significant (P = 0.012), providing strong support for a scoring system that uses these variables simultaneously. This screening tool enables physicians to rapidly diagnose myxedema coma to expedite treatment. A more refined diagnostic tool may be used in future clinical studies designed to determine the optimal treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

Spanish translation and adaptation of Victoria Champion's Health Belief Model Scales for breast cancer screening--mammography.

PubMed

Medina-Shepherd, Rosario; Kleier, Jo Ann

2010-01-01

Victoria Champion used the constructs of the Health Belief Model as the foundation for developing Champion's Health Belief Scales for Mammography Screening (CHBMS). The instrument has been used to collect health beliefs about breast screening behaviors among various ethnic populations but has not been translated, adapted, or psychometrically evaluated in the Hispanic population. The purpose of this article was to report the translation and adaptation process from English to Spanish and the psychometric estimates of the validity and reliability of CHBMS-Spanish. The original instrument was translated from English to Spanish by a professional translator and back-translated into English by a focus group of healthcare professionals. The tool was given to 5 monolingual women to evaluate for content validity, translation validity, and cultural appropriateness. A total of 200 self-identified Hispanic women, literate in speaking and reading Spanish, aged 45 to 75 years, and without history of breast cancer were included in the analyses. The items of the scale formed coherent subsets that were relatively independent of each other and aligned to the 3 factors prescribed by the Health Belief Model constructs. Internal consistency values presented acceptable Cronbach alpha levels ranging from .69 to .83. Test-retest reliability correlations were .57 for susceptibility, .63 for benefits, and .83 for barriers. Overall, the Spanish version of CHBMS demonstrated acceptable preliminary values of reliability and validity. Further psychometric testing is recommended. The Spanish version of the CHBMS can be used by practicing nurses as an instrument to assess health beliefs concerning mammography screening among Spanish-speaking Hispanic women.

Productivity Savings from Colorectal Cancer Prevention and Control Strategies

PubMed Central

Bradley, Cathy J.; Lansdorp-Vogelaar, Iris; Yabroff, K. Robin; Dahman, Bassam; Mariotto, Angela; Feuer, Eric J.; Brown, Martin L.

2011-01-01

Background Lost productivity represents a considerable portion of the total economic burden of colorectal cancer (CRC), but cost-effectiveness studies of CRC prevention and control have not included these costs and therefore underestimate potential savings from CRC prevention and control. Purpose To use microsimulation modeling study to estimate and project productivity costs of CRC and to model the savings from four approaches to reducing CRC incidence and mortality: risk factor reduction, improved screening, improved treatment, and a simultaneous approach where all three strategies are implemented. Methods A model was developed to project productivity losses from CRC using the U.S. population with CRC incidence and mortality projected through the year 2020. Outcome measures were CRC mortality, morbidity, and productivity savings. Results With 2005 levels in risk factors, screening, and treatment, 48,748 CRC deaths occurred in 2010, amounting to $21 billion of lost productivity. Using prevention and treatment strategies simultaneously, 3586 deaths could have been avoided in 2010, leading to a savings of $1.4 billion. Cumulatively, by 2020, simultaneous strategies that reduce risk factors and increase screening and treatment could result in 101,353 deaths avoided and $33.9 billion in savings in reduced productivity loss. Improved screening rates alone led to nearly $14.7 billion in savings between 2005 and 2020, followed by risk factor reduction ($12.4 billion) and improved treatment ($8.4 billion). Conclusions The savings in productivity loss from strategies to reduce CRC incidence and mortality are substantial, providing evidence that CRC prevention and control strategies are likely to be cost-saving. PMID:21767717

Productivity savings from colorectal cancer prevention and control strategies.

PubMed

Bradley, Cathy J; Lansdorp-Vogelaar, Iris; Yabroff, K Robin; Dahman, Bassam; Mariotto, Angela; Feuer, Eric J; Brown, Martin L

2011-08-01

Lost productivity represents a considerable portion of the total economic burden of colorectal cancer (CRC), but cost-effectiveness studies of CRC prevention and control have not included these costs and therefore underestimate potential savings from CRC prevention and control. To use microsimulation modeling study to estimate and project productivity costs of CRC and to model the savings from four approaches to reducing CRC incidence and mortality: risk factor reduction, improved screening, improved treatment, and a simultaneous approach where all three strategies are implemented. A model was developed to project productivity losses from CRC using the U.S. population with CRC incidence and mortality projected through the year 2020. Outcome measures were CRC mortality, morbidity, and productivity savings. With 2005 levels in risk factors, screening, and treatment, 48,748 CRC deaths occurred in 2010, amounting to $21 billion of lost productivity. Using prevention and treatment strategies simultaneously, 3586 deaths could have been avoided in 2010, leading to a savings of $1.4 billion. Cumulatively, by 2020, simultaneous strategies that reduce risk factors and increase screening and treatment could result in 101,353 deaths avoided and $33.9 billion in savings in reduced productivity loss. Improved screening rates alone led to nearly $14.7 billion in savings between 2005 and 2020, followed by risk factor reduction ($12.4 billion) and improved treatment ($8.4 billion). The savings in productivity loss from strategies to reduce CRC incidence and mortality are substantial, providing evidence that CRC prevention and control strategies are likely to be cost-saving. Copyright © 2011 American Journal of Preventive Medicine. All rights reserved.

Applying Risk Prediction Models to Optimize Lung Cancer Screening: Current Knowledge, Challenges, and Future Directions.

PubMed

Sakoda, Lori C; Henderson, Louise M; Caverly, Tanner J; Wernli, Karen J; Katki, Hormuzd A

2017-12-01

Risk prediction models may be useful for facilitating effective and high-quality decision-making at critical steps in the lung cancer screening process. This review provides a current overview of published lung cancer risk prediction models and their applications to lung cancer screening and highlights both challenges and strategies for improving their predictive performance and use in clinical practice. Since the 2011 publication of the National Lung Screening Trial results, numerous prediction models have been proposed to estimate the probability of developing or dying from lung cancer or the probability that a pulmonary nodule is malignant. Respective models appear to exhibit high discriminatory accuracy in identifying individuals at highest risk of lung cancer or differentiating malignant from benign pulmonary nodules. However, validation and critical comparison of the performance of these models in independent populations are limited. Little is also known about the extent to which risk prediction models are being applied in clinical practice and influencing decision-making processes and outcomes related to lung cancer screening. Current evidence is insufficient to determine which lung cancer risk prediction models are most clinically useful and how to best implement their use to optimize screening effectiveness and quality. To address these knowledge gaps, future research should be directed toward validating and enhancing existing risk prediction models for lung cancer and evaluating the application of model-based risk calculators and its corresponding impact on screening processes and outcomes.

In-well time-of-travel approach to evaluate optimal purge duration during low-flow sampling of monitoring wells

USGS Publications Warehouse

Harte, Philip T.

2017-01-01

A common assumption with groundwater sampling is that low (<0.5 L/min) pumping rates during well purging and sampling captures primarily lateral flow from the formation through the well-screened interval at a depth coincident with the pump intake. However, if the intake is adjacent to a low hydraulic conductivity part of the screened formation, this scenario will induce vertical groundwater flow to the pump intake from parts of the screened interval with high hydraulic conductivity. Because less formation water will initially be captured during pumping, a substantial volume of water already in the well (preexisting screen water or screen storage) will be captured during this initial time until inflow from the high hydraulic conductivity part of the screened formation can travel vertically in the well to the pump intake. Therefore, the length of the time needed for adequate purging prior to sample collection (called optimal purge duration) is controlled by the in-well, vertical travel times. A preliminary, simple analytical model was used to provide information on the relation between purge duration and capture of formation water for different gross levels of heterogeneity (contrast between low and high hydraulic conductivity layers). The model was then used to compare these time–volume relations to purge data (pumping rates and drawdown) collected at several representative monitoring wells from multiple sites. Results showed that computation of time-dependent capture of formation water (as opposed to capture of preexisting screen water), which were based on vertical travel times in the well, compares favorably with the time required to achieve field parameter stabilization. If field parameter stabilization is an indicator of arrival time of formation water, which has been postulated, then in-well, vertical flow may be an important factor at wells where low-flow sampling is the sample method of choice.

The role of BPH, lower urinary tract symptoms, and PSA levels on erectile function of Brazilian men who undergo prostate cancer screening.

PubMed

Antunes, Alberto A; Srougi, Miguel; Dall'oglio, Marcos F; Vicentini, Fabio; Paranhos, Mario; Freire, Geraldo C

2008-07-01

Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are common problems in middle-aged and older men. Recently, epidemiologic studies have shown significant associations between severity of LUTS and male sexual dysfunction. We analyzed the role of prostate enlargement, LUTS, and prostate specific antigen (PSA) levels in the erectile function of Brazilian men who underwent prostate cancer (PCa) screening. We analyzed data from 1,008 consecutive patients enrolled in a PCa screening program. Benign prostatic hyperplasia (BPH) was defined as a prostate weight greater than 30 g as defined by digital rectal examination. For statistical analysis, we used the chi-squared and analysis of variance tests. The odds ratios (OR) for correlation of ED with prostate volume LUTS and PSA were estimated using logistic regression models. The American Urological Association (AUA) symptom score for LUTS and the International Index of Erectile Function. Mean patient age was 61.2 years (45-87) and median PSA value was 1.9 ng/mL. BPH was identified in 48.5% of patients. Mild, moderate, and severe LUTS were found in 52.3%, 30.9%, and 16.8% of cases, respectively. ED was classified as absent, mild, mild to moderate, moderate, and severe in 18.6%, 23.1%, 18.6%, 15.2%, and 24.5%, respectively. While only 5.4% of the patients with no ED presented severe LUTS, this finding was observed in 27.1% of patients with severe ED (P < 0.001). Univariate logistic regression analysis demonstrated that age, prostate volume, AUA symptom score, and PSA levels were significant predictors of ED. However, when controlled for patient age, only LUTS remained as an independent predictor of ED. Controlling for patient age, LUTS are independent risk factors for the development of ED among Brazilian men who undergo PCa screening. Antunes AA, Srougi M, Dall'Oglio MF, Vicentini F, Paranhos M, and Freire GC. The role of BPH, lower urinary tract symptoms, and PSA levels on erectile function of Brazilian men who undergo prostate cancer screening.

Estimating biodegradation half-lives for use in chemical screening.

PubMed

Aronson, Dallas; Boethling, Robert; Howard, Philip; Stiteler, William

2006-06-01

Biodegradation half-lives are needed for many applications in chemical screening, but these data are not available for most chemicals. To address this, in phase one of this work we correlated the much more abundant ready and inherent biodegradation test data with measured half-lives for water and soil. In phase two, we explored the utility of the BIOWIN models (in EPI Suite) and molecular fragments for predicting half-lives. BIOWIN model output was correlated directly with measured half-lives, and new models were developed by re-regressing the BIOWIN fragments against the half-lives. All of these approaches gave the best results when used for binary (fast/slow) classification of half-lives, with accuracy generally in the 70-80% range. In the last phase, we used the collected half-life data to examine the default half-lives assigned by EPI Suite and the PBT Profiler for use as input to their level III multimedia models. It is concluded that estimated half-lives should not be used for purposes other than binning or prioritizing chemicals unless accuracy improves significantly.

Elevated Blood Lead Levels by Length of Time From Resettlement to Health Screening in Kentucky Refugee Children.

PubMed

Kotey, Stanley; Carrico, Ruth; Wiemken, Timothy Lee; Furmanek, Stephen; Bosson, Rahel; Nyantakyi, Florence; VanHeiden, Sarah; Mattingly, William; Zierold, Kristina M

2018-02-01

To examine elevated blood lead levels (EBLLs) in refugee children by postrelocation duration with control for several covariates. We assessed EBLLs (≥ 5µg/dL) between 2012 and 2016 of children younger than 15 years (n = 1950) by the duration of resettlement to health screening by using logistic regression, with control for potential confounders (gender, region of birth, age of housing, and intestinal infestation) in a cross-sectional study. Prevalence of EBLLs was 11.2%. Length of time from resettlement to health screening was inversely associated with EBLLs (tertile 2 unadjusted odds ratio [OR] = 0.79; 95% confidence interval [CI] = 0.56, 1.12; tertile 3 OR = 0.62; 95% CI = 0.42, 0.90; tertile 2 adjusted odds ratio [AOR] = 0.62; 95% CI = 0.39, 0.97; tertile 3 AOR = 0.57; 95% CI = 0.34, 0.93). There was a significant interaction between intestinal infestation and age of housing (P < .003), indicating significant risk in the joint exposure of intestinal infestation (a pica proxy) and age of house. Elevated blood lead levels were reduced with increasing length of time of resettlement in unadjusted and adjusted models. Improved housing, early education, and effective safe-house inspections may be necessary to address EBLLs in refugees.

Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010

PubMed Central

Blencowe, Hannah; Lawn, Joy E.; Vazquez, Thomas; Fielder, Alistair; Gilbert, Clare

2013-01-01

Background: Retinopathy of prematurity (ROP) is a leading cause of potentially avoidable childhood blindness worldwide. We estimated ROP burden at the global and regional levels to inform screening and treatment programs, research, and data priorities. Methods: Systematic reviews and meta-analyses were undertaken to estimate the risk of ROP and subsequent visual impairment for surviving preterm babies by level of neonatal care, access to ROP screening, and treatment. A compartmental model was used to estimate ROP cases and numbers of visually impaired survivors. Results: In 2010, an estimated 184,700 (uncertainty range: 169,600–214,500) preterm babies developed any stage of ROP, 20,000 (15,500–27,200) of whom became blind or severely visually impaired from ROP, and a further 12,300 (8,300–18,400) developed mild/moderate visual impairment. Sixty-five percent of those visually impaired from ROP were born in middle-income regions; 6.2% (4.3–8.9%) of all ROP visually impaired infants were born at >32-wk gestation. Visual impairment from other conditions associated with preterm birth will affect larger numbers of survivors. Conclusion: Improved care, including oxygen delivery and monitoring, for preterm babies in all facility settings would reduce the number of babies affected with ROP. Improved data tracking and coverage of locally adapted screening/treatment programs are urgently required. PMID:24366462

A multivariate cure model for left-censored and right-censored data with application to colorectal cancer screening patterns.

PubMed

Hagar, Yolanda C; Harvey, Danielle J; Beckett, Laurel A

2016-08-30

We develop a multivariate cure survival model to estimate lifetime patterns of colorectal cancer screening. Screening data cover long periods of time, with sparse observations for each person. Some events may occur before the study begins or after the study ends, so the data are both left-censored and right-censored, and some individuals are never screened (the 'cured' population). We propose a multivariate parametric cure model that can be used with left-censored and right-censored data. Our model allows for the estimation of the time to screening as well as the average number of times individuals will be screened. We calculate likelihood functions based on the observations for each subject using a distribution that accounts for within-subject correlation and estimate parameters using Markov chain Monte Carlo methods. We apply our methods to the estimation of lifetime colorectal cancer screening behavior in the SEER-Medicare data set. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011

PubMed Central

2012-01-01

Background The London Boroughs of Lambeth and Southwark have high levels of sexually transmitted infections including Chlamydia trachomatis. Modelling studies suggest that reductions in the prevalence of chlamydia infection will require a high level of population screening coverage and positivity among those screened. General practice has a potentially important role to play in delivering these levels of coverage since large numbers (up to 60%) of young people visit their general practice every year but previous work suggests that there are barriers to delivering screening in this setting. The aim of this study was to evaluate an intervention to increase chlamydia screening in general practice within Primary Care Trusts (PCTs) of Lambeth and Southwark, a strategy combining financial incentives and supportive practice visits to raise awareness and solve problems. Methods Data on age, gender, venue and chlamydia result for tests on under 25 s in Lambeth from 2003–11 was obtained from the National Chlamydia Screening Programme. We analysed the number and percentage of tests generated in general practice, and looked at the number of practices screening more than 10% of their practice cohort of 15–24 year olds, male/female ratio and positivity rates across other screening venues. We also looked at practices screening less than 10% and studied change over time. We compared data from Lambeth and Southwark with London and England. We also studied features of the level and type of educational and financial incentive interventions employed. Results Chlamydia tests performed in general practice increased from 23 tests in 2003–4 to 4813 tests in 2010–11 in Lambeth. In Southwark they increased from 5 tests in 2003/04 to 4321 in 2010/11. In 2011, 44.6% of tests came from GPs in Lambeth and 46% from GP’s in Southwark. In Lambeth 62.7% of practices tested more than 10% of their cohort and in Southwark this was 55.8%. In Lambeth, postivity rate in 2010/11 was 5.8% in men and 6.0% in women. In Southwark positivity rate was 3.9% in men and 5.3% in women. In 2003/04 13% tests in general practice (Lambeth) were from men, this increased to 25% in 2010/11. In Southwark this increased from 20% in 2003/04 to 27.6% in 2010/11. We compared the results with London and national data and showed significant differences between GP testing in Lambeth and Southwark, and GP testing in London and the rest of England. Conclusions General practices can be important potential providers of chlamydia tests. With a combination of sustained support, financial incentives and feedback on performance, general practice may be able to test a large percentage of 15–24 year olds. General practice is also a potentially important provider of chlamydia tests to young men. PMID:22984897

Anxiety levels in women undergoing prenatal maternal serum screening for Down syndrome: the effect of a fast reporting system by mobile phone short-message service.

PubMed

Cheng, Po-Jen; Wu, Tzong-Lin; Shaw, Sheng-Wen; Chueh, Ho-Yen; Lin, Cheng-Tao; Hsu, Jenn-Jeih; Hsieh, T'sang-T'ang; Soong, Yung-Kuei

2008-05-01

To study the effect of fast reporting by mobile phone short-message service (SMS) on anxiety levels in women undergoing prenatal biochemical screening for Down syndrome. From January 2005 to December 2006, 2782 women undergoing prenatal biochemical serum screening were randomized into fast reporting by SMS (group A) or without mobile phone reporting (group B). Anxiety levels were measured with the Spielberger State-Trait Anxiety Inventory (STAI) before prenatal screen testing, before the appointed clinic (when the SMS report had already been given to group A), and 3 days after the appointed clinic (when the full screening report had been given to groups A and B). For screen-negative women, anxiety scores did not differ between groups before prenatal screen testing and 3 days after the appointed clinic. The state-anxiety scores measured on the second occasion had declined significantly in group A. The state-anxiety scores in both groups increased over the 3-week period after being informed of positive screen results. The trait- and state-anxiety scores at all points did not differ between the two groups of screen-positive women. The provision of a routine reporting system plus additional SMS report revealed some overall benefits in reducing anxiety among women with screen-negative result. 2008 John Wiley & Sons, Ltd

Shortcomings in bladder cancer etiology research and a model for its prevention.

PubMed

Radosavljevic, Vladan; Belojevic, Goran

2014-01-01

Bladder cancer (BC) is the most expensive cancer to treat. Its incidence and mortality have not decreased in the last three decades. Numerous uncertainties are still surrounding the etiology of BC. There is a need for a low-cost screening test for BC that would be applicable for early detection in asymptomatic persons, a test that would preferably be noninvasive and have satisfactory sensitivity and specificity. The first part of this paper addresses critical issues in the research into BC etiology, which we classified as entrances, toxicity and metabolism, amounts, and duration of exposure to carcinogens in the bladder. In the second part, based on the proven risk factors for BC, we present a simple scoring system as part of a new BC screening method. The heterogeneous results of studies on BC etiology are largely due to a lack of research into the compounds (and their mutual interactions) present in the urinary bladder, carcinogens absorbed through the skin and/or inhaled, and the daily dynamics of exposure to exogenous risk factors. We have calculated a score for BC screening which is an integral component of a new, four-level system of BC prevention. Interactions of carcinogens and their daily dynamics deserve more attention in further clarifying BC etiology. New attempts in BC screening should be focused on urine content analyses (carcinogens, antioxidants, vitamins, minerals) and not only on hematuria and currently used biomarkers. We propose a score for BC pre-evaluation and recruitment for screening and a new model of BC prevention.

Step-by-step guide to building an inexpensive 3D printed motorized positioning stage for automated high-content screening microscopy.

PubMed

Schneidereit, Dominik; Kraus, Larissa; Meier, Jochen C; Friedrich, Oliver; Gilbert, Daniel F

2017-06-15

High-content screening microscopy relies on automation infrastructure that is typically proprietary, non-customizable, costly and requires a high level of skill to use and maintain. The increasing availability of rapid prototyping technology makes it possible to quickly engineer alternatives to conventional automation infrastructure that are low-cost and user-friendly. Here, we describe a 3D printed inexpensive open source and scalable motorized positioning stage for automated high-content screening microscopy and provide detailed step-by-step instructions to re-building the device, including a comprehensive parts list, 3D design files in STEP (Standard for the Exchange of Product model data) and STL (Standard Tessellation Language) format, electronic circuits and wiring diagrams as well as software code. System assembly including 3D printing requires approx. 30h. The fully assembled device is light-weight (1.1kg), small (33×20×8cm) and extremely low-cost (approx. EUR 250). We describe positioning characteristics of the stage, including spatial resolution, accuracy and repeatability, compare imaging data generated with our device to data obtained using a commercially available microplate reader, demonstrate its suitability to high-content microscopy in 96-well high-throughput screening format and validate its applicability to automated functional Cl - - and Ca 2+ -imaging with recombinant HEK293 cells as a model system. A time-lapse video of the stage during operation and as part of a custom assembled screening robot can be found at https://vimeo.com/158813199. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Correlates of screen time among 8-19-year-old students in China.

PubMed

Ye, Sunyue; Chen, Lijian; Wang, Qineng; Li, Qinggong

2018-04-10

Previous studies have shown that prolonged time spent on screen-based sedentary behavior was significantly associated with lower health status in children, independent of physical activity levels. The study aimed to explore the individual and environmental correlates of screen time (ST) among 8-19-year-old students in China. The study surveyed ST using a self-administered questionnaire in Chinese students aged 8-19 years; 1063 participants were included in the final analysis. Individual and environmental correlates of ST were assessed using a mixed-effects model (for continuous outcome variables) and multiple logistic regression model (for binary outcome variables). Prolonged ST was observed in 14.7% of boys and 8.9% of girls. Of the ST, weekend and mobile phone/tablet use represented 80% and 40%, respectively. A positive relationship was observed between media accessibility and ST in both boys and girls (p < 0.05), whereas the presence of parents/others while using screens was a negative factor for longer ST (p < 0.05). Among the assessed correlates, access to a television (TV) in students' bedrooms was associated with prolonged total and weekend ST (p < 0.05 and p < 0.001, respectively). However, spending time on a mobile phone/tablet or a computer rather than viewing a TV, along with increased media accessibility, increased ST. These results indicate that greater media accessibility was positively associated and the presence of parents/others was negatively associated with prolonged ST in both Chinese boys and girls. Development of new and effective strategies against prolonged ST are required, especially for small screen device-based ST on weekends.

Validation of Models Used to Inform Colorectal Cancer Screening Guidelines: Accuracy and Implications.

PubMed

Rutter, Carolyn M; Knudsen, Amy B; Marsh, Tracey L; Doria-Rose, V Paul; Johnson, Eric; Pabiniak, Chester; Kuntz, Karen M; van Ballegooijen, Marjolein; Zauber, Ann G; Lansdorp-Vogelaar, Iris

2016-07-01

Microsimulation models synthesize evidence about disease processes and interventions, providing a method for predicting long-term benefits and harms of prevention, screening, and treatment strategies. Because models often require assumptions about unobservable processes, assessing a model's predictive accuracy is important. We validated 3 colorectal cancer (CRC) microsimulation models against outcomes from the United Kingdom Flexible Sigmoidoscopy Screening (UKFSS) Trial, a randomized controlled trial that examined the effectiveness of one-time flexible sigmoidoscopy screening to reduce CRC mortality. The models incorporate different assumptions about the time from adenoma initiation to development of preclinical and symptomatic CRC. Analyses compare model predictions to study estimates across a range of outcomes to provide insight into the accuracy of model assumptions. All 3 models accurately predicted the relative reduction in CRC mortality 10 years after screening (predicted hazard ratios, with 95% percentile intervals: 0.56 [0.44, 0.71], 0.63 [0.51, 0.75], 0.68 [0.53, 0.83]; estimated with 95% confidence interval: 0.56 [0.45, 0.69]). Two models with longer average preclinical duration accurately predicted the relative reduction in 10-year CRC incidence. Two models with longer mean sojourn time accurately predicted the number of screen-detected cancers. All 3 models predicted too many proximal adenomas among patients referred to colonoscopy. Model accuracy can only be established through external validation. Analyses such as these are therefore essential for any decision model. Results supported the assumptions that the average time from adenoma initiation to development of preclinical cancer is long (up to 25 years), and mean sojourn time is close to 4 years, suggesting the window for early detection and intervention by screening is relatively long. Variation in dwell time remains uncertain and could have important clinical and policy implications. © The Author(s) 2016.

Electron transport in high aspect ratio semiconductor nanowires and metal-semiconductor interfaces

NASA Astrophysics Data System (ADS)

Sun, Zhuting

We are facing variability problems for modern semiconductor transistors due to the fact that the performances of nominally identical devices in the scale of 10 100 nm could be dramatically different attributed to the small manufacturing variations. Different doping strategies give statistical variations in the number of dopant atom density ND in the channel. The material size gives variations in wire diameter dW. And the immediate environment of the material leads to an additional level of variability. E.g. vacuum-semiconductor interface causes variations in surface state density Ds, metal-semiconductor interface causes variations in Schottky barrier and dielectric semiconductor interface induces dielectric confinement at small scales. To approach these variability problems, I choose Si-doped GaAs nanowires as an example. I investigate transport in Si-doped GaAs nanowire (NW) samples contacted by lithographically patterned Gold-Titanium films as function of temperature T. I find a drastically different temperature dependence between the wire resistance RW, which is relatively weak, and the zero bias resistance RC, which is strong. I show that the data are consistent with a model based on a sharp donor energy level slightly above the bottom of the semiconductor conduction band and develop a simple method for using transport measurements for estimates of the doping density after nanowire growth. I discuss the predictions of effective free carrier density n eff as function of the surface state density Ds and wire size dW. I also describe a correction to the widely used model of Schottky contacts that improves thermodynamic consistency of the Schottky tunnel barrier profile and show that the original theory may underestimate the barrier conductance under certain conditions. I also provide analytical calculations for shallow silicon dopant energy in GaAs crystals, and find the presence of dielectrics (dielectric screening) and free carriers (Coulomb screening) cause a reduction of ionization energy and shift the donor energy level ED upward, accompanying conduction band EC shift downward due to band gap narrowing for doped semiconductor material. The theoretical results are in a reasonable agreement with previous experimental data. I also find that when the material reduces to nanoscale, dielectric confinement and surface depletion compete with both Coulomb screening and dielectric screening that shift the donor level ED down towards the band gap. The calculation should be appropriate for all types of semiconductors and dopant species.

Exploitation of the Apoptosis-Primed State of MYCN-Amplified Neuroblastoma to Develop a Potent and Specific Targeted Therapy Combination

PubMed Central

Ham, Jungoh; Costa, Carlotta; Sano, Renata; Lochmann, Timothy L.; Sennott, Erin M.; Patel, Neha U.; Dastur, Anahita; Gomez-Caraballo, Maria; Krytska, Kateryna; Hata, Aaron N.; Floros, Konstantinos V.; Hughes, Mark T.; Jakubik, Charles T.; Heisey, Daniel A.R.; Ferrell, Justin T.; Bristol, Molly L.; March, Ryan J.; Yates, Craig; Hicks, Mark A.; Nakajima, Wataru; Gowda, Madhu; Windle, Brad E.; Dozmorov, Mikhail G.; Garnett, Mathew J.; McDermott, Ultan; Harada, Hisashi; Taylor, Shirley M.; Morgan, Iain M.; Benes, Cyril H.; Engelman, Jeffrey A.; Mossé, Yael P.; Faber, Anthony C.

2016-01-01

Summary Fewer than half of children with high-risk neuroblastoma survive. Many of these tumors harbor high-level amplification of MYCN, which correlates with poor disease outcome. Using data from our large drug screen we predicted, and subsequently demonstrated, that MYCN-amplified neuroblastomas are sensitive to the BCL-2 inhibitor ABT-199. This sensitivity occurs in part through low anti-apoptotic BCL-xL expression, high pro-apoptotic NOXA expression, and paradoxical, MYCN-driven upregulation of NOXA. Screening for enhancers of ABT-199 sensitivity in MYCN-amplified neuroblastomas, we demonstrate that the Aurora Kinase A inhibitor MLN8237 combines with ABT-199 to induce widespread apoptosis. In diverse models of MYCN-amplified neuroblastoma, including a patient-derived xenograft model, this combination uniformly induced tumor shrinkage, and in multiple instances led to complete tumor regression. PMID:26859456

Regional Screening Levels (RSLs) - User's Guide

EPA Pesticide Factsheets

Regional Screening Level RSL user guide provides extensive guidance for risk assessors doing Chemical Risk Assessment preliminary remediation goal PRG risk based concentration RBC and rick calculations for the assess

[Psychopathology screening in medical school students].

PubMed

Galván-Molina, Jesús Francisco; Jiménez-Capdeville, María E; Hernández-Mata, José María; Arellano-Cano, José Ramón

2017-01-01

Screening of psychopathology and associated factors in medical students employing an electronic self-report survey. A transversal, observational, and comparative study that consisted of the following instruments: Sociodemographic survey; 2. Adult Self-Report Scale-V1 (ASRS); State-Trait Anxiety Inventory (STAI); Zung and Conde Self-Rating Depression Scale, Almonte-Herskovic Sexual Orientation Self-Report; Plutchik Suicide Risk Scale; Alcohol Use Disorders Identification Test Identification (AUDIT); Fagerström Test for Nicotine Dependence; 9. Maslach Burnout Inventory (MBI); Eating Disorder Inventory 2 (EDI). We gathered 323 student surveys from medical students of the first, third and sixth grades. The three more prevalent disorders were depression (24%), attention deficit disorders with hyperactivity (28%) and anxiety (13%); the prevalence of high-level burnout syndrome was 13%. Also, the fifth part of the students had detrimental use of tobacco and alcohol. Sixty percent of medical students had either one or more probable disorder or burnout. An adequate screening and treatment of this population could prevent severe mental disorders and the associated factors could help us to create a risk profile. This model is an efficient research tool for screening and secondary prevention.

Screening Effect of Plasma Flow on RMP Penetration in EXTRAP T2R

NASA Astrophysics Data System (ADS)

Frassinetti, Lorenzo; Olofsson, Erik; Brunsell, Per; Menmuir, Sheena; Drake, James

2011-10-01

The penetration of resonant magnetic perturbations (RMP) can be screened by plasma flow and the understanding of this phenomenon is important for ELM mitigation techniques. This work studies the screening effect in EXTRAP T2R. EXTRAP T2R is equipped with a feedback system able to suppress all error fields and to produce one or more external perturbations in a controlled fashion. The EXTRAP T2R feedback system is used to generate a RMP that interacts with the dynamics of its corresponding tearing mode (TM). The level of RMP penetration is quantified by analyzing the RMP effect on the TM amplitude and velocity. To study the screening effect, the flow is changed by applying a second perturbation that is non resonant (non-RMP). This produces the flow reduction without perturbing significantly the other parameters. By modifying the amplitude of the non-RMP, an experimental study of the flow effect on the RMP penetration is performed. Experimental results are compared with the model described in [Fitzpatrick R et al., Phys. Plasmas 8, 4489 (2001)].

Automated analysis of siRNA screens of cells infected by hepatitis C and dengue viruses based on immunofluorescence microscopy images

NASA Astrophysics Data System (ADS)

Matula, Petr; Kumar, Anil; Wörz, Ilka; Harder, Nathalie; Erfle, Holger; Bartenschlager, Ralf; Eils, Roland; Rohr, Karl

2008-03-01

We present an image analysis approach as part of a high-throughput microscopy siRNA-based screening system using cell arrays for the identification of cellular genes involved in hepatitis C and dengue virus replication. Our approach comprises: cell nucleus segmentation, quantification of virus replication level in the neighborhood of segmented cell nuclei, localization of regions with transfected cells, cell classification by infection status, and quality assessment of an experiment and single images. In particular, we propose a novel approach for the localization of regions of transfected cells within cell array images, which combines model-based circle fitting and grid fitting. By this scheme we integrate information from single cell array images and knowledge from the complete cell arrays. The approach is fully automatic and has been successfully applied to a large number of cell array images from screening experiments. The experimental results show a good agreement with the expected behaviour of positive as well as negative controls and encourage the application to screens from further high-throughput experiments.

Participant selection for lung cancer screening by risk modelling (the Pan-Canadian Early Detection of Lung Cancer [PanCan] study): a single-arm, prospective study.

PubMed

Tammemagi, Martin C; Schmidt, Heidi; Martel, Simon; McWilliams, Annette; Goffin, John R; Johnston, Michael R; Nicholas, Garth; Tremblay, Alain; Bhatia, Rick; Liu, Geoffrey; Soghrati, Kam; Yasufuku, Kazuhiro; Hwang, David M; Laberge, Francis; Gingras, Michel; Pasian, Sergio; Couture, Christian; Mayo, John R; Nasute Fauerbach, Paola V; Atkar-Khattra, Sukhinder; Peacock, Stuart J; Cressman, Sonya; Ionescu, Diana; English, John C; Finley, Richard J; Yee, John; Puksa, Serge; Stewart, Lori; Tsai, Scott; Haider, Ehsan; Boylan, Colm; Cutz, Jean-Claude; Manos, Daria; Xu, Zhaolin; Goss, Glenwood D; Seely, Jean M; Amjadi, Kayvan; Sekhon, Harmanjatinder S; Burrowes, Paul; MacEachern, Paul; Urbanski, Stefan; Sin, Don D; Tan, Wan C; Leighl, Natasha B; Shepherd, Frances A; Evans, William K; Tsao, Ming-Sound; Lam, Stephen

2017-11-01

Results from retrospective studies indicate that selecting individuals for low-dose CT lung cancer screening on the basis of a highly predictive risk model is superior to using criteria similar to those used in the National Lung Screening Trial (NLST; age, pack-year, and smoking quit-time). We designed the Pan-Canadian Early Detection of Lung Cancer (PanCan) study to assess the efficacy of a risk prediction model to select candidates for lung cancer screening, with the aim of determining whether this approach could better detect patients with early, potentially curable, lung cancer. We did this single-arm, prospective study in eight centres across Canada. We recruited participants aged 50-75 years, who had smoked at some point in their life (ever-smokers), and who did not have a self-reported history of lung cancer. Participants had at least a 2% 6-year risk of lung cancer as estimated by the PanCan model, a precursor to the validated PLCOm2012 model. Risk variables in the model were age, smoking duration, pack-years, family history of lung cancer, education level, body-mass index, chest x-ray in the past 3 years, and history of chronic obstructive pulmonary disease. Individuals were screened with low-dose CT at baseline (T0), and at 1 (T1) and 4 (T4) years post-baseline. The primary outcome of the study was incidence of lung cancer. This study is registered with ClinicalTrials.gov, number NCT00751660. 7059 queries came into the study coordinating centre and were screened for PanCan risk. 15 were duplicates, so 7044 participants were considered for enrolment. Between Sept 24, 2008, and Dec 17, 2010, we recruited and enrolled 2537 eligible ever-smokers. After a median follow-up of 5·5 years (IQR 3·2-6·1), 172 lung cancers were diagnosed in 164 individuals (cumulative incidence 0·065 [95% CI 0·055-0·075], incidence rate 138·1 per 10 000 person-years [117·8-160·9]). There were ten interval lung cancers (6% of lung cancers and 6% of individuals with cancer): one diagnosed between T0 and T1, and nine between T1 and T4. Cumulative incidence was significantly higher than that observed in NLST (4·0%; p<0·0001). Compared with 593 (57%) of 1040 lung cancers observed in NLST, 133 (77%) of 172 lung cancers in the PanCan Study were early stage (I or II; p<0·0001). The PanCan model was effective in identifying individuals who were subsequently diagnosed with early, potentially curable, lung cancer. The incidence of cancers detected and the proportion of early stage cancers in the screened population was higher than observed in previous studies. This approach should be considered for adoption in lung cancer screening programmes. Terry Fox Research Institute and Canadian Partnership Against Cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

The impact of preventive screening resource distribution on geographic and population-based disparities in colorectal cancer in Mississippi.

PubMed

Faruque, Fazlay S; Zhang, Xu; Nichols, Elizabeth N; Bradley, Denae L; Reeves-Darby, Royce; Reeves-Darby, Vonda; Duhé, Roy J

2015-09-08

The state of Mississippi has the highest colorectal cancer (CRC) mortality rate in the USA. The geographic distribution of CRC screening resources and geographic- and population-based CRC characteristics in Mississippi are investigated to reveal the geographic disparity in CRC screening. The primary practice sites of licensed gastroenterologists and the addresses of licensed medical facilities offering on-site colonoscopies were verified via telephone surveys, then these CRC screening resource data were geocoded and analyzed using Geographic Information Systems. Correlation analyses were performed to detect the strength of associations between CRC screening resources, CRC screening behavior and CRC outcome data. Age-adjusted colorectal cancer incidence rates, mortality rates, mortality-to-incidence ratios, and self-reported endoscopic screening rates from the years 2006 through 2010 were significantly different for Black and White Mississippians; Blacks fared worse than Whites in all categories throughout all nine Public Health Districts. CRC screening rates were negatively correlated with CRC incidence rates and CRC mortality rates. The availability of gastroenterologists varied tremendously throughout the state; regions with the poorest CRC outcomes tended to be underserved by gastroenterologists. Significant population-based and geographic disparities in CRC screening behaviors and CRC outcomes exist in Mississippi. The effects of CRC screening resources are related to CRC screening behaviors and outcomes at a regional level, whereas at the county level, socioeconomic factors are more strongly associated with CRC outcomes. Thus, effective control of CRC in rural states with high poverty levels requires both adequate preventive CRC screening capacity and a strategy to address fundamental causes of health care disparities.

Verification of screening level for decontamination implemented after Fukushima nuclear accident

PubMed Central

Ogino, Haruyuki; Ichiji, Takeshi; Hattori, Takatoshi

2012-01-01

The screening level for decontamination that has been applied for the surface of the human body and contaminated handled objects after the Fukushima nuclear accident was verified by assessing the doses that arise from external irradiation, ingestion, inhalation and skin contamination. The result shows that the annual effective dose that arises from handled objects contaminated with the screening level for decontamination (i.e. 100 000 counts per minute) is <1 mSv y−1, which can be considered as the intervention exemption level in accordance with the International Commission on Radiological Protection recommendations. Furthermore, the screening level is also found to protect the skin from the incidence of a deterministic effect because the absorbed dose of the skin that arises from direct deposition on the surface of the human body is calculated to be lower than the threshold of the deterministic effect assuming a practical exposure duration. PMID:22228683

Effect of vibration on retention characteristics of screen acquisition systems. [for surface tension propellant acquisition

NASA Technical Reports Server (NTRS)

Tegart, J. R.; Aydelott, J. C.

1978-01-01

The design of surface tension propellant acquisition systems using fine-mesh screen must take into account all factors that influence the liquid pressure differentials within the system. One of those factors is spacecraft vibration. Analytical models to predict the effects of vibration have been developed. A test program to verify the analytical models and to allow a comparative evaluation of the parameters influencing the response to vibration was performed. Screen specimens were tested under conditions simulating the operation of an acquisition system, considering the effects of such parameters as screen orientation and configuration, screen support method, screen mesh, liquid flow and liquid properties. An analytical model, based on empirical coefficients, was most successful in predicting the effects of vibration.

Drug screening using model systems: some basics

PubMed Central

2016-01-01

ABSTRACT An increasing number of laboratories that focus on model systems are considering drug screening. Executing a drug screen is complicated enough. But the path for moving initial hits towards the clinic requires a different knowledge base and even a different mindset. In this Editorial I discuss the importance of doing some homework before you start screening. 'Lead hits', 'patentable chemical space' and 'druggability' are all concepts worth exploring when deciding which screening path to take. I discuss some of the lessons I learned that may be useful as you navigate the screening matrix. PMID:27821602

The utility of Google Trends data to examine interest in cancer screening.

PubMed

Schootman, M; Toor, A; Cavazos-Rehg, P; Jeffe, D B; McQueen, A; Eberth, J; Davidson, N O

2015-06-08

We examined the utility of January 2004 to April 2014 Google Trends data from information searches for cancer screenings and preparations as a complement to population screening data, which are traditionally estimated through costly population-level surveys. State-level data across the USA. Persons who searched for terms related to cancer screening using Google, and persons who participated in the Behavioral Risk Factor Surveillance System (BRFSS). (1) State-level Google Trends data, providing relative search volume (RSV) data scaled to the highest search proportion per week (RSV100) for search terms over time since 2004 and across different geographical locations. (2) RSV of new screening tests, free/low-cost screening for breast and colorectal cancer, and new preparations for colonoscopy (Prepopik). (3) State-level breast, cervical, colorectal and prostate cancer screening rates. Correlations between Google Trends and BRFSS data ranged from 0.55 for ever having had a colonoscopy to 0.14 for having a Pap smear within the past 3 years. Free/low-cost mammography and colonoscopy showed higher RSV during their respective cancer awareness months. RSV for Miralax remained stable, while interest in Prepopik increased over time. RSV for lung cancer screening, virtual colonoscopy and three-dimensional mammography was low. Google Trends data provides enormous scientific possibilities, but are not a suitable substitute for, but may complement, traditional data collection and analysis about cancer screening and related interests. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Knowledge, Attitude and Practice Regarding Cervical Cancer Screening Among Women Attending a Teaching Hospital, Bharatpur, Chitwan.

PubMed

Shrestha, Smita; Dhakal, Prativa

2017-03-01

Objective: To find out the knowledge, attitude and practice regarding cervical cancer screening among women. Materials and methods: A descriptive cross-sectional study design was used to collect data from 96 women. Each woman was selected alternately from Gynae Out-Patient Department of Teaching Hospital. Data was collected by using semi-structured interview schedule to find out knowledge and practice and Likert scale to find out the attitude regarding cervical cancer screening. Data was analyzed by using SPSS version 20.0 and interpreted in terms of descriptive and inferential statistics. Results: Out of 96 women, mean age was 38.83 ± 6.57 and 90.6% respondents followed Hinduism. More than three fourth (85.4%) were literate and 59.4% were housewife. Only 9.4% were involved in cervical cancer prevention and screening awareness programme and 2.1% had family history of cervical cancer. As per the findings, only 34.4% and 27.8% had adequate knowledge and practice respectively whereas cent percent women had favorable attitude. Only education level of women was statistically significant with level of knowledge regarding cervical cancer screening (p = 0.041). There was strong negative correlation between knowledge score and practice score regarding cervical cancer screening among women (r = -0.194). Conclusion: Considerable proportions of women have inadequate knowledge and practice regarding cervical cancer screening. Therefore cervical cancer screening health camps and awareness program should be conducted at community level for women to increase the level of knowledge and practice regarding cervical cancer screening.

Knowledge, Attitude and Practice Regarding Cervical Cancer Screening Among Women Attending a Teaching Hospital, Bharatpur, Chitwan

PubMed Central

Shrestha, Smita; Dhakal, Prativa

2017-01-01

Objective: To find out the knowledge, attitude and practice regarding cervical cancer screening among women. Materials and methods: A descriptive cross-sectional study design was used to collect data from 96 women. Each woman was selected alternately from Gynae Out-Patient Department of Teaching Hospital. Data was collected by using semi-structured interview schedule to find out knowledge and practice and Likert scale to find out the attitude regarding cervical cancer screening. Data was analyzed by using SPSS version 20.0 and interpreted in terms of descriptive and inferential statistics. Results: Out of 96 women, mean age was 38.83 ± 6.57 and 90.6% respondents followed Hinduism. More than three fourth (85.4%) were literate and 59.4% were housewife. Only 9.4% were involved in cervical cancer prevention and screening awareness programme and 2.1% had family history of cervical cancer. As per the findings, only 34.4% and 27.8% had adequate knowledge and practice respectively whereas cent percent women had favorable attitude. Only education level of women was statistically significant with level of knowledge regarding cervical cancer screening (p = 0.041). There was strong negative correlation between knowledge score and practice score regarding cervical cancer screening among women (r = -0.194). Conclusion: Considerable proportions of women have inadequate knowledge and practice regarding cervical cancer screening. Therefore cervical cancer screening health camps and awareness program should be conducted at community level for women to increase the level of knowledge and practice regarding cervical cancer screening. PMID:29114264

Primary Care Provider Practices and Perceptions Regarding HPV Vaccination and Anal Cancer Screening at a Boston Community Health Center.

PubMed

Apaydin, Kaan Z; Fontenot, Holly B; Shtasel, Derri L; Mayer, Kenneth H; Keuroghlian, Alex S

2018-02-26

Human papillomavirus (HPV) vaccination and anal cancer screening are valuable, yet underutilized, tools in prevention of HPV-related cancers among sexual and gender minority (SGM) populations. The aim of this study was to characterize primary care providers' (PCPs) practices and perceptions pertaining to HPV vaccination and anal cancer screening. A survey assessing self-reported practice characteristics related to HPV vaccination and anal cancer screening, as well as perceived barriers to vaccination and anal cancer screening at the patient-, provider-, and system-level was distributed to PCPs at a Federally-Qualified Health Center that specializes in care for SGM populations in the greater Boston area. A total of 33 PCPs completed the survey. All PCPs strongly recommended HPV vaccination to their patients by emphasizing that the vaccine is extremely important or very important. Most PCPs told their patients that the HPV vaccine prevents cervical cancer (96.9%), anal cancer (96.9%), oropharyngeal cancer (72.7%), penile cancer (57.5%), and genital warts (63.6%). There is substantial variability among providers regarding recommendations for anal cancer screening and follow-up. Most PCPs perceived that patient-level factors such as poverty, mental illness, and substance use disorders were barriers to HPV vaccination and anal cancer screening. Systems-level barriers such as lack of clinical time with each patient and lack of staffing were also described as barriers to vaccination and screening. Patient-, provider- and systems-level improvements are important to increase HPV vaccination and anal cancer screening rates.

Development of in vitro-in vivo correlation for extended-release niacin after administration of hypromellose-based matrix formulations to healthy volunteers.

PubMed

Kesisoglou, Filippos; Rossenu, Stefaan; Farrell, Colm; Van Den Heuvel, Michiel; Prohn, Marita; Fitzpatrick, Shaun; De Kam, Pieter-Jan; Vargo, Ryan

2014-11-01

Development of in vitro-in vivo correlations (IVIVCs) for extended-release (ER) products is commonly pursued during pharmaceutical development to increase product understanding, set release specifications, and support biowaivers. This manuscript details the development of Level C and Level A IVIVCs for ER formulations of niacin, a highly variable and extensively metabolized compound. Three ER formulations were screened in a cross-over study against immediate-release niacin. A Multiple Level C IVIVC was established for both niacin and its primary metabolite nicotinuric acid (NUA) as well as total niacin metabolites urinary excretion. For NUA, but not for niacin, Level A IVIVC models with acceptable prediction errors were achievable via a modified IVIVC rather than a traditional deconvolution/convolution approach. Hence, this is in contradiction with current regulatory guidelines that suggest that when a Multiple Level C IVIVC is established, Level A models should also be readily achievable. We demonstrate that for a highly variable, highly metabolized compound such as niacin, development of a Level A IVIVC model fully validated according to agency guidelines may be challenging. However, Multiple Level C models are achievable and could be used to guide release specifications and formulation/manufacturing changes. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement.

PubMed

Bibbins-Domingo, Kirsten; Grossman, David C; Curry, Susan J; Davidson, Karina W; Epling, John W; García, Francisco A R; Gillman, Matthew W; Harper, Diane M; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Owens, Douglas K; Phillips, William R; Phipps, Maureen G; Pignone, Michael P; Siu, Albert L

2016-06-21

Colorectal cancer is the second leading cause of cancer death in the United States. In 2016, an estimated 134,000 persons will be diagnosed with the disease, and about 49,000 will die from it. Colorectal cancer is most frequently diagnosed among adults aged 65 to 74 years; the median age at death from colorectal cancer is 68 years. To update the 2008 US Preventive Services Task Force (USPSTF) recommendation on screening for colorectal cancer. The USPSTF reviewed the evidence on the effectiveness of screening with colonoscopy, flexible sigmoidoscopy, computed tomography colonography, the guaiac-based fecal occult blood test, the fecal immunochemical test, the multitargeted stool DNA test, and the methylated SEPT9 DNA test in reducing the incidence of and mortality from colorectal cancer or all-cause mortality; the harms of these screening tests; and the test performance characteristics of these tests for detecting adenomatous polyps, advanced adenomas based on size, or both, as well as colorectal cancer. The USPSTF also commissioned a comparative modeling study to provide information on optimal starting and stopping ages and screening intervals across the different available screening methods. The USPSTF concludes with high certainty that screening for colorectal cancer in average-risk, asymptomatic adults aged 50 to 75 years is of substantial net benefit. Multiple screening strategies are available to choose from, with different levels of evidence to support their effectiveness, as well as unique advantages and limitations, although there are no empirical data to demonstrate that any of the reviewed strategies provide a greater net benefit. Screening for colorectal cancer is a substantially underused preventive health strategy in the United States. The USPSTF recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years (A recommendation). The decision to screen for colorectal cancer in adults aged 76 to 85 years should be an individual one, taking into account the patient's overall health and prior screening history (C recommendation).

Application of ToxCast High-Throughput Screening and ...

EPA Pesticide Factsheets

Slide presentation at the SETAC annual meeting on High-Throughput Screening and Modeling Approaches to Identify Steroidogenesis Distruptors Slide presentation at the SETAC annual meeting on High-Throughput Screening and Modeling Approaches to Identify Steroidogenssis Distruptors

Carbon monoxide screen for signalized intersections COSIM, version 3.0 : technical documentation.

DOT National Transportation Integrated Search

2008-07-01

The Illinois Department of Transportation (IDOT) currently uses the computer screening model Illinois : CO Screen for Intersection Modeling (COSIM) to estimate worst-case CO concentrations for proposed roadway : projects affecting signalized intersec...

Head-to-Head Comparison and Evaluation of 92 Plasma Protein Biomarkers for Early Detection of Colorectal Cancer in a True Screening Setting.

PubMed

Chen, Hongda; Zucknick, Manuela; Werner, Simone; Knebel, Phillip; Brenner, Hermann

2015-07-15

Novel noninvasive blood-based screening tests are strongly desirable for early detection of colorectal cancer. We aimed to conduct a head-to-head comparison of the diagnostic performance of 92 plasma-based tumor-associated protein biomarkers for early detection of colorectal cancer in a true screening setting. Among all available 35 carriers of colorectal cancer and a representative sample of 54 men and women free of colorectal neoplasms recruited in a cohort of screening colonoscopy participants in 2005-2012 (N = 5,516), the plasma levels of 92 protein biomarkers were measured. ROC analyses were conducted to evaluate the diagnostic performance. A multimarker algorithm was developed through the Lasso logistic regression model and validated in an independent validation set. The .632+ bootstrap method was used to adjust for the potential overestimation of diagnostic performance. Seventeen protein markers were identified to show statistically significant differences in plasma levels between colorectal cancer cases and controls. The adjusted area under the ROC curves (AUC) of these 17 individual markers ranged from 0.55 to 0.70. An eight-marker classifier was constructed that increased the adjusted AUC to 0.77 [95% confidence interval (CI), 0.59-0.91]. When validating this algorithm in an independent validation set, the AUC was 0.76 (95% CI, 0.65-0.85), and sensitivities at cutoff levels yielding 80% and 90% specificities were 65% (95% CI, 41-80%) and 44% (95% CI, 24-72%), respectively. The identified profile of protein biomarkers could contribute to the development of a powerful multimarker blood-based test for early detection of colorectal cancer. ©2015 American Association for Cancer Research.

Ambient volatile organic compounds (VOCs) in Calgary, Alberta: Sources and screening health risk assessment.

PubMed

Bari, Md Aynul; Kindzierski, Warren B

2018-08-01

Exposure to ambient volatile organic compound (VOCs) in urban areas is of interest because of their potential chronic and acute adverse effects to public health. Limited information is available about VOC sources in urban areas in Canada. An investigation of ambient VOCs levels, their potential sources and associated risks to public health was undertaken for the urban core of Alberta's largest city (downtown Calgary) for the period 2010-2015. Twenty-four hour arithmetic and geometric mean concentrations of total VOCs were 42μg/m 3 and 39μg/m 3 , respectively and ranged from 16 to 160μg/m 3 , with winter levels about two-fold higher than summer. Alkanes (58%) were the most dominant compounds followed by halogenated VOCs (22%) and aromatics (11%). Mean and maximum 24h ambient concentrations of selected VOCs of public health concern were below chronic and acute health risk screening criteria of the United States regulatory agencies and a cancer screening benchmark used in Alberta equivalent to 1 in 100,000 lifetime risk. The Positive matrix factorization (PMF) model revealed nine VOC sources at downtown Calgary, where oil/natural gas extraction/combustion (26%), fuel combustion (20%), traffic sources including gasoline exhaust, diesel exhaust, mixed fugitive emissions (10-15%), and industrial coatings/solvents (12%) were predominant. Other sources included dry cleaning (3.3%), biogenic (3.5%) and a background source (18%). Source-specific health risk values were also estimated. Estimated cancer risks for all sources were below the Alberta cancer screening benchmark, and estimated non-cancer risks for all sources were well below a safe level. Copyright © 2018 Elsevier B.V. All rights reserved.