Search results for: screening test

Authors: Tarek K. Jalouta, Jolietta R. Holliman, Kathryn R. Burke, Kathleen M. Bewley-Thomas

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Background: Chronic hepatitis C virus (HCV) infection is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. In the United States, HCV screening awareness, treatment, and linkage to care are under continues ascending progress. However, still millions of people are asymptomatically infected and undiagnosed yet. Through this community mission, we sought to identify the best and the newest strategies to identify those infected people to educate them, link them to care and cure them. Methods: We have identified patients that did not have a prior HCV screening in our Electronic medical record (EMR) including all our different hospital locations (South Suburban Chicago, Northern, Western and Central Indiana). Providing education to all Primary care/Gastroenterology/Infectious diseases providers and staff in the clinic to increase awareness of the HCV screening. Health-related quality of life, chronic clinical complications, and demographics data were collected for each patient. All outcomes of HCV antibody-reactive and HCV RNA–positive results were identified and statistically analyzed. Results: From July 2016 to July 2018 we screened 35,720 individuals of birth cohort in our different Franciscan’s health medical centers. Of the screened population, 986 (2.7%) individuals were HCV AB-reactive. Of those, 319 (1%) patients were HCV RNA-positive, and 264 patients were counseled and linked to providers. 34 patients initiated anti-HCV therapy with successful treatment. Conclusions: Our HCV screening augmentation project considered the largest screening program in the Midwest. Augmenting the HCV screening process through creating a Best Practice Alert (BPA) in the EMR (Epic Sys.) and point of care testing could be helpful. Although continued work is required, our team is working on increase screening through adding HCV test to CBC-Panels in Emergency Department settings, phone calls to all birth cohort individuals through Robo-Calling System aimed to reach 75,000 individuals by 2019. However, a better linkage to care and referral monitoring system to all HCV RNA positive patients is still needed, and access to therapy, especially for uninsured patients, is challenging.

Keywords: chronic hepatitis C, chronic hepatitis C treatment, chronic hepatitis C screening, chronic hepatitis C prevention, liver cancer

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Authors: Fatma Acheuk, Akila Hamichi, Siham Semmar

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The crude ethanolic extract from Solenostemma argel was obtained by maceration of leaves and stems of the plant. Phytochimical study revealed the richness of the species on flavonoids, alkaloids, tannins and glycosides. Antimicrobial activity of the growth of clinical isolates of Eschirichia coli, Pseudomonas aeriginosa, Staphylococus aureus and Bacillus Subtilis was carried out using agar disc diffusion. The results of the study revealed that the test compound has antimicrobial activity against gram-positive bacteria which are resistant to commonly antimicrobial agents used. However, no effect was observed on other species tested.

Keywords: Solenostemma argel, crude extract, phytochemical screening, antimicrobial activity

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Authors: S. Sudhakar, Geetha Manjunath, Siva Teja Kakileti, Himanshu Madhu

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Diagnosis of breast cancer at early stages has seen better clinical and survival outcomes. Survival rates in developing countries like India are very low due to accessibility and affordability issues of screening tests such as Mammography. In addition, Mammography is not much effective in younger women with dense breasts. This leaves a gap in current screening methods. Thermalytix is a new technique for detecting breast abnormality in a non-contact, non-invasive way. It is an AI-enabled computer-aided diagnosis solution that automates interpretation of high resolution thermal images and identifies potential malignant lesions. The solution is low cost, easy to use, portable and is effective in all age groups. This paper presents the results of a retrospective comparative analysis of Thermalytix over Mammography and Clinical Breast Examination for breast cancer screening. Thermalytix was found to have better sensitivity than both the tests, with good specificity as well. In addition, Thermalytix identified all malignant patients without palpable lumps.

Keywords: breast cancer screening, radiology, thermalytix, artificial intelligence, thermography

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Authors: Folajinmi Oluwasina, Towolawi Adetayo, Kate Ssamula, Penninah Iutung, Daniel Reijer

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Objective: Routine HIV screening has been promoted as an essential component of efforts to reduce incidence, morbidity, and mortality. The objectives of this study were to identify the optimal annual volume needed to realize the public health goals of HIV screening in the AIDS Healthcare Foundation supported hospitals and establish an implementation process to realize that optimal annual volume. Methods: Starting in 2011 a program was established to routinize HIV screening within communities and government hospitals. In 2016 Five-years of HIV screening data were reviewed to identify the optimal annual proportions of age-eligible patients screened to realize the public health goals of reducing new diagnoses and ending late-stage diagnosis (tracked as concurrent HIV/AIDS diagnosis). Analysis demonstrated that rates of new diagnoses level off when 42% of age-eligible patients were screened, providing a baseline for routine screening efforts; and concurrent HIV/AIDS diagnoses reached statistical zero at screening rates of 70%. Annual facility based targets were re-structured to meet these new target volumes. Restructuring efforts focused on right-sizing HIV screening programs to align and transition programs to integrated HIV screening within standard medical care and treatment. Results: Over one million patients were screened for HIV during the five years; 16, 033 new HIV diagnoses and access to care and treatment made successfully for 82 % (13,206), and concurrent diagnosis rates went from 32.26% to 25.27%. While screening rates increased by 104.7% over the 5-years, volume analysis demonstrated that rates need to further increase by 62.52% to reach desired 20% baseline and more than double to reach optimal annual screening volume. In 2011 facility targets for HIV screening were increased to reflect volume analysis, and in that third year, 12 of the 19 facilities reached or exceeded new baseline targets. Conclusions and Recommendation: Quantifying targets against routine HIV screening goals identified optimal annual screening volume and allowed facilities to scale their program size and allocate resources accordingly. The program transitioned from utilizing non-evidence based annual volume increases to establishing annual targets based on optimal volume analysis. This has allowed efforts to be evaluated on the ability to realize quantified goals related to the public health value of HIV screening. Optimal volume analysis helps to determine the size of an HIV screening program. It is a public health tool, not a tool to determine if an individual patient should receive screening.

Keywords: HIV screening, optimal volume, HIV diagnosis, routine

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Authors: A. Zurraini, Syed Alwi Sar, H. Helmy, H. Nazeefah

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Early Dementia Questionnaire (EDQ) was developed as a screening tool to detect patients with early dementia in primary care. It was developed based on 20 symptoms of dementia. From a preliminary study, EDQ had been shown to be a promising alternative for screening of early dementia. This study was done to further test on EDQ’s reliability and validity. Using a systematic random sampling, 200 elderly patients attending primary health care centers in Kuching, Sarawak had consented to participate in the study and were administered the EDQ. Geriatric Depression Scale (GDS) was used to exclude patients with depression. Those who scored >21 MMSE, were retested using the EDQ. Reliability was determined by Cronbach’s alpha for internal consistency and construct validity was assessed using confirmatory factor analysis (principle component with varimax rotation). The result showed that the overall Cronbach’s alpha coefficient was good which was 0.874. Confirmatory factor analysis on 4 factors indicated that the Cronbach’s alpha for each domain were acceptable with memory (0.741), concentration (0.764), emotional and physical symptoms (0.754) and lastly sleep and environment (0.720). Pearson correlation coefficient between the first EDQ score and the retest EDQ score among those with MMSE of >21 showed a very strong, positive correlation between the two variables, r = 0.992, N=160, P <0.001. The results of the validation study showed that Early Dementia Questionnaire (EDQ) is a valid and reliable tool to be used as a screening tool to detect early dementia in primary care.

Keywords: Early Dementia Questionnaire (EDQ), screening, primary care, construct validity

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Authors: Aishat Abdul-Qadir Zubair

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Background: The absence of Shari’ah screening methodology for companies in Nigeria has further engineered the uncertainty surrounding the acceptability of investing in certain companies by people professing the religion of Islam due to the nature of the activities carried out by these companies. There are some existing shariah screening indices in other jurisdictions whose criteria can be used to check if a company or business is shariah-compliant or not. Examples such as FTSE, DJIM, Standard and Poor to mention just a few. What these indices have tried to do is to ensure that there are benchmarks to check with before investing in companies that carry out mixed activities in their business, wherein some are halal and others may be haram. Purpose: There have been numerous studies on the need to adopt certain screening methodologies as well as call for new methods in screening companies for shariah compliance in order to suit the investments needs of Muslims in other jurisdictions. It is, however, unclear how suitable these methodologies will be to Nigeria. This paper, therefore, seeks to address this gap to consider an appropriate screening methodology to be employed in Nigeria, drawing from the experience of other jurisdictions. Methods: This study employs a triangulation of both quantitative and qualitative methods to analyze the need for Shari’ah screening of companies in Nigeria. The qualitative method is used by way of ijtihad, and this study tries to apply some Islamic Principles of Maqasid al-shari’ah as well as Qawaid al-Fiqiyyah to analyze activities of companies in order to ensure that they are indeed Shari’ah compliant. In addition, using the quantitative data gathered from the interview survey, the perspective of the investors with regards to the need for Shari’ah screening of companies in Nigeria is further analyzed. Results: The result of the study shows that there is a lack of awareness from the teeming Muslim population in Nigeria on the need for Shari’ah screening of companies in Nigeria. The result further shows that there is the need to take into cognizance the peculiar nature of company activities in Nigeria before any particular Shari’ah screening methodology is adopted and setting the necessary benchmarks. Conclusion and Implications: The study concludes that there is the need to ensure that the conscious Muslims in Nigeria screen companies for Shari’ah compliance so that they can easily identify the companies to invest in. The paper, therefore, recommends that the Nigerian government need to come up with a screening methodology that will suit the peculiar nature of companies in Nigeria. The study thus has a direct implication on the Investment regulatory bodies in Nigeria such as the Securities and Exchange Commission (SEC), Central Bank of Nigeria (CBN) as well as the investor Muslims.

Keywords: Shari'ah screening, Muslims, investors, companies

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Authors: Zeynep Yazgan, Gökhan Aygün, Reyhan Çalışkan

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Objective: Invasive fungal infections are a serious threat in terms of morbidity and mortality, especially in immunocompromised patients. The most frequently isolated agents are Aspergillus genus fungi, and sensitivity to azoles, which are the first choice in treatment, decreases. In our study, we aimed to investigate the use of the agar plate screening method as a fast, easy, and practical method in determining azole resistance in Aspergillus spp. species. Methods: Our study was conducted with 125 Aspergillus spp. isolates produced from various clinical samples. Aspergillus spp. isolates were identified by conventional methods and azole resistance was determined by gradient test and agar plate screening method. Broth microdilution method was applied to resistant isolates, and CypA-L98H and CypA-M220 mutations in the cyp51A gene were investigated. Results: In our study, 55 A. fumigatus complex (44%), 42 A. flavus (33.6%), 6 A. terreus (5%), 4 A. niger (3%) and 18 Aspergillus spp. (14%) were identified. With the gradient test method, resistance to VOR and POS was detected in 1 (1.8%) of A.fumigatus isolates, and resistance to ITR was detected in 3 (5.45%). With the agar plate method, 1 of the A.fumigatus isolates (1.8%) had VOR, ITR, POS, 1 of the A.terreus isolates (16.7%) had VOR, 1 of the A.niger isolates (25%) had ITR. Resistance to VOR and POS was detected in 2 Aspergillus spp. isolates (11%), and resistance to ITR was detected in 1 (5.6%). Sensitivity and specificity were determined as 100% for VOR and POS in A. fumigatus species, 33.3% and 100% for ITR, respectively, 100% for ITR in A. flavus species, and 100% for ITR and POS in A. terreus species. By broth microdilution method in 7 isolates in which resistance was detected by gradient test and/or agar plate screening method; 1 A.fumigatus resistant to ITR, VOR, POS, 2 A.fumigatus resistant to ITR, 2 Aspergillus spp. ITR, VOR, POS MICs were determined as 2µg/ml and 8µg/ml, 8µg/ml and >32µg/ml, 0.5µg/ml and 4µg/ml, respectively. CypA-L98H mutations were detected in 5 of these isolates, CypA-M220 mutations were detected in 6, and no mutation was detected in 1. CypA-L98H and CypA-M220 mutations were detected in 1 isolate for which resistance was not detected. Conclusion: The need for rapid antifungal susceptibility screening tests is increasing in the treatment of aspergillosis. Although the sensitivity of the agar plate method was determined to be 33.3% for A.fumigatus ITR in our study, its sensitivity and specificity were determined to be 100% for ITR, VOR, and POS in other species. The low sensitivity value detected for A.fumigatus showed that agar plate drug concentrations should be updated in accordance with the latest regulations of EUCAST guidelines. The CypA-L98H and CypA-M220 mutations detected in our study suggested that the distribution of azole resistance-related mutations in different regions in our country should be investigated. In conclusion, it is thought that the agar plate method, which can be easily applied to detect azole resistance, is a fast and practical method in routine use and can contribute to both the determination of effective treatment strategies and the generation of epidemiological data.

Keywords: Aspergillus, agar plate, azole resistance, cyp51A, cypA-L98H, cypA-M220

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Authors: Sumi Manjipparambil Surendran, Subrata Majumdar

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Aim: The aim of the study is to find out if low PAPP-A (Pregnancy-Associated Plasma Protein A) levels in the first trimester are associated with adverse obstetric outcome. Methods: A retrospective study was carried out on 114 singleton pregnancies having undergone combined test screening. Results: There is statistically significant increased incidence of low birth weight infants in the low PAPP-A group. However, significant association was not found in the incidence of pre-eclampsia, miscarriage, and placental abruption. Conclusion: Low PAPP-A in the first trimester is associated with fetal growth restriction. Recommendation: Women with low PAPP-A levels in first trimester pregnancy screening require consultant-led care and serial growth scans.

Keywords: pregnancy, pregnancy-associated plasma protein A, PAPP-A, fetal growth restriction, trimester

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Authors: Scott Ashby, Emily Granger, Mark Connellan

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Background: In-hospital management of Out-of-Hospital Cardiac Arrest (OHCA) is complex as the aetiologies are varied. Acute coronary angiography has been shown to improve outcomes for patients with coronary occlusion as the cause; however, these patients are difficult to identify. ECG results may help identify these patients, but the accuracy of this diagnostic test is under debate, and requires further investigation. Methods: Arrest and hospital management information was collated retrospectively for OHCA patients who presented to a single clinical site between 2009 and 2013. Angiography results were then collected and checked for significance with survival to discharge. The presence of a severe lesion (>70%) was then compared to categorised ECG findings, and the accuracy of the test was calculated. Results: 104 patients were included in this study, 44 survived to discharge, 52 died and 8 were transferred to other clinical sites. Angiography appears to significantly correlate with survival to discharge. ECG showed 54.8% sensitivity for detecting the presence of a severe lesion within the group that received angiography. A combined criterion including any ECG pathology showed 100% sensitivity and negative predictive value, however, a low specificity and positive predictive value. Conclusion: In the cohort investigated, ST elevation on ECG is not a sensitive enough screening test to be used to determine whether OHCA patients have coronary stenosis as the likely cause of their arrest, and more investigation into whether screening with a combined ECG criterion, or whether all patients should receive angiography routinely following OHCA is needed.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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Authors: I. Sani, F. Bello, I. M. Fakai, A. Abdulhamid

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Abelmoschus esculentus L. fruit is very common especially in northern part of Nigeria, but people are ignorant of its medicinal and pharmacological benefits. Preliminary phytochemical screening, antioxidant potential and mineral composition of the dried form of this fruit were determined. The Phytochemical screening was conducted using standard methods. Antioxidant potential screening was carried out using Ferric Reducing Antioxidant Power Assay (FRAP) method, while, the mineral compositions were analyzed using an atomic absorption spectrophotometer by wet digest method. The result of the qualitative phytochemical screening revealed that the fruits contain saponins, flavonoids, tannins, steroids, and terpenoids, while, anthraquinone, alkaloids, phenols, glycosides, and phlobatannins were not detected. The quantitative analysis revealed that the fruits contain saponnins (380 ± 0.020 mg/g), flavonoids (240±0.01 mg/g), and tannins (21.71 ± 0.66 mg/ml). The antioxidant potential was determined to be 54.1 ± 0.19%. The mineral composition revealed that 100 g of the fruits contains 97.52 ± 1.04 mg of magnesium (Mg), 94.53 ± 3.21 mg of calcium (Ca), 77.10 ± 0.79 mg of iron (Fe), 47.14 ± 0.41 mg of zinc (Zn), 43.96 ± 1.49 mg of potassium (K), 42.02 ± 1.09 mg of sodium (Na), 0.47 ± 0.08 mg of copper (Cu) and 0.10 ± 0.02 mg of lead (Pb). These results showed that the Abelmoschus esculentus L. fruit is a good source of antioxidants, and contains an appreciable amount of phytochemicals, therefore, it has some pharmacological attributes. On the other side, the fruit can serve as a nutritional supplement for Mg, Ca, Fe, Zn, K, and Na, but a poor source of Cu, and contains no significant amount of Pb.

Keywords: Abelmoschus esculentus Fruits, antioxidant potential, mineral composition, phytochemical screening

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Authors: Mary Kiviiri Nakawuka, Mary Namugalu, Andrew Otiti

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BACKGROUND Cervical cancer is the fourth most common cancer in women and seventh overall among all cancers worldwide. It accounts for about 7.5% of all female-cancer deaths with 85% occurring in low and middle-income countries and the first most common female cancer in women aged 15 to 44 years in Uganda with an annual number of new cases at 3,915 and 2,275 annual number of cervical cancer deaths in 2012 (ICO INFORMATION CENTRE ON HPV AND CANCER, 2017).Despite the available free cervical cancer screening services whose uptake has been documented to improve the chances of successful treatment of pre-cancers and cancers among women of reproductive age, there is a low uptake of these services thus we sought to examine the uptake of cervical cancer services and associated factors among women of reproductive age (25-49) attending the ART clinic of KISWA HCII in Kampala, Uganda METHODS The research was carried out in the ART clinic of KISWA HCII among 385 participants. An analytical, cross-sectional study with quantitative methods of data collection was used. The study adopted a non-probability convenience sampling method to select participants. Quantitative data was collected through structured questionnaires. RESULTS 72.2% of the participants were found to have been screened for cervical cancer. 36 % of the screened women had a positive HPV or VIA result ,59.2% of the screened women had a negative HPV or VIA result and 4.8% had an invalid HPV test result. Only 39.5% of the participants had adequate overall knowledge about cervical cancer, more than a third of the participants (50%) had moderate or low knowledge and minority of them (10.5%) had no knowledge. There was no significant association between the uptake of cervical cancer screening services among participants and their socio-demographic characteristics. CONCLUSIONS Although majority of the women surveyed had been screened for cervical cancer, a comparatively large number of participants had inadequate knowledge about cervical cancer and therefore there is still need to continue teaching about cervical cancer and this may include education campaigns, improvements to the accessibility and convenience of the screening services.

Keywords: cervical cancer uptake, cervical cancer screening, women of reproductive age., cervical cancer knowledge

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Authors: Rebecca-Lee Kuhnert, Ron Rapee

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Up to 15% of Australian youth will experience an emotional disorder, yet relatively few get the help they need. Schools provide an ideal environment through which we can identify young people who are struggling and provide them with appropriate help. Universal mental health screening is a method by which all young people in school can be quickly assessed for emotional disorders, after which identified youth can be linked to appropriate health services. Despite the obvious logic of this process, universal mental health screening has received little scientific evaluation and even less application in Australian schools. This study will develop methods for Australian education systems to help identify young people (aged 9-17 years old) who are struggling with existing and emerging emotional disorders. Prior to testing, a series of focus groups will be run to get feedback and input from young people, parents, teachers, and mental health professionals. They will be asked about their thoughts on school-based screening methods and and how to best help students at risk of emotional distress. Schools (n=91) across New South Wales, Australia will be randomised to do either immediate screening (in May 2021) or delayed screening (in February 2022). Students in immediate screening schools will complete a long online mental health screener consisting of standard emotional health questionnaires. Ultimately, this large set of items will be reduced to a small number of items to form the final brief screener. Students who score in the “at-risk” range on any measure of emotional health problems will be identified to schools and offered pathways to relevant help according to the most accepted and approved processes identified by the focus groups. Nine months later, the same process will occur among delayed screening schools. At this same time, students in the immediate screening schools will complete screening for a second time. This will allow a direct comparison of the emotional health and help-seeking between youth whose schools had engaged in the screening and pathways to care process (immediate) and those whose schools had not engaged in the process (delayed). It is hypothesised that there will be a significant increase in students who receive help from mental health support services after screening, compared with baseline. It is also predicted that all students will show significantly less emotional distress after screening and access to pathways of care. This study will be an important contribution to Australian youth mental health prevention and early intervention by determining whether school screening leads to a greater number of young people with emotional disorders getting the help that they need and improving their mental health outcomes.

Keywords: children and young people, early intervention, mental health, mental health screening, prevention, school-based mental health

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Authors: Basant Singh Sikarwar, Mukesh Roy, Ayush Goyal, Priya Ranjan

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This work combines two bodies of knowledge which includes biomedical basis of blood stain formation and fluid communities’ wisdom that such formation of blood stain depends heavily on physical properties. Moreover biomedical research tells that different patterns in stains of blood are robust indicator of blood donor’s health or lack thereof. Based on these valuable insights an innovative screening tool is proposed which can act as an aide in the diagnosis of diseases such Anemia, Hyperlipidaemia, Tuberculosis, Blood cancer, Leukemia, Malaria etc., with enhanced confidence in the proposed analysis. To realize this powerful technique, simple, robust and low-cost micro-fluidic devices, a micro-capillary viscometer and a pendant drop tensiometer are designed and proposed to be fabricated to measure the viscosity, surface tension and wettability of various blood samples. Once prognosis and diagnosis data has been generated, automated linear and nonlinear classifiers have been applied into the automated reasoning and presentation of results. A support vector machine (SVM) classifies data on a linear fashion. Discriminant analysis and nonlinear embedding’s are coupled with nonlinear manifold detection in data and detected decisions are made accordingly. In this way, physical properties can be used, using linear and non-linear classification techniques, for screening of various diseases in humans and cattle. Experiments are carried out to validate the physical properties measurement devices. This framework can be further developed towards a real life portable disease screening cum diagnostics tool. Small-scale production of screening cum diagnostic devices is proposed to carry out independent test.

Keywords: blood, physical properties, diagnostic, nonlinear, classifier, device, surface tension, viscosity, wettability

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Authors: Jichan Jang

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Mycobacterium abscessus is a rapidly growing life-threatening mycobacterium with multiple drug-resistance mechanisms. In this study, we screened the library to identify active molecules targeting Mycobacterium abscessus using resazurin live/dead assays. In this screening assay, the Z-factor was 0.7, as an indication of the statistical confidence of the assay. A cut-off of 80% growth inhibition in the screening resulted in the identification of four different compounds at a single concentration (20 μM). Dose-response curves identified three different hit candidates, which generated good inhibitory curves. All hit candidates were expected to have different molecular targets. Thus, we found that compound X, identified, may be a promising candidate in the M. abscessus drug discovery pipeline.

Keywords: Mycobacterium abscessus, antibiotics, drug discovery, emerging Pathogen

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Authors: Che-An Lin, Wan-Ying Tsai, Ying-Shin Chen, Yu-Jen Chung

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With the number and area of contaminated sites continued to increase in Taiwan, the Government have to make a priority list of screening contaminated sites under the limited funds and information. This study investigated the announcement of Taiwan EPA land 261 contaminated sites (except the agricultural lands), after preliminary screening 211 valid data to propose a screening system, removed contaminated sites were used to check the accuracy. This system including two dimensions which can create the sequence and use the XY axis to construct four quadrants. One dimension included environmental and social priority and the other related economic. All of the evaluated items included population density, land values, traffic hub, pollutant compound, pollutant concentrations, pollutant transport pathways, land usage sites, site areas, and water conductivity. The classification results of this screening are 1. Prioritization promoting sites (10%). 2. Environmental and social priority of the sites (17%), 3. Economic priority of the sites (30%), 4. Non-priority sites (43 %). Finally, this study used three of the removed contaminated sites to check screening system verification. As the surmise each of them are in line with the priority site and Economic priority of the site.

Keywords: contaminated sites, redevelopment, environmental, economics

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Authors: Amal Saafan, Kareem Al Sofy, Sameh AbdelGhani, Magdy Amin

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Background: Acinetobacter spp. resistance towards β-lactam antibiotics is mediated mainly by different classes of β-lactamases production; detection of some genes responsible for production of β-lactamases is the objective of the study. Methods: One hundred fifty bacterial isolates were recovered from blood, sputum, and urine specimens from different hospitals in Egypt. Sixty-nine isolate were identified as Acinetobacter baumannii using traditional biochemical tests, CHROM agar, MicroScan and PCR amplification of blaoxa-51like gene. Acinetobacterbaumannii isolates were grouped into carbapenem resistant group (GP1), cefotaxime, ceftazidime and cefoxitin resistant group (GP2) and carbapenem and cephalosporin non-resistant group (GP3). Carbapenemase activity was screened using modified Hodge test (MHT) for GP1.Metallo-β-lactamases screening was performed for MHT positive isolates using double disk synergy test (DDST) and combined disk test (CDT). Amp C activity was screened using Amp C disk test with Tris-EDTA, DDST, and CDT for GP2. Finally, PCR amplification of blaoxa-51like, blaoxa-23like, blaIMP-like, blaVIM-like, and blaADC-like genes was performed for isolates that showed, at least, two positive results of three for both AmpC and carbapenemases phenotypic screening tests (obvious activity), in addition to GP3 (for comparison). Detection of blaoxa-51like and blaADC-like genes preceded by ISAba1 was also performed. Results: Antibiogram of 69 pure Acinetobacter baumannii isolates resulted in 57, 64, and 2 isolates enrolled into GP1, GP2, and GP3, respectively. Carbapenemase activity was shown by 49(85.9%) isolate using MHT. Metallo-β-lactamases screening revealed 32(65.3%) and 35(71.4%) using DDST and CDT, respectively.AmpC activity was shown by 43(67.2%) and 50 (78.1%) isolates using AmpC disk test with Tris-EDTA, and both DDST and CDT, respectively. Twenty-seven isolates showed obvious activity, all of them (100%) were harboring blaoxa-51like and blaADC-like genes, while blaoxa-23like, blaIMP-like andblaVIM-like genes were harbored by 23(85.2%), 9 (33.%) and no isolate respectively. Only 12 (44.4%) isolates harbored blaoxa-51like and blaADC-like genes preceded by ISAba1. GP3 isolates showed only positive blaoxa-51like and blaADC-like genes. Conclusion: It is not possible to correlate resistance with presence of blaoxa-51like and blaADC-like genes and presence of ISAba1 was immediate as transcriptional promoter. A blaoxa-23like gene played an important role in carbapenem resistance when compared with blaIMP-like and blaVIM-like gene.

Keywords: acinetobacter, beta-lactams, resistance, antimicrobial agents

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Authors: Muhammad Solikhudin Nafi, Wahyu Afif Mufida, Mita Erna Wati, Fitri Setyani Rokim, M. Al-Rizqi Dharma Fauzi

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High dose activity without any pre-exercise will impact Delayed Onset Muscle Soreness (DOMS). DOMS known as delayed pain post-exercise and induce skeletal injury which will decrease athletes’ performances. From now on, post-exercise muscle damage can be detected by measuring skeletal troponin I (sTnI) concentration in serum using ELISA but this method needs more time and cost. To prevent decreased athletes performances, screening need to be done rapidly. We want to introduce our new prototype to detect DOMS acutely. Rapid detection tests are based on immunological reaction between skeletal troponin I antibodies and sTnI in human serum or whole blood. Chemical methods that are used in the manufacture of diagnostic test is lateral flow immunoassay. The material used is rat monoclonal antibody sTnI, colloidal gold, anti-mouse IgG, nitrocellulose membrane, conjugate pad, sample pad, wick and backing card. The procedure are made conjugate (colloidal gold and mAb sTnI) and insert into the conjugate pad, gives spray sTnI mAb and anti-mouse IgG into nitrocellulose membrane, and assemble RDT. RDT had been evaluated by measuring the sensitivity of positive human serum (n = 30) and negative human serum (n = 30). Overall sensitivity value was 93% and specificity value was 90%. ADCOR as the first rapid detection test qualitatively showed antigen-antibody reaction and showed good overall performances for screening of muscle damage. Furthermore, these finding still need more improvements to get best results.

Keywords: DOMS, sTnI, rapid detection test, ELISA

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Authors: Wafa Al Jabri

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Background: In Middle Eastern Islamic Countries (MEICs), there is a high prevalence of genetic blood disorders (GBDs), particularly sickle cell disease and thalassemia. The GBDs are considered a major public health concern, especially with the increase in affected populations along with the associated psychological, social, and financial cost of management. Despite the availability of premarital screening services (PSS) that aim to identify the asymptomatic carriers of GBDs and provide genetic counseling to couples in order toreduce the prevalence of these diseases; yet, the success rate of PSS is very low due to religious and socio-cultural concerns. Purpose: This paper aims to highlight the factors that affect the success of PSS in MEICs. Methods: A literature review of articles located in CINAHL, PubMed, SCOPUS, and MedLinewas carried out using the following terms: “premarital screening,” “success,” “effectiveness,” and “ genetic blood disorders.” Second, a hand search of the reference lists and Google searches were conducted to find studies that did not exist in the primary database searches. Only studies which are conducted in MEICs countries and published in the last five years were included. Studies that were not published in English were excluded. Results: Fourteen articles were included in the review. The results showed that PSS in most of the MEICs was successful in achieving its objective of identifying high-risk marriages; however, the service failed to meetitsultimate goal of reducing the prevalence of GBDs. Various factors seem to hinder the success of PSS, including poor public awareness, late timing of the screening, culture and social stigma, religious beliefs, availability of prenatal diagnosis and therapeutic abortion, emotional factors, and availability of genetic counseling services. However, poor public awareness, late timing of the screening, and unavailability of adequate counseling services were the most common barriers identified. Conclusion: Overcoming the identified barriers by providing effective health education programs, offering the screening test to young adults at an earlier stage, and tailoring the genetic counseling would be crucial steps to provide a framework for an effective PSS in MEICs.

Keywords: premarital screening, success, effectiveness, and genetic blood disorders

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Authors: Ritu Nambiar, Shazia Tariq, Sumaira Jamil, Farida Munawar, Imelda Israell

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GBS has emerged as a leading cause of neonatal infections worldwide and clinical trials have demonstrated that giving IAP was effective in reducing early onset GBS (EOGBS) disease of the newborn. There is no available data on the prevalence of GBS in the UAE, therefore, a retrospective chart analysis of our parturients were done to look at our prevalence. The aim of this study is: 1. To study the prevalence of GBS colonization of parturients at al Rahba Hospital following universal screening between 35-37 week. 2. To look at efficacy of GBS intrapartum antibiotic prophylaxis by NICU admission for EO GBS disease of the newborn. 1) The prevalence of GBS in our patient population is 24.15%. 2) Incidence of EO GBS disease of the newborn was 0.6%.

Keywords: GBS Screening, universal intrapartum antibiotic prophylaxis, parturients, newborn

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Authors: F. Kovács, K. Kádár, G. Hosszú, Á. T. Balogh, T. Zsedrovits, N. Kersner, A. Nagy, Gy. Jeney

Abstract:

The paper presents a novel screening method to indicate congenital heart diseases (CHD), which otherwise could remain undetected because of their low level. Therefore, not belonging to the high-risk population, the pregnancies are not subject to the regular fetal monitoring with ultrasound echocardiography. Based on the fact that CHD is a morphological defect of the heart causing turbulent blood flow, the turbulence appears as a murmur, which can be detected by fetal phonocardiography (fPCG). The proposed method applies measurements on the maternal abdomen and from the recorded sound signal a sophisticated processing determines the fetal heart murmur. The paper describes the problems and the additional advantages of the fPCG method including the possibility of measurements at home and its combination with the prescribed regular cardiotocographic (CTG) monitoring. The proposed screening process implemented on a telemedicine system provides an enhanced safety against hidden cardiac diseases.

Keywords: cardiac murmurs, fetal phonocardiography, screening of CHDs, telemedicine system

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Authors: Zoe Lynch, Kirsty Zieschank

Abstract:

There are several factors that compromise the utility and wide-spread use of existing emotional and behavioural distress screening instruments. Some of these factors include lengthy administration times, high costs, feasibility issues, and a lack of self-report options for children under 12 years of age. This animation-based resource was developed to overcome as many of these factors as possible. Developed for educators and medical and mental health professionals, this resource offers children a self-guided mechanism for reporting any current emotional and behavioural distress. An avatar assistant, selected by the child, accompanies them through each stage of the screening process, offering further instruction if prompted. Children enter their age and gender before viewing comparative animations conveying common childhood emotional and behavioural difficulties. The child then selects the most relatable animations, along with the frequency with which they experience the depicted emotions. From a perspective of intellectual development, an engaging, animated format means that outcomes will not be constrained by children’s reading, writing, cognitive, or verbal expression abilities. Having been user-tested with children aged 6 to 12, this resource shows promising results as a self-guided screening instrument.

Keywords: animation-based screening instrument, mental health, primary-aged children, self-guided

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Authors: S. Abd Rahim, F. A. Rahman, E. M. Nasir, N. A. Ramle

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Co-crystal is believed to improve the solubility and dissolution rates and thus, enhanced the bioavailability of poor water soluble drugs particularly during the oral route of administration. With the existing of poorly soluble drugs in pharmaceutical industry, the screening of co-crystal formation using carbamazepine (CBZ) as a model drug compound with dicarboxylic acids co-crystal formers (CCF) namely fumaric (FA) and succinic (SA) acids in ethanol has been studied. The co-crystal formations were studied by varying the mol ratio values of CCF to CBZ to access the effect of CCF concentration on the formation of the co-crystal. Solvent evaporation, slurry, and cooling crystallisations which representing the solution based method co-crystal screening were used. The product crystal from the screening was characterized using X-ray powder diffraction (XRPD). The XRPD pattern profile analysis has shown that the CBZ co-crystals with FA and SA were successfully formed for all ratios studied. The findings revealed that CBZ-FA co-crystal were formed in two different polymorphs. It was found that CBZ-FA form A and form B were formed from evaporation and slurry crystallisation methods respectively. On the other hand, in cooling crystallisation method, CBZ-FA form A was formed at lower mol ratio of CCF to CBZ and vice versa. This study disclosed that different methods and mol ratios during the co-crystal screening can affect the outcome of co-crystal produced such as polymorphic forms of co-crystal and thereof. Thus, it was suggested that careful attentions is needed during the screening since the co-crystal formation is currently one of the promising approach to be considered in research and development for pharmaceutical industry to improve the poorly soluble drugs.

Keywords: co-crystal, dicarboxylic acid, carbamazepine, industry

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Authors: Marzieh Amiri, Zahra Iranpour Mobarakeh, Fatemeh Mehrbakhsh, Mehran Amiri

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Introduction: Early diagnosis and intervention of congenital hearing loss is necessary to minimize the adverse effects of hearing loss. The aim of the present study was to report the results of newborn hearing screening in a centerin the south part of Iran, Fasa. Material and methods: In this study, the data related to 6,144 newbornsduring September 2018 up to September2021, was analyzed. Hearing screening was performed using transient evoked otoacoustic emissions (TEOAEs) and automated auditory brainstem response (AABR) tests. Results: From all 6144 newborns,3752 and 2392referred to the center from urban and rural part of Fasa, respectively. There were 2958 female and 3186 male in this study. Of 6144 newborns, 6098 ones passed the screening tests, and 46 neonates were referred to a diagnostic audiology clinic. Finally, nine neonates were diagnosed with congenital hearing loss (seven with sensorineural hearing loss and two with conductive hearing loss). The severity of all the hearing impaired neonates was moderate and above. The most important risk factors were family history of hearing loss, low gestational age, NICU hospitalization, and hyperbilirubinemia. Conclusion: Our results showed that the prevalence of hearing loss was 1.46 per 1000 infants. Boosting public knowledge by providing families with proper education appears to be helpful in preventing the negative effects of delayed implementation of health screening programs.

Keywords: newborn hearing screening, hearing loss, risk factor, prevalence

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Authors: Anne-Margré C. Vink

Abstract:

Background: Food-related allergies and intolerances are frequently occurring in dogs. Diagnosis and monitoring according to ‘Golden Standard’ of elimination efficiency are time-consuming, expensive, and requires expert clinical setting. In order to facilitate rapid and robust, quantitative testing of intolerance, and determining the individual offending foods, a serological test is implicated. Method: As we developed Medisynx IgG Human Screening Test ELISA before and the dog’s immune system is most similar to humans, we were able to develop Medisynx IgG Dog Screening Test ELISA as well. In this study, 47 dogs suffering from Canine Atopic Dermatitis (CAD) and several secondary induced reactions were included to participate in serological Medisynx IgG Dog Screening Test ELISA (within < 0,02 % SD). Results were expressed as titers relative to the standard OD readings to diagnose alimentary induced diseases and monitoring the efficacy of an individual eliminating diet in dogs. Split sample analysis was performed by independently sending 2 times 3 ml serum under two unique codes. Results: The veterinarian monitored these dogs to check dog’ results at least at 3, 7, 21, 49, 70 days and after period of 6 and 12 months on an individual negative diet and a positive challenge (retrospectively) at 6 months. Data of each dog were recorded in a screening form and reported that a complete recovery of all clinical manifestations was observed at or less than 70 days (between 50 and 70 days) in the majority of dogs(44 out of 47 dogs =93.6%). Conclusion: Challenge results showed a significant result of 100% in specificity as well as 100% positive predicted value. On the other hand, sensitivity was 95,7% and negative predictive value was 95,7%. In conclusion, an individual diet based on IgG ELISA in dogs provides a significant improvement of atopic dermatitis and pruritus including all other non-specific defined allergic skin reactions as erythema, itching, biting and gnawing at toes, as well as to several secondary manifestations like chronic diarrhoea, chronic constipation, otitis media, obesity, laziness or inactive behaviour, pain and muscular stiffness causing a movement disorders, excessive lacrimation, hyper behaviour, nervous behaviour and not possible to stay alone at home, anxiety, biting and aggressive behaviour and disobedience behaviour. Furthermore, we conclude that a relatively more severe systemic candidiasis, as shown by relatively higher titer (class 3 and 4 IgG reactions to Candida albicans), influence the duration of recovery from clinical manifestations in affected dogs. These findings are consistent with our preliminary human clinical studies.

Keywords: allergy, canine atopic dermatitis, CAD, food allergens, IgG-ELISA, food-incompatibility

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Authors: Nicolas Georges, Akiki Simon, Bassil Naim, Nawfal Georges, Abi Fares Georges

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Introduction: Dyslipidemia has been recognized as a risk factor for cardiovascular diseases. While the development of atherosclerotic lesions begins in childhood and progresses throughout life, data on the prevalence of dyslipidemic children in Lebanon is lacking. Objectives: This study was conducted to assess the benefit of a protocol for universal screening for lipid disorder in Lebanese children aged between two and ten years old. Materials and Methods: A total of four hundred children aged 2 to 10 years old (51.5% boys) were included in the study. The subjects were recruited from private pediatric clinics after parental consent. Fasting total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL) levels were measured and non-HDL cholesterol was calculated. The values were categorized according to 2011 Expert on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Results: The overall prevalence of high TC ( ≥ 200 mg/dL), high non-HDL-C ( ≥ 145 mg/dL), high LDL ( ≥ 130 mg/dL), high TG ( ≥ 100 mg/dL) and low HDL ( < 40 mg/dL) was respectively 19.5%, 23%, 19%, 31.8% and 20%. The overall frequency of dyslipidemia was 51.7%. In a bivariate analysis, dyslipidemia in children was associated with a BMI ≥ 95ᵗʰ percentile and parents having TC > 240 mg/dL with a P value respectively of 0.006 and 0.0001. Furthermore, high TG was independently associated with a BMI ≥ 95ᵗʰ percentile (P=0.0001). Children with parents having TC > 240 mg/dL was significantly correlated with high TC, high non-HDL-C and high LDL (P=0.0001 for all variables). Finally, according to the Pediatric dyslipidemia screening guidelines from the 2011 Expert Panel, 62.3% of dyslipidemic children had at least 1 risk factor that qualified them for screening while 37.7% of them didn’t have any risk factor. Conclusions: It is preferable to review the latest pediatric dyslipidemia screening guidelines by performing a universal screening program since a third of our dyslipidemic Lebanese children have been missed.

Keywords: cardiovascular risk factors, dyslipidemia, Lebanese children, screening

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Authors: Michelle Nighswander

Abstract:

Suicide can be a tragic response to mental illness. It is difficult for people to disclose or discuss suicidal impulses. The stigma surrounding mental health can create a reluctance to seek help for mental illness. Patients may feel pressure to exhibit a socially desirable demeanor rather than reveal these issues, especially if they sense their healthcare provider is pressed for time or does not have an extensive history with their provider. Overcoming these barriers can be challenging. Although there are several validated depression and suicide risk instruments, varying processes used to administer these tools may impact the truthfulness of the responses. A literature review was conducted to find evidence of the impact of the environment on the accuracy of depression screening. Many investigations do not describe the environment and fewer studies use a comparison design. However, three studies demonstrated that computerized self-reporting might be more likely to elicit truthful and accurate responses due to increased privacy when responding compared to a face-to-face interview. These studies showed patients reported positive reactions to computerized screening for other stigmatizing health conditions such as alcohol use during pregnancy. Computerized self-screening for depression offers the possibility of more privacy and patient reflection, which could then send a targeted message of risk to the healthcare provider. This could potentially increase the accuracy while also increasing time efficiency for the clinic. Considering the persistent effects of mental health stigma, how these screening questions are posed can impact patients’ responses. This literature review analyzes trends in depression screening methodologies, the impact of setting on the results and how this may assist in overcoming one barrier caused by stigma.

Keywords: computerized self-report, depression, mental health stigma, suicide risk

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Authors: Rachmat Mauludin, Dita Sasri Primaviri, Irda Fidrianny

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Propolis contains several antioxidant compounds which can be used in topical application to protect skin against free radical, prevent skin cancer and skin aging. Previous study showed that 70% ethanolic extract of propolis (EEP) provided the greatest antioxidant activity. Since EEP has very small solubility in water, the extract was prepared in nanoemulsion (NE). Nanoemulsion is chosen as cosmetic dosage forms according to its properties namely to decrease the risk of skin’s irritation, increase penetration, prolong its time to remain in our skin, and improve stability. Propolis was extracted using reflux methods and concentrated using rotavapor. EEP was characterized with several tests such as phytochemical screening, density, and antioxidant activity using DPPH method. Optimation of total surfactant, co-surfactant, oil, and amount of EEP that can be included in NE were required to get the best NE formulation. The evaluations included to organoleptic observation, globul size, polydispersity index, morphology using TEM, viscosity, pH, centrifuge, stability, Freeze and Thaw test, radical scavenging activity using DPPH method, and primary irritation test. The yield extracts was 11.12% from raw propolis contained of steroid/triterpenoid, flavonoid, and saponin based on phytochemical screening. EEP had the value of DPPH scavenging activity 61.14% and IC50 0.41629 ppm. The best NE formulation consisted of 26.25% Kolliphor RH40; 8.75% glycerine; 5% rice bran oil; and 3% EEP. NE was transparant, had globul size of 21.9 nm; polydispersity index of 0.338; and pH of 5.67. Based on TEM morphology, NE was almost spherical and has particle size below 50 nm. NE propolis revealed to be physically stable after stability test within 63 days at 25oC, centrifuged for 30 mins at 13.000 rpm, and passed 6 cycles of Freeze and Thaw test without separated. NE propolis reduced 58% of free radical DPPH similar to antioxidant activity of the original extracts. Antioxidant activity of NE propolis is relatively stable after stored for 6 weeks. NE Propolis was proven to be safe by primary irritation test with the value of primary irritation index (OECD) was 0. The best formulation for NE propolis contained of 26.25% Kolliphor RH40; 8.75% glycerine; 5% rice bran oil; and 3% EEP with globul size of 21.9 nm and polydispersity index of 0.338. NE propolis was stable and had antioxidant activity similar to EEP.

Keywords: propolis, antioxidant, nanoemulsion, irritation test

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Authors: Riyas Peringattuthodiyil, Mark Taylor, Ian Wallace, Ailish Nugent, Mike Mitchell, Judith Thompson, Allison McKee, Philip C. Johnston

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Aim of Study: The purpose of the study was to screen for diabetes through HbA1c in patients with chronic pancreatitis (CP) within the Belfast Trust. Background: Patients with chronic pancreatitis are at risk of developing diabetes, earlier diagnosis with subsequent multi-disciplinary input has the potential to improve clinical outcomes. Methods: Clinical and laboratory data of patients with chronic pancreatitis were obtained through the Northern Ireland Electronic Healthcare Record (NIECR), specialist hepatobiliary, and gastrointestinal clinics. Patients were invited to have a blood test for HbA1c. Newly diagnosed patients with diabetes were then invited to attend a dedicated Belfast City Hospital (BCH) specialist chronic pancreatitis and diabetes clinic for follow up. Results: A total of 89 chronic pancreatitis patients were identified; Male54; Female:35, mean age 52 years, range 12-90 years. Aetiology of CP included alcohol 52/89 (58%), gallstones 18/89 (20%), idiopathic 10/89 11%, 2 were genetic, 1: post ECRP, 1: IgG autoimmune, 1: medication induced, 1: lipoprotein lipase deficiency 1: mumps, 1: IVDU and 1: pancreatic divisum. No patients had pancreatic carcinoma. Mean duration of CP was nine years, range 3-30 years. 15/89 (16%) of patients underwent previous pancreatic surgery/resections. Recent mean BMI was 25.1 range 14-40 kg/m². 62/89 (70%) patients had HbA1c performed. Mean HbA1c was 42 mmol/mol, range 27-97mmol/mol, 42/62 (68%) had normal HbA1c (< 42 mmol/mol) 13/62 (21%) had pre-diabetes (42-47mmol/mol) and 7/62 (11%) had diabetes (≥ 48 mmol/mol). Conclusions: Of those that participated in the screening program around one-third of patients with CP had glycaemic control in the pre and diabetic range. Potential opportunities for improving screening rates for diabetes in this cohort could include regular yearly testing at gastrointestinal and hepatobiliary clinics.

Keywords: pancreatogenic diabetes, screening, chronic pancreatitis, trust experience

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Authors: Jindriska Svobodova, Jan Novotny

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A teacher’s attitude to creativity plays an essential role in the thinking development of his/her students. The purpose of this study is to understand if a science teacher's personal creativity can modify his/her ability to produce various kinds of questions. This research used an education activity based on cosmic sketches and pictures by K.E. Tsiolkovsky, the founder of astronautics, to explore if any relationship between individual creativity and the asking questions skill exists. As a screening instrument, which allows an assessment of the respondent's creative potential, a common test of creative thinking was used. The results of the creativity test and the diversity of the questions are mentioned.

Keywords: science education, active learning, physics teaching, religious cosmology

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Authors: Atefeh Ahmadi, Mohamed Sharif Mustaffa

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Mental health problems that children introspect them are hardly identified. The internalizing nature of Anxiety Disorders as the most prevalent psychological diseases, make them been under recognized by parents and teachers and so become under attended by school counsellors and subsequently under referred to clinicians. The aim of this study is to investigate the level of Anxiety Disorders to clarify if it is necessary to run screening programs in rural educational settings. Spence children anxiety scale-malay-child for the first time in Malaysia distributed among 640 Malay rural primary school students aged from 9-11 years old. Cut-off score was considered one standard deviation more than the mean of all students’ scores. The results of descriptive analyses revealed the mean for scores of SCAS was 32.84 and 15.6% of students had high level of anxiety. In addition, the level and prevalence of six types of anxiety disorders based on SCAS were described. In regards to the study outcomes, screening for anxiety disorders in academic settings could prevent and reduce their side effects by early identification.

Keywords: anxiety disorders, primary schools, SCAS, screening

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