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Background: The effectiveness of screening strategies targeting pregnancies at higher risk of congenital heart disease (CHD) is reduced by the low prevalence of severe CHD, the increase in CHD detection rates by second-trimester ultrasound (U/S), and the high proportion of severe CHD in low-risk pregnancies. We aimed to determine situations in which additional screening by fetal echocardiography (FE) would result in a significant increase in sensitivity and a sizable decrease in the false-negative rate of detection of severe CHD. Methods: We simulated the change in the numbers of detected severe CHD cases when FE is offered to women with a normal second-trimester U/S who have a higher risk of bearing a child with CHD, compared to U/S alone. The primary outcome was the increase in sensitivity. Secondary outcomes were the number needed to screen and the reduction in the rate of missed cases. Results: For an U/S sensitivity of 60%, the addition of FE in pregnancies at high risk of CHD (risk ratio 3.5; range: 2 to 5) increased sensitivity by 2.4 percentage points (1.1 to 7.9). The number needed to screen to detect one additional case of severe CHD was 436 (156 to 952). The rate of additional severe CHD cases detected by FE was 4 per 100,000 pregnancies (2 to 32). Conclusions: The addition of FE to U/S for severe CHD prenatal screening in pregnancies at high risk of CHD yielded marginal benefits in terms of increased sensitivity and decreased rates of false negatives, at the expense of significant resource utilization. Résumé: Contexte: L'efficacité des stratégies de dépistage ciblant les grossesses à haut risque de cardiopathie congénitale (CC) se trouve réduite par la faible prévalence des CC sévères, par l'augmentation des taux de détection des CC par l'échographie (E/G) du deuxième trimestre, et par la proportion élevée de CC sévères dans les grossesses à faible risque. Dans le cadre de la détection prénatale des CC sévères, nous avons cherché à identifier les situations pour lesquelles un dépistage supplémentaire par échocardiographie fœtale (EF) entraînerait une augmentation significative de la sensibilité et une diminution notable du taux de faux négatifs. Méthodes: Nous avons simulé le changement du nombre de cas de CC sévère détectées lorsque l'EF est proposée aux femmes dont l'E/G du deuxième trimestre est normal et qui présentent un risque plus élevé de porter un enfant atteint de CC, par rapport à l'examen du deuxième trimestre seul. L'issue primaire était l'augmentation de la sensibilité. Les issues secondaires étaient le nombre de dépistages nécessaires et la réduction du taux de cas manqués. Résultats: Pour une sensibilité de l'E/G de 60 %, l'ajout de l'EF pour les grossesses à haut risque de CC (rapport de risque de 3,5; intervalle: 2 à 5) a accru la sensibilité de 2,4 points de pourcentage (1,1 à 7,9). Le nombre de dépistages nécessaires pour détecter un cas supplémentaire de CC sévères était de 436 (156 à 952). La proportion de cas supplémentaires de CC sévères détectées par EF était de 4 pour 100 000 grossesses (2 à 32). Conclusions: L'ajout de l'EF à l'E/G pour le dépistage prénatal des CC sévères pour les grossesses à risque élevé de CC n'a apporté que des avantages marginaux en termes d'augmentation de la sensibilité et de diminution des taux de faux négatifs, cela au prix d'une utilisation importante des ressources.

Background Early tuberculosis case detection is important for early commencement of treatment to improve treatment outcomes and also to prevent community spread of the disease. However, there is a paucity of data in Ghana on the efficiency of the symptom-based screening tool (SBS tool) to detect Mycobacterium tuberculosis in the communities. Therefore, this study assessed the usefulness of the SBS tool for community-based active case finding in the Volta Region of Ghana. Methods and materials This cross-sectional study used house-to-house and durbar screening approaches for active tuberculosis (TB) case searching from six communities, three each from the Ketu South (high TB risk) and Akatsi North (low TB risk) districts in the Volta Region of Ghana. Random eligible participants were screened with the SBS tool to identify presumptive TB cases. One sputum sample was collected from each person with presumptive TB for detection of M. tuberculosis by the GeneXpert real-time technique. Results A total of 1,025 people were screened from a population of 40,462, from which 332 (32.4%) were presumed to have M. tuberculosis infection. Of the 332 presumptive TB cases, 63.9% were obtained through house-to-house screening, while 36.1% were obtained through community durbar screening. Six M. tuberculosis-positive cases (with one rifampicin resistance) were detected by house-to-house screening but not from community durbar samples, yielding an overall prevalence of 15 per 100,000 population. Among TB symptoms screened and analysed, association existed only between night sweat and TB case detection (χ2 = 3.9, P = 0.049). Conclusion Although cumbersome and capital intensive, community-based active case searching through house-to-house screening using the SBS tool proved effective in detecting M. tuberculosis in the communities.

Depression is a leading cause of maternal morbidity and mortality worldwide and the most common complication of the perinatal period. Women in sub-Saharan Africa (SSA) are disproportionately impacted by perinatal depression. Maternal and child health (MCH) clinics are widely attended in SSA, offering a potential access point for depression screening. Yet, selection of optimal depression screening instruments for use within MCH clinics in SSA remains unclear. We synthesized evidence depicting relative strength of perinatal depression screening scales for use among African perinatal women within four evaluation domains: 1) diagnostic performance, 2) cultural adaptation, 3) feasibility and ease of implementation, 4) experience using the tool in SSA perinatal populations. The Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire-9 (PHQ-9) had the most evidence among peripartum women in SSA, and a balance of feasibility, diagnostic performance metrics, and cultural adaptations. Other depressive screening instruments developed for general populations show strengths for application in African perinatal populations in at least one evaluation domain. Building health services capacity to integrate depression screening within routine MCH visits is an important next step to address perinatal depression in SSA.

A rapid and effective identification of fungal species is essential for numerous applications, and electronic nose systems are being proposed as suitable alternatives to currently available fungi identification techniques. Hence, the present review aims to unveil all published information concerning fungi identification by electronic nose systems. A systematic review of the literature was conducted according to the PRISMA guidelines. A total of 16 articles met the inclusion criteria and were included in the analysis. The results of the reviewed studies demonstrated that effective detection of fungi was possible through sensor-based electronic nose systems, which may actually function as a mycotoxin screening tool for several applications. The obtained results suggest that the sensor-based electronic nose systems may not only screen different fungi genera, but also identify the associated species. This technology has already been experimented in several fields, from food industry to clinical practice. By summarizing these results, the present review may accelerate the standardization of electronic noses in fungi detection and discrimination, allowing a faster and more efficient screening of samples. This work has been performed within the framework of the EXALAR 21 project, which was funded by the European Regional Development Fund (FEDER), through the Competitiveness and Internationalization Operational Programme, and by national funding from the Foundation for Science and Technology (FCT) under the reference info:eu-repo/grantAgreement/FCT/9471 - RIDTI/PTDC/GES-AMB/30193/2017/PT (POCI-01-0145-FEDER-030193, 02/SAICT/2017 - Project nº 30193).

Our aim was to critically review the literature on the utility and limitations of a Screening Tool of Older Person's Prescription (STOPP) among the elderly, with special focus on older individuals with mental illness. We conducted a literature search on PubMed from January 1991 until July 2019. STOPP criteria was first developed in 2008, in Ireland, by Gallagher and colleagues, last updated in 2015 and culturally adapted to a few countries in the meantime. Compared to other existing tools, like Beers criteria, STOPP seems to be more practical to use, also because their organization focuses on medications classes instead of specific drugs. However, several limitations inherent to the use of explicit criteria are known, namely lack of sensitivity to assess the appropriateness of drug therapy in older individuals with mental illness, which are detailed in the manuscript. STOPP criteria is one of the most comprehensive and useful tool to use in practice. However, more studies in geriatric populations with psychiatric conditions should be performed to assess the real value of this tool in clinical practice.

Introduction: A wide variety of diseases alter the perceptions of different sensations, often evaluated in a subjective manner. Assessment of temperature perception and tolerance is a useful screening tool to evaluate the Degenerative and neuropathic changes of an individual. Therefore the current study was intended to design and develop an inexpensive device to quantify the heat threshold and tolerance in healthy participants. Materials and methods: The study was carried out in 30 apparent healthy participants for heat threshold, and tolerance was recorded on both hands' thenar and dorsal sites on two occasions. The minimum temperature when the subject was perceived is threshold and maximum until the subject withstood tolerance. The data was collected using the electronically controlled device for these two extremes. The entire study was carried out at a controlled room temperature precisely. Results: The heat threshold was 39.84 ± 2.33 °C, and the tolerance was perceived at 46.84 ± 3.36 °C. There were no intraindividual differences (p > 0.05) in the heat threshold measured on two different periods as well as between the two hands (p > 0.05). As expected, there were significantly higher threshold values on the palm's thenar aspect than dorsum (p

Highlights • By March 11, 2020, 64.1% of the world’s COVID-19 cases originated in China. • Only 7.6% of Canada’s COVID-19 cases in early March had previously traveled to China. • The majority of Canada’s early cases originated from the Middle East and the U.S. • Broadening travel bans to more countries may be needed to limit COVID-19 spread., The original coronavirus disease (COVID-19) outbreak in Wuhan, China has become a global pandemic. By tracking the earliest 118 COVID-19 cases in Canada, we produced a Voronoi treemap to show the travel origins of the country’s earliest COVID-19 cases. By March 11, 2020, even though the majority (64.1%) of the world’s COVID-19 confirmed cases still had their origin in China, only 7.6% of Canada’s first 118 COVID-19 cases arose due in travelers to China. The most commonly reported travel history among the 118 cases originated from the Middle East, the United States, and Europe. Thus, in retrospect, broadening of early screening tools and travel restrictions to countries and regions outside China may help control global COVID-19 spread.

Purpose: This study aimed to validate the psychometric properties of the CRAFFT (Car, Relax, Alone, Forget, Family/Friends, Trouble) by using item response theory (IRT) and further examine gender differences in item-level responses. Methods: This study used the 13th (2017) Korea Youth Risk Behavior Survey data conducted by the Korean Centers for Disease and Prevention and analyzed data of 8,568 students who reported drinking alcohol in the previous 30 days. IRT assumptions including unidimensionality, local independence, and monotonicity were tested. A one-factor two-parameter IRT model was fitted for item parameterization (M2 = 76.92, 20 df, p

Cancer immunotherapy is a type of treatment that restores and stimulates human immune system to inhibit cancer growth or eradicate cancer. It serves as one of the latest systemic therapies, which has been approved to treat different types of cancer in patients. Nevertheless, the clinical response rate is unsatisfactory and the response observed is mostly a partial response in patients. Despite the continuous improvement and identification of novel cancer immunotherapy, there is a pressing need to establish a robust platform to evaluate the efficacy and safety of pre-clinical drugs, simulate the interaction between patients' tumor and immune system, and predict patients' responses to the treatment. In this review, we summarize the pros and cons of existing immuno-oncology assay platforms, especially the humanized mouse models for the screening of cancer immunotherapy drugs. In addition, various emerging trends and progress of utilizing humanized mouse models as the screening tool are discussed. Of note, humanized mouse models can also be used for further development of personalized precision medicines to treat cancer. Collectively, these highlight the significance of humanized mouse models as the important platform for the screening of next generation cancer immunotherapy in vivo.

Purpose The Interactive Child Distress Screener (ICDS) is a novel, digital screening tool that is currently under development and aims to broadly assess self-reported emotional and behavioural distress in children aged five to 11 years. This study implemented a generative participatory codesign and iterative refinement process to qualitatively validate the content of 30 animated assessment items developed for the ICDS by assessing their acceptability and accuracy from the child's perspective. Methods The participants (N = 62) were five to 11-year-old children. Individual interviews were conducted with each child to determine acceptability and validity of animated items and facilitate the co-design refinement process of the animated assessment items. Results Twenty-two out of 30 (73%) items met ≥80% satisfaction and accuracy consensus in their original format, six items (20%) required one round of refinement before meeting consensus, and two items (7%) required two rounds of refinements. Combined acceptability of animated items was high, ranging from 4.1 to 5 out of 5 across all items. Conclusion Participants were able to accurately identify and understand socio-emotional and behavioural constructs when depicted as animated items. Acceptability was high, even in first iterations when accuracy of understanding required refinement. This study highlighted the importance and benefits of iterative participatory design methodology in ensuring assessment items developed for children are understood, accepted and likely to be effective in obtaining accurate self-report., Highlights • Children 5–11 years can identify and understand complex emotions and behaviours presented as animations. • Participatory co-design with children increases assessment item accuracy and acceptability. • Young children reported high acceptability of animated scenarios as assessment items.

Many algorithms have been developed and publicised over the past 2 decades for identifying those most likely to have osteoporosis or low BMD, or at increased risk of fragility fracture. The Osteoporosis Self-assessment Tool index (OSTi) is one of the oldest, simplest, and widely used for identifying men and women with low BMD or osteoporosis. OSTi has been validated in many cohorts worldwide but large studies with robust analyses evaluating this or other algorithms in adult populations residing in the Republic of Ireland are lacking, where waiting times for public DXA facilities are long. In this study we evaluated the validity of OSTi in men and women drawn from a sampling frame of more than 36,000 patients scanned at one of 3 centres in the West of Ireland. 18,670 men and women aged 40 years and older had a baseline scan of the lumbar spine femoral neck and total hip available for analysis. 15,964 (86%) were female, 5,343 (29%) had no major clinical risk factors other than age, while 5,093 (27%) had a prior fracture. Approximately 2/3 had a T-score ¿-1.0 at one or more skeletal sites and 1/3 had a T-score ¿-1.0 at all 3 skeletal sites, while 1 in 5 had a DXA T-score ¿-2.5 at one or more skeletal sites and 5% had a T-score ¿-2.5 at all 3 sites. OSTi generally performed well in our population with area under the curve (AUC) values ranging from 0.581 to 0.881 in men and 0.701 to 0.911 in women. The performance of OSTi appeared robust across multiple sub-group analyses. AUC values were greater for women, proximal femur sites, those without prior fractures and those not taking osteoporosis medication. Optimal OSTi cut-points were '2' for men and '0' for women in our study population. OSTi is a simple and effective tool to aid identification of Irish men and women with low BMD or osteoporosis. Use of OSTi could improve the effectiveness of DXA screening programmes for older adults in Ireland. peer-reviewed 2022-03-03

Introduction In this study, we sought to further characterize ROS1 protein expression in solid tumors with the complete spectrum of ROS1 genomic alterations. Methods ROS1 immunohistochemistry (IHC) was performed using the ROS1 (SP384) class I assay per manufacturer's instructions on a variety of solid tumors (n = 32) with known ROS1 genomic alterations. Genomic alterations included fusions (n = 17), gene amplifications (n = 10), and short-variant mutations (n = 11). Results Of the 32 cases with ROS1 IHC results, 100% (11 of 11) with canonical ROS1 fusions were positive for ROS1 IHC. Among noncanonical ROS1 fusions, only two (of five) cases with SQSTM1-ROS1 and RDX-ROS1 fusions were positive for ROS1 IHC whereas PTPRK-ROS1 (two) and TTC28-ROS1 fusions were negative for ROS1 IHC. One sample with a canonical ROS1 fusion and co-occurring ROS1 resistance mutation (6094G>A, p.G2032R) was positive for ROS1 IHC. A total of 10% (one of 10) of ROS1 amplified tumors were positive for ROS1 IHC. None of the cases (zero of five) with ROS1 short-variant mutations were positive for ROS1 protein expression. Conclusions These findings suggest that if ROS1 IHC was used as a screening tool for ROS1 fusion, a subset of fusion-negative tumors will reveal positive IHC staining highlighting the value of reflexing to genomic profiling to confirm the presence of a targetable fusion-driver before the initiation of therapy. In addition, the ability of comprehensive genomic profiling to detect ROS1 resistance mutations will be important for clinical decision making.

Epigenetic features are influenced by exogenous stimuli and constitute a link between physiological changes and genome modulation in a cell-specific manner. Because disruptions of epigenetic features are implicated in various complex traits, epigenetic mechanisms need to be integrated into toxicology, at least for two reasons. (1) The attraction of epigenetic therapy has created a boost in the development of newer (epigenetic) drugs with DNA and chromatin-modifying capabilities to revert epigenetic imbalances in complex human diseases. (2) Conversely, the exposure of humans to external stimuli, also including therapeutics and environmental factors, can trigger unwanted epigenetic modulation. The role of epigenetic changes in the pre-disease state (e.g., pre-diabetes or pre-Alzheimers’) is a valuable area of investigation as healthcare paradigms shift toward disease prevention. This chapter reviews the important role of epigenetics in toxicology, and provides information on several relevant aspects: (1) disease-associated epigenetic aberrations in cellular and molecular depth as potential adverse effects as well as therapeutic targets, (2) critical safety insight on environmental hazards, (3) the current knowledge gaps in the medical field, (4) epigenetic drugs in practice and in development, and (5) viable solutions for the exploration of novel endpoints and the integration of screening tools toward the prediction of adverse epigenetic modulation in human safety assessment.

The routine usage of screening instruments can be useful to assist in the diagnosis of depression in nonpsychiatric clinical settings. The PHQ-9 has become the most widely used instrument in research and clinical practice for this purpose. An abbreviated version, the PHQ-2, can also be useful. In this chapter, we review the literature on the content of the questionnaire, the methods of correction, its psychometric characteristics, and its capacity for screening and case finding of major depression, while comparing it with other instruments and in different specific populations. Several systematic reviews and meta-analysis have usually found high specificity but moderate sensitivity, with controversy about which cut-off score should be applied depending on the characteristics of the population and the settings. The use of these screening tools can be improved by a two-step procedure using first PHQ-2 and then PHQ-9 only following a positive initial PHQ-2 assessment.

A vital aspect of preclinical drug development involves assessing hepatic metabolism and toxicity. These screenings are typically conducted utilizing in vitro assays and in vivo animal models; however, recent advancements in tissue engineering offer a hybrid approach to augment current protocols. Three dimensional (3D) bioprinting has enabled the creation of assays that offer a more accurate model of human physiology, especially in the realm of hepatotoxicity. Herein we review and compare current 2D and 3D hepatic models and assess their pros and cons. While two dimensional (2D) in vitro assays continue to serve as efficient, low-cost and high-throughput screening tools to assess hepatotoxicity prior to in vivo studies, recent advances in 3D methods are delivering improved analysis of the complex in vivo microenvironment.

Background Autism spectrum disorder (ASD) is characterised by many of features including problem in social interactions, different ways of learning, some children showing a keen interest in specific subjects, inclination to routines, challenges in typical communication, and particular ways of processing sensory information. Early intervention and suitable supports for these children may make a significant contribution to their development. However, considerable difficulties have been encountered in the screening and diagnosis of ASD. The literature has indicated that certain retinal features are significantly associated with ASD. In this study, we investigated the use of machine learning approaches on retinal images to further enhance the classification accuracy. Methods Forty-six ASD participants were recruited from three special needs schools and 24 normal control were recruited from the community. Among them, 23 age-gender matched ASD and normal control participant-pairs were constructed for the primary analysis. All retinal images were captured using a nonmydriatic fundus camera. Automatic retinal image analysis (ARIA) methodology applying machine-learning technology was used to optimise the information of the retina to develop a classification model for ASD. The model's validity was then assessed using a 10-fold cross-validation approach to assess its validity. Findings The sensitivity and specificity were 95.7% (95% CI 76.0%, 99.8%) and 91.3% (95% CI 70.5%, 98.5%) respectively. The area under the ROC curve was 0.974 (95% CI 0.934, 1.000); however, it was noted that the specificity for female participants might not be as high as that for male participants. Interpretation Because ARIA is a fully automatic cloud-based algorithm and relies only on retinal images, it can be used as a risk assessment tool for ASD screening. Further diagnosis and confirmation can then be made by professionals, and potential treatment may be provided at a relatively early stage.

Background Frailty is an important condition in elderly individuals because it increases disability, morbidity, and mortality. The definition frailty from the Cardiovascular Health Study (CHS) criteria is used worldwide and defined as fulfilling 3 out of the 5 phenotypic criteria that indicate compromised energetics: weakness, slowness, low level of physical activity, self-reported exhaustion, and unintentional weight loss. Objective This research aims to study the validity of 5 screening methods, e.g., Clinical Frailty Scale, simple FRAIL questionnaire, PRISMA-7 questionnaire, Time Up and Go Test (TUG), and Gérontopôle frailty screening tool (GFST), and compare those results with the definition of frailty by using the CHS criteria for screening frailty. Methods We conducted a cross-sectional study. The sample was 214 elderly individuals, aged ≥60 years, and living in the community. We used 5 screening tests and the Fried phenotype (CHS criteria) as a reference standard. Analysis of the sensitivity, specificity, PPV, NPV, LR+, LR-, and accuracy of each screening was compared with the Fried phenotype (CHS criteria). Results The prevalence of frailty of elderly individuals in the community was 11.7% when using the Fried phenotype (CHS criteria). The Clinical Frailty Scale has sensitivity 56%, specificity 98.41%, PPV 82.35%, NPV 94.42%, LR+ 35.28, LR- 0.45, and accuracy 93.46%. The simple FRAIL questionnaire has sensitivity 88%, specificity 85.71%, PPV 44.90%, NPV 98.18%, LR+ 6.61, LR- 0.14, and accuracy 85.98%. The PRISMA-7 questionnaire has sensitivity 76%, specificity 86.24%, PPV 42.22%, NPV 96.45%, LR+ 5.52, LR- 0.28, and accuracy 85.05%. TUG has sensitivity 72%, specificity 82.54%, PPV 35.29%, NPV 95.71%, LR+ 4.12, LR- 0.34, and accuracy 81.31%. The GFST has sensitivity 88%, specificity 83.56%, PPV 41.51%, NPV 98.14%, LR+ 5.37, LR- 0.14, and accuracy 84.11%. Conclusions The simple FRAIL questionnaire and GFST have the highest sensitivity compared with the CHS criteria. All screening tests in this study have an accuracy of more than 80% compared with the CHS criteria., Public health; Internal medicine; Health promotion; Diagnostics; Geriatric assessment; Elderly; Frailty; Medicine; Screening tools

The Montreal Cognitive Assessment (MoCA) is a widespread and concise screening tool for the assessment of cognitive impairment that has had a significant impact on the evaluation of age-related cognitive decline. Since 2010 there have been a great number of national validations of the MoCA. The most important contribution of this huge corpus of research has been the indication of special cutoff values to be used in clinical practice for detecting patients with dementia and mild cognitive impairment. The present chapter aims to describe the most widely disseminated uses of the MoCA in aging clinical practice and a cutting-edge approach to using the MoCA in the assessment of minor and major neurocognitive disorders based on Bayesian statistics.

Background/Objective: Although the functional movement screen (FMS) has been widely applied for screening athletes, no previous study has used FMS scores to examine the association between distinct training seasons in high school baseball players. The aims of this study were to ascertain the functional movement screen (FMS) scores differences between the preparative period (PPP) and the competitive period (CPP) among high school baseball players and further determine whether FMS can be used as a tool to predict injuries during two major periods. Methods: Fifty-five male high school baseball players (age 15.3 ± 1.7 years; height 1.7 ± 0.8 m; weight 64.6 ± 11.5 kg) volunteered. Athletic injuries were reported through a self-report questionnaire. Players performed the FMS during the PPP and the CPP. A receiver operator characteristic (ROC) curve to calculate a cutoff total composite score ≤ 14 for the relationship between the FMS score and injury. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and an area under the curve (AUC) were calculated. Results: FMS individual task score and total composite score were significantly lower in the CPP than in the PPP. However, a cutoff total composite score ≤14 for risk of injury, determined through a ROC curve, represented a low sensitivity of 58%, NPV of 66%, an AUC of 69%, specificity of 79%, and PPV of 71%. Conclusion: Although the low sensitivity and NPV and AUC scores indicated that the FMS does not accurately predict the risk of injury, the FMS individual task and total composite scores differed significantly between the PPP and CPP. Therefore, FMS could be used as a tool to identify physical deficiencies between distinct training seasons; however, utilizing the FMS as a screening tool for injury prediction in particular during the CPP in this population would not be recommended. Keywords: Functional movement screen, Assessment, Athlete

Marine debris from the Great Tsunami of 2011 represents a unique transport vector for Japanese species to reach Pacific North America and Hawaii. Here we characterize the invasion risk of invertebrate species associated with tsunami debris using a screening-level risk assessment tool - the Canadian Marine Invasive Screening Tool (CMIST). Higher-risk invertebrate invaders were identified for each of five different ecoregions. Some of these are well-known global invaders, such as the mussel Mytilus galloprovincialis and the ascidian Didemnum vexillum which already have invasion histories in some of the assessed ecoregions, while others like the sea star Asterias amurensis and the shore crab Hemigrapsus sanguineus have yet to invade large portions of the assessed ecoregions but also are recognized global invaders. In general, the probability of invasion was lower for the Gulf of Alaska and Hawaii, in part due to lower climate matches and the availability of other invasion vectors.

Objective To assess the validity of the cutting movement assessment score (CMAS) to estimate the magnitude of peak knee abduction moments (KAM) against three-dimensional (3D) motion analysis, while comparing whole-body kinetics and kinematics between subjects of low (bottom 33%) and high CMASs (top 33%). Design Cross-sectional study. Setting Laboratory. Participants Forty-one participants (soccer, rugby, netball, and cricket). Main outcome measures Association between peak KAM and CMAS during a 90° cut. Comparison of 3D whole-body kinetics and kinematics between subjects with low (bottom 33%) and high CMASs (top 33%). Results A very large significant relationship (ρ = 0.796, p

This exploratory study collected data via the Massachusetts Department of Veterans’ Services (DVS) network from mental health providers and site administrators to examine current views on existing resources, challenges, opportunities, and attitudes towards treatment guidelines. Unlicensed providers, predominantly peer support specialists, were the largest professional group that responded to the state-wide survey. Results demonstrated significant differences between providers with and without military experience as it pertains to knowledge of military topics, ambivalence towards clients, ability to work with military families, and the use of standardized screening tools.

Objective: The Problem Areas In Diabetes (PAID) questionnaire is widely used to assess emotional distress related to living with diabetes, although it is lengthy for routine clinical use. Our aim was to determine whether the original 20-item PAID questionnaire can be abbreviated, whilst maintaining its reliability, validity and utility. Methods: We analysed data from the UK DAFNE (Dose Adjustment For Normal Eating) education programme for adults with Type 1 diabetes. Data were analysed at baseline (n=1547) and 1-year post intervention (n=846). Exploratory factor analysis (EFA) with principal axis factoring method was used to examine PAID responses within a random half of the baseline data (n=746). Then, two confirmatory factor analyses (CFA) were conducted using the remaining baseline (n=801) and 1-year data. Reliability, predictive validity, convergent validity and responsiveness were also examined. Results: Based on the EFA results, which were corroborated by CFA, an 11-item PAID questionnaire was identified with a cut-off score of 18 indicating severe diabetes distress. In the current sample, this brief version has high internal consistency (Cronbach’s α=.93). Predictive validity was demonstrated with the PAID-11 identifying severe diabetes distress from the original 20-item measure, with 95% sensitivity and 96% specificity. Convergent validity was demonstrated by strong positive correlations with HADS anxiety and depressive symptoms (average r=.65 and r=.55, respectively), while divergent validity was shown with weaker correlations with EQ5D health status (average r=.37).Conclusions: Based on present results, PAID-11 appears to be a valid and reliable measure, which seems suitable for use as a brief tool for the detection of diabetes distress in adults with type 1 diabetes. Importantly, this tool may reduce participant burden in multi-measure studies. However, further studies are urgently needed to determine the validity and utility of PAID-11 beyond the UK DAFNE population.

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. The frequent misdiagnosis of bipolar disorder (BD) is associated with detrimental consequences and inappropriate treatments. The 32-item Hypomania Checklist (HCL-32) and the Mood Disorder Questionnaire (MDQ) are widely used self-report screening instruments for BD. This is a systematic review and meta-analysis to compare the psychometric properties of the HCL-32 and the MDQ based on the same patient samples. Two reviewers systematically and independently searched PubMed, PsycINFO, Embase, Web of Science, and Cochrane Library databases. Studies using the HCL-32 and MDQ concurrently, and reporting their psychometric properties were included. Eleven studies that met the entry criteria were included in the systematic review, and 9 studies with relevant data were included in the meta-analysis. Using study-defined cutoffs, summary sensitivities were 82% (95% CI: 72%-89%) and 80% (95% CI: 71%-86%), while specificities were 57% (95% CI: 48%-66%) and 70% (95% CI: 59%-71%) for the HCL-32 and the MDQ respectively. Both the HCL-32 and the MDQ have acceptable psychometric properties to identify BD and appear to be useful screening tools for BD.

Worldwide, one out of five adults is physically inactive, with more developed countries plagued by sedentary lifestyles and a lack of cardiorespiratory fitness. Adolescence is characterized by dynamic changes in physiological and psychological development and often the establishment of healthy and unhealthy behaviors. Reduced physical activity levels in adolescence predict reduced physical activity levels in adulthood, with potential long-term health implications. Accordingly, instilling a habit of activity during adolescence can profoundly impact mental health and school performance, fostering long-term socioeconomic gain and health into adulthood. In 1997, the Centers for Disease Control and Prevention suggested a multifaceted approach to promote physical activity among young people that has remained relatively unchanged since its inception: at least 60 minutes per day of moderate-to-vigorous physical activity for school-aged children. Recent studies suggest that only 42% of children and 8% of adolescents in the United States meet these modest recommendations. Despite the compelling evidence and medical intuition, clinicians do not routinely screen patients for physical inactivity or provide adequate counseling, citing lack of training, experience, or validated screening tools about how best to identify those at risk as significant impediments. Exercise deficit disorder is a new phrase in the literature that has emerged with the hopes of raising awareness among patients, parents, policy makers, and physicians, with the goal of beginning the process of improvement. This chapter describes the potentially profound and lasting impact of physical activity during adolescence and elucidates the importance of identifying exercise-deficient adolescents for early intervention.

Though the neuropsychological symptoms and signs of mild traumatic brain injury (mTBI) are mostly subtle and transient, the sequelae can be persistent even after mTBI. Thus, it is important to raise the possibility of the diagnosis of mTBI among the patients complaining vague neurosensory symptoms; however, current research investigating the diagnosis/screening of mTBI has yet to produce accepted diagnostic criteria and no single assessment can identify all mTBI patients. Recently, a multifaceted approach to mTBI, focusing on the use of objective assessment tools to obtain information about clinical symptoms, signs, cognitive dysfunction, and physical problems has been employed. It is not recommended to diagnose mTBI or monitor the recovery solely with cognitive and balance evaluation. However, these measures can be used in conjunction with clinical examinations and a symptom checklist. This section reviews the update of screening tools for the diagnosis of mTBI in the literatures.

Sleep disorders and chronically insufficient sleep are common and often debilitating conditions that are associated with numerous adverse health outcomes and enormous economic costs. Many patients with sleep problems are not routinely screened in primary care clinics, and access to sleep medicine providers as well as diagnostic equipment is limited in many parts of the world. Screening tools offer a means to identify patients with potential sleep disorders who would benefit from further evaluation. As consumer technologies become more available and affordable, many patients are also turning to wearable devices that claim to track sleep duration and quality. In this chapter, we review the more frequently used screening tools and consumer sleep technologies available for identifying patients at risk for sleep disorders.

There are several ways of measuring health anxiety. To assess symptom severity and follow the course of health anxiety over time, dimensional symptom measures are crucial. Three self-report measures that are well used and have been shown to be both reliable and valid are the Health Anxiety Inventory, the Illness Attitude Scales, and the Whiteley Index. These instruments can also be used as screening tools to detect health anxiety, but clinicians should consider the context in which the screening will take place before deciding on clinical cut-off. An alternative to self-rated questionnaires is the use of dimensional clinician-administered health anxiety measures, such as the Yale-Brown Obsessive Compulsive Scale for Hypochondriasis. As for diagnostic assessment, several structured interviews have been developed for DSM-IV hypochondriasis and for the DSM-5 diagnoses somatic symptom disorder and illness anxiety disorder.

Fingerprints and pharmacophores are amongst the most fundamental and widely used methods in cheminformatics and virtual screening. Fingerprints can describe molecular structures and their properties in a bit string, making them powerful and versatile analysis and screening tools. Pharmacophore models are 3D representations of a compound’s chemical functionalities that are essential for specific biological activity. This entry describes the two approaches, their applications and gives an outlook on future developments in the field.

Amino acid production has been traditionally carried out using naturally amino acid–producing bacterial strains, which were improved further through classical strain improvement efforts. The progress made in the fields of genetic and metabolic engineering along with the development of various analytical and high-throughput screening tools and techniques, during the last three decades, has heralded the era of rational design of both existing and de novo construction of the key biosynthetic and ancillary pathways in various microorganisms to ultimately increase the yield of amino acids. In this chapter, an endeavor is made to summarize the recent advances made in the approaches of synthetic biology and its implementation to improve the yield of high-value amino acids.

High-performance thin-layer chromatography (HPTLC) is one of the important analytical instrumental techniques, which is widely used for standardization and quality evaluation of drugs and pharmaceuticals. It has the potential to provide both qualitative and quantitative analysis. HPTLC has several advantages, including automation, densitometric scanning, minimum sample preparation, selective detection, and hyphenation. The HPTLC technique is rapid, comparatively simple, robust, and extremely versatile. It is also an ideal screening tool for detection of adulterations and is highly suitable for evaluation and monitoring of cultivation, harvesting, and extraction processes, and testing of stability. This analytical technique is used for chromatographic analysis of phytopharmaceuticals, medicinal plants, clinical samples, food products and other samples. The evidence of many scientific reports suggests the utilization of HPLTC in chromatographic fingerprinting analysis of drugs from botanicals, which has increased the acceptance of herbal drugs to provide the core scaffolds for future drugs. There are several developmental aspects in the use of this novel analytical technique in medicinal plant research for drug discovery and development. Different aspects of this technique that are used for the analysis of herbal drugs have been described in this chapter.