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Introduction: Emergency department (ED) patients requiring immediate treatment often bypass a triage process that includes HIV screening. In this study we aimed to investigate the potential missed opportunity to screen these patients for HIV.Methods: We conducted this cross-sectional study in a municipal ED over a six-week period between June–August 2019. The patient population in this study arrived in the ED as a pre-notification from prehospital services or designated by the ambulance or walk-in triage nurse as requiring immediate medical attention. Medical student researchers collected demographic data and categorized patients into three clinical groups (trauma, medical, psychiatric). They documented the patient’s eligibility for HIV screening as determined by a physician and confirmed that the patient met criteria of clear mental status, controlled pain, stable vital signs, and ability to contribute to a medical history and physical examination. The student researchers did this at initial presentation and then again during the patient’s ED stay of up to eight hours. The study outcomes measured the percentage of total patients within each clinical group (trauma, medical, psychiatric) able to engage in the HIV screening process upon arrival and during an eight-hour ED stay.Results: On average, 700 patients per month are announced on arrival via overhead page, indicating that they require immediate medical attention. During the six-week study, 205 patients (approximately 20% of total) were enrolled: 114 trauma; 56 medical; and 35 psychiatric presentations. The average patient age was 53; 60% of patients were male. Niney-eight (48%) patients were eligible for HIV screening within an eight-hour ED stay; 63 (31%) were able to be screened upon initial presentation and 35 (17%) in the first eight hours of their ED visit. Within medical and trauma subgroups, there was no significant difference in the proportion (36%) of patients that could be screened upon presentation. Among the psychiatric presentations, only five (14%) were able to be screened during their hospital stay.Conclusion: Triage protocols for high-acuity medico-surgical patients resulted in a missed opportunity to screen 48% of patients for HIV. Acute psychiatric patients represented a particular missed opportunity. We advocate for universal HIV screening, facilitated through electronic best practice advisories and a modified triage tailored to higher acuity patients. Implementing these changes would ensure that HIV screening is not overlooked in high-acuity ED patients, leading to early detection and timely interventions.

We report findings of this replication study, examining the internalizing subscale (SRSS-I4) of the revised version of the Student Risk Screening Scale for Internalizing and Externalizing behavior (SRSS-IE 9) and the internalizing subscale of the Teacher Report Form (TRF). Using the sample from 13 elementary schools across three U.S. states with 195 K–5 students, we replicated the initial data analytic plan used to determine initial cutting scores. Results from logistic regression and receiver operator characteristic curves suggested the following preliminary SRSS-I4 risk categories: 0–1 low, 2 moderate, and 3–12 high risk for internalizing behavior patterns relative to the TRF internalizing subscale score. Results yielded adequate levels of sensitivity and specificity for the first cut, and questionable sensitivity for the upper cut. We planned to conduct subsequent analysis to address the nested nature of the data. Yet, most teachers completed the TRF for one student making this not possible. We discuss limitations and directions for future research, calling for replication with larger samples to facilitate nesting given schoolwide screening practices involve teachers screening multiple students. We also encourage consideration of two risk categories: 0–1 for low and 2+ for a risk category, not distinguishing between moderate- and high-risk categories. [ABSTRACT FROM AUTHOR]

We report the results of a convergent validity study examining the externalizing subscale (SRSS-E5, five items) of the adapted Student Risk Screening Scale for Internalizing and Externalizing (SRSS-IE 9) with the externalizing subscale of the Teacher Report Form (TRF) with two samples of K–12 students. Results of logistic regression and receiver operating characteristic curves analyzed with a sample of 195 K–5 students from 13 schools across three U.S. states suggested the following preliminary cutting scores for the SRSS-E5 for use at the elementary level: 0 to 1 for low risk, 2 to 3 for moderate risk, and 4 to 15 for high risk for externalizing behaviors. Results of the same analyses with a sample of 227 students in Grades 6 to 12 suggested the following preliminary cutting scores for the SRSS-E5 for use in middle and high (secondary) schools: 0 to 4 for low risk, 5 to 6 for moderate risk, and 7 to 15 for high risk for externalizing behaviors. For both samples, sensitivity and specificity levels were acceptable, as was the correct classification rate. We discuss findings and limitations and emphasize the importance of replication before shifting screening practices from the SRSS-IE 12 (12 items) to the newly adapted SRSS-IE 9 (9 items). [ABSTRACT FROM AUTHOR]

Background: Primary school students struggling with mental health are less likely than high school students to access mental health care, due to barriers such as mental health stigma and low mental health literacy among children and parents. The near universal reach of schools offers a potential avenue to increase access to mental health care through early identification. The potential risks of this approach also need to be understood. This study monitored the impact of universal screening for mental health symptoms on stigma and mental health outcomes for primary school students. Methods: Across 6 primary schools, a cluster randomised controlled trial allocated schools to one of two conditions. Conditions varied based on the order and frequency of symptom and stigma questionnaires. A sample of 798 children (8 to 13 years; Mage = 10.29) completed assessments at baseline, 6-week, and 12-week follow-ups. Results: Significant time-by-group interaction effects were present, indicating differing changes in mental health stigma between groups. Follow-up analyses of subscales showed significant time-by-group interaction effects for concerns around self-stigma and secrecy, but not for public stigma. The frequency and presentation order of the questionnaires impacted on mental health stigma. Initially, children reporting on mental health symptoms before stigma, reported heightened stigma, but over time, those receiving more frequent presentations of the symptom check experienced an overall stigma reduction, contrasting with an increase in the comparison group. Conclusion: The frequency and presentation order of mental health symptom assessments impact children's reports of mental health stigma, underscoring the importance of screening context. Potential screening harms, such as exacerbating self-stigma and secrecy, warrant consideration. Addressing stigma-related barriers is crucial for enhancing mental health care access for children in schools. Trial registration Australian and New Zealand Clinical Trials Registry (ACTRN12622001114730) https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384472 Date of trial registration: 12th August 2022. [ABSTRACT FROM AUTHOR]

Early adolescence is a time of rapid cognitive, psychosocial, and physical development, and an array of contextual factors, such as systemic racism, exert significant influence. Universal behavioral health screening data of 4,234 middle school students were examined to explore the influence of demographic (e.g. ethnicity, race) and contextual factors (e.g. school configuration). Findings suggest that middle school students are rated as having higher levels of behavioral concerns and lower adaptive skills compared with elementary and high school students and are influenced by both factors. Implications for universal screening, critical analysis of structural inequities, and district practices are also examined. [ABSTRACT FROM AUTHOR]

Background: Universal lipid screening in childhood for early detection and treatment of familial hypercholesterolemia is under discussion, but will also detect children with multifactorial dyslipidemia. Results from population-based studies can support the design of public health strategies. As few previous studies considered pubertal changes in serum lipid levels, we examined tracking of serum lipids from prepuberty to young adulthood in a population-based cohort. Methods: This longitudinal study includes 692 children from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS; baseline: 2003–2006, follow-up: 2014–2017) who were 6–8 years old at baseline, at least 18 years old at follow-up, and had measurements of serum total cholesterol (TC), high-density and non-high-density lipoprotein cholesterol (HDL-C; non-HDL-C) at both time points. We calculated proportions of participants by life stage-specific risk categories applying cut points for young children and young adults. We used correlation coefficients to estimate serum lipid tracking from childhood to young adulthood. The association between follow-up and baseline lipid levels was examined in sex-specific multivariable linear regression models including body mass index (BMI), health-related behaviors and medication use as covariables. Results: The correlation coefficient between baseline and follow-up was 0.60 for non-HDL-C, 0.56 for TC, and 0.43 for HDL-C and was higher in males than in females. 67% of participants had acceptable and 9% had borderline/elevated non-HDL-C levels at both time points. Of participants with borderline/elevated non-HDL-C levels at baseline 32% remained in this category and 68% improved. Non-HDL-C levels at baseline explained 53% of the variance in levels at follow-up in males and 28% in females. After adjustment for covariables, the explained variance increased to 62% in males and 45% in females. An increase in BMI z-scores from childhood to young adulthood in all sexes and oral contraceptive use in females was positively associated with higher levels at follow-up. Conclusions: Non-HDL-C levels in prepuberty are moderate predictors of levels in young adulthood, along with increasing BMI from childhood to young adulthood, and oral contraceptive use among women. Comprehensive strategies including public health interventions targeting elevated lipid levels and obesity in combination, are essential to prevent premature cardiovascular events. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to evaluate the management and results of our standarized protocol for preoperative identification of MRSA colonisation in patients undergoing primary total hip and knee replacement procedures. Methods: Following hospital protocol, between January 2016 and June 2019 37,745 patients awaiting elective joint replacement underwent a standardized questionnaire to assess the risk of MRSA infection, identifying patients requiring preoperative MRSA screening. An evaluation of the questionnaire identified effective questions for identifying infected patients. Furthermore, an analysis evaluated the impact of comorbidities or Charlson Comorbidity Index scores on positive MRSA colonization. Additionally, we evaluated the cost savings of targeted testing compared to testing all surgery patients. Results: Of the 37,745 patients, 8.057 (21.3%) were swabbed, with a total of 65 (0.81%) positive tests. From this group 27 (36.48%) who were treated were negative before surgery. Some of the questionnaire results were consistently associated with a higher chance of colonization, including hospitalization during the past year (47,7%), previous history of MRSA (44,6%), and agriculture or cattle farming related work (15,4%). By selectively testing high-risk patients identified through the questionnaire, we achieved a 79% reduction in costs compared to universal MRSA screening. Conclusion: Our results suggest that the simple and standardized questionnaire is a valuable tool for preoperative screening, effectively identifying high-risk patients prone to MRSA colonisation. The risk of periprosthetic joint infection (PJI) and its associated sequelae may be reduced by this approach. [ABSTRACT FROM AUTHOR]

Universal screening to predict students' risk for reading problems is a foundational component of the Multi-Tiered Systems of Support framework and is required by law in many US states. School or district administrators are tasked with selecting screening assessments that are both technically adequate and feasible given the resources of their local context. One common recommendation is that educational screening assessments should have at least a sensitivity of.9 and a specificity of.8. The two studies presented here used simulation methodology to identify the screener-outcome correlation(s) needed to achieve these recommended levels of sensitivity and sensitivity with a one-indicator (study 1) or two-indicator (study 2) screening battery. In both studies, the base rates of non-proficiency were manipulated. Results showed that the minimum correlations needed to achieve this recommendation were higher than what is typically observed in practice, and also varied across samples with differing base rates. Furthermore, screening assessments with the recommended levels of sensitivity and specificity had high rates of false positive classifications that depended on the base rate, cut-point, and method of assigning risk. These results suggest that the practice of issuing specific criteria for the sensitivity and specificity of screeners may be misguided. Implications for the evaluation of the technical adequacy of screening assessments and recommendations for practitioners are discussed. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Methods Results Conclusions To compare the prevalence of GDM and pregnancy outcomes between the one‐step and two‐step methods of universal screening among Thai pregnant women.A randomized controlled trial was conducted on singleton Thai pregnant women at a gestational age of 24–28 weeks. They were randomly assigned to either the one‐step method group (a universal 75‐gm 2‐h oral glucose tolerance test: OGTT) or the two‐step method group (a universal 50‐gm oral glucose challenge test followed by a 100‐gm 3‐h OGTT). The women received standard antenatal care. The prevalence of GDM and obstetric outcomes were compared.A total of 143 women meeting the inclusion criteria were randomly allocated into the one‐step group (72 cases) and the two‐step group (71 cases). The prevalence of GDM was significantly higher in the one‐step group than in the two‐step group, with rates of 24/73 (33.3%) vs 8/70 (11.3%); P value 0.002; relative risk of 2.96, 95% CI: 1.43–6.14, respectively. Demographic data and maternal and neonatal outcomes were comparable between the two groups.The one‐step method can markedly increase the prevalence of GDM to nearly three times that of the two‐step method, leading to a substantial increase in care costs and burdens without clear benefits. Convincingly, the one‐step method as a new approach may not be suitable for universal screening in a busy antenatal care setting, especially in low‐resource health centers in developing countries or among populations with a high prevalence of GDM. [ABSTRACT FROM AUTHOR]

Background: In 2017, the Food and Drug Administration approved pembrolizumab for treatment of any mismatch repair–deficient (dMMR) tumor making MMR immunohistochemistry (IHC) testing beneficial for all tumor types. For the first time, MMR IHC was not performed exclusively to screen for Lynch syndrome (LS). Methods: In this study, all MMR IHC reports issued between 2017 and 2021 at an academic hospital were reviewed and completion of genetic testing was determined through chart review. Colorectal cancers (CRCs), endometrial cancers (ECs), and noncancerous lesions were excluded. Results: Between 2017 and 2021, MMR IHC was completed in 1939 patients with a malignancy other than CRC or EC. Absent or weak staining for at least one MMR protein was detected in 115 (5.9%) patients and 59 (51%) of those completed germline genetic testing. Overall, the identification rate of LS in this cohort was 0.72%, which is similar to the rate in our previously reported CRC and EC universal screening cohort. A diagnosis of LS was most commonly made in patients with dMMR brain (18.75%) and small intestinal cancers (10.20%). Five additional patients were found to carry a pathogenic variant in a non‐LS gene. Conclusions: Pan‐cancer MMR testing for pembrolizumab consideration can identify LS cases at a rate similar to universal CRC and EC screening programs. A persistent challenge is subsequent uptake of genetic testing. MMR testing should be prioritized in brain and small intestinal tumors, and multigene panel testing is recommended in patients with dMMR, as unexpected pathogenic variants in non‐LS genes were found as frequently as LS gene variants. The use of mismatch repair immunohistochemistry testing across tumor types has increased significantly in the age of immune checkpoint inhibitors. Pan‐cancer mismatch repair–deficient immunohistochemistry testing has identified Lynch syndrome cases at a rate similar to the colorectal and endometrial cohorts. [ABSTRACT FROM AUTHOR]

Suicide is the second leading cause of death among adolescents. As nearly 20% of adolescents visit emergency departments (EDs) each year, EDs have an opportunity to identify previously unrecognized suicide risk. A novel Computerized Adaptive Screen for Suicidal Youth (CASSY) was shown in a multisite study to be predictive for suicide attempts within 3 months. This study uses site-specific data to estimate the cost of CASSY implementation with adolescents in general EDs. When used universally with all adolescents who are present and able to participate in the screening, the average cost was USD 5.77 per adolescent. For adolescents presenting with non-behavioral complaints, the average cost was USD 2.60 per adolescent. Costs were driven primarily by time and personnel required for the further evaluation of suicide risk for those screening positive. Thus, universal screening using the CASSY, at very low costs relative to the cost of an ED visit, can facilitate services needed for at-risk adolescents.

Background Congenital cytomegalovirus (cCMV) is the most common infectious cause of neurodevelopmental deficits in US children. To inform patient management, it is important to define whether central nervous system (CNS) manifestations are present at birth. This study characterized neuroimaging findings in infants with cCMV identified by a universal screening study in Minnesota during February 2016–December 2022. Methods Newborns with cCMV infection (confirmed by urine CMV polymerase chain reaction [PCR] testing, obtained following a positive screening saliva and/or dried blood spot result) underwent a diagnostic evaluation that included a cranial ultrasound (cUS) exam, laboratory studies, ophthalmological, and audiological evaluation. Neuroimaging findings and cCMV disease classification were interpreted based on international consensus guidelines. Results Among 87 newborns with confirmed cCMV, 76 underwent cUS. Of these, 53/76 (70%) had normal examinations, while 23/76 (30%) exhibited cUS findings: for 5 infants, these were clearly cCMV disease-defining, while for 18 infants, there were findings of uncertain significance. Magnetic resonance imaging (MRI) results (n  = 10 infants) aligned with cUS cCMV disease-defining findings in 2 infants, while cCMV-specific abnormalities were noted by MRI in 2 of 6 infants with nondiagnostic/incidental cUS findings. Of 9 infants who had both cUS and MRI examination, the average time interval between studies was 220 days (range, 2–1061). Excluding infants with cCMV CNS disease-defining cUS abnormalities, incidental findings were observed more commonly in infants with clinical/laboratory features described in cCMV disease classification guidelines (9/13) than in newborns with completely asymptomatic infections (9/58; P  < .0001). Conclusions Among infants with cCMV identified in a universal screening study, the majority had a normal cUS. CNS disease-defining abnormalities were present in 7%, while 24% had findings of uncertain significance. We propose that many cUS findings are incidental, and not diagnostic of symptomatic cCMV infection. Although these findings may not be sufficient to define the presence of symptomatic cCMV disease involving the CNS, in our study they were more commonly observed in infants with other clinical and/or laboratory findings associated with symptomatic cCMV infection. [ABSTRACT FROM AUTHOR]

Developmental dysplasia of the hip (DDH) is the most common musculoskeletal disease in infants, and delayed diagnosis can worsen the prognosis. Clinical evidence increasingly supports universal ultrasound (US) screening over selective US screening. The Graf method remains the most widely accepted US technique. Performing an US screening at one month of age seems appropriate as it allows for some hip maturity and early detection, thereby increasing the chances of a favorable outcome. This paper presents an approach to US findings based on the femoral head coverage method. Considering the long-term cost and psychosocial impact of missed DDH cases, universal ultrasound screening appears to be a cost-effective alternative. [ABSTRACT FROM AUTHOR]

Reading screenings are an essential element of a preventative model of education. Early language and literacy screenings can identify students at risk of later reading difficulties. This pilot study investigated the feasibility and impact of a community-based organization providing free language and literacy screenings using an application based screening with largely automated scoring. The community organization paired screening results with parent education on language and literacy acquisition and evidence-based instructional practices tailored to the students' identified risks. The mixed methods utilized survey data from parents/caregivers (n = 19) and volunteer screeners (n = 8) and interviews of community partners (n = 2), volunteers (n = 2), and parents (n = 2). Results of the pilot met the feasibility and impact goals. Community partners felt it was important to provide access to screening, and volunteers found the screening application easy to administer. Volunteer screeners reported the screening application was easy to administer, and children were engaged throughout the screening. Parents reported that the screening results and parent education significantly impacted their decision-making for their child(ren). [ABSTRACT FROM AUTHOR]

Universal screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on admission is reportedly beneficial in preventing nosocomial infections. However, some issues remain, including low positivity rate, cost, and time required for testing. We describe SARS-CoV-2 reverse transcription polymerase chain reaction (PCR) for universal screening in asymptomatic patients on planned admissions. In total, 14,574 patients were included between October 12, 2020, and June 23, 2022. The PCR-positive rate for the period was 0.44 % (64/14,574). The PCR positivity for the epidemic period by strain was 0.28 % (95 % confidence interval [CI] 0.12–0.56 %), 0.16 % (95 % CI 0.05–0.37 %), 0.21 % (95 % CI 0.09–0.41 %), and 0.9 % (95 % CI 0.65–1.2 %) for the wild-type strain, Alpha, Delta, and Omicron variants, respectively. The proportion of Ct values < 30 was higher in the first half of the epidemic (first vs. second, 29.4 % [95 % CI 16.9–44.8 %] vs. 16.7 % [95 % CI 6.0–28.5 %]), whereas that of Ct values ≥ 35 increased significantly in the second half (first vs. second, 32.4 % [95 % CI 19.3–47.8 %] vs. 70.0 % [95 % CI 53.5–83.4 %]). Of all positives, 50 % (32/64) had a coronavirus disease (COVID-19) history before PCR screening, with a median of 28 days (10–105) from COVID-19 onset or positive to PCR screening. PCR screening may help detect positives with high viral loads early in the epidemic for each mutant strain, with an increasing proportion of positives with low viral loads later in the epidemic. PCR testing may be unnecessary for recently diagnosed cases and patients in whom reinfection is unlikely. [ABSTRACT FROM AUTHOR]

Childhood represents a critical window for the emergence and treatment of mental health disorders, yet many are not being identified, or are identified too late to receive adequate intervention. This systematic review (Prospero registration: CRD42022299560) aimed to determine the effectiveness and acceptability of parent reported universal mental health screening (UMHS) to improve the early identification of children at-risk of mental health difficulties, and to identify barriers and enablers that may influence parental engagement. Six databases were searched in February 2022 for peer-reviewed, primary research. Studies conducted in targeted populations, evaluating psychometric properties, or focused on screening non-psychological problems were excluded. Ten studies examined parent reported (n = 3,464 parents) UMHS for children from birth to 18 years, suggesting an overall scarcity of research. Findings are presented in a table of study characteristics and a narrative summary of acceptability, effectiveness, barriers, and enablers. Quantitative findings indicated that parents generally support and accept UMHS. Research assessing effectiveness was limited, although two studies indicated increased referrals and referral adherence following positive screens. Confidentiality and stigma were commonly identified barriers. Quality assessment using the Mixed Methods Appraisal Tool indicated that studies varied in quality, meeting four to seven of the seven quality criteria. Understanding and addressing parent attitudes to UMHS across settings is necessary for the successful implementation of screening and improvement of child mental health outcomes. More high-quality research studies, including randomized controlled trials are therefore needed to examine the acceptability and effectiveness of UMHS for parents and their children. [ABSTRACT FROM AUTHOR]

This paper describes the development and psychometric evaluation of a brief self‐report measure (BEACON) to inform universal mental health screening in schools. Items assess symptoms and impairment associated with anxiety and attention/hyperactivity problems (grades 4–11) as well as depression and eating difficulties (grades 6–11), with optional items for suicidality and self‐harm (grades 7–11). Initial item examination based on Item Response Theory (IRT) and classical test theory involved 3844 students in grades 4 through 11 (Study 1) and identified 18 items for grades 4–5 and 31 items for grades 6–11 that fulfilled pre‐set criteria. Study 2 extended testing with 10,479 students in grades 4–11 and added an additional four items assessing impairment associated with eating difficulties for older students (grades 6–11) creating a total of 35 items for grades 6–11. All items, for both grade‐level versions, met the pre‐set criteria for IRT and classical test theory analysis supporting their strength in the measurement of the dimensions of concern. The measure showed good reliability (subscale alphas.87 to.95). Validity was also demonstrated against standard symptom measures, school grades, school absenteeism, and help‐seeking. The BEACON appears to be a psychometrically sound measure to use in the first stage of school‐based screening for mental health problems. [ABSTRACT FROM AUTHOR]

When conducting universal social and emotional learning (SEL) screening, schools need clear decision-making guidelines for selecting informants. The current study examined informant profiles for screening SEL functioning using latent profile analysis with the student and teacher forms of the SSIS SEL Brief Scales for 536 students in grades 3–7. Teacher and student models each had three profiles emerge with roughly similar meanings of the profiles (Developing, Competent, and Advanced profiles), although a larger percentage of students were identified in the developing profile for the student rater. Profile categories aligned for 42% of students, with the most disagreement according between the Competent and Advanced SEL categories. For the teacher and student combined model, five profiles emerged (Competent-Developing, Developing-Competent, Competent-High Competent, Competent-Competent, and Advanced-Competent), with one profile indicating informant agreement. We explore gender and grade setting covariates and discuss implications for multi-informant research and practice. [ABSTRACT FROM AUTHOR]

Youth in the United States are experiencing mental health concerns at alarming rates. Considering the nation's legacy of racism and growing recognition of the impact of social determinants of health on educational and mental health inequities, it is imperative to re-envision how we approach mental health screening in schools to center equity. A focus on mental health screening for the sole purpose of identifying individual at-risk students ignores key contextual considerations, is ineffective in addressing health and educational inequities, and has the potential to perpetuate oppressive practices in schools. Equity-focused mental health screening requires a shift from individual- and deficit-focused approaches to systems- and holistic-focused approaches that (a) identify strengths and stressors among individuals, groups, and communities; (b) dismantle structural forms of oppression; and (c) promote positive mental health outcomes for minoritized youth. Integrating recommendations from the educational equity literature and critical school mental health frameworks, this paper identifies core considerations for equitable school mental health screening and provides guiding principles for each phase of the screening process, from screening readiness to execution to follow up. To implement these recommendations and transform school-based mental health care, schools should (a) incorporate multiple perspectives; (b) prioritize student, family, and community voices; and (c) build collaborative partnerships to co-construct a vision for equitable school mental health.

Abstract Background Congenital cytomegalovirus (cCMV) infection, resulting from non-primary maternal infection or reactivation during pregnancy, can cause serious fetal abnormalities, complications in the immediate neonatal period, and severe sequelae later in childhood. Maternal non-primary cytomegalovirus infection in pregnancy is transmitted to the fetus in 0.5-2% of cases (1). Case presentation An African full term male newbornwas delivered by emergency caesarean section. Due to signs of asphyxia at birth and clinical moderate encephalopathy, he underwent therapeutic hypothermia. Continuous full video-electroencephalography monitoring showed no seizures during the first 72 h, however, soon after rewarming, he presented refractory status epilepticus due to an intracranial hemorrhage, related to severe thrombocytopenia. The patient also presented signs of sepsis (hypotension and signs of reduced perfusions). An echocardiography revealed severe cardiac failure with an ejection fraction of 33% and signs suggestive of cardiomyopathy. Research for CMV DNA Polymerase Chain Reaction (PCR) on urine, blood, cerebrospinal fluid, and nasopharyngeal secretions was positive.The mother had positive CMV IgG with negative IgM shortly before pregnancy. Serology for CMV was therefore not repeated during pregnancy, but CMV DNA performed on the Guthrie bloodspot taken at birth yielded a positive result, confirming the intrauterine transmission and congenital origin of the infection. The baby was discharged in good general condition and follow up showed a normal neurodevelopmental outcome at 9 months. Conclusion Although uncommon, congenital cytomegalovirus infection should be included in the differential diagnosis of intraventricular hemorrhage and cardiomyopathy. Furthermore, this case highlights the possible severity of congenital cytomegalovirus infection, even in cases of previous maternal immunity.

While there is evidence suggesting school-based transitions impact student mental health and academics (Lester et al., 2013), it is unknown how these transitions specifically impact the domains of social, academic, and emotional behavior, as measured via the Social, Academic, and Emotional Behavior Risk Screener (SAEBRS). The purpose of this study was to explore the relationship between school-based transitions and teacher ratings of student SAEBRS scores in a midsize, suburban school district. Using paired t-tests and McNemar's test we examined changes in SAEBRS scores and benchmark risk levels across grade level changes and school-based transitions. SAEBRS scores decreased significantly from 8th to 9th grade (school-based transition) in the total, academic, and emotional subscales, although risk level did not increase significantly during this transition. In contrast, SAEBRS scores increased significantly in each subscale as students transitioned from 7th to 8th grade (no school-based transition). Implications for research and school psychology are discussed. Impact Statement Findings from this study confirm students transitioning to high school experience academic and emotional behavior risk, as observed by teachers. In contrast, students transitioning from the middle grade in their school to the top grade (e.g., 7th to 8th grade) experienced improvement in social, academic, and emotional behavior. Therefore, school psychologists can focus school-based mental health efforts on equipping students with the socioemotional skills and academic enablers to cope prior to the transition to high school. [ABSTRACT FROM AUTHOR]

Background: Several screening strategies for identifying congenital CMV (cCMV) have been proposed; however, the optimal solution has yet to be determined. We aimed to determine the prevalence of cCMV by universal screening with saliva pool testing and to identify the clinical variables associated with a higher risk of cCMV to optimize an expanded screening strategy. Methods: We carried out a prospective universal cCMV screening (September/2022 to August/2023) of 2186 newborns, analyzing saliva samples in pools of five (Alethia-LAMP-CMV®) and then performed confirmatory urine CMV RT-PCR. Infants with risk factors (small for gestational age, failed hearing screening, HIV-exposed, born to immunosuppressed mothers, or <1000 g birth weight) underwent expanded screening. Multivariate analyses were used to assess the association with maternal/neonatal variables. Results: We identified 10 infants with cCMV (prevalence: 0.46%, 95% CI 0.22–0.84), with significantly higher rates (2.1%, 95% CI 0.58–5.3) in the high-risk group (p = 0.04). False positives occurred in 0.09% of cases. No significant differences in maternal/neonatal characteristics were observed, except for a higher prevalence among infants born to non-Chilean mothers (p = 0.034), notably those born to Haitian mothers (1.5%, 95% CI 0.31–4.34), who had higher odds of cCMV (OR 6.82, 95% CI 1.23–37.9, p = 0.04). Incorporating maternal nationality improved predictive accuracy (AUC: 0.65 to 0.83). Conclusions: For low-prevalence diseases such as cCMV, universal screening with pool testing in saliva represents an optimal and cost-effective approach to enhance diagnosis in asymptomatic patients. An expanded screening strategy considering maternal nationality could be beneficial in resource-limited settings. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the association between changes in cervical length (CL) after vaginal progesterone treatment and preterm delivery (PTD). Methods: This was a retrospective cohort study that included 197 singleton pregnancies without (n = 178) and with (n = 19) a history of PTD which were found to have a short cervix (≤ 25 mm) between 18 + 0 and 23 + 6 weeks' gestation with a follow‐up transvaginal CL measurement taken at least 1 week after vaginal progesterone treatment started. Receiver‐operating‐characteristics (ROC)‐curve analysis was performed and three CL shortening patterns were evaluated: (1) ≥ 10% reduction; (2) ≥ 20% reduction; and (3) ≥ 5 mm reduction relative to the first CL measurement. The predictive performance of each CL reduction cut‐off and its association with PTD ≤ 34 weeks and PTD < 37 weeks were evaluated. Results: Overall, the rate of PTD ≤ 34 weeks was 16.8% (33/197) and that of PTD < 37 weeks was 36.5% (72/197). The area under the ROC curve of cervical shortening expressed in % for predicting PTD ≤ 34 weeks and PTD < 37 weeks was 0.703 and 0.608, respectively. Cervical shortening was observed in 60/197 (30.5%) patients, with 49/60 (81.7%) women showing ≥ 10% reduction, 32/60 (53.3%) ≥ 20% reduction and 27/60 (45.0%) ≥ 5 mm reduction in CL. Sensitivity and specificity for PTD ≤ 34 weeks were, respectively, 48.5% and 79.9% for ≥ 10% reduction; 36.4% and 87.8% for ≥ 20% reduction; and 27.3% and 89.0% for ≥ 5 mm reduction in CL. For PTD < 37 weeks, sensitivity and specificity were, respectively, 36.1% and 81.6% for ≥ 10% reduction; 27.8% and 90.4% for ≥ 20% reduction; and 20.8% and 90.4% for ≥ 5 mm reduction in CL. The highest positive likelihood ratios for PTD ≤ 34 and < 37 weeks were for ≥ 20% CL reduction (2.98 (95% CI, 1.62–5.49) and 2.89 (95% CI, 1.52–5.57), respectively). Despite significant differences in sensitivity among the different cut‐offs for cervical shortening, favoring the ≥ 10% reduction cut‐off, a reduction of ≥ 20% in CL showed the strongest association with PTD ≤ 34 weeks (odds ratio (OR), 4.11 (95% CI, 1.75–9.62)) and < 37 weeks (OR, 3.62 (95% CI, 1.65–7.96)), as compared with a less pronounced reduction in CL. Conclusions: In women with a short cervix treated with vaginal progesterone, a reduction in CL on a subsequent ultrasound scan can predict PTD ≤ 34 and < 37 weeks. A ≥ 20% reduction in CL had the highest positive likelihood ratio and strongest association with PTD ≤ 34 and < 37 weeks compared with ≥ 10% or ≥ 5 mm reduction. © 2023 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Suicide is the second leading cause of death for youth 12 to 18 years of age. Suicidal ideation can be predictive of suicide attempt, so screening for suicidal ideation by emergency nurses can help identify those at risk and facilitate timely intervention. This study evaluates the use of a universal suicide screening using the Patient Safety Screener 3 and the Columbia Suicide Severity Rating Scale to identify youth ages 12 to 18 years experiencing suicide risk and assess factors predictive of suicide risk level. We conducted a retrospective cohort study using data from patients presenting to the emergency department at an acute care hospital that uses a universal screening program for suicide risk. We determined the frequency of positive screens and performed multivariate analyses to identify predictive factors of scoring high on the Columbia Suicide Severity Rating Scale. Notably, 9.1% of patients were experiencing some level of suicide risk; 10% of those with positive scores had no mental health history and were not presenting for a mental health reason. After controlling for other independent variables, insurance status, mental health presentation, and known mental health history were significantly associated with Columbia Suicide Severity Rating Scale score. Universal screening for suicide risk in pediatric emergency departments by nurses is critical for all patients older than 12 years, given that we identified patients at risk of suicide who presented for non–mental health reasons. These patients may not have been identified or referred to treatment if they were not screened for suicidality increasing risk of future suicide attempt. [ABSTRACT FROM AUTHOR]

Schoolwide social-emotional screening identifies students who may be at-risk for school problems and benefit from prevention efforts, additional supports, or individualized interventions. Data from screening can also pinpoint topics that bolster teachers' knowledge and skills when they provide supports and instruction focused on social, emotional, and behavioral needs. While research has explored many aspects of schoolwide screening, studies that focus on how the process of summarizing and using screening data are limited. This study investigated school teams' perspectives on the use of a structured guide for reviewing their screening data. After collecting schoolwide screening data, 47 participants from seven school leadership teams used a Discussion Guide (DG) to answer a series of questions about their Student Risk Screening Scale - Internalizing and Externalizing (SRSS-IE) data. Using content analysis, this qualitative study identified what teams found helpful, less helpful, and what they might add to the DG. Participants valued the DG's usefulness in developing data-based responses to the SRSS-IE results and identifying patterns and trends in their data. Including a menu of specific intervention strategies and supports was a frequent suggestion for improving the DG. Reviewing their screening data took longer than expected; participants recommended that teams needed multiple meetings for organizing, analyzing, and developing action plans. [ABSTRACT FROM AUTHOR]

Background: Congenital cytomegalovirus (cCMV) infection, resulting from non-primary maternal infection or reactivation during pregnancy, can cause serious fetal abnormalities, complications in the immediate neonatal period, and severe sequelae later in childhood. Maternal non-primary cytomegalovirus infection in pregnancy is transmitted to the fetus in 0.5-2% of cases (1). Case presentation: An African full term male newbornwas delivered by emergency caesarean section. Due to signs of asphyxia at birth and clinical moderate encephalopathy, he underwent therapeutic hypothermia. Continuous full video-electroencephalography monitoring showed no seizures during the first 72 h, however, soon after rewarming, he presented refractory status epilepticus due to an intracranial hemorrhage, related to severe thrombocytopenia. The patient also presented signs of sepsis (hypotension and signs of reduced perfusions). An echocardiography revealed severe cardiac failure with an ejection fraction of 33% and signs suggestive of cardiomyopathy. Research for CMV DNA Polymerase Chain Reaction (PCR) on urine, blood, cerebrospinal fluid, and nasopharyngeal secretions was positive.The mother had positive CMV IgG with negative IgM shortly before pregnancy. Serology for CMV was therefore not repeated during pregnancy, but CMV DNA performed on the Guthrie bloodspot taken at birth yielded a positive result, confirming the intrauterine transmission and congenital origin of the infection. The baby was discharged in good general condition and follow up showed a normal neurodevelopmental outcome at 9 months. Conclusion: Although uncommon, congenital cytomegalovirus infection should be included in the differential diagnosis of intraventricular hemorrhage and cardiomyopathy. Furthermore, this case highlights the possible severity of congenital cytomegalovirus infection, even in cases of previous maternal immunity. [ABSTRACT FROM AUTHOR]

The present study compared the diagnostic accuracy of a single computer adaptive test (CAT), Star Reading or Star Math, and a combination of the two in a gated screening framework to predict end‐of‐year proficiency in reading and math. Participants included 13,009 students in Grades 3–8 who had at least one fall screening score and end‐of‐year state test score in reading and math. First, diagnostic accuracy statistics were evaluated for a single screening measure to predict proficiency on end‐of‐year tests. Second, a gated screening framework was simulated to examine the diagnostic accuracy of a combination of screening measures (i.e., scores from the CATs and the end‐of‐year test). The diagnostic accuracy of each screening method was compared. Results suggest that diagnostic accuracy did not improve for the gated screening method when compared to the single screening method. The gated screening method tended to yield low sensitivity values (M = 0.42, range = 0.35–0.48) and high specificity values (M = 0.97, range = 0.95–0.99). The only condition to reach acceptable sensitivity and specificity (>0.70) was a single reading screener predicting reading outcomes. Sample specific cut‐scores from receiver operating curve (ROC) analyses led to improved diagnostic accuracy outcomes relative to all other methods. Practitioner Points: The diagnostic accuracy did not improve for the gated screening method when compared to the single screening method.Across the screening conditions, the only method to yield acceptable diagnostic accuracy was when a single reading screener predicted reading outcomes.Utilizing multiple assessment measures cannot be justified according to the results of the study. [ABSTRACT FROM AUTHOR]

School-based universal screening in the social, emotional, and behavioral (SEB) domains allows for the early identification of students in need of SEB support. Importantly, equitable assessment in universal screening for the SEB domains is critical to engage in accurate and ethical data-based decision-making. Measurement invariance is one method for examining potential inequities in assessment tools, permitting the ability to evaluate which assessments or assessment items perform differently across groups. As such, this study utilized multi-group confirmatory factor analysis to evaluate the extent of measurement invariance for a commonly used universal screening tool for the SEB domains: the Social, Academic, and Emotional Behavior Risk Screener - Teacher Rating Scale (SAEBRS-TRS). The sample consisted of 1949 students in kindergarten through fourth grade in a Midwest, suburban school district. Examination of factor structures indicated the bifactor model yielded adequate fit and was utilized for measurement invariance testing. Multi-group confirmatory factor analysis results provided preliminary evidence that the SAEBRS-TRS displays invariance across a variety of student characteristics. Specifically, results supported configural and metric/scalar invariance of the bifactor model across the student characteristics of racial or ethnic identity, sex assigned at birth, and eligibility for free or reduced-price lunch. Yet, future research is needed to corroborate these findings. Limitations, implications for practice, and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Universal screening is one of the most-common topics and well-accepted best practices within the field of gifted and talented education. There appears to be little disagreement that universally screening all students as part of a gifted and talented identification process results in fewer missed students. But surprisingly, there is little guidance on what makes for a quality universal screener—the tool that decides who needs further consideration. In this paper, we provide guidance that can help schools select the universal screener that helps them correctly identify as many students as possible at the lowest possible cost. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of the introduction of universal transvaginal cervical screening and certification on the quality of cervical length ultrasound images. Methods: The present study included a retrospective cohort of singleton pregnancies that underwent transvaginal cervical length measurement at the anatomical scan (180/7 and 236/7 weeks) before (period A, 2015–2017) and after (period B, 2017–2019) the introduction of universal transvaginal cervical length screening. Independent observers blindly evaluated the images obtained for cervical length using a qualitative scoring method based on five criteria, according to the Fetal Medicine Foundation. Results: In all, 6013 patients met the inclusion criteria, 3333 in period A and 2680 in period B. Maternal characteristics and risk factors for preterm birth were similar between the two periods. The acceptance of transvaginal cervical length measurement in period B was 95.5% in the overall cohort and 100% in the subgroup of high‐risk patients. The quality score was significantly higher in period B than in period A. Among the image quality criteria, the anterior/posterior ratio, the correct magnification of the images, and the calipers' placement contributed significantly to the improved quality score in period B. Most of the sonographers performed better in period B, irrespective of the years of experience, but certificate holders obtained higher scores than non‐certified sonographers, particularly those in mid‐career. The identification of short cervix was significantly higher in period B than in period A. Conclusion: The implementation of universal transvaginal cervical length screening and the certification process are associated with improved quality of cervical length images, even among expert sonographers and in the presence of anatomical pitfalls. Synopsis: The impact of the introduction of universal transvaginal cervical screening and certification on the quality of cervical length ultrasound images in both low‐ and high‐risk populations. [ABSTRACT FROM AUTHOR]

Universal screening continues to be a missed opportunity for addressing mental health in schools. The current study compared three separate self-report screening tools: the Behavior Assessment System for Children-Third Edition: Behavioral and Emotional Screening System (BASC-3 BESS), Youth Internalizing and Externalizing Problems Screener (YIEPS), and Strengths and Difficulties Questionnaire Self-Report Impact Supplement (SDQ-IS). The performance of the YIEPS, which combines the Youth Internalizing Problems Screener (YIPS) and Youth Externalizing Problems Screener (YEPS), was examined as two separate measures (i.e., the YIPS and YEPS), as well as one composite measure (i.e., the YIEPS) to determine its most effective use. The SDQ-IS was included to evaluate the performance of a screener of self-reported impairment (SDQ-IS) relative to screeners of self-reported symptom count (YIEPS and BASC-3 BESS). Participants included 400 youth in grades 6–12 attending a charter school system in Louisiana. Analyses included evaluating concurrent validity and classification accuracy for the screening tools (i.e., sensitivity, specificity, positive predictive value, and negative predictive value). For the latter analyses, the BASC-3 BESS was the criterion measure to which the other measures were compared. Receiver operating characteristic curve analyses were run, treating the BASC-3 BESS as the anchor variable, to evaluate cut scores for the YIPS, YEPS, YIEPS, and SDQ-IS. Results found the screening tools to be comparable in performance, identifying a similar proportion of students as at-risk. The YIPS and the YEPS performed best when administered together as the YIEPS, as the YEPS by itself displayed low sensitivity in identifying students in need of services. [ABSTRACT FROM AUTHOR]

Universal mental health screening is a proactive approach to identify students who may benefit from prevention or early intervention services. Despite known benefits, few schools are engaging in screening efforts and it is critical to examine factors that may impede or enhance implementation. Following implementation of a universal screening program across five preschools and elementary schools, this study investigated the attitudes of teachers (N = 40) and parents (N = 330) and found strong agreement among stakeholders about the acceptability and appropriateness of universal mental health screening. Teachers and parents expressed less willingness to regularly complete screening forms, yet teachers reported that the Behavior Assessment System for Children - Third Edition: Behavioral Emotional Screening System was a usable screening tool. Implications and future directions to enhance implementation efforts are discussed.

Universal lipid screening (ULS) is recommended for all 9- to 11-year-old children. We investigated ULS outcomes and long-term pediatrician management of children with dyslipidemia using a retrospective chart review of well-child visits between 2014 and 2016. Descriptive statistics summarized demographics, ULS results, and follow-up visits/testing. Pearson χ2 test examined differences between those with and without an abnormal screen. A total of 1039 children aged 9 to 11 years were seen for a well-child visit; only 33.3% (343/1039) completed screening. Of children screened, 18.1% (62/343) had abnormal screen results and were more likely to have an elevated body mass index (P < .001), though 30.1% (19/62) had no risk factors. A total of 10.2% (35/343) had dyslipidemia. A total of 77.1% of children with dyslipidemia received nutrition/exercise counseling and 57.1% received dietitian referrals; only 68.6% had a follow-up visit and 31.4% had repeat lipid testing. Pediatricians would benefit from more practical strategies for universal testing such as point-of-care testing and long-term management to ensure ULS is an effective screening tool.

Schools are an essential setting for mental health supports and services for students. To support student well-being, schools engage in universal mental health screening to identify students in need of support and to provide surveillance data for district-wide or state-wide policy changes. Mental health data have been collected via anonymous and self-identified response formats depending on the purpose of the screening (i.e., surveillance and screening, respectively). However, most surveys do not provide psychometric evidence for use in both types of response formats. The current study examined whether responses to the Social Emotional Health Survey–Secondary (SEHS-S), a school mental health survey, are comparable when administered using anonymous versus self-identified response formats. The study participants were from one high school and completed the SEHS-S using self-identified ( n = 1,700) and anonymous ( n = 1,667) formats. Full measurement invariance was found across the two response formats. Both substantial and minimal latent mean differences were detected. Implications for the use and interpretation of the SEHS-S for schoolwide mental health are discussed.

Abstract Background This study aimed to identify patients with upper urinary tract urothelial carcinoma (UTUC) having potential Lynch syndrome (pLS) by immunohistochemistry (IHC) of DNA mismatch repair gene-related proteins (MMRPs) and Amsterdam criteria II and explore their clinical characteristics. Methods We retrospectively collected the clinical data of 150 consecutive patients with UTUC who underwent surgical resection at our institution between February 2012 and December 2020, and immunohistochemistry (IHC) of four MMRPs (MLH1, MSH2, MSH6, and PMS2) on all UTUC specimens was performed. Patients who tested positive for Amsterdam criteria (AMS) II and/or IHC screening were classified as having pLS and others as non-pLS, and their characteristics were explored. Results In this study, 5 (3%) and 6 (4%) patients were positive for AMS II and IHC screening, respectively. Two patient were positive for both AMS II and IHC screening, resulting in 9 (6%) patients with pLS. The pLS group was predominantly female (67% vs. 36%; p = 0.0093) and had more right-sided tumors (100% vs. 43%; p = 0.0009) than the non-pLS group. Of the 6 patients who were positive for IHC screening, 4 showed a combined loss of MSH2/MSH6 (n = 3) and MLH1/PMS2 (n = 1). Other two patients showed single loss of MSH6 and PSM2. Conclusions AMS II and IHC screening identified pLS in 6% of patients with UTUC. The IHC screening-positive group tends to have relatively high rate of combined loss, but some patients have single loss. AMS II may overlook patients with LS, and a universal screening may be required for patients with UTUC as well as those with colorectal and endometrial cancer.

Schoolwide social-emotional screening identifies students who may be at-risk for school problems and benefit from prevention efforts, additional supports, or individualized interventions. Data from screening can also pinpoint topics that bolster teachers’ knowledge and skills when they provide supports and instruction focused on social, emotional, and behavioral needs. While research has explored many aspects of schoolwide screening, studies that focus on how the process of summarizing and using screening data are limited. This study investigated school teams’ perspectives on the use of a structured guide for reviewing their screening data. After collecting schoolwide screening data, 47 participants from seven school leadership teams used a Discussion Guide (DG) to answer a series of questions about their Student Risk Screening Scale – Internalizing and Externalizing (SRSS-IE) data. Using content analysis, this qualitative study identified what teams found helpful, less helpful, and what they might add to the DG. Participants valued the DG’s usefulness in developing data-based responses to the SRSS-IE results and identifying patterns and trends in their data. Including a menu of specific intervention strategies and supports was a frequent suggestion for improving the DG. Reviewing their screening data took longer than expected; participants recommended that teams needed multiple meetings for organizing, analyzing, and developing action plans.

Background: International guidelines recommend universal screening for Lynch syndrome (LS) through somatic DNA mismatch repair deficiency (dMMR) testing in all colorectal cancers (CRCs). However, LS remains largely underdiagnosed. Mainstreaming LS diagnosis through oncologist-driven genetic testing could increase detection rates, thus extending the benefits of precision prevention to patients with LS and their families. We aim to evaluate the feasibility of the mainstreaming diagnostic algorithm for LS. Patients and methods: ItaLynch is an ongoing, prospective, observational, multicenter, multidisciplinary, Italian study in patients with dMMR CRC. Being descriptive in nature, it does not attempt to test any specific, a priori, hypothesis. Patients with dMMR CRC are selected by universal screening by immunohistochemistry (IHC). In MLH1-deficient patients, reflex testing for BRAFV600E and, when appropriate, for MLH1 promoter hypermethylation is carried out. For all dMMR CRC, a ‘Lynch Alert’ is added to the pathology report: positive when a patient is at high risk for LS, due to reflex testing results or to loss of non-MLH1 proteins. Conversely, a ‘Lynch Alert’ is negative when the patient is likely to be a nonhereditary case (i.e. MLH1 loss and BRAFV600E or MLH1 promoter hypermethylation). In patients with a positive ‘Lynch Alert’, after providing a brief explanation about the risks and benefits of genetic testing, the oncologist asks patients for their consent to mainstream genetic testing. Thus a blood sample is drawn for constitutional variants of the MMR genes. Carriers of a germline variant are then referred to post-test genetic counseling. Referral to clinical genetic services is also advised for patients with clinical suspect criteria.

Background: Congenital cytomegalovirus (CMV) infection is the leading cause of hearing loss and neurocognitive delay among children. Affected infants may be asymptomatic at birth and even pass their universal hearing screen. Early identification of CMV-infected infants will allow earlier detection, evaluation and management. The prevalence of congenital CMV infection in the developed world varies geographically from 0.6% to 0.7% of all deliveries and certain regions are at higher risk. The prevalence of congenital CMV is unknown for our region. Aim: The purpose of this study was to determine the prevalence of CMV infection among the neonatal population at an urban, tertiary hospital in northeast Florida which serves a large population of patients with low socioeconomic status to assess if universal screening program for congenital asymptomatic CMV infection can be determined. Methods: The study was submitted and approved by our Institutional Review Board. We tested the urine for CMV infection in 100 asymptomatic newborns (>32 weeks gestational age and >1,750 g weight at the time of delivery) delivered between June 2016 and July 2017. Results: Urine CMV was tested on 100 infants. One infant had a positive urine NAAT for CMV, making the prevalence of congenital CMV infection among asymptomatic newborns in our hospitals' population 1%. Conclusion: CMV prevalence in our setting of an urban, tertiary hospital is relatively consistent with the national average of all congenital CMV infections. A policy of universal screening for congenital CMV may be necessary. [ABSTRACT FROM AUTHOR]

• Economic evaluations of FH screening were systematically reviewed. • The average quality score of 18 included economic evaluations is 0.73. • Cascading and universal screening of young adults show economic advantages. • FH screening studies in children and low- and middle-income countries are needed. Diagnosis rate of familial hypercholesterolemia (FH) remained less than 10 % globally and the economic evaluation results of different FH screening strategies varied. This study aimed to systematically review the methodology and results of cost effectiveness analysis (CEA) of FH screening, which will provide evidence support for health-related decision-making. The Medline/PubMed, Embase, Cochrane Library, Web of science, National Health Service Economic Evaluation Database (NHSEED) and CEA Registry databases were electronically searched to collect full economic evaluation from the establishment of the databases to June 30, 2022. The quality of included studies was evaluated by the Consolidated Health Economic Evaluation Reporting Standards statement 2022 (CHEERS 2022) checklist. Among 232 retrieved studies, 18 economic evaluations were included and all of them are from developed countries, with an average quality score of 0.73. The decision tree model and/or Markov model were constructed by thirteen articles (72 %). Twelve studies (67 %) adopted the healthcare perspective and the lifetime horizon to compare the costs and health outcome of different screening strategies. The results of eight studies indicated that cascade screening was a cost-effective strategy compared with no screening, which was more pronounced in younger adults. Universal screening in young adults aged 16 years or 18-40 years (n=3) and in children aged 1-2 years combined with reverse cascade screening (n=3) are both cost-effective. The probability of being cost-effective for cascade screening (n=6) and universal screening (n=1) of young aged 18-40 years were greater than 95 %. Our review demonstrated the economic advantages of cascade screening, universal screening of young adults, and universal screening of newborns combined with reverse cascade screening. Further health economic evaluation is needed in children and in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Background: Limited awareness, social stigma, and access to mental health professionals hinder early detection and intervention of internet gaming disorder (IGD), which has emerged as a significant concern among young individuals. Prevalence estimates vary between 0.7% and 15.6%, and its recognition in the International Classification of Diseases, 11th Revision and Diagnostic and Statistical Manual of Mental Disorders, 5th Edition underscores its impact on academic functioning, social isolation, and mental health challenges. Objective: This study aimed to uncover digital phenotypes for the early detection of IGD among adolescents in learning settings. By leveraging sensor data collected from student tablets, the overarching objective is to incorporate these digital indicators into daily school activities to establish these markers as a mental health screening tool, facilitating the early identification and intervention for IGD cases. Methods: A total of 168 voluntary participants were engaged, consisting of 85 students with IGD and 83 students without IGD. There were 53% (89/168) female and 47% (79/168) male individuals, all within the age range of 13-14 years. The individual students learned their Korean literature and mathematics lessons on their personal tablets, with sensor data being automatically collected. Multiple regression with bootstrapping and multivariate ANOVA were used, prioritizing interpretability over predictability, for cross-validation purposes. Results: A negative correlation between IGD Scale (IGDS) scores and learning outcomes emerged (r166=-0.15; P=.047), suggesting that higher IGDS scores were associated with lower learning outcomes. Multiple regression identified 5 key indicators linked to IGD, explaining 23% of the IGDS score variance: stroke acceleration (β=.33; P<.001), time interval between keys (β=-0.26; P=.01), word spacing (β=-0.25; P<.001), deletion (β=-0.24; P<.001), and horizontal length of strokes (β=0.21; P=.02). Multivariate ANOVA cross-validated these findings, revealing significant differences in digital phenotypes between potential IGD and non-IGD groups. The average effect size, measured by Cohen d, across the indicators was 0.40, indicating a moderate effect. Notable distinctions included faster stroke acceleration (Cohen d=0.68; P=<.001), reduced word spacing (Cohen d=.57; P=<.001), decreased deletion behavior (Cohen d=0.33; P=.04), and longer horizontal strokes (Cohen d=0.34; P=.03) in students with potential IGD compared to their counterparts without IGD. Conclusions: The aggregated findings show a negative correlation between IGD and learning performance, highlighting the effectiveness of digital markers in detecting IGD. This underscores the importance of digital phenotyping in advancing mental health care within educational settings. As schools adopt a 1-device-per-student framework, digital phenotyping emerges as a promising early detection method for IGD. This shift could transform clinical approaches from reactive to proactive measures. [ABSTRACT FROM AUTHOR]

Given the dearth of technically adequate universal screening tools in the Greek language, the current study sought to examine the psychometric properties of a 67-item universal screener (i.e. Integrated Teacher Rating Form; ITRF), that was originally developed in American English and then translated and implemented in Greek primary schools. The ITRF, which was designed to identify students at risk and facilitate the planning of interventions targeting classroom behaviors that interfere with academic and social functioning, incorporates four constructs (i.e. Disorganized/Academic Performance Problems, Disruptive behavior, Anxious/Depressed behavior, Socially Withdrawn behavior). To test the classification accuracy of the ITRF, a multi-gated screening procedure was followed, consisting of a brief 4-item screening measure that Greek teachers completed for all students in classroom, followed by completion of the ITRF for those students whose first-gate ratings indicated concern. Results suggested that teachers reported the highest level of concern for students' academic performance problems, followed by oppositional/disruptive behaviors, socially withdrawn behaviors, and anxious/depressed behaviors. Classification accuracy was found to be excellent for the Disorganized/Academic Productivity Problems Gate 1 measure, good for the Disruptive/Oppositional measure, fair for the Socially Withdrawn measure and poor for the Anxious/Depressed measure. [ABSTRACT FROM AUTHOR]