关于零散快运货物和混装货物安检查危工作的对策

零散快运货物和混装货物装载运输安全对铁路货运安全至关重要,为提升上海铁路局货运系统货物安检查危管理水平,在阐述零散快运货物和混装货物安检工作存在安检查危制度流于形式、安检查危设备配备不足、班组作业岗位间互控工作落实不到位等问题的基础上,从现场作业层和管理层2个方面对问题产生原因进行分析,提出从制度管理、设施配置、职责分工、检查标准、考核力度等方面入手,完善安检查危基础管理制度,规范各运输产品安检查危的作业流程,确保零散货物和混装货物运输安全风险有序可控。

Investigation of Types and Hazard of Weeds in Coffea arabica Orchads in Nujiang River Basin

[Objective] Through the investigation of weeds in Coffea arabica orchads in NuJiang River basin, this study aimed to provide scientific guidance for the weed control and improving the ecological and economic benefits of the plantation of Cof- fea arabica. [Method] The types of weeds and the characteristics of weed occur- rence in Coffea arabica orchads in Nujiang River basin were investigated from July to August in 2012. [Result] The results showed that there were 69 types of weeds belonging to 21 families in Coffea arabica orchads. The predominant harmful types were shown as follows： Commelina nudiflora L. ＋ Leptochloa chinensis, Cyperus ro- tundus L. ＋ Bidens pilosa L. ＋ Eleusine indica, Imperata cylindrical ＋ Ageratum conyzoides L. ＋ Eupatorium odoratum L., Ageratum conyzoides L. ＋ Digitaria san- guinalis （L.） Scop. The preponderant weeds consisted mainly of 10 species, namely, Cyperus rotundus L., Commelina nudiflora L., Leptochloa chinensis, Digitaria san- guinalis （L.） Scop, Imperata cylindrical, Bidens pilosa L., Ageratum conyzoides L, E- upatorium odoratum L., Eleusine indica and Chenopodium serotinum L. [Conclusion] The result from this study is of great significance for the plantation of Coffea arabica in Nujiang River basin, as well as the control of weeds.

Weekend and nighttime effect on the prognosis of peptic ulcer bleeding

AIM:To evaluate whether weekend or nighttime admission affects prognosis of peptic ulcer bleeding despite early endoscopy.METHODS:Retrospective data collection from four referral centers,all of which had a formal out-of-hours emergency endoscopy service,even at weekends.A total of 388 patients with bleeding peptic ulcers who were admitted via the emergency room between January 2007 and December 2009 were enrolled.Analyzed parameters included time from patients' arrival until endoscopy,mortality,rebleeding,need for surgery and length of hospital stay.RESULTS:The weekday and weekend admission groups comprised 326 and 62 patients,respectively.There were no significant differences in baseline characteristics between the two groups,except for younger age in the weekend group.Most patients (97%) had undergone early endoscopy,which resulted in a low mortality rate regardless of point of presentation (1.8% overall vs 1.6% on the weekend).The only outcome that was worse in the weekend group was a higher rate of rebleeding (12% vs 21%,P = 0.030).However,multivariate analysis revealed nighttime admission and a high Rockall score (≥ 6) as significant independent risk factors for rebleeding,rather than weekend admission.CONCLUSION:Early endoscopy for peptic ulcer bleeding can prevent the weekend effect,and nighttime admission was identified as a novel risk factor for rebleeding,namely the nighttime effect.

Clinical and epidemiological features of patients with clonorchiasis

AIM:To study the clinical and epidemiological features of patients with clonorchiasis so as to provide scientific evidences for the diagnosis and prevention of clonorchiasis. METHODS:Stools from 282 subjects suspected of having clonorchiasis were examined for helminth eggs with modified Kato's thick smear and sedimentation methods,and their sera were tested for HAV-DNA,HBV-DNA,HCV-RNA,HDV- RNA and HEV-RNA with polymerase chain reaction (PCR). Clinical symptoms of patients with clonorchiasis only were analyzed,and their blood samples were tested for circulating antigen (CAg) with Dot-ELISA,esoinophilic granulocyte count, and alanine aminotransferase (ALT).Meanwhile,they were asked to provide data of occupation,eating habit,hygienic habit and knowledge of donorchiasis.In addition,the ecosystem of the environment in epidemic areas was surveyed. RESULTS:Among the 282 patients,61 (21.43%) were infected with clonorchis sinensis only,97 (34.64%) were co-infected with clonorchis sinensis and other pathogens, 92 (32.86%) were infected with hepatitis virus only and 31 (11.07%) neither with clonorchis sinensis nor hepatitis virus. Among the 61 patients with clonorchiasis only,there were 14 (22.95%) subjects with discomfort over hepatic region or epigasfrium,12 (19.67%) with general malaise or discomfort and inertia in total body,6 (9.84%) with anorexia,indigestion and nausea,4 (6.56%) with fever,dizziness and headache (6.56%),and 25 (40.98%) without any symptoms;sixty one (100%) with CAg (+),98.33% (59160) with eosinophilic granulocytes increased and 65.00% (39/60) with ALT increased.B-mode ultrasonography revealed 61 cases with dilated and thickened walls of intrahepatic bile duct,and blurred patchy echo acoustic image in liver.Twenty-six cases had stones in the bile duct,39 cases had slightly enlarged liver with diffuse coarse spots in liver parenchyma.Twenty cases had enlarged gallbladder with thickened coarse wall and image of floating plagues,9 cases had slightly enlarged spleen.By analysis of epidemiological data,we found that the ecologic environment was favorable for the epidemiology of clonorchiasis.Most patients with clonorchiasis were lack of knowledge about the disease.Their living environment, hygienic habits,eating habits and their occupations were the related factors that caused the prevalence of the disease. CONCLUSION:The clinical symptoms of clonorchiasis are non-specific,and the main evidences for diagnosis of clonorchiasis should be provided by etiologic examination, B-mode ultrasonography and clinical history.The infection of clonorchis sinensis is related to occupations,bad eating habits and lack of knowledge about prevention of the disease.

The distribution of 10-year cardiovascular risk in Chinese adults： analysis of the China Health Examination Database （CHED） 2008

Objective Global cardiovascular risk assessment has been incorporated into current Chinese guidelines for the management of hypertension and hypercholesterolemia. The aim of our study is to determine the distribution of 10-year risk for ischemic cardiovascular disease （ICVD） among middle-aged Chinese adults, and to evaluate the usefulness of global risk assessment tools in the primary prevention of ICVD in Chinese population.Methods Simplified prediction tools derived from the USA-PRC Collaborative Study of Cardiovascular Epidemiology cohort were applied to the Chinese Health Examination Database （CHED） 2008. 10-year risk for ICVD was estimated in 461 157 ICVD-free subjects （264 432 male and 196 725 female） aged 35 to 59 years. Results Among the male subjects, 82.4% had a 10-year risk for ICVD of 〈5%, 14.4% of 5% to 12.1% and 3.4 of≥ 12.2%, and in female subjects, 86.7% had a 10-year risk for ICVD of 〈5%, 12.1% of 5% to 12.0% and 1.2% of ≥ 12.1%. All subjects with predicted high level ICVD risk （≥ 12.2% in male or ≥ 12.1% in female） had either remarkably elevated （≥ 160 mmHg） blood pressure, significantly increased （≥ 6.22 mml/L） total serum cholesterol or diabetes.Conclusion Using the currently recommended prediction tools, only very small proportions of middle-aged Chinese men and women who were free of ICVD would be classified into high level risk group. These prediction tools are unlikely to help for the medical intervention decision making in Chinese adult patients with hypertension and/or hypercholesterolemia

Experimental study on characteristics of trapping and regulating sediment with an open-type check dam in debris flow hazard mitigation

Beam dams are a highly effective and commonly used open-type check dam in debris-flow hazard mitigation. In this study, dimensional analysis was used to obtain empirical equations for quantitatively determining the sediment-trapping and flow-regulating characteristics of a beam dam. To determine the coefficients of the empirical equations, flume experiments were conducted to simulate the trapping and regulating processes. The flow pattern, trapping, and regulating characteristics were investigated when debris flows passed through a beam dam. Debris-flow bulk density and peak discharge, and sediment-trapping ratios, were measured directly and indirectly. The results showed that three blocking actions occurred, and that blockage-breaking considerably influenced the trapping and regulating performance of the beam dam. The relative opening size and the sediment concentration were the two main factors affecting the performance of the beam dam. The ratio of trapping sediment decreased with relative opening, and increased with sediment concentration as well as reducing ratio of bulk density and reducing ratio of peak discharge. The sediment concentration and relative opening were the leading factors influencing the trapping and regulating sediment of a beam dam, followed by flume gradient. The results showed that the calculated values obtained using empirical equations were in good agreement with the values derived from the experiments, and that the deviation was acceptable. Finally, taking Zechawa Gully as an example, using the empirical equations we designed the opening size of a beam dam aimed to trap sediment and regulate peak discharge of debris flow in the main gully.

Barrier-focused intervention to increase colonoscopy attendance among nonadherent high-risk populations

AIM： To increase attendance tor colonoscopy among nonadherent high-risk individuals for colorectal cancer （CRC） screening in China. METHODS： During the first 12 mo without intervention, only 428 of the 2398 high-risk subjects attended a scheduled colonoscopy examination. The 1970 subjects who did not attend for CRC screening were enrolled in the present study. Prior barrier investigation was performed to ascertain the reasons for nonadherence. A barrier-focused intervention program was then established and implemented among eligible nonadherent subjects by telephone interviews and on-site consultations. The completion rates of colonoscopy during the first 12 mo without intervention and the second 12 mo with intervention were compared. Variations in the effect of the intervention on some high-risk factors and barrier characteristics were analyzed using logistic regression. RESULTS： 540 subjects who were not eligible were excluded from the study. The colonoscopy attendance rate was 23.04% （428/1858） during the first 12 mo without intervention, and 37.69% （539/1430） during the second 12 mo with intervention （P 〈 0.001）. Logistic regression analysis showed that the intervention was more effective among subjects with only objective barriers （OR： 34.590, 95% CI： 23.204-51.563） or subjects with some specific highrisk characteristics： first-degree relatives diagnosed with CRC （OR： 1.778, 95% CI： 1.010-3.131）, personal history of intestinal polyps （OR： 3.815, 95% CI： 1.994-7.300） and positive result for immunochemical fecal occult blood testing （OR： 2.718, 95% CI： 1.479-4.996）. CONCLUSION： The barrier-focused telephone or on- site consultation intervention appears to be a feasible means to improve colonoscopy attendance among nonadherent high-risk subjects for CRC screening in China.

XPD Lys751Gln polymorphism and esophageal cancer risk: A meta-analysis involving 2288 cases and 4096 controls

AIM: To evaluate the association between xeroderma pigmentosum group D (XPD), genetic polymorphism Lys751Gln and esophageal cancer risk. METHODS: We searched PubMed up to September 1, 2010 to identify eligible studies. A total of 10 casecontrol studies including 2288 cases and 4096 controls were included in the meta-analysis. Statistical analysis was performed with Review Manage version 4.2. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of the association.RESULTS: The results suggested that there is no significant association between XPD Lys751Gln polymorphism and esophageal cancer susceptibility in the overall population. However, in subgroup analysis by histology type, a significant association was found between XPD Lys751Gln polymorphism and esophageal adenocarcinoma (for CC vs AA: OR = 1.25, 95% CI = 1.01-1.55, P = 0.05 for heterogeneity). CONCLUSION: Our meta-analysis suggested that XPD Lys751Gln polymorphism may be associated with increased risk of esophageal adenocarcinoma.

Analysis of risk factors for polypoid lesions of gallbladder among health examinees

AIM: To investigate the prevalence and risk factors of polypoid lesions of gallbladder (PLG) among the health examinees in the Shanghai region, China. METHODS: A total of 11 816 subjects who underwent health examinations in our hospital between August 2010 and February 2011 were analyzed retrospectively. Among them, there were 7174 men and 4642 women. PLG was diagnosed by the real-time ultrasonography. Those with the body mass index (BMI) ≥ 28 were considered to be obese. Blood biochemical indices were detected with the fully automatic biochemical analyzer and hepatitis B surface antigen (HBsAg) was tested by the automated enzyme immunoassay. The correlations between the prevalence of PLG and age, sex, BMI, serum cholesterol (T-Cho), triglycerides (TG),blood sugar, HBsAg, high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), gallstone and fatty liver were investigated. After univariate analysis of 11 variables, stepwise logistic regression analysis was performed to explore the risk factors of PLG. RESULTS: There was a significant difference in sex, T-Cho, HBsAg, HDL-C, LDL-C and fatty liver between the PLG-positive group and the PLG-negative group (332/163 vs 6842/4479, P = 0.003; 22/473 vs 295/11 026, P =0.013; 92/403 vs 993/10 328, P = 0.001; 47/448 vs 332/10 989, P = 0.001; 32/463 vs 381/10 940, P = 0.001; 83/412 vs 3260/8061, P = 0.001). No significant difference was found in the age, BMI, TG, blood sugar and gallstone between the two groups (47.3 ± 26 vs 45.1 ± 33, P = 0.173; 59/436 vs 1097/10 224, P = 0.102; 52/443 vs 982/10 339, P = 0.158; 17/478 vs 295/11 026, P = 0.26; 24/471 vs 395/10 926, P = 0.109). Logistic regression analysis showed that the sex, HBsAg and HDL-C were independent risk factors for the development of PLG in a descending order of HDL-C > HBsAg > sex. CONCLUSION: In healthy people, the male gender, positive HBsAg, and low HDL-C confer higher risks of PLG development.

Review of screening for pancreatic cancer in high risk individuals

Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival.Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation.Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer.Recent efforts have focused on detecting disease at an earlier stage to improve survival in these high-risk groups.This article reviews high-risk groups,screening methods,and current screening programs and their results.

Population survey and conservation assessment of the globally threa- tened cheer pheasant （Catreus wallicht） in Jhelum Valley, Azad Kas- hmir, Pakistan

The cheer pheasant Catreus wallichi is a globally threatened species that inhabits the western Himalayas. Though it is well established that the species is threatened and its numbers declining, updated definitive estimates are lacking, so in 2011, we conducted a survey to assess the density, population size, and threats to the species in Jhelum valley, Azad Kashmir, which holds the largest known population of cheer pheasants in Pakistan. We conducted dawn call count surveys at 17 points clustered in three survey zones of the valley, 11 of which had earlier been used for a 2002-2003 survey of the birds. Over the course of our survey, 113 birds were recorded. Mean density of cheer pheasant in the valley was estimated at 11.8±6.47 pairs per km2, with significant differences in terms of both counts and estimated density of cheer were significantly different across the three survey zones, with the highest in the Chinari region and the lowest, that is the area with no recorded sightings of the pheasants, in Gari Doppata. The total breeding population of cheer pheasants is estimated to be some 2 490 pairs, though this does not consider the actual area of occupancy in the study area. On the whole, more cheer pheasants were recorded in this survey than from the same points in 2002-2003, indicating some success in population growth. Unfortunately, increasing human settlement, fires, livestock grazing, hunting, and the collection of non-timber forest products continue to threaten the population of cheer in the Jhelum valley. To mitigate these potential impacts, some degree of site protection should be required for the conservation of cheer pheasants in Pakistan, and more effective monitoring of the species is clearly needed.

Surface Rupture and Coseismic Displacement of the M_S7.1 Yushu Earthquake

On April 14, 2010, a devastating earthquake measured 7.1 on the Richter scale struck Yushu county, Qinghai Province, China. Field geological investigation and remote sensing interpretation show that this earthquake generated an inverse ＂L-shaped＂ surface rupture zone, approximately 50km long. The surface rupture zone can be divided into three segments. Between the northern and middle segments of the surface rupture, there is a 16km-long segment, where no rupture was observed. The middle and the southern segments are arranged in a left-step manner, and there are right-step en echelon ruptures developed in the stepovers. The seismogenic structure is the Yushu fault, which is dominated by strike-slip with a small amount of thrust component. The earthquake results from the differential movements between the southern Qiangtang Block and northern Bayan Har Block. The earthquake recurrence interval is 185a^108a. Along an approximately 20km-long part of the Garze-Yushu fault, between the southern surface rupture of Yushu Ms7. 1 earthquake and the 1896 earthquake, there is no surface rupture, its seismic risk needs further research.

STUDY ON HIV/STDS KNOWLEDGE AND RISK BEHAVIORS RELATED FACTORS AMONG FEMALE SEX WORKERS IN SHANGHAI,CHINA

Objective To assess the HIV/STDs knowledge and risk behaviors related factors among female sex workers(FSWs)in Shanghai,China.Methods A cross-sectional study was conducted in 5 districts(including 3 suburbs and 2 urban districts).A total of 324 FSWs from 88 massage parlors and hair-beauty salons participated in the survey.An interviewer-administrated questionnaire was used to collect information.Results The average score of HIV/STDs knowledge was 15.2±3.9.Multivariate analyses indicated that limited education [odds ratio(OR):8.6,95% confidence interval(CI):2.9-25.6],coming from suburbs [odds ratio(OR):3.7,95% confidence interval(CI):2.0-6.8],monthly income less than 1500 RMB(220 US$)[odds ratio(OR):3.9,95% confidence interval(CI):1.9-8.1],without HIV/STDs-related education experience(OR:5.2,95% CI:2.8-9.5),and coming from provinces of low epidemic(OR:2.7,95% CI:1.1-6.6)were significant predictors of lower HIV/STDs knowledge.And 29.5% FSWs had sex without a condom when clients paid much more money,and 46.3% had the experience of condom broke or slipped during commercial sexual intercourse.Conclusion Health promotion should be conducted to enhance HIV/STDs knowledge and reduce risk behaviors among FSWs from suburbs with limited education in Shanghai especially.

Risk factors for rebleeding after angiographically negative acute gastrointestinal bleeding

AIM:To identify possible predictive factors for rebleeding after angiographically negative findings in patients with acute non-variceal gastrointestinal bleeding.METHODS: From January 2000 to July 2007, 128 patients with acute non-variceal gastrointestinal bleeding had negative f indings after initial angiography. Clinical and laboratory parameters were analyzed retrospectively.RESULTS: Among 128 patients, 62 had no recurrent gastrointestinal bleeding and 66 had recurrent gastrointestinal bleeding within 30 d. As determined by the use of multivariate analysis, an underlying malignancy, liver cirrhosis and hematemesis were significant factors related to recurrent gastrointestinal bleeding.CONCLUSION: Clinical factors including underlying malignancy, liver cirrhosis, and hematemesis are important predictors for rebleeding after angiographically negative findings in patients with acute non-variceal gastrointestinal bleeding.

Risk Communication： Survey on Quality of Safety Data Sheets of Agricultural Substances

Manufacturers of chemicals are responsible for setting up a list of tools, including labels and safety data sheets, in order to provide adequate information about dangerous properties being labels and safety data sheets the main instruments for the immediate advice about dangerous substances and preparations for general public and workers. While correct labelling gives the possibility to general public to recognise the risks arising from handling and use of dangerous chemicals, safety data sheets are provided for professionals in order to allow safe handling and storage of dangerous chemicals in work places. Information contained in safety data sheets are also designed to suggest safety measures to be taken for the protection of workers as well as precaution measures and adequate actions to be taken in the case of accident. This project has critically revised the information contained in a list of safety data sheets of active ingredients provided for plant protection products, in order to assess the quality and the consistency of the data contained. Reported data have been then compared to published data. Considerable deficiencies/mistakes/inconsistencies have been found in the data reported along the safety data sheets of the examined substances, showing an urgent need of improving the enforcement related to a systematic recognition in this field as well as training of people involved in compilation of safety data sheets by producer side.

Safe Disposal of Medicines in Palestine

The disposal of unwanted and expired medications has been a concern to public health practitioners, and patients alike. The objective of the current investigation was to look closely at the practice of patients and carers in Nablus-Palestine with regard to disposal of unused or expired medicines. The study was a cross-sectional survey administered via face-to-face structured interviews with randomly selected patients, community pharmacists and physicians from Nablus-Palestine. Two hundred and fifty patients/carers completed a questionnaire regarding medicines disposal current practice, effects on environment, and their views to overcome this problem. Most of the people completing the questionnaire （67%） stated that they throw unwanted medicines in the normal household bins, and about 75% think that this can impose illegal and environmental hazards. Nearly half of the questionnaire showed that main reason for need to dispose medicines was possessing expired ones with almost believe there should be more appropriate way to dispose medicines. About 95% said they have not been directed for safe disposal of medicines with 46% thinking that a national campaign can be very educative in this issue mainly through Ministry of Health （54%） followed by .73% of the sampled patients were in favor of national campaign to direct people to safe disposal of medicines. This pilot study in Nablus clearly highlights the need for appropriate method for safe disposal of medicines in Palestine through guidelines in pharmacies and hospitals. A well organized method for collecting unwanted medicines from people should be encouraged through appropriate teaching of patients and caters about effects of waste medicines on environment as well as being domestic hazard. The data and information is valuable for furthering discussions regarding patients behaviour and also provides a basis for future research into determining what quantities of active pharmaceutical ingredients （APIs） are disposed, enter the environment and what effects it can impose.

Reviewing Design References with Diagrams： A Metropolitan Performance Assessment Perspective

The announcement of major sporting events scheduled to take place in Rio de Janeiro in the coming years is now producing several radical urban transformations that are attracting the attention of renowned architects of the international circuit. All this is happening in a city where relevant architectural references have not been produced for a long while because of the prolonged economic crisis of the past. Despite these conditions, people were able to detect “invisible” design lessons to be learned in this city by sharing perceptual experiences with foreign observers who are, by definition, unaware of their preconceptions. This paper deals with the development of a strategy for re-presenting design references that are locally rooted and accessible for direct embodied experience. The strategy put forward a MPI （metropolitan performance index） drawn out from a bibliographical survey coupled with analytical spatial diagrams of different case-studies presented as a tour guide for the recognition of the architecture produced in Rio de Janeiro. It is believed that this strategy can favor the adoption of an eye attuned to contemporary theories especially interested in the spatial and programmatic concerns that today instigate the designer.

Progress in advanced methodology development for food-safetyinspection

Food safety is of great concern worldwide,directly related to human health through diet.Multifarious food contaminants could cause severe public health hazards,such as gastrointestinal,neurological,immunological diseases,and even cancers,thus food safety has always been a hot-button issue.Development of rapid,accurate,and non-destructive methods is required to ensure food safety for human consumption.In this review,we summarize the main factors threatening food safety,such as foodborne pathogens,toxins,residues,and adulteration as well as the corresponding food safety inspection methods,focusing on the up-to-date progress.Due to the merits of increasing sensitivity,specificity and convenience,those methods will take food detection and analysis into a new era.

Screening for colorectal cancer in Tianhe,Guangzhou:results of combining fecal immunochemical tests and risk factors for selecting patients requiring colonoscopy

Objective:To explore the performance of a protocol combining fecal immunochemical test(FIT)and a high-risk factor questionnaire(HRFQ)for selecting patients requiring colonoscopy as part of a population-based colorectal cancer(CRC)screening program in China.Methods:From 2015 to 2016,we conducted a CRC screening program for all residents aged 45 years or older in Tianhe District,Guangzhou City,China.Participants underwent an FIT and received an HRFQ as part of primary screening.Those with positive FIT and/or HRFQ results were considered to be at high risk and were recommended to undergo colonoscopy.Results:A total of 10074 subjects were recruited and enrolled in the screening program.In the enrolled population,17.5%had positive FIT results and 19.4%had positive HRFQ results.Of those recommended to undergo diagnostic colonoscopy,773 did so.The screening method’s overall positive predictive value(PPV)was 4.9%for non-adenomatous polyps,11.4%for low-risk adenomas(LRAs),15.9%for high-risk adenomas(HRAs)and 1.6%for CRC.The PPVs of positive FIT results for nonadenomatous polyps,LRAs,HRAs and CRC were 5.2%,15.9%,22.5%and 2.5%,respectively.The PPVs of positive HRFQ results for non-adenomatous polyps,LRA,HRA and CRC were 4.1%,10.2%,14.3%and 1.4%,respectively.The PPVs associated with combined positive FIT and HRFQ results for non-adenomatous polyps,LRAs,HRAs and CRC were 4.5%,16.4%,23.7%and 2.8%,respectively.Conclusion:Our results suggest that this two-step CRC screening strategy,involving a combination of FIT and HRFQ followed by colonoscopy,is useful to identify early-stage CRC.The high detection rates and PPVs for CRC and adenomas encourage this strategy’s use in ongoing screening programs.