Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?

BACKGROUND Colorectal cancer(CRC)is a global health concern,with advanced-stage diagnoses contributing to poor prognoses.The efficacy of CRC screening has been well-established;nevertheless,a significant proportion of patients remain unscreened,with>70%of cases diagnosed outside screening.Although identifying specific subgroups for whom CRC screening should be particularly recommended is crucial owing to limited resources,the association between the diagnostic routes and identification of these subgroups has been less appreciated.In the Japanese cancer registry,the diagnostic routes for groups discovered outside of screening are primarily categorized into those with comorbidities found during hospital visits and those with CRC-related symptoms.AIM To clarify the stage at CRC diagnosis based on diagnostic routes.METHODS We conducted a retrospective observational study using a cancer registry of patients with CRC between January 2016 and December 2019 at two hospitals.The diagnostic routes were primarily classified into three groups:Cancer screening,follow-up,and symptomatic.The early-stage was defined as Stages 0 or I.Multivariate and univariate logistic regressions were exploited to determine the odds of early-stage diagnosis in the symptomatic and cancer screening groups,referencing the follow-up group.The adjusted covariates were age,sex,and tumor location.RESULTS Of the 2083 patients,715(34.4%),1064(51.1%),and 304(14.6%)belonged to the follow-up,symptomatic,and cancer screening groups,respectively.Among the 2083 patients,CRCs diagnosed at an early stage were 57.3%(410 of 715),23.9%(254 of 1064),and 59.5%(181 of 304)in the follow-up,symptomatic,and cancer screening groups,respectively.The symptomatic group exhibited a lower likelihood of early-stage diagnosis than the follow-up group[P<0.001,adjusted odds ratio(aOR),0.23;95%confidence interval(95%CI):0.19-0.29].The likelihood of diagnosis at an early stage was similar between the follow-up and cancer screening groups(P=0.493,aOR for early-stage diagnosis in the cancer screening group vs follow-up group=1.11;95%CI=0.82-1.49).CONCLUSION CRCs detected during hospital visits for comorbidities were diagnosed earlier,similar to cancer screening.CRC screening should be recommended,particularly for patients without periodical hospital visits for comorbidities.

Who should be screened for colorectal cancer and how can it be prevented more effectively?

In this editorial,we comment on the article published by Agatsuma et al in a recent issue of the World J Gastroenterol(2024;30:1368-1376).We firmly concur with Agatsuma et al regarding the vital significance of colorectal cancer(CRC)screening as a public health strategy to diminish disease burden.Individuals exposed to risk factors for CRC,those with comorbid conditions,and those with limited health literacy should undergo screening.However,we believe that more regular screenings should be accompanied by a greater focus on primary prevention(PP)of CRC.CRC remains a significant global health challenge,and its incidence is strongly linked to age,lifestyle,and socioeconomic factors.It is particularly noteworthy that the majority of CRC patients are diagnosed outside of established screening pathways and frequently at an advanced stage of the disease,and the majority of patients possess inadequate or even nonexistent knowledge regarding CRC,which significantly impacts the prognosis and imposes a substantial economic burden.This study revealed that CRC identified during hospital visits for comorbid conditions was typically diagnosed at an earlier stage than detected via symptomatic pathways.Remarkably,early incidental detection of CRC aligns closely with the timing of discovery through routine cancer screenings.This suggests that by adopting more inclusive screening protocols that combine opportunistic testing with traditional screening methods,health care systems can create a more comprehensive safety net for individuals at risk of CRC.However,before maximizing the health benefits of screening programs,it is essential to make additional efforts prior to screening,such as raising awareness via public education,risk assessment,and personalized recommendations,enhancing the knowledge and skills of health care professionals,optimizing the accessibility and convenience of screening processes,ensuring the quality and safety of screening services,strengthening follow-up and support systems,and providing policy support and financial investment.The establishment of a comprehensive screening system often requires substantial investment in human,material,and financial resources,which can be challenging to achieve in regions with limited health care resources.Strengthening PP strategies can reduce the disease burden by targeting the cause,representing a more cost-effective and impactful approach.Establishing a comprehensive cancer PP service platform that integrates authoritative public education on malignant tumor PP,individualized malignant tumor risk assessment,and self-health management assistance accessible to the entire population will significantly enhance the overall effectiveness of CRC PP strategies.

Binding Energies of Screened Excitons in a Strained(111)-Oriented Zinc-Blende GaN/AlGaN Quantum Well Under Hydrostatic Pressure

We investigate the binding energies of excitons in a strained （111）-oriented zinc-blende GaN/Al0.3 Ga0.7 N quantum well screened by the electron-hole （e-h） gas under hydrostatic pressure by combining a variational method and a selfconsistent procedure. A built-in electric field produced by the strain-induced piezoelectric polarization is considered in our calculations. The result indicates that the binding energies of excitons increase nearly linearly with pressure,even though the modification of strain with hydrostatic pressure is considered, and the influence of pressure is more apparent under higher e-h densities. It is also found that as the density of an e-h gas increases,the binding energies first increase slowly to a maximum and then decrease rapidly when the e-h density is larger than about 1 ×10^11 cm^-2. The excitonic binding energies increase obviously as the barrier thickness decreases due to the decrease of the built-in electric field.

Approximate solution to the time-dependent Kratzer plus screened Coulomb potential in the Feinberg–Horodecki equation

We obtain the quantized momentum eigenvalues Pn together with space-like coherent eigenstates for the space-like counterpart of the Schr¨odinger equation,the Feinberg–Horodecki equation,with a combined Kratzer potential plus screened coulomb potential which is constructed by temporal counterpart of the spatial form of these potentials.The present work is illustrated with two special cases of the general form:the time-dependent modified Kratzer potential and the time-dependent screened Coulomb potential.

Momentum Eigensolutions of Feinberg-Horodecki Equation with Time-Dependent Screened Kratzer-Hellmann Potential

We obtain an approximate value of the quantized momentum eigenvalues, Pn, together with the space-like coherent eigenvectors for the space-like counterpart of the Schrödinger equation, the Feinberg-Horodecki equation, with a screened Kratzer-Hellmann potential which is constructed by the temporal counterpart of the spatial form of this potential. In addition, we got exact eigenvalues of the momentum and the eigenstates by solving Feinberg-Horodecki equation with Kratzer potential. The present work is illustrated with three special cases of the screened Kratzer-Hellman potential: the time-dependent screened Kratzer potential, time-dependent Hellmann potential and, the time-dependent screened Coulomb potential.

A New Method for the Atomic Ground-State Energy in the Screened Coulomb Potential

The new method proposed recently by Friedberg,Lee and Zhao is applied to the derivation of the atomic ground-state energy with the inclusion of the screening effect.The present results are compared with those obtained in the pure Coulomb potential and by the variational approach.The overall good results are obtained with this new method.

Bound State Solutions of the Schrödinger Equation for the More General Exponential Screened Coulomb Potential Plus Yukawa (MGESCY) Potential Using Nikiforov-Uvarov Method

The solutions of the Schr&#246;dinger with more general exponential screened coulomb (MGESC), Yukawa potential (YP) and the sum of the mixed potential (MGESCY) have been presented using the Parametric Nikiforov-Uvarov Method (pNUM). The bound state energy eigenvalues and the corresponding un-normalized eigenfunctions expressed in terms of hypergeometric functions were obtained. Some derived equations were used to calculate numerical values for MGESC, YP, and MGESCY potentials for diatomic molecules with different screening parameters (α) for l = 0 and l = 1 state with V0 = 2.75 MeV and V1 = 2.075 MeV. We observed an increase in l value;the particles behave more repulsive than attractive. The numerical values for different l-states at different screening parameters for CO molecules (r = 1.21282) and NO molecule (r = 1.1508) were obtained using the bound state energy eigenvalue of the Schrodinger equation for MGESC, YP and MGESCY potentials. Potential variation with intermolecular distance (r) for some of the particles moving under the influence of MGESC, Yukawa and the mixed potential (MGESCY) were also studied. We also observed the variation of the MGESC potential with the radial distance of separation between the interacting particles (r) for different screening parameters (α) with V0 = 2.75 MeV at l = 0 and l = 1 and YP with V1 = 2.075 MeV at l = 0 and l = 1 as purely diatomic particles in nature. The energies plotted against the principal quantum number n for different values of (α) for both CO and NO show closed resemblance even at different values of the potential depth. The energy plots of the YP and MGESC potential for both CO and NO molecules as n→∞, and the energy E→0, shows exothermal behaviour. The energy expression for the mixed potentials V0 = 5 MeV and V1 = 10 MeV, shows that both diatomic molecules possesses similar behaviour.

The likelihood of having a serum PSA level of ≥ 2.5 or ≥ 4.0 ng ml^-1 according to obesity in a screened Korean population

This study aimed to determine if lower serum total prostate-specific antigen （PSA） levels in obese Korean men affect prostate cancer （PCa） screening, as an increased body mass index （BMI） is inversely associated with the PSA level. Between March 2007 and December 2012, 22 208 native Korean men who were eligible to receive a serum PSA test were recruited. Logistic regression was used to estimate the odds of an ＇abnormal＇ PSA （ ≥ 2.5 or/〉 4.0 ng ml^- 1） in these men （age： 45-75 years, PSA 〈 10 ng ml^-1） based on BMI, which was categorized as normal （BMI 〈25 kg m^-2） and obese （BMI i〉 25 kg m-2）. In all, 20 509 men （92.3%） were included in the study after applying the inclusion criteria. After controlling for age, there was a statistically significant trend towards a lower likelihood of having a serum PSA level ≥ 2.5 ng ml^-1 with an increased BMI, with obese men having an 18% lower likelihood （odds ratio： 0.823, 95% confidence interval： 0.743-0.912; P〈0.001） compared to men with a normal BMI. Obese men were approximately 82% as likely to have a PSA level ≥ 2.5 ng ml^-2 as men with a normal BMI. These results might affect PCa screening using serum total PSA. Further studies are needed to better define these results in clinical biopsy practice.

Are diabetic patients being screened for sleep related breathing disorder?

Prevalence of both diabetes mellitus and obstructive sleep apnea(OSA)is high among general population.Both of these conditions are associated with significant morbidity.OSA affects approximately 25%of men and 9%of women,and its prevalence is even higher among obese,Hispanics,African American and diabetic patients.Diabetes on the other hand besides having high prevalence in general population has even higher prevalence among ethnic populations as Hispanics and African American.Despite the availability of several simple screening tools for OSA,as Berlin questionnaire,STOP-BANG questionnaire,NAMES Criteria,the utility for screening of OSA among the diabetic population remains marginal.This in turn can lead to significant morbidity and complications related to OSA as well as worsening of diabetes mellitus and increase in diabetic complications due to untreated sleep related breathing disorder.It is therefore imperative for the primary care giver to screen for OSA among the diabetic population as a part of their routine evaluation to prevent worsening of diabetes,and its cardiovascular,renal,ophthalmologic and neurological complications.

Neutrino energy loss by electron capture on strongly screened iron group nuclei

The influences on the neutrino energy loss rates in iron group nuclei at the same density are investigated in the presence of strong electron screening and in the absence of electron screening. The results show that at a temperature of 15 × 10^9 K, the neutrino energy loss rates which come from the electron capture process for most iron group nuclei decrease no more than 2 orders of magnitude but for the others （such as ^53,55,56,57,58,59,6o Co, ^56,59Ni） they can decrease about 3 orders of magnitude due to strong electron screening （SES）, whereas, at a temperature of 10^9K the neutrino energy loss rates of the most iron group nuclei can be diminished greatly due to the SES. For example, ^61Fe, ^60Fe, and ^62Ni the neutrino energy loss rates decrease about 4, 15 and 16 orders of magnitude and for ^57Cr, ^58Cr, and ^60Cr decrease about 18, 12, and 10 orders of magnitude respectively. According to our calculations the neutrino energy loss rates of nuclei ^58Mn, ^59Mn, ^60Mn, and ^62Mn may decrease about 13 orders of magnitude at a temperature of 10^9 K due to the SES.

Syphilis and HIV Infection among Pregnant Women Previously Screened Negative during Their First Antenetal Care Visit (ANC) at Some Selected Health Facilities in the Buea Health District, Cameroon

Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of concern now are the rising rates of congenital syphilis and HIV in Cameroon. Cameroon only mandates testing pregnant women for syphilis and HIV during their first ANC visit. This study was aimed at determining the incidence of new syphilis and HIV infections and factors associated with pregnant women who previously tested negative during their first ANC visit. A cohort design was used, where 335 pregnant women were followed up for a period from December 2019 to August 2020. A blood sample was drawn and the serum was analyzed using the WANTAI ELISA and AIDTM HIV 1 + 2 Ag/Ab ELISAPlus test methods for syphilis and HIV respectively at three intervals. A questionnaire was used to identify risk factors. Data was analyzed using SPSS 23.0. Out of the 335 pregnant women who were followed up during this study, 49 (14.6%) were later diagnosed with syphilis (32 in 2nd trimester and 17 in 3rd trimester). 54 (16.1%) were diagnosed with HIV infection (13 at two months post-1st-trimester visit, 23 in the 2nd trimester and 18 in the 3rd trimester). Lastly, 10 (2%) were co-infected with syphilis and HIV of which 8 occurred during 2nd trimester and 2 in the 3rd trimester. The factors associated with contracting new syphilis infections include;younger age group aOR (1.302, 95% CI), leaving in an urban area aOR (3.158, 95% CI), lower level of education (Primary and no formal) with aOR of (9.055, 95% CI) (P = 0.001) and (6.764, 95% CI) (P = 0.006) respectively, inadequate knowledge on the diseases aOR (2.176, 95% CI), women unaware of their partner status aOR (3.190, 95% CI). Most factors associated with contracting new HIV infections were similar to the factors associated with contracting new syphilis infections post 1st ANC visit aOR (1.174, 95% CI) and pregnant women with more than one sexual partner aOR (7.342, 95% CI) were observed for HIV infection.. There is an increased incidence of new infection of syphilis and HIV post first ANC screening in the Buea Health District, Cameroon. The need for constant education on the identifiable factors and these diseases, and screening during every ANC visit irrespective of their previous laboratory results is warranted.

Application of the Screened Hydrogenic Model to Light Atoms

The purpose of this work was to develop a Screened Hydrogenic Model (SHM) to accurately calculate the electron energies for light atoms and ions with up to ten electrons for atomic numbers up to 18. The total energy of an atom or ion was calculated with effective nuclear charges and screening parameters for each electron type (1s, 2s and 2p) within a specific electron configuration. Multiple energy states, centered at the total energy, were calculated for electron configurations that have Russell-Saunders coupling. The energy of each electron included its relativistic energy, EREL, but close overall agreement between the calculated and experimental energies of multi-electron configurations required that the one-electron expression for EREL be modified in a simple manner. In the present work, 98% of the 587 calculated energies for light atoms/ions have a relative error within ±0.1% of the corresponding experimental energies. The effective nuclear charges described in this work allow hydrogen-like wave functions to be defined for the electrons within a multi-electron configuration. The SHM, described in this work, is available for future calculations involving light atoms and ions.

p-wave resonances in the exponential cosine screened Coulomb potential

We perform benchmark calculations of the p-wave resonances in the exponentially cosine screened Coulomb potential using the uniform complex-scaling generalized pseudo-spectral method.The present results show significant improvement in calculation accuracy compared to previous predictions and correct the misidentification of resonance electron configuration in previous works.It is found that the resonance states approximately follow an n^(2)-scaling law which is similar to the bound counterparts.The birth of a new resonance would distort the trajectory of an adjacent higher-lying resonance.

Higgs Algebraic Symmetry of Screened System in a Spherical Geometry

The orbits and the dynamical symmetries for the screened Coulomb potentials and isotropic harmonic oscillators have been studied by Wu and Zeng [Z.B. Wund J.Y. Zeng, Phys. Rev. A 62 （2000） 032509]. We find similar properties in the corresponding systems in a sphericM space, whose dynamical symmetries are described by Higgs algebra. There exist extended Runge-Lenz vector for screened Coulomb potentials and extended quadruple tensor for screened harmonic oscillators. They, together with angular momentum, constitute the generators of the geometrical symmetry group. Moreover, there exist an infinite number of dosed orbits for suitable angular momentum values, and we give the equations of the classical orbits. The eigenenergy spectrum and corresponding eigenstates in these systems are derived.

Early identification of stroke through deep learning with multi-modal human speech and movement data

Early identification and treatment of stroke can greatly improve patient outcomes and quality of life.Although clinical tests such as the Cincinnati Pre-hospital Stroke Scale(CPSS)and the Face Arm Speech Test(FAST)are commonly used for stroke screening,accurate administration is dependent on specialized training.In this study,we proposed a novel multimodal deep learning approach,based on the FAST,for assessing suspected stroke patients exhibiting symptoms such as limb weakness,facial paresis,and speech disorders in acute settings.We collected a dataset comprising videos and audio recordings of emergency room patients performing designated limb movements,facial expressions,and speech tests based on the FAST.We compared the constructed deep learning model,which was designed to process multi-modal datasets,with six prior models that achieved good action classification performance,including the I3D,SlowFast,X3D,TPN,TimeSformer,and MViT.We found that the findings of our deep learning model had a higher clinical value compared with the other approaches.Moreover,the multi-modal model outperformed its single-module variants,highlighting the benefit of utilizing multiple types of patient data,such as action videos and speech audio.These results indicate that a multi-modal deep learning model combined with the FAST could greatly improve the accuracy and sensitivity of early stroke identification of stroke,thus providing a practical and powerful tool for assessing stroke patients in an emergency clinical setting.

Gallbladder carcinoma in the era of artificial intelligence: Early diagnosis for better treatment

Gallbladder carcinoma(GBC)is the most common malignant tumor of biliary tract,with poor prognosis due to its aggressive nature and limited therapeutic options.Early detection of GBC is a major challenge,with most GBCs being detected accidentally during cholecystectomy procedures for gallbladder stones.This letter comments on the recent article by Deqing et al in the World Journal of Gastrointestinal Oncology,which summarized the various current methods used in early diagnosis of GBC,including endoscopic ultrasound(EUS)examination of the gallbladder for high-risk GBC patients,and the use of EUS-guided elasto-graphy,contrast-enhanced EUS,trans-papillary biopsy,natural orifice translu-minal endoscopic surgery,magnifying endoscopy,choledochoscopy,and confocal laser endomicroscopy when necessary for early diagnosis of GBC.However,there is a need for novel methods for early GBC diagnosis,such as the use of artificial intelligence and non-coding RNA biomarkers for improved screening protocols.Additionally,the use of in vitro and animal models may provide critical insights for advancing early detection and treatment strategies of this aggressive tumor.

Revolutionizing diabetic retinopathy screening and management:The role of artificial intelligence and machine learning

Diabetic retinopathy(DR)remains a leading cause of vision impairment and blindness among individuals with diabetes,necessitating innovative approaches to screening and management.This editorial explores the transformative potential of artificial intelligence(AI)and machine learning(ML)in revolutionizing DR care.AI and ML technologies have demonstrated remarkable advancements in enhancing the accuracy,efficiency,and accessibility of DR screening,helping to overcome barriers to early detection.These technologies leverage vast datasets to identify patterns and predict disease progression with unprecedented precision,enabling clinicians to make more informed decisions.Furthermore,AI-driven solutions hold promise in personalizing management strategies for DR,incorpo-rating predictive analytics to tailor interventions and optimize treatment path-ways.By automating routine tasks,AI can reduce the burden on healthcare providers,allowing for a more focused allocation of resources towards complex patient care.This review aims to evaluate the current advancements and applic-ations of AI and ML in DR screening,and to discuss the potential of these techno-logies in developing personalized management strategies,ultimately aiming to improve patient outcomes and reduce the global burden of DR.The integration of AI and ML in DR care represents a paradigm shift,offering a glimpse into the future of ophthalmic healthcare.

Importance of neonatal screening:A case study of sickle cell disease and cystic fibrosis coexistence

BACKGROUND Neonatal screening(NS)is a public health policy to identify genetic pathologies such as cystic fibrosis(CF),sickle cell disease,and other diseases.Sickle cell disea-se is the comprehensive term for a group of hemoglobinopathies characterized by the presence of hemoglobin S.CF is an autosomal recessive multisystemic disease with pathophysiology involving deleterious mutations in the transmembrane re-gulatory gene that encodes a protein that regulates the activity of chloride and sodium channels in the cell surface epithelium.NS is crucial for early diagnosis and management,which ensures a better quality of life.AIM To report a case of the coexistence of sickle cell anemia(SCA)and CF and perform an integrative literature review.METHODS This is an observational study and a review of the literature focusing on two rare genetic pathologies identified simultaneously in NS from the perspective of a clinical case.The authors identified only 5 cases of SCA associated with CF.No clinical trials or review articles were identified considering the rarity of the coexistence of these two pathologies.RESULTS Herein,the authors reported the case of a girl who after undergoing NS on day 8 of life was diagnosed with SCA with an alteration in the dosage of immunoreactive trypsin.The diagnosis of CF was confirmed by the Coulometry Sweat Test.The rarity of the co-occurrence of these two severe genetic pathologies(CF and SCA)is a challenge for medical science.CONCLUSION This study adds to the few case reports present in the literature that highlight the identification of two severe diseases via NS.

Gender disparities and woman-specific trends in Barrett’s esophagus in the United States:An 11-year nationwide populationbased study

BACKGROUND Barrett's esophagus(BE)is a known premalignant precursor to esophageal adenocarcinoma(EAC).The prevalence rates continue to rise in the United States,but many patients who are at risk of EAC are not screened.Current practice guidelines include male gender as a predisposing factor for BE and EAC.The population-based clinical evidence regarding female gender remains limited.AIM To study comparative trends of gender disparities in patients with BE in the United States.METHODS A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample(NIS)database.Patients with a primary or secondary diagnosis code of BE were identified.The major outcome of interest was determining the gender disparities in patients with BE.Trend analysis for respective outcomes for females was also reported to ascertain any time-based shifts.RESULTS We identified 1204190 patients with BE for the study period.Among the included patients,717439(59.6%)were men and 486751(40.4%)were women.The mean age was higher in women than in men(67.1±0.4 vs 66.6±0.3 years,P<0.001).The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019(P<0.001).The rate for females increased from 96.8 in 2009 to 148.7 in 2019(P<0.001).There was a higher frequency of obesity among women compared to men(17.4%vs 12.6%,P<0.001).Obesity prevalence among females increased from 12.3%in 2009 to 21.9%in 2019(P<0.001).A lower prevalence of smoking was noted in women than in men(20.8%vs 35.7%,P<0.001).However,trend analysis showed an increasing prevalence of smoking among women,from 12.9%in 2009 to 30.7%in 2019(P<0.001).Additionally,there was a lower prevalence of alcohol abuse,Helicobacter pylori(H.pylori),and diabetes mellitus among females than males(P<0.001).Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of H.pylori and diabetes mellitus among women(P<0.001).CONCLUSION The prevalence of BE among women has steadily increased from 2009 to 2019.The existing knowledge concerning BE development has historically focused on men,but our findings show that the risk in women is not insignificant.

Systematic study on α-decay half-lives of uranium isotopes with a screened electrostatic barrier

In the present work,we systematically study the α-decay half-lives of uranium(Z=92) isotopes based on the Gamow model with a screened electrostatic barrier.There are only two adjustable parameters in our model i.e.the parameter g and the screening parameter t in the Hulthen potential for considering the screened electrostatic effect of the Coulomb potential.The calculated results are in good agreement with experimental data,and the corresponding root-mean-square(rms) deviations of uranium isotopes with α transition orbital angular momentum l=0 and l=2 are 0.141 and 0.340,respectively.Moreover,we extend this model to predict α-decay half-lives of uranium isotopes whose a decay is energetically allowed or observed but not yet quantified in NUBASE2020.For comparison,the modified Hatsukawa formula(XLZ),the unified Royer formula(DZR),the universal decay law(UDL) and the Viola-Seaborg-Sobiczewski formula(VSS) are also used.The predictions are basically consistent with each other.Meanwhile,the results also indicate that N=126 shell closure is still robust at Z=92 and the spectroscopic factor S_(α) is almost the same for uranium isotopes with the same l.