Detection and Classification of Pneumonia Using Deep Learning by the Dense Net-121 Model

A chronic respiratory disease known as pneumonia can be devastating if it is not identified and treated in a timely manner. For successful treatment and better patient outcomes, pneumonia must be identified early and properly classified. Deep learning has recently demonstrated considerable promise in the area of medical imaging and has successfully applied for a few image-based diagnosis tasks, including the identification and classification of pneumonia. Pneumonia is a respiratory illness that produces pleural effusion (a condition in which fluids flood the lungs). COVID-19 is becoming the major cause of the global rise in pneumonia cases. Early detection of this disease provides curative therapy and increases the likelihood of survival. CXR (Chest X-ray) imaging is a common method of detecting and diagnosing pneumonia. Examining chest X-rays is a difficult undertaking that often results in variances and inaccuracies. In this study, we created an automatic pneumonia diagnosis method, also known as a CAD (Computer-Aided Diagnosis), which may significantly reduce the time and cost of collecting CXR imaging data. This paper uses deep learning which has the potential to revolutionize in the area of medical imaging and has shown promising results in the detection and classification of pneumonia. Further research and development in this area is needed to improve the accuracy and reliability of these models and make them more accessible to healthcare providers. These models can provide fast and accurate results, with high sensitivity and specificity in identifying pneumonia in chest X-rays. © 2023 IEEE.

Suicidal Risk and Depression in Pregnant Women in Times of Pandemic.

PURPOSE: Pregnancy is a risk period for the development of mental disorders. About 10% of pregnant women worldwide experience a mental disorder, mainly depression, and this percentage has been aggravated by the COVID-19 pandemic. This study aims to understand the impact of COVID-19 on the mental health of pregnant women. METHODS: Three hundred and one pregnant women in the week 21.85 ± 9.9 were recruited through social media and pregnant women forums from September 2020 to December 2020. A multiple-choice questionnaire was administered to evaluate the sociodemographic characteristics of the women, the care provided, and different aspects related to COVID-19. A Beck Depression Inventory was also delivered. RESULTS: Of the pregnant women 23.5% had seen or had considered seeing a mental health professional during pregnancy. Predictive models using multivariate logistic regression found that this fact was associated with an increased risk of depression (OR = 4.22; CI 95% 2.39-7.52; P < 0.001). Among women with moderate-severe depression, it was associated with an increased risk of having suicidal thoughts (OR = 4.99; CI 95% 1.11-27.9; P = 0.044) and age was found to be a protective variable (OR = 0.86; CI 95% 0.72-0.98; P = 0.053). CONCLUSIONS: The COVID-19 pandemic represents a major mental health challenge for pregnant women. Despite the decrease in face-to-face visits, there are opportunities for health professionals to identify the existence of psycho-pathological alterations and suicidal ideation by asking the patient if she is seeing or considering seeing a mental health professional. Therefore, it is necessary to develop tools for early identification to ensure correct detection and care.

Coverage of cervical cancer screening in Uruguay, 2018 / Cobertura de tamizaje de cáncer de cuello de útero en Uruguay, 2018 / Cobertura do rastreamento do câncer do colo do útero no Uruguai, 2018

Introducción: el cáncer de cuello uterino (CCU) causa una significativa pérdida de años por discapacidad y muerte prematura en el mundo. Se relaciona fuertemente, por su etiología, a las inequidades socioeconómicas. Alcanzar una cobertura del 80% del tamizaje poblacional a través de la colpocitología oncológica constituye una de las principales estrategias para disminuir la morbimortalidad por este cáncer. Objetivos: describir la cobertura de tamizaje en CCU de las mujeres de 21 a 64 años, usuarias del Sistema Nacional Integrado de Salud (SNIS) de Uruguay en el año 2018 y explorar su comportamiento según edad, lugar de residencia, características socioeconómicas y culturales del territorio. Métodos: estudio descriptivo, en base a fuentes de datos secundarios, con una muestra que alcanzó el 95% del universo. La técnica de tamizaje considerada fue la colpocitología oncológica de (PAP) con vigencia de hasta 3 años al 30/9/2018. Resultados: la cobertura de tamizaje en CCU en 2018 fue del 57%, siendo menor en las primeras y últimas edades consideradas, variando por zona geográfica, encontrándose menor porcentaje de PAP vigente en las mujeres residentes en departamentos con menores índices de desarrollo humano y con mayor porcentaje de hogares por debajo de la línea de pobreza. Conclusiones: la cobertura de tamizaje en CCU en Uruguay debe aumentar para disminuir la morbimortalidad por este cáncer. Se requiere implementar acciones para reducir la heterogeneidad entre edades y departamentos de residencia. Esta estimación constituye una línea de base que permite comparar la situación país pospandemia COVID-19 replicando la misma metodología.

Summary: Introduction: cervical cancer causes a significant loss of years due to disabilities and early deaths around the world. Due to its etiology, it is closely linked to socio- economic inequalities. Cervical cancer screening coverage of 80 % of the population through and pap smear constitutes one of the main strategies to reduce morbimortality of this kind of cancer. Objectives: to describe cervical cancer screening coverage in women between 21 and 64 years old, users of the National Integrated Health System (SNIS) in Uruguay in 2018 and explore their behavior according to age, place of residence, socio-economic and territorial cultural characteristics. Method: descriptive study, based on secondary data sources of a sample representing 95% of the universe. The screening technique considered in the study was a pap smear, valid for up to three years on September 30, 2019. Results: cervical cancer screening coverage in 2018 was 57%, lower in the first and last ages considered and it varied depending on the geographical area. A lower percentage of valid smear tests was found in women who were residents of provinces with lower human development index and a higher percentage of homes below the poverty line. Conclusions: cervical cancer screening coverage in Uruugay needs to increase in order to reduce morbimortality. The implementation of actions aimed at reducing differences between ages and places of residence is required. This estimation may be taken as a baseline that allows for a comparison with the post-COVID 19 pandemic situation, by replicating the same method.

Introdução: o câncer do colo do útero (CCU), causa uma perda significativa de anos por incapacidade e morte prematura no mundo estando fortemente relacionada, por sua etiologia, às iniquidades socioeconômicas. Uma das principais estratégias para reduzir a morbimortalidade por esse câncer é alcançar 80% de cobertura de rastreamento populacional por meio da colpocitologia oncológica. Objetivos: descrever a cobertura do rastreamento do CCU em mulheres de 21 a 64 anos, usuárias do Sistema Nacional Integrado de Saúde (SNIS) do Uruguai em 2018 e analisar seu comportamento de acordo com idade, local de residência, características socioeconômicas e culturais do território. Métodos: estudo descritivo, baseado em fontes de dados secundárias de uma amostra que atingiu 95% do universo. A técnica de rastreamento considerada foi a colpocitologia oncológica (PAP) válida por até 3 anos a partir de 30/09/2018. Resultados: a cobertura de rastreamento no CCU em 2018 foi de 57%, sendo menor nas primeiras e últimas idades consideradas, variando por área geográfica, encontrando menor percentual de PAP atual em mulheres residentes em departamentos com menores índices de desenvolvimento humano e com maior percentual de famílias abaixo da linha de pobreza. Conclusões: deve-se aumentar a cobertura de rastreamento no CCU no Uruguai para reduzir a morbimortalidade por esse câncer. É necessário implementar ações para reduzir a heterogeneidade entre idades e departamentos de residência. Essa estimativa constitui uma linha de base que permite comparar a situação do país pós-pandemia por COVID-19, replicando a mesma metodologia.

COVID-19 Pandemisinin Kanser Erken Teşhis Tarama ve Eğitim Merkezleri Hizmetlerinin Kullanımına Etkisi

Objective: This study was conducted to evaluate the impact of the COVID-19 pandemic on the use of Cancer Early Diagnosis, Screening, and Education Centers (KETEM) services. Materials and Methods: In this study, which was conducted as a descriptive retrospective cohort type, a total of 52.955 patient application records made to KETEM between January 1st and December 31st, 2017-2020 and January 1st-1 October 2021 were examined. The data obtained within the scope of the study were expressed as frequency and percentage. Results: In the study, it was determined that the numbers decreased as compared to previous three years (2017, 2018 and 2019) 70.4%, 59.1%, 68.8% for mammography screenings, 75.8%, 68.8%, 65.8% for HPV-Pap smear scans and 46.1%, 81.9%, and 72.2% for colorectal scans, respectively. Conclusion: It was detected that mammography, HPV-Pap, smear, and colorectal screenings offered within the scope of KETEM services decreased significantly in 2020 and 2021 which includes the pandemic process, compared to the previous years. It is estimated that cancers that cannot be detected in the early period due to the decrease in the number of applications will cause a significant increase in cancer mortality in the following years. Accordingly, it is recommended that the society, especially the individuals in the risk group, not delay their applications to cancer screening services, to take the necessary pandemic measures to inform them about making their applications without delay, and to improve their awareness about this issue. Amaç: Bu çalışma COVID-19 pandemisinin Kanser Erken Teşhis, Tarama ve Eğitim Merkezleri (KETEM) hizmetlerinin kullanımı üzerindeki etkisini değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntem: Retrospektif kohort tipinde betimleyici olarak yürütülen bu araştırmada, 2017-2020 yıllarında 1 Ocak-31 Aralık tarihleri ile 1 Ocak-1 Ekim 2021 tarihleri arasında bir ilin Kanser Erken Teşhis, Tarama ve Eğitim Merkezleri'ne yapılan toplam 52.955 hasta başvuru kaydı incelenmiştir. Çalışma kapsamında elde edilen veriler frekans ve yüzde ile ifade edilmiştir. Bulgular: Çalışmada 2020 yılındaki mamografi tarama sayısının önceki üç yıla kıyasla (2017, 2018, 2019) sırasıyla %70.4, %59.1, %68.8 oranında;HPV-Pap smear tarama sayısının %75.8, %68.8, %65.8 oranında;kolorektal tarama sayısının ise sırasıyla %46.1, %81.9 ve %72.2 oranında düştüğü saptanmıştır. Sonuç: Bu araştırmada KETEM hizmetleri kapsamında sunulan mamografi, HPV-Pap smear ve kolorektal taramalarının pandemi sürecini kapsayan 2020 ve 2021 yıllarında önceki yıllara nazaran önemli düzeylerde azaldığı belirlenmiştir. Başvuru sayısındaki azalmaya bağlı olarak erken dönemde tespit edilemeyen kanserlerin ilerleyen yıllarda kanser mortalitesinde önemli bir artışa neden olacağı ön görülmektedir. Bu doğrultuda özellikle risk grubunda yer alan bireyler başta olmak üzere toplumun kanser tarama hizmetlerine başvurularını ertelememeleri, gerekli pandemi tedbirlerini alarak vakit kaybetmeden başvurularını gerçekleştirmeleri konusunda bilgilendirilmesi ve bu duruma yönelik farkındalıklarının geliştirilmesi önerilmektedir.

Features of attention deficit/hyperactivity disorder and antisocial behaviour in a general population-based sample of adults.

BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) is known to be a risk factor for antisocial and delinquent behaviour, but there is still a lack of information on how features of ADHD relate to offending behaviour among adults not already defined by their offending. AIMS: Our aim was to add to knowledge about relationships between ADHD and antisocial behaviour among adults in the general population by answering the following questions: (A) Does the level of self-reported ADHD features relate to criminal and non-criminal antisocial behaviour? (B) To what extent are self-ratings of ADHD features independent of socio-demographic features previously identified as predictors of antisocial behaviour? METHODS: A sample of adults was originally recruited to study public response to the COVID-19 outbreak through an online panel to be representative of the Israeli population. Among other scales, the 2025 participants completed an ADHD self-report scale, an antisocial behaviour self-report scale and a socio-demographic questionnaire probing for age, gender, urbanity, place of birth, socioeconomic status (education and income), family status (being in a relationship and having children) and religiosity. RESULTS: Higher mean totals for the inattention and hyperactivity ADHD scale scores were associated with higher mean antisocial behaviour scores. These relationships were only slightly affected by socio-demographic variables, including sex, age, education and income. CONCLUSION: Our findings suggest that not only may features of ADHD, even below a diagnostic threshold, constitute a risk factor for antisocial behaviour, but also that the self-rated levels of these problems covary. These findings are important for informing the early detection of risk of antisocial behaviour in the general population and its prevention.

An Early Detection Of NIPAH Infectious Disease Based On Integrated Medical Features For Human Using Ensemble RBM Techniques

Background: The importance of early diagnosis of a hazardous illness cannot be overstated. The transmission rate is extremely high, especially in the current pandemic condition. The ability to predict epidemics will aid public health in reducing mortality and morbidity. Machine Learning (ML) approaches are used in the construction of an effective disease prognosis model. Furthermore, only if the model learns good associated features from the data is it possible to generate a speedy outcome. As a result, selecting features is also necessary before beginning the forecasting process. Objective(s): However, because of the virus's dynamic structure, it's difficult to predict Nipah disease and/or zoonotic infection. Furthermore, there is no clinical treatment for Nipah. The major goal of this research is to develop a prognostic model for early diagnosis of Nipah disease using a combination of several clinical factors such as symptoms, disease incubation information, and routine blood test results confirmed by a lab technician.Proposed System: The healthcare application and data are more complex to handle than other ML applications since various clinical features are assessed throughout disease manifestation. As a result, selecting the most relevant variables is critical when designing a prognosis model for any viral disease. To deal with clinical features from a vast number of features, we proposed a Restricted Boltzmann Machine (RBM) method in this research. Additionally, we employed a hybrid ensemble learning method to predict if the patient was infected with NiV after choosing features using the RBM. Data Collection: The proposed system is being implemented using the NiV infection dataset that erupted in Kozhikode, Kerala in 2018 and 2019. Result(s): The developed stacking-based ensemble Meta classifier was successfully implemented using the python programming language, and its performance was evaluated using a variety of metrics includingaccuracy, precision, recall, f1-score, log loss, AUROC and MCC. Our proposed Stacking Ensemble Meta Classifier (SEMC) model achieved an accuracy rate of 88.3% with a log loss of 0.36. Model precision, recall, f1-score, AUROC, and MCC value were 92.5%, 89.2%, 90.9%, 92.1%, and 0.74 respectively. In addition, we calculated the gravitational pull of each feature using the SHAP approach and discovered that altered sensorium, fever, headache, and cough were the most critical clinical indicators that distinguished NiVD infection from our dataset. Therefore, this classification may assist the pathologist in diagnosing NiVD with symptoms before performing the RT-PCR medical test. Conclusion(s): Using our proposed SEMC technique, we developed a prognostic model for the diagnosis of Nipah in humans. The proposed technique's discriminatory efficiency exhibited good NiVD diagnosis efficacy. We anticipate that this model will aid medics in determining a prognosis more quickly during future epidemics. However, to achieve maximum accuracy, the model requires more unique samples.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Cloud-Based Architecture for Early Detection and Postoperative Monitoring of Hypospadias Patients in Indonesia

Covid-19 Epidemic has significantly changed how hypospadias patients are delivered to healthcare services, particularly after hypospadias repairs (postoperative care). Some studies reported that using telemedicine schemes by sending digital documentation such as images and videos through cell phones can facilitate an assessment of postoperative monitoring of hypospadias patients. However, this approach raises various concerns, such as managing digital documentation of hypospadias patients, analyzing the data, and the security of individuals' health information. This study proposes a design of cloud-based architecture for early detection and postoperative monitoring of hypospadias patients to address the concerns above. The user acceptance test shows that most users agree that this application may be used for early detection, monitoring hypospadias patients, and helping capture videos and provide labeling to patients' data. © 2022 IEEE.

The New Coronavirus Pandemic and the Trend of Breast Cancer Diagnosis according to Age-Group: Total and Interrupted Time Series Study.

OBJECTIVE: There is a lack of studies evaluating the COVID-19 pandemic effect on breast cancer detection according to age-group. This study aimed to assess the pandemic impact on the trend of mammograms, breast biopsies, and breast cancer stage at diagnosis according to age-group. METHODS: This was an ecological time series study by inflection point regression model. We used data from women aged between 30 and 49, 50 and 69, and 70 years or more available in an open-access dataset of the Brazilian public healthcare system (2017-2021). We analyzed the trend of the variables in the pre-pandemic and the pandemic effect on the total time series. RESULTS: The decreasing or stationary trend of mammograms in the pre-pandemic has changed to a decreasing trend in the total time series in all age-groups. Before the pandemic, the increasing trend of breast biopsies has changed to stationary in the total time series in all age-groups. The increasing trend of tumors at stages 0 to II in the pre-pandemic has changed to decreasing or stationary in the total time series. Finally, the increasing trend of tumors at stage III or IV remained increasing in the total time series in all age-groups. CONCLUSION: The pandemic has changed the stationary or increasing trend to a decreasing or stationary trend of mammograms, breast biopsies, and tumors at stages 0 to II but has not influenced the increasing trend of tumors at stages III and IV in all age-groups.

Multiplex RT-qPCR Application in Early Detection of Bovine Respiratory Disease in Healthy Calves.

Bovine respiratory diseases (BRD) are associated with various predisposing factors, such as physical and physiological stress factors, and bacterial and viral pathogens. These stressors and viruses suppress immune defenses, leading to bacterial growth in the upper respiratory tract and invasion of pathogens into the lower respiratory tract. Therefore, continuous monitoring of the causative pathogens would contribute to the early detection of BRD. Nasal swabs and sera from 63 clinically healthy calves were continuously collected from seven farms in Iwate prefecture from 2019 to 2021. We attempted to monitor dynamics of BRD-associated pathogens by multiplex real-time RT-PCR (RT-qPCR) using their nasal swab samples. In addition, we attempted to monitor fluctuation of antibody titers against each BRD-associated pathogen by virus neutralization test (VNT) using their sera. In contrast, nasal swabs from 89 calves infected with BRD were collected from 28 farms in Iwate prefecture from 2019 to 2021. We attempted to analyze their nasal swab samples by multiplex RT-qPCR aim to detect BRD-associated pathogens that are dominant in this region. As a result, our analyses using samples from clinically healthy calves showed that positive results by multiplex RT-qPCR were closely related to a significant increase of antibody titers by VNT in bovine coronavirus (BCoV), bovine torovirus (BToV), and bovine respiratory syncytial virus (BRSV). In addition, our data exhibited that BCoV, BToV, BRSV, bovine parainfluenza virus 3, and Mycoplasma bovis have been more frequently detected in calves infected with BRD compared to those detected in clinically healthy calves. Moreover, the data presented herein revealed co-infections by combination multiple viral pathogens with bacterial pathogens are closely involved in the onset of BRD. Taken together, our study demonstrates multiplex RT-qPCR which can simultaneously analyze multiple pathogens, including viruses and bacteria, and is useful for the early detection of BRD.

Lung cancer screening in rural primary care practices in Colorado: time for a more team-based approach?

BACKGROUND: Despite lung cancer being a leading cause of death in the United States and lung cancer screening (LCS) being a recommended service, many patients eligible for screening do not receive it. Research is needed to understand the challenges with implementing LCS in different settings. This study investigated multiple practice members and patient perspectives impacting rural primary care practices related to LCS uptake by eligible patients. METHODS: This qualitative study involved primary care practice members in multiple roles (clinicians n = 9, clinical staff n = 12 and administrators n = 5) and their patients (n = 19) from 9 practices including federally qualified and rural health centers (n = 3), health system owned (n = 4) and private practices (n = 2). Interviews were conducted regarding the importance of and ability to complete the steps that may result in a patient receiving LCS. Data were analyzed using a thematic analysis with immersion crystallization then organized using the RE-AIM implementation science framework to illuminate and organize implementation issues. RESULTS: Although all groups endorsed the importance of LCS, all also struggled with implementation challenges. Since assessing smoking history is part of the process to identify eligibility for LCS, we asked about these processes. We found that smoking assessment and assistance (including referral to services) were routine in the practices, but other steps in the LCS portion of determining eligibility and offering LCS were not. Lack of knowledge about screening and coverage, patient stigma, and resistance and practical considerations such as distance to LCS testing facilities complicated completion of LCS compared to screening for other types of cancer. CONCLUSIONS: Limited uptake of LCS results from a range of multiple interacting factors that cumulatively affect consistency and quality of implementation at the practice level. Future research should consider team-based approaches to conduct of LCS eligibility and shared decision making.

Psychosocial factors associated with the risk of developing psychosis in a Mexican general population sample.

Epidemiological evidence has linked an array of sociodemographic and psychosocial factors with an increased risk of developing psychosis. However, research in samples from low- and middle-income countries is still scarce. This study used a Mexican sample to explore (i) sociodemographic and psychosocial differences between individuals with and without a positive screen for Clinical High-Risk for psychosis (CHR), and (ii) sociodemographic and psychosocial factors associated with screening positive for CHR. The sample consisted of 822 individuals from the general population who completed an online survey. Of the participants, 17.3% (n = 142) met the CHR screening criteria. Comparisons between those who screened positive (CHR-positive group) and those who did not (Non-CHR group) showed that participants in the CHR-positive group were younger, had a lower educational level, and reported more mental health problems than the Non-CHR group. Furthermore, relative to the Non-CHR group, the CHR-positive group had a greater prevalence of medium/high risk associated with cannabis use, a higher prevalence of adverse experiences (bullying, intimate partner violence, and experiencing a violent or unexpected death of a relative or friend), as well as higher levels of childhood maltreatment, poorer family functioning, and more distress associated with the COVID-19 pandemic. Groups did not differ in sex, marital/relationship status, occupation, and socio-economic status. Finally, when examined in multivariate analyses, the variables associated with screening positive for CHR were: having an unhealthy family functioning (OR = 2.75, 95%CI 1.69-4.46), a higher risk associated with cannabis use (OR = 2.75, 95%CI 1.63-4.64), a lower level of education (OR = 1.55, 95%CI 1.003-2.54), having experienced a major natural disaster (OR = 1.94, 95%CI 1.18-3.16), having experienced a violent or unexpected death of a relative or friend (OR = 1.85, 95%CI 1.22-2.81), higher levels of childhood emotional abuse (OR = 1.88, 95%CI 1.09-3.25), physical neglect (OR = 1.68, 95%CI 1.08-2.61), and physical abuse (OR = 1.66, 95%CI 1.05-2.61), and higher COVID-related distress (OR = 1.10, 95%CI 1.01-1.20). An older age was a protective factor for screening positive for CHR (OR = 0.96, 95%CI 0.92-0.99). Overall, the findings highlight the importance of examining potential psychosocial contributors to psychosis vulnerability across different sociocultural contexts to delineate risk and protective processes relevant to specific populations and better target preventive intervention efforts.

Feasibility of Single - Encounter Telemedicine Lung Cancer Screening: A Retrospective Cohort Study in an Underserved Population.

BACKGROUND: COVID-19 forced a delay of non-essential health services, including lung cancer screening. Our institution developed a single-encounter, telemedicine (SET) lung cancer screening whereby patients receive low-dose CT in-person, but counseling regarding results, coordination of follow-up care and smoking cessation is delivered using telemedicine. This study compares outcomes of SET lung cancer screening to our pre-COVID, single-visit, in-person (SIP) lung cancer screening. METHODS: A retrospective cohort study was performed we recorded independent variables of gender, race/ethnicity, age, educational attainment, smoking status and dependent variables including cancer diagnosis, stage and treatment between March 2019 to July 2021. Using retrospective analysis, we compared outcomes of SIP lung cancer screening before COVID-19 and SET lung cancer screening amid COVID-19. RESULTS: There was a significant difference in number of patients screened pre- and amid COVID-19.673 people were screened via SIP, while only 440 were screened via SET. SIP screening consisted of 52.5% Black/African American patients, which decreased to 37% with SET lung cancer screening. There was no significant difference in gender, age, or educational attainment. There was also no significant difference in Lung-RADS score between the 2 methods of screening or diagnostic procedures performed. Ultimately telemedicine based screening diagnosed fewer cancers, 1.6% diagnosed via telemedicine vs 3.3% screened by in person. CONCLUSION: We implemented SET lung cancer screening to continue lung cancer screening during a global pandemic. Our study established feasibility of telemedicine-based lung cancer screening among our predominantly African American/Black population, though fewer patients were screened. We found no difference in distribution between age, or educational attainment suggesting other factors discouraging lung cancer screening amid COVID-19.

Help-seeking behaviour in women diagnosed with gynaecological cancer: a systematic review.

BACKGROUND: Identifying what prompts or hinders women's help-seeking behaviour is essential to ensure timely diagnosis and management of gynaecological cancers. AIM: To understand the factors that influence the help- seeking behaviour of women diagnosed with gynaecological cancer. DESIGN AND SETTING: Systematic review and narrative synthesis of studies from high-income settings worldwide. METHOD: Five databases were searched for studies, of any design, that presented factors related to the help-seeking behaviour of women diagnosed with a gynaecological cancer. Data from the articles were extracted and presented using narrative synthesis, which was both inductive and deductive. The COM-B (capability, opportunity, motivation, behaviour) model of behaviour change was used as a framework. RESULTS: In total, 21 studies were included in the review. Inductive synthesis presented three main themes of factors related to the help-seeking behaviour of women diagnosed with gynaecological cancer: patient factors, such as knowledge of symptoms; emotional factors, including previous healthcare experience, embarrassment, and trust; and practical factors, including time and resources. Deductive synthesis demonstrated that capability (namely, symptom knowledge), opportunity (having the required time and overcoming the cultural taboos surrounding gynaecological symptoms), and motivation (believing that seeking help is beneficial) are all required to initiate help-seeking behaviour. CONCLUSION: Although it is a journey of defined steps, the help- seeking behaviour of women with symptoms diagnosed with gynaecological cancer is influenced by personal and societal factors. Interventions to improve help seeking will need to address the specific identified factors, as well as capability, opportunity, and motivation.

Early detection of hepatocellular carcinoma: roadmap for improvement.

INTRODUCTION: Hepatocellular carcinoma (HCC) has a poor prognosis, related, in part, to frequent late-stage diagnosis. Improved implementation of effective HCC surveillance is critical to reduce HCC mortality. AREAS COVERED: We performed a targeted literature review to identify intervention targets for improving HCC surveillance effectiveness, including enriched risk stratification tools, improved surveillance tools with higher accuracy for early HCC detection, and increasing surveillance adherence. EXPERT OPINION: HCC surveillance has been demonstrated to be efficacious in several cohort studies but has lower surveillance effectiveness in clinical practice. HCC surveillance is currently recommended in all patients with cirrhosis, and improved risk stratification using clinical risk scores, genetic scores, and novel biomarkers are important to move from a 'one-size-fits-all' strategy to one more aligned with values of precision medicine. Current surveillance modalities, ultrasound, and AFP, miss over one-third of HCC at an early stage and are associated with potential surveillance harms, underscoring a need for alternative surveillance strategies with higher accuracy. MRI- and biomarker-based surveillance strategies have promising early data in phase II studies but require validation in phase III cohorts before routine use in practice. Finally, surveillance is underused in clinical practice, highlighting a need for intervention strategies to increase utilization.

COVID-19 Epidemic Forecast using Machine Learning Regression Techniques

The COVID-19 Coronavirus (SARS-CoV-2), has caused destruction all around the world, since December 2019. It is still managing to grow at an unprecedented scale. It was declared as a health emergency for the entire globe by the World Health Organization (WHO) in January 2022. The virus continues to impact the lives of millions of people. An early detection system warning about the repercussions of the virus at a county level can be favorable for the residents as well and aid the government to enforce appropriate safety measures. This research aims at modeling such a warning system which predicts the positivity rate of COVID-19 for a geographical location. The proposed solution uses supervised machine learning techniques such as Random Forest, Linear Regression, Naive Bayes, and Gradient Boosting Regression. The prediction is made based on the analysis of the past data in each time frame with temporal input such as the population of the area, number of tests conducted, number of positive tests, reported cases in that area among others. The Gradient Boosting algorithm outperforms all the other algorithms used in this research. Machine learning based recommendation system for COVID-19 spread can help the public and government to take necessary precautions for suppressing its effect. The proposed modeling approach provides a reliable tool to predict COVID-19 transmission with an accuracy of 99.4%. © 2022 IEEE.

The impact of the COVID-19 pandemic on Italian population-based cancer screening activities and test coverage: Results from national cross-sectional repeated surveys in 2020.

Background: In Italy, regions have the mandate to implement population-based screening programs for breast, cervical, and colorectal cancer. From March to May 2020, a severe lockdown was imposed due to the COVID-19 pandemic by the Italian Ministry of Health, with the suspension of screening programs. This paper describes the impact of the pandemic on Italian screening activities and test coverage in 2020 overall and by socioeconomic characteristics. Methods: The regional number of subjects invited and of screening tests performed in 2020 were compared with those in 2019. Invitation and examination coverage were also calculated. PASSI surveillance system, through telephone interviews, collects information about screening test uptake by test provider (public screening and private opportunistic). Test coverage and test uptake in the last year were computed by educational attainment, perceived economic difficulties, and citizenship. Results: A reduction of subjects invited and tests performed, with differences between periods and geographical macro areas, was observed in 2020 vs. 2019. The reduction in examination coverage was larger than that in invitation coverage for all screening programs. From the second half of 2020, the trend for test coverage showed a decrease in all the macro areas for all the screening programs. Compared with the pre-pandemic period, there was a greater difference according to the level of education in the odds of having had a test last year vs. never having been screened or not being up to date with screening tests. Conclusions: The lockdown and the ongoing COVID-19 emergency caused an important delay in screening activities. This increased the preexisting individual and geographical inequalities in access. The opportunistic screening did not mitigate the impact of the pandemic. Funding: This study was partially supported by Italian Ministry of Health - Ricerca Corrente Annual Program 2023 and by the Emilian Region DGR 839/22.

The impact of the COVID-19 pandemic on breast cancer screening and diagnosis in a Brazilian metropolitan area.

OBJECTIVES: To evaluate the performance of breast cancer screening and early diagnosis during the pandemic, compared to the pre-pandemic period.Setting: The public referral centre for screening in Campinas, São Paulo State, Brazil. METHODS: This is an audit study of performance screening and diagnostic indicators. Two periods were analysed: 2019, the pre-COVID period, and 2020, the COVID period. All women who underwent mammography in these periods were included. Indicators were compared between periods, and the US Breast Cancer Surveillance Consortium benchmarks were used as a reference. RESULTS: A comparison between the periods shows a reduction of 57.4% in screening and 4.4% in diagnosis using mammography. Cancer detection rate per 1000 screening mammograms dropped from 4.62 to 2.83 (p = 0.031), while it increased from 84.43 to 89.36 in diagnosis mammograms (p = 0.701), higher than the reference (34.4, p < 0.001). With regard to diagnosis, the proportion of minimal cancers was reduced (p = 0.005) and was lower than the reference (40.0%, p < 0.001), along with the proportion of node-negative invasive cancers (p < 0.001). The mean size of invasive tumours was similar in the two periods (32.50 mm and 33.40 mm, p = 0.808) but larger than the reference value (16.50 mm, p < 0.001). Recall rate was lower in the COVID period (22.55% vs. 27.37%, p = 0.015). CONCLUSION: The COVID pandemic caused an overall decrease in breast screening and detection of breast cancer cases, although the reduction in number of diagnosis mammograms performed was minimal. Tumour mean size was large in both periods, the pandemic highlighting a previous profile of detection at an advanced stage.

Impact of the COVID-19 pandemic on the diagnosis and treatment of onco-hematologic patients: a discussion paper.

We do not know the precise figure for solid organ tumors diagnosed each year in Spain and it is therefore difficult to calculate whether there has been a decrease in cancer diagnoses as a consequence of the pandemic. Some indirect data suggest that the pandemic has worsened the stage at which some non-hematological neoplasms are diagnosed. Despite the lack of robust evidence, oncology patients seem more likely to have a poor outcome when they contract COVID-19. The antibody response to infection in cancer patients will be fundamentally conditioned by the type of neoplasia present, the treatment received and the time of its administration. In patients with hematological malignancies, the incidence of infection is probably similar or lower than in the general population, due to the better protective measures adopted by the patients and their environment. The severity and mortality of COVID-19 in patients with hematologic malignancies is clearly higher than the general population. Since the immune response to vaccination in hematologic patients is generally worse than in comparable populations, alternative methods of prevention must be established in these patients, as well as actions for earlier diagnosis and treatment. Campaigns for the early diagnosis of malignant neoplasms must be urgently resumed, post-COVID manifestations should be monitored, collaboration with patient associations is indisputable and it is urgent to draw the right conclusions to improve our preparedness to fight against possible future catastrophes.

Cancer screening in the COVID-19 pandemic, Development of early diagnostic strategies

Aim: Early diagnosis is very important in some cancers such as breast, cervical and colorectal. However, the COVID-19 pandemic has severely disrupted cancer screening programmers in many countries. In this study, it is aimed to contribute to the literature on this subject by reviewing the status of local cancer screenings during the pandemic period.Methods:This retrospective study includes the 114.727 people in the risky group for cancer screening determined in Bolu, Turkey as two groups. During 2017-2019 years was determined as pre-pandemic group while the year of 2020 was the pandemic group. Data about patients' results of smear / HPV (Human Papilloma Virus), fecal occult blood test (FOBT) and mammography had analyzed and compared with chi-square test.Results: For all of the screening strategies, smear / HPV, FOBT and mammography, mean of screening cases, positive cases and biopsies had significantly decreased (p<0.05), but there was no statistically difference for mean of definitive diagnoses about all of these cancers even if it has been decreased between two groups.Conclusion: The results of our study show that cancer screening processes are significantly disrupted during the pandemic period. Therefore, it is important to develop new screening strategies for the uninterrupted execution of cancer screening programs, especially during pandemic periods. However, we believe in the necessity of supporting studies with larger patient groups.

When COVID-19 Approaches Again: Early Detection of an Incoming New Wave of COVID-19 Positive Cases Inspired by Linear Breakpoint Models

From time to time, breakouts of COVID-19 income as waves of rapidly increasing numbers of positive cases alternated by time periods, varying in length, of low numbers of positive cases. Early detection of an incoming COVID-19 wave may enable pro-actively and quick activating all epidemiological measures that belong, together with vaccination, between a few effective weapons against unlimited COVID-19 transmission in a population. In this work, we applied an approach for the early detection of an incoming COVID-19 wave inspired by linear breakpoint models. Moreover, we refined the task of early detection as an optimization. Fitting a linear model on increasing numbers of positives from the present day to the past requires a sufficient number of daily records of positives from the past to get a significant positive regression slope. However, the more daily records of positives, usually stagnating in the past, we need to consider, the flatter the regression line becomes, which lowers the chance the regression slope is significant. Thus, finding a breakpoint, i. e. the beginning of the new wave of positives, is tricky. To address this issue, we propose an iterative algorithm searching for a breakpoint followed by a significantly positive regression slope. Finally, considering that a new wave is fitted by increasing the regression line, we also discuss an average number of days after the beginning of the incoming wave, when the early detection is, on average, firstly possible on a given statistical confidence level. © 2022 IEEE.