Who should undergo gastroscopy: a smartphone-based noninvasive auxiliary screening system (Preprint)

2021 ◽  
Author(s):  
Changzheng Ma ◽  
Peng Zhang ◽  
Xinxing Lai ◽  
Xin Wang ◽  
Chaofan Ji ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Medical Records ◽  
Large Scale ◽  
Precancerous Lesions ◽  
Natural Populations ◽  
Cost Effective ◽  
Screening Methods ◽  
Screening System ◽  
Populations At Risk ◽  
Screening Strategies

BACKGROUND Gastroscopy is conducive to the early diagnosis of gastric cancer. It remains a key issue to screen premalignant patients who need gastroscopy in the clinic. Current screening strategies, including serum testing-based screening, are limited by high cost or invasive sampling, making them difficult to apply to large-scale natural populations. Therefore, a cost-effective and noninvasive auxiliary screening method that is suitable for large-scale application is urgently needed. OBJECTIVE The aim of this study was to construct a smartphone-based noninvasive auxiliary screening system suitable for screening patients with precancerous lesions of gastric cancer. Based on the auxiliary screening system, we expect to apply the concept of mobile health (mHealth) to establish a system to assist in screening natural populations at risk of gastric cancer and in need of gastroscopy. METHODS We developed the screening system by applying a naive Bayes classification algorithm based on collected questionnaires and gastritis medical records. We then established an affiliated app for application testing. The system was validated in three communities and we assessed the performance by comparison with other methods. RESULTS We constructed a “BIANQUE” screening system. First, we collected 841 questionnaires and 75,624 medical records. Second, we selected 9 risk factors in 20 factors. Third, we developed a screening system that achieved an AUC of 0.78 (95% CI [0.71,0.86]), comparable to blood testing-based screening methods (AUC=0.76). Fourth, we carried out a community validation. The odds ratio (OR) of different degrees of risk and gastric precancerous lesions was 2.85. CONCLUSIONS We have established an auxiliary screening system to help predict who needs gastroscopy. This system can achieve noninvasive and cost-effective testing with comparable performance to current invasive screening strategies. Thus, we speculate that this system could be easily applied on large-scale natural populations. CLINICALTRIAL Chinese clinical trial registry ChiCTR2100044006 http://www.chictr.org.cn/

scholarly journals Effect and cost-effectiveness of national gastric cancer screening in Japan: a microsimulation modeling study

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Hsi-Lan Huang ◽  
Chi Yan Leung ◽  
Eiko Saito ◽  
Kota Katanoda ◽  
Chin Hur ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cost Effectiveness ◽  
Screening Program ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Endoscopic Screening ◽  
Screening Guidelines ◽  
Screening Strategies ◽  
Gastric Cancer Screening ◽  
The Cost

Abstract Background A national endoscopic screening program for gastric cancer was rolled out in Japan in 2015. We used a microsimulation model to estimate the cost-effectiveness of current screening guidelines and alternative screening strategies in Japan. Methods We developed a microsimulation model that simulated a virtual population corresponding to the Japanese population in risk factor profile and life expectancy. We evaluated 15 endoscopic screening scenarios with various starting ages, stopping ages, and screening intervals. The primary outcomes were quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratio. Cost-effective screening strategies were determined using a willingness-to-pay threshold of $50,000 per QALY gained. One-way sensitivity and probabilistic sensitivity analyses were done to explore model uncertainty. Results Using the threshold of $50,000 per QALY, a triennial screening program for individuals aged 50 to 75 years was the cost-effective strategy, with an incremental cost-effectiveness ratio of $45,665. Compared with no endoscopic screening, this strategy is predicted to prevent 63% of gastric cancer mortality and confer 27.2 QALYs gained per 1000 individuals over a lifetime period. Current screening guidelines were not on the cost-effectiveness efficient frontier. The results were robust on one-way sensitivity analyses and probabilistic sensitivity analysis. Conclusions This modeling study suggests that the endoscopic screening program in Japan would be cost-effective when implemented between age 50 and 75 years, with the screening repeated every 3 years. These findings underscore the need for further evaluation of the current gastric cancer screening recommendations.

scholarly journals Helicobacter pylori Infection following Endoscopic Resection of Early Gastric Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Lan Li ◽  
Chaohui Yu
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Early Gastric Cancer ◽  
Endoscopic Resection ◽  
Precancerous Lesions ◽  
Cost Effective ◽  
Reduce Healthcare Cost ◽  
Metachronous Gastric Cancer ◽  
H Pylori ◽  
Meta Analyses

The role of Helicobacter pylori (H. pylori) infection in patients following endoscopic resection of early gastric cancer (EGC) remains unclear. This article presents a review of literature published in the past 15 years. H. pylori‐mediated persistent methylation levels are associated with the development of metachronous gastric cancer. The methylation of certain specific genes can be used to identify patients with a high risk of metachronous gastric cancer even after H. pylori eradication. H. pylori eradication after endoscopic resection should be performed as early as possible for eradication success and prevention of metachronous precancerous lesions. Although whether the eradication of H. pylori could prevent the development of metachronous cancer after endoscopic resection is controversial, several meta‐analyses concluded that H. pylori eradication could reduce the incidence of metachronous gastric cancer significantly. In addition, H. pylori eradication in gastric cancer survivors after endoscopic resection could reduce healthcare cost and save lives in a cost‐effective way. Taken together, H. pylori eradication after endoscopic resection of EGC is recommended as prevention for metachronous precancerous lesions and metachronous gastric cancer.

scholarly journals Survey of Early-Diverging Lineages of Fungi Reveals Abundant and Diverse Mycoviruses

mBio ◽  
2020 ◽  
Vol 11 (5) ◽  
Author(s):  
J. M. Myers ◽  
A. E. Bonds ◽  
R. A. Clemons ◽  
N. A. Thapa ◽  
D. R. Simmons ◽  
...  
Keyword(s):  
Large Scale ◽  
Effective Means ◽  
Cost Effective ◽  
Laboratory Culture ◽  
Ecological Impacts ◽  
Screening Methods ◽  
Culture Collections ◽  
Future Studies ◽  
The Public ◽  
Large Scale Survey

ABSTRACT Mycoviruses are widespread and purportedly common throughout the fungal kingdom, although most are known from hosts in the two most recently diverged phyla, Ascomycota and Basidiomycota, together called Dikarya. To augment our knowledge of mycovirus prevalence and diversity in underexplored fungi, we conducted a large-scale survey of fungi in the earlier-diverging lineages, using both culture-based and transcriptome-mining approaches to search for RNA viruses. In total, 21.6% of 333 isolates were positive for RNA mycoviruses. This is a greater proportion than expected based on previous taxonomically broad mycovirus surveys and is suggestive of a strong phylogenetic component to mycoviral infection. Our newly found viral sequences are diverse, composed of double-stranded RNA, positive-sense single-stranded RNA (ssRNA), and negative-sense ssRNA genomes and include novel lineages lacking representation in the public databases. These identified viruses could be classified into 2 orders, 5 families, and 5 genera; however, half of the viruses remain taxonomically unassigned. Further, we identified a lineage of virus-like sequences in the genomes of members of Phycomycetaceae and Mortierellales that appear to be novel genes derived from integration of a viral RNA-dependent RNA polymerase gene. The two screening methods largely agreed in their detection of viruses; thus, we suggest that the culture-based assay is a cost-effective means to quickly assess whether a laboratory culture is virally infected. This study used culture collections and publicly available transcriptomes to demonstrate that mycoviruses are abundant in laboratory cultures of early-diverging fungal lineages. The function and diversity of mycoviruses found here will help guide future studies into mycovirus origins and ecological functions. IMPORTANCE Viruses are key drivers of evolution and ecosystem function and are increasingly recognized as symbionts of fungi. Fungi in early-diverging lineages are widespread, ecologically important, and comprise the majority of the phylogenetic diversity of the kingdom. Viruses infecting early-diverging lineages of fungi have been almost entirely unstudied. In this study, we screened fungi for viruses by two alternative approaches: a classic culture-based method and by transcriptome-mining. The results of our large-scale survey demonstrate that early-diverging lineages have higher infection rates than have been previously reported in other fungal taxa and that laboratory strains worldwide are host to infections, the implications of which are unknown. The function and diversity of mycoviruses found in these basal fungal lineages will help guide future studies into mycovirus origins and their evolutionary ramifications and ecological impacts.

Computed Tomography Findings in Gastric Intestinal Metaplasia

2019 ◽  
pp. 1-4
Keyword(s):  
Gastric Cancer ◽  
Computed Tomography ◽  
Early Diagnosis ◽  
Intestinal Metaplasia ◽  
Large Scale ◽  
Precancerous Lesions ◽  
Precancerous Lesion ◽  
Endoscopic Examination ◽  
Cancer Risk Factors ◽  
Gastric Intestinal Metaplasia

Because the prevalence of gastric cancer is high and its prognosis is poor in the general population, early diagnosis is important. For gastric cancer, risk factors and precancerous lesions are well known. For gastric cancer, computed tomography has an important role in diagnosis, staging and treatment planning. When we look at the literature for the diagnosis of precancerous lesion, which will be an early diagnosis guide, we did not find any information about imaging findings. Gastric intestinal metaplasia was a precancerous lesion and we retrospectively analyzed the computed tomography sections of three patients who underwent endoscopic examination. In the pathological specimen, we noticed that the intestinal metaplasia, gastric mucosal rachas, lasagna-like, lace-style, parallel to each other showed a rough coincidence. We believe that large-scale, prospective studies will increase the incidence of gastric intestinal metaplasia, a precancerous lesion, and contribute to the early diagnosis of gastric cancer.

Statewide Identification of Adverse Events Using Retrospective Nurse Review: Methods and Outcomes

2007 ◽  
Vol 15 (3) ◽  
pp. 220-232 ◽  
Author(s):  
Michael P. Silver ◽  
Paul Hougland ◽  
Susan Elder ◽  
Jan Haug ◽  
Tracey Pritchett ◽  
...  
Keyword(s):  
Adverse Event ◽  
Patient Safety ◽  
Adverse Events ◽  
Medical Records ◽  
Large Scale ◽  
Cost Effective ◽  
Discharge Data ◽  
Physician Review ◽  
State Study ◽  
Cost Effective Alternative

This study was conducted as part of a two-state study of the validity of hospital discharge data for adverse event (AE) surveillance. Reliability of nurse identification of AEs was assessed through comparison with physician review. Nurses reviewed 6,296 medical records selected from two sampling frames. All were patients in 41 Utah acute care hospitals and surgery patients in 36 Missouri hospitals. A total of 1,035 records were independently reviewed by physicians using the same methods. Overall agreement between nurse and physician findings in Utah and Missouri, at the case level, was 78.5% (238/303) and 68.2% (499/732), respectively. Nurse review of medical records to identify AEs represents a cost-effective alternative to physician review for large-scale and ongoing patient safety improvements and surveillance purposes.

Adsorption Isotherm Predictions for Multiple Molecules in MOFs Using the Same Deep Learning Model

2019 ◽  
Author(s):  
Ryther Anderson ◽  
Achay Biong ◽  
Diego Gómez-Gualdrón
Keyword(s):  
Neural Network ◽  
Machine Learning ◽  
Molecular Simulation ◽  
Large Scale ◽  
Learning Model ◽  
Operating Conditions ◽  
Small Subset ◽  
Screening Methods ◽  
Large Set ◽  
Metal Organic

<div>Tailoring the structure and chemistry of metal-organic frameworks (MOFs) enables the manipulation of their adsorption properties to suit specific energy and environmental applications. As there are millions of possible MOFs (with tens of thousands already synthesized), molecular simulation, such as grand canonical Monte Carlo (GCMC), has frequently been used to rapidly evaluate the adsorption performance of a large set of MOFs. This allows subsequent experiments to focus only on a small subset of the most promising MOFs. In many instances, however, even molecular simulation becomes prohibitively time consuming, underscoring the need for alternative screening methods, such as machine learning, to precede molecular simulation efforts. In this study, as a proof of concept, we trained a neural network as the first example of a machine learning model capable of predicting full adsorption isotherms of different molecules not included in the training of the model. To achieve this, we trained our neural network only on alchemical species, represented only by their geometry and force field parameters, and used this neural network to predict the loadings of real adsorbates. We focused on predicting room temperature adsorption of small (one- and two-atom) molecules relevant to chemical separations. Namely, argon, krypton, xenon, methane, ethane, and nitrogen. However, we also observed surprisingly promising predictions for more complex molecules, whose properties are outside the range spanned by the alchemical adsorbates. Prediction accuracies suitable for large-scale screening were achieved using simple MOF (e.g. geometric properties and chemical moieties), and adsorbate (e.g. forcefield parameters and geometry) descriptors. Our results illustrate a new philosophy of training that opens the path towards development of machine learning models that can predict the adsorption loading of any new adsorbate at any new operating conditions in any new MOF.</div>

scholarly journals Tu1497 NATIONWIDE SURVEY OF HELICOBACTER PYLORI ANTIBIOTIC RESISTANCE IN HIGH PREVALENCE OF GASTRIC CANCER COUNTRY (BHUTAN): A LARGE-SCALE COMMUNITY-BASED STUDY

2020 ◽  
Vol 91 (6) ◽  
pp. AB591-AB592
Author(s):  
Ratha-Korn Vilaichone ◽  
Natsuda Aumpan ◽  
Tomohisa Uchida ◽  
Thawee Ratanachu-ek ◽  
Lotay Tshering ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Large Scale ◽  
Nationwide Survey ◽  
Community Based ◽  
High Prevalence

Efficient Schedule of Energy-Constrained UAV Using Crowdsourced Buses in Last-Mile Parcel Delivery

2021 ◽  
Vol 5 (1) ◽  
pp. 1-23
Author(s):  
Yan Pan ◽  
Shining Li ◽  
Qianwu Chen ◽  
Nan Zhang ◽  
Tao Cheng ◽  
...  
Keyword(s):  
Traffic Congestion ◽  
Large Scale ◽  
Load Capacity ◽  
Scheduling Algorithm ◽  
Cost Effective ◽  
Promising Alternative ◽  
Logistics Industry ◽  
Last Mile ◽  
Delivery Scheduling ◽  
Schedule Approach

Stimulated by the dramatical service demand in the logistics industry, logistics trucks employed in last-mile parcel delivery bring critical public concerns, such as heavy cost burden, traffic congestion and air pollution. Unmanned Aerial Vehicles (UAVs) are a promising alternative tool in last-mile delivery, which is however limited by insufficient flight range and load capacity. This paper presents an innovative energy-limited logistics UAV schedule approach using crowdsourced buses. Specifically, when one UAV delivers a parcel, it first lands on a crowdsourced social bus to parcel destination, gets recharged by the wireless recharger deployed on the bus, and then flies from the bus to the parcel destination. This novel approach not only increases the delivery range and load capacity of battery-limited UAVs, but is also much more cost-effective and environment-friendly than traditional methods. New challenges therefore emerge as the buses with spatiotemporal mobility become the bottleneck during delivery. By landing on buses, an Energy-Neutral Flight Principle and a delivery scheduling algorithm are proposed for the UAVs. Using the Energy-Neutral Flight Principle, each UAV can plan a flying path without depleting energy given buses with uncertain velocities. Besides, the delivery scheduling algorithm optimizes the delivery time and number of delivered parcels given warehouse location, logistics UAVs, parcel locations and buses. Comprehensive evaluations using a large-scale bus dataset demonstrate the superiority of the innovative logistics UAV schedule approach.

scholarly journals Multi-Country Scale Assessment of Available Energy Recovery Potential Using Micro-Hydropower in Drinking, Pressurised Irrigation and Wastewater Networks, Covering Part of the EU

Water ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 899
Author(s):  
Djordje Mitrovic ◽  
Miguel Crespo Chacón ◽  
Aida Mérida García ◽  
Jorge García Morillo ◽  
Juan Antonio Rodríguez Diaz ◽  
...  
Keyword(s):  
Drinking Water ◽  
Northern Ireland ◽  
Energy Recovery ◽  
Large Scale ◽  
Significant Proportion ◽  
Value Added ◽  
Cost Effective ◽  
Net Energy ◽  
Water Networks ◽  
Scale Assessment

Studies have shown micro-hydropower (MHP) opportunities for energy recovery and CO2 reductions in the water sector. This paper conducts a large-scale assessment of this potential using a dataset amassed across six EU countries (Ireland, Northern Ireland, Scotland, Wales, Spain, and Portugal) for the drinking water, irrigation, and wastewater sectors. Extrapolating the collected data, the total annual MHP potential was estimated between 482.3 and 821.6 GWh, depending on the assumptions, divided among Ireland (15.5–32.2 GWh), Scotland (17.8–139.7 GWh), Northern Ireland (5.9–8.2 GWh), Wales (10.2–8.1 GWh), Spain (375.3–539.9 GWh), and Portugal (57.6–93.5 GWh) and distributed across the drinking water (43–67%), irrigation (51–30%), and wastewater (6–3%) sectors. The findings demonstrated reductions in energy consumption in water networks between 1.7 and 13.0%. Forty-five percent of the energy estimated from the analysed sites was associated with just 3% of their number, having a power output capacity >15 kW. This demonstrated that a significant proportion of energy could be exploited at a small number of sites, with a valuable contribution to net energy efficiency gains and CO2 emission reductions. This also demonstrates cost-effective, value-added, multi-country benefits to policy makers, establishing the case to incentivise MHP in water networks to help achieve the desired CO2 emissions reductions targets.

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