ObjectiveA potential psychological harm of screening is unexpected diagnosis—labelling. We need to know the frequency and severity of this harm to make informed decisions about screening. We asked whether current evidence allows an estimate of any psychological harm of labelling. As case studies, we used two conditions for which screening is common: prostate cancer (PCa) and abdominal aortic aneurysm (AAA).DesignSystematic review with narrative synthesis.Data sources and eligibility criteriaWe searched the English language literature in PubMed, PsychINFO and Cumulative Index of Nursing and Allied Health Literature (CINAHL) for research of any design published between 1 January 2002 and 23 January 2017 that provided valid data about the psychological state of people recently diagnosed with early stage PCa or AAA. Two authors independently used explicit criteria to review and critically appraise all studies for bias, applicability and the extent to which it provided evidence about the frequency and severity of harm from labelling.Results35 quantitative studies (30 of PCa and 5 of AAA) met our criteria, 17 (48.6%) of which showed possible or definite psychological harm from labelling. None of these studies, however, had either appropriate measures or relevant comparisons to estimate the frequency and severity of psychological harm. Four PCa and three AAA qualitative studies all showed clear evidence of at least moderate psychological harm from labelling. Seven population-based studies found increased suicide in patients recently diagnosed with PCa.ConclusionsAlthough qualitative and population-based studies show that at least moderate psychological harm due to screening for PCa and AAA does occur, the current quantitative evidence is insufficient to allow a more precise estimation of frequency and severity. More sensitive measures and improved research designs are needed to fully characterise this harm. In the meantime, clinicians and recommendation panels should be aware of the occurrence of this harm.

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Considerations were identified for recommendation-making groups to use when gathering and assessing the adequacy of evidence about the IO-HO link. Using a standard set of written principles could improve the transparency of assessments of the IO-HO link, especially if used together with judgment in a reasoned conjecture and refutation process. Ideally, the process would result in an estimate of the magnitude of change in HOs that is expected for specified changes in IOs.

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Indium-tin oxide (ITO) nanoparticles, 6.1 ± 0.8 nm in diameter, were synthesized using a hot injection method. After reaction with 3-aminopropyldimethylethoxysilane to replace the initial oleylamine and oleic acid capping ligands, the aminated nanoparticles were rendered electroactive by functionalization with ferrocenoyl chloride. The nanoparticle color changed from blue-green to light brown, and the nanoparticles became more soluble in polar solvents, notably acetonitrile. The nanoparticle diffusion coefficient (D = 1.0 × 10(-6) cm(2)/s) and effective ferrocene concentration (C = 0.60 mM) in acetonitrile solutions were determined using ratios of DC and D(1/2)C data measured by microdisk voltammetry and chronoamperometry. The D result compares favorably to an Einstein-Stokes estimate (2.1 × 10(-6) cm(2)/s), assuming an 8 nm hydrodynamic diameter in acetonitrile (6 nm for the ITO core plus 2 nm for the ligand shell). The ferrocene concentration result is lower than anticipated (ca. 1.60 mM) based on a potentiometric titration of the ferrocene sites with Cu(II) in acetonitrile. Cyclic voltammetric data indicate tendency of the ferrocenated nanoparticles to adsorb on the Pt working electrode.