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In this issue, we challenge readers with the salient question of whether charity always begins at home, particularly as the world witnessed a surge in armed conflicts around the globe in 2023, with devastating consequences for millions of people. As children are among the most vulnerable members of societies, the first three articles of this issue focus on them as a target group. Thereafter, attention is turned to women, older persons, and people dealing with mental health issues, as vulnerable groups. Recognising that social work, especially in a forensic context, increases the likelihood of secondary traumatic stress among social workers, we have also addressed this topic in the issue. In conclusion, a disaster-specific approach to the social work curriculum in an undergraduate social work course is presented. We also offer a book review covering the challenges arising from the interplay of culture and human rights through the lenses of emancipatory social work and Afrocentricity in a globalised world.

The third edition of 2023 presents a collection of eight articles that delve into four central themes: role players in social work, the interface of Covid-19, gender-based violence, and child rights. The articles engage with diverse challenges and dynamics within the social work landscape, contributing to the advancement of theory and practice in both local and global contexts. In this editorial, we provide an overview of the themes and the contributions each article makes to the broader discourse.

Early Childhood Development (ECD) has become a priority area of social work, in both developed and developing countries. In this article, the term ECD supervisors refers to the social workers working with ECD centres in the capacity of supervisor. These social workers can provide valuable insight into the unique management tasks and associated professional development areas uniquely required when working in the ECD sector. The goal of this conceptual article is to identify these professional development areas of management tasks required from social workers who supervise ECD centres. Ultimately, these management tasks are synthesised into three categories, namely tasks which require technical, relational and administrative skills respectively. This is an attempt to preserve the institutional memory of South African social workers, given the current shift of ECD governance functions from the Department of Social Development to the Department of Basic Education.

This paper describes a collaboration between a university and a local child welfare agency in the development and delivery of a Bachelor of Social Work (BSW) child welfare course featuring lived experience knowledge and learning situated in community-based child welfare sites. We present results of an exploratory mixed methods pre-post survey and focus group evaluation which examined changes in student general knowledge, perceptions of skills for decision- making and orienting beliefs about child welfare families. The results did not yield uniform significant results. The discussion delves into lessons learned about the importance of supporting students to develop skills for respectfully gathering and critically analyzing information and how to break through what we observed as student reluctance to learn about child welfare wrongdoings. We reflect on why, despite centering curriculum on lived experience knowledge, we were not successful in overturning students' negative orienting beliefs about families and children receiving child welfare services. We conclude with considerations for new directions in BSW child welfare curriculum. [ABSTRACT FROM AUTHOR]

This edition of Social Work/Maatskaplike Werk offers a range of themes to the reader, with topics focusing on income-generating activities, homelessness, gangsterism, substance abuse, effective parenting, sexual orientation, community development practitioner profiling and supervision of social workers.

This article reports on qualitative research, aimed at acquiring an understanding of what transpires in an individual social work supervision session in South Africa. Findings reveal that supervision sessions are chiefly “open door” and “on the run”, with minimal evidence of critical reflection. A key recommendation stresses that the evolution of supervision in the country should enter a new phase as response to the hegemony of a neoliberal inspired managerial discourse in social work. The deliberate utilisation of more clinical educational and supportive elements, and critical reflection-in-action and reflection-on-action in supervision sessions is therefore recommended.

This is the first edition of SW/MW published by a new editorial team, who has to following in the inestimable footsteps of Prof Sulina Green and Ms Hester Uys, the former editor and business manager of the journal respectively. Their contributions towards the body of social work knowledge in South Africa and beyond are evident from the fact that under their leadership, the journal was transformed into an open access journal, was awarded a Scopes accreditation, and is ranked in the top 50 social work journals in the world, as listed by the Scimago journal ranking.

Widespread socio-economic challenges such as high levels of poverty and unemployment continue to plague South Africa. Owing to the nature of social work service delivery, social workers often serve the most vulnerable populations. However, it seems that social workers remain metaphorically in the trenches in the war on poverty, meaning that tangible evidence on the progress of poverty alleviation due to the direct involvement of social workers is meagre in social development. This article argues for the integration of a financial social work practice perspective into South African social work service delivery as a potential means of facilitating more efficient social development. The article is conceptual in nature and draws on the principles of theoretical adaptation. It posits social developmental theory as the dominant theoretical paradigm, and financial social work as the practice perspective. Analysis will highlight the current gaps in social developmental practice, and the appropriateness of financial social work to address it. The discussion aims to activate scholarly discourse on financial social work in South Africa and beyond, and to firmly position this practice perspective within sustainable social development. [ABSTRACT FROM AUTHOR]

Early Childhood Development (ECD) has become a priority area of social work, in both developed and developing countries. In this article, the term ECD supervisors refers to the social workers working with ECD centres in the capacity of supervisor. These social workers can provide valuable insight into the unique management tasks and associated professional development areas uniquely required when working in the ECD sector. The goal of this conceptual article is to identify these professional development areas of management tasks required from social workers who supervise ECD centres. Ultimately, these management tasks are synthesised into three categories, namely tasks which require technical, relational and administrative skills respectively. This is an attempt to preserve the institutional memory of South African social workers, given the current shift of ECD governance functions from the Department of Social Development to the Department of Basic Education. [ABSTRACT FROM AUTHOR]

Lisdexamfetamine (LDX) is a prodrug that is enzymatically converted into dextroamphetamine (d -AMP), a central nervous system stimulant. The stability of LDX in sampled whole blood is an important issue that may be crucial in the assessment of impaired driving caused by d -AMP. This study investigated the stability of LDX in whole blood collected in two different tubes containing a fluoride oxalate (FX) mixture and a fluoride citrate (FC) mixture. Without additives, LDX was unstable. LDX was also unstable in FX blood stored at ambient temperature or 4°C. After 3 days of storage at ambient temperature, an initial LDX concentration of 47 ± 1 ng/g (mean ± SD) was no longer detectable in the samples (n  = 3). Instead, 19 ± 0.6 ng/g d -AMP was formed. The stability was improved at 4°C. After 7 days of storage at 4°C, 88 ± 5% of an initial LDX concentration of 50 ± 0.4 ng/g was recovered and 3.8 ± 0.3 ng/g d -AMP was formed. The stability of LDX was greater in FC blood than in FX blood; 79 ± 10% and 93 ± 4% of initial LDX concentrations of 48 ± 2 and 51 ± 0.5 ng/g were recovered from FC blood after 7 days of storage at ambient temperature and 4°C, respectively, and the corresponding formation of d -AMP was 5.8 ± 0.6 and 0.5 ± 0.3 ng/g, respectively. When FX and FC blood were stored at −20°C or −80°C, no detectable degradation of LDX or formation of d -AMP was observed after 3 weeks of storage. [ABSTRACT FROM AUTHOR]

This article reports on qualitative research, aimed at acquiring an understanding of what transpires in an individual social work supervision session in South Africa. Findings reveal that supervision sessions are chiefly "open door" and "on the run", with minimal evidence of critical reflection. A key recommendation stresses that the evolution of supervision in the country should enter a new phase as response to the hegemony of a neoliberal inspired managerial discourse in social work. The deliberate utilisation of more clinical educational and supportive elements, and critical reflection-in-action and reflection-on-action in supervision sessions is therefore recommended. [ABSTRACT FROM AUTHOR]

Background: Dietary modification is an important component of chronic kidney disease (CKD) management. The aim of this study was to explore the perceptions of people with earlier-stage CKD living in rural Australia about the role of dietary intervention in their health and access to dietetic care., Methods: Semi-structured interviews were conducted with 14 people with stage 3-4 CKD living in a rural Australian health district. Interview questions were guided by the principles of the appreciative inquiry study methodology. The thematic analysis involved inductive coding of data, discussions of emerging themes between co-researchers as coding proceeded and thematic memoing to finalise the transformation of data into distinct themes., Results: Three predominant themes were evident from the data. First, people with CKD expressed that 'Dietary change empowers' them in self-management. Second, 'Dietetics is valued' in achieving dietary change. Third, it was clear that nephrologists had a key role in determining service access through 'Awareness and advocacy' of renal dietetic services., Conclusions: People with CKD living in rural Australia desire early, specialised renal dietetic care. The unexpectedly high acceptability of less resource-intensive technology for dietetic intervention suggests that there is an opportunity for service reorientation. Access to dietetic care could be enhanced by building on the key role of nephrologists in dietetic referral, service awareness and perception of value., (© 2024 The British Dietetic Association Ltd.)

Context: Prior research has explored the effect of synbiotics, the combination of probiotics and prebiotics, on the gut microbiota in clinical populations. However, evidence related to the effect of synbiotics on the gut microbiota in healthy adults has not been reviewed to date., Objective: A systematic review and meta-analysis was conducted to comprehensively investigate the effect of synbiotics on the gut microbiota and inflammatory markers in populations of healthy adults., Data Sources: Scopus, PubMed, Web of Science, ScienceDirect, MEDLINE, CINAHL, and The Cochrane Library were systematically searched to retrieve randomized controlled trials examining the primary outcome of gut microbiota or intestinal permeability changes after synbiotic consumption in healthy adults. Secondary outcomes of interest were short-chain fatty acids, inflammatory biomarkers, and gut microbiota diversity., Data Extraction: Weighted (WMD) or standardized mean difference (SMD) outcome data were pooled in restricted maximum likelihood models using random effects. Twenty-seven articles reporting on 26 studies met the eligibility criteria (n = 1319)., Data Analysis: Meta-analyses of 16 studies showed synbiotics resulted in a significant increase in Lactobacillus cell count (SMD, 0.74; 95% confidence interval [CI], 0.15, 1.33; P = 0.01) and propionate concentration (SMD, 0.22; 95% CI, 0.02, 0.43; P = 0.03) compared with controls. A trend for an increase in Bifidobacterium relative abundance (WMD, 0.97; 95% CI, 0.42, 2.52; P = 0.10) and cell count (SMD, 0.82; 95% CI, 0.13, 1.88; P = 0.06) was seen. No significant differences in α-diversity, acetate, butyrate, zonulin, IL-6, CRP, or endotoxins were observed., Conclusion: This review demonstrates that synbiotics modulate the gut microbiota by increasing Lactobacillus and propionate across various healthy adult populations, and may result in increased Bifidobacterium. Significant variations in synbiotic type, dose, and duration should be considered as limitations when applying findings to clinical practice., Systematic Review Registration: PROSPERO no. CRD42021284033., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Life Sciences Institute.)

Dysregulated differentiation of naïve CD4+ T cells into T helper 17 (Th17) cells is likely a key factor predisposing to many autoimmune diseases. Therefore, better understanding how Th17 differentiation is regulated is essential to identify novel therapeutic targets and strategies to identify individuals at high risk of developing autoimmunity. Here, we extend our prior work using chemical inhibitors to provide mechanistic insight into a novel regulator of Th17 differentiation, the kinase dual-specificity tyrosine phosphorylation-regulated kinase 1A (DYRK1A). We generated a conditional knockout mouse model to validate DYRK1A as a regulator of Th17 differentiation that acts in a dose-dependent fashion at least in part by modulating interleukin (IL)-6 signaling through multiple mechanisms. We identified a new role for DYRK1A in regulating surface expression of IL-6 receptor subunits in naïve CD4+ T cells, consistent with DYRK1A's impact on Th17 differentiation. Physiologic relevance is supported by findings in people with Down syndrome, in which increased expression of DYRK1A, encoded on chromosome 21, is linked to increased IL-6 responsiveness. Our findings highlight DYRK1A as a druggable target of broad therapeutic and prognostic interest in autoimmunity and immune function., (© The Author(s) 2025. Published by Oxford University Press on behalf of The American Association of Immunologists.)

Background: It is well established that antibiotics administered in preterm prelabor rupture of membranes increases latency to delivery. While data is limited for membrane rupture prior to viability, antibiotics may also increase latency in this population., Objective: To assesses the effect of prophylactic antibiotics on the duration of latency in individuals with previable prelabor rupture of membranes., Study Design: Retrospective cohort of pregnancies with previable prelabor rupture of membranes prior to 23 weeks, 0 days in a single health system(2013-2022). Patients opting for termination or with a contraindication to expectant management were excluded. The primary outcome was latency from previable prelabor rupture of membranes diagnosis to delivery. Secondary outcomes included subanalysis by gestational age as well as maternal and neonatal morbidity and mortality. Bivariate statistics compared patients who did and did not received antibiotics. Kaplan-Meier/Cox proportional hazards ratios using significant covariates(p<0.1) in bivariate analysis models examined antibiotic impact on latency., Results: Of 115 patients, 46(40%) met inclusion criteria, of whom 34(74%) received latency antibiotics. Median latency did not differ with antibiotic receipt(1 week, [0.4,2.6] versus 0.6 weeks [0.3,0.9], p=0.27). When adjusted for gestational age at rupture of membranes, antibiotics were not associated with longer latency(hazard ratio1.33 [0.91,1.93]). Antibiotic receipt was associated with lower rates of previable delivery(23.0 weeks, [22.7, 24.0] versus 21.3 weeks [20.5,23.1], p=0.006). Adjusted odds of previable delivery remained lower with receipt of antibiotics(adjusted odds ratio 0.20, [0.04,0.90]). Antibiotics were associated with longer latency in patients with rupture of membranes at less than 22 week's gestation(2.4wks [1.3,4.4] vs 0.6wks [0.1,0.9], p=0.02)., Conclusion: Antibiotic administration at the time of previable prelabor rupture of membranes was associated with longer latency if prior to 22 weeks' gestation. Antibiotic administration increased the odds of delivering after viability. Further study should address optimal antibiotics strategies for this unique population., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Objective: To describe the process of developing and implementing a novel approach to renal diet education by changing from a nutrient-based food list to a pictorial meal compilation approach through the skill steps: plan, select, cook, eat., Design and Methods: The skill-based teaching method accommodates low literacy levels and respects cultural values. This teaching style aligns the complex renal diet guidelines with family living. Each meal plan is based on a balanced diet and includes family preferences. Appropriate cooking methods and food swaps that match renal diet specifications are included. The accompanying Cook for Life cookbook demonstrates how to prepare the new kidney-friendly family meal. Recipes were supplied by a local Māori elder and his whānau and tested by the dietitian. The cookbook is provided to all patients receiving renal dietetic education. The teaching method has undergone several iterations to accommodate feedback from dietitians, nurses, doctors, and patients. This included patient engagement to develop the Storybook, a pictorial representation of typical meals consumed in the community with a corresponding food substitution to illustrate how to compile kidney-friendly meals., Results: Analysis of feedback regarding this approach indicates high levels of acceptance and engagement with this new teaching style., Conclusion: This practical skill-based dietary education teaching style appears to be a feasible, acceptable, culturally sensitive, and appropriate approach to dietary education for people who live with kidney disease. Patient engagement in the design of this approach supports effective learning and behavior change., (Copyright © 2024 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Studies exploring early life-course BMI trajectories and subsequent mental health outcomes are limited but may provide important insights for early intervention. We investigated associations between BMI trajectories from 0 to 18 years and mental health outcomes in emerging adulthood., Methods: Data were obtained from 434 participants in the Melbourne Atopy Cohort Study (MACS). Anthropometric data were collected across 26 timepoints from infancy to age 25 and group-based trajectory modelling was used to develop BMI trajectories from 0.1 to 18 years. Moderate-to-severe psychological distress (MSPD) and likely depression were assessed at age 18 and 25 years. Associations between BMI trajectories and mental health at 25 years and change in mental health between 18 and 25 years were estimated using logistic regression. History of asthma, hay fever or eczema were independently examined as potential effect modifiers., Results: Five BMI trajectories were identified from 1 month to 18 years. When compared to the stable average BMI trajectory, we found an increased risk of MSPD (OR = 2.97; 95%CI: 1.09,8.06) and likely depression (3.56; 1.39,9.12) at age 25 in the average increasing-to-high trajectory. This group also had a greater likelihood of new-onset depression (4.82; 1.54,15.0) from 18 to 25 years of age., Limitations: MACS participants are not representative of the general population and mental health data was not available before 18 years of age., Conclusion: Excessive weight gain across the childhood transition was associated with poorer mental health in emerging adulthood, highlighting the importance of monitoring growth to allow for early identification and stratification of individuals at risk of poor mental health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Antimicrobial resistance (AMR) has been declared one of the top 10 global public health challenges of our age by the World Health Organization, and the World Bank describes AMR as a crisis affecting the finance, health, and agriculture sectors and a major threat to the attainment of Sustainable Development Goals. But what is AMR? It is a phenotype that evolves in microbes exposed to antimicrobial molecules and causes dangerous infections. This suggests that scientists and healthcare workers should be on the frontline in the search for sustainable solutions to AMR. Yet AMR is also a societal problem to be understood by everyone. This review aims to explore the need to address the problem of AMR through a coherent, international strategy with buy-in from all sectors of society. As reviewed here, the sustainable solutions to AMR will be driven by better understanding of AMR biology but will require more than this alone to succeed. Some advances on the horizon, such as the use of bacteriophage (phage) to treat AMR infections. However, many of the new technologies and new therapeutics to address AMR require access to biodiversity, where the custodians of that biodiversity-and the traditional knowledge required to access it-are needed as key partners in the scientific, clinical, biotechnological, and international ventures that would treat the problem of AMR and ultimately prevent its further evolution. Many of these advances will be built on microbial assessments to understand the extent of AMR in our environments and bioprospecting to identify microbes that may have beneficial uses. Genuine partnerships for access to this biodiversity and sharing of benefits accrued require a consideration of ethical practice and behavior. Behavior change is needed across all sectors of culturally diverse societies so that rapid deployment of solutions can be implemented for maximum effect against the impacts of AMR., (© 2024 The Author(s). IUBMB Life published by Wiley Periodicals LLC on behalf of International Union of Biochemistry and Molecular Biology.)

Background/objectives: The goals of sports nutrition are to support athletic performance. However, the diet quality of athletes remains poorly understood. This scoping review aims to synthesise the existing body of literature, evaluating the diet quality of adult athletes., Methods: The scoping review was conducted in accordance with guidance from the Joanna Briggs Institute. Database searches were conducted in Medline, Scopus, SPORTDiscus, Web of Science, and EMBASE. Eligible studies were observational, utilised a validated dietary quality assessment tool (diet quality index), and assessed athletes aged 18 to 65 years. Screening was performed independently by two researchers, with any conflicts resolved by a third researcher., Results: The search yielded 1142 articles, of which 18 met the inclusion criteria. Basketball athletes and gymnasts were the most frequently examined groups. Studies were dominated by one gender ( n = 7 all males studies, n = 4 only female). Eleven diet quality tools were used, including variations of the Healthy Eating Index ( n = 7). Overall diet quality was rated as poor ( n = 3 studies), needs improvement ( n = 12), or adequate ( n = 3). Food groups where intake was suboptimal included wholegrains ( n = 8), fruit ( n = 5), and dairy intake ( n = 3). The intake of protein-rich foods was adequate in n = 9 studies, whilst fat intake was excessive in 4 studies., Conclusions: These findings suggested that the diet quality of athletes is suboptimal and needs improvement in the areas of wholegrain, fruit, and dairy/alternatives intake. The inadequate intake of these food groups and the consumption of excessive fat intake may increase the long-term risk of developing non-communicable diseases and impair short-term performance and recovery. Further exploration is warranted to develop targeted nutrition education and interventions that address these inadequacies.

Background: Few studies have explored the relationship between habitual dietary patterns and disease activity in people with Inflammatory Bowel Disease (IBD). This cross-sectional study explored the association between dietary patterns and clinical and objective markers of inflammation in adults from the Australian IBD Microbiome Study., Methods: Dietary patterns were derived using principal component analysis (PCA) of baseline food frequency questionnaire data. Food intake was quantified using 3-day food record data. Associations between dietary intake and both clinical disease activity index (CDAI) and faecal calprotectin (FCP) were analysed., Results: Participants included 412 adults (IBD = 223, Healthy controls (HC) = 189). Both cohorts consumed poor-quality diets with inadequate servings of most food groups compared to Australian reference standards. IBD participants without FCP inflammation had significantly higher fibre intake than those with moderate FCP. In the Crohn's Disease group, high adherence to 'High plant diversity' and 'Meat eaters' dietary patterns were associated with increased CDAI and FCP, respectively. In the combined IBD cohort, high adherence to a 'Vegan-style' dietary pattern was associated with increased FCP., Conclusions: There is a need for dietary modifications among Australian adults, both with and without IBD, to improve dietary fibre intake and adherence to dietary guidelines. Dietary patterns characterised by a high intake of plant foods or meat products were both positively associated with indicators of active IBD. It is possible that some participants with active IBD were modifying their diet to try to manage their disease and reduce symptoms, contributing to the association between healthier dietary patterns and active disease. Further clinical and longitudinal studies are needed to expand upon the findings. This study offers a unique contribution by utilising FCP as an objective marker of intestinal inflammation and applying dietary pattern analysis to investigate the relationship between diet and inflammatory markers.

Introduction: The autoimmune encephalitides (AE) are a heterogeneous group of neurological disorders with significant morbidity and healthcare costs. Despite advancements in understanding their pathophysiology, uncertainties persist regarding long-term prognosis and optimal management. This study aims to address these gaps, focusing on immunotherapeutic strategies, neoplastic associations and functional outcomes., Methods and Analysis: The Retrospective Linkage Study of Autoimmune Encephalitis project will use data linkage techniques to establish a retrospective 10-year population cohort of Australian patients with AE. Two cohorts will be analysed, the Reference Cohort (clinically confirmed AE cases obtained from hospital medical records, n=145) and the Operationally Defined Cohort (AE cases identified through administrative coding data, n≈5000). Univariate statistical methods will identify candidate coding elements for use in the operational case definition and multivariate models and evaluation methods used to identify and internally validate the optimal coding algorithms. The two study cohorts will be analysed separately due to the high likelihood of overlap. Primary outcomes include relapse rate, prevalence and control of epilepsy, cognitive disability, poor educational attainment, delayed tumour diagnosis and mortality. Statistical analyses, including random mixed-effects regression models, will assess treatment effects, covariates and outcomes., Ethics and Dissemination: This project has been approved by the leading investigators' institutional Human Research Ethics Committee (HREC), the St Vincent's Hospital Melbourne HREC, as well as the Australian Institute of Health and Welfare HREC and relevant jurisdictional HRECs where required. The dissemination of findings through peer-reviewed publications and patient advocacy channels will maximise the impact of this research., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective'Placement poverty' refers to the financial burdens imposed upon students by the completion of mandatory professional placement. We aimed to identify the financial implications of mandatory professional placements on student wellbeing.MethodsA cross-sectional online survey (August 2023 to January 2024) completed during students' most recent professional placement in the final year of their degree. Eligible participants were health or teaching students studying at Australian and New Zealand universities in degrees requiring mandatory professional placement. Questions included total and accommodation costs, financial support, impact of finances on placement preferences, presence of food insecurity, and implications for student wellbeing.ResultsParticipants (n=530) were mostly health professional (65%) students (median, 25; interquartile range (IQR), 22-30 years, 95.3% domestic, 88.3% full time, 2.0% New Zealand). Health students had higher total costs (in Australian dollars) for the recent placement ($1500; IQR, 600-3453) compared to teaching students ($1200; IQR, 600-2757) (P=0.02), likely due to longer placement duration (6weeks for health students). A higher proportion of health students required financial support (P=0.0001). Placement preferences were always or sometimes (63.8%) determined by cost rather than learning opportunity. Food insecurity was experienced by most students (70.2%) (10.4% marginal, 32.1% moderate, 27.7% severe), with no difference by degree type. Thematic analysis identified themes of burnout, emotional distress, inability to focus on learning, postponing care of oneself, urgent need for financial support, unanticipated family and other circumstances, and worsened societal inequity.ConclusionsOur study identified widespread financial difficulty in students undertaking placement that adversely impacted personal wellbeing. Strategies are needed to support wellbeing and ameliorate the financial burden.

Marchiafava Bignami Disease (MBD) is a reversible neurological disorder with can be difficult to diagnose initially due to variable neurological presentations that can be seen in patients. Physicians need to consider this diagnosis as the readily available treatment of thiamine can help reverse symptoms and prevent long lasting effects. We present the case of a 52-year-old man with a history of alcohol use disorder who presented with concerns for a cerebrovascular accident. The patient had neurological signs that were vague and included intermittent confusion, subtle droop to the lower lip, and ataxia in their limbs. MRI revealed restricted diffusion in the corpus callosum which helped confirm the diagnosis of MBD. Treatment with thiamine helped the patient get back to their usual state of health with no new neurological deficits. This case emphasizes that MBD is a rare neurological disorder that must be considered in patients with alcohol use disorder who present with varying neurological symptoms as early thiamine treatment can reverse symptoms., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To summarize practice patterns and outcomes among patients with non-myoinvasive high-grade (formerly stage IA, now stage IC) endometrial cancer., Methods: We conducted a systematic search using MEDLINE, Embase, Cochrane, Web of Science, and ClinicalTrials.gov databases from inception to May 8, 2024 to identify studies reporting on treatment and outcomes of non-myoinvasive high-grade endometrial cancer. We included full-text English reports of patients undergoing adjuvant therapy or surveillance for polyp- or endometrium-confined high-grade endometrial cancer without myometrial invasion containing data on recurrence or survival outcomes. Two reviewers independently screened studies; a third reviewer resolved disagreements. Data were extracted using a standardized form. The primary outcome was recurrence risk. Random-effects meta-analysis was used to summarize binomial proportions and to compare outcomes by adjuvant treatment strategy., Results: A total of 29 studies were included, representing 2770 unique patients. Overall, 49.0 % of patients were managed with observation and 37.9 % with chemotherapy. Most patients (92.5 %) had serous histology. Of 23 studies with data on recurrence, 13.7 % of patients recurred, with a meta-analysis estimate recurrence risk of 11 % (95 % confidence interval [CI]: 8-15 %). Across 13 studies reporting on recurrence by receipt of chemotherapy versus no chemotherapy, comparative meta-analysis showed similar likelihood of recurrence (8.0 % versus 13.2 %; odds ratio 0.73, 95 % CI: 0.38-1.42). Comparative meta-analyses for (1) adjuvant therapy versus observation and (2) observation or vaginal brachytherapy versus chemotherapy and/or external beam radiation therapy demonstrated no statistically significant difference in recurrence risk. Sensitivity analyses results, including those limiting to studies of patients with serous histology (12 studies) or complete surgical staging (10 studies), were overall consistent with the primary analysis. Survival data was inconsistently reported and not amenable to meta-analysis., Conclusion: Among patients with non-myoinvasive high-grade endometrial cancer, recurrence risk was 11 % and use of adjuvant therapy was not associated with reduced recurrence risk. Prospective study of this population is warranted., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)