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In this paper we provide new refinements of Aczel-type inequality and give some applications. Furthermore, we show that two of three theorems in the work by J. Tian and M.-H. Ha (J. Math. Inequal. 12 (1) (2018), 175-189) are incorrect whereas the proof of the other is technically wrong. We establish an improvement of the correctly stated theorem with a simple proof and give counterexamples to the wrong ones. [ABSTRACT FROM AUTHOR]

Abstract Introduction In Viet Nam, key populations (KPs) face barriers accessing HIV services. Virtual platforms can be leveraged to increase access for KPs, including for HIV self‐testing (HIVST). This study compares reach and effectiveness of a web‐based HIVST intervention from pilot to scale‐up in Viet Nam. Methods A mixed‐methods explanatory sequential design used cross‐sectional and thematic analysis. The pilot launched in Can Tho in November 2020, followed by Hanoi and Nghe An in April 2021. Scale‐up included Can Tho and Nghe An, with 21 novel provinces from April to December 2022. After risk assessment, participants registered on the website, receiving HIVST (OraQuick®) by courier, peer educator or self‐pick‐up. Test result reporting and completing satisfaction surveys were encouraged. Intervention reach was measured through numbers accessing the testing, disaggregated by demographics, and proportion of individuals reporting self‐testing post‐registration. Effectiveness was measured through numbers reporting self‐test results, testing positive and linking to care, and testing negative and using HIVST to manage pre‐exposure prophylaxis (PrEP) use. Thematic content analysis of free‐text responses from the satisfaction survey synthesized quantitative outcomes. Results In total, 17,589 participants registered on the HIVST website; 11,332 individuals ordered 13,334 tests. Participants were generally young, aged

Objective Pre-exposure prophylaxis (PrEP) was introduced in Viet Nam in 2017, but data on oral PrEP preference and effective use beyond 3 months are limited. We aimed to evaluate PrEP preferences for PrEP, factors influencing uptake, choice and effective use, as well as barriers to PrEP.Methods This is a prospective cohort study in Can Tho, Viet Nam. Participants who were eligible for PrEP and provided informed consent were interviewed at baseline on demographic information, willingness to pay, reasons for choosing their PrEP regimen and the anticipated difficulties in taking PrEP and followed up at 3 months, 6 months and 12 months after PrEP initiation.Findings Between May 2020 and April 2021, 926 individuals at substantial risk for HIV initiated PrEP. Of whom 673 (72.7%) choose daily PrEP and 253 (27.3%) choose event-driven (ED)-PrEP. The majority of participants were men (92.7%) and only 6.8% were women and 0.5% were transgender women. Median participant age was 24 years (IQR 20–28) and 84.7% reported as exclusively same-sex relationship. The three most common reasons for choosing daily PrEP were effectiveness (24.3%) and unplanning for sex (22.9%). Those opting for ED-PrEP also cited effectiveness (22.7%), as well as convenience (18.0%) and easier effective use (12.0%). Only 7.8% of PrEP users indicated they were unwilling to pay for PrEP and 76.4% would be willing to pay if PrEP were less than US$15 per month. The proportion of user effectively using PrEP at 12 months was 43.1% and 99.2% in daily PrEP and ED-PrEP users, respectively.Conclusions ED-PrEP was preferred by more than a quarter of 23.5% of the participants and there was little concern about potential adverse events. High rates of effective use were reported by ED-PrEP users. Future research to inform implementation of PrEP in Viet Nam is needed to develop ways of measuring adherence to ED-PrEP more accurately and to understand and address difficulties in taking daily PrEP use.

Modern wide field radio surveys typically detect millions of objects. Manual determination of the morphologies is impractical for such a large number of radio sources. Techniques based on machine learning are proving to be useful for classifying large numbers of objects. The self-organizing map (SOM) is an unsupervised machine learning algorithm that projects a many-dimensional dataset onto a two- or three-dimensional lattice of neurons. This dimensionality reduction allows the user to visualize common features of the data better and develop algorithms for classifying objects that are not otherwise possible with large datasets. To this aim, we use the PINK implementation of a SOM. PINK incorporates rotation and flipping invariance so that the SOM algorithm may be applied to astronomical images. In this cookbook we provide instructions for working with PINK, including preprocessing the input images, training the model, and offering lessons learned through experimentation. The problem of imbalanced classes can be improved by careful selection of the training sample and increasing the number of neurons in the SOM (chosen by the user). Because PINK is not scale-invariant, structure can be smeared in the neurons. This can also be improved by increasing the number of neurons in the SOM. We also introduce pyink , a Python package used to read and write PINK binary files, assist in common preprocessing operations, perform standard analyses, visualize the SOM and preprocessed images, and create image-based annotations using a graphical interface. A tutorial is also provided to guide the user through the entire process. We present an application of PINK to VLA Sky Survey (VLASS) images. We demonstrate that the PINK is generally able to group VLASS sources with similar morphology together. We use the results of PINK to estimate the probability that a given source in the VLASS QuickLook Catalogue is actually due to sidelobe contamination. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVD) continue to be the leading cause of deaths and disability worldwide and the major contributor is hypertension. Despite all the improvements in detecting hypertension together with technological advances and affordable, efficacious and relatively free of adverse effects anti-hypertensive agents, we continue to struggle to prevent the onset of hypertension and to control blood pressure (BP) to acceptable targets. The poor control of hypertension is commonly due to non-adherence to medications. Another reason is the failure to adopt diet and lifestyle changes. Reduction of dietary salt intake is important for lowering BP but the role of potassium intake is also important. Globally the intake of sodium is double that of the recommended 2 gm per day (equivalent to 5 gm of sodium chloride/salt) and half that of the daily recommended intake of potassium of 3500 mg/day, giving a sodium-to-potassium ratio of >1, when ideally it should be <1. Many studies have shown that a higher potassium intake is associated with lower BPs, particularly when coupled concurrently with a lower sodium intake giving a lower sodium to potassium ratio. Most hypertension guidelines, while recommending reduction of salt intake to a set target, do not specifically recommend a target for potassium intake nor potassium supplementation. Here we review the role of potassium and salt substitution with potassium in the management of hypertension. Hence, the focus of dietary changes to lower BP and improve BP control should not be on reduction of salt intake alone but more importantly should include an increase in potassium intake., (© 2024. The Author(s), under exclusive licence to The Japanese Society of Hypertension.)

Background: Diabetes is one of the leading causes of noncommunicable diseases worldwide. It is known to induce cardiovascular remodeling, which can result in a variety of complications, including a considerable increase in aortic stiffness. While studies in Western populations have explored these effects, data on Asians, mainly Vietnamese, are limited. This study aimed to assess aortic elasticity in type 2 diabetes mellitus (T2DM) patients compared to healthy individuals., Methods: This quantitative, cross-sectional study compared aortic elasticity indices between individuals with T2DM and healthy controls in Vietnam. Aortic elasticity indices were assessed for all participants using M-mode echocardiography., Results: A comparison between the healthy and T2DM groups revealed substantial differences in aortic elasticity indices. The aortic stiffness index (ASI) was significantly greater in the T2DM group than in the control group, with median values of 6.10 (3.64-12.47) and 3.79 (2.40-8.50), respectively (p = 0.003). Aortic strain (AS) was substantially lower in the T2DM group than in the control group, with median values of 8.21% (4.24-13.07) and 10.66% (6.01-18.23), respectively (p = 0.039). Furthermore, the median aortic compliance (AC, 10-2mm/mmHg) and aortic distensibility (AD, 10-3mmHg-1) in individuals with T2DM were 4.07 (2.28-7.44) and 3.08 (1.57-5.26), respectively, lower than those in the control group, with median values of 6.40 (3.08-10.75) and 5.33 (2.80-9.79). A longer diabetes duration was linked to a greater ASI (r = 0.43, p < 0.05), while the AS decreased (r = -0.37, p < 0.05)., Conclusions: Substantial variations in aorta elasticity indices were found in patients with T2DM using M-mode echocardiography. These differences highlight the impact of T2DM on vascular health. More research is needed to investigate the consequences of these discrepancies and their significance for clinical purposes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Dang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aim: The "2024 Guideline for the Primary Prevention of Stroke" replaces the 2014 "Guidelines for the Primary Prevention of Stroke." This updated guideline is intended to be a resource for clinicians to use to guide various prevention strategies for individuals with no history of stroke., Methods: A comprehensive search for literature published since the 2014 guideline; derived from research involving human participants published in English; and indexed in MEDLINE, PubMed, Cochrane Library, and other selected and relevant databases was conducted between May and November 2023. Other documents on related subject matter previously published by the American Heart Association were also reviewed., Structure: Ischemic and hemorrhagic strokes lead to significant disability but, most important, are preventable. The 2024 primary prevention of stroke guideline provides recommendations based on current evidence for strategies to prevent stroke throughout the life span. These recommendations align with the American Heart Association's Life's Essential 8 for optimizing cardiovascular and brain health, in addition to preventing incident stroke. We also have added sex-specific recommendations for screening and prevention of stroke, which are new compared with the 2014 guideline. Many recommendations for similar risk factor prevention were updated, new topics were reviewed, and recommendations were created when supported by sufficient-quality published data.

Background: Androgen-deprivation therapy (ADT) remains a cornerstone in treatment for patients with advanced prostate cancer. ADT is associated with several adverse effects, including osteoporosis, metabolic syndrome, and cardiovascular events, leading to guidelines recommending routine testing to monitor for these toxicities. There is a lack of data assessing adherence to these recommendations., Methods: The authors conducted a retrospective cohort study using administrative data from Ontario, Canada between 2008 and 2021. They identified all older men (aged 65 years and older) who received ADT for prostate cancer using comprehensive provincial health databases. The primary outcomes were the use of testing for lipids, dysglycemia (glucose), bone health serum, and bone density between 6 weeks before and 1 year after the initiation of ADT., Results: In total, 29,097 patients were examined, of whom 52.8% were prescribed ADT by urologists, 37.9% were prescribed ADT by radiation oncologists, 2.8% were prescribed ADT by medical oncologists, and 2.4% were prescribed ADT by other physicians. Adherence to guidelines was low: only 21.3% of patients received a bone density scan, 41.2% underwent bone health-related serum tests, 51.3% completed a lipid profile, and 65.9% underwent dysglycemia testing within 1 year of diagnosis. Overall, only 11.9% of patients received all of the recommended investigations. Adherence to testing did not appear to improve over time (2008-2021) or with guideline publication. Patient (age) and physician (specialty) factors had important associations with adherence to testing., Conclusions: Most patients receiving ADT for prostate cancer do not receive recommended testing to monitor for treatment-related toxicity. Further study is required to address barriers to therapeutic monitoring of men on ADT and to reduce treatment-associated adverse events., (© 2024 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)

Background: Detrended fluctuation analysis (DFA) and sample entropy (SE) measure the long-term correlations and regularity of gait patterns, respectively, having previously been used to identify participants at risk of falling, previous history of injury, or patients with motor diseases. Since these measures are more sensitive to gait impairment than linear measures (e.g., the standard deviation [SD] of stride time), they can be potentially used in military medicine to identify soldiers at risk of injury. However, clinometric properties are yet to be established., Research Question: What is the repeatability of DFA, SE, and traditional linear measures of stride time variability (SD and coefficient of variation [CV]) under various load and speed constraints?, Methods: Fourteen Australian Army trainee soldiers (age: 25.6 ± 5.9 y, height: 1.74 ± 0.08 m, body mass: 77.2 ± 15.1 kg, service: 1.5 ± 1.8 y) attended three sessions over two weeks, completing four 12-minute walking trials on an instrumented treadmill in each session. Participants walked with a combination of 0 kg or 23 kg loads at a self-selected or 5.5 km/h speed. Heel contacts from the right foot were identified using treadmill-embedded force plates. From 512 stride time intervals, linear (SD and CV), and non-linear (DFA and SE) measures were obtained. To assess the between-session repeatability, intraclass correlations (ICC 2,1) were employed., Results and Significance: There was poor-to-moderate repeatability for the SD (ICC: 0.357-0.545) and CV (ICC: 0.371-0.529). DFA showed poor-to-moderate repeatability (ICC: 0.013-0.504), while SE had poor repeatability (ICC: 0.133-0.226). Previous studies have shown that differences of > 0.19 in DFA and > 0.66 in SE can differentiate between healthy and pathological gait. These values are greater than this study's reported standard error of measurement, indicating that clinically meaningful changes may still be detectable despite low repeatability., Competing Interests: Declaration of Competing Interest All authors declare that they have no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Purpose: This investigation sought to determine industry perceptions of postgraduate strength and conditioning (S&C) degrees to understand whether graduates are equipped for the demands of sport performance service roles., Methods: Survey data were collected from 111 participants employed as performance staff or in a role that recruits and supervises performance staff. The survey consisted of 3 main sections: (1) perceptions of career-development opportunities in S&C, (2) perception of S&C postgraduate programs, and (3) perceptions of employability in S&C. Exploratory factor analysis was conducted to identify the key factors considered to be of greatest relevance to career progression in S&C., Results: A 2-factor solution was achieved for each of the 3 sections, resulting in 6 total factors. These factors are Academic and Professional Development, Mentorship and Sport Diversity, Student Preparation, Require Greater Emphasis, Testing and Training, and Personal and Professional Growth., Conclusions: Postgraduate S&C programs require a broad range of placement/internship opportunities to (1) provide diverse experiences, (2) allow students to build contacts and develop professional networks, (3) gain exposure to working in high-performance environments and multidisciplinary teams, and (4) access high-quality mentors. Alongside the ability to deliver training and testing, graduates should be equipped with strong organizational and relationship-building skills. Improved graduate capabilities can raise the standards of the profession and result in enhanced service provision to athletes.

Purpose: Women with breast cancer (BC) are at high risk of developing cardiovascular disease (CVD). We examined adherence to CVD medications and their association with major CVD events over 14 years of follow-up in the Pathways Heart Study, a prospective study of 4,776 stage I-III BC patients diagnosed from 2005-2013., Methods: Eligibility included being alive 6 months post-BC diagnosis, with dyslipidemia, hypertension, or diabetes at diagnosis along with ≥1 prior outpatient order or dispensing for a statin, anti-hypertensive, or diabetes medication, respectively, in the 30 months prior. Medication adherence was measured from pharmacy data to calculate cumulative average adherence (CAA). Incident heart failure (HF), ischemic heart disease (IHD), and stroke were determined via validated diagnosis and procedure codes. Working marginal structural models (MSM) fitted with inverse probability weighting evaluated the effect of adherence regimens on the hazards for each CVD event, while controlling for baseline and time-varying confounders. MSM parameterizations included: 1) CAA<100% versus CAA = 100% (ref), 2) CAA<80% versus CAA≥80% (ref) and 3) CAA<80% versus 80%≤CAA<100% versus CAA = 100%., Results: Poor statin adherence (CAA<80%) was associated with higher risk of composite CVD (HR = 2.54; 95% CI: 1.09, 5.94) versus CAA≥80%. Poor statin adherence was also associated with a higher risk of stroke (HR = 8.13; 95% CI: 2.03, 32.51) but not risk of IHD and HF. Further, compared with perfect adherence (CAA = 100%), good adherence (80%≤CAA<100%) was associated with lower risk (HR = 0.35; 95% CI: 0.13, 0.92) while poor adherence (CAA<80%) was associated with higher risk of composite CVD (HR = 2.45; 95% CI: 1.05, 5.70). Levels of adherence to anti-hypertensives and diabetes medications had mixed or null associations with risk of CVD., Conclusions: Maintaining good adherence (≥80%) to statins after BC treatment is beneficial for cardiovascular health in patients with dyslipidemia. Future studies should determine factors associated with lower adherence to statins and ways to improve adherence., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kwan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Abstract: Pairwise comparison of heavy dynamic strength and fast dynamic strength interventions on sprint performance: a systematic review and meta-analysis. J Strength Cond Res 38(9): 1675-1686, 2024-Previous studies have shown that both heavy dynamic strength (HDS) and fast dynamic strength (FDS) training can be used to improve sprint performance; however, a review and meta-analysis investigating pairwise studies that compare these two training interventions have not been performed. The aims of the study were to systematically review and analyze HDS and FDS training methodologies and evaluate their effect size difference, in pairwise comparison studies to determine and compare their effects on sprint performance. Databases were systematically searched using Boolean phrasing to identify eligible articles, and meta-analyses were performed on the extracted data. Seven studies met the inclusion criteria, which resulted in data from 138 subjects across 24 separate sprint assessments. Overall, there was a small effect in favor of FDS (standardized mean difference = 0.27, 95% confidence intervals [-0.07; 0.60], 95% prediction intervals [-1.01; 1.55]), but this was deemed not significant because of the wide-ranging prediction intervals. There is no distinguishable difference between HDS and FDS training on sprint performance. The wide-ranging prediction intervals suggest the variability is too great to determine whether one training type is more effective than the other. Practitioners should consider the individual needs of their athletes when deciding which training type to use for long-term sprint development., (Copyright © 2024 National Strength and Conditioning Association.)

Bone marrow aspiration (BMA) smear analysis is essential for diagnosis, treatment, and monitoring of a variety of benign and neoplastic hematological conditions. Currently, this analysis is performed by manual microscopy. We conducted a multicenter study to validate a computational microscopy approach with an artificial intelligence-driven decision support system. A total of 795 BMA specimens (615 Romanowsky-stained and 180 Prussian blue-stained) from patients with neoplastic and other clinical conditions were analyzed, comparing the performance of the Scopio Labs X100 Full Field BMA system (test method) with manual microscopy (reference method). The system provided an average of 1,385 ± 536 (range, 0-3,131) cells per specimen for analysis. An average of 39.98 ± 19.64 fields of view (range, 0-140) per specimen were selected by the system for analysis, of them 87% ± 21% (range, 0%-100%) were accepted by the qualified operators. These regions were included in an average of 17.62 ± 7.24 regions of interest (range, 1-50) per specimen. The efficiency, sensitivity, and specificity for primary and secondary marrow aspirate characteristics (maturation, morphology, and count assessment), as well as overall interuser agreement, were evaluated. The test method showed a high correlation with the reference method for comprehensive BMA evaluation, both on Romanowsky- (90.85% efficiency, 81.61% sensitivity, and 92.88% specificity) and Prussian blue-stained samples (90.0% efficiency, 81.94% sensitivity, and 93.38% specificity). The overall agreement between the test and reference methods for BMA assessment was 91.1%. For repeatability and reproducibility, all standard deviations and coefficients of variation values were below the predefined acceptance criteria both for discrete measurements (coefficient of variation below 20%) and differential measurements (SD below 5%). The high degree of correlation between the digital decision support system and manual microscopy demonstrates the potential of this system to provide a high-quality, accurate digital BMA analysis, expediting expert review and diagnosis of BMA specimens, with practical applications including remote BMA evaluation and possibly new opportunities for the research of normal and neoplastic hematopoiesis., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Objectives: Electronic consults (e-consults) are asynchronous, formalized requests by a provider to involve a specialist to assist with decision making. E-consults are an alternative to face-to-face consultation and are a promising strategy to efficiently address certain requests for advice. The objective of this project was to examine the utility and characteristics of electronic consults utilized in a safety-net hospital outpatient neurology clinic., Methods: We retrospectively reviewed e-consults to the neurology clinic from1 January 2021 to 31 September 2021. The reasons for requests and any diagnostic or treatment recommendations were collected. The time to completion of the e-consults and the percentage of e-consult referred for an in-person clinic evaluation were determined as outcome measures. Following each e-consult, the consulting provider completed a survey to gather their assessment on the appropriateness of the consult, time spent answering the consult, and if unnecessary testing or clinic visits were avoided., Results: A total of 528 e-consults were completed during the study period. The most frequent e-consult referrals were for headache (22%), stroke/neurovascular (21%), neuropathy/neuritis/disturbance of skin sensation (11%), and seizures/spells (11%). The majority of e-consults (94%) were answered in one business day (defined as occurring within 24 h) with 67% of consults answered the same day (defined as occurring within the same calendar day). The consulting providers reported that more than 90% of e-consults took <15 min to answer, and 84% of e-consult requests were felt to be appropriate. A total 156 (41.4%) patients initially seen as an e-consult were referred for a face-to-face visit within 90 days of the e-consult., Discussion: E-consults provided expedited input from neurologists, which is vital in health systems that provide care to vulnerable populations. The majority of e-consults were answered within 1 day of referral, offering rapid access to neurological expertise in comparison to wait times currently encountered for face-to-face visits. Accordingly, e-consults have the potential to expedite treatment for patients, empower primary care providers, and reduce demand for in-person consultations, particularly in large health systems caring for vulnerable populations., Competing Interests: Declaration of conflicting interestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Khan has received financial support for serving as a consultant for UCB pharma and serving on advisory boards for Alexion, UCB pharma, and Argenx. She receives additional research support from the Fichtenbaum Charitable Trust. Dr Blackburn has received financial support for advisory board work for TG Therapeutics. Dr Tardo has received financial support for advisory board work for EMD Serono. She is also a non-paid medical advisor for The MOG Project. She has also received paid support from MJH Life Sciences and NeurologyLive. Dr Salter receives research funding from Multiple Sclerosis Society of Canada, National Multiple Sclerosis Society, CMSC and the Department of Defense Congressionally Directed Medical Research Program and is a member of editorial board for Neurology. She serves as a consultant for Gryphon Bio, LLC and Abata Therapeutics. She is a member of the Data and Safety Monitoring Board for Premature Infants Receiving Milking or Delayed Cord Clamping (PREMOD2), Central Vein Sign: A Diagnostic Biomarker in Multiple Sclerosis (CAVS-MS), and Methotrexate treatment of Arthritis caused by Chikungunya virus (MARCH). She holds the Kenney Marie Dixon-Pickens Distinguished Professorship in Multiple Sclerosis Research.

Aims: Multidisciplinary tumor boards (MDTs) are an integral part of ensuring high-quality, evidence-based and personalized cancer care. In this study, we aimed to evaluate the adherence to and implementation of MDT recommendations in patients with oligometastatic disease (OMD)., Methods: We screened all oncologic positron emission tomography (PET) scans conducted at a single comprehensive cancer center in 2020. Patients were included if they had evidence of imaging-based OMD from a solid organ malignancy on the index scans, had their OMD case discussed at an MDT, and were treated and followed up at the same center. A switch away from the MDT-recommended treatment modalities was classified as a major deviation ; non-MDT-mandated adjustments to a recommended treatment modality were coded as minor deviation . Clinical data was obtained via chart review; statistical calculations were computed using the R software., Results: After review of PET and/or concurrent brain scans, 787 cases of OMD were identified. Thereof, 347 (44.1 %) cases were discussed at MDT, of which 331 (42.1 %) were therapeutically managed and subsequently followed. The three most commonly recommended therapies were systemic therapy (35.6 %), multimodality treatment including definitive local therapy (17.8 %), and radiotherapy (13.9 %). A major deviation was recorded in 16.3 % of cases (most commonly: none of the MDT-recommended treatment modalities were performed: 19 (35.2 %); not all MDT-planned treatment modalities were performed: 12 (22.2 %); and additional treatment modality was performed: 11 (20.3 %). A minor deviation was found in 1.5 % of cases. On multivariable regression, number of distant metastases (n > 1) was associated with a major deviation (OR: 1.85; 95 % CI, 1.0-3.52). Major deviations were associated with a significantly worse OS (p = 0.0034)., Conclusions: Adherence to and implementation of MDT recommendations in OMD patients was generally high (83.7%). Major deviations might be further reduced by more careful and elaborate discussions of OMD patient characteristics s and patient preferences., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: AW received research grants through a research collaboration (“POP”) of the University of Zurich with Hoffmann-La Roche Ltd. MAH received research grants from Immune-Sensor, Inc. and ViewRay, Inc., as well as speaking honoraria for presenting at the Harvard Medical School Breast Cancer Symposium. M.H. received grants and speaker honoraria from GE Healthcare, a fund by the Alfred and Annemarie von Sick legacy and a grant from the clinical research priority program (CRPP) Artificial Intelligence in Oncological Imaging Network of the University of Zurich. NA has received grants from ViewRay Inc. and BrainLab and personal fees from AstraZeneca, Debiopharm, ViewRay and BrainLab, and non-financial support from ViewRay, all outside of the submitted work. MG has received grants from AstraZeneca and Varian and personal fees from AstraZeneca, all outside of the submitted work. Moreover, the USZ Department of Radiation Oncology has research and teaching agreements with Siemens/Varian, ViewRay and VisionRT. PB cited research grants to the institution from ViewRay Inc. (Mountain View, CA, USA)., (© 2024 The Author(s).)

A 6-year-old intact female domestic dwarf rabbit (Oryctolagus cuniculus) was referred because of a chronic obstructive rhinitis not resolving despite antibiotic treatments. Computed tomography examination revealed 2 sub-obstructive structures of mineral density in the right nasal cavity and nasopharynx. Neoplasia and rhinolithiasis were the main differential diagnoses. A dorsal rhinostomy was performed and 1 mineralized lesion was removed. Infrared spectrophotometric and histological examinations of the lesion and nasal mucosa were consistent with a 100% calcium carbonate rhinolith with bacterial colonization and chronic lymphocytic rhinitis. Clinical signs improved during the first 4 wk following surgery. However, despite inhaled anti-inflammatory treatment, the rabbit's condition deteriorated when the rhinostomy site closed, and she died 7 wk after surgery. Rhinolith and lymphocytic rhinitis should be considered as differential diagnoses for upper respiratory tract signs in rabbits resistant to antimicrobial treatment. Key clinical message: Rhinolithiasis and chronic lymphocytic rhinitis should be included in the differential diagnoses of rabbits presenting with chronic obstructive upper respiratory tract signs characterized by purulent nasal discharge and failure of treatment despite adequate antimicrobial therapy, especially with unilateral signs. Computed tomography and rhinoscopy with biopsies are suggested to explore those possibilities., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

Background: The establishment of microbial communities in neonatal mammals plays a pivotal role in shaping their immune responses to infections and other immune-related conditions. This process is influenced by a combination of endogenous and exogenous factors. Previously, we reported that depletion of CD71 + erythroid cells (CECs) results in an inflammatory response to microbial communities in newborn mice., Results: Here, we systemically tested this hypothesis and observed that the small intestinal lamina propria of neonatal mice had the highest frequency of CECs during the early days of life. This high abundance of CECs was attributed to erythropoiesis niches within the small intestinal tissues. Notably, the removal of CECs from the intestinal tissues by the anti-CD71 antibody disrupted immune homeostasis. This disruption was evident by alteration in the expression of antimicrobial peptides (AMPs), toll-like receptors (TLRs), inflammatory cytokines/chemokines, and resulting in microbial dysbiosis. Intriguingly, these alterations in microbial communities persisted when tested 5 weeks post-treatment, with a more notable effect observed in female mice. This illustrates a sex-dependent association between CECs and neonatal microbiome modulation. Moreover, we extended our studies on pregnant mice, observing that modulating CECs substantially alters the frequency and diversity of their microbial communities. Finally, we found a significantly lower proportion of CECs in the cord blood of pre-term human newborns, suggesting a potential role in dysregulated immune responses to microbial communities in the gut., Conclusions: Our findings provide novel insights into pivotal role of CECs in immune homeostasis and swift adaptation of microbial communities in newborns. Despite the complexity of the cellular biology of the gut, our findings shed light on the previously unappreciated role of CECs in the dialogue between the microbiota and immune system. These findings have significant implications for human health. Video Abstract., (© 2024. The Author(s).)

This study examined reliability and validity of the Fulltrack AI application to identify cricket ball landing position (line, length). Nine hundred and thirty-two deliveries were compared to 3D motion capture, the criterion measure, with 836 included in analysis (516 bowled (pace = 420, spin = 96), 320 Sidearm TM ; 301 facing a batter). Agreement analysis indicated an intraclass correlation coefficient of >0.96 for raw and filter 3D line and length data, compared to Fulltrack AI . The coefficient of variation was acceptable for length (<10%) and larger for line (23.82%), albeit with a smaller standard error of measurement (SEM = 0.05 m), improving with outliers removed. Bland-Altman plots confirmed good statistical agreement between devices, with limits of agreement largely within maximal allowable difference values. There are potential practical application considerations, given SEM = 0.47 m for length (diameter of seven cricket balls); with greater variability detecting length closer to the batters-end, and line closer to the bowlers-end. Validity, using a generalised additive model, showed no significant differences between devices ( p  > 0.05), with no condition-based interaction effects. The Fulltrack AI application enables ecologically valid assessment of bowling performance. Considering the trade-off between this and the accuracy of information is warranted when deciding how best to apply it to coaching environments to support augmented feedback.

Purpose: Understanding the test-retest reliability of physiological responses to load carriage influences the interpretation of those results. The aim of this study was to determine the test-retest reliability of physiological measures during loaded treadmill walking at 5.5 km h -1 using the MetaMax 3B., Methods: Fifteen Australian Army soldiers (9 male, 6 female) repeated two 12-min bouts of treadmill walking at 5.5 km h -1 in both a 7.2 kg Control condition (MetaMax 3B, replica rifle) and a 23.2 kg Patrol condition (Control condition plus vest) across three sessions, separated by one week. Expired respiratory gases and heart rate were continuously collected, with the final 3 min of data analysed. Ratings of Perceived Exertion and Omnibus-Resistance Exercise Scale were taken following each trial. Reliability was quantified by coefficient of variation (CV), intra-class correlation coefficients (ICC), smallest worthwhile change (SWC), and standard error of the measurement., Results: Metabolic and cardiovascular variables were highly reliable (≤ 5% CV; excellent-moderate ICC), while the respiratory variables demonstrated moderate reliability (< 8% CV; good-moderate ICC) across both conditions. Perceptual ratings had poorer reliability during the Control condition (12-45% CV; poor ICC) than the Patrol condition (7-16% CV; good ICC)., Conclusions: The test-retest reliability of metabolic and cardiovascular variables was high and relatively consistent during load carriage. Respiratory responses demonstrated moderate test-retest reliability; however, as the SWC differed with load carriage tasks, such data should be interpreted independently across loads. Perceptual measures demonstrated poor to moderate reliability during load carriage, and it is recommended that they only be employed as secondary measures., (© 2024. The Author(s).)

Monomethylation of lysine 20 of histone H4 (H4K20me1) is catalyzed by Set8 and thought to play important roles in many aspects of genome function that are mediated by H4K20me binding proteins. We interrogated this model in a developing animal by comparing in parallel the transcriptomes of Set8 null , H4 K20R/A , and l(3)mbt mutant Drosophila melanogaster We found that the gene expression profiles of H4 K20A and H4 K20R larvae are markedly different than Set8 null larvae despite similar reductions in H4K20me1. Set8 null mutant cells have a severely disrupted transcriptome and fail to proliferate in vivo, but these phenotypes are not recapitulated by mutation of H4 K20 , indicating that the developmental defects of Set8 null animals are largely due to H4K20me1-independent effects on gene expression. Furthermore, the H4K20me1 binding protein L(3)mbt is recruited to the transcription start sites of most genes independently of H4K20me even though genes bound by L(3)mbt have high levels of H4K20me1. Moreover, both Set8 and L(3)mbt bind to purified H4K20R nucleosomes in vitro. We conclude that gene expression changes in Set8 null and H4 K20 mutants cannot be explained by loss of H4K20me1 or L(3)mbt binding to chromatin and therefore that H4K20me1 does not play a large role in gene expression., (© 2024 Crain et al.; Published by Cold Spring Harbor Laboratory Press.)

Monoclonal antibodies, as tixagevimab/cilgavimab, have been introduced as prophylaxis against COVID-19 infections in high-risk populations. However, data on efficacy are limited. This study investigates efficacy and tolerability of tixagevimab/cilgavimab in hematological patients under real-life conditions. Tixagevimab/cilgavimab was administered to 155 hematological patients (March-August 2022) at two Austrian centres. S/RBD-antibody assessments were performed before (T0), four weeks (T1), and six months (T2) after application. Side effects, the occurrence of COVID-19 infections, and the course of S/RBD-antibody titres were analysed retrospectively in relation to clinical variables. 155 hematological patients, who refused tixagevimab/cilgavimab, were included as a control group to compare the frequency of COVID-19 infections. Of all immunised patients (52.3% males; 91% triple vaccinated), 25.8% had a COVID-19 breakthrough infection (76% mild) compared to 43.9% in the control group. Patients with chronic lymphocytic leukaemia (CLL)/lymphoma were at highest risk of a COVID-19 infection (OR = 2.21; 95% CI 1.05-4.65; p = 0.037). After immunisation, a steep increase in median antibody levels (1193.4BAU/ml, IQR 0-2318.94) was observed in 67.8%, followed by a rapid decrease between T1 and T2 (465.95BAU/ml, IQR 0-1900.65.3) with the greatest declines in CLL/lymphoma (848.7BAU/ml, IQR 0-1949.6, p = 0.026). Side-effects occurred in 21.2% (CTCAE I/II). These real-world data indicate that S/RBD antibodies respond rapidly after passive immunisation in all hematological patients without safety concerns. Given the rapid decline in S/RBD antibodies, early booster immunisations should be considered for future scenarios in this vulnerable group., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: New York City's automated mortality syndromic surveillance system monitors temporal and spatial patterns in mortality. To describe the use of the syndromic surveillance system, we used the system to find mortality patterns for the 15 leading causes of death and for deaths from rare and reportable diseases in New York City from February 2015 through June 2020. We used results to find aberrations that indicate threats to public health., Methods: We used unobserved components models to analyze time series of mortality counts for leading causes of death, historical limits methods for rare and reportable diseases, and SaTScan for temporal-spatial cluster analysis. We obtained data on the number of deaths from the electronic death registry system maintained by the city's Bureau of Vital Statistics., Results: The mortality syndromic surveillance system detected an increase in the number of deaths from heart disease by April 1, 2020, when 75.0 deaths occurred on March 24, 2020, instead of an expected 45.8 deaths (95% upper prediction limit of 61.0) and an increase in the number of deaths from all causes on March 20, 2020, when 194.0 deaths were observed while 150.1 deaths were expected (95% upper prediction limit of 178.0). The number of deaths from all causes returned to normal the week beginning June 14, 2020, when 990.0 deaths were observed and 998.8 deaths were expected., Practice Implications: When compared with efforts from New York City to provide yearly vital statistics, the automated mortality syndromic surveillance system can provide timely mortality data with fewer resources and raise the capacity to detect anomalous increases in mortality., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Glycated hemoglobin is an adjunct tool in early pregnancy to assess glycemic control. We examined trends and maternal predictors for those who had A1c screening in early pregnancy using hospital discharge and vital registry data between 2009 and 2017 linked with the New York City A1C Registry ( N  = 798,312). First-trimester A1c screening increased from 2.3% in 2009 to 7.7% in 2017. The likelihood of screening became less targeted to high-risk patients over time, with a decrease in mean A1c values from 5.8% (95% confidence interval [CI]: 5.8, 5.9) to 5.3 (95% CI: 5.3, 5.4). The prevalence of gestational diabetes mellitus increased while testing became less discriminate for those with high-risk factors, including pregestational type 2 diabetes, chronic hypertension, obesity, age over 40 years, as well as Asian or Black non-Hispanic race/ethnicity. KEY POINTS: · First-trimester A1c screening increased from 2.3% in 2009 to 7.7% in 2017 in New York City.. · The likelihood of screening became less targeted to high-risk patients over time.. · The prevalence of gestational diabetes mellitus increased, while testing became less discriminate.., Competing Interests: None declared., (Thieme. All rights reserved.)

Objective: Assessing excess deaths from benchmarks across causes of death during the first wave of the COVID-19 pandemic and identifying morbidities most frequently mentioned alongside COVID-19 deaths in the death record., Methods: Descriptive study of death records between 11 March 2020 and 27 July 2020, from the New York City Bureau of Vital Statistics. Mortality counts and percentages were compared with the average for the same calendar period of the previous 2 years. Distributions of morbidities from among forty categories of conditions were generated citywide and by sex, race/ethnicity and four age groups. Causes of death were assumed to follow Poisson processes for Z-score construction., Results: Within the study period, 46 563 all-cause deaths were reported; 132.9% higher than the average for the same period of the previous 2 years (19 989). Of those 46 563 records, 19 789 (42.5%) report COVID-19 as underlying cause of death. COVID-19 was the most prevalent cause across all demographics, with respiratory conditions (prominently pneumonia), hypertension and diabetes frequently mentioned morbidities. Black non-Hispanics had greater proportions of mentions of pneumonia, hypertension, and diabetes. Hispanics had the largest proportion of COVID-19 deaths (52.9%). Non-COVID-19 excess deaths relative to the previous 2-year averages were widely reported., Conclusion: Mortality directly due to COVID-19 was accompanied by significant increases across most other causes from their reference averages, potentially suggesting a sizable COVID-19 death undercount. Indirect effects due to COVID-19 may partially account for some increases, but findings are hardly dispositive. Unavailability of vaccines for the time period precludes any impact over excess deaths. Respiratory and cardiometabolic-related conditions were most frequently reported among COVID-19 deaths across demographic characteristics., 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.)

Background: Novel deep brain stimulation devices can record local field potentials (LFPs), which represent the synchronous synaptic activity of neuronal populations. The clinical relevance of LFPs in patients with dystonia remains unclear., Objectives: We sought to determine whether chronic LFPs recorded from the globus pallidus internus (GPi) were associated with symptoms of dystonia in children., Materials and Methods: Ten patients with heterogeneous forms of dystonia (genetic and acquired) were implanted with neurostimulators that recorded LFP spectral snapshots. Spectra were compared across parent-reported asymptomatic and symptomatic periods, with daily narrowband data superimposed in 24 one-hour bins., Results: Spectral power increased during periods of registered dystonic symptoms: mean increase = 102%, CI: (76.7, 132). Circadian rhythms within the LFP narrowband time series correlated with dystonic symptoms: for delta/theta-waves, correlation = 0.33, CI: (0.18, 0.47) and for alpha waves, correlation = 0.27, CI: (0.14, 0.40)., Conclusions: LFP spectra recorded in the GPi indicate a circadian pattern and are associated with the manifestation of dystonic symptoms., Competing Interests: Conflict of interest Carolina Gorodetsky reports a relationship with Medtronic, Inc that includes consulting or advisory and speaking and lecture fees. George M. Ibrahim reports a relationship with LivaNova that includes board membership and consulting or advisory. Alfonso Fasano reports a relationship with Medtronic, Inc, Abbott, and Boston Scientific that includes consulting or advisory and speaking and lecture fees. Lior M. Elkaim is an employee of Neuralink. The remaining authors report no conflict of interest., (Copyright © 2023 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.)

The nucleus is an essential organelle for the function of cells. It holds most of the genetic material and plays a crucial role in the regulation of cell growth and proliferation. Since many antitumoral therapies target nucleic acids to induce cell death, tumor-specific nuclear drug delivery could potentiate therapeutic effects and prevent potential off-target side effects on healthy tissue. Due to their great structural variety, good biocompatibility, and unique physico-chemical properties, organometallic complexes and other metal-based compounds have sparked great interest as promising anticancer agents. In this review, strategies for specific nuclear delivery of metal complexes are summarized and discussed to highlight crucial parameters to consider for the design of new metal complexes as anticancer drug candidates. Moreover, the existing opportunities and challenges of tumor-specific, nucleus-targeting metal complexes are emphasized to outline some new perspectives and help in the design of new cancer treatments., (© 2024 The Authors. Advanced Materials published by Wiley‐VCH GmbH.)

Background: Repeated-sprint training (RST) is a common training method for enhancing physical fitness in athletes. To advance RST prescription, it is important to understand the effects of programming variables on physical fitness and physiological adaptation., Objectives: This study (1) quantifies the pooled effects of running RST on changes in 10 and 20 m sprint time, maximal oxygen consumption (VO 2max ), Yo-Yo Intermittent Recovery Test Level 1 (YYIR1) distance, repeated-sprint ability (RSA), countermovement jump (CMJ) height and change of direction (COD) ability in athletes, and (2) examines the moderating effects of program duration, training frequency, weekly volume, sprint modality, repetition distance, number of repetitions per set and number of sets per session on changes in these outcome measures., Methods: Pubmed, SPORTDiscus and Scopus databases were searched for original research articles up to 04 July 2023, investigating RST in healthy, able-bodied athletes, between 14 and 35 years of age, and a performance calibre of trained or above. RST interventions were limited to repeated, maximal running (land-based) sprints of ≤ 10 s duration, with ≤ 60 s recovery, performed for 2-12 weeks. A Downs and Black checklist was used to assess the methodological quality of the included studies. Eligible data were analysed using multi-level mixed-effects meta-analysis, with standardised mean changes determined for all outcomes. Standardised effects [Hedges G (G)] were evaluated based on coverage of their confidence (compatibility) intervals (CI) using a strength and conditioning specific reference value of G = 0.25 to declare an improvement (i.e. G > 0.25) or impairment (i.e. G < - 0.25) in outcome measures. Applying the same analysis, the effects of programming variables were then evaluated against a reference RST program, consisting of three sets of 6 × 30 m straight-line sprints performed twice per week for 6 weeks (1200 m weekly volume)., Results: 40 publications were included in our investigation, with data from 48 RST groups (541 athletes) and 19 active control groups (213 athletes). Across all studies, the effects of RST were compatible with improvements in VO 2max (G 0.56, 90% CI 0.32-0.80), YYIR1 distance (G 0.61, 90% CI 0.43-0.79), RSA decrement (G - 0.61, 90% CI - 0.85 to - 0.37), linear sprint times (10 m: G - 0.35, 90% CI - 0.48 to - 0.22; 20 m: G - 0.48, 90% CI - 0.69 to - 0.27), RSA average time (G - 0.34, 90% CI - 0.49 to - 0.18), CMJ height (G 0.26, 90% CI 0.13-0.39) and COD ability (G - 0.32, 90% CI - 0.52 to - 0.12). Compared with the reference RST program, the effects of manipulating training frequency (+ 1 session per week), program duration (+ 1 extra training week), RST volume (+ 200 m per week), number of reps (+ 2 per set), number of sets per session (+ 1 set) or rep distance (+ 10 m per rep) were either non-substantial or comparable with an impairment in at least one outcome measure per programming variable., Conclusions: Running-based RST improves speed, intermittent running performance, VO 2max , RSA, COD ability and CMJ height in trained athletes. Performing three sets of 6 × 30 m sprints, twice per week for 6 weeks is effective for enhancing physical fitness and physiological adaptation. Additionally, since our findings do not provide conclusive support for the manipulation of RST variables, further work is needed to better understand how programming factors can be manipulated to augment training-induced adaptations., Study Registration: Open Science Framework registration https://doi.org/10.17605/OSF.IO/RVNDW ., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: The minimal clinically important difference (MCID) is the smallest perceived treatment effect that patients deem clinically significant. There is currently no agreement on an appropriate MCID for the pain visual analogue scale (VAS) in the context of thumb osteoarthritis (OA)., Methods: We approximated MCIDs using a distribution-based approach that pooled standard deviations (SDs) associated with baseline mean values of the pain VAS (0-100 mm). We extracted the data from randomized controlled trials (RCTs) included in a systematic review of adults with long-term OA of the thumb. We excluded RCTs that did not report baseline SD values. The MCIDs were derived at 0.4 and 0.5 SDs of the pooled SD and compared with previously published MCIDs for the pain VAS in OA., Results: A total of 403 patients were pooled from 7 RCTs for the analysis. The mean baseline VAS pain score was 5.6 cm. We derived an MCID of 0.72 cm at 0.4 SDs and 0.91 cm at 0.5 SDs using baseline SDs. We found that MCIDs derived from a distribution-based approach approximated published MCIDs for the VAS for pain for OA in the knee and hip., Conclusion: The authors propose that a change of 0.7 to 0.9 cm on the VAS is clinically meaningful in the context of long-term OA of the thumb., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: Exercise-based falls-prevention programs are cost-effective population-based approaches to reduce the risk of falling for older adults. The aim was to evaluate the short-term and long-term efficacy of three existing falls-prevention programs., Methods: A non-randomized study design was used to compare the immediate-post and long-term physical outcome measures for three falls prevention programs; one high-level land-based program, one low-level land-based program and a water-based Ai Chi program. Timed-up-and-go (TUG), five-times sit-to-stand (5xSTS), six-minute walk test (6MWT) and six-meter walk test were assessed at baseline, post-program, and at six-months follow-up. Linear mixed models were used to analyze between- and within- group differences, with the high-level land-based program used as the comparator., Results: Thirty-two participants completed post-program assessment and 26 returned for follow-up. There was a difference in the age (years) of participants between programs (p = 0.049). The intercept for TUG and six-meter walk test time was 47.70% (23.37, 76.83) and 32.31s (10.52, 58.41), slower for the low-level group and 40.49% (17.35, 69.89) and 36.34s (12.75, 64.87), slower for the Ai Chi group (p < 0.01), compared with the high-level group. Mean time taken to complete the TUG was less both immediately post-program and at 6-month follow-up (p = 0.05). Walking speed for the six-meter walk test was only faster at six-months (p < 0.05). The 5xSTS duration was significantly reduced only at post-intervention (p < 0.05)., Conclusion: These results indicate land-based and water-based falls-prevention programs improve physical outcome measures associated with falls-risk and many improvements are maintained for six months after the completion of the program. (Retrospective trial registration: ACTRN1262300119069)., Competing Interests: Candice Oberholster declares a competing interest of employment at the health organization that implemented the program that was evaluated. She was employed at the organization to implement the program that was evaluated at the time of data collection. The other authors have no competing interests to declare that are relevant to the content of this article. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2024 Oberholster et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Context: Handheld percussive massage devices (ie, massage guns) are a relatively new and under-researched recovery tool. These tools are intended to increase range of motion and reduce muscle soreness by delivering targeted vibration to soft tissues. Empirical knowledge about the potential influence of these devices on perceptual recovery and the recovery of performance characteristics after exercise is scarce., Objective: To investigate the effect of a 5-minute massage gun application, using a commercially available device, on physical and perceptual recovery after a strenuous bout of lower body exercise., Design: Controlled laboratory study., Setting: Physiology laboratory., Patients or Other Participants: A total of 65 active young adults (age = 21.3 ± 1.4 years; age range = 18-30 years; 34 women: height = 165.8 ± 6.1 cm, mass = 66.0 ± 7.4 kg; 31 men: height = 181.1 ± 6.0 cm, mass = 81.5 ± 11.8 kg)., Intervention(s): Participants applied a massage gun on the calf muscles of 1 leg after strenuous exercise (massage gun recovery group) for 5 minutes and used no recovery intervention on the other leg (control group)., Main Outcome Measure(s): Ankle range of motion, calf circumference, isometric strength, calf endurance, and perceived muscle soreness measures were collected at baseline and at various points after lower body exercise., Results: No significant group × time interactions were recorded for any of the performance or perceptual measures (P values > .05). Effect sizes were mostly unclear, except for a small increase in perceived muscle soreness in the massage gun recovery group compared with the control group immediately (d = -0.35) and 4 hours (d = -0.48) postrecovery., Conclusions: Massage guns appeared to have little effect on physical measures when applied for 5 minutes immediately after strenuous calf exercise. Given the small increase in muscle soreness up to 4 hours after their use, caution is recommended when using massage guns immediately after strenuous lower body exercise., (© by the National Athletic Trainers’ Association, Inc.)

Objective: Review literature on facial feminization surgery (FFS) for the transgender population and identify whether heterogeneity in reported outcomes and outcome measures exists across studies, as measured by a lack of consensus, and number of outcomes and outcome measures used. Evidence Review: A search of MEDLINE and EMBASE (database inception to January 20, 2021) was performed to retrieve FFS studies. Primary outcomes included number of reported outcomes and outcome measures; secondary outcomes included clinimetric properties of outcome measures and study characteristics. Findings: In total, 15 articles were included. Sixty-nine outcomes and 12 outcome measures were identified. Of those outcome measures, zero were found to be valid, reliable, and responsive in patients who had undergone FFS. A variety of FFS interventions were studied, with the three most common interventions being: rhinoplasty ( n  = 7, 46.7%), mandibuloplasty ( n  = 7, 46.7%), and chondrolaryngoplasty ( n  = 6, 40%). Conclusion and Relevance: Heterogeneity was evident in reported outcomes and outcome measures in FFS literature and there is currently no outcome measure commonly used for this patient population.

Background: Women with breast cancer are at higher risk of cardiovascular disease (CVD) compared with women without breast cancer. Whether higher diet quality at breast cancer diagnosis lowers this risk remains unknown. We set out to determine if higher diet quality at breast cancer diagnosis was related to lower risk of CVD and CVD-related death., Methods: This analysis included 3415 participants from the Pathway Study, a prospective cohort of women diagnosed with invasive breast cancer at Kaiser Permanente Northern California between 2005 and 2013 and followed through December 31, 2021. Scores from 5 diet quality indices consistent with healthy eating were obtained at the time of breast cancer diagnosis. Scores were categorized into ascending quartiles of concordance for each diet quality index, and multivariable adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated. P values were 2-sided., Results: The Dietary Approaches to Stop Hypertension diet quality index was associated with lower risk of heart failure (HR = 0.53, 95% CI = 0.33 to 0.87; Ptrend = .03), arrhythmia (HR = 0.77, 95% CI = 0.62 to 0.94; Ptrend = .008), cardiac arrest (HR = 0.77, 95% CI = 0.61 to 0.96; Ptrend = .02), valvular heart disease (HR = 0.79, 95% CI = 0.64 to 0.98; Ptrend = .046), venous thromboembolic disease (HR = 0.75, 95% CI = 0.60 to 0.93; Ptrend = .01), and CVD-related death (HR = 0.70, 95% CI = 0.50 to 0.99; Ptrend = .04), when comparing the highest with lowest quartiles. Inverse associations were also found between the healthy plant-based dietary index and heart failure (HR = 0.60, 95% CI = 0.39 to 0.94; Ptrend = .02), as well as the alternate Mediterranean dietary index and arrhythmia (HR = 0.74, 95% CI = 0.60 to 0.93; Ptrend = .02)., Conclusion: Among newly diagnosed breast cancer patients, higher diet quality at diagnosis was associated with lower risk of CVD events and death., (© The Author(s) 2024. Published by Oxford University Press.)

Objectives: To describe the characteristics of patients receiving a clinical referral for neuropsychological evaluation in two Huntington's Disease Society of America Centers of Excellence (HDSA COE). In this exploratory pilot study, we used an empirically supported clinical neuropsychological battery to assess differences in cognitive performance between premanifest and manifest HD patient groups (compared with each other and normative expectations)., Method: Clinical data from 76 adult genetically confirmed patients referred for neuropsychological evaluations was retrospectively collected from two HDSA COEs. ANOVA and Chi-square tests were used to compare variables between pre-manifest (n = 14) and manifest (n = 62) groups for demographic, cognitive, neuropsychiatric, and disease severity variables., Results: Our clinics serviced a disproportionate number of motor manifest patients. Six measures were excluded from analyses due to infrequent administration. The full WAIS-IV Digit Span was disproportionately administered to the manifest group. The premanifest group showed stronger cognitive performance with effect sizes in the large range on subtests of the WAIS-IV Digit Span, HVLT-R, SDMT, and verbal fluency., Conclusions: This is the first study to assess an empirically supported neuropsychological research battery in a clinical setting with a relatively large sample size given the rarity of HD. The battery adequately captured areas of impairment across the disease spectrum. Application of the current battery with larger premanifest samples is warranted., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Small-cell carcinomas (SCCs) of the genitourinary (GU) tract are rare malignancies with high metastatic potential. The most common primary sites are the bladder and prostate, but case reports of primary SCC of the kidney, ureter, and urethra also exist. The majority of patients present with gross hematuria, irritative or obstructive urinary symptoms, and symptoms of locoregionally advanced or metastatic disease at initial presentation. SCC of the bladder presents with nodal or metastatic involvement in the majority of cases and requires the use of platinum-based chemotherapy in combination with surgery and/or radiation. SCC of the prostate is most commonly seen in the metastatic castrate-resistant setting, and aggressive variant disease presents with a greater propensity for visceral metastases, osteolytic lesions, and relatively low serum prostate-specific antigen for volume of disease burden. Multiple retrospective and prospective randomized studies support the use of a multimodal approach combining platinum-based systemic therapy regimens with radiation and/or surgery for localized disease. This evidence-based strategy is reflected in multiple consensus guidelines. Emerging data suggest that small-cell bladder and prostate cancers transdifferentiate from a common progenitor of conventional urothelial bladder carcinoma and prostatic acinar adenocarcinoma, respectively. Areas of active basic research include efforts to identify the key genetic and epigenetic drivers involved in the emergence of small cell cancers to exploit them for novel therapies. Here, we review these efforts, discuss diagnosis and currently supported management strategies, and summarize ongoing clinical trials evaluating novel therapies to treat this rare, aggressive GU cancer.