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While physical activity ensures healthy aging, rural community-dwelling older women tend to be more physically inactive compared with their counterparts in Malaysia. As social support is one of the key determinants of physical activity, this retrospective, cross-sectional study investigated the prevalence of physical activity and its association with social support among 1,221 rural community-dwelling older women in Kuala Pilah, Negeri Sembilan, Malaysia. The prevalence of physical activity among older women was 45.1% with the highest prevalence reported for housework domain (52.3%). The total mean Duke Social Support index score was 27.24 ± 3.40. Multivariate analysis reported age, employment status, and income level to demonstrate significant association with the physical activity after adjusting for confounders. Older women with an increase in social interaction score were more likely (odds ratio = 1.22; 95% confidence interval [1.10, 1.34]; p <.001) to have high physical activity when adjusted for sociodemographic, health, mental health, and physical disability. Contrarily, older women with an increase in one subjective social support score were less likely (odds ratio = 0.91; 95% confidence interval [0.87, 0.96]; p <.001) to have high physical activity when adjusted for confounders. The findings were insightful to tailor interventions on promoting social support for physical activity enhancement among older women. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Colorectal cancer is the third most common cancer worldwide. Micropapillary carcinoma (MPC) is increasingly identified as a poor prognostic marker in various cancers, including breast, bladder and lung. It remains an under recognized subtype in colorectal cancer. The aim of this study is to evaluate the prevalence, implications and impact on survival of MPC in colorectal cancer in an Australian cohort.A retrospective review of all colorectal cancer resections in two tertiary centres in Sydney Australia was performed, between 2019 and 2024. MPC was identified on histolopathology as per standard guidelines of the resected specimens. Variables collected included age, sex, TNM, site, lymphovascular invasion (LVI), and lymph node involvement.Of 597 colorectal cancer resections during the study period, 21 cases of MPC were identified (3.5%). Mean age was 60 years (SD 15 years). Twenty patients (95%) had T3–T4 tumours, 19 (90%) had positive lymph node involvement, 18 (86%) had confirmed or suspected LVI, and 4 (19%) had distant metastatic disease. Overall 1‐year survival was 90% and 3‐year survival was 76%.MPC is associated with high risk features in colorectal adenocarcinoma. Accurate histopathological diagnosis of these more aggressive cancers should guide prognostication, individualized adjuvant treatment and close surveillance. [ABSTRACT FROM AUTHOR]

The recent advances in technological capabilities have led to a massive production of time‐series data and remarkable progress in longitudinal designs and analyses within psychological research. However, implementing time‐series analysis can be challenging due to the various characteristics and complexities involved, as well as the need for statistical expertise. This paper introduces a statistical pipeline on time‐series analysis for studying the changes in a single process over time at either a population or individual level, both retrospectively and prospectively. This is achieved through systemization and extension of existing modelling and inference techniques. This analytical approach enables practitioners not only to track but also to model and evaluate emerging trends and apparent seasonality. It also allows for the detection of unexpected events, quantifying their deviations from baseline and forecasting future values. Given that other discernible population‐ and individual‐level changes in psychological and behavioural processes have not yet emerged, continued surveillance is warranted. A near real‐time monitoring tool of time‐series data could guide community psychological responses across multiple ecological levels, making it a valuable resource for field practitioners and psychologists. An empirical study is conducted to illustrate the implementation of the introduced analytical pipeline in practice and to demonstrate its capabilities. [ABSTRACT FROM AUTHOR]

Background: Basal cell carcinoma is the most common nonmelanoma skin cancer, followed by cutaneous squamous cell carcinoma. The objective of the current study was to retrospectively evaluate the epidemiology, characteristic variations, histological aspects, and prognosis of basal cell carcinoma of the facial region based on a single-centre experience. Methods: Data from 125 patients admitted to the Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein (UKSH), Kiel, for surgical treatment of basal cell carcinomas of the face between January 2015 and April 2021 were evaluated. Results: The mean patient age was 79.58 years, 60.5% were male and 39.5% were female. Six patients (4.8%) had tumour recurrence with no regional metastasis. Seventy-nine patients (63%) were classified as T1. The nose and the temporal region were the most common areas. The mean tumour thickness was 3.20 mm. Conclusions: Micronodular, sclerosing/morphoeic, nodular, and superficial growth patterns of basal cell carcinoma are highly correlated to recurrence, so an excision safety margin is recommended. There is a strong correlation between tumour thickness and recurrence among basal cell carcinoma cases. When completely excised, the recurrence rate for basal cell carcinoma is relatively low. [ABSTRACT FROM AUTHOR]

Purpose: Parastomal hernia (PH) is a frequent complication following radical cystectomy and ileal conduit. The purpose of this study was to summarize the clinical experience and technical characteristics of laparoscopic Sugarbaker repair of PH following radical cystectomy and ileal conduit. Methods: We retrospectively evaluated all patients who underwent laparoscopic treatment of PH following radical cystectomy and ileal conduit at Huashan Hospital, Fudan University from May 2013 to December 2022. Results: Thirty-five patients were included in the study. Median follow up was 32months (IQR, 25–38 months). Three patients presented with a recurrence (8.6%), with a median time to recurrence of 14 months. Out of the 35 patients, Thirty-two underwent totally laparoscopic repair using the Sugarbaker technique, Three patients required open surgery to repair the intestinal injury after laparoscopic exploration. One patient died 9 months post-surgery due to COVID-19. During the follow-up period, two patients developed a peristomal abscess, and one patient experienced partial intestinal obstruction 10 days after surgery. Conclusion: Surgical management of PH following radical cystectomy and ileal conduit is challenging. The laparoscopic Sugarbaker technique for repairing PH following radical cystectomy and ileal conduit has low complication and recurrence rate. [ABSTRACT FROM AUTHOR]

Background: Direct acting antivirals (DAAs) for the Hepatitis C virus (HCV) have shifted the World Health Organisation global strategic focus to the elimination of HCV by 2030. In England, the UK Health Security Agency (UKHSA) led a national 'patient re-engagement exercise', using routine surveillance data, which was delivered through the HCV Operational Delivery Networks (ODNs) with support from National Health Service England (NHSE), to help find and support people with a positive HCV PCR test result to access treatment. We report a quantitative evaluation of outcomes of this exercise. Methods: Individuals with a recorded positive HCV antibody or PCR result between 1996 and 2017 were identified using UKHSA's records of HCV laboratory diagnosis. Linkage with established health-care datasets helped to enhance patient identification and minimise attempts to contact deceased or previously treated individuals. From September to November 2018 each ODN was provided with a local list of diagnosed individuals. ODNs were asked to perform further data quality checks through local systems and then write to each individual's GP to inform them that the individual would be contacted by the ODN to offer confirmatory HCV PCR testing, assessment and treatment unless the GP advised otherwise. Outcomes of interest were receipt of treatment, a negative PCR result, and death. Data were collected in 2022. Results: Of 176,555 individuals with a positive HCV laboratory report, 55,329 individuals were included in the exercise following linkage to healthcare datasets and data reconciliation. Participants in the study had a median age of 51 years (IQR: 43, 59), 36,779 (66.5%) were males, 47,668 (86.2%) were diagnosed before 2016 and 11,148 (20.2%) lived in London. Of the study population, 7,442 (13.4%) had evidence of treatment after the re-engagement exercise commenced, 6,435 (11.6%) were reported as PCR negative (96% had no previous treatment records), 4,195 (7.6%) had prescription data indicating treatment before the exercise commenced or were reported to have been treated previously by their ODN, and 2,990 (5.4%) had died. The status of 32,802 (59.3%) people remains unknown. Conclusions: A substantial number of those included had treatment recorded after the exercise commenced, however, many more remain unengaged. Evaluation of the exercise highlighted areas that could be streamlined to improve future exercises. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, the term "behavioural fatigue" became the centre of policy debates in Great Britain. These debates involved deciding when to go into lockdown and whether behavioural interventions could be effective. Behavioural interventions can only succeed where people's Capabilities, Opportunities, and Motivations to perform target behaviours are supported. Our retrospective data analyses examine the relationships between people's Capabilities, Opportunities, Motivations, and Behaviours, i.e., adherence to lockdown guidelines. Our cross-sectional analyses include 17,962 unique participants in Great Britain who completed a survey over the initial 30 days of the first lockdown (April 2020). We examine trends in responses to each scale and then the relationships between the scales using Granger's causality test with tests for stationarity and cointegration. A mixture of increasing and decreasing trends was identified for Capabilities and Opportunities. Decreasing trends were identified for Motivation and Behaviour. Granger's causality tests found that Capability forecasts Opportunity and Behaviour and that Motivation forecasts Opportunity. The discussion reiterates that to realise and maintain Behaviour changes, policies surrounding people's Capabilities, Opportunities, and Motivations must continue to support target behaviours. [ABSTRACT FROM AUTHOR]

Simple Summary: In daily veterinary practice, canine otitis externa is a common presentation and, therefore, many studies were conducted to evaluate predispositions. This study on the other hand aims to evaluate factors that have potentially statistically reduced risks for developing otitis externa. Regarding the results, Rhodesian Ridgebacks and Collies have shown significantly low odds for otitis externa. Furthermore, regarding dogs with endocrinopathies, it was shown that those who are overweight seem to develop otitis externa more likely than those with a normal weight. Especially the latter result should be used in communication with pet owners to point out the importance of strict weight management and, therefore, increasing the quality of life of their dogs. Background: Canine otitis externa is a common presentation in small animal practice. The clinical signs vary individually from patient to patient. Regardless of the expression, they all decrease the quality of life. Therefore, this study aimed to identify factors that showed reduced odds for otitis externa. Methods: Clinical case records were searched for key terms regarding canine otitis. Statistical analyses were applied to evaluate associations with otitis externa. p-values of <0.05 were considered statistically significant. Results: Rhodesian Ridgeback and dogs with underlying infectious diseases had a reduced risk for otitis externa, while Retrievers and dogs with allergies had an increased risk. Furthermore, in the group of dogs with endocrinopathies, those with normal weight showed a reduced risk of developing canine otitis in comparison to those which were overweight. Conclusions: These results show a new point of view to reduce the prevalence of canine otitis by reducing the animals' weight due to an additional risk of otitis in obese or overweight dogs. Furthermore, for the first time, Rhodesian Ridgebacks were identified in our study population to have a lower risk of developing otitis externa. Thus, breeders should reflect—within other responsibilities for the quality of life in their offspring—on breed-specifics about otitis when planning ahead. [ABSTRACT FROM AUTHOR]

This document is a memoir written by Ralph J. Greenspan about the early years of the CSHL summer Drosophila neurobiology course from 1984-1985. The course was a reincarnation of the first fly neurobiology course taught by Bill Pak in the 1970s. The memoir describes the structure of the course, including intensive lectures, lab sessions, and discussions held in the dining hall. The course attracted a diverse group of participants, including established scientists and postdocs interested in expanding their perspectives. Despite some challenges, the course was successful and contributed to the development of Drosophila neurobiologists. [Extracted from the article]

Introduction: The aim of this study was to determine the sociodemographic characteristics of psychiatric emergencies presenting to emergency departments (ED), the provisional diagnoses and reasons for consultation by emergency physicians, and to determine the rate of suicide attempts among patients presenting to emergency departments for psychiatric emergencies. Methods: The records of all patients aged 18 years and older admitted to the emergency department of the Department of Emergency Medicine, a tertiary hospital, with either a pre-existing psychiatric diagnosis or a new psychiatric provisional diagnosis made by emergency physicians between January 2020 and December 2023 were reviewed. Results: According to the data obtained in the study, it was determined that the most common provisional diagnoses made by emergency physicians in psychiatric emergencies were suicide attempts (41.88%), agitation (21.94%), schizophrenia (8.44%), psychosis (7.91%) and manic attack (6.54%). It was found that 49.3% of psychiatric emergencies resulted in discharge and 25.5% resulted in hospitalisation. Among the provisional diagnoses, depression, mutism and sleep disorders were most commonly associated with refusal of treatment, while depression and suicide were the most common reasons for hospitalisation. Among psychiatric emergency patients who attempted suicide, medication, sharp objects and chemicals were the most common substances ingested. Discussion: In this study, it was determined that a great portion of the emergency psychiatric cases admitted to the emergency department consisted of patients who attempted suicide. However, due to the crowdedness and fast pace of emergency departments, it is understood that in psychiatric emergencies, epidemiological profile data are missing in the files of the cases and detailed medical history cannot be obtained from the patients We think that recording better data of patient who admitted a psychiatric condition to the emergency department will provide better information about the patients in future visits and improve the care to be provided. Psychiatrists and psychiatric nurses recommend the implementation of emergency department-based rehabilitation programs for these patients. Highlights: Psychiatric emergencies presenting to emergency departments should not be overlooked in terms of suicide risk. Psychiatric emergencies who have attempted suicide should be closely followed at frequent intervals. Emergency department staff should be educated about psychiatric emergencies and suicide risk. [ABSTRACT FROM AUTHOR]

Background: A better understanding of the association between chronic kidney disease (CKD) and glaucoma is required to optimize clinical outcomes. Therefore, this study aimed to investigate the association of chronic kidney disease (CKD) with new diagnoses of glaucoma over time from January 2009 to December 2019. Method: This retrospective propensity-matched cohort study utilizing Taiwanese electronic health records examined the incidence of newly diagnosed glaucoma in patients with and without chronic kidney disease (CKD). The exposure variable was the diagnosis of CKD, identified through diagnostic codes. The primary outcome was the incidence of new-onset glaucoma. Subgroup analyses on glaucoma risk included age, gender, comorbidities, glaucoma subtypes, and dialysis status. Statistical analyses included Kaplan–Meier analysis, Cox proportional hazards models, and Poisson regression models, with the associated hazard ratios and confidence intervals reported. Results: Seven hundred twenty-three thousand two hundred sixteen patients with CKD (42.3% female; mean [SD] age at index, 66.3 [15.6] years) and 723,216 patients without CKD (42.3% female; mean [SD] age at index, 66.3 [15.7]) were recruited. We showed a significantly increased risk of glaucoma irrespective of subtypes in CKD patients compared to those without CKD (HR: 1.29 [CI: 1.26–1.32], p < 0.001). Kaplan–Meier curves revealed a significantly increased glaucoma risk in both the dialytic subtype and non-dialytic CKD patients when compared to their non-CKD counterparts (p < 0.001). We also showed that all genders (aHR 1.17 [CI: 1.13–1.21] for females vs. aHR 1.39 [CI:1.35–1.43] for males), all ages (< = 49: aHR 1.49 [CI: 1.37–1.62]; 50–59: aHR 1.48 [CI: 1.40–1.56]; 60–69: aHR 1.30 [CI: 1.25–1.6]; 70–79: aHR 1.21 [CI: 1.17–1.26]; > 80: aHR 1.29 [CI: 1.21–1.37]); all income brackets and all urbanization status were associated with significantly increased risk of glaucoma from among the CKD cohort when compared to their respective non-CKD cohort (p < 0.001). Conclusions: Our cohort study spanning 12 years showed an elevated glaucoma risk following a CKD diagnosis compared to a frequency-matched non-CKD cohort. Our findings have relevance for the clinical practice of at-risk CKD patients. Trial registration: Due to the retrospective nature of the study, no registration was necessary. [ABSTRACT FROM AUTHOR]

The loosening of a series of domestic and international policies before May 2023 means that the global situation of the COVID-19 has changed from emergency to normalization. However, research on the abnormal changes in macro data of China’s agricultural product import and export trade during the entire epidemic period is extremely scarce. This article uses macro data of China’s agricultural product import and export trade from the first three years of the epidemic and the entire three years of the epidemic, namely from 2017 to 2022, for statistical analysis. By combining literature review, quantitative data analysis, comparative research, and other methods, it sorts out, and summarizes the changes in China’s agricultural product import and export situation compared to the pre epidemic situation during the epidemic period, thoroughly analyzes the characteristics of China’s agricultural product import and export trade before and throughout the epidemic. Research has found that the total import and export trade of agricultural products in China has been continuously increasing throughout the entire epidemic period;due to trade restrictions on agricultural products from multiple countries around the world, rising domestic agricultural production price indices, and the impact of the China US trade agreement, China’s agricultural import and export trade deficit has further expanded. The volume and price fluctuations in the import and export trade of major agricultural products such as grains, cotton, and sugar are significant. Overall, the basic structure of China’s agricultural product import and export trade has not changed under the epidemic. The COVID-19 epidemic has not changed China’s natural endowment of agricultural resources, nor has it changed China’s agricultural structure, trade environment and government agricultural policies. During the entire epidemic period, the overall structure of China’s agricultural product import and export trade did not change, but the agricultural product trade indicators showed significant suddenness in early 2020, with significant phased impacts on agricultural product trade and significant structural impacts on a few agricultural product trade. This article suggests that China should vigorously ensure the bottom line of food security, enhance its bargaining power in the international agricultural trade market under the risk of the epidemic, and continue to leverage China’s comparative advantage in agricultural trade. [ABSTRACT FROM AUTHOR]

BackgroundAimsMethodFindingsConclusionsPregnancy is a transformative time for women and their bodies, and therefore thoughts and feelings about the body understandably change during this period. While previous research has established the impact of body dissatisfaction on factors like antenatal attachment and maternal mental health, there is a notable gap in understanding its long-term effects on postnatal factors. This is often due to high attrition rates in longitudinal studies. Using retrospective measures could address this issue, however a measure of retrospective pregnant body dissatisfaction has not yet been identified.This paper aimed to create a retrospective measure of pregnancy body dissatisfaction by adapting a previously validated measure. It also aimed to investigate the relationship between retrospective accounts of body dissatisfaction during pregnancy and postnatal anxiety, depression, and bonding.Cross-sectional online survey data was collected from women postnatally (N = 404).An exploratory and confirmatory factor analysis identified a two-factor model of retrospective body dissatisfaction, adapted from the Body Understanding Measure for Pregnancy Scale, which was equivalent to two of the original subscales. Using this factor structure, linear regressions demonstrated that higher levels of retrospective pregnant body dissatisfaction were associated with elevated rates of postnatal anxiety and depression and lower bonding scores.This study successfully established a measure for assessing retrospective pregnant body dissatisfaction, potentially aiding future research. Additionally, it has highlighted the link between pregnant body dissatisfaction and postnatal levels of depression, anxiety, and bonding. Thus, improving the pregnant bodily experience may have the potential to enhance the postnatal experience. [ABSTRACT FROM AUTHOR]

Background and aims: Legal regulations for dispensing in Swiss heroin‐assisted treatment were relaxed during the COVID‐19 pandemic, allowing prolonged take‐home of up to 7 days instead of two to reduce patient contact and the risk of infection. Our study aimed to measure the consequences of this new practice. Design, setting and participants: This was a retrospective cohort study set in Switzerland's largest outpatient centre for opioid agonist therapy. One hundred and thirty‐four (72.4%) of the 185 patients receiving oral diacetylmorphine (DAM) participated in the study. Measurements: Through the utilization of electronic medication prescription and dispensing software, as well as the electronic medical record, the following data were extracted to explore the potential consequences: dose of DAM, the number of antibiotic therapies, emergency hospitalizations and incarcerations. Age, gender, prescriptions for psychotrophic drugs and additional prescription for injectable DAM were tested to assess an increased risk of losing prolonged take‐home privileges. Data in the year since prolonged take‐home (period 2) were compared with data from the equivalent prior year (period 1). Findings DAM take‐home was not associated with a change in DAM dose (P = 0.548), the number of emergency hospitalizations (P = 0.186) or the number of incarcerations (P = 0.215); 79.1% of all patients were able to maintain their extended take‐home privileges. However, patients who had injectable DAM experienced significant reductions in their prolonged take‐home privileges. Conclusion: Allowing patients to take home oral diacetylmorphine for up to 7 days as treatment for opioid use disorder does not appear to pose any demonstrable health risk. It is generally manageable for the large majority of patients. However, careful consideration of prolonged take‐home for patients with additional injectable diacetylmorphine is recommended, as these patients are more likely to lose take‐home privileges. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate treatment outcomes of the apical barrier technique with premixed calcium silicate-based putty for treating necrotic permanent teeth with open apices and to identify prognostic factors. Materials and methods: Permanent teeth with necrotic pulps and open apices treated by the apical barrier technique with premixed calcium silicate-based putty, with a minimum follow-up of 12 months, were included. Treatment outcomes were based on clinical signs, symptoms, and radiographic evaluation. The treatment outcome was dichotomized into success or failure according to strict and loose criteria. The chi-square test (or Fisher’s exact test) and multiple logistic regression analysis were used to evaluate possible prognostic factors associated with treatment outcomes. Results: Seventy-four teeth with a follow-up time of 12–72 months (mean, 25.74 ± 14.36 months) were included in the final evaluation. The success rate was 97.30% using the loose criteria and 66.22% using the strict criteria. Multiple logistic regression analysis indicated that the size of pre-operative periapical lesion (≥ 5 mm) (odds ratio [OR]: 18.96; P = 0.0153) and root canal underfilling (OR: 8.341; P = 0.0448) were significant predictors for treatment failure under the strict criteria. Conclusion: The apical barrier technique with premixed calcium silicate-based putty is a highly successful procedure for treating necrotic permanent teeth with open apices after an observation period of up to 6 years. Treatment success under the strict criteria is primarily affected by the size of the pre-operative periapical lesion and the apical extent of root-filling. Clinical relevance: Careful case selection and ensuring adequate root filling quality are essential to the successful outcome of the apical barrier technique with premixed calcium silicate-based putty. [ABSTRACT FROM AUTHOR]

Sediments are an integral component of aquatic systems, linking multiple water uses, functions, and services. Contamination of sediments by chemicals is a worldwide problem, with many jurisdictions trying to prevent future pollution (prospective) and manage existing contamination (retrospective). The present review assesses the implementation of sediment toxicity testing in environmental regulations globally. Currently, the incorporation of sediment toxicity testing in regulations is most common in the European Union (EU), North America, and Australasian regions, with some expansion in Asia and non‐EU Europe. Employing sediment toxicity testing in prospective assessments (i.e., before chemicals are allowed on the market) is most advanced and harmonized with pesticides. In the retrospective assessment of environmental risks (i.e., chemicals already contaminating sediments), regulatory sediment toxicity testing practices are applied inconsistently on the global scale. International harmonization of sediment toxicity tests is considered an asset and has been successful through the widespread adoption and deployment of Organisation for Economic Co‐operation and Development guidelines. On the other hand, retrospective sediment assessments benefit from incorporating regional species and protocols. Currently used toxicity testing species are diverse, with temperate species being applied most often, whereas test protocols are insufficiently flexible to appropriately address the range of environmental contaminants, including nanomaterials, highly hydrophobic contaminants, and ionized chemicals. The ever‐increasing and ‐changing pressures placed on aquatic resources are a challenge for protection and management efforts, calling for continuous sediment toxicity test method improvement to insure effective use in regulatory frameworks. Future developments should focus on including more subtle and specific toxicity endpoints (e.g., incorporating bioavailability‐based in vitro tests) and genomic techniques, extending sediment toxicity testing from single to multispecies approaches, and providing a better link with ecological protection goals. Environ Toxicol Chem 2024;43:1697–1716. © 2024 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC. [ABSTRACT FROM AUTHOR]

Background: The randomized, dose-optimization, open-label ReDOS study in US patients with metastatic colorectal cancer (CRC) showed that, compared with a standard dosing approach, initiating regorafenib at 80 mg/day and escalating to 160 mg/day depending on tolerability increased the proportion of patients reaching their third treatment cycle and reduced the incidence of adverse events without compromising efficacy. Subsequently, the ReDOS dose-escalation strategy was included as an alternative regorafenib dosing option in the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines. A retrospective analysis was conducted using a US claims database to assess whether inclusion of this dose-escalation strategy in NCCN Guidelines has influenced the use of flexible dosing in routine US clinical practice, and to describe clinical outcomes pre- and post-inclusion in NCCN Guidelines. Methods: Patients with CRC in the Optum's de-identified Clinformatics® Data Mart database initiating regorafenib for the first time between January 2016 and June 2020 were stratified based on whether they initiated regorafenib pre- or post-inclusion of ReDOS in NCCN Guidelines, and in two groups: flexible dosing (< 160 mg/day; < 84 tablets in the first treatment cycle) and standard dosing (160 mg/day; ≥ 84 tablets in the first treatment cycle). The primary endpoints were the proportion of patients who initiated their third treatment cycle and the mean number of treatment cycles per group. Results: 703 patients initiated regorafenib during the study period, of whom 310 (44%) initiated before and 393 (56%) initiated after inclusion of ReDOS in NCCN Guidelines. After inclusion in the guidelines, the proportion of patients who received flexible dosing increased from 21% (n = 66/310) to 45% (n = 178/393), the proportion who received standard dosing decreased from 79% (n = 244/310) to 55% (n = 215/393), the proportion who initiated their third treatment cycle increased from 36% (n = 113/310) to 46% (n = 179/393), and the mean (standard deviation) number of treatment cycles increased from 2.6 (2.9) to 3.2 (3.1). Conclusions: Following inclusion of ReDOS in NCCN Guidelines, real-world data suggest that US clinicians have markedly increased use of flexible dosing in clinical practice, potentially maximizing clinical benefits and safety outcomes for patients with metastatic CRC receiving regorafenib. [ABSTRACT FROM AUTHOR]

Objectives: To assess the diagnostic performance of 3D automated breast ultrasound (3D-ABUS) in breast cancer screening in a clinical setting. Materials and methods: All patients who had 3D-ABUS between January 2014 and January 2022 for screening were included in this retrospective study. The images were reported by 1 of 6 breast radiologists based on the Breast Imaging Reporting and Data Systems (BI-RADS). The 3D-ABUS was reviewed together with the digital breast tomosynthesis (DBT). Recall rate, biopsy rate, positive predictive value (PPV) and cancer detection yield were calculated. Results: In total, 3616 studies were performed in 1555 women (breast density C/D 95.5% (n = 3455/3616), breast density A/B 4.0% (n = 144/3616), density unknown (0.5% (n = 17/3616)). A total of 259 lesions were detected on 3D-ABUS (87.6% (n = 227/259) masses and 12.4% (n = 32/259) architectural distortions). The recall rate was 5.2% (n = 188/3616) (CI 4.5–6.0%) with only 36.7% (n = 69/188) cases recalled to another date. Moreover, recall declined over time. There were 3.4% (n = 123/3616) biopsies performed, with 52.8% (n = 65/123) biopsies due to an abnormality detected in 3D-ABUS alone. Ten of 65 lesions were malignant, resulting in a positive predictive value (PPV) of 15.4% (n = 10/65) (CI 7.6–26.5%)). The cancer detection yield of 3D-ABUS is 2.77 per 1000 screening tests (CI 1.30–5.1). Conclusion: The cancer detection yield of 3D-ABUS in a real clinical screening setting is comparable to the results reported in previous prospective studies, with lower recall and biopsy rates. 3D-ABUS also may be an alternative for screening when mammography is not possible or declined. Clinical relevance statement: 3D automated breast ultrasound screening performance in a clinical setting is comparable to previous prospective studies, with better recall and biopsy rates. Key Points: • 3D automated breast ultrasound is a reliable and reproducible tool that provides a three-dimensional representation of the breast and allows image visualisation in axial, coronal and sagittal. • The diagnostic performance of 3D automated breast ultrasound in a real clinical setting is comparable to its performance in previously published prospective studies, with improved recall and biopsy rates. • 3D automated breast ultrasound is a useful adjunct to mammography in dense breasts and may be an alternative for screening when mammography is not possible or declined. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of suicide presents a significant public health challenge globally, affecting diverse populations around the world. This study is motivated by the urgency to tackle suicide as a crucial public health issue on a global level, according to the United Nations Sustainable Development Goals and the General Programme of Work and Mental Health Action by the World Health Organization. Materials and Methods: The research was performed at the Forensic Unit of Hospital Canselor Tuanku Muhriz, spanning a retrospective analysis covering 2012 to 2021. A descriptive analysis was conducted to analyse the patterns of suicide and the sociodemographic characteristics of the cases. Results: The findings show monthly variations and a recent increase in suicide rates, especially during the pandemic of COVID-19. Analysis of suicide methods indicates that hanging is the most common suicide method, which accounts for almost half of the sample population, followed by jumping from a height and burning charcoal. Adult males are primarily implicated in suicidal acts, and the study reveals unique trends among different age groups, genders and employment statuses. Conclusion: This study aims to offer thorough insights and comprehension into suicide within the Malaysian sociodemographic framework. Consequently, it could furnish valuable insights for public health authorities and governmental bodies. [ABSTRACT FROM AUTHOR]

Background: In recent years, transcatheter aortic valve replacement (TAVR) has emerged as a pivotal treatment for pure native aortic regurgitation (PNAR). Given patients with severe aortic regurgitation (AR) are prone to suffer from pulmonary hypertension (PH), understanding TAVR’s efficacy in this context is crucial. This study aims to explore the short-term prognosis of TAVR in PNAR patients with concurrent PH. Methods: Patients with PNAR undergoing TAVR at Zhongshan Hospital, Affiliated with Fudan University, were enrolled between June 2018 to June 2023. They were categorized based on pulmonary artery systolic pressure (PASP) into groups with or without PH. The baseline characteristics, imaging records, and follow-up data were collected. Results: Among the 103 patients recruited, 48 were afflicted with PH. In comparison to PNAR patients without PH, the PH group exhibited higher rates of renal dysfunction (10.4% vs. 0.0%, p = 0.014), increased Society of Thoracic Surgeons scores (6.4 ± 1.9 vs. 4.7 ± 1.6, p < 0.001), and elevated Nterminal fragment of pro–brain natriuretic peptide (NT-proBNP). Transthoracic ultrasound examination revealed that patients with PH displayed lower left ventricular ejection fraction, larger left ventricle dimension, and more frequent moderate to severe tcuspid regurgitation (TR). Following TAVR, both groups experienced significant reductions in PASP, mitral regurgitation (MR) and TR. There were no significant differences in the incidence of postoperative adverse events in patients with or without PH. Conclusions: We found TAVR to be a safe and effective treatment for patients with PNAR and PH, reducing the degree of aortic regurgitation and PH without increasing the risk of postoperative adverse events. [ABSTRACT FROM AUTHOR]

Purpose: This retrospective study aimed to investigate the effect of frequent computed tomography (CT) examinations with contrast media on the renal function of patients with oral squamous cell cancer (OSCC) that underwent radical surgery, by using estimated glomerular filtration rate (eGFR); to identify risk factors of occurrence of post-operative chronic kidney disease (CKD) in these patients; and to explore the relationship between risk factors and occurrence of postoperative CKD during follow-up. Methods: Herein, 188 patients (107 male; 81 female) who underwent radical surgery for OSCC were included. We evaluated the risk factors for postoperative CKD after treatment, including demographic, perioperative, and postoperative factors by univariate and multivariate analyses. Patients were divided into post-operative CKD and control groups based on eGFR evaluation. Overall survival (OS) rates were compared between the groups. Results: eGFR decreased over time after treatment in both patient groups. Postoperative CKD was diagnosed in 56 (29.8%) patients. The average number of contrast-enhanced CT examinations was not an independent risk factor for postoperative CKD. However, lower hemoglobin on hospital discharge [odds ratio (OR) = 0.53], lower eGFR on hospital discharge (OR = 0.84), and common use of nonsteroidal anti-inflammatory drugs (OR = 48.79) were significant risk factors associated with postoperative CKD. The control group was associated with a better OS than the postoperative CKD group; however, this difference was not significant. Conclusions: Clinicians should pay close attention to these risk factor of post-operative CKD during the management of patients with OSCC that undergo radical surgery and frequent follow-up CT examinations with contrast media. [ABSTRACT FROM AUTHOR]

Zhen Ruan,1,&ast; Xianwen Chen,1,&ast; Menghuan Song,1 Ruxu Jia,2 Hang Luo,3 Carolina Oi Lam Ung,1,4,5 Hao Hu1,4,5 1State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, Macau SAR, People’s Republic of China; 2Global Business School for Health, University College London, London, UK; 3Shanghai Palan DataRx Co., Ltd, Shanghai, People’s Republic of China; 4Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau, Macau SAR, People’s Republic of China; 5Centre for Pharmaceutical Regulatory Sciences, University of Macau, Macau, Macau SAR, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hao Hu, University of Macau, Room 1050, E12 Research Building, Macau, Macau SAR, People’s Republic of China, Email haohu@um.edu.moAim: This study aimed to conduct a retrospective observational study in China to investigate the real-world utilization of glucagon-like peptide-1 receptor (GLP-1RA) in China.Methods: Type 2 diabetes mellitus (T2DM) patients were retrieved from the electronic medical records of 18 hospitals from 2016 to 2020. A descriptive analysis detailed patient characteristics and clinical outcomes. Multivariate logistic regression analysed the factors associated with daily and weekly GLP-1RA.Results: Fifteen thousand one hundred and seventy-six individuals were included. At the 6-month follow-up, the overall estimated mean change from baseline in HbA1c was − 1.26± 1.91% (p < 0.001), the “Weekly GLP-1RA” group was − 1.58± 2.03% (p < 0.001), and the “Daily GLP-1RA” group was − 1.25± 1.90% (p < 0.001). At the 12-month follow-up, the overall estimated mean change from baseline in HbA1c was − 0.95± 1.80% (p < 0.001), the “Weekly GLP-1RA” group was − 1.05± 1.93% (p < 0.001), and the “Daily GLP-1RA” group was − 0.95± 1.80% (p < 0.001). At 6 months following GLP-1RA initiation, there were statistically significant improvements in the mean TC, LDL-C, and TG at 6 months or 12 months separately following GLP-1RA initiation. Statistically significant improvements were observed in the mean HDL-C after 6 months. Compared with the baseline (11.92%), the proportion of patients who had an incidence of all hypoglycemia was lower at the 6-month follow-up (9.73%). Patients with dyslipidemia were more likely to use weekly GLP-1RA (OR =1.61, 95% CI: 1.27– 2.06, p < 0.001).Conclusion: In China, weekly GLP-1RA demonstrated better effectiveness compared to the daily GLP-1RA. The results confirmed the efficacy of GLP-1RA in clinical trials.Keywords: type 2 diabetes mellitus, glucagon-like peptide-1 receptor agonist, GLP-1RA, retrospective, China, electronic medical record, real-world

Abstract Purpose Parastomal hernia (PH) is a frequent complication following radical cystectomy and ileal conduit. The purpose of this study was to summarize the clinical experience and technical characteristics of laparoscopic Sugarbaker repair of PH following radical cystectomy and ileal conduit. Methods We retrospectively evaluated all patients who underwent laparoscopic treatment of PH following radical cystectomy and ileal conduit at Huashan Hospital, Fudan University from May 2013 to December 2022. Results Thirty-five patients were included in the study. Median follow up was 32months (IQR, 25–38 months). Three patients presented with a recurrence (8.6%), with a median time to recurrence of 14 months. Out of the 35 patients, Thirty-two underwent totally laparoscopic repair using the Sugarbaker technique, Three patients required open surgery to repair the intestinal injury after laparoscopic exploration. One patient died 9 months post-surgery due to COVID-19. During the follow-up period, two patients developed a peristomal abscess, and one patient experienced partial intestinal obstruction 10 days after surgery. Conclusion Surgical management of PH following radical cystectomy and ileal conduit is challenging. The laparoscopic Sugarbaker technique for repairing PH following radical cystectomy and ileal conduit has low complication and recurrence rate.

Abstract Background Direct acting antivirals (DAAs) for the Hepatitis C virus (HCV) have shifted the World Health Organisation global strategic focus to the elimination of HCV by 2030. In England, the UK Health Security Agency (UKHSA) led a national ‘patient re-engagement exercise’, using routine surveillance data, which was delivered through the HCV Operational Delivery Networks (ODNs) with support from National Health Service England (NHSE), to help find and support people with a positive HCV PCR test result to access treatment. We report a quantitative evaluation of outcomes of this exercise. Methods Individuals with a recorded positive HCV antibody or PCR result between 1996 and 2017 were identified using UKHSA’s records of HCV laboratory diagnosis. Linkage with established health-care datasets helped to enhance patient identification and minimise attempts to contact deceased or previously treated individuals. From September to November 2018 each ODN was provided with a local list of diagnosed individuals. ODNs were asked to perform further data quality checks through local systems and then write to each individual’s GP to inform them that the individual would be contacted by the ODN to offer confirmatory HCV PCR testing, assessment and treatment unless the GP advised otherwise. Outcomes of interest were receipt of treatment, a negative PCR result, and death. Data were collected in 2022. Results Of 176,555 individuals with a positive HCV laboratory report, 55,329 individuals were included in the exercise following linkage to healthcare datasets and data reconciliation. Participants in the study had a median age of 51 years (IQR: 43, 59), 36,779 (66.5%) were males, 47,668 (86.2%) were diagnosed before 2016 and 11,148 (20.2%) lived in London. Of the study population, 7,442 (13.4%) had evidence of treatment after the re-engagement exercise commenced, 6,435 (11.6%) were reported as PCR negative (96% had no previous treatment records), 4,195 (7.6%) had prescription data indicating treatment before the exercise commenced or were reported to have been treated previously by their ODN, and 2,990 (5.4%) had died. The status of 32,802 (59.3%) people remains unknown. Conclusions A substantial number of those included had treatment recorded after the exercise commenced, however, many more remain unengaged. Evaluation of the exercise highlighted areas that could be streamlined to improve future exercises.

Jing Su,1,&ast; Lina She,1,&ast; Yang Fan,1 Honghong Wang,2 Qiaorui Zhang,1 Jiao Zhang,1 Hongyun Ma1 1Department of Obstetrics and Gynecology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, People’s Republic of China; 2Department of Pathology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hongyun Ma, Department of Obstetrics and Gynecology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, No. 301, Zhengyuan North Street, Jinfeng District, Yinchuan, 750002, Ningxia, People’s Republic of China, Tel +86-15378975354, Email mahongyun2021@163.comBackground: This study retrospectively analyzed the medical records of 200 patients with endometrial hyperplasia to predict the risk of concurrent endometrial cancer.Methods: Patients were categorized into either the endometrial cancer group or the endometrial hyperplasia group based on post-hysterectomy pathology. The investigation compared general information, tumor indices, fertility history, preoperative endometrial sampling methods, comorbidities, and clinical symptoms between the groups to identify risk factors for endometrial hyperplasia complicating endometrial cancer.Results: (1) Of the 200 patients, 68 (34.0%) were diagnosed with concurrent endometrial cancer post-hysterectomy. Among these, 60 (88.24%) had endometrioid adenocarcinoma, while 8 (11.76%) had other types. Stage I was identified in 58 patients (85.29%) and Stage II in 10 patients (14.71%). High differentiation was observed in 57 cases (83.82%), moderate differentiation in 7 cases (10.29%), and poor differentiation in 4 cases (5.89%), indicating that most endometrial cancers complicated by hyperplasia were early-stage, well-differentiated endometrioid carcinomas; (2) Univariate analysis revealed statistically significant differences in age, menopausal status, length of menopause, and preoperative endometrial pathology of severe atypical hyperplasia between the groups; (3) Multivariate analysis indicated significant differences for age ≥ 53.5 years (OR: 4.307, 95% CI: 2.018– 9.192, p < 0.05), menopausal status (OR: 5.250, 95% CI: 2.449– 11.252, p < 0.05), and severe atypical endometrial hyperplasia (OR: 4.817, 95% CI: 1.260– 18.419, p < 0.05); (4) Significant differences were observed among patients with endometrial hyperplasia when stratified by the presence of zero, one, two, or three high-risk factors.Conclusion: In conclusion, patients aged ≥ 53.5 years, those who are menopausal, and those with severe atypical endometrial hyperplasia preoperatively are at higher risk for endometrial cancer. The risk increases with the number of high-risk factors present in patients with atypical endometrial hyperplasia.Keywords: retrospective, endometrial hyperplasia, endometrial cancer, clinical features, high-risk factors, regression

Background: Zika virus is a mosquito-borne virus that has resurfaced. It has been confirmed to cause microcephaly and Guillain–Barré syndrome. The number of Zika virus infections in South America has increased considerably since 2015. Aim: This study confirmed the epidemiological characteristics of the cases of Zika virus infections imported into Taiwan. Methods: Patients with travel history to areas at risk of Zika virus infections and had their blood, urine, or saliva samples tested positive for Zika virus through reverse transcription polymerase chain reaction by the Taiwan Centers for Disease Control were included in this study. Results: Taiwan reported its first case of Zika virus infection in January 2016, and it has reported 26 cases as of December 2021. Most of the patients were men (76.9%, 20/26), aged 20–59 years (73.1%, 19/26), and lived in Northern Taiwan (73.1%, 19/26). Most of the cases were reported in summer and autumn (76.9%, 20/26). The 26 patients included one 4-year-old girl and three teenage boys aged 15–19 years; 22 patients were from Southeast Asia, three patients were from the Americas, and one patient was from Africa. Conclusion: This study is the first to report on the epidemiological characteristics of Zika virus infections imported into Taiwan between 2016 and 2021. These findings can aid policymakers and clinical experts in developing prevention and control measures targeting Zika virus infections, which cause severe illness and imposes a considerable burden on the population.

Abstract Background A better understanding of the association between chronic kidney disease (CKD) and glaucoma is required to optimize clinical outcomes. Therefore, this study aimed to investigate the association of chronic kidney disease (CKD) with new diagnoses of glaucoma over time from January 2009 to December 2019. Method This retrospective propensity-matched cohort study utilizing Taiwanese electronic health records examined the incidence of newly diagnosed glaucoma in patients with and without chronic kidney disease (CKD). The exposure variable was the diagnosis of CKD, identified through diagnostic codes. The primary outcome was the incidence of new-onset glaucoma. Subgroup analyses on glaucoma risk included age, gender, comorbidities, glaucoma subtypes, and dialysis status. Statistical analyses included Kaplan–Meier analysis, Cox proportional hazards models, and Poisson regression models, with the associated hazard ratios and confidence intervals reported. Results Seven hundred twenty-three thousand two hundred sixteen patients with CKD (42.3% female; mean [SD] age at index, 66.3 [15.6] years) and 723,216 patients without CKD (42.3% female; mean [SD] age at index, 66.3 [15.7]) were recruited. We showed a significantly increased risk of glaucoma irrespective of subtypes in CKD patients compared to those without CKD (HR: 1.29 [CI: 1.26–1.32], p 80: aHR 1.29 [CI: 1.21–1.37]); all income brackets and all urbanization status were associated with significantly increased risk of glaucoma from among the CKD cohort when compared to their respective non-CKD cohort (p

Abstract Background The randomized, dose-optimization, open-label ReDOS study in US patients with metastatic colorectal cancer (CRC) showed that, compared with a standard dosing approach, initiating regorafenib at 80 mg/day and escalating to 160 mg/day depending on tolerability increased the proportion of patients reaching their third treatment cycle and reduced the incidence of adverse events without compromising efficacy. Subsequently, the ReDOS dose-escalation strategy was included as an alternative regorafenib dosing option in the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines. A retrospective analysis was conducted using a US claims database to assess whether inclusion of this dose-escalation strategy in NCCN Guidelines has influenced the use of flexible dosing in routine US clinical practice, and to describe clinical outcomes pre- and post-inclusion in NCCN Guidelines. Methods Patients with CRC in the Optum’s de-identified Clinformatics® Data Mart database initiating regorafenib for the first time between January 2016 and June 2020 were stratified based on whether they initiated regorafenib pre- or post-inclusion of ReDOS in NCCN Guidelines, and in two groups: flexible dosing (

STUDY DESIGN: Retrospective Comparative Study, Level III. OBJECTIVE: In patients with scoliosis >90°, cranio-femoral traction (CFT) has been shown to obtain comparable curve correction with decreased operative time and blood loss. Routine intraoperative CFT use in the treatment of AIS

Background: Acne vulgaris (AV) is a skin condition that mostly occurs in adolescents, although it can occur at any age. Most occur during adolescence, with a prevalence of around 85%. Acne vulgaris is a multifactorial disease triggered by many factors, namely, genetics, environment, hormonal and emotional stress, food, trauma, cosmetics, and medications. Purpose: This study identifies the precipitating factors of acne vulgaris. Methods: This study was retrospective based on medical record data at the Dermatology and Venereology Outpatient Clinic of Dr. Soetomo General Academic Hospital Surabaya in the period January 2018–December 2019. Results: The number of AV patients within 2 years from January 2018 to December 2019 obtained 517 cases of acne vulgaris patients with complete data. There were female AV patients (80.7%) and male AV patients (19.3%). The most common age of AV patients was 15–24 years old (60.5%), the most common occupation of AV patients was student (59.8%), and patients suffered from AV for >12 months (18.6%). The most precipitating factors for AV are hormonal (69.6%) and cosmetic (50.1%); the most common type of AV is mild AV (64.2%); and the most common AV therapy is the combination of topical tretinoin, benzoyl peroxide (BPO), and topical clindamycin. Conclusion: The results of this study showed that hormonal and cosmetic precipitating factors caused most AV patients in women.

Abstract Background The COVID-19 pandemic affected hundreds of millions of people and lives, and vaccination was the safest and most effective strategy to prevent and mitigate the burden of this disease. The implementation of COVID-19 vaccination in Vietnam in 2021 was unprecedentedly challenging in scale and complexity, yet economic evidence on the cost of delivery vaccines thought the program was lacking. Methods This retrospective costing study utilized a bottom-up, ingredient-based approach to estimate the cost of delivering COVID-19 vaccines in Vietnam in 2021, from a payer perspective. The study included 38 study sites across all administrative and implementation level, including three geographic areas and two delivery strategies, in two provinces, Hanoi and Dak Lak. The study findings were complemented with qualitative interviews with health staff and stakeholders. Results The economic cost to deliver one COVID-19 vaccine dose was $1.73, mostly comprised of opportunity costs ($1.14 per dose) which were driven by labor costs ($1.12 per dose). The delivery cost in urban areas was the highest ($2.02), followed by peri-urban areas ($1.45) and remote areas ($1.37). Delivery costs were higher at temporary sites ($1.78) when compared to facility-based delivery ($1.63). Comparing low-volume and high-volume periods showed that the delivery cost decreased significantly as volume increased, from $5.24 per dose to $1.65 per dose. Conclusions The study estimates the cost of delivering COVID-19 vaccines in Vietnam in 2021. Enabling factors and challenges during the implementation of the program were explored. Study limitations may lead to underestimation of results and reduce generalizability.

Abstract Background Tuberculosis (TB) is a major public health concern in the developing countries. Moreover, the emergence of multidrug-resistant tuberculosis is challenging. However, there are no organized data on the trends of pulmonary tuberculosis and rifampicin-resistant Mycobacterium tuberculosis in the study area. Methods A retrospective cross-sectional study was conducted to fill the information gap in Central Tigray at St. Mary General Hospital between 2018 and 2023. Data were collected from the GeneXpert™ tuberculosis registration logbooks using standard checklists and analyzed using Statistical Package for Social Science version 22. After performing logistic regression, a p-value

Zhuangzhi Zhou,1 Yao Chen,2 Na Tan,1 Li Hu3 1Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 3Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China Correspondence : Li Hu, Email 993602708@qq.comBackground: Extramammary Paget’s disease (EMPD) is a rare skin cancer with unclear pathogenesis, insidious progression, and high recurrence rate. The purpose of this study was to investigate the clinical features and postoperative recurrence factors of primary EMPD.Methods: We retrospectively analyzed the medical records of 40 patients with primary EMPD who underwent wide local excision surgery at a single medical center between 2009 and 2019. Risk factors for recurrence of primary EMPD were analyzed using multivariate binary logistic regression.Results: The study included 40 patients with primary EMPD, comprising 31 males (77.5%) and 9 females (22.5%), with a median age of 75.52 years (range 52– 99 years). The most common lesion location was the scrotum (22 cases, 55.0%), followed by the vulva, penis, scrotum, underarm and anus. Multivariable regression analysis revealed significant differences in the presence of ill-defined tumour borders, exudation and nodules in the primary lesion affecting the relapse of primary EMPD (p< 0.05).Conclusion: Our findings indicate that ill-defined tumour borders, exudation and nodules in the primary site should be considered as independent risk factors for disease recurrence, which may provide useful suggestions for the diagnosis, treatment and follow-up of primary EMPD.Keywords: extramammary paget’s disease, factors, recurrence, postoperative, retrospective

Acute graft-versus-host disease (aGVHD) remains a barrier to successful allogeneic hematopoietic stem cell transplantation (HSCT) outcomes. Contemporary comprehensive analyses of real-world clinical outcomes among patients who develop aGVHD post-HSCT are needed to better understand the unmet needs of this patient population. This multicenter, retrospective chart review describes treatment patterns and clinical outcomes among patients (≥18 years old) from Finland, Sweden, and France who developed grades II–IV aGVHD after their first HSCT (January 2016–June 2017). From 13 participating centers, 151 patients were included. The median (Q1, Q3) age at HSCT was 56 (45, 62) years old. One line of aGVHD treatment was received by 47.7%, and the most common first-line treatment was methylprednisolone (alone or in a combination regimen, 74.2%; monotherapy, 25.8%). Among patients treated with methylprednisolone, 79.5% achieved a complete or partial response. The median (Q1, Q3) number of treatment lines was 2.0 (1.0, 3.0). The median (Q1, Q3) time to obtain an aGVHD diagnosis from transplant was 29.5 (21.0, 44.0) days, and 14.5 (7.0, 34.0) days to achieve the best response for 110 evaluable patients. At 6 and 12 months, 53.6% and 49.0%, respectively, achieved a complete response. Chronic GVHD occurred in 37.7% of patients, and aGVHD reoccurred in 26.5%. Following aGVHD diagnosis, mortality rates were 30.0% at 6 months and 37.3% at 12 months. Findings from this study demonstrate a continuing unmet need for new therapies that control aGVHD and improve mortality.

Abstract Nanoliposomal irinotecan with fluorouracil and folinic acid (NFF) is a standard regimen after gemcitabine-based therapy for patients with unresectable or recurrent pancreatic cancer. However, there are limited clinical data on its efficacy and safety in the real-world. We therefore initiated a retrospective and prospective observational study (NAPOLEON-2). The results of the retrospective part were reported herein. In this retrospective study, we evaluated 161 consecutive patients who received NFF as second-or-later-line regimen. The main endpoint was overall survival (OS), and the other endpoints were response rate, disease control rate, progression-free survival (PFS), dose intensity, and adverse events (AEs). The median age was 67 years (range, 38–85 years). The median OS and PFS were 8.1 and 3.4 months, respectively. The objective response and disease control rates were 5% and 52%, respectively. The median relative dose intensity was 81.6% for nanoliposomal irinotecan and 82.9% for fluorouracil. Grade 3 or 4 hematological and nonhematological AEs occurred in 47 and 42 patients, respectively. Common grade 3 or 4 AEs included neutropenia (24%), anorexia (12%), and leukocytopenia (12%). Subanalysis of patients treated with second-line and third-or-later-line demonstrated no statistical significant difference in OS (7.6 months vs. 9.1 months, respectively; hazard ratio, 0.92; 95% confidence interval, 0.64–1.35; p = 0.68). In conclusion, NFF has acceptable efficacy and safety profile even in real-world clinical settings. The prospective study is in progress to validate these findings.

Abstract Background Malaria is a major public health concern in Ethiopia, where more than half of the population lives in malaria risk areas. While several studies have been conducted in different eco-epidemiological settings in Ethiopia, there is a notable scarcity of data on the prevalence of malaria in the Gindabarat district. Therefore, this study aimed to analyse 10-year trend of malaria prevalence in Gindabarat district, West Shawa Zone of Oromia, Western Ethiopia. Methods A retrospective laboratory record review was conducted at Gindabarat General Hospital and Gindabarat District Health Office from September 2011 to August 2020. The retrieved data included the date of examination, age, sex and laboratory results of the blood smears, including the Plasmodium species identified. Data were summarized and presented in the form of tables, figures, and frequencies to present the results. The data were analysed using SPSS (version 25.0) and Microsoft Excel. Results Over the course of 10 years, a total of 11,478 blood smears were examined in the public health facilities in the district. Of the total blood smears examined, 1372 (11.95%) were microscopically confirmed malaria. Plasmodium falciparum, Plasmodium vivax and mixed infections (P. falciparum and P. vivax) accounted for 70.77%, 20.55% and 8.67% of the cases, respectively. Malaria prevalence was significantly higher among individuals aged ≥ 15 years (12.60%, x2 = 13.6, df = 2, p = 0.001) and males (14.21%, x2 = 59.7, df = 1, p = 0.001). The highest number of malaria cases was recorded from September to November. Conclusion Malaria remains a public health problem in the district. P. falciparum was the most predominant parasite species in the area. Malaria prevalence was significantly higher among individuals aged ≥ 15 years and males. There was a remarkable fluctuation in the number of malaria cases in different months and years. In the study area malaria cases peaked in 2015 and 2017 then decreasing from 2017 to 2019, with sharp increase in 2020. Moreover, this study showed malaria cases were reported in all seasons and months, but the highest was observed from September to November. Strengthening malaria control activities is essential to further reduce the burden of malaria and pave the way for the anticipated elimination.

Mitiku Desalegn,1 Tewoderos Shitemaw,2 Mesfin Tesfaye,3 Genanew Kassie Getahun3 1Department of Anesthesia, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia; 2Menelik II Medical and Health Science College, Addis Ababa, Ethiopia; 3Department of Public Health, Menelik II Medical and Health Science College, Addis Ababa, EthiopiaCorrespondence: Mitiku Desalegn, Email mitikudesalegn44@gmail.comBackground: The causes of virological failure are poorly recognized and investigated. This study aimed to identify determinant factors of viral failure in children taking first-line ART at a randomly selected federal hospital in Addis Ababa, Ethiopia.Methods: A facility-based unmatched case–control study was carried out from May 10, 2022, to July 20, 2022, G.C. among HIV-infected children on first-line antiretroviral therapy. There were 209 HIV-positive youngsters in the study’s overall sample size, comprising 53 cases and 156 controls. Data was gathered by chart review using an organized checklist in English. The data were entered using Epi-data 4.2 and exported into SPSS version 24 for analysis. The relationship between each explanatory variable and the result variable was described using both bivariate and multivariate analysis. An adjusted odds ratio with 95% confidence intervals was conducted, and a p-value < 0.05 was considered statistically significant.Results: Being male (AOR= 4.504; 95% CI: 1.498, 13.539), duration on ART exceeding 47 months (AOR=40.6; 95% CI:9.571,172.222), fair and poor drug adherence (AOR=16.348; 95% CI:4.690,56.990), missed clinical appointments (AOR = 3.177; 95% CI: 1.100– 9.174), and baseline WHO clinical stage 4 disease (AOR = 6.852; 95% CI: 1.540– 30.49) were associated with an increased risk of virological failure. Conversely, a history of drug change and a CD4 count ranging from 250 to 500 cells/mm3 were significantly protective factors (AOR = 0.071; 95% CI: 0.024– 0.214 and AOR=0.118; 95% CI: 0.030, 0.464, respectively).Conclusion: Being male, duration on ART > 47 months, fair and poor adherence, missed clinical appointments, and baseline WHO Stage 4 are factors that increase the odds of virological failure. History of ART Drug change and a CD4 count between 250 and 500 cells/mm3 are factors that decrease the odds of virological failure.Keywords: retrospective, virological failure, antiretroviral therapy, children, Ethiopia

Abstract Magnetic resonance (MR) acquisitions of the torso are frequently affected by respiratory motion with detrimental effects on signal quality. The motion of organs inside the body is typically decoupled from surface motion and is best captured using rapid MR imaging (MRI). We propose a pipeline for prospective motion correction of the target organ using MR image navigators providing absolute motion estimates in millimeters. Our method is designed to feature multi-nuclear interleaving for non-proton MR acquisitions and to tolerate local transmit coils with inhomogeneous field and sensitivity distributions. OpenCV object tracking was introduced for rapid estimation of in-plane displacements in 2D MR images. A full three-dimensional translation vector was derived by combining displacements from slices of multiple and arbitrary orientations. The pipeline was implemented on 3 T and 7 T MR scanners and tested in phantoms and volunteers. Fast motion handling was achieved with low-resolution 2D MR image navigators and direct implementation of OpenCV into the MR scanner’s reconstruction pipeline. Motion-phantom measurements demonstrate high tracking precision and accuracy with minor processing latency. The feasibility of the pipeline for reliable in-vivo motion extraction was shown on heart and kidney data. Organ motion was manually assessed by independent operators to quantify tracking performance. Object tracking performed convincingly on 7774 navigator images from phantom scans and different organs in volunteers. In particular the kernelized correlation filter (KCF) achieved similar accuracy (74%) as scored from inter-operator comparison (82%) while processing at a rate of over 100 frames per second. We conclude that fast 2D MR navigator images and computer vision object tracking can be used for accurate and rapid prospective motion correction. This and the modular structure of the pipeline allows for the proposed method to be used in imaging of moving organs and in challenging applications like cardiac magnetic resonance spectroscopy (MRS) or magnetic resonance imaging (MRI) guided radiotherapy.

Background: The COVID-19 pandemic affected hundreds of millions of people and lives, and vaccination was the safest and most effective strategy to prevent and mitigate the burden of this disease. The implementation of COVID-19 vaccination in Vietnam in 2021 was unprecedentedly challenging in scale and complexity, yet economic evidence on the cost of delivery vaccines thought the program was lacking. Methods: This retrospective costing study utilized a bottom-up, ingredient-based approach to estimate the cost of delivering COVID-19 vaccines in Vietnam in 2021, from a payer perspective. The study included 38 study sites across all administrative and implementation level, including three geographic areas and two delivery strategies, in two provinces, Hanoi and Dak Lak. The study findings were complemented with qualitative interviews with health staff and stakeholders. Results: The economic cost to deliver one COVID-19 vaccine dose was $1.73, mostly comprised of opportunity costs ($1.14 per dose) which were driven by labor costs ($1.12 per dose). The delivery cost in urban areas was the highest ($2.02), followed by peri-urban areas ($1.45) and remote areas ($1.37). Delivery costs were higher at temporary sites ($1.78) when compared to facility-based delivery ($1.63). Comparing low-volume and high-volume periods showed that the delivery cost decreased significantly as volume increased, from $5.24 per dose to $1.65 per dose. Conclusions: The study estimates the cost of delivering COVID-19 vaccines in Vietnam in 2021. Enabling factors and challenges during the implementation of the program were explored. Study limitations may lead to underestimation of results and reduce generalizability. [ABSTRACT FROM AUTHOR]

Over the past twenty-five years, the Medical Library Association (MLA) has pursued a range of diversity, equity, and inclusion (DEI) initiatives. This article, written by members of the Journal of the Medical Library Association (JMLA)'s Equity Advisory Group (EAG), outlines significant measures taken to raise awareness about specific concepts, opportunities, and challenges related to DEI among MLA members. Topics discussed include the impact of influential Black, Indigenous, and people of color (BIPOC) leaders, the establishment of DEI and social justice-focused membership communities, and specific initiatives led by various working groups and committees which have served to strengthen MLA's commitment to diversity, equity, and inclusion during the last three decades. [ABSTRACT FROM AUTHOR]

Passive surveillance of wildlife disease is a valuable tool for the identification of emerging and changing disease patterns. Free-ranging leporids play an important role in their ecosystem and in the culture and diet of Canadians; however, little is known about their health status and the zoonotic pathogens they may carry. We summarized major causes of mortality and morbidity, as well as incidental infections and lesions, of free-ranging leporids submitted to the Canadian Wildlife Health Cooperative (CWHC) between 1990 and 2019. We identified Canadian leporids as competent hosts for several zoonotic pathogens, most notably Francisella tularensis (20/569; 3.5%). Trauma was the most frequent cause of mortality or morbidity among leporids, accounting for 46.0% of cases submitted to the CWHC, followed by bacterial infections (13.7%) and emaciation (5.1%). Human-mediated mortalities, such as those involving machines (23.7%), were the most common trauma case type, with apparently healthy individuals overrepresented within this mortality group. Harvesters proved to be a valuable resource for the monitoring of diseased and infected animals, as more than half (69.6%) of the animals submitted by this group had an incidental infection or lesion. The results from this study provide a scientific understanding the cause of mortality in free-ranging leporids in Canada with relevance to public health, wildlife biologists, veterinarians, and potential future surveillance programs. [ABSTRACT FROM AUTHOR]

RNAscope in situ hybridization (ISH) detects target RNA in formalin-fixed, paraffin-embedded (FFPE) tissues. Protocols suggest that prolonged FFPE storage and formalin fixation may impact signal detection, potentially limiting the utility of RNAscope ISH in retrospective studies. To develop parameters for RNAscope use with archived specimens, we evaluated the effect of formalin-fixation time by measuring the signal of a reference gene (16srRNA) in selected tissues fixed in 10% neutral-buffered formalin for 1, 2, 3, 5, 7, 10, 14, 21, 28, 60, 90, 180, and 270 d. The signal intensity and percent area of signal decreased after 180 d. Tissues had detectable signal at 180 d but not at 270 d of formalin fixation. To assess target detection in paraffin blocks, we qualitatively compared the signal of canine distemper virus (CDV) antigen via immunohistochemistry and CDV RNA via RNAscope ISH in replicate sections from blocks stored at room temperature for 6 mo, 1, 3, 6, 8, 11, 13, and 15 y; RNA was detected in FFPE tissues stored for up to 15 y. Our results demonstrate that RNAscope ISH can detect targets in tissues with prolonged paraffin storage intervals and formalin-fixation times. [ABSTRACT FROM AUTHOR]

Emotion recognition systems are typically trained to classify a given psychophysiological state into emotion categories. Current platforms for emotion ground-truth collection show limitations for real-world scenarios of long-duration content (e.g. $> $ > 10 minutes), namely: 1) Real-time annotation tools are distracting and become exhausting; 2) Perform retrospective annotation of the whole content in bulk (providing highly coarse annotations); or 3) Are used by external experts (depending on the number of annotators and their subjective experience). We explore a novel approach, the EmotiphAI Annotator, that allows undisturbed content visualisation and simplifies the annotation process by using segmentation algorithms that select brief clips for emotional annotation retrospectively. We compare three methods for content segmentation based on physiological data (Electrodermal Activity (EDA), emotion-based), scene (time-based), and random (control) selection. The EmotiphAI Annotator attained a B+ System Usability Scale score and low-average mental workload as per the NASA Task Load Index (40%). The reliability of the self-report was analysed by the inter-rater agreement (STD $< $ < 0.75), coherence across time segmentation methods (STD $< $ < 0.17), comparison against the state-of-the-art ground truth (STD $< $ < 0.7), and correlation to EDA ($> $ > 0.3 to 0.8), where the EDA-based method obtained the overall best performance. [ABSTRACT FROM AUTHOR]

The emergence of methicillin-resistant Staphylococcus pseudintermedius (MRSP) presents a significant public health concern globally, particularly within veterinary medicine. MRSP's resistance to multiple antibiotics is limiting treatment options and potentially leading to severe infections in companion animals. This study aimed to understand antimicrobial resistance in dogs and cats, focusing on MRSP resistance patterns and its prevalence in Germany. We analyzed results of bacterial diagnostic samples from canines and felines, sourced from a German veterinary diagnostic microbiology laboratory between 2019 and 2021. This dataset included samples from 3491 veterinary practices, covering 33.1% of veterinary practices and clinics in Germany. MRSP rates were detailed by host species, sample types and co-resistance patterns. Analysis of 175,171 bacterial examination results revealed S. pseudintermedius in 44,880 samples, yielding a 25.6% isolation rate. S. pseudintermedius was more prevalent in dogs (35.0%) than cats (3.6%). Methicillin resistance was found in 7.5% of all S. pseudintermedius isolates. MRSP prevalence was higher in feline samples (16.1%, 95% CI 14.4–17.8) compared to canine samples (7.1%, 95% CI 6.8–7.0). S. pseudintermedius showed high resistance rates to ampicillin (cats: 48.6%, dogs: 67.6%) and clindamycin (cats: 37.2%, dogs: 32.7%), while MRSP exhibited high co-resistance to clindamycin (cats: 82.8%, dogs: 85.4%) and sulfamethoxazole + trimethoprim (cats: 66.4%, dogs: 66.2%). Our study revealed distinct resistance patterns of MRSP in cats compared to dogs, highlighting the need for tailored treatment approaches and the importance of antimicrobial resistance surveillance. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is a major public health concern in the developing countries. Moreover, the emergence of multidrug-resistant tuberculosis is challenging. However, there are no organized data on the trends of pulmonary tuberculosis and rifampicin-resistant Mycobacterium tuberculosis in the study area. Methods: A retrospective cross-sectional study was conducted to fill the information gap in Central Tigray at St. Mary General Hospital between 2018 and 2023. Data were collected from the GeneXpert™ tuberculosis registration logbooks using standard checklists and analyzed using Statistical Package for Social Science version 22. After performing logistic regression, a p-value < 0.05 with a corresponding 95% confidence interval was considered statistically significant. Moreover, chi square test for trend was performed to assess the percentage of annual detection of pulmonary tuberculosis and rifampicin-resistant Mycobacterium tuberculosis during the study years. Result: Presumptive pulmonary tuberculosis patients with complete data (n = 3696) were included in the study. The overall prevalence of pulmonary tuberculosis was 11.7%, of which 8.1% were resistant to rifampicin. The study revealed that the incidence of pulmonary tuberculosis has been increasing, mainly in the recent four years. Likewise, an increase in rifampicin-resistant Mycobacterium tuberculosis was observed with considerable fluctuations. Age, human immunodeficiency virus infection, and presumptive rifampicin-resistant Mycobacterium tuberculosis infection were significantly associated with the presence of pulmonary tuberculosis. Moreover, pulmonary tuberculosis was more prevalent among participants in the productive-age group. Conclusion: Although there have been fluctuations, an increasing of pulmonary tuberculosis and rifampicin-resistant Mycobacterium tuberculosis has been observed in recent years. Hence, prevention and treatment strategies for tuberculosis should be strengthened to alleviate the burden of pulmonary tuberculosis and rifampicin-resistant Mycobacterium tuberculosis in the study area. [ABSTRACT FROM AUTHOR]

Background: Nowadays, different therapeutic options are available for the first-line treatment of metastatic renal cell carcinoma (mRCC). Immuno-combinations are the standard first-line therapy in all mRCC patients regardless of the International Metastatic RCC Database Consortium (IMDC) risk category, even though TKI monotherapy is still a therapeutic option in selected patients. However, comparisons between the different first-line treatment strategies are lacking and few real-world data are available in this setting. For this reason, the regimen choice represents an important issue in clinical practice and the optimal treatment sequence remains unclear. Methods: The REGAL study is a multicentric prospective observational study enrolling mRCC patients treated with first-line systemic therapy according to clinical practice in a real-world setting. A retrospective cohort of mRCC patients who received first-line systemic therapy from the 1st of January 2021 will also be included. The primary objective is to identify potential prognostic and predictive factors that could help guide the treatment choice; secondary objectives included the assessment of the prognostic performance of the novel prognostic Meet-URO score (IMDC score + neutrophil-to-lymphocyte ratio + bone metastases) compared with the IMDC score and the comparison between treatment strategies according to response and survival outcomes and toxicity profile. Discussion: Considering the high number of therapeutic first-line strategies available for mRCC, the identification of clinical prognostic and predictive factors to candidate patients to a preferable systemic therapy is still an unmet clinical need. The Meet-URO 33 study aims to provide a large-scale real-world database on mRCC patients, to identify the clinical predictive and prognostic factors and the different performances between the ICI-based combinations according to response, survival and toxicity. Trial Registration: CESC IOV 2023-78. [ABSTRACT FROM AUTHOR]