Frequency Distribution of Pediatric Primary Care Cases in a Rural Site in The Philippines: A Cross-Sectional Study.

Background: Primary care for pediatric patients focuses on providing comprehensive, accessible, and coordinated healthcare from the neonatal period to adolescence. The implementation and use of electronic medical records (EMR) in pediatric primary care facilities is an efficient strategy to gather necessary information on the epidemiology of common pediatric diseases in the Philippines. Objectives: This study aimed to determine the frequency distribution of pediatric diseases in a rural primary healthcare facility in the Philippines. Methods: This cross-sectional study reviewed the EMR of all pediatric patients who consulted in a primary care facility in Samal, Bataan from April 2019 to March 2021. Data gathered include sex, age in years, chief complaint, diagnosis, and month of consultation. Data was summarized using descriptive statistics. Results: A total of 14,462 pediatric consults were recorded from April 2019 to March 2021. There were slightly more male patients (52.1%). The mean age of the patients was 6.5 years (standard deviation 5.22). The highest number of consults came from the 1- to 4-year-old age group (41.5%). The most common chief complaints were cough (45.9%), fever (25.5%), and colds (24.9%). The most frequent diagnoses were upper respiratory tract infections (47.4%), followed by lower respiratory tract infections (6.9%), and skin and soft tissue infections (5.3%). Majority of the consults for respiratory tract infections, skin and soft tissue infections, gastroenteritis, asthma, and dermatitis were in the 1- to 4-year-old age group. Urinary tract infections and otitis media or externa were recorded more frequently in the 5- to 9-year-old age group. Conclusions: Respiratory tract infections, followed by skin and soft tissue infections, were the most frequently identified diseases in children consulting a primary care facility at a rural site in the Philippines. The most common chief complaints, defined as the primary reason for seeking consult, were cough, fever, and colds. Data was gathered through EMR review, which may aid in the planning of programs and policies to improve primary care service delivery.

Cancers attributable to diet in Italy.

Cancer burden can be reduced by controlling modifiable risk factors, including diet. We provided an evidence-based assessment of cancer cases and deaths attributable to diet in Italy in 2020. We considered dietary factor-cancer type pairs for which the World Cancer Research Fund/American Institute for Cancer Research - Continuous Update Project reported either 'convincing' or 'probable' evidence of causal association. Relative risks were retrieved from recent meta-analyses and dietary intakes (around 2005) from a national food consumption survey. Sex-specific population attributable fractions (PAFs) were computed by comparing the distribution of dietary intakes in the Italian population against counterfactual scenarios based on dietary recommendations. Using data from national cancer and mortality registries in 2020, we estimated the number of attributable cancer cases and deaths, assuming ~15-year lag period. Unhealthy diet accounted for 6.3% (95% CI: 2.5%-9.9%) of all cancer cases in men and 4.5% (95% CI: 1.7%-7.4%) in women. PAFs of colorectal cancer were 10.5% and 7.0% for any intake of processed meat, 3.3% and 2.0% for high red meat, 4.8% and 4.3% for low dairy products, and 7.9% and 9.0% for low fiber intakes in men and women, respectively. PAFs for low intake of non-starchy vegetables and fruit ranged from 0.8% to 16.5% in men and 0.6%-17.8% in women for cancers of the aerodigestive tract. The estimated cancer burden associated with unfavorable dietary habits in Italy is considerable, but appears lower than for other high-income countries, reflecting the typically Mediterranean diet.

Proficiency testing within Eurotransplant.

Eurotransplant is responsible for the international allocation of organs between eight countries in Europe. All HLA laboratories affiliated to Eurotransplant must be EFI or ASHI-accredited and must participate in the Eurotransplant external proficiency testing (EPT) program, organized by the Eurotransplant Reference Laboratory (ETRL). EPT within Eurotransplant has a long tradition, starting in 1978. The current EPT program consists of the following schemes: HLA typing including serology, CDC crossmatching, HLA-specific antibody detection, and identification. Participants enter the results of laboratory tests using a web-based application. Assessed results are visible on the website. An additional component called "patient-based cases" runs since 2016. Results are summarized and published on the EPT website. Furthermore, these results are discussed during the annual extramural tissue typers meeting, which is organized by the ETRL. Thanks to this EPT program, the performance of all HLA laboratories affiliated to Eurotransplant can be monitored and corrected, if necessary. Because all affiliated laboratories are assessed in the same EPT program, where these laboratories show to be consistent in most of their results, Eurotransplant EPT has proven to be an efficient tool to create a more uniform level of quality of histocompatibility testing within Eurotransplant.

Post-mortem interval determinations using insects collected from illegally hunted and dehorned rhinoceros in the Republic of South Africa from 2014 to 2021.

Wildlife forensic science is a growing research field globally with application in criminal cases of illegal hunting requiring an estimate of time of death based on insect fauna. The techniques and procedures of forensic entomology acquired over the last 40 years, used in legal cases relating to human remains, can be adapted to decomposing wildlife. Research on carrion utilising the rate of development of insect immatures provides a biological clock from which a minimum post-mortem interval (minPMI) can be derived. The following study concerns 19 rhinoceros that were illegally killed and dehorned in the Republic of South Africa between 2014 and 2021. The paper details 74 samples of insect evidence collected from these rhinoceros remains from which an accurate estimate of their PMI was calculated. The specimens comprised 18 species from 12 families belonging to three insect orders. Many Dipteran and Coleopteran species were found on and around each carcass. The species of fly larvae (family Calliphoridae) used in each case to estimate the PMI are as follows: Chrysomya marginalis (Wiedemann) (13 cases), Chrysomya chloropyga (Wiedemann) (2 cases), Chrysomya albiceps (Wiedemann) (1 case) and Chrysomya megacephala (Fabricius) (1 case). Two species of Coleoptera from the family Dermestidae and Silphidae involved Dermestes maculatus (DeGeer) and Thanatophilus micans (Fabricius), respectively, also were involved in one PMI estimation each. The paper highlights opportunities for improving our global understanding of gaps in procedures and training related to wildlife criminal cases.

Diagnostic delay in patients with sporadic hereditary transthyretin-mediated amyloidosis.

BACKGROUND: Hereditary transthyretin-mediated amyloidosis (ATTRv amyloidosis) is a rare progressively incapacitating condition with a wide range of genotype/phenotype presentations. It is frequently diagnosed late in its course, particularly in sporadic cases. OBJECTIVES: Analysing predictors of diagnostic delay in this subpopulation should be, therefore, a priority. METHODS: 109 apparently sporadic ATTRv amyloidosis patients followed in a reference centre in Hospital de Santa Maria (ULS Santa Maria-CAML), in Lisbon, were studied. Time from symptom onset to diagnosis, age, sex, municipality of origin and initial symptoms were obtained. Diagnostic delay was compared between different decades with a Kruskal-Wallis test, and its predictors were evaluated in a univariate model followed by a binary logistic regression analysis to calculate the adjusted odds ratio. RESULTS: The median diagnostic delay was 1262 days. There was a non-significant difference in diagnostic delay between the 80 s, 90 s, 2000s and 2010s decades. There was a non-significant trend for a longer diagnostic delay in woman and in patients having no neurologic symptoms at onset. CONCLUSION: There is an important diagnostic delay in sporadic cases of ATTRv amyloidosis. Awareness should be spread among clinicians regarding the various manifestations of this disease, stressing the importance of family history and epidemiological data.

[Assessment of the radiation risk to health caused by the intake of Cs-137 and Sr-90 radionuclides from food in the able-bodied population of the Samara region].

Monitoring of the content of technogenic radionuclides (Cs-137 and Sr-90) in foods is one of the key areas in ensuring radiation safety of the population, taking into account the current radiation situation. The greatest risk to health is food produced or imported from the territories that have been subjected to man-made radiation accidents. The purpose of the research was to assess the radiation risk caused by oral intake of radionuclides based on the study of the actual nutrition of the adult population and contamination of food with Cs-137 and Sr-90 radionuclides. Material and methods. The specific activity of Cs-137 and Sr-90 radionuclides (median and 90 percentile) was assessed by gamma spectrometric method in 1235 samples of food produced in the Samara region and imported from outside. Data on the actual nutrition of 894 respondents aged 18 to 68 years (in the autumn-winter period) were obtained by the 24-hour dietary recall using the automated software package Nutri-prof (version 2.9). Based on the data obtained, effective annual doses of internal radiation were calculated, information was obtained on the risks of malignant neoplasms, including in the long-term period under various scenarios of internal radiation. Results. Radiometric studies of food samples did not reveal deviations from hygienic standards. The highest median values of Cs-137 specific activity were observed in samples of forest mushrooms (1.23 Bq/kg), wild berries (0.97 Bq/kg), fish and fish products (0.96 Bq/kg). The highest median values of Sr-90 specific activity were also observed in samples of forest mushrooms (3.86 Bq/kg), fish and fish products (2.71 Bq/kg). The radiation risk under various scenarios of Cs-137 intake was regarded as «negligible¼, while the risk was regarded as «small¼ when consuming food contaminated with Sr-90. The number of additional cases of malignant neoplasms at the admission of Cs-137 in the median values of specific activity is 0.38 per year, at maximum values - 0.57 per year, at the admission of Sr-90 - 2.04 per year and 3.30 cases per year, respectively. Conclusion. The implementation of radiation monitoring of food, especially those imported from areas of high radiation risk, is a necessary condition for ensuring radiation safety of the population. It is also necessary to take into account the stochastic effect of the influence of small doses of internal exposure on the organism when consuming food, which make a significant contribution to the formation of the dose of internal radiation.

A Machine Learning Model Based on Global Mammographic Radiomic Features Can Predict Which Normal Mammographic Cases Radiology Trainees Find Most Difficult.

This study aims to investigate whether global mammographic radiomic features (GMRFs) can distinguish hardest- from easiest-to-interpret normal cases for radiology trainees (RTs). Data from 137 RTs were analysed, with each interpreting seven educational self-assessment test sets comprising 60 cases (40 normal and 20 cancer). The study only examined normal cases. Difficulty scores were computed based on the percentage of readers who incorrectly classified each case, leading to their classification as hardest- or easiest-to-interpret based on whether their difficulty scores fell within and above the 75th or within and below the 25th percentile, respectively (resulted in 140 cases in total used). Fifty-nine low-density and 81 high-density cases were identified. Thirty-four GMRFs were extracted for each case. A random forest machine learning model was trained to differentiate between hardest- and easiest-to-interpret normal cases and validated using leave-one-out-cross-validation approach. The model's performance was evaluated using the area under receiver operating characteristic curve (AUC). Significant features were identified through feature importance analysis. Difference between hardest- and easiest-to-interpret cases among 34 GMRFs and in difficulty level between low- and high-density cases was tested using Kruskal-Wallis. The model achieved AUC = 0.75 with cluster prominence and range emerging as the most useful features. Fifteen GMRFs differed significantly (p < 0.05) between hardest- and easiest-to-interpret cases. Difficulty level among low- vs high-density cases did not differ significantly (p = 0.12). GMRFs can predict hardest-to-interpret normal cases for RTs, underscoring the importance of GMRFs in identifying the most difficult normal cases for RTs and facilitating customised training programmes tailored to trainees' learning needs.

Morphology of the unique egg cases of hornsharks (Heterodontiformes: Heterodontidae).

Many of the egg cases of oviparous chondrichthyans remain unknown and undescribed in the literature. Egg cases can be a useful taxonomic character for species distinction and can be a valuable indicator of a species distribution in the field. In this study, the egg cases for 9 of the 10 nominal species of Heterodontus are described and compared, and the terminology and methodology for studying them are standardized. Heterodontus egg cases are distinct and easily identifiable from other oviparous egg cases by having a unique corkscrew shape formed by a pair of lateral keels spiraling along its length. Heterodontus egg cases range between 7.5 and 14.5 cm in egg case length, 3.7 and 5.8 cm in egg case width at midportion, and have 0.75-4 complete rotations. Morphometric measurements of egg cases from the nine species were subjected to multivariate analysis, with unique characters enabling distinction between them. Egg cases can be separated into three morphotypes: the "wide keels lacking tendrils" group, the "narrow keels with tendrils" group, and the "wide keels with tendrils" group. The egg case of Heterodontus ramalheira remains unknown.

Distinguishing genetic alterations versus (epi)mutations in Silver-Russell syndrome and focus on the IGF1R gene.

CONTEXT: Silver-Russell Syndrome (SRS) is a growth retardation disorder characterized by pre- and post-natal growth failure, relative macrocephaly at birth, prominent forehead, body asymmetry, and feeding difficulties. The main molecular mechanisms are imprinting alterations at multiple loci, though a small number of pathogenic variants have been reported in the SRS genes IGF2-PLAG1-HMGA2 and CDKN1C. However, around 40% of clinically suspected SRS cases do not achieve a molecular diagnosis, highlighting the necessity to uncover the underlying mechanism in unsolved cases. OBJECTIVE: evaluate the frequency of genetic variants in undiagnosed SRS patients (NH-CSS≥4), and investigate whether (epi)genetic patients may be distinguished from genetic patients. METHODS: 132 clinically SRS patients without (epi)genetic deregulations were investigated by Whole Exome (n=15) and Targeted (n=117) Sequencing. Clinical data from our cohort and from an extensive revision of literature were compared. RESULTS: pathogenic variants were identified in 9.1% of this cohort: 3% in IGF2, PLAG1, and HMGA2 genes, while 3% in the IGF1R gene, associated with IGF-1 resistance (IGF1RES), an SRS differential diagnosis. Overall, IGF2-PLAG1-HMGA2 and IGF1R account for 3.6% of SRS with NH-CSS score ≥ 4. A clinical cross-comparison of (epi)genetic versus genetic SRS underlined (epi)genotype-phenotype correlation, highlighted the prevalence of body asymmetry and relative macrocephaly in mosaic (epi)genetic SRS and recurrence of genetic familial cases. Furthermore, overlapping features were evidenced in (epi)genetic SRS and IGF1RES patients. CONCLUSION: Our study explores the frequency of genetic SRS, underscores body asymmetry as distinctive phenotype in (epi)genetic SRS and suggests IGF1R sequencing in SRS diagnostic flow-chart.

Formative key feature examinations as innovative teaching approach in dental education: A project report.

Introduction: Clinical reasoning ability is one of the core competencies of physicians. It should already be trained during undergraduate medical education. At University Medical Center Göttingen (UMG), medical students can participate in formative key feature examinations in which they work on virtual patient cases in order to apply and deepen the procedural knowledge acquired in lectures and seminars. Problem and objective: While this teaching format is already established in the medical curriculum at the UMG, it has not yet been implemented in the dental curriculum at the same institution. Therefore, the current project aimed to evaluate the feasibility of formative key feature examinations in dental education. Methods: In 2022, new key feature cases focusing on dental-surgical teaching content were created. For pilot testing, the new cases were worked on by two cohorts of dental students via an online learning platform in February 2023. The students were also asked to complete an anonymous online questionnaire in order to evaluate the new teaching format. Results: Overall, the formative key feature examinations were evaluated positively by the dental students, and they demanded for further dental key feature cases. However, descriptive analyses of item characteristics as well as students' comments in the questionnaire revealed some potential for improvements, so that a few cases were partly revised afterwards. Conclusion and outlook: This project shows that formative key feature examinations are feasible in dental education and that dental students can benefit from working on virtual case scenarios. Whether dental students' clinical reasoning competence can be improved by completing formative key feature examinations is being investigated in an ongoing study at the UMG.

Comprehensive analysis of the global impact and distribution of tick paralysis, a deadly neurological yet fully reversible condition.

SUMMARYTick paralysis is a potentially fatal condition caused by neurotoxins secreted by the salivary glands of certain ticks. Documented cases have been reported worldwide, predominantly in the United States, Canada, and Australia, with additional reports from Europe and Africa. This condition also affects animals, leading to significant economic losses and adverse impacts on animal health and welfare. To date, 75 tick species, mostly hard ticks, have been identified as capable of causing this life-threatening condition. Due to symptom overlap with other conditions, accurate diagnosis of tick paralysis is crucial to avoid misdiagnosis, which could result in adverse patient outcomes. This review provides a comprehensive analysis of the current literature on tick paralysis, including the implicated tick species, global distribution, tick toxins, molecular pathogenesis, clinical manifestations, diagnosis, treatment, control, and prevention. Enhancing awareness among medical and veterinary professionals is critical for improving the management of tick paralysis and its health impacts on both humans and animals.

Epidemiological characteristics of influenza outbreaks in schools in Jiangsu Province, China, 2020-2023 post-COVID-19 pandemic.

BACKGROUND: This study aimed to analyze the epidemic characteristics and influencing factors of school influenza outbreaks in Jiangsu Province, China from 2020 to 2023,following the COVID-19 pandemic, to inform prevention and control strategies. METHODS: Data on influenza-like illness(ILI) outbreaks from the Chinese Influenza Surveillance Information System and national-level influenza surveillance sentinel hospitals were analyzed. The temporal distribution, school type, virus strains, and outbreak scales were examined using descriptive statistics. RESULTS: From 2020 to 2023, 1142 influenza outbreaks occurred in schools, with primary schools(ages 6 to 12) accounting for 71.80%. Most large outbreaks were caused by A(H1N1) and A(H3N2), responsible for 8.99% of total outbreaks. Outbreaks were predominantly reported in the pre-peak periods of B(Victoria) and A(H1N1) circulation, accounting for 86.31% and 92.32% of their respective total outbreaks. No concurrent influenza and COVID-19 outbreaks were observed during the study period. CONCLUSION: Primary and secondary schools are high-risk settings for influenza outbreaks. A(H3N2) shows higher adaptability and is more likely to co-circulate with other subtypes/lineages, especially A(H1N1), leading to larger outbreaks. B(Victoria)-caused outbreaks are more frequent but smaller in scale. School influenza outbreaks are more likely to occur during the early stages of seasonal peaks, particularly for B(Victoria) and A(H1N1). This suggests that influenza outbreaks in schools may play a crucial role in seeding and accelerating the spread of the virus within the broader community.

Long-term outcome of tacrolimus-based immunosuppressive treatment for patients with paediatric-onset lupus nephritis.

AIM: We have previously reported the mid-term efficacy and safety of tacrolimus (Tac)-based immunosuppressive therapy in such patients, and herein, we aimed to determine their long-term outcomes (over 10 years). METHODS: We retrospectively evaluate the data of 13 consecutive patients with biopsy-proven long-standing LN who underwent a long-term Tac-based treatment regimen. Tac was administered once daily at a dose of 3 mg as reinduction or maintenance treatment. Treatment outcomes were defined using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), urinary protein/creatinine ratio (Up/cr), serum creatinine, estimated glomerular filtration rate (eGFR) and serological lupus markers (complement C3, complement hemolytic activity [CH 50], and anti-dsDNA antibody titre), and the concomitantly administered prednisolone (PDN) dose. Data on clinical parameters and serological lupus activity were collected annually from each patient throughout the study period. RESULTS: The patients' baseline characteristics at the treatment initiation were as follows: mean age, 18 years; Up/cr, 0.63 ± 0.69; serum C3 level, 57.2 ± 22.4 mg/dL (normal range, 79-152 mg/dL); CH50, 27.9 ± 15.7 U/mL (normal range, 23.0-46.0 U/mL); serum anti-dsDNA antibody titre, 111.7 ± 123.4 IU/mL (normal range, <12.0 IU/mL); serum creatinine, 0.60 ± 0.19 mg/dL; eGFR, 115.6 ± 21.3 mL/min and SLEDAI, 13 ± 8.1. Despite the gradual tapering of the concomitantly administered PDN dose from 18.7 ± 13.5 mg/day at baseline to 3.5 ± 2.8 mg/day at 10 years (p = .002), a marked improvement in the outcomes, compared with the baseline values, was observed within a year. Additionally, these favourable changes persisted throughout study period in most patients. Compared with the baseline values, the following measures confirmed sustained outcome improvements after a 10-year treatment: SLEDAI, 1.7 ± 2.0; serum C3 level, 83.8 ± 16.1 mg/dL; CH50, 45.6 ± 10.9 U/mL (all p < .01) and Up/cr, 0.16 ± 0.18 and serum anti-dsDNA antibody titre, 25.8 ± 28.8 IU/mL (both p < .05). Serum creatinine level and eGFR remained within the normal range in all study participants except for one patient who experienced several flare-ups. No serious adverse effects were observed. CONCLUSION: Our results suggest that long-term Tac-based immunosuppressive treatment as maintenance therapy is beneficial and has low cytotoxicity. Therefore, it represents an attractive option for the treatment of selected patients with paediatric-onset LN in a real-world setting.

Leveraging Multiple Administrative Data Sources to Reduce Missing Race and Ethnicity Data: A Descriptive Epidemiology Cross-Sectional Study of COVID-19 Case Relative Rates.

BACKGROUND: Understanding race and ethnicity (RE) differentials improves health outcomes. However, RE data are consistently missing from electronic laboratory reports, the primary source of COVID-19 case metrics. We addressed the missing RE differentials and compared vaccinated and unvaccinated cases from March 1, 2020, to May 30, 2023, in New York State (NYS), excluding New York City. METHODS: This descriptive epidemiology cross-sectional study linked the NYS Electronic Clinical Laboratory Reporting System (ECLRS) with NYS Immunization Information System (NYSIIS) to address the missing RE data in the ECLRS system. The primary metric was the COVID-19 case relative risk (RR) for each RE relative to white individuals. RESULTS: There were 4,212,741 COVID-19 cases with 39% (1,624,818) missing RE data in ECLRS; missing RE data declined to 17% (726,023) after matching with NYSIIS. For those aged 65 years or older (after matching), 42% were missing in 2020, which declined by 17% by 2023. In May 2021, COVID-19 RRs for vaccinated individuals were 1.09 (95% CI 0.90-1.32), 1.11 (95% CI 0.87-1.43), 1.13 (95% CI 0.93-1.39), and 1.89 (95% CI 1.01-3.52), and for unvaccinated individuals were 1.73 (95% CI 1.66-1.82), 0.84 (95% CI 0.78-0.92), 3.10 (95% CI 2.98-3.22), and 3.49 (95% CI 3.05-3.98) respectively for Hispanic, Asian/Pacific Islander, Black people, and American Indian/Alaska Native individuals. CONCLUSION: Matching case data with vaccine registries reduce missing RE data for COVID-19 cases. Disparity was lower in vaccinated than in unvaccinated individuals indicating that vaccination mitigated RE disparities early in the pandemic. This underscores the value of interoperable systems with automated matching for disparity analyses.

Canine vector-borne infections of working dogs of the Sri Lanka Air Force, and free roaming, and privately owned dogs.

Canine vector-borne infections (CVBIs) are a global health problem. The military working dogs of Sri Lanka die at an early age, and CVBIs have been a leading speculated cause. We examined CVBIs in the working dogs of the Sri Lanka air force (SLAF) and free-roaming dogs (FRDs) and privately owned dogs (PODs) country-wide. Giemsa-stained smears were prepared and conventional PCR-positive DNA was subjected to sequencing and phylogeny. Of the 668 dogs sampled, 212 (31.7%) had one or more CVBIs. The prevalence of infections among the FRDs (40.0%) was significantly higher than SLAF working dogs (30.0%; χ2 = 10.5216; p = 0.0012) and PODs (26.2%; χ2 = 5.3414, p = 0.0208) but not between SLAF dogs and PODs (χ2 = 1.7655, p = 0.1838). Many infected dogs were asymptomatic (57.4%), which was higher among the FRDs. Seven infectious agents were identified: Babesia gibsoni, B. canis, Ehrlichia canis, Anaplasma platys, Leishmania sp., Hepatozoon canis, and filaria worms. The most common infection was B. gibsoni (13.8%), followed by E. canis (9.9%). Three tick species: Rhipicephalus linneai, Rhipicephalus haemaphysaloides and Haemophysalis bispinosa were found infesting the dogs. The SLAF dogs were thoroughly quarantined upon arrival, but the infection prevalence was similar to PODs.

Researcher and partner perspectives on the relationship between engagement in research and three uses of patient-centered comparative clinical effectiveness research study findings.

BACKGROUND: The uptake of research findings into clinical practice is critical to providing health care that improves health outcomes for patients. This study explored how Patient-Centered Outcomes Research Institute (PCORI) awardees perceive the relationship between engagement of patients and other partners in research and three uses, or applications, of patient-centered comparative clinical effectiveness research (CER) study findings, which may lead to uptake in clinical practice: (1) Integration into clinical practice guidelines, recognized point-of-care decision tools, or documents that may inform policy; (2) Implementation beyond the study, including at sites outside of the study setting or patient populations; and (3) Active dissemination of findings to specific audiences by parties external to the study team. METHODS: This exploratory qualitative study examined awardee and partner perceptions of what led to each use of study findings and how engaged partners contributed. We purposively selected PCORI-funded research projects with documentation of each use and conducted virtual interviews with 42 individuals (15 PIs or project leads, 2 research team members, and 25 partners) from 17 projects. We conducted thematic analysis of individual projects or project sets, across projects within each use case, and across the three uses. RESULTS: Participants described three primary activities in which engaged partners made contributions before, during and after CER studies that facilitated the use of study findings: (1) generating relevant study findings, (2) distributing study findings strategically, and (3) making connections to people or organizations outside the study team. In addition, engagement continued to facilitate the use of study findings during subsequent PCORI-funded implementation and dissemination-specific projects, with partners adapting interventions and creating and tailoring dissemination messages and products. Finally, participants described attributes of teams' engagement approaches that may have supported partner contributions, including early and ongoing engagement, leveraging partners' connections and understanding of community needs, and using multiple engagement approaches. CONCLUSION: This study identified examples of how engagement can help facilitate the use of CER study findings, especially when engagement contributions occur in meaningful ways. Findings from this study suggest a framework for future research on the relationship between engagement in research and uptake of study findings into clinical practice.

This study looked at how PCORI awardees describe the relationship between engagement in research and three uses of study findings: (1) Citing findings in clinical practice guidelines or other documents that support health policy; (2) Putting findings into practice after the study; and (3) Sharing findings with specific audiences by people not on the study team. We selected PCORI-funded research projects that had signs of each use. Then, we interviewed 42 people, including 15 lead investigators or project leads, 2 research team members, and 25 partners. We summarized findings for each project and then across the three uses.Partners helped move forward each of the three uses of study findings. They helped to plan and conduct the studies, making findings relevant. Partners also helped to plan and then share study findings. They made connections to people and organizations for the use of study findings. In addition, partners helped to put findings into practice after the study and tailored and shared findings in their communities.Finally, the way project teams engaged partners may have supported partner contributions. Project teams had early and ongoing engagement in their study. Partners shared their understanding of community needs and used their connections to share findings. Also, projects often had more than one way to work with partners.Findings from this study highlight ways engagement in research can contribute to use and potentially uptake of study findings in clinical practice. The study also suggests topics for future research on how engagement affects the use of findings.Manuscript Text.

Efficacy of surgery in the management of multiple recurrences of retroperitoneal dedifferentiated liposarcoma.

BACKGROUND: Retroperitoneal dedifferentiated liposarcoma is associated with a high risk of recurrence; however, treatment strategies that are more effective than surgery remain to be established. This study aimed to determine the optimal number of surgeries that would be effective for patients with recurrent disease. Furthermore, the improvement in prognosis was evaluated according to the malignancy level. METHODS: The effect of each type of surgery on the prognosis of 118 patients with retroperitoneal dedifferentiated liposarcoma treated at the Osaka International Cancer Institute between 1997 and 2022 was investigated. Among the 118 patients, 103 underwent initial surgery, while 54 and 30 patients underwent second and third surgeries, respectively. The overall and disease-free survival rates of each group were compared using the Kaplan-Meier method, and the log-rank test was used to determine statistical significance in univariate analysis. 18F-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) was used to assess malignancy. Maximum standardized uptake values (SUVmax) of ≥ 4 and < 4 were classified as high and low malignancy, respectively. RESULTS: The first and second surgeries resulted in a significant improvement in the overall survival rate, regardless of the malignancy level (p < 0.001); however, no significant improvement in prognosis was observed after the third surgery (p = 0.077). Low-grade malignancies are associated with a better postoperative prognosis, even in cases of recurrence. In contrast, high-grade malignancies exhibit a reduction in surgical efficacy. CONCLUSIONS: This study highlights the importance of considering the tumor malignancy level and the patient's overall condition when deciding whether to perform repeated surgical interventions. Surgical treatment can prolong overall survival, even in patients with recurrence; however, it is advisable to assess malignancy levels when determining the suitability of surgery beyond the second recurrence.

Destroyed lung syndrome in patients with drug-susceptible pulmonary tuberculosis.

Destroyed lung syndrome is a recognized devastating complication of pulmonary tuberculosis (TB) that affects the quality of life of patients. Clinicians in TB-endemic countries should be aware of this complication aiming at prevention. TB control programs should intensify efforts at early detection and treatment and also provide interventions for post-TB complications.

Bioinformatics-driven untargeted metabolomic profiling for clinical screening of methamphetamine abuse.

PURPOSE: Amphetamine-type stimulants are very common, and their usage is becoming a very big social problem all over the world. Thousands of addicts encounter several health problems including mental, metabolic, behavioral and neurological disorders. In addition to these, there are several reports about the elevated risk of tendency on committing criminal cases by addicted persons. Hence, methamphetamine addiction is not only an individual health problem but also a social problem. In our study, we aimed to investigate the pathogenesis of chronic usage of methamphetamine via untargeted metabolomics approach. METHODS: 38 plasma samples were carefully collected and extracted for untargeted metabolomics assay. A liquid-liquid extraction was performed to get as much metabolite as possible from the samples. After the extraction procedure, samples were transferred into vials and they were evaluated via time of flight mass spectrometry instrument. RESULTS: Significantly, altered metabolites were identified by the fold analysis and Welch's test between the groups. 42 different compounds were annotated regarding to data-dependent acquisition method. Pathway analysis were also performed to understand the hazardous effect of methamphetamine on human body. CONCLUSION: It has been reported that drug exposure may affect several metabolic pathways for amino acids, fats, energy metabolism and vitamins. An alternative bioinformatic model was also developed and validated in order to predict the chronic methamphetamine drug users in any criminal cases. This generated model passes the ROC curve analysis and permutation test and classify the controls and drug users correctly by evaluating the metabolic alterations between the groups.

Rest-fMRI-A Potential Substitute for Task-fMRI?

Objective The aim of this study was to assess the reliability of resting-state functional magnetic resonance imaging (rest-fMRI) in mapping language areas for preoperative planning, versus standard task-based techniques, which are at times difficult to perform in clinical settings. Our study also aimed to evaluate the overlap between language areas identified through rest-fMRI and the standard task-fMRI, in neurosurgical cases. Materials and Methods Using a seed-based analysis of rest-fMRI with multiple template seeds, we identified functionally connected language regions in patients undergoing preoperative language mapping. Four language task paradigms (word, verb, picture, and semantics) were evaluated. We quantified the degree of overlap between language areas identified on rest-fMRI and task-fMRI, categorizing the results as more than 50% or less than 50% overlap. Results Seventy-seven percent of patients demonstrated an overlap exceeding 50% between rest- and task-fMRI maps, with the left Broca's area being the most frequently observed region of overlap. This finding was noted even in cases with lesions in Broca's or Wernicke's areas, highlighting the method's robustness. The verb task showed the best blood-oxygen-level dependent activity and overlap with rest-fMRI, highlighting its reliability. To identify a specific language area, the contralateral seed of the same area most commonly displayed connectivity with the area of interest. Conclusion Our findings demonstrate the potential of using rest-fMRI in accurately mapping eloquent language areas, in clinical settings The strong concordance observed, especially in the left Broca's area, underscores the reliability of this method. Further research and larger studies are essential to validate these results, potentially establishing the use of routine rest-fMRI, in clinical preoperative workup.