Parastomal hernia after ileal conduit: Incidence, natural history and risk factors.

INTRODUCTION: Parastomal hernias are a challenging complication of digestive ostomies. Ileal-conduit parastomal hernias after cystectomy have specific aspects. The aim of this study was to describe the incidence and natural history of ileal-conduit parastomal hernias in order to guide their management, as well as to identify risk factors to prevent them. PATIENTS AND METHODS: All consecutive patients undergoing cystectomy with a Bricker's ileal conduit in 3 academic centers were retrospectively identified. Data were collected regarding their medical history prior to cystectomy, the operation, the postoperative period, imaging results within 5 years of follow-up, and the onset and timing of clinically or radiologically diagnosed ICPH. RESULTS: Among 577 patients included in the study, 115 (20.6%) developed an ICPH during the study period. Most patients did not present any symptom and the diagnosis was made at imaging in 74.8% of them. Most hernias were detected between 1 and 2 years after the cystectomy, with a mean time to diagnosis of 12.4 months. At multivariate analysis, overweight and obesity were independent risk factors for developing an ICPH (adjusted hazard ratio [aHR] 1.96; p = 0.046), while a trans-rectus position of the ostomy was a significant protective factor (aHR 0.45; p = 0.011). CONCLUSIONS: A PH develops in almost 20% of patients after ileal conduit urinary diversion, with a mean time of onset of 12.4 months. It is often a subclinical condition detected at medical imaging. Obesity increases the risk, while passing the ileal-conduit through the rectus muscle can help to prevent it.

Ni-Based Materials for Industrial Alkaline Hydrogen Production.

Hydrogen has been recognized as a green energy carrier, which can relieve energy shortage and environmental pollution. Currently, alkaline water electrolysis (AWE) driven by renewable energy to produce large-scale green hydrogen is a mainstream technology. However, tardy cathodic hydrogen evolution reaction (HER) and stability issue of catalysts make it challenging to meet the industrial requirements. Ni-based materials have attracted wide attention, thanks to their low cost and rich tuning possibilities, and many efforts have focused on their activity and stability. However, due to the significant discrepancy between laboratory and industrial conditions, these catalysts have not been widely deployed in industrial AWE. In this review, we first introduce the differences between laboratory and industrial stage, especially concerning equipment, protocols and evaluation metrics. To shorten these gaps, some strategies are proposed to improve the activity and stability of the Ni-based catalysts. Besides, some key issues related to the catalysts in industrial AWE device are also emphasized, including reverse-current and foreign ions in the electrolyte. Finally, the challenges and outlooks on the industrial alkaline AWE are discussed.

PMEL is involved in snake colour pattern transition from blotches to stripes.

Corn snakes are emerging models for animal colouration studies. Here, we focus on the Terrazzo morph, whose skin pattern is characterized by stripes rather than blotches. Using genome mapping, we discover a disruptive mutation in the coding region of the Premelanosome protein (PMEL) gene. Our transcriptomic analyses reveal that PMEL expression is significantly downregulated in Terrazzo embryonic tissues. We produce corn snake PMEL knockouts, which present a comparable colouration phenotype to Terrazzo and the subcellular structure of their melanosomes and xanthosomes is also similarly impacted. Our single-cell expression analyses of wild-type embryonic dorsal skin demonstrate that all chromatophore progenitors express PMEL at varying levels. Finally, we show that in wild-type embryos PMEL-expressing cells are initially uniformly spread before forming aggregates and eventually blotches, as seen in the adults. In Terrazzo embryos, the aggregates fail to form. Our results provide insights into the mechanisms governing colouration patterning in reptiles.

Contributions of birds to the feeding of ticks at host community level: Effects of tick burden, host density and yearly fluctuations.

The eco-epidemiology of tick-borne diseases hinges on the abundance and distribution of hosts that sustain tick populations and the pathogens they carry. Research into the role of bird species in the feeding of Ixodes ricinus ticks, the primary tick species of veterinary and public health importance in Europe, remains scarce. This study endeavors to bridge these knowledge gaps by (i) assessing the density of feeding ticks (DFT) within a bird community to pinpoint species making substantial contributions, and (ii) exploring interannual variations in DFT over an extended timeline. Furthermore, we investigate whether variations in individual tick burden (TB) were more closely associated with the characteristics of bird species or interannual variations affecting the density of questing tick, using interannual TB variation as a surrogate. To fulfill these aims, we conducted a 13-year longitudinal study monitoring I. ricinus ticks feeding on a bird community in a periurban forest in France, covering breeding periods from 2007 to 2019. Within this community, we identified seven principal bird species significantly contributing to I. ricinus tick feeding: the Common Blackbird (Turdus merula), the Song Thrush (Turdus philomelos), the European Robin (Erithacus rubecula), the Dunnock (Prunella modularis), the Eurasian Blackcap (Sylvia atricapilla), the Great Tit (Parus major), and the Common Nightingale (Luscinia megarhynchos). Our results show that the bird community's contribution to tick feeding remained relatively consistent from year-to-year, though certain years displayed higher or lower DFT values related to the average over the study period. Moreover, five out the seven major species accounted for 80 % to 95 % of DFT annually. Consequently, we emphasized the need to broaden the scope of future research on bird contributions to tick population dynamics beyond merely thrushes (Turdidae species), to encompass a more diverse range of species, particularly those common birds that engage in ground foraging activities. Furthermore, variations in individual tick burden were predominantly influenced by the characteristics of bird species rather than by interannual variability in infestation rates. This finding suggests a significant role for species-specific traits in determining tick exposure and susceptibility. In conclusion, our study offers new insights into the medium-term dynamics of tick-bird ecological systems, underscoring the need for future study of tick populations and their interactions with vertebrate hosts to improve our understanding of tick-borne disease circulation.

Gestational age, maternal smoking, neurological lesion and retinopathy predict strabismus at age 5.5 in preterm children.

AIM: Prematurity is a risk factor for strabismus, but the roles of intermediate factors like retinopathy of prematurity (ROP) and neurological lesions are less understood. We aimed to identify neonatal risk factors for strabismus at age 5.5 in preterm children. METHODS: Data were extracted from the étude épidémiologique sur les petits âges gestationnels 2 cohort, a French prospective population-based study of preterm children born in 2011 with gestational age of 34 weeks or less. Strabismus was recorded during a medical interview at 5.5 years. Using a directed acyclic graph, intermediate and confounding factors were identified. Total and direct effects of gestational age on strabismus risk were analysed using generalised estimating equation. RESULTS: Among 2419 children assessed, 274 (52.6% male) presented strabismus at 5.5 years. The direct effect of gestational age remained significant after adjustment (p < 0.001). In the complete imputed model: maternal smoking during pregnancy (odds ratio, OR 1.8; 95% confident interval, 95% CI 1.3-2.6), neonatal severe cerebral lesions (OR 2.9, 95% CI 1.8-4.6) and severe ROP (OR 4.2, 95% CI 1.9-9.0) were independent risk factors. CONCLUSION: Special attention is needed regarding strabismus screening at age 5.5 in preterm children, even without severe cerebral lesions and ROP. Smoking cessation during pregnancy should be encouraged.

Comparison of Performance for Cochlear-Implant Listeners Using Audio Processing Strategies Based on Short-Time Fast Fourier Transform or Spectral Feature Extraction.

OBJECTIVES: We compared sound quality and performance for a conventional cochlear-implant (CI) audio processing strategy based on short-time fast-Fourier transform (Crystalis) and an experimental strategy based on spectral feature extraction (SFE). In the latter, the more salient spectral features (acoustic events) were extracted and mapped into the CI stimulation electrodes. We hypothesized that (1) SFE would be superior to Crystalis because it can encode acoustic spectral features without the constraints imposed by the short-time fast-Fourier transform bin width, and (2) the potential benefit of SFE would be greater for CI users who have less neural cross-channel interactions. DESIGN: To examine the first hypothesis, 6 users of Oticon Medical Digisonic SP CIs were tested in a double-blind design with the SFE and Crystalis strategies on various aspects: word recognition in quiet, speech-in-noise reception threshold (SRT), consonant discrimination in quiet, listening effort, melody contour identification (MCI), and subjective sound quality. Word recognition and SRTs were measured on the first and last day of testing (4 to 5 days apart) to assess potential learning and/or acclimatization effects. Other tests were run once between the first and last testing day. Listening effort was assessed by measuring pupil dilation. MCI involved identifying a five-tone contour among five possible contours. Sound quality was assessed subjectively using the multiple stimulus with hidden reference and anchor (MUSHRA) paradigm for sentences, music, and ambient sounds. To examine the second hypothesis, cross-channel interaction was assessed behaviorally using forward masking. RESULTS: Word recognition was similar for the two strategies on the first day of testing and improved for both strategies on the last day of testing, with Crystalis improving significantly more. SRTs were worse with SFE than Crystalis on the first day of testing but became comparable on the last day of testing. Consonant discrimination scores were higher for Crystalis than for the SFE strategy. MCI scores and listening effort were not substantially different across strategies. Subjective sound quality scores were lower for the SFE than for the Crystalis strategy. The difference in performance with SFE and Crystalis was greater for CI users with higher channel interaction. CONCLUSIONS: CI-user performance was similar with the SFE and Crystalis strategies. Longer acclimatization times may be required to reveal the full potential of the SFE strategy.

Brain growth until adolescence after a neonatal focal injury: sex related differences beyond lesion effect.

Introduction: Early focal brain injuries lead to long-term disabilities with frequent cognitive impairments, suggesting global dysfunction beyond the lesion. While plasticity of the immature brain promotes better learning, outcome variability across individuals is multifactorial. Males are more vulnerable to early injuries and neurodevelopmental disorders than females, but long-term sex differences in brain growth after an early focal lesion have not been described yet. With this MRI longitudinal morphometry study of brain development after a Neonatal Arterial Ischemic Stroke (NAIS), we searched for differences between males and females in the trajectories of ipsi- and contralesional gray matter growth in childhood and adolescence, while accounting for lesion characteristics. Methods: We relied on a longitudinal cohort (AVCnn) of patients with unilateral NAIS who underwent clinical and MRI assessments at ages 7 and 16 were compared to age-matched controls. Non-lesioned volumes of gray matter (hemispheres, lobes, regions, deep structures, cerebellum) were extracted from segmented T1 MRI images at 7 (Patients: 23 M, 16 F; Controls: 17 M, 18 F) and 16 (Patients: 18 M, 11 F; Controls: 16 M, 15 F). These volumes were analyzed using a Linear Mixed Model accounting for age, sex, and lesion characteristics. Results: Whole hemisphere volumes were reduced at both ages in patients compared to controls (gray matter volume: -16% in males, -10% in females). In ipsilesional hemisphere, cortical gray matter and thalamic volume losses (average -13%) mostly depended on lesion severity, suggesting diaschisis, with minimal effect of patient sex. In the contralesional hemisphere however, we consistently found sex differences in gray matter volumes, as only male volumes were smaller than in male controls (average -7.5%), mostly in territories mirroring the contralateral lesion. Females did not significantly deviate from the typical trajectories of female controls. Similar sex differences were found in both cerebellar hemispheres. Discussion: These results suggest sex-dependent growth trajectories after an early brain lesion with a contralesional growth deficit in males only. The similarity of patterns at ages 7 and 16 suggests that puberty has little effect on these trajectories, and that most of the deviation in males occurs in early childhood, in line with the well-described perinatal vulnerability of the male brain, and with no compensation thereafter.

An Unusual Case of HHV-8 Negative, Idiopathic, Multicentric Castleman Disease Following Chronic Lymphocytic Leukaemia.

Background: Castleman disease is a rare condition characterised by polytypic lymphocytes proliferation and lymphadenopathy generally with a benign course. Whereas high grade lymphoma (Richter syndrome) is a classical complication seen in chronic lymphocytic leukaemia with a poor outcome, benign conditions mimicking this entity are infrequent. Case description: We describe the case of an 81-year-old Caucasian male who developed a human herpesvirus-8 (HHV-8)-negative, idiopathic multicentric Castleman disease (iMCD) following a treated Binet C chronic lymphocytic leukaemia (CLL). The clinical and radiological pattern raised initially the suspicion of a classical Richter transformation. Blood analysis showed auto-immune haemolytic anaemia and thrombocytopenia. He had normal immunoglobulin levels. The anatomopathological analysis of a cervical adenomegaly showed hypervascularisation and a polytypic plasmocytic proliferation compatible with a plasmocytic iMCD type. Interestingly, bone marrow examination showed reticuline fibrosis but, in the absence of anasarca or generalised oedema, we were not allowed to conclude to the diagnosis of a TAFRO syndrome. We excluded all other mimicking conditions, comprising haematological malignancies, infections, and auto-immune diseases He was first treated with corticosteroids with poor results but dramatically responded to tocilizumab (anti-Il6). Conclusion: To our knowledge, this the first case described of a Castleman disease following CLL and surprisingly mimicking Richter syndrome. Clinicians should be aware of this rare misleading condition. LEARNING POINTS: Castleman disease can mimic a Richter transformation in a CLL patient.

Transfer Learning Approach to Multitarget QSRR Modeling in RPLC.

QSRR is a valuable technique for the retention time predictions of small molecules. This aims to bridge the gap between molecular structure and chromatographic behavior, offering invaluable insights for analytical chemistry. Given the challenge of simultaneous target prediction with variable experimental conditions and the scarcity of comprehensive data sets for such predictive modelings in chromatography, this study introduces a transfer learning-based multitarget QSRR approach to enhance retention time prediction. Through a comparative study of four models, both with and without the transfer learning approach, the performance of both single and multitarget QSRR was evaluated based on Mean Squared Error (MSE) and R2 metrics. Individual models were also tested for their performance against benchmark studies in this field. The findings suggest that transfer learning based multitarget models exhibit potential for enhanced accuracy in predicting retention times of small molecules, presenting a promising avenue for QSRR modeling. These models will be highly beneficial for optimizing experimental conditions in method development by better retention time predictions in Reversed-Phase Liquid Chromatography (RPLC). The reliable and effective predictive capabilities of these models make them valuable tools for pharmaceutical research and development endeavors.

Surface enhanced transmission Raman spectroscopy: Quantitative performances for impurity analysis in complex matrices.

A transmission detection mode was investigated with SERS analyses (SETRS). A comparison between backscattering and transmission detection modes was conducted to demonstrate the feasibility of performing SETRS analyses. The impact of various parameters on the SERS signal intensity such as sample volume, lens collection optic, laser beam size and laser power were then examined. The analytical performances of SETRS were further evaluated through the quantification of an impurity (4-aminophenol) ranging from 3 to 20 µg/mL in a commercial pharmaceutical product using a total error risk-based approach. To account for expected variability of routine analysis, 9 batches of silver nanoparticles suspensions were used and experiments were performed over 5 different days and by 2 operators. Univariate spectral analysis based on a quadratic regression was compared to a multivariate approach using a partial least square regression. The presented results demonstrated that SETRS can be used to determine an impurity in a complex matrix opening new perspectives for quantitative applications.

Case-control study of the characteristics and risk factors of hot clot artefacts on 18F-FDG PET/CT.

INTRODUCTION: The pulmonary Hot Clot artifact (HCa) on 18F-FDG PET/CT is a poorly understood phenomenon, corresponding to the presence of a focal tracer uptake without anatomical lesion on combined CTscan. The hypothesis proposed in the literature is of microembolic origin. Our objectives were to determine the incidence of HCa, to analyze its characteristics and to identify associated factors. METHODS: All 18F-FDG PET/CT retrieved reports containing the keywords (artifact/vascular adhesion/no morphological abnormality) during the period June 2021-2023 at Brest University Hospital were reviewed for HCa. Each case was associated with 2 control patients (same daily work-list). The anatomical and metabolic characteristics of HCa were analyzed. Factors related to FDG preparation/administration, patient and vascular history were investigated. Case-control differences between variables were tested using Chi-2 test and OR (qualitative) or Student's t-test (quantitative). RESULTS: Of the 22,671 18F-FDG PET/CT performed over 2 years, 211 patients (0.94%) showed HCa. The focus was single in 97.6%, peripheral in 75.3%, and located independently in the right or left lung (51.1% vs. 48.9%). Mean ± SD values for SUVmax, SUVmean, MTV and TLG were 11.3 ± 16.5, 5.1 ± 5.0, 0.3 ± 0.3 ml and 1.5 ± 2.1 g respectively. The presence of vascular adhesion (p < 0.001), patient age (p = 0.002) and proximal venous access (p = 0.001) were statistically associated with the presence of HCa. CONCLUSION: HCa is a real but rare phenomenon (incidence around 1%), mostly unique, intense, small in volume (< 1 ml), and associated with the presence of vascular FDG uptake, confirming the hypothesis of a microembolic origin due to probable vein wall trauma at the injection site.

Stick to your role! Stability of personal values expressed in large language models.

The standard way to study Large Language Models (LLMs) through benchmarks or psychology questionnaires is to provide many different queries from similar minimal contexts (e.g. multiple choice questions). However, due to LLM's highly context-dependent nature, conclusions from such minimal-context evaluations may be little informative about the model's behavior in deployment (where it will be exposed to many new contexts). We argue that context-dependence should be studied as another dimension of LLM comparison alongside others such as cognitive abilities, knowledge, or model size. In this paper, we present a case-study about the stability of value expression over different contexts (simulated conversations on different topics), and as measured using a standard psychology questionnaire (PVQ) and behavioral downstream tasks. We consider 21 LLMs from six families. Reusing methods from psychology, we study Rank-order stability on the population (interpersonal) level, and Ipsative stability on the individual (intrapersonal) level. We explore two settings: with and without instructing LLMs to simulate particular personalities. We observe similar trends in the stability of models and model families-Mixtral, Mistral, GPT-3.5 and Qwen families being more stable than LLaMa-2 and Phi-over those two settings, two different simulated populations, and even on three downstream behavioral tasks. When instructed to simulate particular personas, LLMs exhibit low Rank-Order stability, and this stability further diminishes with conversation length. This highlights the need for future research directions on LLMs that can coherently simulate a diversity of personas, as well as how context-dependence can be studied in more thorough and efficient ways. This paper provides a foundational step in that direction, and, to our knowledge, it is the first study of value stability in LLMs. The project website with code is available at https://sites.google.com/view/llmvaluestability.

miR-876-3p is a tumor suppressor on 9p21 that is inactivated in melanoma and targets ERK.

BACKGROUND: While melanomas commonly harbor losses of 9p21, on which CDKN2A resides, the presence of additional tumor suppressor elements at this locus is incompletely characterized. Here we assess the expression levels and functional role of microRNA-876-3p (miR-876), whose gene also maps to 9p21. METHODS: Expression of miR-876 was assessed in human tissues and cell lines using quantitative miRNA reverse transcriptase polymerase chain reaction (qRT-PCR). MIR876 copy number was determined in The Cancer Genome Atlas (TCGA) melanoma cohort. The consequences of regulation of miR-876 expression were assessed on melanoma cell colony formation, migration, invasion, apoptosis, cell cycle progression, and drug sensitivity in culture, and on in vivo tumor growth in a xenograft model. Genome-wide transcriptomic changes induced by miR-876 overexpression were determined using RNA sequencing (RNA-Seq). RESULTS: miR-876 expression was significantly decreased in primary melanoma samples when compared with nevi, and in human melanoma cell lines when compared with human melanocytes. Analysis of the TCGA cohort revealed deletions in MIR876 in > 50% of melanomas. miR-876 overexpression resulted in decreased melanoma cell colony formation, migration, and invasion, which was accompanied by cell cycle arrest and increased apoptosis. Intra-tumoral injections of miR-876 significantly suppressed melanoma growth in vivo. RNA-Seq analysis of miR-876-treated tumors revealed downregulation of several growth-promoting genes, along with upregulation of tumor suppressor genes, which was confirmed by qRT-PCR analysis. Computational analyses identified MAPK1 (or ERK2) as a possible target of miR-876 action. Overexpression of miR-876 significantly suppressed luciferase expression driven by the MAPK1/ERK2 3' UTR, and resulted in decreased ERK protein expression in melanoma cells. MAPK1/ERK2 cDNA overexpression rescued the effects of miR-876 on melanoma colony formation. miR-876 overexpression sensitized melanoma cells to treatment with the BRAF inhibitor vemurafenib. CONCLUSIONS: These studies identify miR-876 as a distinct tumor suppressor on 9p21 that is inactivated in melanoma and suggest miR-876 loss as an additional mechanism to activate ERK and the mitogen activated protein kinase (MAPK) pathway in melanoma. In addition, they suggest the therapeutic potential of combining miR-876 overexpression with BRAF inhibition as a rational therapeutic strategy for melanoma.

Synthesis of Well-Defined Poly(vinyl alcohol-co-vinyl acetate) Copolymers by Alcoholysis of Poly(vinyl acetate) Synthesized by Macromolecular Design via Interchange of Xanthate Polymerization, and Their Use as a Stabilizer in Emulsion (Co)polymerization of Vinyl Acetate.

This work aims at synthesizing tailor-made poly(vinyl alcohol-co-vinyl acetate) (PVA) amphiphilic copolymers, obtained by alcoholysis of poly(vinyl acetate) (PVAc) that could display improved properties as stabilizers compared to commercially available PVAs. Well-defined PVAs with different alcoholysis degrees were produced from a library of PVAc homopolymers synthesized by macromolecular design via interchange of xanthate polymerization and exhibiting different degrees of polymerization degrees. Subsequently, these PVAs were evaluated as stabilizers in the emulsion copolymerization of VAc and vinyl neodecanoate (VERSA 10, referred to as V10) and compared to a commercially available reference PVA obtained by alcoholysis of PVAc formed by conventional radical polymerization. In all cases, stable latexes were obtained and compared in terms of their colloidal characteristics. To identify the best stabilizer candidate, the amount of PVA remaining in water and not participating to the particle stabilization was evaluated in each case.

Performance and Interpretation of Lung Scintigraphy: An Evaluation of Current Practices in Australia, Canada, France, Germany, and United States.

PURPOSE: Although ventilation/perfusion (V/Q) scintigraphy is a widely used imaging test, different options are possible for the acquisition and interpretation of the scan. The aim of this study was to assess current practices regarding the use and interpretation of lung scintigraphy in various clinical indications. PATIENTS AND METHODS: An online survey comprising 25 questions was sent to nuclear medicine departments in Australia, Canada, France, Germany, and United States between 2022 and 2023. A single response per department was consolidated. RESULTS: Four hundred nineteen responses were collected (Australia: 32, Canada: 58, France: 149, Germany: 92, and United States: 88). For acute pulmonary embolism (PE) diagnosis, 82.8% of centers reported using SPECT acquisitions (Australia: 93.3%, Canada: 91.8%, France: 99.2%, Germany: 96.2%, and United States: 32.1%). Among them, SPECT images were combined with a CT scan in 70.5% of centers. A total of 10.6% of centers reported not using ventilation for acute PE diagnosis. SPECT acquisition was used in 97.8% of centers using 99m Tc carbon particles, 97.1% 81m Kr gas, 58.7% 99m Tc-DTPA, and 19.4% 133 Xe gas, respectively. For V/Q SPECT interpretation, the EANM criteria were used in 65.0% of departments. A very wide variety of practices were observed in pregnant women and in COVID-19 patients. SPECT acquisition was widely used in the follow-up of PE and for the screening of chronic thromboembolic pulmonary hypertension (>90% of centers), with inconsistency regarding the interpretation of matched perfusion defects in this setting. CONCLUSIONS: This survey shows the strong adoption of SPECT in the various clinical indications of lung scintigraphy, except in the United States, where planar imaging is still mostly used. The survey also shows variability in interpretation criteria both for PE diagnosis and screening for chronic thromboembolic pulmonary hypertension, highlighting the need for further standardizations of practices.

Hysteroscopic metroplasty: Ultrasound parameters to optimize fertility benefits?

INTRODUCTION: Metroplasty is a procedure used by some teams to correct certain uterine anomalies to improve fertility outcomes. Our goal was to evaluate hysteroscopic metroplasty in the management of nulliparous and infertile patients with a uterine anomalies. MATERIAL AND METHODS: We conducted a single-center, retrospective, observational study of women who underwent hysteroscopic metroplasty for infertility between January 1, 2015 and December 31, 2019. The primary endpoint was the occurrence of a live birth at 18 months post-surgery. The secondary endpoint was to identify predictive factors for the success of the procedure, in particular ultrasound criteria, and live-birth rate during total follow up. RESULTS: We included 43 nulliparous patients with an average of 5.2±-2.4 years of primary infertility, including 84.2 % patients who had at least one IVF cycle prior to the surgery. The mean age was 37±5 years. The post-surgery live-birth rate was 27.9 % at 18 months and 53.5 % during the total postoperative follow-up (mean follow-up 4.5 ± 1 years). Pregnancies were obtained spontaneously after surgery for 8/28 (28.6 %) patients who were undergoing assisted reproduction technology before surgery. No intra- or postoperative complications were recorded. We did not identify any predictive ultrasound factors, pre- or postoperatively, for a live birth at 18 months post-surgery. DISCUSSION: Hysteroscopic metroplasty appears to improve the chances of a live birth in a population of nulliparous and infertile patients with at least one uterine pathology. Spontaneous pregnancy can occur after hysteroscopic metroplasty. The Congenital-Ultrasound-Malformation-by-Expert ultrasound criteria do not appear to be predictive of post-surgery outcomes.

Navigating the evolving landscape of atopic dermatitis: Challenges and future opportunities: The 4th Davos declaration.

The 4th Davos Declaration was developed during the Global Allergy Forum in Davos which aimed to elevate the care of patients with atopic dermatitis (AD) by uniting experts and stakeholders. The forum addressed the high prevalence of AD, with a strategic focus on advancing research, treatment, and management to meet the evolving challenges in the field. This multidisciplinary forum brought together top leaders from research, clinical practice, policy, and patient advocacy to discuss the critical aspects of AD, including neuroimmunology, environmental factors, comorbidities, and breakthroughs in prevention, diagnosis, and treatment. The discussions were geared towards fostering a collaborative approach to integrate these advancements into practical, patient-centric care. The forum underlined the mounting burden of AD, attributing it to significant environmental and lifestyle changes. It acknowledged the progress in understanding AD and in developing targeted therapies but recognized a gap in translating these innovations into clinical practice. Emphasis was placed on the need for enhanced awareness, education, and stakeholder engagement to address this gap effectively and to consider environmental and lifestyle factors in a comprehensive disease management strategy. The 4th Davos Declaration marks a significant milestone in the journey to improve care for people with AD. By promoting a holistic approach that combines research, education, and clinical application, the Forum sets a roadmap for stakeholders to collaborate to improve patient outcomes in AD, reflecting a commitment to adapt and respond to the dynamic challenges of AD in a changing world.

Identifying the drivers of overall rating of cancer care: Insights from the second wave of the Swiss Cancer Patient Experiences study.

BACKGROUND: Patient experience surveys gather information on various aspects of care via numerous survey items. Identifying the most critical areas of patient experience to prioritize for quality care improvement can be challenging. The objective of this study was to determine which care experience items are the drivers influencing patients' overall rating of cancer care. METHODS: Data from 2750 adult patients with cancer from the second wave of the Swiss Cancer Patient Experiences study were analyzed. This cross-sectional survey was conducted in eight Swiss hospitals from September 2021 to February 2022. Stepwise logistic regression examined the relationship between overall care rating and 29 patient experience items covering different patient-centered care dimensions while adjusting for sociodemographic and health variables. RESULTS: Overall, patients rated their cancer care experience at 8.9 out of 10. Stepwise regression identified seven drivers contributing to overall care rating. The strongest drivers were "professionals worked well together" (odds ratio [OR], 4.81) and "tests were not repeated" (OR, 2.09) from the coordination and integration dimension, "offered support for symptoms during treatment" (OR, 2.11) from the physical comfort dimension, followed by "hospital staff ensured available home support" (OR, 1.99), "offered to see health professional for concerns" (OR, 1.91), "treatment options were explained" (OR, 1.75), and "involved in treatment decisions as desired" (OR, 1.68). CONCLUSIONS: This study evaluated the care experiences of patients with cancer with a comprehensive tool that identified seven key factors independently associated with overall care rating. By concentrating on these areas, hospitals can not only improve the patient care experience but also efficiently allocate resources to quality improvement initiatives.