Utilization of Advance Care Planning for Homeless Adults: Case Studies.

Given the barriers to advance care planning (ACP) and low utilization of outpatient advance directives in hospital settings, it is unclear if ACP in primary care for adults who have experienced homelessness is effective and a valuable use of clinical time. As part of our ACP Project, we examined the feasibility and outcomes of ACP in primary care for patients who have experienced homelessness. We found that such efforts had significant impacts on patients' hospital care and allowed their wishes to be honored when they lost capacity for medical decision-making, particularly at the end of life. Here, we present six case studies demonstrating the outcomes of ACP in primary care for homeless adults and highlight lessons learned. To our knowledge, this is the first case series showing how ACP for homeless adults in primary care has been utilized during hospital care. Based on our findings, we believe that outpatient ACP even for the most socially vulnerable patients is feasible, often impactful, and should be integrated into routine primary care.

Melanotic neuroectodermal tumour of infancy: a case report.

Melanotic neuroectodermal tumour of infancy is a rare benign pigmented tumour that typically appears in the first year of life. We report an atypical presentation of this tumour, associated with an erupted primary tooth in a 7-month-old boy. We discuss the clinical, radiographic and histologic features of this rare tumour, as well as its surgical management and the follow-up treatment plan.

Quantifying research interests in 7,521 mammalian species with h-index: a case study.

BACKGROUND: Taxonomic bias is a known issue within the field of biology, causing scientific knowledge to be unevenly distributed across species. However, a systematic quantification of the research interest that the scientific community has allocated to individual species remains a big data problem. Scalable approaches are needed to integrate biodiversity data sets and bibliometric methods across large numbers of species. The outputs of these analyses are important for identifying understudied species and directing future research to fill these gaps. FINDINGS: In this study, we used the species h-index to quantity the research interest in 7,521 species of mammals. We tested factors potentially driving species h-index, by using a Bayesian phylogenetic generalized linear mixed model (GLMM). We found that a third of the mammals had a species h-index of zero, while a select few had inflated research interest. Further, mammals with higher species h-index had larger body masses; were found in temperate latitudes; had their humans uses documented, including domestication; and were in lower-risk International Union for Conservation of Nature Red List categories. These results surprisingly suggested that critically endangered mammals are understudied. A higher interest in domesticated species suggested that human use is a major driver and focus in mammalian scientific literature. CONCLUSIONS: Our study has demonstrated a scalable workflow and systematically identified understudied species of mammals, as well as identified the likely drivers of this taxonomic bias in the literature. This case study can become a benchmark for future research that asks similar biological and meta-research questions for other taxa.