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Retrospective Comparison of Operational Metrics Across Diagnostic Approaches for Molecular Testing in Lung and Colon Cancers in a Community-Based Setting.

CONTEXT.—: Identifying oncogenic driver mutations in non-small cell lung cancer (NSCLC) and colorectal cancer (CRC) is critical for targeted therapies, requiring accurate and timely molecular testing. OBJECTIVE.—: To compare turnaround time (TAT; days from order to results), quantity not sufficient (QNS) rate, and detection rates of National Comprehensive Cancer Network-recommended alterations in NSCLC (epidermal growth factor receptor [EGFR]; MET proto-oncogene, receptor tyrosine kinase [MET] exon 14 skipping; ROS proto-oncogene 1, receptor tyrosine kinase [ROS1]; ALK receptor tyrosine kinas

Moiré fringes of photon counting grating interferometer with single-focal-spot and flat-panel X-ray sources.

BACKGROUND: The cold-cathode flat-panel X-ray sources (FPXS) achieve planar integration of X-ray point sources, which have the potential advantages of cathode addressability and anode patterning tailored to predefined imaging tasks. However, the potential benefits of the FPXS-based grating interferometer (GI) with photon-counting detectors (PCD) remain to be determined. PURPOSE: In this work, we aim to study if the moiré fringes of the FPXS-based photon-counting GI (PCGI) can be formed by utilizing a benchtop system. MATERIALS AND METHODS: To address this issue, a dedicated in-house X-ray re

Rates of Viral Non-Suppression and Acquired HIV-1 Drug Resistance Emergence among Children during the Sociopolitical Crisis in the Northwest Region of Cameroon: A Call for Improved Monitoring Strategies.

BACKGROUND: Virological failure (VF) among children remains concerning, with high risks of HIV drug resistance (HIVDR) emergence and increased disease progression. Therefore, monitoring of viral non-suppression and emerging HIVDR is crucial, especially in the frame of sociopolitical unrest. OBJECTIVE: The study sought to determine the prevalence of VF and evaluate the acquired HIVDR and viral genetic diversity among children in the Northwest region of Cameroon during the ongoing sociopolitical crisis. METHODS: A cross-sectional facility-based study was conducted among HIV-infected children a

Surgical management of brain-stem cavernous malformations: report of 137 cases.

BACKGROUND: With the improvement in neuroimaging and microsurgical techniques, brain stem cavernous malformations are no longer considered inoperable. Surgical indications for brainstem cavernoma are evolving, with better understanding of its natural history and decreasing surgical complications. METHODS: During 1986 through 1998, a series of 137 patients (4 patients each with two brain stem lesions, total number of lesions, 141) with brain stem cavernous malformations were treated microsurgically at Beijing Neurosurgery Institute. The age distribution, lesion location, and clinical presentat

Implementing Diabetic Eye Care in Rural Primary Care Through Teleophthalmology and Pop-Up Clinics: Mixed Methods Study.

BACKGROUND: Diabetic retinopathy is the leading cause of blindness in US adults. Fewer than half of patients with diabetes in rural areas co … lly disadvantaged, with the lowest proportions reporting no transportation needs (42/91, 46.2%), no housing instability (28/91, 30.8%), and no food insecurity (36/91, 39.6%). Over 18 months, 58.4% (52/89) of scheduled pop-up clinic appointments were completed, and 92.3% (36/39) of teleophthalmology images were gradable. Pop-up clinics detected higher rates of diabeti …

Residential Neighborhood Disadvantage and Access to Kidney Transplantation.

IMPORTANCE: Residence in a disadvantaged neighborhood is a key driver of racial and ethnic disparities in the diagnosis and management of ch … ge score (built environment disadvantage, criminal injustice, education disadvantage, unemployment, housing instability, poverty, social fragmentation, transportation barrier, and wealth inequality) ascertained by American Community Survey and other public data sources. MAIN OUTCOMES AND MEASURES: The adjusted hazard ratios (AHRs) of waitlisting and KT (any KT, live …

Methamphetamine Use, Methamphetamine Use Disorder, and Associated Overdose Deaths Among US Adults.

IMPORTANCE: Mortality associated with methamphetamine use has increased markedly in the US. Understanding patterns of methamphetamine use ma … equent use included lower educational attainment, lower annual household income, lack of insurance, housing instability, criminal justice involvement, comorbidities (eg, HIV/AIDS, hepatitis B or C virus, depression), suicidal ideation, and polysubstance use. CONCLUSIONS AND RELEVANCE: This cross-sectional study found consistent upward trends in overdose mortality, g …

Socioeconomic and Clinical Determinants Driving Access to BRCA Genetic Testing in Cancer : A Case-Control Study Using Observational Electronic Health Records Across Multiple Sites.

IMPORTANCE: BRCA genetic testing is critical for cancer risk assessment, treatment and personalization, yet substantial underutilization persists. Socioeconomic and clinical factors may strongly influence testing uptake; therefore, identifying the potential drivers to BRCA testing and treatment is essential for addressing gaps in access, increasing retention into care, and improving cancer outcomes. OBJECTIVE: To quantify the putatively causal effects of SDoH on BRCA genetic testing among individuals with breast, ovarian, pancreatic, and prostate cancers and to develop a predictive model to i

Behavioural variability, physical activity, rumination time, and milk characteristics of dairy cattle in response to regrouping.

In the commercial dairy industry worldwide, it is common practice to periodically regroup cows as part of their management strategy within housed systems. While this animal husbandry practice is intended to improve management efficiency, cows may experience social stress as a result of the social environment changes, which may have an impact on their behavioural patterns, performance, and welfare. We investigated whether regrouping altered dairy cows' behaviour and impacted their cortisol concentration (a physiological marker of stress), oxytocin, milk yield, and quality in a robotic milking s

[10-Year Follow-Up of the NexGen CR Total Knee Prosthesis].

BACKGROUND: The purpose of this study was to evaluate long-term clinical and radiological results as well as survival rates of the NexGen® CR posterior cruciate retaining prosthesis. PATIENTS AND METHODS: We evaluated a consecutive series of 761 total knee replacements performed on 716 patients from 1999 to 2001 at our institution. All patients had been recorded prospectively in our in-house arthroplasty register. Follow-up data were available for 379 patients at 10 years postoperatively. Functional outcome was evaluated using the Knee Society score. An additional radiographic evaluation was

Pre-Exposure Prophylaxis Barriers, Facilitators and Unmet Need Among Rural People Who Inject Drugs: A Qualitative Examination of Syringe Service Program Client Perspectives.

BACKGROUND: People who inject drugs (PWID) are at high risk for HIV infection, yet in rural areas PWID are understudied with respect to prev … e, knowledge of PrEP, perceived barriers to PrEP, as well as aspects of the risk environment (e.g., housing instability, community stigma) that may impact PrEP uptake. Interviews were digitally recorded, transcribed verbatim and verified by project staff. A detailed coding scheme was developed and applied by independent coders using NVivo. Coded transcripts were synt …

Transforaminal Percutaneous Endoscopic Discectomy and Foraminoplasty after Lumbar Spinal Fusion Surgery.

BACKGROUND: The most common causes of pain following lumbar spinal fusions are residual herniation, or foraminal fibrosis and foraminal stenosis that is ignored, untreated, or undertreated. The original surgeon may advise his patient that nothing more can be done in his opinion that the nerve was visually decompressed by the original surgery. Post-operative imaging or electrophysiological assessment may be inadequate to explain all the reasons for residual or recurrent symptoms. Treatment of failed lumbar spinal fusions by repeat traditional open revision surgery usually incorporates more exte

Analysis of a pan-cancer panel reveals the amino acid metabolism-related gene MTHFD1 as a potential prognostic and immunotherapeutic biomarker.

Methylenetetrahydrofolate dehydrogenase 1 (MTHFD1) serves a role in amino acid metabolism and may influence tumor progression. However, to the best of our knowledge, a comprehensive analysis of MTHFD1 in various types of cancer has not been previously performed. Therefore, the present study aimed to investigate the expression profile and prognostic implication of MTHFD1 across various types of cancer, whilst assessing its potential as a novel biomarker and therapeutic target. The expression of MTHFD1 in tissues from various types of cancer was analyzed using online tools based on data from the

Managing Spontaneous Abortion Hemorrhage: An Adult Simulation Case for Emergency Medicine Residents.

AUDIENCE: This simulation is intended for emergency medicine residents, PGY 1-4. INTRODUCTION: Postpartum hemorrhage (PPH) is defined as cumulative blood loss ≥1000 mL or any postpartum bleeding with signs of hypovolemia within 24 hours of delivery. Post-abortion hemorrhage (PAH) has no single universally adopted numeric definition but clinically is defined as excessive bleeding following spontaneous or induced abortion that results in hemodynamic instability, need for transfusion, hospital admission, or procedural intervention. Due to its rarity, PAH may be underrecognized and thus is the ta

Endoscopic foraminal decompression for failed back surgery syndrome under local anesthesia.

BACKGROUND: The most common causes of failed back surgery are residual or recurrent herniation, foraminal fibrosis and foraminal stenosis that is ignored, untreated, or undertreated. Residual back ache may also be from facetal causes or denervation and scarring of the paraspinal muscles.(1-6) The original surgeon may advise his patient that nothing more can be done on the basis of his opinion that the nerve was visually decompressed by the original surgery, supported by improved post-op imaging and follow-up studies such as EMG and conduction velocity studies. Post-op imaging or electrophysiol

Interventions to reduce tobacco use in people experiencing homelessness.

BACKGROUND: Populations experiencing homelessness have high rates of tobacco use and experience substantial barriers to cessation. Tobacco-c … cialized Register, MEDLINE, Embase and PsycINFO for studies using the terms: un-housed*, homeless*, housing instability, smoking cessation, tobacco use disorder, smokeless tobacco. We also searched trial registries to identify unpublished studies. Date of the most recent search: 06 January 2020. SELECTION CRITERIA: We included randomized controlled trials that recru …

Impact of telemedicine on the practice of pediatric cardiology in community hospitals.

BACKGROUND: Tele-echocardiography has the potential to bring real-time diagnoses to neonatal facilities without in-house pediatric cardiologists. Many neonates in rural areas, smaller cities, and community hospitals do not have immediate access to pediatric sonographers or echocardiogram interpretation by pediatric cardiologists. This can result in suboptimal echocardiogram quality, delay in initiation of medical intervention, unnecessary patient transport, and increased medical expenditures. Telemedicine has been used with increased frequency to improve efficiency of pediatric cardiology care

SARS-CoV-2 Infection, Hospitalization, and Mortality in Adults With and Without Cancer.

ImportancePatients with cancer are at increased risk of SARS-CoV-2-associated adverse outcomes.ObjectiveTo determine the associations of tumor type with SARS-CoV-2 infection, hospitalization, intensive care unit (ICU) admission, and death.Design, setting, and participantsThis retrospective, population-based cohort study included community-dwelling adults aged at least 18 years in Ontario, Canada, ICES-linked provincial health databases from January 1, 2020, to November 30, 2021. Data were analyzed from December 1, 2021, to November 1, 2022.ExposuresCancer diagnosis.Main outcomes and measuresTh

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… Instability quintile measures area-level concentration of people who experience high rates of family or housing instability. … Instability quintile measures area-level concentration of people who experience high rates of family or housing instability. …

Social Susceptibility to Multiple Air Pollutants in Cardiovascular Disease.

INTRODUCTION: Cardiovascular disease (CVD) is the leading cause of death in the United States, and substantial research has linked ambient a … redictable chronic stressors in many lower-SEP communities, including violence, job insecurity, and housing instability. As such, elucidating susceptibility to pollution in the etiology of CVD, and in the risk of CVD events, has been identified as a research priority. This interplay among social and environmental conditions may be particularly relevant for CVD, becau …

Impact of Social Needs and Identity Experiences on the Burden of Illness in Patients with Multiple Myeloma: A Mixed-Methods Study.

Multiple myeloma (MM) is a common hematologic malignancy, but due to its incurable nature, patients experience many relapses in their lifetime and hence face unique challenges. This mixed-methods study consisting of an online survey and subsequent focus groups aimed to understand how social and identity experiences affected the diagnostic, treatment, and care journey for patients with MM. Twenty-three adult patients with MM participated in this study. The survey participants identified common determinants negatively impacting their health, including mental health concerns (experienced by 90.5%