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Since the Open Source Initiative laid the foundation for the open source software environment in 1998, the popularity of free and open source software has been steadily increasing. Model‐informed drug discovery and development (MID3), a key component of pharmaceutical research and development, heavily makes use of computational models which can be developed using various software including the Open Systems Pharmacology (OSP) software (PK‐Sim/MoBi), a free and open source software tool for physiologically based pharmacokinetic (PBPK) modeling. In this study, we aimed to investigate the impact, application areas, and reach of the OSP software as well as the relationships and collaboration patterns between organizations having published OSP‐related articles between 2017 and 2023. Therefore, we conducted a bibliometric analysis of OSP‐related publications and a social network analysis of the organizations with which authors of OSP‐related publications were affiliated. On several levels, we found evidence for a significant growth in the size of the OSP community as well as its visibility in the MID3 community since OSP's establishment in 2017. Specifically, the annual publication rate of PubMed‐indexed PBPK‐related articles using the OSP software outpaced that of PBPK‐related articles using any software. Our bibliometric analysis and network analysis demonstrated that the expansion of the OSP community was predominantly driven by new authors and organizations without prior connections to the community involving the generation of research clusters de novo and an overall diversification of the network. These findings suggest an ongoing evolution of the OSP community toward a more segmented, diverse, and inclusive network. [ABSTRACT FROM AUTHOR]

Background: The goal of health care systems is to ensure high quality of medical services provided, including patient safety. The intensive care unit (ICU) is an environment conducive to the occurrence of adverse events and medical errors because of the complexity of the care provided, the severity of the conditions of patients treated in these units and work often performed under stressful conditions. Aim: Assessment of attitudes of nurses working in ICUs towards patient safety. Study Design: A cross‐sectional, descriptive study was conducted in a group of 214 nurses employed in ICUs in hospitals located in the southern part of Poland. The study used the Polish version of the Attitudes towards safety: (SAQ‐SF PL) questionnaire and an original questionnaire consisting of questions on socio‐demographic and professional data. Results: The overall SAQ score for the whole group was 61.89, 57.29 for adult ICU nurses and 68.20 for children's ICU. The surveyed nurses in general obtained the highest average results in terms of teamwork climate (TC)—66.92, while the lowest scores were given to the management—hospital management (PM)—45.08 and working conditions (WC)—57.56. job satisfaction (JS) positively correlated with the assessment of the TC, the assessment of the safety climate (SC), the assessment of the management staff (Head of Department) (PM), the assessment of the management staff (hospital management) (PM) and the assessment of work conditions (WC). A statistically significant, negative correlation was found between the assessment of JS and the assessment of stress recognition (SR) (r = −.20; p <.01). Conclusions: In the surveyed ICU branches, there is a low SC, and it is related, among others, to the perception of WC and the role of the management staff. The level of JS among nursing staff mainly depends on the SC, the TC, WC and the support of the management staff. Relevance to Clinical Practice: The results of the research presented here provide valuable assistance in identifying areas related to patient safety in ICUs. Managers' awareness of the importance of coping with occupational stress, WC or effective teamwork can help to improve staff attitudes and attitudes towards patient safety. When shaping a safe culture in a health care organization, it is important to remember that ensuring safe patient care is not only about programmes, standards or procedures, but safety is primarily about human resources—the staff involved in the treatment process—doctors, nurses, paramedics and physiotherapists. High awareness of safety at work, cooperation in an interdisciplinary team, assessment of safety culture at work and analysis and drawing conclusions may result in a real increase in quality and safety, and the patient will feel safer in 'XX' hospitals. [ABSTRACT FROM AUTHOR]

Objectives: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long‐term debilitating illness characterised by profound and persistent fatigue (JAMA: The Journal of the American Medical Association, 313, 2015, 1101). The current study aims to explore the experiences of women with ME/CFS living with their partners during the COVID‐19 pandemic in the United Kingdom. Design: The study adopted a qualitative design comprising semi‐structured interviews with participants. Interviews were analysed using thematic analysis (TA). Methods: Participants were women with ME/CFS (n = 21) recruited through ME/CFS support groups in the United Kingdom. All participants were in romantic relationships and lived with their partners. Results: Data were organised into three themes: (1) lockdown disrupting routine, (2) reducing difference and (3) fear of getting COVID‐19. People with ME/CFS found that lockdown disrupted their well‐established routines. Although routines were disrupted by partners and increased working‐from‐home practices, participants found having partners at home helpful. People with ME/CFS believed that the changes induced by the pandemic reduced the differences between themselves and the outside world which, prior to lockdown, had felt prominent. They were fearful of getting COVID‐19 as they believed this would make their ME/CFS worse. This meant that for people with ME/CFS, the lifting of the lockdown restrictions was an anxiety‐provoking time, hence impacting symptoms. People with ME/CFS continued to adhere to government guidelines after national restrictions were eased. Conclusions: This study outlines the experiences of women with ME/CFS during COVID‐19, alongside the long‐term impact this has had due to the changes that the pandemic imposed. These findings may have implications for those with long COVID. [ABSTRACT FROM AUTHOR]

The REPRIEVE trial investigated the use of statin therapy to prevent cardiovascular disease (CVD) in people with HIV. The trial involved over 7,700 participants from 12 countries and found that statin therapy reduced major adverse cardiovascular events by 36% over 5.6 years. This therapy was effective and safe, even for individuals without traditional risk factors. The results of the trial are applicable globally and emphasize the importance of considering factors such as sex, genetics, and local plaque biology when recommending CVD prevention therapy for people with HIV. The collaboration between various stakeholders was essential for the success of the study. [Extracted from the article]

This research letter examines the cost-effectiveness of using natriuretic peptides (NPs) to screen for and treat stage B heart failure in individuals with type 2 diabetes. The study suggests that the NP screening strategy is valuable according to American Heart Association guidelines after 7 years. However, the study has limitations, such as not considering additional therapy options and using Medicare pricing for medications and imaging studies. Further research is needed to address these limitations and determine the most effective screening strategy for clinical practice guidelines. The study was funded in part by the American Heart Association, and the authors have no conflicts of interest. The data supporting the findings are available upon request. [Extracted from the article]

Objective Materials and Methods Results Conclusions To describe the evolution and aims of the European Association for Osseointegration (EAO) Junior Committee (JC).Former members of the EAO JC and members of the board were interviewed, and current projects and initiatives were summarized.The EAO JC was launched in 2007 as the first young committee in Europe. Despite initial skepticism, it became a famous initiative, and the concept was copied by other dental and medical associations and societies. Since 2010, the committee organizes summer camps allowing young talents to discuss, network and interact beyond traditional boundaries.The EAO JC is giving fresh energy to the entire society and provides education and network opportunities for young clinicians and scientists. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion To describe the management and treatment practices of venous thromboembolism (VTE) in cancer patients, assess compliance with the 2023 European Society for Medical Oncology recommendations, and identify factors that may limit or influence their application.We conducted, in a Tunisian center, a retrospective study that included patients treated for cancer or hematologic malignancies and diagnosed with deep vein thrombosis (DVT) and/or pulmonary embolism between January 1, 2022, and August 1, 2023.The study involved 90 patients. DVTs were significantly predominant (81.1%). VTE mostly occurred within 3 months of the cancer diagnosis (41.1%). All patients received anticoagulant treatment. The most frequently prescribed class of anticoagulants was direct oral anticoagulants (42.2%), followed by low molecular weight heparin (36.7%), and finally vitamin K antagonists (21.1%). Financial constraints and/or refusal of social security to provide the treatment were the main cause for changes in the anticoagulant therapy (16.7%). Deaths (25.5%) and repermeabilization of the initially thrombosed venous network on imaging (11.1%) were the two primary reasons for treatment discontinuation. Bleeding complication was the cause of treatment modification or discontinuation in 7.7% and 5.5% of patients, respectively. Overall, guidelines were fully followed in 49 patients (54.4%) concerning the choice of pharmacological class, dose and duration of treatment. Financial constraints experienced by patients were significantly and independently associated with lower adherence to recommendations (p = 0.032).Adherence to guidelines is insufficient. Measures must be implemented to enhance the management of VTE and to develop strategies for improving access to anticoagulants. [ABSTRACT FROM AUTHOR]

This article explores the potential use of biologic therapies for the treatment of cryptogenic multifocal ulcerous stenosing enteritis (CMUSE), a rare inflammatory bowel disease. The effectiveness of current treatments for CMUSE varies, and glucocorticoids, the preferred treatment, can lead to resistance and dependency. The article presents a case report of a patient who was successfully treated with infliximab, a monoclonal TNF-α antibody, after becoming refractory to glucocorticoid treatment. However, due to the limited evidence available and the challenges in diagnosing CMUSE, further research and larger studies are needed to evaluate the therapeutic outcomes and determine the optimal biologic agent for CMUSE treatment. [Extracted from the article]

Follicular lymphoma (FL) is the most common indolent non‐Hodgkin lymphoma subtype, accounting for 15–20% of all lymphoma diagnoses. Although typically slow‐growing and responsive to frontline therapies, advanced‐stage FL remains incurable with current treatments and typically follows a chronic relapsing/remitting course with increasingly shorter responses to subsequent lines of therapy. Outcomes are highly variable; some patients experience prolonged first remissions that may approximate a 'functional cure'. By contrast, a significant minority of patients experience disease progression shortly after frontline treatment resulting in high rates of lymphoma‐related mortality. Reflecting on the heterogeneous natural history of FL, clinical practice varies widely, particularly in controversial areas, including appropriate disease staging, selection of management strategies and duration of clinical follow‐up. This position statement presents an evidence‐based synthesis of the literature for application in Australasian practice. [ABSTRACT FROM AUTHOR]

Objectives: Precision medicine is data‐driven health care tailored to individual patients based on their unique attributes, including biologic profiles, disease expressions, local environments, and socioeconomic conditions. Emergency medicine (EM) has been peripheral to the precision medicine discourse, lacking both a unified definition of precision medicine and a clear research agenda. We convened a national consensus conference to build a shared mental model and develop a research agenda for precision EM. Methods: We held a conference to (1) define precision EM, (2) develop an evidence‐based research agenda, and (3) identify educational gaps for current and future EM clinicians. Nine preconference workgroups (biomedical ethics, data science, health professions education, health care delivery and access, informatics, omics, population health, sex and gender, and technology and digital tools), comprising 84 individuals, garnered expert opinion, reviewed relevant literature, engaged with patients, and developed key research questions. During the conference, each workgroup shared how they defined precision EM within their domain, presented relevant conceptual frameworks, and engaged a broad set of stakeholders to refine precision EM research questions using a multistage consensus‐building process. Results: A total of 217 individuals participated in this initiative, of whom 115 were conference‐day attendees. Consensus‐building activities yielded a definition of precision EM and key research questions that comprised a new 10‐year precision EM research agenda. The consensus process revealed three themes: (1) preeminence of data, (2) interconnectedness of research questions across domains, and (3) promises and pitfalls of advances in health technology and data science/artificial intelligence. The Health Professions Education Workgroup identified educational gaps in precision EM and discussed a training roadmap for the specialty. Conclusions: A research agenda for precision EM, developed with extensive stakeholder input, recognizes the potential and challenges of precision EM. Comprehensive clinician training in this field is essential to advance EM in this domain. [ABSTRACT FROM AUTHOR]

Aims Methods and Results Conclusions Judicious antimicrobial use in companion animal practice is critical for maintaining the effectiveness of antimicrobial agents against bacterial infections and reducing the selection of antimicrobial‐resistant bacteria. This study aimed to provide insights into companion animal veterinarians' antimicrobial treatment recommendations for common bacterial infections in dogs and cats and describe the factors influencing their prescription choices.An online survey using QualtricsXM® software was administered between September and November 2022 to companion animal veterinarians who were Illinois State Veterinary Medical Association members. Descriptive and text analyses were conducted to assess the participants' responses. A total of 78 surveys were included in the analysis. Skin infections were ranked as the most common bacterial infections for which veterinarians prescribed antimicrobial agents, followed by ear, urinary tract, respiratory, and enteric infections. The severity of clinical symptoms and the results of bacterial culture and susceptibility tests were the most influential factors for veterinarians when making antimicrobial prescription choices. Veterinarians were aware of the current antimicrobial prescription guideline recommendations when prescribing antimicrobials empirically to nine hypothetical scenarios of bacterial infections. According to the results of the text analysis that assessed veterinarians' responses to an open‐ended question, regarding their challenges when prescribing antimicrobial agents, the pairwise correlation of word frequencies within each response showed the highest correlations between the words ‘owner’ and ‘compliance’, ‘administration’ and ‘route’, ‘cost’ and ‘culture’, and ‘patients’ and ‘acceptance’.The study results can support animal health stakeholders in the development of antimicrobial stewardship programmes to promote appropriate antimicrobial use and limit the emergence of antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Background Study design Endpoints Methods and analysis Ethics and dissemination Trial registration number Salvage radiotherapy (SRT) and androgen‐deprivation therapy (ADT) are widely used in routine clinical practice to treat patients with prostate cancer who develop biochemical recurrence (BCR) after radical prostatectomy (RP). However, there is no standard‐of‐care consensus on optimal duration ADT. Investigators propose three distinct risk groups in patients with prostate cancer treated with SRT in order to better define the indications and duration of ADT combined with SRT.The URONCOR 06‐24 trial (ClinicalTrials.gov identifier NCT05781217) is a prospective, multicentre, randomised, open‐label, phase III, clinical trial. The aim of the trial is to determine the impact of short‐term (6 months) vs long‐term (24 months) ADT in combination with SRT on distant metastasis‐free survival (MFS) in patients with prostate cancer with BCR after RP (intermediate and high risk).The primary endpoint is 5‐year MFS rates in patients with prostate cancer treated with long‐ vs short‐term ADT in combination with SRT. Secondary objectives are biochemical‐relapse free interval, pelvic progression‐free survival, time to start of systemic treatment, time to castration resistance, cancer‐specific survival, overall survival, acute and late toxicity, and quality of life.Total of 534 patients will be randomised 1:1 to ADT 6 months or ADT 24 months with a luteinizing hormone‐releasing hormone analogue in combination with SRT, stratified by risk group and pathological lymph node status.The study is conducted under the guiding principles of the World Medical Association Declaration of Helsinki. The results will be disseminated at research conferences and in peer‐reviewed journals.EudraCT number 2021‐006975‐41. [ABSTRACT FROM AUTHOR]

Background: Invasive fungal disease (IFD) is typically aggressive and related with high mortality in children with a hematological malignancy. The association of medical and surgical treatment may ameliorate the outcome. The aim of this study was to analyze the surgical treatment of fungal infections in pediatric oncological populations. Methods: Retrospective study (2000–2022) of a single‐center experience. We reviewed the medical record of all patients with hematologic malignancies and IFD, analyzing the outcome. Results: From the 70 pediatric cases of hematologic malignancies with the diagnosis IFD over 22 years, we included in the present study 44 cases who required surgical approaches for either diagnosis or treatment. Twenty‐one patients were males and the mean age was 11 (range 1–23) years. The main indications for surgery were lack of improvement following medical treatment and/or progression of fungal infection (80%) and diagnosis confirmation (20%). Only five patients needed an emergency operation for rapid worsening of symptoms. The most common site of infection was the lung (80%) and the most frequently identified pathogen was Aspergillus (75%). The most common surgical procedures were lobectomy (performed in 17 patients) and atypical lung resection (10). Complications of surgery were mostly treated by medical approach. The mean time of resumption of oncological treatment was 40 (range 0–150) days. Conclusions: Surgery is an important step in the multimodal treatment of invasive fungal infection with excellent resolution rate. Overall mortality depends on the underlying malignancy. [ABSTRACT FROM AUTHOR]

Quantification, that is, the shaping of human environments in numerical terms, is so widespread in contemporary societies that it has contaminated almost all spheres of human life. We explore the links between performance quantification and individuals' feelings of being treated in a dehumanized way, that is, metadehumanization. We present an integrative research that assessed the relationships between performance quantification, metadehumanization, and on two of metadehumanization's consequences, that is, stress and disidentification, in three contexts, that is, organizations, sport, and social networks. In addition, we test the moderating roles of two individual variables, that is, competitiveness and tender‐mindedness, in this model. In three samples (Ns = 204, 300, 297, for Samples A, B, and C, respectively), we show a mediation effect of metadehumanization on the links between performance quantification and stress and disidentification that holds despite of contextual variations. Unexpectedly, our two moderated mediation hypotheses did not hold or showed inconsistent effects across samples. [ABSTRACT FROM AUTHOR]

The article discusses the development of an orthobiologics curriculum by the American Academy of Physical Medicine & Rehabilitation (AAPM&R) and the AAPM&R Orthobiologics Workgroup. Orthobiologics refers to procedures that use minimally manipulated autologous cell preparations, such as platelet-rich plasma (PRP), bone marrow, and adipose tissues. The curriculum aims to establish educational standards and promote the ethical delivery of these treatments. It emphasizes the need for clinicians to stay informed about the emerging literature, properly counsel patients, and consider factors such as evidence, patient needs, and financial considerations. The article also addresses concerns about the undiscerning adoption of orthobiologics and the importance of responsible delivery and informed consent. The AAPM&R encourages other specialty societies to develop similar curricula and raise the standard of training and practice in orthobiologics. [Extracted from the article]

Background: Molecular characterization has significantly improved the management of advanced endometrial cancer (EC). It distinguishes four molecular subclasses associated with prognosis and personalized therapeutic strategies. This study assesses the clinical utility of cell‐free DNA (cfDNA) profiling in EC to identify targetable alterations. Methods: Women with metastatic or recurrent EC were prospectively recruited within the framework of the STING trial (NCT04932525), during which cfDNA was analyzed. Genomic alterations were identified with the FoundationOne CDx assay. Each molecular report underwent review by a molecular tumor board. Alterations were categorized via the European Society of Medical Oncology Scale for Clinical Actionability of Molecular Targets (ESCAT). Results: A total of 61 patients were enrolled. The median age was 66.9 years, with 43% presenting frontline metastatic disease. All histologic subgroups were represented. Notably, 89% of patients yielded informative cfDNA analysis. Six tumors were classified with deficient mismatch repair/microsatellite instability (11%) and 37 as TP53 gene mutant (67%), and 12 had nonspecific molecular profiles (22%). Molecular classification based on liquid biopsy showed 87.5% accuracy in correlating with tissue results. Moreover, 65% of cases exhibited ≥1 actionable alteration, including 25% ESCAT I alterations and 13% ESCAT II alterations. Consequently, 16% of patients received a molecularly matched therapy, and presented with a 56% response rate and median progression‐free survival of 7.7 months. Conclusions: cfDNA sequencing in EC is a feasible approach that produces informative results in 89% of cases and accurately categorizes patients into the main molecular subclasses. It also reveals multiple actionable alterations, which offers the potential for personalized therapeutic strategies. Cell‐free DNA sequencing is a highly feasible assay that allows an accurate molecular characterization of patients with advanced endometrial cancer while detecting multiple actionable alterations. It serves as a valuable tool for tailoring the management of patients with metastatic endometrial cancer. [ABSTRACT FROM AUTHOR]

Western‐trained doctors in India struggled to establish themselves as a medical 'profession' in the 1920s and 1930s and these struggles continued into the post‐colonial period. The direction of travel is, however, no longer clear. Increasing evidence of a crisis in doctors' collective ability to provide a form of self‐regulation since 2000 is highlighted. India's Supreme Court suspended the operations of their country's medical councils in the face of a proliferation of poorly regulated private medical colleges. Practitioners of alternative systems of medicine and unqualified medical practice continue, while new 'short‐course' doctors take over tasks previously restricted to fully fledged MBBS doctors. The diversification of the social origins of medical students, with rising numbers of doctors from a wider range of social backgrounds, threatens their aspirations to high status. There is little diminution of the earnings of elite doctors, yet their conditions of work are increasingly constrained by financial targets. Young doctors face uncertain futures. This article analyses the increasingly diverse occupational positions of doctors in India using a Bourdieusian lens and asks whether an alternative, stable form of institutional arrangements is emerging, as some have claimed, or if fragmentation is a more apt description. [ABSTRACT FROM AUTHOR]

The recent Federal Trade Commission (FTC) and Department of Justice (DOJ) action against Monument Inc. for selling patient data, is just the tip of the iceberg. Monument Inc. positions itself as a treatment provider (the website home page says it provides "therapy" for alcoholism) but in its extensive terms of use, it says it is not a treatment provider. And in fact, since the FTC/DOJ action this spring, Monument radically changed its website, removing the offending promise of "confidentiality" which it breached, but still selling services (lowest price $15/month). [ABSTRACT FROM AUTHOR]

Liver cirrhosis, characterized by diffuse necrosis, insufficient regeneration of hepatocytes, angiogenesis, severe fibrosis, and the formation of pseudolobules, is a progressive, chronic liver disease induced by a variety of causes. It is clinically characterized by liver function damage and portal hypertension, and many complications may occur in its late stage. Based on the updated practice guidelines, expert consensuses, and research advances on the diagnosis and treatment of cirrhosis, the Chinese Society of Gastroenterology of Chinese Medical Association established the current consensus to standardize the clinical diagnosis and management of liver cirrhosis and guide clinical practice. This consensus contains 43 statements on the etiology, pathology and pathogenesis, clinical manifestations, major complications, diagnosis, treatment, prognosis, and chronic disease control of liver cirrhosis. Since several practice guidelines and expert consensuses on the complications of liver cirrhosis have been published, this consensus emphasizes the research progress of liver cirrhosis itself. [ABSTRACT FROM AUTHOR]

Summary: Background: Immune checkpoint inhibitors (ICIs) are effective oncologic agents which frequently cause immune‐related adverse events (irAEs) which can impact multiple organ systems. Onco‐Gastroenterology is a novel and emerging subspecialty within gastroenterology focused on cancer treatment‐related complications. Gastroenterologists must be prepared to identify and manage diverse immune‐mediated toxicities including enterocolitis, hepatitis, pancreatitis and other ICI‐induced toxicities. Aim: To provide a narrative review of the epidemiology, diagnostic evaluation and management of checkpoint inhibitor‐induced gastrointestinal and hepatic toxicities. Methods: We searched Cochrane and PubMed databases for articles published through August 2023. Results: Gastrointestinal and hepatic irAEs include most commonly enterocolitis and hepatitis, but also pancreatitis, oesophagitis, gastritis, motility disorders (gastroparesis) and other rarer toxicities. Guidelines from the National Comprehensive Cancer Network, American Society of Clinical Oncology and European Society for Medical Oncology, in combination with emerging cohort and clinical trial data, offer strategies for management of ICI toxicities. Evaluation of irAEs severity by formal classification and clinical stability, and a thorough workup for alternative etiologies which may clinically mimic irAEs underlie initial management. Treatments include corticosteroids, biologics and other immunosuppressive agents plus supportive care; decisions on dosing, timing and choice of steroid adjuncts and potential for subsequent checkpoint inhibitor dosing are nuanced and toxicity‐specific. Conclusions: Expanding clinical trial and cohort data have clarified the epidemiology and clinical characteristics of gastrointestinal, pancreatic and hepatic toxicities of ICIs. Guidelines, though valuable, remain based principally on retrospective cohort data. Quality prospective, controlled studies may refine algorithms for treatment and potential immunotherapy rechallenge. [ABSTRACT FROM AUTHOR]

Background & Aims: Short videos, crucial for disseminating health information on metabolic dysfunction‐associated steatotic liver disease (MASLD), lack a clear evaluation of quality and reliability. This study aimed to assess the quality and reliability of MASLD‐related videos on Chinese platforms. Methods: Video samples were collected from three platforms (TikTok, Kwai and Bilibili) during the period from November 2019 to July 2023. Two independent reviewers evaluated the integrity of the information contained therein by scoring six key aspects of its content: definition, epidemiology, risk factors, outcomes, diagnosis and treatment. The quality and reliability of the videos were assessed using the Journal of the American Medical Association (JAMA) criteria, the Global Quality Score (GQS) and the modified DISCERN score. Results: A total of 198 videos were included. The video content exhibited an overall unsatisfactory quality, with a primary emphasis on risk factors and treatment, while diagnosis and epidemiology were seldom addressed. Regarding the sources of the videos, the GQS and modified DISCERN scores varied significantly between the platforms (p =.003), although they had generally similar JAMA scores (p =.251). Videos created by medical professionals differed significantly in terms of JAMA scores (p =.046) compared to those created by nonmedical professionals, but there were no statistically significant differences in GQS (p =.923) or modified DISCERN scores (p =.317). Conclusions: The overall quality and reliability of the videos were poor and varied between platforms and uploaders. Platforms and healthcare professionals should strive to provide more reliable health‐related information regarding MASLD. [ABSTRACT FROM AUTHOR]

The article focuses on late-breaking scientific abstracts presented at the American Headache Society's 66th Annual Scientific Meeting, highlighting advancements in preclinical and clinical research on headache disorders. Topics include the efficacy of an ABHD6 inhibitor in reversing medication overuse headache induced allodynia, characterization of nummular headache cases through a specialized headache center.

The purpose of this report was to describe the emergency management and subsequent surgical treatment of a 6‐year‐old, entire, male Epagneul Breton referred for septic uroperitoneum of 5 days duration. Clinical stabilisation was achieved by the insertion of a percutaneous small‐bore wire‐guided chest tube as an abdominal drain in association with conventional medical treatment. The small‐bore wire‐guided chest tube was inserted percutaneously into the abdomen, under ultrasound guidance, using a modified Seldinger technique. It was connected to a closed active collection system, and successfully drained the peritoneal urinary effusion. The medical treatment associated with the application of the small‐bore wire‐guided chest tube contributed to the patient's stabilisation, which was reached within 5 hours from arrival, allowing for an exploratory laparotomy with repair of the bladder laceration. The small‐bore wire‐guided chest tube was replaced during surgery by a Jackson–Pratt drain, which remained in place for 4 days postoperatively. The dog has completely recovered, and no complications were recorded. [ABSTRACT FROM AUTHOR]

The article presents a study on the National Institutes of Health, National Institute on Aging's Diversity Administrative Supplement Program. Topics discussed include purpose of establishing the NIH Diversity Supplements (DS) program in 1989, demographics and scientific areas of interest, and institutional characteristics.

The article provides information on the Claude D. Pepper Older Americans Independence Centers (OAIC) Program sponsored by the National Institute on Aging (NIA)./ Topics discussed include goal of the program, factor to which the OAIC Program's success can be attributed, and research themes of the OAICs.

This article discusses a case study of a patient with refractory multiple myeloma who developed psoriasis as a side effect of lenalidomide treatment. The patient was successfully treated with narrowband ultraviolet B phototherapy (NB-UVB) without discontinuing the lenalidomide. The article highlights the efficacy and safety of NB-UVB in managing lenalidomide-induced psoriasis and suggests that NB-UVB can be considered as a therapeutic option for psoriasis secondary to anti-multiple myeloma agents. However, further validation through larger prospective trials is needed. [Extracted from the article]

Advances in the treatment of chronic thromboembolic pulmonary hypertension (CTEPH) over the past decade changed the disease landscape, yet global insight on clinical practices remains limited. The CTEPH global cross‐sectional scientific survey (CLARITY) aimed to gather information on the current diagnosis, treatment, and management of CTEPH and to identify unmet medical needs. This paper focuses on the treatment and management of CTEPH patients. The survey was circulated to hospital‐based medical specialists through Scientific Societies and other medical organizations from September 2021 to May 2022. The majority of the 212 respondents involved in the treatment of CTEPH were from centers performing up to 50 pulmonary endarterectomy (PEA) and/or balloon pulmonary angioplasty (BPA) procedures per year. Variation was observed in the reported proportion of patients deemed eligible for PEA/BPA, as well as those that underwent the procedures, including multimodal treatment and subsequent follow‐up practices. Prescription of pulmonary arterial hypertension‐specific therapy was reported for a variable proportion of patients in the preoperative setting and in most nonoperable patients. Reported use of vitamin K antagonists and direct oral anticoagulants was similar (86% vs. 82%) but driven by different factors. This study presents heterogeneity in treatment approaches for CTEPH, which may be attributed to center‐specific experience and region‐specific barriers to care, highlighting the need for new clinical and cohort studies, comprehensive clinical guidelines, and continued education. [ABSTRACT FROM AUTHOR]

This article explores the use of the drug ruxolitinib in treating chronic enteropathy associated with the SLCO2A1 gene (CEAS). CEAS is a rare condition characterized by ulcers in the small intestine and chronic gastrointestinal bleeding. Traditional treatments for inflammatory bowel disease (IBD) are ineffective for CEAS, but this case study demonstrates that ruxolitinib, a Janus kinase (JAK) inhibitor, significantly improved symptoms. JAK inhibitors have shown promise in treating IBD, and further research is needed to determine the most effective JAK-selective inhibitor for CEAS. The article also discusses the dysregulation of the JAK/STAT pathway as a key factor in myelofibrosis, regardless of the mutation profile. The authors recommend genetic screening for patients with refractory enteropathy and considering JAK inhibitors as a treatment option for those with an SLCO2A1 mutation. [Extracted from the article]

The article focuses on the establishment of the RANZCOG Academy of Clinician Educators (ACE) during the 2023 Annual Scientific Meeting, aimed at enhancing medical education in obstetrics and gynaecology. Topics include the ACE's goals to foster excellence in teaching, provide professional development opportunities, promote collaboration, and define essential competencies for medical educators.

This article discusses myopathies associated with Streptococcus equi equi (S. equi) infection in horses, specifically focusing on complications such as purpura haemorrhagica (PH) and myosin heavy chain myopathy (MYHM). PH is characterized by fever, lethargy, and limb swelling due to immune complexes in vessel walls, while MYHM is a genetic condition that causes muscle atrophy. Quarter Horse-related breeds are particularly susceptible to these complications. Treatment options, such as antibiotics and corticosteroids, are discussed, as well as the importance of early detection and genetic testing. [Extracted from the article]

The article discusses concise guidelines for catheter ablation of atrial fibrillation (AF) by the European Cardiac Arrhythmias Society (ECAS). It critiques existing guideline methodologies for their reliance on lower levels of evidence (LOE B and C) and emphasizes the need for more rigorous standards. It aims to enhance guideline clarity and practical utility for clinicians, addressing the criticism that current guidelines are dense and slow to incorporate new evidence.

Objective: Patients with myotonic muscular dystrophy (MMD) were observed to have numerous basal cell carcinoma (BCC) and abnormal dysplastic nevi (DN) on non‐sun exposed skin. Simultaneously a large study published in the Journal of American Medical Association (JAMA) illustrated that patients with MMD have "overall" an increased risk for cancer development. Based on these findings, this author in 2010 postulated that dysregulation of RNA binding proteins (RBP), responsible for clinical manifestations of MMD, is also responsible for the development of BCC and melanoma. Methods: To report new research elucidating the etiology of melanoma, BCC, MMD‐induced cancers, and potentially other environmentally induced malignancies. Results: Dysregulation of RBP induces aberrant mRNA splicing; recent data indicates that abnormal mRNA splicing not just plays a key role in the pathogenesis of melanoma but is a hallmark of essentially all human malignancies. Conclusion: The author's hypothesis is that ultraviolet (UV) radiation induces DNA damage in intronic regions of a variety of genes. Furthermore, these UV‐induced abnormal DNA dimers, repeats and mutations interfere with normal mRNA splicing thus producing abnormal proteins. These abnormal proteins in turn activate oncogenic pathways such as hedgehog, MAP kinase, and WNT. [ABSTRACT FROM AUTHOR]

From the earliest days of the pandemic, the American Medical Association Enterprise Communications team was operating in the white space. Organisational development gurus define "white space" as places where "rules are vague, authority is fuzzy, budgets are nonexistent, and strategy is unclear-and where, as a consequence, entrepreneurial activity that helps reinvent and renew an organisation takes place," according to the Harvard Business Review. [ABSTRACT FROM AUTHOR]

Background: Bleeding after cardiac surgery is common and continues to require 10–20% of the national blood supply. Transfusion of allogeneic blood is associated with increased morbidity and mortality. Excessive protamine in the absence of circulating heparin after weaning off CPB can cause anticoagulation and precipitate bleeding. Hence, adequate dose calculation of protamine is crucial yet under evaluated. Study Design: Retrospective cohort study. Methods: We conducted a retrospective bi‐institutional analysis of cardiac surgical patients who underwent cardiopulmonary bypass (CPB)‐assisted cardiac surgery to assess the impact of protamine dosing in transfusion practice. Total 762 patients were identified from two institutions using electronic medical records and the Society of Thoracic Surgery (STS) database who underwent cardiac surgery using CPB. Patients were similar in demographics and other baseline characteristics. We divided patients into two groups based on mg of protamine administered to neutralize each 100 U of unfractionated heparin (UFH)—low‐ratio group (Protamine: UFH ≤ 0.8) and high‐ratio group (Protamine: UFH > 0.8). Results: We observed a higher rate of blood transfusion required in high‐ratio group (ratio >0.8) compared with low‐ratio group (ratio ≤0.8) (p <.001). The increased requirement was consistently demonstrated for intraoperative transfusions of red blood cells, plasma, platelets, and cryoprecipitate. Conclusion: High protamine to heparin ratio may cause increased bleeding and transfusion in cardiac surgical patients. Protamine to heparin ratio of 0.8 or lower is sufficient to neutralize circulating heparin after weaning off cardiopulmonary bypass. [ABSTRACT FROM AUTHOR]

Diabetic foot ulcer complicated with lower extremity vasculopathy is highly prevalent, slow healing and have a poor prognosis. The final progression leads to amputation, or may even be life‐threatening, seriously affecting patients' quality of life. The treatment of lower extremity vasculopathy is the focus of clinical practice and is vital to improving the healing process of diabetic foot ulcers. Recently, a number of clinical trials on diabetic foot ulcers with lower extremity vasculopathy have been reported. A joint group of Chinese Medical Association (CMA) and Chinese Medical Doctor Association (CMDA) expert representatives reviewed and reached a consensus on the guidelines for the clinical diagnosis and treatment of this kind of disease. These guidelines are based on evidence from the literature and cover the pathogenesis of diabetic foot ulcers complicated with lower extremity vasculopathy and the application of new treatment approaches. These guidelines have been put forward to guide practitioners on the best approaches for screening, diagnosing and treating diabetic foot ulcers with lower extremity vasculopathy, with the aim of providing optimal, evidence‐based management for medical personnel working with diabetic foot wound repair and treatment. [ABSTRACT FROM AUTHOR]

Dry eye disease (DED) is a widespread ophthalmic illness that inflicts massive economic and medical burdens on society. Although oxidative stress is closely associated with the onset of DED, barely any quantities of antioxidants are clinically available owing to low efficiency, toxicity, and poor bioavailability. Cerium‐based nanozymes possess promising enzyme‐mimetic activities in scavenging reactive oxygen species (ROS). Moreover, the ultra‐small metal–organic frameworks (MOFs) have the potential for more efficient drug delivery, ROS elimination, and therapeutic efficacy. However, the development of ultra‐small cerium‐based MOFs (Ce‐MOFs) is limited to a small minority due to challenges in the synthetic process and stability. By simply adjusting raw ingredients concentrations, three types of Ce‐MOFs with distinct particle sizes are synthesized: Ce‐MOF 1 (213 nm), Ce‐MOF 2 (36 nm), and Ce‐MOF 3 (2 nm). In comparison, the obtained ultra‐small Ce‐MOF 3 exhibited superior ROS scavenging and antioxidant capacity, decreased cytotoxicity, and excellent ocular penetration. Therapeutically, Ce‐MOF 3 is demonstrated to be highly efficient in alleviating DED by suppressing oxidative stress and inflammation, boosting corneal epithelial repair, and facilitating tear secretion recovery. The novel ultra‐small Ce‐MOF 3 may serve as a promising alternative treatment for DED and other ROS‐related disorders when combined with ocular biocompatibility. [ABSTRACT FROM AUTHOR]

The article presents a study which developed a standardized version of the peripheral blood smear (PBS) reporting format according to the International Society of Hematology (ICSH) recommendations and system that allowed automatic descriptions of quantitative values of complete blood count (CBC) data in this reporting format. Topics include components of the automated PBS reporting system and automatically described quantitative results and qualitative results in the PBS smear reporting system.

Rationale: Audit and feedback is an evidence‐based implementation strategy, but studies reporting the use of theory to guide design elements are limited. Aims and Objectives: Within the context of a programme of research aiming to improve the implementation of supported asthma self‐management in UK primary care (IMPlementing IMProved Asthma self‐management as RouTine [IMP2ART]), we aimed to design and develop theoretically‐informed audit and feedback that highlighted supported asthma self‐management provision and areas for improvement in primary care general practices. Method: Aligned with the Medical Research Council (MRC) complex intervention framework, the audit and feedback was developed in three phases: (1) Development: literature and theory exploration, and prototype audit and feedback design; (2) Feasibility: eliciting feedback on the audit and feedback from general practice staff (n = 9); (3) Prepiloting: delivering the audit and feedback within the IMP2ART implementation strategy (incorporating patient and professional resources and an asthma review template) and eliciting clinician feedback (n = 9). Results: Audit and feedback design was guided by and mapped to existing literature suggestions and theory (e.g., Theoretical Domains Framework, Behaviour Change Technique Taxonomy). Feedback on the prototype audit and feedback confirmed feasibility but identified some refinements (a need to highlight supporting self‐management and importance of asthma action plans). Prepiloting informed integration with other IMP2ART programme strategies (e.g., patient resources and professional education). Conclusion: We conclude that a multistage development process including theory exploration and mapping, contributed to the design and delivery of the audit and feedback. Aligned with the MRC framework, the IMP2ART strategy (incorporating the audit and feedback) is now being tested in a UK‐wide cluster randomised controlled trial. [ABSTRACT FROM AUTHOR]

Endoscopy‐guided endobiliary radiofrequency ablation has emerged as a novel treatment for malignant biliary strictures in recent years. When combined with biliary stenting and systemic chemotherapy, it can effectively postpone local tumor progression, improve patient's quality of life, and prolong their survival, which is mainly indicated for patients with inoperable extrahepatic cholangiocarcinoma and ampullary cancer. Based on the existing clinical evidence, the Digestive Endoscopology Branch of Chinese Medical Association, the Digestive Endoscopy Professional Committee, Endoscopic Physicians Branch of Chinese Medical Doctor Association, and the National Clinical Research Center for Digestive Diseases (Shanghai) organized relevant experts to discuss the indications, contraindications, technical operation specifications, and prevention and treatment of the complications during endoscopy‐guided endobiliary radiofrequency ablation. Consensus statements were established, trying to provide references for standard treatment of malignant biliary tumors in clinical practice. [ABSTRACT FROM AUTHOR]

Aim: To explore nurses' experiences and perspectives about evidence‐based practice (EBP) implementation in the healthcare context. Design: A qualitative descriptive study design using focus group discussions (FGDs). Method: Sixty‐four nurses who purposefully selected and worked at various healthcare organizations in Bisha Governorate, Saudi Arabia, were included. Eight FGDs were used to obtain data using open‐ended questions. The collected data underwent inductive qualitative content analysis. Results: Two main categories were extracted: experiences and perspectives towards EBP. The experiences category emerged into four sub‐categories: familiarity with concepts and benefits, steps, dissemination sources of EBP and sources of EBP knowledge, while perspectives towards the EBP category included four sub‐categories: application of EBP in clinical practice, barriers, facilitators and EBP application methods. The participants experienced being in a non‐supportive and non‐encouraging atmosphere which results from a lack of organizational commitment to EBP implementation and illuminates the complexities involved in the integration process. Conclusion: The nurses' experience with EBP indicated that there was limited support for the implementation of this approach. Furthermore, they experienced varying barriers to EBP implementation. They viewed EBP as a complex technique as they lacked knowledge and skills related to the formulation of research questions, and retrieving, applying and disseminating of EBP in clinical practice decision‐making. That is due to barriers pertinent to the individual, organizational and patient factors. The key to successfully implementing an EBP in nursing practice is to promote professional development, comprehensive and continuous training, a culture of change, organizational support and motivation. Clinical Relevance: Through the construction and provision of ongoing educational interventions and mentoring programmes about EBP, healthcare organizations and nursing leadership may develop a comprehensive strategy to encourage staff nurses' participation in the EBP process. This is to enhance nurses' experiences and perspectives towards the EBP approach and overcome the barriers to effective implementation. No Patient or Public Contribution to this Study: Patients or the general public were not involved in the design, analysis or interpretation of the data in this study. [ABSTRACT FROM AUTHOR]

Objectives: The American Heartworm Society medical protocol represents the current standard of therapy for canine heartworm disease without caval syndrome. However, data on the tolerability of this protocol are limited. This study aimed to describe efficacy and prevalence of possible treatment‐related side effects in dogs with heartworm disease treated using the American Heartworm Society protocol. Materials and Methods: For this retrospective multi‐centre cohort study, dogs diagnosed with classes 1 to 3 heartworm disease that completed the American Heartworm Society medical protocol were searched in four medical databases. Demographic, clinical, diagnostic, therapeutic and outcome data, including the number and type of possible treatment‐related side effects, were retrieved. Results: Thirty‐five dogs were included. The median age and bodyweight were 6 years (1 to 13 years) and 17.3 kg (4.9 to 50 kg), respectively. Heartworm disease was classified as classes 1, 2 and 3 in 20 of 35, 11 of 35 and four of 35 dogs, respectively. In addition to the therapeutic recommendations of the American Heartworm Society, eight of 35 dogs underwent sedation to favour melarsomine administration, and 30 of 35 received ice at the injection site. After adulticide therapy, all dogs were hospitalised with cage rest [median time 12 hours (6 to 48 hours)]. All dogs survived the treatment. All dogs with long‐term follow‐up (32/35) became negative. Furthermore, treatment‐related side effects were rare, mild and rapidly recovered without the need for supporting therapies; these included depression/lethargy (4/35 dogs), cough (2/35 dogs) and lameness, pain and gastrointestinal signs (1/35 dog each). Clinical Significance: The American Heartworm Society medical protocol is efficient and safe in dogs with classes 1 to 3 heartworm disease. [ABSTRACT FROM AUTHOR]

The article discusses the use of multidisciplinary approaches in healthcare, particularly in the context of cancer treatment. While multidisciplinarity is seen as a suitable strategy for addressing complex health issues, the evidence supporting its effectiveness is limited and methodologically weak. The article also highlights the challenges and risks associated with multidisciplinary care, such as treatment delays, conflicting advice, and increased costs. The authors suggest that an interdisciplinary approach, which integrates different expertise, may be more suitable. They emphasize the need for more clinical research, particularly pragmatic trials, to enhance healthcare decision-making. [Extracted from the article]

The article discusses the rare diagnosis of subarachnoid diverticula in horses, which are intradural extramedullary lesions that can cause spinal cord compression and neurological disease. The use of computed tomography (CT) has become popular in recent years for imaging the equine cervical spine, allowing for more accurate diagnosis of spinal abnormalities. However, subarachnoid diverticula in horses are still poorly understood, and more research is needed to develop treatment options and prognosis. The article emphasizes the need for further investigation into rare spinal diseases in horses and highlights the importance of advanced imaging techniques in diagnosing these conditions. [Extracted from the article]

Four young researchers presented their studies in the field of traditional Japanese herbal medicine (Wakan‐yaku) at the Fourth Annual Young Researcher Forum held the day before the 2023 annual meeting of the Japan Society of Medical and Pharmaceutical Sciences for Traditional Medicine. Mr Sakoda outlined his research plan, emphasizing the potential of yokukansan to enhance palliative care for cancer patients. Meanwhile, Ms Tanide and Mr Nishihara explored the correlation among component contents in Coptis japonica on Sado Island. Additionally, Mr Okayama presented his study, focusing on the use of Sinomenium acutum‐derived compounds to inhibit the Wnt/β‐catenin pathway and eradicate cancer stem cells. Finally, Mr Muraoka shared insights from his research on the inhibitory properties of Cassia obtusifolia sprout components. The event, conducted both in person and online, attracted a total of 58 participants. Looking ahead, we aim to further develop and continue hosting this forum in 2024 and beyond, fostering the advancement of research in this field. [ABSTRACT FROM AUTHOR]

Several medical organisations have developed evidence‐based guidelines for the diagnosis, management, and follow‐up of testicular cancer. This article aimed to review, compare, and summarise the most updated international guidelines and surveillance protocols for clinical stage 1 (CS1) testicular cancer. We reviewed a total of 46 articles on proposed follow‐up strategies for testicular cancer, and six clinical practice guidelines including four guidelines published by urological scientific associations and two guidelines published by medical oncology associations. Most of these guidelines have been developed by panels of experts with different backgrounds in clinical training, and geographic practise patterns, which explains the considerable variability between published schedules, and recommended follow‐up intensity. We present you with a comprehensive review of the most important clinical practice guidelines and propose unifying recommendations based on the most up to date evidence to help standardise follow‐up schedules based on patterns and risk of disease relapse. [ABSTRACT FROM AUTHOR]