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* Context.--Quality measures that are supported by evidence-based clinical practice guidelines are preferred for assessing the quality of pathologists' practices. Careful testing of a measure ensures that scores obtained by that measure reflect the quality of a pathologist's practice. Objective.--To specify a new quality measure and to demonstrate through testing that it is suitable for measuring pathologists' appropriate incorporation of information regarding microsatellite instability (MSI) and/or mismatch repair (MMR) status in pathology reports for colorectal, endometrial, gastroesophageal, and small bowel carcinoma. Design.--The College of American Pathologists collaborated with the American Gastroenterological Association to specify and test the new measure. Face validity testing was used to investigate the validity of the measure. Feasibility testing was conducted to understand if data elements required by the measure specification were readily acces sible. Signal-to-noise analysis was used to characterize the measure's reliability. Results.--Guideline recommendations for MSI and/or MMR testing supported specifications for the measure. Face validity testing indicated that the measure could distinguish the quality of care provided. Data elements required by the measure specification were found to be accessible, which supported the measure's feasibility. Reliability testing showed that differences in measure score were attributable to real differences in performance rather than random variation in scoring. Conclusions.--The Mismatch Repair or Microsatellite Instability Biomarker Testing Status in Colorectal Carcinoma, Endometrial, Gastroesophageal, or Small Bowel Carcinoma measure was appropriately specified, and testing demonstrated that it is well suited for characterizing the quality of pathologists' communication of MMR and/or MSI status. (Arch Pathol Lab Med. 2024;148:728-734; doi: 10.5858/arpa.2022-0418-OA), The Medicare Access and CHIP Reauthorization Act of 2015 established the Quality Payment Program (QPP), which allowed for adjustments to reimbursement based on a provider's demonstration of quality and cost [...]

Background and Aims: The use of a face mask while inducing general anaesthesia (GA) in obese patients is often ineffective in providing adequate ventilation. Although nasal mask ventilation has demonstrated effectiveness for continuous positive airway pressure (CPAP) in obese patients with obstructive sleep apnoea (OSA), it has not yet been applied to the induction of anaesthesia. This study evaluated the efficacy of nasal mask ventilation against standard face mask ventilation in anaesthetised obese patients with body mass index (BMI)>25 kg/m[sup.2]. Methods: Ninety adult patients with BMI >25 kg/m[sup.2] were randomly assigned to receive either facemask (Group FM) or nasal-mask (Group NM) ventilation during induction of GA. Expired tidal volume (Vt[sub.E]), air leak, peak inspiratory pressure (PIP), plateau pressure (P[sub.PLAT]), oxygen saturation (SpO[sub.2]), and end-tidal carbon dioxide (EtCO[sub.2]) were recorded for10 breaths, and their mean was analysed. Results: The mean (standard deviation) Vt[sub.E] measured was not significantly higher in Group NM [455.98 (55.64) versus 436.90 (49.50) mL, P = 0.08, degree of freedom (df):88, mean difference (95% confidence interval [CI]) -19.08 (-41.14, 2.98) mL]. Mean air-leak [16.44 (22.16) versus 31.63 (21.56) mL, P = 0.001, df: 88, mean difference 95%CI: 15.19 (6.03,24.35)], mean PIP [14.79 (1.39) versus 19.94 (3.05) cmH[sub.2]O, P = 0.001, df: 88, mean difference, 95%CI: 5.15 (4.16, 6.14)], and mean P[sub.PLAT] [12.04 (1.21) versus 16.66 (2.56) cmH[sub.2]O, P = 0.001, df: 88, mean difference 95% CI: 4.62 (3.78, 5.45)] were significantly lower in Group NM. EtCO[sub.2,] SpO[sub.2], and haemodynamic measurements were similar between the two groups. Conclusion: Nasal mask ventilation is an effective ventilation method and can be used as an alternative to face mask ventilation in anaesthetised obese adults with BMI>25 kg/m[sup.2]. Keywords: Body mass index, face mask, general anaesthesia, nasal, obese, tidal volume, ventilation, Author(s): Gyan Singh [1]; Neeru Luthra [1]; Richa Jain (corresponding author) [1]; Anju Grewal [2]; Shubham Garg [1]; Livleen Deep Mann [1] INTRODUCTION Mask ventilation is pivotal in the initial [...]

Background: The literature on fatigue in children and adolescents undergoing cancer treatment is highly variable, creating uncertainties about its prevalence and identifying those at higher risk. Objectives: The primary purpose was to describe the prevalence of fatigue among patients (< 21 years) undergoing cancer treatment across cancer types. Secondary outcomes included the prevalence of severe fatigue and factors associated with fatigue. Methods: Systematic searches of MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, and PsycINFO were conducted from inception to May 22, 2023. Two reviewers independently identified relevant citations and extracted data. Pooled prevalence estimates were derived using an inverse variance, random‐effects model. We used Joanna Briggs's critical appraisal checklist to assess study quality. (PROSPERO: CRD42020179307). Results: We included 47 studies: 26 for prevalence and 29 for factors associated with fatigue. The pooled prevalence of fatigue was 73% (95% [Confidence Interval, CI: 66%–79%; I2 96%; 26 studies; 2699 patients], and severe fatigue was 30% [95% CI 14%–46%, I2 98%; 8 studies; 1027 patients]). Subgroup analyses based on cancer type, study design, fatigue scale, fatigue reporting personnel, sample frame, and response rate did not reveal significant differences in fatigue prevalence. Fatigue prevalence significantly differed by treatment setting (inpatient [83%] vs. outpatient [55%] vs. inpatient and outpatient [69%]; p: 0.02). Due to considerable heterogeneity among studies, data on fatigue‐associated factors are presented descriptively. Conclusions: The prevalence of fatigue among children and adolescents undergoing cancer treatment is variable but notably high. Systematic evaluation of factors associated with fatigue is essential to understanding which children are at high risk of developing fatigue. Trial Registration: PROSPERO: CRD42020179307 [ABSTRACT FROM AUTHOR]

Cancer predisposition syndromes (CPS) are a group of genetic disorders that increase the risk of various cancers. Identifying CPS has a significant impact on the treatment plan, screening and follow-up strategy, and genetic counseling of the family. However, in children, it goes underdiagnosed in most clinical setups, especially in low- and middle-income (LMIC) countries. In the present study, we screened 60 pediatric oncology patients for a possible CPS based on pre-defined selection criteria. Six patients met the criteria, three of whom had hematological malignancy, while the remaining three had sarcoma. Whole exome sequencing was performed in the selected patients to confirm the diagnosis. Germline mutation in CPS-related genes was discovered in five of six cases, including novel mutations discovered in two. An adverse outcome was observed in all five patients with underlying cancer predisposition syndrome, with three having relapsed and two having progressive disease. Our study reflects a prevalence of 10% underlying CPS in a limited cohort of patient based on the phenotype-genotype approach in our cohort. Using pre-defined clinical selection criteria, screening can be directed to a high-risk patient cohort with high-pick up rate for CPS. The selection criteria could be utilized in any LMIC-based clinical setup for pediatric cancer patients who may benefit from modification of treatment as well as genetic counseling. [ABSTRACT FROM AUTHOR]

In this study, we map the origin, acceleration, and propagation of the high-speed solar wind streams (HSS) and observe their impact on the low-latitude Earth's ionosphere. Data from radio-sounding experiments conducted by the Indian Mars Orbiter Mission (MOM) from 2015 May 9–19 is analysed to understand the solar wind speed's evolution at various helio-centric distances. The slope of the turbulence spectrum from 25 to 35 Rs was in the range of 0.2–0.4, indicative of the underdeveloped turbulence corresponding to the high-flow streams. It coincided with the appearance of the earth-facing coronal holes as observed in the coronal EUV images. The particle bulk velocity at L1 showed that the speeds began to rise from 400 km s−1 on May 11th–12th, reaching a peak of around 800 km s−1 on May13th–14th, followed by a gradual decrease to the average slow speeds. Geomagnetic disturbances during the same period manifested as a dip in the DST index values. The GNSS (Global Navigation Satellite System) data from the InSWIM (Indian network for Space Weather Impact Monitoring) network show an appreciable increase in the VTEC (vertical total electron content) of the ionosphere on disturbed days in entire low-latitude ionospheric region in the Indian sector. All these observed parameters correlate well with the HSS arrival. This is a unique study that connects the propagation of the HSS and its impact on near-Earth's environment from the different vantage points in interplanetary space and proposes the application of Radio beacons to improve space weather forecasting. [ABSTRACT FROM AUTHOR]

Lung cancer emerges as a major factor in cancer-related fatalities in the current generation, and it is predicted to continue having a long-term impact. Detecting symptoms early becomes crucial for effective treatment, underscoring innovative therapy's necessity. Many researchers have conducted extensive work in this area, yet challenges such as high false-positive rates and achieving high accuracy in detection continue to complicate accurate diagnosis. In this research, we aim to develop an ecologically considerate lung cancer therapy prototype model that maximizes resource utilization by leveraging recent advancements in computational intelligence. We also propose an Internet of Medical Things (IoMT)-based, consumer-focused integrated framework to implement the suggested approach, providing patients with appropriate care. Our proposed method employs Logistic Regression, MLP Classifier, Gaussian NB Classifier, and Intelligent Feature Selection using K-Means and Fuzzy Logic to enhance detection procedures in lung cancer dataset. Additionally, ensemble learning is incorporated through a voting classifier. The proposed model's effectiveness is improved through hyperparameter tuning via grid search. The proposed model's performance is demonstrated through comparative analysis with existing NB, J48, and SVM approaches, achieving a 98.50% accuracy rate. The efficiency gains from this approach have the potential to save a significant amount of time and cost. This study underscores the potential of computational intelligence and IoMT in developing effective, resource-efficient lung cancer therapies. [ABSTRACT FROM AUTHOR]

Background: Diabetes Mellitus Type II (DM-II) and periodontitis are interlinked chronic conditions with complex pathophysiological mechanisms. Micronutrient deficiencies have been implicated in both conditions, but the evaluation of their serum profile in individuals with DM-II and periodontitis remains underexplored. Understanding the micronutrient status in these populations could provide valuable insights into their nutritional needs and potential therapeutic interventions. Materials and Methods: Serum samples were collected from DM-II patients with periodontitis (n=50), healthy individuals with periodontitis (n=50), and healthy controls without periodontitis (n=50). Micronutrient analysis was performed using high-performance liquid chromatography (HPLC) to quantify levels of vitamins (e.g., A, C, D, E), minerals (e.g., zinc, iron, magnesium), and antioxidants (e.g., selenium, glutathione). Statistical analysis was conducted using ANOVA and post-hoc tests to compare micronutrient levels among the groups. Results: In DM-II patients with periodontitis, serum levels of vitamin C were significantly lower (p < 0.05) compared to both healthy individuals with periodontitis and healthy controls without periodontitis. Similarly, levels of vitamin D and zinc were significantly decreased (p < 0.05) in DM-II patients with periodontitis compared to healthy controls without periodontitis. However, no significant differences were observed in the levels of other micronutrients among the groups. Conclusion: This study highlights distinct alterations in the serum micronutrient profile of DM-II patients with periodontitis, particularly lower levels of vitamin C, D, and zinc. These findings suggest the importance of nutritional interventions targeting these deficiencies in managing the comorbidity of DMII and periodontitis. Further research is warranted to elucidate the mechanistic links between micronutrient status and the pathogenesis of these chronic conditions. [ABSTRACT FROM AUTHOR]