Practical guide

BACKGROUND: Current staging systems have limitations in stratifying high-risk cases of cutaneous squamous cell carcinoma (cSCC). Tumor budding (TB) has emerged as a potential prognostic factor in various cancers. OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the prognostic significance of TB in predicting lymph node metastases (NM) in cSCC. METHODS: A comprehensive search of the PubMed, Web of Science, EMBASE, and Cochrane databases was conducted...

OBJECTIVE: Necrotizing pneumonia is a rare and serious complication in pediatric patients, and its treatment often involves the complexity of choosing between surgical intervention and medical management. The disease is difficult to treat because of its devastating characteristics and high mortality rate, especially when considering the risks associated with surgery. The purpose of this report is to present two cases of necrotizing pneumonia in pediatric patients and demonstrate successful conservative management to provide additional insights for clinical decision-making...

OBJECTIVE: Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition...

BACKGROUND: Emergency healthcare services are under intense pressure to meet increasing patient demands. Many patients presenting to emergency departments could be managed by general practitioners in general practitioner-emergency department service models. OBJECTIVES: To evaluate the effectiveness, safety, patient experience and system implications of the different general practitioner-emergency department models. DESIGN: Mixed-methods realist evaluation...

There is an emerging population of older adults (≥65 years) living with type 1 diabetes. Optimizing health through nutrition during this life stage is challenged by multiple and ongoing changes in diabetes management, comorbidities, and lifestyle factors. There is a need to understand nutritional status, dietary intake, and nutrition-related interventions that may maximize well-being throughout the life span in type 1 diabetes, in addition to nutrition recommendations from clinical guidelines and consensus reports...

PURPOSE: The use of endobronchial ultrasound (EBUS) is standard practice for lung cancer diagnosis and staging. Next generation sequencing (NGS) for detection of genetic alterations is recommended in advanced, non-squamous, non-small-cell lung cancer (NSCLC). Existing protocols for NGS testing are minimal and reported yields vary. This study aimed to determine the yield of EBUS samples obtained for NGS using a sampling protocol at our institution and assess predictive factors to form collection protocols...

Residual substances that are considered hazardous to the recipient must be removed from final cellular therapeutic products manufactured for clinical purposes. In doing so, quality rules determined by competent authorities (CAs) for the clinical use of tissue- and cell-based products can be met. In our study, we carried out residual substance analyses, and purity determination studies of trypsin and trypsin inhibitor in clinically manufactured bone marrow-derived mesenchymal stromal/stem cell products, using the sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) method...

The latest guidelines include azithromycin as a preferred regimen for treating Mycobacterium avium complex (MAC) pulmonary disease. However, serially collected susceptibility data on clinical MAC isolates are limited, and no breakpoints have been determined. We investigated the minimum inhibitory concentrations (MICs) of azithromycin and clarithromycin for all MAC strains isolated in 2021 from a single center in Japan, excluding duplicates. The MICs were determined using a panel based on the microbroth dilution method, according to the latest Clinical and Laboratory Standards Institute recommendations...

As the number of infants entering Out-of-Home Care at birth internationally continues to rise, Hospital-based healthcare workers (HBHCWs) are increasingly likely to become involved in ethically, morally, and legally complex child protection processes. This scoping review aimed to identify and synthesize qualitative literature pertaining to the perspectives of HBHCWs with experiences of involvement in child protection processes occurring in the perinatal period. JBI Methodology for Scoping Reviews guided this review...

BACKGROUND: Three-dimensional (3-D) printing offers an innovative option to produce clinical simulators because of its low production costs and widespread availability. We aimed to develop a low-cost, 3-D printed knot-tying simulator that overcomes the barriers students face in self-directed skills development. APPROACH: Medical students completing a procedural residency preparation course (PRPC) completed a pre-survey with Likert scales and multiple choice questions to assess their perceptions of and barriers to self-directed knot-tying practice...

BACKGROUND: The objectives of this study were to (1) evaluate telemetry use pre- and postimplementation of clinical decision support tools to support American Heart Association practice standards for telemetry monitoring and (2) understand the factors that may contribute to variation of telemetry monitoring in practice. METHODS AND RESULTS: First, we captured overall variability in telemetry use pre- and postimplementation of the clinical decision support intervention...

BACKGROUND: The aim of the study was to establish a weighted comprehensive evaluation model (WCEM) of image registration for cone-beam computed tomography (CBCT) guided lung cancer radiotherapy that considers the geometric accuracy of gross target volume (GTV) and organs at risk (OARs), and assess the registration accuracy of different image registration methods to provide clinical references. METHODS: The planning CT and CBCT images of 20 lung cancer patients were registered using diverse algorithms (bony and grayscale) and regions of interest (target, ipsilateral, and body)...

BACKGROUND: Rough sex refers to consensual sexual activities that incorporate playful aggression, such as hair pulling, spanking, or choking. It is relevant in the context of sexual health as it can enhance sexual arousal, pleasure, and intimacy among consenting partners. However, it can also be associated with consent violations, discomfort, and injuries ranging from mild to severe or even fatal. The prevalence of rough sex in Germany is widely unknown. Our study aims to establish, for the first time, the overall age-related and gender-related prevalence rates of active and passive rough sex involvement among adults in Germany...

Vegetable cultivation stands as a pivotal element in the agricultural transformation illustrating a complex interplay between technological advancements, evolving environmental perspectives, and the growing global demand for food. This comprehensive review delves into the broad spectrum of developments in modern vegetable cultivation practices. Rooted in historical traditions, our exploration commences with conventional cultivation methods and traces the progression toward contemporary practices emphasizing the critical shifts that have refined techniques and outcomes...

BACKGROUND AND OBJECTIVE: The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were significant and succinct indicators of systemic inflammation. We assessed the influence of stereotactic body radiotherapy (SBRT) on NLR and PLR in patients with locally advanced non-small cell lung cancer (LA-NSCLC). METHODS: We reviewed the medical data of patients with LA-NSCLC who underwent SBRT between 1 January 2013 and 31 December 2018. NLR and PLR values recorded at pre- and post-SBRT were examined...

BACKGROUND: The prevalence and healthcare cost of metabolic dysfunction-associated steatotic liver disease (MASLD) has increased alongside the epidemic surge in obesity and Type 2 diabetes. Weight loss through lifestyle modification remains the primary effective therapy for MASLD. Incorporation of mobile technology in lifestyle interventions has been previously found to be efficacious and cost-effective in facilitating weight loss. However, there is a paucity of studies that have successfully translated lifestyle research into clinical service for weight loss to alleviate disease burden...

Outcome measurement and feedback are key to quality improvement in healthcare. Goal attainment scaling (GAS) is a tool that could be used to measure outcomes of mental health services delivering recovery-oriented care. The objective of this prospective study was to evaluate the effectiveness of tailored, interprofessional, multilevel and adaptable GAS training on clinician views, learning, competence, performance and confidence in the use of GAS. Thematic analysis of eight clinician participant views was done using the method proposed by Braun and Clarke (Thematic analysis: a practical guide to understanding and doing, 2022)...

BACKGROUND: Asthma classification into different sub-phenotypes is important to guide personalized therapy and improve outcomes. OBJECTIVES: This study sought to further explore asthma heterogeneity through determination of multiple patient groups by using novel machine learning (ML) approaches and large-scale real-world data. METHODS: We used electronic health records of patients with asthma followed at the Cleveland Clinic between 2010 and 2021...

The Upper White Nile (UWN) basin plays a critical role in supporting essential ecosystem services and the livelihoods of millions of people in East Africa. The basin has been exposed to tremendous environmental pressures following high population growth, urbanisation, and land use change, all of which are compounded by the threats posed by climate change and insufficient financial and human resources. The water-energy-food-environment (WEFE) nexus provides a framework to assess solution options towards sustainable development by minimising the trade-offs between water, energy, and food resources...

BACKGROUND: Recently, two molecular subtypes of pancreatic ductal adenocarcinoma (PDAC) have been proposed: the "Classical" and "Basal-like" subtypes, with the former showing better clinical outcomes than the latter. However, the "molecular" classification has not been applied in real-world clinical practice. This study aimed to establish patient-derived organoids (PDOs) for PDAC and evaluate their application in subtype classification and clinical outcome prediction. METHODS: We utilized tumor samples acquired through endoscopic ultrasound-guided fine-needle biopsy and established a PDO library for subsequent use in morphological assessments, RNA-seq analyses, and in vitro drug response assays...