Prevalence and predictors of sub-optimal laboratory monitoring of selected higher risk medicines in Irish general practice: a 5-year retrospective cohort study of community-dwelling older adults.

Objectives: To describe the prevalence of sub-optimal monitoring for selected higher-risk medicines in older community-dwelling adults and to evaluate patient characteristics and outcomes associated with sub-optimal monitoring.

Study Design: Retrospective observational study (2011-2015) using historical general practice-based cohort data and linked dispensing data from a national pharmacy claims database.

Setting: Irish primary care.

Treatment effects of nitrogen and phosphorus addition on foliar traits in six northern hardwood tree species.

Foliar traits can reflect fitness responses to environmental changes, such as changes in nutrient availability. Species may respond differently to these changes due to differences in traits and their plasticity. Traits and community composition together can influence forest nutrient cycling.

Adjuvant radiation therapy is not associated with a survival benefit after R0 resection in non-metastatic adrenocortical carcinoma.

The benefit of adjuvant radiation therapy (RT) in adrenocortical carcinoma (ACC) is not well characterized for those who undergo initial R0 surgical resection. Patients in the NCDB who underwent R0 resection were placed into two cohorts - those who underwent adjuvant RT and those who did not. 388 patients were identified with 51 receiving RT.

Splenic Infarctions and Sepsis Secondary to Ceftriaxone-Associated Acute Pancreatitis: A Case of Interdisciplinary Collaboration.

The spleen plays a crucial role in filtering aging blood cells and defending against encapsulated microorganisms. While not essential for survival, splenic dysfunction can lead to severe complications, including organ failure, infection, and death. This case study examines a rare presentation of drug-induced splenic septic thrombophlebitis secondary to pancreatitis caused by an adverse reaction to ceftriaxone.

Multi-institutional development and testing of attention-enhanced deep learning segmentation of thyroid nodules on ultrasound.

Purpose: Thyroid nodules are common, and ultrasound-based risk stratification using ACR's TIRADS classification is a key step in predicting nodule pathology. Determining thyroid nodule contours is necessary for the calculation of TIRADS scores and can also be used in the development of machine learning nodule diagnosis systems. This paper presents the development, validation, and multi-institutional independent testing of a machine learning system for the automatic segmentation of thyroid nodules on ultrasound.

Patterns in coarse root decomposition of woody plants: effects of climate, root quality, mycorrhizal associations and phylogeny.

Coarse roots represent a globally important belowground carbon pool, but the factors controlling coarse root decomposition rates remain poorly understood relative to other plant biomass components. We compiled the most comprehensive dataset of coarse root decomposition data including 148 observations from 60 woody species, and linked coarse root decomposition rates to plant traits, phylogeny and climate to address questions of the dominant controls on coarse root decomposition. We found that decomposition rates increased with mean annual temperature, root nitrogen and phosphorus concentrations.

Commercial influences on patient and public involvement: a renewed call for research and action.

Patient and public involvement is increasingly advocated in health policy, research and practice. Patients and people with lived experience, carers and the general public should have a say in how policy is generated, how services are delivered and how research is conducted. Through this perspective article, we hope to stimulate discussion and debate around industry influence in patient and public involvement, specifically pertaining to patient organizations, which often play a key role in patient and public involvement activities.

Core medication use in general practice prescriptions: A pilot study evaluating the Drug Utilization 90% Index in Irish general practice.

Aims: The Drug Utilization 90% Index (DU90%), the number of medicines making up 90% of a doctor's prescribing, is a simple tool that can be used to describe core prescribing patterns. This research aimed to pilot the application of the DU90% in the Irish context, to investigate the relationship between the DU90% and prescriber and practice characteristics and prescribing quality.

Methods: Retrospective observational study using anonymous prescription data from a sample of Irish general practitioners (GPs).

The Impact of Radioactive Iodine on Disease-Specific Survival in Low-to-Intermediate Risk N1b Papillary Thyroid Carcinoma.

Background: The association of radioactive iodine (RAI) with disease-specific survival (DSS) is controversial in N1b papillary thyroid carcinoma (PTC). We aimed to evaluate whether RAI is associated with DSS in low-to-intermediate-risk N1b PTC.

Methods: The Surveillance, Epidemiology, and End Results database was queried for pT1-3, N1b, M0/Mx classic PTC treated with total thyroidectomy.

Evaluation of factors associated with reflux recurrence after fundoplication.

Introduction: Reflux recurrence after fundoplication remains poorly understood, prompting an investigation into factors associated with it.

Methods: A study was conducted to review patients who had primary fundoplication. The main focus was on identifying recurrent reflux confirmed by an abnormal DeMeester score of > 14.

Identifying genomic signatures of recurrence in adrenocortical carcinoma after R0 resection.

Background: Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with limited treatment options. Although there have been recent advancements revealing genomic drivers of these tumors, it remains unclear which genomic signatures are associated with recurrence, particularly following R0 resection.

Methods: Adrenocortical carcinoma patients treated with adrenalectomy in the Cancer Genome Atlas with recurrence data were identified using cBioPortal.

DAXX is associated with early recurrence of pancreatic neuroendocrine tumors after R0 resection.

Introduction: ATRX, DAXX, MEN1, and PTEN mutations are proposed drivers of pancreatic neuroendocrine tumor tumorigenesis and independent prognostic factors for metastasis and mortality. However, their implications after R0 resection remain debated. Thus, we sought to identify genomic signatures of pancreatic neuroendocrine tumor disease-specific mortality and recurrence after surgery for curative intent.

Disparities in postoperative adjuvant therapy utilization and factors impacting survival among anaplastic thyroid cancer patients.

Background: Anaplastic thyroid cancer (ATC) is highly aggressive with a poor prognosis. Adjuvant systemic therapy and radiation post-surgery are endorsed by NCCN and ATA guidelines. Our study aimed to identify those at risk of forgoing postoperative adjuvant treatment and to determine survival predictors.

Comparative anatomic and symptomatic recurrence outcomes of diaphragmatic suture cruroplasty versus biosynthetic mesh reinforcement in robotic hiatal and paraesophageal hernia repair.

Background: Hiatal and paraesophageal hernia (HH/PEH) recurrence is the most common cause of failure after gastroesophageal anti-reflux surgery. Crural reinforcement with mesh has been suggested to address this issue, but its efficacy remains debated. In this study, we aimed to determine the impact of biosynthetic mesh reinforcement compared to suture cruroplasty on anatomic and symptomatic hernia recurrence.

The impact of obesity on gastroesophageal reflux disease recurrence following re-operative anti-reflux surgery.

Introduction: Obese patients represent a large proportion of patients experiencing recurrent reflux and re-operations after initial anti-reflux surgery. However, there is a limited data describing the impact of obesity on GERD recurrence following re-operative procedures.

Methods: A review of patients who underwent re-operative anti-reflux surgery (Re-ARS) between 2012 and 2023.

Clinical outcomes of endoscopic balloon dilation for dysphagia after anti-gastroesophageal reflux surgery.

Background: Dysphagia is a potential complication following anti-gastroesophageal reflux surgery (ARS), with challenging management. Endoscopic balloon dilation is recommended for patients with significant dysphagia from tight wraps or strictures. We aim to evaluate factors associated with the need for post-ARS dilation and the outcomes of balloon dilation.

Determination of causes of post-operative dysphagia after anti-reflux surgery based on intra-operative planimetry.

Introduction: Dysphagia after anti-reflux surgery (ARS) is one of the most common indications for re-operative anti-reflux surgery and a leading cause of patient dissatisfaction. Unfortunately, the factors affecting its development are poorly understood. We investigated the correlation between pre-operative manometric and the intra-operative impedance planimetry (EndoFLIP™) measurements and development of post-operative dysphagia.

Safety and efficacy of robotic anti-reflux surgery in geriatric patients: a comparative analysis.

Introduction: As our population ages, older adults are being considered for anti-reflux surgery (ARS). Geriatric patients typically have heightened surgical risk, and literature has shown mixed results regarding postoperative outcomes. We sought to evaluate the safety and efficacy of robotic ARS in the geriatric population.

Stakeholder perceptions of and attitudes towards problematic polypharmacy and prescribing cascades: a qualitative study.

Introduction: Problematic polypharmacy is the prescribing of five or more medications potentially inappropriately. Unintentional prescribing cascades represent an under-researched aspect of problematic polypharmacy and occur when an adverse drug reaction (ADR) is misinterpreted as a new symptom resulting in the initiation of a new medication. The aim of this study was to elicit key stakeholders' perceptions of and attitudes towards problematic polypharmacy, with a focus on prescribing cascades.

Developing a Predictive Model for Metastatic Potential in Pancreatic Neuroendocrine Tumor.

Context: Pancreatic neuroendocrine tumors (PNETs) exhibit a wide range of behavior from localized disease to aggressive metastasis. A comprehensive transcriptomic profile capable of differentiating between these phenotypes remains elusive.

Objective: Use machine learning to develop predictive models of PNET metastatic potential dependent upon transcriptomic signature.

Patterns in the Reporting of Aggressive Histologic Subtypes in Papillary Thyroid Cancer.

Introduction: The tall cell, columnar, and diffuse sclerosing subtypes are aggressive histologic subtypes of papillary thyroid cancer (PTC) with increasing incidence, yet there is a wide variation in reporting. We aimed to identify and compare factors associated with the reporting of these aggressive subtypes (aPTC) to classic PTC (cPTC) and secondarily identify differences in outcomes.

Methods: The National Cancer Database was utilized to identify cPTC and aPTC from 2004 to 2017.

Radioactive iodine administration is not associated with improved disease-specific survival in classic papillary thyroid carcinoma greater than 4 cm confined to the thyroid.

Background: We aimed to evaluate the impact of radioactive iodine on disease-specific survival in intrathyroidal (N0M0) papillary thyroid carcinoma >4 cm, given conflicting data in the American Thyroid Association guidelines regarding their management.

Methods: The Surveillance, Epidemiology, and End Results database was queried for N0M0 classic papillary thyroid carcinoma >4 cm. Kaplan-Meier estimates were performed to compare disease-specific survival between radioactive iodine-treated and untreated groups.