Modified Delphi Consensus on Interventions for Acute Radiation Dermatitis in Breast Cancer: A Canadian Expert Perspective.

Acute radiation dermatitis (ARD) is a prevalent adverse effect of radiotherapy in patients with breast cancer, and there is a lack of high-quality data regarding its prevention and management. This study employs a systematic and iterative process to compile the perspectives of Canadian radiation oncology, nursing, and dermatology experts, aiming to establish consensus-based recommendations for the prevention and management of ARD in breast cancer patients. A modified Delphi consensus was conducted with the participation of 19 experts from across Canada.

Deep learning models can predict violence and threats against healthcare providers using clinical notes.

Violence, verbal abuse, threats, and sexual harassment of healthcare providers by patients is a major challenge for healthcare organizations around the world, contributing to staff turnover, distress, absenteeism, reduced job satisfaction, and worsening mental and physical health. To enable interventions prior to possible violent episodes, we trained two deep learning models to predict violence against healthcare workers 3 days prior to violent events for case and control patients. The first model is a document classification model using clinical notes, and the second is a baseline regression model using largely structured data.

Bespoke ctDNA for longitudinal detection of molecular residual disease in high-risk melanoma patients.

Background: Locally advanced melanoma has a variable prognosis. Currently, there are no reliable criteria to stratify the risk of disease relapse and identify those patients who will benefit the most from adjuvant therapies. Circulating tumor DNA (ctDNA) is an emerging biomarker measuring the presence of tumor-derived DNA in blood.

Management of human epidermal growth factor receptor inhibitors-related acneiform rash: A position paper based on the first Europe/USA Delphi consensus process.

Background: There is a need for unified guidance in the management of acneiform rash induced by epidermal growth factor receptor inhibitors (EGFRi) among dermatologists.

Objective: To establish unified international guidelines for the management of acneiform rash caused by EGFR inhibitors, based on an experts' Delphi consensus.

Methods: The initiative was led by five members of the European Academy of Dermatology and Venereology Task Force 'Dermatology for Cancer Patients' who developed a questionnaire that was circulated to a group of 32 supportive oncodermatology experts in Europe, Canada, Argentina, the US States and Asia.

INDIVIDUAL ARTICLE: NECOM 4: Algorithm Integrating Skincare for the Management of Immunotherapy-Related Cutaneous Adverse Events for Cancer Patients and Survivors.

Background: In the Nordic European Countries, cancer is the leading cause of death. The last decade has brought revolutionizing cancer treatments including immune checkpoint inhibitors (ICIs). Patients on ICIs have a high risk of developing cutaneous immune-related adverse events.

Defining D-irAEs: consensus-based disease definitions for the diagnosis of dermatologic adverse events from immune checkpoint inhibitor therapy.

With an increasing number of patients eligible for immune checkpoint inhibitors, the incidence of immune-related adverse events (irAEs) is on the rise. Dermatologic immune-related adverse events (D-irAEs) are the most common and earliest to manifest, often with important downstream consequences for the patient. Current guidelines lack clarity in terms of diagnostic criteria for D-irAEs.

Exploring Generative Artificial Intelligence-Assisted Medical Education: Assessing Case-Based Learning for Medical Students.

The recent public release of generative artificial intelligence (GenAI) has brought fresh excitement by making access to GenAI for medical education easier than ever before. It is now incumbent upon both students and faculty to determine the optimal role of GenAI within the medical school curriculum. Given the promise and limitations of GenAI, this study aims to assess the current capabilities of a GenAI (Chat Generative Pre-trained Transformer, ChatGPT), specifically within the framework of a pre-clerkship case-based active learning curriculum.

Autoimmune PaneLs as PrEdictors of Toxicity in Patients TReated with Immune Checkpoint InhibiTors (ALERT).

Background: Immune-checkpoint inhibitors (ICI) can lead to immune-related adverse events (irAEs) in a significant proportion of patients. The mechanisms underlying irAEs development are mostly unknown and might involve multiple immune effectors, such as T cells, B cells and autoantibodies (AutoAb).

Methods: We used custom autoantigen (AutoAg) microarrays to profile AutoAb related to irAEs in patients receiving ICI.

Dupilumab as a treatment for cutaneous immune-related adverse events induced by immune checkpoint inhibitors: A case series and review of the literature.

Immune checkpoint inhibitors have revolutionized cancer treatment. They can induce cutaneous immune-related adverse events. One patient with immune-related eczema and two with immune-related bullous pemphigoid were successfully treated with dupilumab.

The use of interleukin-23 inhibitors to treat immune-related psoriasis induced by immune checkpoint inhibitors and in patients with active cancer: A case series and review of the literature.

Immune checkpoint inhibitors have revolutionized cancer treatment but can induce immune-related adverse events including psoriasis. Managing immune-related psoriasis or psoriasis in a cancer setting is challenging with a lack of safety data. We describe three patients receiving interleukin-23 inhibitors to manage psoriasis in an active cancer setting, including one with immune-related psoriasis.

Traumatic Brain Injury, Electrolyte Levels, and Associated Outcomes: A Systematic Review.

Introduction: Although it has been established that electrolyte abnormalities are a consequence of traumatic brain injury (TBI), the degree to which electrolyte imbalances impact patient outcomes has not been fully established. We aim to determine the impact of sodium, potassium, calcium, and magnesium abnormalities on outcomes in patients with TBI.

Methods: Four databases were searched for studies related to the impact of electrolyte abnormalities on outcomes for TBI patients.

Outcomes of Transfusion With Whole Blood, Component Therapy, or Both in Adult Civilian Trauma Patients: A Systematic Review and Meta-Analysis.

Introduction: This systematic review and meta-analysis was conducted to compare outcomes, including transfusion volume, complications, intensive care unit length of stay, and mortality for adult civilian trauma patients transfused with whole blood (WB), components (COMP), or both (WB + COMP).

Methods: A systematic review and meta-analysis were conducted using studies that evaluated outcomes of transfusion of WB, COMP, or WB + COMP for adult civilian trauma patients. A search of PubMed, Embase, and Cochrane from database inception to March 3, 2022 was conducted.

Identifying the Impact of Sexual Scripts on Consent Negotiations.

In light of research that shows the importance of effective sexual communication for healthier sexual relationships, less unwanted sexual activity, and less sexual violence, this article explores how both dominant and alternative sexual scripts influence sexual communication. Drawing on 51 in-depth interviews with adults in heterosexual, queer, non-monogamous, and kink sex communities about their actual communication and consent practices in sexual interactions, we asked 1) In what ways do dominant sexual scripts affect communication and consent in sexual interactions? 2) What factors encourage people to diverge from these dominant scripts? and 3) How do alternative scripts produce new forms of communication and consent? We found that traditional scripts remain common, especially among those with less sexual experience, and that adherence to these scripts is more likely to correspond to coercive or unwanted sex. Conversely, exposure to alternative sexual scripts via sexual experience, education, or communities often encourages sexual agency and communication.

Supplement Individual Article: NECOM Skincare Algorithm for Patients With Cancer and Survivors.

Background: Cancer treatment-related cutaneous adverse events (cAEs) frequently occur, which can interfere with anticancer treatment outcomes and can severely impact quality of life for patients.

Methods: The Nordic European Cutaneous Oncodermatology Management (NECOM) project aims to improve cancer patient outcomes by offering tools for preventing and managing cAEs. The first NECOM paper explored clinical insights in cAEs and focused on skincare regimens involving hygiene, moisturization, sun protection, and camouflage products.

Clinical Implications of Targeting the JAK-STAT Pathway in Psoriatic Disease: Emphasis on the TYK2 Pathway.

Cytokines in the interleukin (IL)-23/IL-17 axis are central to psoriasis pathogenesis. Janus kinase (JAK) signal transducer and activator of transcription (STAT) regulates intracellular signalling of several cytokines (including IL-12, 23, 22, 6, 17, and interferon (IFN)-γ) in the IL-23/IL-17 axis, and, as a result, has become a therapeutic target for psoriasis treatment. Although several JAK1-3 inhibitors, with varying degrees of selectivity, have been developed for immune-mediated inflammatory diseases, use in psoriasis is limited by a low therapeutic index as anticipated by signals from other disease indications.

Comparing Outcomes of Appendectomy Versus Non-operative Antibiotic Therapy for Acute Appendicitis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Background: Acute appendicitis is one of the most common etiologies of an acute abdomen in the emergency department and first-line standard surgical care for the condition has recently been reconsidered. We aim to evaluate the effectiveness and outcomes of surgical intervention versus non-operative antibiotic therapy in the treatment of acute appendicitis in adult and pediatric patients.

Methods: A literature search was conducted using PubMed, Google Scholar, and EMBASE.

Standardized Medical Coding Curriculum in Surgical Graduate Medical Education.

Introduction: Despite the increasing importance of coding and billing in healthcare as a whole and calls from the Accreditation Council for Graduate Medical Education (ACGME) to emphasize systems-based practice, many surgical training programs have not prioritized coding and billing within their curricula. We aim to evaluate the performance of surgical residents and early career surgeons in coding and billing and to appraise interventions to improve coding and billing abilities within this group.

Methods: A literature search from conception to March 15th, 2022 utilizing PubMed, Google Scholar, and EMBASE was conducted to search for studies that evaluate surgical resident coding practices and interventions to improve practice management and financial competency.