Incidence of testicular tumor subtypes according to the updated WHO classification, North Rhine-Westphalia, Germany, 2008-2013.

Background: In 2016, the WHO introduced an updated classification for testicular tumors. The application of this updated classification to cancer registry data requires some recoding of tumors.

Objectives: The aim of this study was to provide up-to-date population-based incidence estimates of subtypes of testicular germ cell tumors (TGCT) according to the updated classification.

Association of progressive thoracic aortic calcification with future cardiovascular events and all-cause mortality: ability to improve risk prediction? Results of the Heinz Nixdorf Recall (HNR) study.

Aims: Thoracic aortic calcification (TAC) is measured by computed tomography (CT). We investigated the association of TAC-progression with incident cardiovascular (CV) events and all-cause mortality in a population-based cohort and to determine its predictive value for these endpoints.

Methods And Results: In 3080 participants (45-74 years, 53.

Multi-omic based molecular profiling of advanced cancer identifies treatable targets and improves survival in individual patients.

A proof-of-concept study was conducted to assess whether patients with advanced stage IV cancer for whom predominantly no standard therapy was available could benefit from comprehensive molecular profiling of their tumor tissue to provide targeted therapy. Tumor samples of 83 patients were collected under highly standardized conditions and analyzed using immunohistochemistry, next-generation sequencing and phosphoprotein profiling. Expression and phosphorylation of key oncogenic pathways were measured to identify targets at the (phospho-) proteomic level.

[Lung cancer screening: current trends].

Screening studies on conventional chest X‑rays and on sputum cytology did not show a reduction in lung cancer mortality. However, screening by low-dose computed tomography (LDCT) is more promising because it allows tumor detection in early stages at fairly low radiation levels. No reduction of lung cancer mortality was found in two small, randomized clinical studies on LDCT screening in Europe.

Extending resectability of hilar cholangiocarcinomas: how can it be assessed and improved?

Until the 1980's, Klatskin tumors were considered 'desperate cases' and most of them were not resected; almost no oncologic concept was available. After many improvements, today, extended hepatectomy, including caudate lobe resection and lymphoadenectomy, have become a standard of care for oncologicaly radical resection of Klatskin tumors. Portal vein en bloc resection, if necessary, is a diffused standard assuring R0-resection without any improvement of survival in most series.

Diagnostic Interpretation Guidance for Pediatric Enteric Pathogens: A Modified Delphi Consensus Process.

Background: We sought to develop diagnostic test guidance definitions for pediatric enteric infections to facilitate the interpretation of positive test results in the era of multianalyte molecular diagnostic test platforms.

Methods: We employed a systematic, two-phase, modified Delphi consensus process consisting of three web-based surveys and an expert panel face-to-face meeting. In phase 1, we surveyed an advisory panel of North American experts to select pathogens requiring diagnostic test guidance definition development.

Management of Wheezy Preschoolers in the Emergency Department: A Discrete Choice Experiment.

Objectives: This study aimed to elicit pediatric emergency physician's treatment choices for preschool-aged children with wheeze, determine the characteristics of the presenting child that influence treatment choices, and determine whether there is clinical equipoise by eliciting physician willingness to enroll these children in a placebo-controlled trial of corticosteroids.

Methods: Discrete choice experiments varying the characteristics of the presenting child were designed to elicit Canadian emergency physician's treatment choices, both in the emergency department (ED) and at discharge, for young children presenting with wheeze and their willingness to enroll in a randomized controlled trial (RCT).

Results: Most physicians chose to treat children with albuterol both in the ED and at discharge for all clinical scenarios.

Case study in major quotation errors: a critical commentary on the Newcastle-Ottawa scale.

The Newcastle-Ottawa scale (NOS) is one of many scales used to judge the quality of observational studies in systematic reviews. It was criticized for its arbitrary definitions of quality items in a commentary in 2010 in this journal. That commentary was cited 1,250 times through December 2016.

Melanoma.

Cutaneous melanoma causes 55 500 deaths annually. The incidence and mortality rates of the disease differ widely across the globe depending on access to early detection and primary care. Once melanoma has spread, this type of cancer rapidly becomes life-threatening.

The Impact of Cancer Screening on All-Cause Mortality.

Background: It is a matter of debate whether, and if so, to what extent, cancer screening programs reduce all-cause mortality. Against this backdrop, we analyzed potential effects of several cancer screening approaches on all-cause mortality in two representative Western European populations.

Methods: We used mortality data from the UK (England &Wales) and Germany from 2015 and published figures from screening studies on relative reduction in mortality for screened cancers to calculate the expected decline in all-cause mortality in these countries.

Tracing scientific reasoning in psychiatry: Reporting of statistical inference in abstracts of top journals 1975-2015.

Objective: To analyze the reporting of statistical inference in psychiatry.

Method: We searched 63,928 abstracts, published in 15 leading psychiatric journals (1975-2015).

Results: Median abstract length increased from 664 (1975) to 1,323 (2015) characters, and median use of numbers from two to 14/abstract.

Treating and reducing anxiety and pain in the paediatric emergency department-TIME FOR ACTION-the TRAPPED quality improvement collaborative.

Background/objectives: In 2013, the TRAPPED-1 survey reported inconsistent availability of pain and distress management strategies across all 15 Canadian paediatric emergency department (PEDs). The objective of the TRAPPED-2 study was to utilize a procedural pain quality improvement collaborative (QIC) and evaluate the number of newly introduced pain and distress-reducing strategies in Canadian PEDs over a 2-year period.

Methods: A QIC was created to increase implementation of new strategies, through collaborative information sharing among PEDs.

Degradability of raw and post-processed chars in a two-year field experiment.

The object of the present work was to analyse the degradation dynamics of four chars and a digestate applied to a sandy soil as well as possible initial priming effects on the mineralisation of soil organic carbon in a two-year field experiment. For that purpose, soil carbon content, soil respiration and the corresponding carbon isotopic abundances were repeatedly measured throughout two consecutive vegetation periods. In order to quantify and separate the amount and the degradation of the substrate-derived carbon and to assess soil priming effects, isotopic mixing models were applied to soil-derived and substrate-derived carbon, and to the respired CO.

Quality improvement primer part 3: Evaluating and sustaining a quality improvement project in the emergency department.

Quality improvement (QI) and patient safety are two areas that have grown into important operational and academic fields in recent years in health care, including in emergency medicine (EM). This is the third and final article in a series designed as a QI primer for EM clinicians. In the first two articles we used a fictional case study of a team trying to decrease the time to antibiotic therapy for patients with sepsis who were admitted through their emergency department.

Pediatric Emergency Research Canada (PERC): Patient/Family-informed Research Priorities for Pediatric Emergency Medicine.

Background: A growing body of literature supports patient and public involvement in the design, prioritization, and dissemination of research and evidence-based medicine. The objectives of this project were to engage patients and families in developing a prioritized list of research topics for pediatric emergency medicine (PEM) and to compare results with prior research prioritization initiatives in the emergency department (ED) setting.

Methods: We utilized a systematic process to combine administrative data on frequency of patient presentations to the ED with multiple stakeholder input including an initial stakeholder survey followed by a modified Delphi consensus methodology consisting of two Web-based surveys and a face-to-face meeting.

Testicular cancer among US men aged 50 years and older.

Background: The incidence of testicular cancer in the United States (US) has substantially increased in recent decades. The majority of testicular cancers are germ cell tumors (TGCT), which are the most commonly occurring malignancies among men aged 15-44 years in the US. To date, few studies have focused on testicular cancer among men aged ≥ 50 years.

Pain management practices surrounding lumbar punctures in children: A survey of Canadian emergency physicians.

Objectives: Lumbar punctures (LPs) are painful for children, and analgesia is recommended by academic societies. However, less than one-third of pediatric emergency physicians (EPs) adhere to recommendations. We assessed the willingness to provide analgesia among pediatric and general EPs and explored patient and provider-specific barriers.

Life expectancy and comorbidities in patients with hereditary hemorrhagic telangiectasia.

There are only a few published studies that demonstrate associations between life expectancy, severe comorbidities, and their complications in patients with hereditary hemorrhagic telangiectasia (HHT). Relatives of 73 deceased patients with suspected HHT completed a questionnaire about causes of death, and symptoms and comorbidities that the patients had developed. We compared the data for 55 cases where HHT had been clinically confirmed with the general population.

Imbalance values for baseline covariates in randomized controlled trials: a last resort for the use of values? A pro and contra debate.

Background: Results of randomized controlled trials (RCTs) are usually accompanied by a table that compares covariates between the study groups at baseline. Sometimes, the investigators report values for imbalanced covariates. The aim of this debate is to illustrate the pro and contra of the use of these values in RCTs.

The association between geographic location and incidence of Merkel cell carcinoma in comparison to melanoma: An international assessment.

Aim: The aim of this article was to provide worldwide, population-based incidence rates for Merkel cell carcinoma (MCC).

Methods: We included 11,576 cases from 20 countries for time trend analyses (1990-2007) and 11,028 cases (2.5 billion person-years) from 21 countries for the period 2003-2007 extracted from Cancer Incidence in Five Continents.

Is caregiver refusal of analgesics a barrier to pediatric emergency pain management? A cross-sectional study in two Canadian centres.

Objectives: The suboptimal provision of analgesia to children in the emergency department (ED) is well-described. A yet unexplored barrier is caregiver or child refusal of analgesia. We sought to evaluate the frequency of caregiver/child acceptance of analgesia offered in the ED.