Conference Report: Review of Clinical Implementation of Advanced Quantitative Imaging Techniques for Personalized Radiotherapy.

The topic of quantitative imaging in radiation therapy was presented as a "Masterclass" at the 2023 annual meeting of the American Society of Radiation Oncology (ASTRO). Dual-energy computed tomography (CT) and single-positron computed tomography were reviewed in detail as the first portion of the meeting session, with data showing utility in many aspects of radiation oncology including treatment planning and dose response. Positron emission tomography/CT scans evaluating the functional volume of lung tissue so as to provide optimal avoidance of healthy lungs were presented second.

Esophagitis and Pneumonitis Related to Concurrent Chemoradiation ± Durvalumab Consolidation in Unresectable Stage III Non-Small-Cell Lung Cancer: Risk Assessment and Management Recommendations Based on a Modified Delphi Process.

The addition of durvalumab consolidation to concurrent chemoradiation therapy (cCRT) has fundamentally changed the standard of care for patients with unresectable stage III non-small-cell lung cancer (NSCLC). Nevertheless, concerns related to esophagitis and pneumonitis potentially impact the broad application of all regimen components. A Canadian expert working group (EWG) was convened to provide guidance to healthcare professionals (HCPs) managing these adverse events (AEs) and to help optimize the patient experience.

VExUS: common misconceptions, clinical use and future directions.

There has been a significant interest in venous congestion in recent years, among which the VExUS score has been prominent, both in clinical practice and research efforts. We have noted some recurrent misconceptions among clinicians which are also reflected in certain research efforts. Notably, the misguided attempt to correlate VExUS to volume status, which is only one of the factors influencing it, as well as attempts to re-interpret VExUS in the context of certain pathologies, which reflects a fundamental misunderstanding of its circulatory perspective.

Kidney and blood pressure outcomes 11 years after pediatric critical illness and longitudinal impact of AKI: a prospective cohort study.

Background: Acute kidney injury (AKI) is common in critically ill children and associated with adverse short-term outcomes; however, long-term outcomes are not well described.

Methods: This longitudinal prospective cohort study examined the prevalence of chronic kidney disease (CKD) and hypertension (HTN) 11 vs. 6 years after pediatric intensive care unit (PICU) admission and association with AKI.

Small-area variation in child under-vaccination in India: a multilevel analysis of cross-sectional data from 36 states and Union Territories, 707 districts, and 22,349 small-area clusters.

Background: India has made exceptional advances in child immunisation, but subnational inequities in vaccination coverage impede attainment of key programmatic goals. Our study provides an up-to-date national portrait of local variations in child vaccination using a comprehensive set of indicators relevant to routine immunisation.

Methods: Indicators representing unvaccinated (zero-dose) children, incomplete basic immunisation, and vulnerability to measles and polio, were constructed from India's 2019-2021 National Family Health Survey.

Pulmonary complications and mortality among COVID-19 patients undergoing a surgery: a multicentre cohort study.

Objectives: Our primary objective was to assess the association between symptoms at the time of surgery and postoperative pulmonary complications and mortality in patients with COVID-19. Our secondary objective was to compare postoperative outcomes between patients who had recovered from COVID-19 and asymptomatic patients and explore the effect of the time elapsed between infection and surgery in the former. Our hypotheses were that symptomatic patients had a higher risk of pulmonary complications, whereas patients who had recovered from the infection would exhibit outcomes similar to those of asymptomatic patients.

Dual virtual non-contrast imaging: a Bayesian quantitative approach to determine radiotherapy quantities from contrast-enhanced DECT images.

Contrast agents in computed tomography (CT) scans can compromise the accuracy of dose calculations in radiation therapy planning, especially for particle therapy. This often requires an additional non-contrast CT scan, increasing radiation exposure and introducing potential registration errors. Our goal is to resolve these issues by accurately estimating radiotherapy parameters from dual virtual non-contrast (dual-VNC) images generated by contrast-enhanced dual-energy CT (DECT) scans, while accounting for noise and variability in tissue composition.

Computational hemodynamic pathophysiology of internal carotid artery blister aneurysms.

Objective: Blister aneurysms of the internal carotid artery (ICA) are rare and are primarily documented in the literature through small series and case reports. The intraoperative observation of a hemorrhage in the artery wall proximal to the aneurysmal bulge led to the hypothesis that some of these aneurysms might develop in a retrograde manner.

Methods: We developed software to reconstruct the ICA with and without Type I and II blister aneurysms using patients' imagery as input to simulate hemodynamic conditions before and after their formation.

Teleworking by hospital pharmacists: Another step to achieve decarbonization of the healthcare system.

Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections.

Background: Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment is uncertain.

Methods: In a multicenter, noninferiority trial, we randomly assigned hospitalized patients (including patients in the intensive care unit [ICU]) who had bloodstream infection to receive antibiotic treatment for 7 days or 14 days.

Multidisciplinary Canadian consensus on the multimodal management of high-risk and radioactive iodine-refractory thyroid carcinoma.

Most follicular cell-derived differentiated thyroid carcinomas are regarded as low-risk neoplasms prompting conservative therapeutic management. Here, we provide consensus recommendations reached by a multidisciplinary group of endocrinologists, medical oncologists, pathologists, radiation oncology specialists, a surgeon and a medication reimbursement specialist, addressing more challenging forms of this malignancy, focused on radioactive iodine (RAI)-resistant or -refractory differentiated thyroid carcinoma (RAIRTC). In this document we highlight clinical, radiographic, and molecular features providing the basis for these management plans.

Virtual scale endoscope vs snares for size measurement accuracy of smaller colorectal polyps: A randomized controlled trial.

Background And Aims: Accurate measurement of polyp size during colonoscopy is crucial for informing clinical decisions such as resection techniques and surveillance scheduling. This study aimed to compare polyp size measurement accuracy when using a virtual scale endoscope (VSE) or snare-based polyp size measurement.

Methods: This randomized controlled trial enrolled 221 patients undergoing screening, surveillance or diagnostic outpatient colonoscopies.

The Impact of Balloon Use during Endobronchial Ultrasound: A Randomized Pilot Study.

Introduction: During endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA), a saline-filled balloon placed over the tip of the bronchoscope is used to improve coupling of the ultrasound transducer to the airway wall. However, it is unknown whether it objectively improves image quality or affects procedural outcomes. Our aim was to establish whether the use of a balloon during EBUS impacts image quality, diagnostic yield, procedure duration or complications.

Prediction of obstetric outcomes in sickle cell patients based on tricuspid regurgitant velocity.

Background: Transthoracic echocardiography, a validated tool for risk assessment in non-pregnant population with sickle cell disease (SCD), uses tricuspid regurgitant velocity (TRV) over 2.5 m/s is an independent mortality risk factor. Its applicability in obstetrics lacks sufficient evidence.

The protective power of dissent? A longitudinal study on cognitive and socio-emotional determinants of COVID-19 vaccine hesitancy among young people in Canada.

COVID-19 has elicited polarized reactions to public health measures, fueling anti-vaccination movements worldwide which indicate that vaccine hesitancy represents a common expression of dissent. We investigate changes in cognitive (i.e.

Evidence Supporting Conservative Scar Management Interventions Following Burn Injury: a review article.

Conservative management for hypertrophic scars (HSc) and scar contractures is of utmost importance to optimally reintegrate burn survivors into society. Many conservative treatment interventions have been described in the literature for the management of HSc. Recent advancements in the literature pertaining to post-burn scarring and HSc formation, have advanced our understanding of the mechanisms that support or refute the use of common rehabilitation treatment modalities after burn injury.

A Nature-Based Intervention and Mental Health of Schoolchildren: A Cluster Randomized Clinical Trial.

Importance: Nature-based therapeutic or preventive interventions for mental health are increasingly popular, but their effectiveness for improving mental health is not well documented.

Objective: To investigate the effectiveness of the Open Sky School Program (École à Ciel Ouvert), a 12-week nature-based intervention for elementary schoolchildren in grades 5 and 6, for reducing mental health symptoms.

Design, Setting, And Participants: This 2-arm, cluster randomized clinical trial was conducted from February 27 to June 16, 2023, in French-language elementary schools in Quebec, Canada, with green space within 1 km.

Defects in meiosis I contribute to the genesis of androgenetic hydatidiform moles.

To identify novel genes responsible for recurrent hydatidiform moles (HMs), we performed exome sequencing on 75 unrelated patients who were negative for mutations in the known genes. We identified biallelic deleterious variants in 6 genes, FOXL2, MAJIN, KASH5, SYCP2, MEIOB, and HFM1, in patients with androgenetic HMs, including a familial case of 3 affected members. Five of these genes are essential for meiosis I, and their deficiencies lead to premature ovarian insufficiency.