Afatinib and Necitumumab in -Mutant NSCLC with Acquired Resistance to Tyrosine Kinase Inhibitors.

Introduction: Although tyrosine kinase inhibitors (TKIs) are effective against NSCLC harboring sensitizing gene mutations, acquired resistance is inevitable. Preclinical studies suggest that combining EGFR TKI and monoclonal antibody therapies may have activity in mutated NSCLC that has progressed on TKI therapy alone. Therefore, we prospectively evaluated afatinib plus necitumumab in patients with mutated NSCLC.

A Pilot Analysis of Patient Portal Use and Breast Cancer Screening Among Black Patients in a Large Academic Health System.

Introduction: Patient portals may facilitate breast cancer screening and could be an important factor to address inequities; however, this association is not well characterized. The authors sought to examine this association in a large academic health system to inform interventions to address breast cancer screening inequities.

Methods: The authors conducted a cross-sectional study among Black patients in a large academic health system using logistic regression to examine the association between breast cancer screening and portal use, adjusting for multilevel covariates and interactions.

Myocardial Inflammation in Cardiac Transthyretin Amyloidosis: Prevalence and Potential Prognostic Implications.

Background: Despite previous histopathologic evidence for its presence, the role of myocardial inflammation in the development and progression of cardiac transthyretin amyloidosis (ATTR-CA) remains insufficiently understood. Thus, this study sought to characterize the prevalence and potential prognostic implications of myocardial inflammation in ATTR-CA.

Methods: A retrospective observational study including patients with ATTR-CA diagnosed by endomyocardial biopsy was conducted.

Impact of adjunct bezlotoxumab for preventing infection recurrence in patients post - hematopoietic stem cell transplantation.

Background: Patients post hematopoietic stem cell transplant (HSCT) are highly susceptible to infection (CDI). Exposure to antibiotic treatment, chemotherapeutic disruption to bacterial microbiome, immunosuppressive therapy, and prolonged hospitalizations synergistically contribute to the risk of CDI and its recurrence. The purpose of this study is to assess if the adjunctive administration of bezlotoxumab decreases the rate of recurrent CDI in patients post-HSCT.

Ethical considerations on surrogacy†.

Surrogacy is the assisted reproductive technology (ART) practice in which a person becomes pregnant, carries, and delivers a child on behalf of another couple/person, who are the intended parent(s). Surrogacy is an especially complex practice as the interests of the intended parents, the gestational carrier, and the future child may differ. This paper considers ethical questions related to different forms of surrogacy.

The Harms of Class Imbalance Corrections for Machine Learning Based Prediction Models: A Simulation Study.

Introduction: Risk prediction models are increasingly used in healthcare to aid in clinical decision-making. In most clinical contexts, model calibration (i.e.

Digital Surveillance of Mental Health Care Services in Saudi Arabia: Cross-Sectional Study of National e-Referral System Data.

Background: Mental illness affects an estimated 25% of the global population, with treatment gaps persisting worldwide. The COVID-19 pandemic has exacerbated these challenges, leading to a significant increase in mental health issues globally. In Saudi Arabia, the lifetime prevalence of mental disorders is estimated at 34.

Exploring the Implementation of Cognitive Screening in First-Episode Psychosis Settings: The CogScreen Implementation Study.

Aim: Accurate and appropriate cognitive screening can significantly enhance early psychosis care, yet no screening tools have been validated for the early psychosis population and little is known about current screening practices, experiences, or factors that may influence implementation. CogScreen is a hybrid type 1 study aiming to validate two promising screening tools with young people with first episode psychosis (primary aim) and to understand the context for implementing cognitive screening in early psychosis settings (secondary aim). This protocol outlines the implementation study, which aims to explore the current practices, acceptability, feasibility and determinants of cognitive screening in early psychosis settings from the perspective of key stakeholders.

Sick Day Management Plans for Aboriginal and/or Torres Strait Islander Peoples With Chronic Kidney Disease on the Cape York Peninsula of Australia: Health Workers' Perspectives.

Objective: This study aimed to explore the perspectives of healthcare professionals on the utility of sick day management plans for people with chronic kidney disease (CKD) in remote communities and collaboratively design a sick day management plan resource.

Design: This qualitative study utilised two phases of data collection: preliminary observational data and semi-structured interviews. The research design and analysis were guided by the normalisation process theory (NPT) framework, tailored for complex interventions in healthcare.

Comparison of conventional coagulation tests and ROTEM in identifying trauma-induced coagulopathy for massive haemorrhage protocol activation.

Objectives: Trauma-induced coagulopathy (TIC) can be fatal but preventable if recognised early. With emerging uses of rotational thromboelastometry (ROTEM) to guide transfusions in trauma, patient outcomes with TIC-defined by initial ROTEM and conventional coagulation tests (CCTs) during massive haemorrhage protocol (MHP) activations were evaluated at a primary trauma centre in British Columbia.

Methods: This retrospective observational study included adult trauma patients requiring MHP from June 1, 2020, to May 31, 2022.

Maternal weight during pregnancy and risk of childhood acute lymphoblastic leukemia in offspring.

In addition to biological factors, maternal exposures during pregnancy can contribute to leukemogenesis in offspring. We conducted a population-based cohort study in Sweden to investigate the association between risk of acute lymphoblastic leukemia (ALL) in offspring and maternal anthropometrics during pregnancy. A total of 2,961,435 live-born singletons during 1983-2018 were followed from birth to ALL diagnosis, end of age 18, or end of 2018.

Overexpression of miR-124 enhances the therapeutic benefit of TMZ treatment in the orthotopic GBM mice model by inhibition of DNA damage repair.

Glioblastoma (GBM) is the most common malignant primary brain cancer with poor prognosis due to the resistant to current treatments, including the first-line drug temozolomide (TMZ). Accordingly, it is urgent to clarify the mechanism of chemotherapeutic resistance to improve the survival rate of patients. In the present study, by integrating comprehensive non-coding RNA-seq data from multiple cohorts of GBM patients, we identified that a series of miRNAs are frequently downregulated in GBM patients compared with the control samples.

Identifying Preferred Features of Influenza Vaccination Programs Among Chinese Clinicians Practicing Traditional Chinese Medicine and Western Medicine: Discrete Choice Experiment.

Background: Achieving high vaccine coverage among clinicians is crucial to curb the spread of influenza. Traditional Chinese medicine (TCM), rooted in cultural symbols and concepts without direct parallels in modern Western medicine, may influence perspectives on vaccination. Therefore, understanding the preferences of TCM clinicians towards influenza vaccines is of great importance.

Exploring the perspectives of early-stage postoperative glioblastoma patients and their caregivers on end-of-life care planning: An exploratory qualitative interview study.

Aim: Compare the convergent and divergent viewpoints of early-stage postoperative patients with glioblastoma and their caregivers on end-of-life care planning in Taiwan.

Background: Decision-making capacity in patients with glioblastoma may be compromised as disease progresses, making early future care planning essential to ensure that the provided care aligns with patients' goals. However, within many Asian cultures, the tendency to avoid discussions about death can lead patients to feel hesitant about addressing end-of-life care options.

Factors influencing shared decision-making on hospital wards as perceived by healthcare professionals: A qualitative study.

Objectives: The extent to which healthcare professionals apply Shared Decision Making (SDM) on hospital wards is still unknown. The aim was to explore the current knowledge of SDM among healthcare professionals and the experienced factors influencing SDM on the wards of Dutch hospitals, regarding both treatment and care decisions.

Setting: Twelve hospital wards in two university medical centres and one teaching hospital.

Occupational management of low back pain secondary to prolapsed intervertebral disc in a Malaysian healthcare worker: a case report emphasizing ergonomic intervention and risk reduction strategies.

Low back pain (LBP) is a commonly encountered medical disorder in Malaysia's primary care setting, though establishing a direct connection between LBP and the workplace environment in adults is challenging. This case presents a clinic nurse who developed LBP due to a prolapsed intervertebral disc and her clinical management from an Occupational Health Doctor perspective. Her occupational management involved a walk-through survey at an urban hospital, which identified bone marrow aspiration as her most physically demanding task.

Randomized Clinical Trial of Extending the Time Window of Endovascular Therapy in the Triage of Late Presenting Stroke Beyond 24 h (SKIP-EXTEND): Rationale and Study Protocol.

The therapeutic time window for endovascular therapy in acute stroke patients with large-vessel occlusion was extended to 24 hours from onset. Although a retrospective study showed the efficacy of endovascular therapy beyond 24 hours from the last known well, it remains unclear whether endovascular therapy is effective. Extending the time window of Endovascular therapy in the Triage of Late Presenting Strokes beyond 24 h (SKIP-EXTEND trial) aimed to clarify the efficacy of endovascular therapy compared to the best medical management.

Mobile Phone App to Promote Lifestyle Change in People at Risk of Type 2 Diabetes: Feasibility 3-Arm Randomized Controlled Trial.

Background: The use of mobile health interventions, such as apps, are proposed to meet the challenges faced by preventive health care services due to the increasing prevalence of type 2 diabetes (T2D). Thus, we developed and conducted initial feasibility testing of the Plunde app for promoting and monitoring individual goals related to lifestyle change for people at risk of T2D.

Objective: The primary aim of this study was to assess the feasibility of an app for promoting lifestyle change in people at risk of T2D.

Patient Characteristics, Management and Long-term Outcomes of Patients with Cardiogenic Shock at a Large Safety Net Hospital.

Data regarding cardiogenic shock (CS) from safety-net hospitals serving socioeconomically-disadvantaged patients are limited. In addition, little is known regarding long-term outcomes and management of heart failure-related CS (HF-CS), a population potentially especially vulnerable to adverse social determinants of health (SDOH). A single-center retrospective cohort study of patients with Stage C, D, or E CS at a public safety-net hospital between 2017-2023 was performed.

Assessing the feasibility of a spiritual healing intervention for adults with moderate depression: A pilot randomized controlled trial.

Background: Many individuals with depression explore complementary and alternative medicine, including spiritual healing. This pilot randomized controlled trial (RCT) aimed to assess the feasibility of a study that integrated spiritual healing with standard care versus standard care alone for adults with moderate depression.

Method: In this pilot RCT with two parallel groups, 28 adult patients with depression were randomized to receive either spiritual healing alongside usual care (n=14) or usual care alone (n=14).

Poor agreement among asthma specialists on the choice and timing of initiation of a biologic treatment for severe asthma patients.

Background: As the number of monoclonal antibodies available for severe asthma is growing, specialists currently choose without clear guidelines. Despite increasing knowledge on treatment response to these monoclonal antibodies, making the optimal choice for each individual patient remains a challenge. However, evidence of this daily challenge is lacking.

Selecting a smartwatch for trials involving older adults with neurodegenerative diseases: A researcher's framework to avoid hidden pitfalls.

Background: Increased prevalence of neurodegenerative diseases complicates care needs for older adults. Sensing technologies, such as smartwatches, are one available solution which can help address the challenges of aging. Knowledge of the possibilities and pitfalls of these sensing technologies is of key importance to researchers when choosing a device for a trial and considering the sustainability of these technologies in real-world settings.

Describing the landscape of nutrition- and diet-related randomized controlled trials: meta-research study of protocols published between 2012 and 2022.

Background: Publishing protocols promotes transparency and reproducibility. The scope and methods of protocols for nutrition- and diet-related randomized controlled trials (RCTs) have not been investigated yet.

Objective: Map the landscape of nutrition- and diet-related interventions research.

Different forms of stigma and rural primary care professionals' willingness to prescribe buprenorphine.

Introduction: Buprenorphine and other medications for opioid use disorder (MOUD) are highly effective but substantially under prescribed in the rural United States. Among the most cited barriers to buprenorphine prescribing is stigma, yet little progress has been made in developing successful strategies to reduce stigma and increase access to life-saving medication. One of the key challenges to developing successful implementation strategies is understanding the different types of stigma that limit implementation.