Identification of Naloxone in Emergency Medical Services Data Substantially Improves by Processing Unstructured Patient Care Narratives.

Objectives: Structured data fields, including medication fields involving naloxone, are routinely used to identify opioid overdoses in emergency medical services (EMS) data; between January 2021 and March 2024, there were approximately 1.2 million instances of naloxone administration. in the United States.

Sociodemographic Differences Impact the Perceived Importance of Social Communication and Interaction Behaviors.

The evaluation of social communication and interaction (SC/I) behaviors is foundational to the autism identification process. However, this type of evaluation is made difficult by the fact that SC/I is a construct in which perceptions and expectations are largely influenced by norms and attitudes of different sociodemographic groups. While there are many factors that influence differences in SC/I behaviors across sociodemographic groups, one factor that may be especially important is the perceived value of these behaviors.

Oocyte maturation defect in women undergoing IVF: contributing factors and effects on mature sibling oocyte outcomes.

Purpose: This study aimed to identify demographic and clinical factors associated with low maturation rates and to investigate if the rate of immature oocytes impacts the outcomes of mature sibling oocytes.

Methods: Women undergoing their first IVF-ICSI cycle between 2018 and 2022 at a fertility clinic were included. Cycles were classified into five groups according to the proportion of Metaphase II stage oocytes (MII): Null (0% MII, n = 46), Poor (1-25% MII, n = 44), Low (26-50% MII, n = 453), Acceptable (51-75% MII, n = 1641), and Optimal (76-100% MII, n = 2642).

Antibody-Drug Conjugates in Breast Cancer: The Road Towards Biologically-Informed Selection and Sequencing.

Purpose Of Review: In this review, we discuss evidence supporting the use of antibody-drug conjugates (ADCs) in breast cancer treatment, describe novel ADCs and combination regimens under development, and examine our current understanding of resistance mechanisms and biomarkers to guide ADC selection and sequencing.

Recent Findings: Three ADCs have proven benefit in patients with metastatic breast cancer: trastuzumab emtansine (T-DM1), trastuzumab deruxtecan (T-DXd), and sacituzumab govitecan (SG). There are over two hundred investigational ADCs on the horizon, as pre-clinical studies work to identify novel ADC targets and structures.

Survey of Urogynecology Fellows on the Care of Patients with Differences in Sex Development/Intersex Traits.

Introduction And Hypothesis: Patients with differences in sex development or intersex traits (DSD/I) struggle to find clinically competent care in adulthood. We sought to describe the surgical exposure of Urogynecology and Reconstructive Pelvic Surgery (URPS) fellows who had previously trained in ObGyn (URPS-Gyn) to patients with DSD/I and their interest in performing 18 relevant procedures. We hypothesized that most graduating fellows would not have had exposure to many of the surgeries.

Primary Care Considerations for Youth Martial Arts Athletes.

Purpose Of Review: This review aims to analyze the impact of martial arts on youth, addressing the physical and psychosocial benefits, as well as the injury risks associated with increased participation.

Recent Findings: Data from the National Federation of State High School Associations indicates a notable increase in youth participation in martial arts, with a rise of over 13,000 participants from 2018 to 2022. In addition to physical benefits, recent studies highlight that martial arts can significantly enhance mindfulness, reduce stress, and improve self-control, thus diminishing bullying behaviors in school-aged children.

Melanoma detection, treatment, survival, and mortality through year 2 of the pandemic.

The COVID-19 pandemic affected the timely diagnosis and treatment of many cancers, including melanoma, the fifth most common cancer in the U.S. This study aimed to quantify the disruption and recovery of melanoma detection, treatment, survival, and mortality during the pandemic by analyzing data from the Surveillance, Epidemiology, and End Results (SEER) program from 2000 to 2021.

Traditional versus modern approaches to screening mammography: a comparison of computer-assisted detection for synthetic 2D mammography versus an artificial intelligence algorithm for digital breast tomosynthesis.

Purpose: Traditional computer-assisted detection (CADe) algorithms were developed for 2D mammography, while modern artificial intelligence (AI) algorithms can be applied to 2D mammography and/or digital breast tomosynthesis (DBT). The objective is to compare the performance of a traditional machine learning CADe algorithm for synthetic 2D mammography to a deep learning-based AI algorithm for DBT on the same mammograms.

Methods: Mammographic examinations from 764 patients (mean age 58 years ± 11) with 106 biopsy-proven cancers and 658 cancer-negative cases were analyzed by a CADe algorithm (ImageChecker v10.

Right Ventricle Function: The Role of the Forgotten Chamber in Mitral Valve Surgery.

Background: Referred to as the "forgotten chamber," the right ventricle (RV) is now widely acknowledged as a significant factor, particularly in certain cardiovascular pathologies. Despite historically being undervalued in comparison to the left ventricle, the RV function is deemed crucial in determining patient outcomes following mitral valve (MV) surgery. In the context of MV surgery, it is important to note that the RV is highly susceptible to dysfunction before, during, and after the surgical procedure.

Psychological and interpersonal dimensions of sexual function and dysfunction: recommendations from the fifth international consultation on sexual medicine (ICSM 2024).

Introduction: Sexual health concerns are common and significantly impact quality of life, but many people do not seek treatment due to embarrassment and other barriers. A biopsychosocial model of assessment and treatment acknowledges the biological, psychological, and social contributors to sexual difficulties and suggests that all these domains should be evaluated.

Objectives: This paper provides an overview of the major psychological factors contributing to sexual difficulties and offer an evidence-based approach for primary care clinicians to assess and treat these issues.

A field resource for the glioma cerebrospinal fluid proteome: impacts of resection and location on biomarker discovery.

Background: While serial sampling of glioma tissue is rarely performed prior to recurrence, cerebrospinal fluid (CSF) is an underutilized longitudinal source of candidate glioma biomarkers for understanding therapeutic impacts. However, the impact of key variables to consider in longitudinal CSF samples for monitoring biomarker discovery, including anatomical location and post-surgical changes, remains unknown.

Methods: Aptamer-based proteomics was performed on 147 CSF samples from 74 patients, 71 of whom had grade 2-4 astrocytomas or grade 2-3 oligodendrogliomas.

Leveraging Natural Language Processing and Machine Learning Methods for Adverse Drug Event Detection in Electronic Health/Medical Records: A Scoping Review.

Background: Natural language processing (NLP) and machine learning (ML) techniques may help harness unstructured free-text electronic health record (EHR) data to detect adverse drug events (ADEs) and thus improve pharmacovigilance. However, evidence of their real-world effectiveness remains unclear.

Objective: To summarise the evidence on the effectiveness of NLP/ML in detecting ADEs from unstructured EHR data and ultimately improve pharmacovigilance in comparison to other data sources.

A Hitchhiker's Guide Toward CSF Biomarkers for Neuro-Oncology.

Cerebrospinal fluid (CSF) has emerged as a valuable liquid biopsy source for glioma biomarker discovery and validation. CSF produced within the ventricles circulates through the subarachnoid space, where the composition of glioma-derived analytes is influenced by the proximity and anatomical location of sampling relative to tumor, in addition to underlying tumor biology. The substantial gradients observed between lumbar and intracranial CSF compartments for tumor-derived analytes underscore the importance of sampling site selection.

Sex-specific risk factors for new-onset heart failure: the PREVEND study at 25 years.

Background And Aims: Current estimates for the lifetime risk to develop heart failure with either a reduced (HFrEF) or preserved ejection fraction (HFpEF) and their associated risk factors are derived from two studies from the USA. The sex-specific lifetime risk and population attributable fraction of potentially modifiable risk factors for incident HFpEF and HFrEF are described in a large European community-based cohort with 25 years of follow-up.

Methods: A total of 8558 participants from the PREVEND cohort were studied at baseline from 1997 onwards and followed until 2022 for cases of new-onset HFrEF (ejection fraction < 50%) and HFpEF (ejection fraction ≥ 50%) by assessment of hospital records.

Percutaneous transhepatic arterial access for coil embolization of hepatic artery infusion pump-associated bleeding.

Background: Hepatic artery infusion pump (HAIP) chemotherapy is a locoregional treatment for intrahepatic malignancies. HAIPs are surgically implanted, and the catheter tip is typically inserted into a ligated gastroduodenal artery stump. Potential complications at the catheter insertion site include dehiscence, pseudoaneurysm or extravasation, and adjacent hepatic arterial stenosis and thrombosis.

Desmoplakin Cardiomyopathy: Role of Inflammation and Potential Role of Disease-Modifying Therapies.

Purpose Of Review: To summarize the available data on the use of immunosuppression therapies for the management of hot phases of disease and recurrent myocarditis in patients with desmoplakin cardiomyopathy (DSP-CMP).

Recent Findings: Occurrence of myocarditis episodes has been associated with worsening of outcomes in DSP-CMP. Multiple case reports and small case series have described potential benefit in using anti-inflammatory and immunosuppressive medications for the treatment of those episodes.

Anterior component separation techniques: is it necessary to preserve the perforators? a systematic review and meta-analysis.

Background: Anterior component separation (ACS), or Ramirez component separation technique, is an established technique still used by surgeons to repair a ventral hernia. Compared with other ventral hernia repair techniques, recent studies about ACS show more postoperative complications like wound breakdown, wound infection, hematoma, skin necrosis, seroma, and recurrence. Our study aims to compare the ACS technique with the preservation perforator technique and verify if the perforator preservation technique can decrease postoperative complications.

Using minimally invasive tissue sampling (MITS) and Determination of Cause of Death (DeCoDe) to establish etiologies of community respiratory deaths among Zambian infants and children.

In low-to-middle income countries, acute lower respiratory infection (ALRI) remains the leading infectious cause of death among infants and children under 5 years old. Case-control studies based on upper respiratory sampling have informed current understandings of ALRI etiologies; in contrast, minimally-invasive tissue sampling (MITS) offers a method of directly interrogating lower respiratory tract pathogens to establish etiologic distributions. This study performed in the post-mortem setting used MITS and a Determination of Cause of Death (DeCoDe) panel to elucidate causes of fatal pneumonia in the community in Lusaka, Zambia.

Central Sleep Apnea and Cardiovascular Disease State-of-the-Art.

Central sleep apnea (CSA), a rare polysomnographic finding in the general population, is prevalent in certain cardiovascular conditions including systolic and diastolic left ventricular dysfunction, atrial fibrillation, coronary artery disease, carotid artery stenosis, stroke and use of certain cardiac-related medications. Polysomnographic findings of CSA with adverse cardiovascular impacts include nocturnal hypoxemia and arousals, which can lead to increased sympathetic activity both at night and in the daytime. Among cardiovascular diseases, CSA is most prevalent in patients with left ventricular systolic dysfunction; a large study of more than 900 treated patients has shown a dose dependent relationship between nocturnal desaturation and mortality.

Development and validation of nomograms and integrated software incorporating preoperative C-reactive protein level for prognostic prediction of nonmetastatic clear cell renal cell carcinoma: Results from the International Marker Consortium for Renal Cancer (INMARC) Registry.

Purpose: Preoperative C-reactive protein (CRP) is a valuable prognostic biomarker in nonmetastatic clear cell renal cell carcinoma (nmccRCC). Incorporation of CRP into prognostic models may improve the prediction of oncologic outcomes. Herein, we aimed to develop and validate prognostic nomograms and an integrated software incorporating preoperative CRP level in nmccRCC.

Characterizing Cognitive Dispersion and its Correlates Across the Adult Lifespan in MIDUS.

Objectives: Although research has shown that higher levels of within-person variability across cognitive tasks (dispersion) are associated with cognitive decline in clinical samples, little is known about dispersion in comparatively younger, non-clinical, and national samples. A better understanding of dispersion is needed to elucidate for whom and under what circumstances dispersion can be used as a reliable indicator of cognitive health.

Method: We used data from the Midlife in the United States Study (MIDUS; n = 2,229; Mage = 56 years, range = 33-83; 56% female) to: (a) characterize dispersion and its cross-sectional correlates in a non-clinical, adult lifespan sample and (b) examine changes in dispersion over time to determine for whom changes in dispersion may reflect better or worse cognitive aging.

Advances in Analytical Methodologies for Detecting Novel Psychoactive Substances (NPS): A Review.

Novel psychoactive substances (NPS) have historically been difficult compounds to analyze in forensic toxicology. The identification, detection and quantitation of these analytes and their metabolites has been difficult due to their rapid emergence, short life span and various potencies. Advancements in analytical instrumentation are fundamental to mitigating these NPS challenges by providing reliable identification and sensitivity.