Impact of the diagnostic label for a low-risk prostate lesion: protocol for two online factorial randomised experiments.

Introduction: Many types of prostate cancer present minimal risk to a man's lifespan or well-being, but existing terminology makes it difficult for men to distinguish these from high-risk prostate cancers. This study aims to explore whether using an alternative label for low-risk prostate cancer influences management choice and anxiety levels among Australian men and their partners.

Methods And Analysis: We will run two separate studies for Australian men and Australian women with a male partner.

Adjusting vehicle secondary safety ratings to account for crash-avoidance technology fitment using real-world crash and injury data.

Objectives: Publicizing safety ratings of vehicles can motivate manufacturers to prioritize safety and help consumers choose safer vehicles, leading to safer fleets. The benefits of primary safety technologies that prevent crash occurrence are not currently incorporated in current ratings in a way that values their safety benefits consistently. We aimed to propose a method for assigning weights for each safety technology to account for established safety benefits using published effectiveness and prevalence from real-life data.

A Randomized Trial of Nafamostat for Covid-19.

BACKGROUND: Nafamostat mesylate is a potent in vitro antiviral agent that inhibits the host transmembrane protease serine 2 enzyme used by severe acute respiratory syndrome coronavirus 2 for cell entry. METHODS: This open-label, pragmatic, randomized clinical trial in Australia, New Zealand, and Nepal included noncritically ill hospitalized patients with coronavirus disease 2019 (Covid-19). Participants were randomly assigned to usual care or usual care plus nafamostat.

Comparing approaches to determining poor oral health among older adults in a national survey.

Objectives: To compare the clinical validity of the three approaches in residential care facility residents.

Background: In NZ residential care facilities, the interRAI assessment tool is used by trained registered nurses for assessing oral status when new residents are admitted, but its validity has been questioned. Although Locker's global oral health item has been used to measure oral health in surveys and health services research, it is not routinely used in care facilities, yet its clinical validity has been demonstrated in population-based samples.

Web-grading-a tool to test personal grading of renal and prostate cancer.

Only a few pathologists have the opportunity to verify their personal grading through objective assessment. This study introduces a web-based grading platform to facilitate and validate the grading of renal cell carcinoma and prostate cancer. Two representative images of two clinically annotated cohorts of 100 cases each of prostate and renal cell carcinoma were used.

Ethnic variation in hospitalisation due to treatment injury and complications of healthcare in older adults residing in New Zealand.

Aim: To describe the incidence, characteristics, and ethnic variation of hospitalisations for treatment injury and complications of medical or surgical care in older adults in two regions of Aotearoa New Zealand.

Methods: This observational study analysed treatment-related hospital admissions (<24 hours; index injury from primary or secondary care) among older adults (<50 years) between 2014-2018 in Lakes and Bay of Plenty District Health Boards. Among all admissions due to a treatment injury (n=296) or a complication of healthcare (n=13,850), age-standardised incidence rates per 100,000 were determined by ethnicity and age group.

Low-risk prostate lesions: An evidence review to inform discussion on losing the "cancer" label.

Background: Active surveillance (AS) mitigates harms from overtreatment of low-risk prostate lesions. Recalibration of diagnostic thresholds to redefine which prostate lesions are considered "cancer" and/or adopting alternative diagnostic labels could increase AS uptake and continuation.

Methods: We searched PubMed and EMBASE to October 2021 for evidence on: (1) clinical outcomes of AS, (2) subclinical prostate cancer at autopsy, (3) reproducibility of histopathological diagnosis, and (4) diagnostic drift.

Oral self-care among dependent older New Zealanders.

Objectives: The objective of the study was to describe the occurrence and associations of oral self-care by dependent older New Zealanders.

Background: Dependent older adults who require some level of assisted daily care have been shown to have poorer oral health than their independent counterparts, yet national estimates are lacking.

Materials And Methods: A secondary analysis was conducted of data from New Zealand's 2012 Older People's Oral Health Survey, a national survey that interviewed and examined a representative sample of 2,218 dependent older adults living in aged residential care or receiving home-based care.

Computational pathology in 2030: a Delphi study forecasting the role of AI in pathology within the next decade.

Background: Artificial intelligence (AI) is rapidly fuelling a fundamental transformation in the practice of pathology. However, clinical integration remains challenging, with no AI algorithms to date in routine adoption within typical anatomic pathology (AP) laboratories. This survey gathered current expert perspectives and expectations regarding the role of AI in AP from those with first-hand computational pathology and AI experience.

'Thinking about pain in a different way': Patient perspectives of a neuroscience-informed physiotherapy programme for rotator cuff-related shoulder pain.

Background: Rotator cuff-related shoulder pain (RCRSP) is a common musculoskeletal problem. The multi-factorial contributors to persistent pain are often overlooked during treatment. Pain neuroscience education (PNE) contributes to a holistic approach for patients with persistent pain but has not yet been researched for patients with RCRSP.

Estimating diagnostic uncertainty in artificial intelligence assisted pathology using conformal prediction.

Unreliable predictions can occur when an artificial intelligence (AI) system is presented with data it has not been exposed to during training. We demonstrate the use of conformal prediction to detect unreliable predictions, using histopathological diagnosis and grading of prostate biopsies as example. We digitized 7788 prostate biopsies from 1192 men in the STHLM3 diagnostic study, used for training, and 3059 biopsies from 676 men used for testing.

LOT and HOT … or not. The proliferation of clinically insignificant and poorly characterised types of renal neoplasia.

The classification of malignant tumours is influenced by both immunohistochemical and molecular genetic findings. This is highlighted in the latest World Health Organization classification of renal neoplasia, which has a tumour category of 'tumours that are molecularly defined'. This implies that the defining molecular features are integral to tumourigenesis, which may not necessarily be the case.

A global view of hypertensive disorders and diabetes mellitus during pregnancy.

Two important maternal cardiometabolic disorders (CMDs), hypertensive disorders in pregnancy (HDP) (including pre-eclampsia) and gestational diabetes mellitus (GDM), result in a large disease burden for pregnant individuals worldwide. A global consensus has not been reached about the diagnostic criteria for HDP and GDM, making it challenging to assess differences in their disease burden between countries and areas. However, both diseases show an unevenly distributed disease burden for regions with a low income or middle income, or low-income and middle-income countries (LMICs), or regions with lower sociodemographic and human development indexes.

Aberrant protein expression of Appl1, Sortilin and Syndecan-1 during the biological progression of prostate cancer.

Diagnosis and assessment of patients with prostate cancer is dependent on accurate interpretation and grading of histopathology. However, morphology does not necessarily reflect the complex biological changes occurring in prostate cancer disease progression, and current biomarkers have demonstrated limited clinical utility in patient assessment. This study aimed to develop biomarkers that accurately define prostate cancer biology by distinguishing specific pathological features that enable reliable interpretation of pathology for accurate Gleason grading of patients.

Bariatric surgery and the neurohormonal switch: Early insulin resistance recordings after laparoscopic sleeve gastrectomy.

Laparoscopic sleeve gastrectomy (LSG) is a bariatric operation with a safe risk profile. It has been proven to successfully reduce weight, decrease insulin resistance (IR), and ameliorate diabetes mellitus. The aim of this study was to determine if there is an early improvement in IR after LSG and its association with weight loss.

Oncological and urinary outcomes following low-dose-rate brachytherapy with a median follow-up of 11.8 years.

Objectives: To examine the long-term oncological outcomes and urological morbidity of low-dose-rate prostate brachytherapy (LDRBT) monotherapy using live intraoperative dosimetry planning and an automated needle navigation delivery system for the treatment of men with low and intermediate-risk prostate cancer.

Patients And Methods: A prospective database of 400 consecutive patients who underwent LDRBT between July 2003 and June 2015 was retrospectively reviewed to assess urinary side-effects and biochemical progression, based on the Phoenix definition and also a definition of a prostate-specific antigen (PSA) level of ≥0.2 μg/L.

Indigenous Māori perspectives of smokefree parks.

Objective: This study aims to understand the context of place associated with smoking in urban Hamilton parks from a Te Ao Māori perspective (the worldview of Māori, the Indigenous people of Aotearoa New Zealand).

Methods: Our study approached smokefree environments in Hamilton through a Māori lens, undertaking interviews with family groups and people from organisations involved in the local Smokefree environments policy.

Results: The majority of the 26 adult participants identified as Māori, with 30% being current smokers.

Validation of a Novel Three-Dimensional () Gross Sampling Protocol for Clear Cell Renal Cell Carcinoma to Overcome Intratumoral Heterogeneity: The Meet-Uro 18 Study.

We aimed to overcome intratumoral heterogeneity in clear cell renal cell carcinoma (clearRCC). One hundred cases of clearRCC were sampled. First, usual standard sampling was applied (1 block/cm of tumor); second, the whole tumor was sampled, and 0.

Point/counterpoint: We should take the direction of blood pressure change into consideration for dynamic cerebral autoregulation quantification.

Accumulating evidence suggests asymmetrical responses of cerebral blood flow during large transient changes in mean arterial pressure. Specifically, the augmentation in cerebral blood flow is attenuated when mean arterial pressure acutely increases, compared with declines in cerebral blood flow when mean arterial pressure acutely decreases. However, common analytical tools to quantify dynamic cerebral autoregulation assume autoregulatory responses to be symmetric, which does not seem to be the case.

Prognostic significance of percentage Gleason grade 5 prostatic adenocarcinoma in needle biopsies from patients treated by radical prostatectomy.

Previous studies have shown that the percentage of high grade prostatic adenocarcinoma (Gleason patterns 4 and 5) in a biopsy correlates with outcome parameters. It has also been shown that the percentage Gleason pattern 4/5 tumour correlates with biochemical failure and overall survival. There are little data relating to the prognostic significance of quantifying the percentage of Gleason pattern 5 in isolation.

Detection of perineural invasion in prostate needle biopsies with deep neural networks.

The presence of perineural invasion (PNI) by carcinoma in prostate biopsies has been shown to be associated with poor prognosis. The assessment and quantification of PNI are, however, labor intensive. To aid pathologists in this task, we developed an artificial intelligence (AI) algorithm based on deep neural networks.