Fungating testicular germ cell tumours: Case report and narrative review of clinical presentation and management strategies.

Fungating testicular germ cell tumours represent a rare and extreme manifestation of neglected testicular cancer. These cases typically arise after significant delays in presentation, reflecting advanced local disease and, in many instances, concurrent metastatic spread. We present the case of a 41 year-old man with a year-long history of a progressively enlarging, ulcerated scrotal mass.

Evaluation of a pilot outreach program to support point-of-care screening for individuals with diabetes who are experiencing homelessness in Alberta, Canada: results of a mixed methods study.

Background: Accessing diabetes care requires effort and time. Homelessness often forces individuals to prioritize securing shelter and safety over medical appointments, particularly for the screening and prevention of long-term diabetes complications. We evaluated the effectiveness and costs associated with a point-of-care screening program with expedited referral pathways within two inner-city community sites in Calgary, Canada serving individuals experiencing homelessness.

Fifteen-Year Mortality Following Periprosthetic Joint Infection in Total Knee Arthroplasty: A Registry Study of 8,642 Revisions for Infection.

Background: Periprosthetic joint infection (PJI) following total knee arthroplasty (TKA) is a serious complication associated with notable loss of function, impaired quality of life, and excess short-term mortality. In this study, we aimed to report the impact of PJI on long-term mortality and its associated risk factors.

Methods: Using data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), we used Kaplan-Meier estimates of survivorship and standardized mortality ratios (SMRs) based on Australian period life tables to describe mortality rates following revision for PJI, aseptic revisions (excluding those for fracture), and unrevised primary TKA.

The association between clock gene polymorphisms and type 2 diabetes: A systematic review and meta-analysis.

Background: Misalignment of the endogenous circadian system may contribute to the risk of type 2 diabetes. This systematic review and meta-analysis examined the association between clock gene polymorphisms and glycemic parameters and type 2 diabetes.

Methods: Embase, Medline, and Web of Science databases were searched from inception to August 20, 2024.

The role of air pressure transients on the spread of bacteria from wash-hand basin sink traps in hospital en-suite bathrooms: A laboratory-based pilot study.

Background: There is growing evidence for the involvement of sink and wash-hand basin traps in the spread of hospital-acquired infections in clinical settings. This Pilot Study used a full-scale model of a hospital wash-hand basin and wastewater drainage system, typical in single-occupancy hospital bathrooms, to examine bacterial transmission from sink traps to wash-hand basins during drainage system air pressure surges.

Methods: Simulating real-world conditions in a laboratory, a 50-metre pipe network was connected to the model en-suite bathroom.

Efficacy of an online mindfulness program () to reduce fear of recurrence in people living with-and beyond-breast, prostate or colorectal cancer: a randomized controlled trial.

Background: Fear of cancer recurrence (FCR) is a prevalent and debilitating condition that effects around 60% of people living with cancer. It is severe, persistent, and imposes a significant financial burden on the healthcare system. Given FCR's profound impact on mental health and quality of life, adopting targeted interventions to mitigate its effects is essential.

Illustrating stories of stigma from the perspective of people living with diabetes while experiencing homelessness: An arts-based community participatory research project.

Aims: Our objective was to explore the stigma experienced by people with lived experiences of both diabetes and homelessness.

Methods: This community-based participatory research (CBPR) project was underpinned by a partnership between academic researchers and those with lived experience (co-researchers). We used two arts-based research methods, Forum Theatre and Participatory Filmmaking, and collected field notes, interviews with co-researchers, and the narrative scripts from the play and film.

A Value Framework for Evaluating Population Genomic Programs: A Mixed Methods Approach.

: Value frameworks are useful tools to explicitly define the dimensions and criteria important for decision-making, but no existing frameworks capture the broad value domains of population genomic programs. Using a mixed methods approach, we aimed to develop a novel value framework for evaluating population genomic programs (PGPs). : We first conducted a targeted literature review of published evidence on the value of PGPs and existing frameworks to evaluate and quantify their impact.

Implementation of a virtual multi-disciplinary model of care for people affected by cancer: a qualitative evaluation.

Objectives: To undertake a qualitative evaluation of the implementation of the Penile and Testicular cancer multidisciplinary meeting (PEN-TEST MDM) model pilot including the acceptability, adoption, appropriateness, feasibility, and requirements for sustaining the model from the perspectives of key informants.

Design, Setting, Participants: A qualitative evaluation of the PEN-TEST MDM model six-month implementation pilot at Barwon Health (Victoria, Australia) (January to July 2024) was undertaken from July to September 2024. Qualitative data was obtained from semi-structured interviews undertaken with key informants, including working group members and end-users (referring and attending clinicians).

Donation after circulatory death with thoracoabdominal normothermic regional perfusion recovery has similar outcomes with donation after brain death for lung transplantation.

Introduction: Donation after circulatory death (DCD) with thoracoabdominal normothermic regional perfusion (TA-NRP) has been increasingly used to procure cardiac allografts; however, concerns persist regarding its impact on lung allografts. We present our institution's experience with DCD TA-NRP and donation after brain death (DBD) lung transplants, comparing outcomes between the two techniques.

Methods: All lung transplants recovered with DBD or DCD TA-NRP performed between October 2022 and December 2024 were included.

Initial Direct Laryngoscopy Versus TORS Alone for Unknown Primary HPV+ Oropharyngeal Squamous Cell Carcinoma.

Objective: This study aims to determine whether initial direct laryngoscopy with biopsy (DLBx) before transoral robotic surgery (TORS) has differences in perioperative outcomes, tumor identification, and oncologic outcomes for unknown primary oropharyngeal human papillomavirus (HPV+) squamous cell carcinoma (OPSCC).

Study Design: A retrospective cohort.

Setting: A single-institution, tertiary referral center.

Interventions to improve diabetes care and self-management for individuals experiencing homelessness: a scoping review with systematic search of qualitative and quantitative literature.

Aims/hypothesis: Optimal diabetes management for people experiencing homelessness can be a challenge. Our aim was to summarise the existing literature on, highlight emerging evidence for and identify gaps in diabetes care for people experiencing homelessness.

Methods: We undertook a comprehensive and systematic search of 11 databases of published academic literature up to 24 September 2024.

Long-Term Mortality Associated with Periprosthetic Infection in Total Hip Arthroplasty: A Registry Study of 4,651 Revisions for Infection.

Background: While the morbidity associated with revision total hip arthroplasty (THA) or periprosthetic infection (PJI) has been well characterized, less is known about the risk of mortality. With this study, we aimed to determine the long-term mortality associated with revision THA for PJI and associated risk factors.

Methods: Data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) were used to study mortality associated with THA procedures for osteoarthritis and subsequent revisions from September 1999 through December 2022.

Restoration of NOX4 signalling reverses endothelial colony-forming cell angiogenic dysfunction associated with experimental and clinical diabetes.

Background: Progenitor endothelial colony forming cells (ECFCs) are critical for vascular homeostasis and hold therapeutic potential for ischaemic cardiovascular disease (CVD). As angiogenic capacity and efficacy within diseased tissues is particularly impacted in diabetic patients, who show high incidence of ischaemic CVD, targeting of critical ECFC pathways in this setting represents an innovative focus towards enhancing intrinsic vasoreparative function. We previously reported that NADPH oxidase 4 (NOX4)-derived reactive oxygen species promote cord blood-derived ECFC (CB-ECFC) pro-angiogenic response, whilst NOX4 overexpression (OE) enhances revascularisation capacity.

Mutations in RNU4ATAC Are Associated With Chilblain-Like Lesions and Enhanced Type I Interferon Signalling.

Mutations in the non-coding RNA gene RNU4ATAC are associated with growth restriction and complications related to antibody deficiency. Here, we report that innate immune dysfunction is a previously unrecognised feature of this disorder. In particular, painful chilblain-like lesions are common in RNU4ATAC patients and are linked to dysregulated type I interferon signalling.

Disparities in screening, diagnosis, treatment, and outcomes for diabetic retinopathy among people with lived experience of homelessness in Canada.

Objective: To estimate the rates of screening, diagnosis, treatment, and outcomes related to diabetic retinopathy among persons with diabetes who have experienced homelessness compared with a matched cohort of nonhomeless controls.

Methods: A propensity score-matched cohort study was conducted using administrative health data from Ontario. Eligible persons required a diagnosis of diabetes and at least 1 hospital encounter between April 2006 and March 2019.

Describing the Experiences of Health-care Providers Who Supported an Outreach Program to Deliver Point-of-care Screening in Adults With Type 1 and Type 2 Diabetes Who Are Experiencing Homelessness in Calgary, Canada: A Qualitative Analysis.

Objectives: Unstable housing and homelessness are associated with increased risks of diabetes-related morbidity and mortality. Concordantly, as few as 12% to 30% of people with lived experience of homelessness (PWLEH) complete recommended screening for microvascular complications of diabetes. Innovative models of care delivery are needed to address this disparity.

Rituximab for the Management of an Australian Cohort of Treatment Refractory Mucous Membrane Pemphigoid.

Background: Mucous membrane pemphigoid (MMP) has a broad range of clinical manifestations, from relatively benign self-limiting oral lesions to significant scarring (cicatrizing) of the oral, nasal and ocular tissues with severe functional impairment and morbidity. European Guidelines recommend rituximab as only second- or third-line therapy, based on the extent/severity of the disease; however, there are no established clinical or serological markers that are predictive of severe disease warranting the use of agents such as rituximab.

Methods: Retrospective cross-sectional cohort study of patients who met the following criteria: (1) biopsy confirmed MMP; (2) required a steroid-sparing immunosuppressant therapy, that is, mycophenolate and/or rituximab and (3) at least 6 months of clinical monitoring.

Assessing the Impact of a Community-Based Narrative Film about Diabetes and Homelessness.

Stigma prevents societal acceptance, reinforces social inequities, and greatly complicates the management of diabetes for those dealing with homelessness. Various forms of media, such as film, can educate audiences and play a role in reducing stigma, but the effectiveness of such interventions in changing individuals' knowledge, attitudes, and beliefs (KAB) requires further exploration. This study assessed the impact of a film on diabetes and homelessness through pre- and post-surveys of audience members ( = 202) at 12 screening events.

Gut microbiome in paediatric short bowel syndrome: a systematic review and sequencing re-analysis.

Children with short bowel syndrome depend on parenteral nutrition, which carries significant risks. Short bowel syndrome patients show reduced gut microbial diversity, increased inflammation-associated bacteria, and fewer beneficial bacteria. This is the first systematic review and meta-analysis examining the gut microbiome in children with short bowel syndrome.

Effect of timed exercise interventions on patient-reported outcome measures: A systematic review.

Background: Exercising at a specific time of day has the potential to mitigate the negative effects of disrupted circadian rhythms caused by irregular work and sleep schedules on the development of chronic diseases. Afternoon/evening exercise is postulated to be superior to morning exercise for various health outcomes, but patient acceptance of timed exercise remains unclear. The aim of this systematic review was to assess the impact of exercise timing on patient-reported outcomes (PROMs).

Complementary medicine among individuals experiencing homelessness in Switzerland: a quantitative and qualitative descriptive study.

Background: People experiencing homelessness (PEH) are disproportionately affected by health issues yet remain underserved by the health care system. Emerging findings suggest that complementary medicine (CM) approaches might help address the low access to earlier treatment and the complex needs of this population. Very little research has explored this topic in Europe.

Confirmatory Testing for Primary Aldosteronism : A Study of Diagnostic Test Accuracy.

Background: Confirmatory testing to verify the diagnosis of primary aldosteronism (PA) in patients who have an abnormal screening result is of uncertain benefit.

Objective: To perform a blinded assessment of the seated saline suppression test (SSST).

Design: Diagnostic test accuracy study.

The financial value of improving patient access to COVID-19 antiviral therapy in Medicare Part D: A simulation study.

Background: Nirmatrelvir-ritonavir is an approved treatment for mild to moderate COVID-19 in adults who are at high risk for progression to severe COVID-19, including hospitalization or death. Age is the leading risk factor for severe COVID-19, making treatment access particularly important for the Medicare population. Part D plans must include COVID-19 antivirals on formularies.