Factors Influencing End-of-Life Decisions in Cancer Patients After Traumatic Injuries.

Introduction: Severe traumatic injuries are frequently associated with poor outcomes, and withdrawal of life-sustaining treatment (WLST) after traumatic brain injury is common. However, the association between WLST and pre-existing cancer in all trauma patients remains underexplored.

Methods: This retrospective cohort study analyzed data from the American College of Surgery Trauma Quality Programs in 2022.

Trauma, Gender, and End-of-Life Care: A Propensity-Matched Cohort Study Analyzing Disparities in Withdrawal of Life Support.

Introduction: Men are known to have more severe injuries at younger ages compared to women. However, the relationship between gender and other sociodemographic factors in the context of end-of-life care after traumatic injuries is not well understood.

Methods: This retrospective observational cohort study utilized data from the American College of Surgeons Trauma Quality Programs in 2022 and included all patients who were 18 y or older while those with missing information on withdrawal of life-sustaining treatment (WLST) were excluded.

Guidance for conducting and evaluating serological surveys to assess interruption of yaws transmission in the context of an eradication target.

This document provides a summary of guidance developed for national programmes on conducting serosurveys to assess yaws transmission status, with the objective of confirming yaws seroprevalence below 1% at each of three serosurveys over a period of 3-10 years after reporting the last case of active yaws in a region. It proposes active testing of children aged 1-5 years through population-based surveys and includes recommendations on survey design, sample size determination, sampling of primary sampling units (PSUs) within an evaluation unit, sampling of households within PSUs, integration with existing public health surveys, and follow-up protocols for positive results. Geospatial analysis and sustained surveillance are recommended for accurate assessment of whether transmission interruption has been achieved.

Effect of travel distance on utilization of ancillary services among patients with pancreatic ductal adenocarcinoma: A single institution study.

Background: Fragmentation of care among patients with pancreatic cancer between specialized tertiary centers and community centers may be associated with increased patient burden and poorer outcomes. However, the impact of distance from a tertiary center on utilization of key ancillary services such as dietician consultation, and palliative or pain medicine consultation is unclear. We sought to examine how this travel distance influences the utilization of key ancillary services.

Artificial intelligence in the management of metabolic disorders: a comprehensive review.

This review explores the significant role of artificial intelligence (AI) in managing metabolic disorders like diabetes, obesity, metabolic dysfunction-associated fatty liver disease (MAFLD), and thyroid dysfunction. AI applications in this context encompass early diagnosis, personalized treatment plans, risk assessment, prevention, and biomarker discovery for early and accurate disease management. This review also delves into techniques involving machine learning (ML), deep learning (DL), natural language processing (NLP), computer vision, and reinforcement learning associated with AI and their application in metabolic disorders.

Access to Primary Care Telemedicine and Visit Characterization in a Pediatric, Low-Income, Primarily Latino Population: Retrospective Study.

Background: Since the COVID-19 pandemic, telemedicine has been widely integrated into primary care pediatrics. While initial studies showed some concern for disparities in telemedicine use, telemedicine uptake for pediatric patients in a low-income, primarily Latino community over a sustained period has yet to be described.

Objective: We aimed to assess the relationship between demographics, patient portal activation, and telemedicine visits, as well as characterize diagnoses addressed in telemedicine, in a low-income, primarily Latino population over time.

Implementation of structured radiology reporting and its associated accuracy in comparison to pancreas multi-disciplinary clinic expert radiology review.

Purpose: To evaluate the feasibility of implementation of structured reporting in the setting of a high-volume pancreatic multidisciplinary clinic (PMDC) and to assess its value by comparing the accuracy of structured reports with expert imaging reviews.

Methods: A single institutional prospective cohort study was conducted during March 2022 to May 2024 to understand the feasibility of implementation of structured reporting (SR) for all patients who were seen in our weekly PMDC. Descriptive and regression analyses were performed to find an association between SR and difference in vascular involvement of the primary pancreatic tumor between the radiology report and expert radiologist review (gold standard) during PMDC.

Nitric oxide in modulating oxidative stress mediated skeletal muscle insulin resistance.

Insulin resistance (IR) being the major cause behind different metabolic disorders, has attracted a lot of attention. Epidemiological data shows marked rise in the cases over a period of time. Nitric oxide (NO), produced from nitric oxide synthases (NOS), is involved in a variety of biological functions, alteration in which causes various disorders like hypertension, atherosclerosis, and angiogenesis-associated disorders.

Variation in outcomes and practice patterns among patients with localized pancreatic cancer: the impact of the pancreatic cancer multidisciplinary clinic.

Introduction: Patients with localized pancreatic adenocarcinoma (PDAC) benefit from multi-modality therapy. Whether care patterns and oncologic outcomes vary if a patient was seen through a pancreatic multi-disciplinary clinic (PMDC) versus only individual specialty clinics is unclear.

Methods: Using institutional Pancreatic Cancer Registry, we identified patients with localized PDAC from 2019- 2022 who eventually underwent resection.

Mechanistic Review on the Role of Gut Microbiota in the Pathology of Cardiovascular Diseases.

Cardiovascular diseases (CVDs), which stand as the primary contributors to illness and death on a global scale, include vital risk factors like hyperlipidemia, hypertension, diabetes, and smoking, to name a few. However, conventional cardiovascular risk factors offer only partial insight into the complexity of CVDs. Lately, a growing body of research has illuminated that the gut microbiome and its by-products are also of paramount importance in the initiation and progression of CVDs.

Transplantation for type 1 diabetes: radiologist's primer on islet, pancreas and pancreas-kidney transplantation imaging.

Whole-organ pancreas, pancreatic-kidney and islet transplantation are surgical therapeutic options for the treatment of type 1 diabetes. They can enable effective glycemic control, improve quality of life and delay/reduce the secondary complications of type 1 diabetes mellitus. Radiologists are integral members of the multidisciplinary transplantation team involved in these procedures, with multimodality imaging serving as the mainstay for early recognition and management of transplant related complications.

Overview of F18-FDG uptake patterns in retroperitoneal pathologies: imaging findings, pitfalls, and artifacts.

Introduction: Retroperitoneum can be the origin of a wide variety of pathologic conditions and potential space for disease spread to other compartments of the abdomen and pelvis. Computed tomography (CT) and magnetic resonance imaging (MRI) are often the initial imaging modalities to evaluate the retroperitoneal pathologies, however given the intrinsic limitations, F18-FDG PET/CT provides additional valuable metabolic information which can change the patient management and clinical outcomes. We highlight the features of retroperitoneal pathologies on F18-FDG PET/CT and the commonly encountered imaging artifacts and pitfalls.

Skin Malignancies: Imaging Review with Radiologic-Histopathologic Correlation.

Skin malignancies are commonly encountered as primary or incidental findings. Neoplasms that affect the skin include primary (basal cell carcinoma, squamous cell carcinoma, melanoma, and Merkel cell carcinoma) and secondary (mesenchymal neoplasms, lymphoma, and metastases) tumors. Imaging provides valuable anatomic information (tumor size, depth of involvement, presence of distant metastasis, and data for guiding biopsy) and functional information (metabolic activity and sentinel node mapping data).

Hypertension treatment capacity in India by increased workforce, greater task-sharing, and extended prescription period: a modelling study.

Background: The worldwide control rate for hypertension is dismal. An inadequate number of physicians to treat patients with hypertension is one key obstacle. Innovative health system approaches such as delegation of basic tasks to non-physician health workers (task-sharing) might alleviate this problem.

Effectiveness of the nutrition referral system in a multidisciplinary pancreatic cancer clinic.

Purpose: Proactive nutrition screening and intervention is associated with improved outcomes for patients with pancreatic adenocarcinoma (PDAC). To better optimize nutrition amongst our PDAC population, we implemented systematic malnutrition screening in the Johns Hopkins pancreas multidisciplinary clinic (PMDC) and assessed the effectiveness of our nutrition referral system.

Methods: This was a single institution prospective study of patients seen in the PMDC, screened for malnutrition using the Malnutrition Screening Tool (MST) (score range=0 to 5, score > 2 indicates risk of malnutrition), and offered referrals to the oncology dietitian.

Spectral Similarity Measures for In Vivo Human Tissue Discrimination Based on Hyperspectral Imaging.

Problem: Similarity measures are widely used as an approved method for spectral discrimination or identification with their applications in different areas of scientific research. Even though a range of works have been presented, only a few showed slightly promising results for human tissue, and these were mostly focused on pathological and non-pathological tissue classification.

Methods: In this work, several spectral similarity measures on hyperspectral (HS) images of in vivo human tissue were evaluated for tissue discrimination purposes.

Serum and cecal metabolic profile of the insulin resistant and dyslipidemic p47 knockout mice.

Involvement of NOX-dependent oxidative stress in the pathophysiology of metabolic disorders as well as in the maintenance of metabolic homeostasis has been demonstrated previously. In the present study, the metabolic profile in p47 and WT mice fed on a chow diet was evaluated to assess the role of metabolites in glucose intolerance and dyslipidemia under altered oxidative stress conditions. p47 mice displayed glucose intolerance, dyslipidemia, hyperglycemia, insulin resistance (IR), hyperinsulinemia, and altered energy homeostasis without any significant change in gluconeogenesis.

Development and validation of risk stratification tool for prediction of increased dependence using preoperative frailty after hepatopancreatic surgery.

Background: Despite the known association between frailty and postoperative morbidity, the use of preoperative frailty in surgical practice remains limited. We sought to develop a risk tool to predict postoperative increase in functional dependence.

Methods: Patients of ≥65 years in the National Surgical Quality Improvement Project database who had a primary hepatopancreatic surgery between 2015 and 2019 were used to identify predictors of increased dependence and development of a simplified tool to calculate the risk stratification score for increased discharge care level (https://ktsahara.

Road Traffic Accidents Presenting to the Emergency Department of a Tertiary Care Center: A Descriptive Cross-sectional Study.

Introduction: Road Traffic Accidents have emerged as the leading cause of mortality and morbidity globally. The burden of road traffic accidents has escalated gradually in Nepal and is a common cause of injury and trauma. The study aims to identify the prevalence of road traffic accidents in the emergency department.

Vancomycin-Induced Modulation of Gram-Positive Gut Bacteria and Metabolites Remediates Insulin Resistance in iNOS Knockout Mice.

The role of oxidative and nitrosative stress has been implied in both physiology and pathophysiology of metabolic disorders. Inducible nitric oxide synthase (iNOS) has emerged as a crucial regulator of host metabolism and gut microbiota activity. The present study examines the role of the gut microbiome in determining host metabolic functions in the absence of iNOS.

Neuroendocrine tumour of the breast: A challenging diagnosis on cytology.

This letter describes the cytological features in a case of primary neuroendocrine tumour of breast.

Modulation of Insulin Resistance, Dyslipidemia and Serum Metabolome in iNOS Knockout Mice following Treatment with Nitrite, Metformin, Pioglitazone, and a Combination of Ampicillin and Neomycin.

Oxidative and nitrosative stress plays a pivotal role in the incidence of metabolic disorders. Studies from this lab and others in iNOS mice have demonstrated occurrence of insulin resistance (IR), hyperglycemia and dyslipidemia highlighting the importance of optimal redox balance. The present study evaluates role of nitrite, L-arginine, antidiabetics (metformin, pioglitazone) and antibiotics (ampicillin-neomycin combination, metronidazole) on metabolic perturbations observed in iNOS mice.

Quality and Safety in Hospital Pediatrics During COVID-19: A National Qualitative Study.

Objective: To describe challenges in inpatient pediatric quality and safety during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: In a previous qualitative study, our team sought to broadly describe changes in pediatric inpatient care during the pandemic. For both that study and this ancillary analysis, we purposefully sampled participants from community and children's hospitals in the 6 US states with the highest COVID-19 hospitalization rates from March to May 2020.

Imaging Review of Obstetric Sequelae of Maternal Diabetes Mellitus.

Diabetes mellitus, whether preexisting or gestational, poses significant risk to both the mother and the developing fetus. A myriad of potential fetal complications in the setting of diabetic pregnancies include, among others, congenital anomalies, delayed fetal lung maturity, macrosomia, and increased perinatal morbidity and mortality. Congenital anomalies most commonly involve the nervous, cardiovascular, genitourinary, and musculoskeletal systems.