Process mapping to compare and improve management of abnormal cervical cancer screening results in two U.S. healthcare systems within the PROSPR Consortium.

Background: Guidelines for management of abnormal cervical cancer screening results have increased in complexity over the past two decades. Little is known about how patient-, clinician-, and organization-level factors influence implementation when guidelines change. Process mapping may offer insight into organizational processes and facilitate visualization for potential intervention opportunities.

Active Antigen-Specific Adaptive Immune Responses Are Shared among Patients with Progressive Fibrotic Interstitial Lung Disease.

Rationale: Enlargement of lung-associated lymph nodes (LN) predicts worse survival in all patients with interstitial lung disease (ILD). This phenomenon occurs in both connective tissue disease-associated (CTD) ILD and, surprisingly, idiopathic pulmonary fibrosis (IPF), where immune-driven pathogenesis is controversial.

Objective: Determine whether immune responses in the lung LN of ILD patients are antigen-specific and significant to pathology and etiology.

When Terror and War Supersede Cancer: A Case Study of a Ukrainian Cancer Survivor and Application of Trauma-Informed Care.

This case study describes the implementation of trauma-informed and culturally informed cancer care, for a 40-year-old Ukrainian female with recurrent follicular lymphoma, displaced to the United States in the Spring of 2022 following the Russian invasion of Ukraine. The patient was referred to the psychosocial oncology service at an NCI-designated Comprehensive Cancer Center for evaluation and treatment of depression and anxiety. Stressors, along with the chronic trauma of fearing for her family's safety and the stress of being displaced from Ukraine, compounded her emotional burden.

Positive predictive value of cervical cancer screening results recommended for colposcopy by human papillomavirus vaccination status at 3 U.S. healthcare systems.

Purpose: The positive predictive value (PPV) of cervical cancer screening was projected to decrease in the era of human papillomavirus (HPV) vaccination.

Methods: We conducted a retrospective cohort study at three U.S.

The length of the warm ischemic interval in lung donation after circulatory death does not impact post-transplantation outcomes.

Introduction: Transplantation of lungs obtained by donation after circulatory death (DCD) has increased the number of available organs. This study aims to determine how donor characteristics and current procurement processes (specifically, agonal and warm ischemic times) influence the outcomes experienced by the recipients of DCD lung transplants.

Materials And Methods: An analysis was conducted on United Network for Organ Sharing data collected from January 2018 to June 30, 2024, with a focus on adult recipients of double lung transplants with a DCD donor.

CAR-T cell therapy in older adults with relapsed/refractory LBCL: benefits and challenges.

Patients with relapsed or refractory diffuse large B-cell lymphoma (r/r DLBCL) have poor prognosis with a high unmet need for efficacious treatment options. Most patients with r/r large B-cell lymphoma (LBCL) are elderly, which adds to the complexity of choosing the appropriate and effective therapy in these patients. Recently approved therapies, such as CD19-targeted chimeric antigen receptor-T cell therapy, have shown improvements in the outcomes of patients with r/r DLBCL.

Improving Preparatory Materials for the Pediatric Infectious Diseases Initial Certifying Exam: A Targeted Needs Assessment.

We conducted a national survey of current pediatric infectious diseases (PID) fellows and PID fellowship graduates from the past 10 years to assess satisfaction with existing PID initial certifying exam preparatory materials. Satisfaction with existing resources was low. The most desired new resource was additional board-style questions.

Adolescents as Co-Designers: How Youth Perspectives Can Shape the Foundation for Mental Health Interventions in Northern Ghana.

Background: Adolescents in low- and middle-income countries (LMICs) face significant mental health challenges, yet their voices are often underrepresented in intervention design. Co-design approaches, such as human-centered design, offer a promising approach to tailor interventions to specific needs and context; however, this requires careful adaption in LMICs where resources, design experience, and cultural factors impact engagement and efficacy. This study documents how human-centered design was adapted to engage adolescents in co-designing a school-based mental health intervention, highlighting the contextualization of co-design methods to the Ghanaian sociocultural context and the unique participation of youth.

Guideline-Concordant Surveillance After Treatment for High-Grade Cervical Dysplasia.

Objective: To quantify how many patients treated for high-grade cervical dysplasia completed guideline-concordant surveillance.

Methods: We retrospectively analyzed patients aged 30-65 treated for high-grade cervical dysplasia (cervical intraepithelial neoplasia 2 or worse) at two PROSPR II METRICS (Population-based Research to Optimize the Screening Process Multi-level Optimization of the Cervical Cancer Screening Process in Diverse Settings & Populations sites) (Massachusetts General Brigham, Parkland Health) from 2010 to 2019. The primary outcome was receipt of two negative co-tests after treatment within 30 months (allowing 6-month scheduling leeway).

Cost-effectiveness of screening for developmental dysplasia of the hip in Karachi, Pakistan using a universally applicable cost-effectiveness model.

Introduction: Developmental dysplasia of the hip (DDH) is a congenital anomaly of the hip socket that can lead to lifelong disability and pain when left untreated. DDH is a good candidate for screening because of its high frequency in population, availability of treatment and the possibility of secondary prevention. Pakistan currently does not have any systematic or universal neonatal screening programme for DDH.

Using a Neural Network Architecture for the Prediction of Neurologic Outcome for Out-of-Hospital Cardiac Arrests Using Hospital Level Variables and Novel Physiologic Markers.

Out-of-hospital cardiac arrest (OHCA) is a major public health burden due to its high mortality rate, sudden nature, and long-term impact on survivors. Consequently, there is a crucial need to create prediction models to better understand patient trajectories and assist clinicians and families in making informed decisions. We studied 107 adult OHCA patients admitted at an academic Emergency Department (ED) from 2018-2023.

Exploring residents' and fellows' confidence in sexually transmitted infection management and confidential care for adolescents.

Background In the United States, many residents and fellows lack confidence in their ability to confidentially counsel adolescents regarding sexual health topics. Little is known about how personal and professional experiences may affect medical residents' and fellows' confidence in counselling adolescents about sexual health services. Methods We invited 361 residents and fellows (trainees) from paediatric, obstetrics and gynaecology, as well as family medicine programs at an academic medical centre in Texas to complete a survey about confidence in counselling about sexual health services.

COVID-19, a natural experiment. Did it create an opportunity to reduce racial disparities in psychosocial oncology and change how we deliver care?

Purpose: There is evidence to support the acceptability of telehealth among oncology patients, but inconsistencies regarding access and use in underserved populations.

Aims: This study used the COVID-19 pandemic as a natural experiment to test whether implementation of telehealth for patients referred to a psychosocial oncology (PSO) service would 1) increase PSO access and utilization and 2) reduce racial disparities.

Methods: Demographic, medical and appointment completion data for patients referred to a PSO service at an NCI-Designated Comprehensive Cancer Center from March, 2018 to March, 2022 were examined.

Ethics in digital phenotyping: considerations regarding Alzheimer's disease, speech and artificial intelligence.

Artificial intelligence (AI)-based digital phenotyping, including computational speech analysis, increasingly allows for the collection of diagnostically relevant information from an ever-expanding number of sources. Such information usually assesses human behaviour, which is a consequence of the nervous system, and so digital phenotyping may be particularly helpful in diagnosing neurological illnesses such as Alzheimer's disease. As illustrated by the use of computational speech analysis of Alzheimer's disease, however, neurological illness also introduces ethical considerations beyond commonly recognised concerns regarding machine learning and data collection in everyday environments.

Trends in Co-morbid Dementia and Chronic Kidney Disease.

Background: Little is known about the population of Medicare beneficiaries with both chronic kidney disease (CKD) and Alzheimer's disease and related dementias (ADRD).

Methods: Using data from Medicare fee-for-service (FFS) beneficiaries aged 65 and over identified through 2011-2019 Master Beneficiary Summary File (MBSF), we estimated the size, growth, and racial-ethnic characteristics of the ADRD and CKD populations. Individuals were classified as having ADRD and CKD based on CMS Chronic Conditions Data Warehouse (CCW) indicators in the MBSF Chronic Conditions file.

Utilization of the Liver-First Approach in Combined Lung-Liver Transplant Provides Comparable Outcomes to the Traditional Lung-First Approach: A UNOS Study.

Multiorgan transplantation is offered to a selected group of patients every year. The sequence in which organs are transplanted depends on ischemic time graft tolerance and the sickest organ first strategy. In the case of Lung-Liver transplantation, lung allografts are usually implanted before the liver.

Dendritic cell-intrinsic PTPN22 negatively regulates antitumor immunity and impacts anti-PD-L1 efficacy.

Background: Individuals with a loss-of-function single-nucleotide polymorphism in the gene encoding PTPN22 have an increased risk for autoimmune diseases, and patients with cancer with such alleles may respond better to checkpoint blockade immunotherapy. Studies in PTPN22 knockout (KO) mice have established it as a negative regulator of T cell responses in cancer models. However, the role of PTPN22 in distinct immune cell compartments, such as dendritic cells (DCs), remains undefined.

Simultaneous Coronoid Bone Grafting in Ballistic Facial Trauma Patients Undergoing Coronoidectomy.

Ballistic facial trauma can cause complex fractures and overlying soft tissue damage, with a zone of injury that extends beyond the bullet tract. Early skeletal fixation is indicated, and previous large case series describe the use of debrided bone fragments as 'spare part' grafts. This series presents the indications and techniques for simultaneous coronoid bone grafting in 2 patients who sustained a gunshot wound to the right midface and required coronoidectomy.

Clinical, Radiological and Pathological Features of a Large American Cohort of Spinocerebellar Ataxia (SCA27B).

Objectives: Spinocerebellar ataxia 27B due to GAA repeat expansions in the fibroblast growth factor 14 (FGF14) gene has recently been recognized as a common cause of late-onset hereditary cerebellar ataxia. Here we present the first report of this disease in the US population, characterizing its clinical manifestations, disease progression, pathological abnormalities, and response to 4-aminopyridine in a cohort of 102 patients bearing GAA repeat expansions.

Methods: We compiled a series of patients with SCA27B, recruited from 5 academic centers across the United States.

Household air pollution disparities between socioeconomic groups in Chicago.

: To assess household air pollution levels in urban Chicago households and examine how socioeconomic factors influence these levels. : We deployed wireless air monitoring devices to 244 households in a diverse population in Chicago to continuously record household fine particulate matter (PM) concentration. We calculated hourly average PM concentration in a 24-hour cycle.

Molecular basis of urostyle development in frogs: genes and gene regulation underlying an evolutionary novelty.

Evolutionary novelties entail the origin of morphologies that enable new functions. These features can arise through changes to gene function and regulation. One key novelty is the fused rod at the end of the vertebral column in anurans, the urostyle.