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A unique window of opportunity for practical reform of cancer clinical trials.

Cancer 2021 Apr 13. Epub 2021 Apr 13.

Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.

With rapid modifications in cancer clinical trial operations necessitated by the global pandemic over the last year, there is now an unprecedented opportunity to reform clinical research permanently and solidify innovative practices that have clearly been effective. On the basis of the authors' experience and recommendations from other institutions, a set of specific proposals for clinical trial reform are identified that can be implemented immediately by sponsors, regulators, and study sites. Improvements in clinical trial processes should include increased leverage of technology to facilitate remote trial activity and electronic documents, more efficient and effective communication of adverse event information, and better study design to optimize inclusion criteria, required research procedures, and data collection. Read More

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Early risk stratification of acute myocardial infarction using a simple physiological prognostic scoring system: insights from the REACP study.

Eur J Cardiovasc Nurs 2021 Apr;20(2):167-174

Department of Cardiology, West China Hospital, Sichuan University, China.

Background: A more accurate and simpler scoring systems for early risk stratification of acute myocardial infarction at admission can accelerate and improve decision-making.

Aim: To develop and validate a simple physiological prognostic scoring system for early risk stratification in patients with acute myocardial infarction.

Methods: Easily accessible physiological vital signs and demographic characteristics of patients with acute myocardial infarction at the time of presentation in the multicentre Retrospective Evaluation of Acute Chest Pain study were used to develop a multivariate logistic regression model predicting 12 and 24-month mortality. Read More

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Machine Learning and Surgical Outcomes Prediction: A Systematic Review.

J Surg Res 2021 Apr 10;264:346-361. Epub 2021 Apr 10.

Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.

Background: Machine learning (ML) has garnered increasing attention as a means to quantitatively analyze the growing and complex medical data to improve individualized patient care. We herein aim to critically examine the current state of ML in predicting surgical outcomes, evaluate the quality of currently available research, and propose areas of improvement for future uses of ML in surgery.

Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) checklist. Read More

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Effectiveness of patient-targeted interventions to inform decision making and improve uptake of colorectal cancer genetic evaluation for at-risk individuals: A systematic review.

Int J Nurs Stud 2021 Mar 20;118:103928. Epub 2021 Mar 20.

Basic Nursing Department, School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin 130021, China. Electronic address:

Background: Inherited colorectal cancer syndromes increase the risk of contracting colorectal and other cancers. International guidelines recommend the identification of individuals with hereditary colorectal cancer and the supervision of asymptomatic individuals with a family history. However, detection of hereditary colorectal cancer is suboptimal. Read More

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LncRNA ZFAS1 plays a role in regulating the inflammatory responses in sepsis-induced acute lung injury via mediating miR-193a-3p.

Authors:
Yan Jiang Wei Zhang

Infect Genet Evol 2021 Apr 10:104860. Epub 2021 Apr 10.

Department of Critical Care Medicine, Yantaishan Hospital, Yantai 264001, China. Electronic address:

Objective: To explore the role of lncRNA ZFAS1-mediated miR-193a-3p in the regulation of inflammatory responses in rats with sepsis-induced acute lung injury (ALI).

Methods: Sepsis-induced ALI models were constructed by LPS induction and then injected with ZFAS1 overexpression plasmid. Thereafter, lung injury score and the W/D weight ratio were calculated. Read More

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Core services that power AI-driven transformation in cancer research and care.

Biochim Biophys Acta Rev Cancer 2021 Apr 10:188535. Epub 2021 Apr 10.

PricewaterhouseCoopers, LLP US, 300 Madison Avenue, New York, NY 10017, United States of America.

This review captures some key lessons learned in the course of helping some of America's leading healthcare AI innovators achieve scale and sustained impact in complex research and care delivery ecosystems. AI innovators may find it useful to access core services to form effective collaborations, find and manage the right data and technology, incentivize and regulate partnerships, demonstrate they can improve lives, and create self-sustaining networks by redistributing realized value. Read More

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What is known about factors improving physiotherapists' adherence to high value interventions in nonspecific low back pain? A scoping review protocol.

Musculoskeletal Care 2021 Apr 13. Epub 2021 Apr 13.

Ashok & Rita Patel Institute of Physiotherapy, Charotar University of Science & Technology (CHARUSAT) CHARUSAT Campus, Changa, Gujarat, India.

Introduction: Despite multiple guidelines providing best practice treatment recommendations for managing low back pain (LBP), current evidence suggests that physiotherapists across the world often provide costly, ineffective, unnecessary, even harmful care. The purpose of this scoping review is to establish the body of evidence regarding factors that improve or hinder physiotherapist's adherence to high-value interventions in the management of non-specific LBP.

Methods: This scoping review will be conducted based on the methodological framework for scoping review recommended by Arksey & O'Malley's and Levac. Read More

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Clinical guidance for diagnosis and management of suspected Pediatric Acute-onset Neuropsychiatric Syndrome in the Nordic countries.

Acta Paediatr 2021 Apr 13. Epub 2021 Apr 13.

Department of Pediatrics and Adolescence Medicin, Copenhagen University Hospital Herlev, Denmark.

Pediatric acute-onset neuropsychiatric syndrome is a clinical concept used to describe a subgroup of children with sudden onset of psychiatric and somatic symptoms. The diagnostic term and especially management of children differs depending on the clinical setting to which they present, and the diagnosis and management is controversial. The aim of this paper is to propose a clinical guidance including homogenous diagnostic work-up and management of pediatric acute onset neuropsychiatric syndrome within the Nordic countries. Read More

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Influenza vaccination uptake and factors influencing vaccination decision among patients with chronic kidney or liver disease.

PLoS One 2021 13;16(4):e0249785. Epub 2021 Apr 13.

Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.

Introduction: Seasonal influenza is a major global health problem causing substantial morbidity and health care costs. Yet, in many countries, the rates of influenza vaccination remain low. Chronic kidney or liver diseases (CKLD) predispose patients to severe influenza infections, but data on vaccination acceptance and status is limited in this risk population. Read More

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Modelling the inhibitors of cold supply chain using fuzzy interpretive structural modeling and fuzzy MICMAC analysis.

PLoS One 2021 13;16(4):e0249046. Epub 2021 Apr 13.

College of Business Administration, Ajman University, Ajman, United Arab Emirates.

The Cold Supply Chain (CSC) is an integral part of the supply chain of perishable products. The aim of this research is to examine the inhibitors that have a major impact on the performance of CSC operations in the United Arab Emirates (UAE). This study provides a synthesis and suggests a hierarchical model among CSC inhibitors and their respective relevance. Read More

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Ensuring COVID-19 Vaccines for Migrant and Immigrant Farmworkers.

Am J Trop Med Hyg 2021 Apr 13. Epub 2021 Apr 13.

1Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, Minnesota.

Migrant and immigrant farmworkers are cornerstones to food security and production in many nations. In the United States, farmworkers have been disproportionately impacted by COVID-19. Because they are considered essential workers, vaccines may be made imminently available to them and offer an opportunity to reduce these COVID-19-related impacts. Read More

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United States Chronic Thromboembolic Pulmonary Hypertension Registry: Protocol Design.

JMIR Res Protoc 2021 Apr 13. Epub 2021 Apr 13.

Temple University Hospital, Philadelphia, US.

Background: Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare sequela of acute pulmonary embolism that is treatable when recognized. Awareness of this disease has increased with recent advancements in therapeutic options, but delays in diagnosis remain common and diagnostic and treatment guidelines are often not followed. Data gathered from international registries has improved our understanding of CTEPH, but this data may not be applicable to the U. Read More

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Clinical guidelines for the treatment of congenital diaphragmatic hernia.

Pediatr Int 2021 Apr 13. Epub 2021 Apr 13.

Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan.

Congenital diaphragmatic hernia (CDH) is a birth defect of the diaphragm in which abdominal organs herniate through the defect into the thoracic cavity. The main pathophysiology is respiratory distress and persistent pulmonary hypertension because of pulmonary hypoplasia caused by compression of the elevated organs. Recent progress in prenatal diagnosis and postnatal care has led to an increase in the survival rate of patients with CDH. Read More

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Diagnostic utility of rapid on-site evaluation of endobronchial ultrasound-guided transbronchial needle aspiration samples: A study in a region of high tuberculosis burden.

Cytopathology 2021 Apr 13. Epub 2021 Apr 13.

Department of Pathology, Dr. Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India.

Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a very useful tool for precise diagnosis of thoracic lesions. However, the procedure sometimes has a poor yield. Rapid on-site evaluation (ROSE) in EBUS-TBNA has been shown to be helpful to improve its diagnostic yield and minimise the need for repeat procedures. Read More

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Current Management of Age-Related Macular Degeneration.

Adv Exp Med Biol 2021 ;1256:295-314

Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.

Age-related macular degeneration (AMD) remains a leading cause of blindness worldwide. The assessment and management of patients with this condition has evolved in the last decades. In this chapter, current standards for diagnosis, follow-up, and treatment of patients with AMD are reviewed and summarized. Read More

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January 2021

Correlation of expression of Akt1 and E2F1 and their phosphorylated forms in breast cancer patients with clinicopathological parameters.

J Mol Histol 2021 Apr 13. Epub 2021 Apr 13.

Department of Pathology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.

Breast cancer is the leading cancer worldwide among women. Traditional clinicopathological prognostic and predictive markers need refining to improve clinical outcomes. This study explored the association between traditional clinicopathological factors and the expression of Akt1 and E2F1 transduction proteins and their phosphorylated forms in breast cancer, to determine their value as novel biomarkers and potential therapeutic targets. Read More

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The scalp cooling therapy for hair loss in breast cancer patients undergoing chemotherapy: a systematic review and meta-analysis.

Support Care Cancer 2021 Apr 13. Epub 2021 Apr 13.

Nursing Department, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.

Purpose: To systematically assess the efficacy and side effects of scalp cooling in patients with breast cancer.

Methods: A systematic literature search was conducted in October 2020 across Cochrane Library, PubMed, Embase, CINAHL, Web of Science, Scopus, and four Chinese databases (CNKI, Wanfang, SinoMed, and VIP database). Our review included all randomized controlled trials, cohort studies, and cross-sectional studies. Read More

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A survey demonstrating that the procedural experience of residents in internal medicine, critical care and emergency medicine is poor: training in ultrasound is required to rectify this.

Ultrasound J 2021 Apr 13;13(1):20. Epub 2021 Apr 13.

Department of Cardiac Sciences, King Abdulaziz Medical City, King Abdulaziz International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.

Background: Training in procedural skills is often suboptimal. The aim of this study was to quantify the needs of residents in internal medicine (IM), critical care (CC), and emergency medicine (EM) for instruction in ultrasound-guided procedures.

Methods: All IM, EM and CC residents (n = 200) at King Abdulaziz Medical City, Riyadh, Saudi Arabia, were invited to participate in a questionnaire-based survey to identify skill and experience gaps. Read More

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Factors of sexual quality of life in gynaecological cancers: a systematic literature review.

Arch Gynecol Obstet 2021 Apr 13. Epub 2021 Apr 13.

School of Health and Behavioural Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sunshine Coast, QLD, 4556, Australia.

Background: The impact of cancer diagnosis and treatment on sexual quality of life (SQoL) is a well-established survivorship issue for gynaecological cancer survivors (GCS), yet little is known on how to intervene.

Purpose: The aim of this systematic review was to identify the factors explaining the variability in SQoL for GCS.

Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and the software Covidence. Read More

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Mitigating the stress response to improve outcomes for older patients undergoing emergency surgery with the addition of beta-adrenergic blockade.

Eur J Trauma Emerg Surg 2021 Apr 13. Epub 2021 Apr 13.

University of Southern California, Los Angeles, USA.

As population age, healthcare systems and providers are likely to experience a substantial increase in the proportion of elderly patients requiring emergency surgery. Emergency surgery, compared with planned surgery, is strongly associated with increased risks of adverse postoperative outcomes due to the short time available for diagnosis, optimization, and intervention in patients presenting with physiological derangement. These patient populations, who are often frail and burdened with a variety of co-morbidities, have lower reserves to deal with the stress of the acute condition and the required emergency surgical intervention. Read More

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[Trauma center management].

Med Klin Intensivmed Notfmed 2021 Apr 13. Epub 2021 Apr 13.

Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstraße, 35043, Marburg, Deutschland.

Every year, more than 20,000 patients with polytrauma are treated in Germany. The term polytrauma refers to simultaneous injury to several body regions that are individually or collectively life-threatening for the patient. However, this assessment is made based on appropriate scoring systems. Read More

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Quality of health care perceived by users in Catalan prisons.

Rev Esp Sanid Penit 2021 Jan-Apr;23(1):9-19

Mas D'Enric Prison. Catalonian Institute of Health. Tarragona.

Objectives: To describe inmates' perceptions of healthcare quality in Catalonian prisons.

Material And Method: Transversal study of 6,856 inmates in Catalan prisons in September 2017. Randomized simple screening was used to randomly distribute 1,048 polls in which different aspects of perceived quality of healthcare were evaluated. Read More

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Intervention protocol to improve scabies control in enclosed communities: a case report.

Rev Esp Sanid Penit 2021 Jan-Apr;23(1):37-42

Primary Care Service Team, La Roca del Vallès-2 Prison. Catalonian Health Institute. Regional Government of Catalonia.

Objectives: To describe patients with scabies in a prison setting. Document what type of treatment was carried out. Prepare an intervention protocol to improve scabies control in the Penitentiary Center. Read More

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Posterior Open-wedge Osteotomy and Glenoid Concavity Reconstruction Using an Implant-free, J-shaped Iliac Crest Bone Graft in Atraumatic Posterior Instability with Pathologic Glenoid Retroversion and Dysplasia: A Preliminary Report.

Clin Orthop Relat Res 2021 Apr 12. Epub 2021 Apr 12.

L. Ernstbrunner, T. Häller, M. Waltenspül MD, K. Wieser MD, C. Gerber, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.

Background: Atraumatic posterior shoulder instability in patients with pathologic glenoid retroversion and dysplasia is an unsolved problem in shoulder surgery.

Questions/purposes: In a preliminary study of a small group of patients with atraumatic posterior shoulder instability associated with glenoid retroversion ≥ 15° and glenoid dysplasia who underwent posterior open-wedge osteotomy and glenoid concavity reconstruction using an implant-free, J-shaped iliac crest bone graft, we asked: (1) What proportion of the patients had persistent apprehension? (2) What were the improvements in patient-reported shoulder scores? (3) What were the radiographic findings at short-term follow-up?

Methods: Between 2016 and 2018, we treated seven patients for atraumatic posterior shoulder instability. We performed this intervention when posterior shoulder instability symptoms were unresponsive to physiotherapy for at least 6 months and when it was associated with glenoid retroversion ≥ 15° and dysplasia of the posteroinferior glenoid. Read More

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A Patient-Oriented App (ThessHF) to Improve Self-Care Quality in Heart Failure: From Evidence-Based Design to Pilot Study.

JMIR Mhealth Uhealth 2021 Apr 13;9(4):e24271. Epub 2021 Apr 13.

Cardiovascular Prevention and Digital Cardiology Lab, Third Cardiology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Background: Heart failure (HF) remains a major public health challenge, while HF self-care is particularly challenging. Mobile health (mHealth)-based interventions taking advantage of smartphone technology have shown particular promise in increasing the quality of self-care among these patients, and in turn improving the outcomes of their disease.

Objective: The objective of this study was to co-develop with physicians, patients with HF, and their caregivers a patient-oriented mHealth app, perform usability assessment, and investigate its effect on the quality of life of patients with HF and rate of hospitalizations in a pilot study. Read More

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Barriers to training in laparoscopic surgery in low- and middle-income countries: A systematic review.

Trop Doct 2021 Apr 13:49475521998186. Epub 2021 Apr 13.

Leeds Institute of Medical Research at St. James's, 4468University of Leeds, Leeds, UK.

Laparoscopic surgery has the potential to improve care in resource-deprived low- and-middle-income countries (LMICs). This study aims to analyse the barriers to training in laparoscopic surgery in LMICs. Medline, Embase, Global Health and Web of Science were searched using 'LMIC', 'Laparoscopy' and 'Training'. Read More

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Radiological and histopathological features of short rib‑polydactyly syndrome type III and identification of two novel variants.

Mol Med Rep 2021 Jun 13;23(6). Epub 2021 Apr 13.

Department of Gynecology and Obstetrics, Key Laboratory of Maternal‑Fetal Medicine of Liaoning Province, Key Laboratory of Obstetrics and Gynecology of Higher Education of Liaoning Province, Liaoning Centre for Prenatal Diagnosis, Research Center of China Medical University Birth Cohort, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China.

Short rib‑polydactyly syndrome type III (SRPS3) is a lethal perinatal skeletal disorder consisting of polydactyly and multi‑system organ abnormalities. To further assess the pathogenicity of two pairs of compound heterozygotes and to search for novel molecular etiology, X‑rays and hematoxylin and eosin staining were conducted in three cases: Two retrospective samples and a newly identified patient with SRPS3. In addition, next‑generation sequencing was used to evaluate a fetus with SRPS3. Read More

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Multiple-micronutrient supplementation in pregnant adolescents in low- and middle-income countries: a systematic review and a meta-analysis of individual participant data.

Nutr Rev 2021 Apr 13. Epub 2021 Apr 13.

E.C. Keats, N. Akseer, P. Thurairajah, and Z.A. Bhutta are with the Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada. S. Cousens is with the London School of Hygiene & Tropical Medicine, London, United Kingdom. Z.A. Bhutta is with the Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. Z.A. Bhutta is with the Aga Khan University, Karachi, Pakistan. H. Ali is with the JiVitA Maternal and Child Nutrition and Health Research Project, Gaibandha, Bangladesh. S. El Arifeen is with the International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh. U. Ashorn is with the Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. J. Belizan is with the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. R.E. Black, P. Christian, A.B. Labrique, K. West, and L.S-F. Wu are with the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. L.M. De-Regil is with Nutrition International, Ottawa, Ontario, Canada. K. Dewey is with the University of California, Davis, Davis, California, USA. M.J. Dibley is with The University of Sydney, Sydney, New South Wales, Australia. W. Fawzi and C.R. Sudfeld are with the Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. H. Friis and P. Kaestel are with the University of Copenhagen, Copenhagen, Denmark. E. Gomo is with the University of Zimbabwe, Harare, Zimbabwe. L. Huybregts is with the International Food Policy Research Institute, Washington, DC, USA. R. Jayatissa is with the Medical Research Institute, Colombo, Sri Lanka. S.K. Khatry is with the Nepal Nutrition Intervention Project-Sarlahi, Kathmandu, Nepal. P.W. Kolsteren is with Ghent University, Ghent, Belgium. M. McCauley is with the Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom. B.M. Oaks is with the University of Rhode Island, Kingston, Rhode Island, USA. E. Piwoz is with the Bill & Melinda Gates Foundation, Seattle, Washington, USA. S. Shaikh is with the Society for Applied Studies, New Delhi, India. D.D. Soekarjo is with the Savica Consultancy, Jakarta, Indonesia. W. Urassa is with the Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. N. Zagre is with the UNICEF Regional Office for West and Central Africa, Dakar, Senegal. L. Zeng and Z. Zhu are with the School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi, China.

Context: Approximately 7.3 million births occur annually among adolescents in low- and middle-income countries. Pregnant adolescents constitute a nutritionally vulnerable group that could benefit from intervention to mitigate the mortality and adverse birth outcomes associated with adolescent pregnancy. Read More

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Use of community-based reference ranges to estimate the prevalence of polycystic ovary syndrome by the recognised diagnostic criteria, a cross-sectional study.

Hum Reprod 2021 Apr 8. Epub 2021 Apr 8.

Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Study Question: Does the application of reference ranges for sex steroids and the modified Ferriman-Gallwey (mFG) scale established in the community from which the study sample was drawn, combined with the most conservative polycystic ovary morphology (PCOM) criteria to the recognised diagnostic criteria for polycystic ovary syndrome (PCOS) improve the certainty of diagnosis of PCOS in non-healthcare-seeking women?

Summary Answer: Despite application of the stringent definitions of the elements used to diagnose PCOS in a non-healthcare seeking community-based sample, the risk of diagnostic uncertainty remains.

What Is Known Already: There is heterogeneity in prevalence estimates for PCOS due, in part, to lack of standardisation of the elements comprising the recognised National Institutes of Health (NIH), Rotterdam and Androgen Excess Society (AE-PCOS) diagnostic criteria. The AE-PCOS Society proposed refinements to the definitions of biochemical androgen excess and PCOM that can now be incorporated into these sets of diagnostic criteria to estimate PCOS prevalence. Read More

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Malnutrition risk prior to hematopoietic stem cell transplantation predicts mortality in adults.

Bone Marrow Transplant 2021 Apr 12. Epub 2021 Apr 12.

Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

Patients with hematological malignancies have a high risk of developing malnutrition. Few data are currently available that illustrate the impact of the patients' nutritional status prior to HSCT on their outcome. The aim of this study was to investigate the association between the patients' malnutrition status prior to receiving autologous or allogeneic HSCT and mortality in adults with hematological malignancies. Read More

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