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Ordering of computed tomography (CT) scans needs to consideration of diagnostic utility as well as resource utilisation and radiation exposure. Several factors influence ordering decisions, including evidence-based clinical decision support tools to rule out serious disease. The aim of this qualitative study was to explore factors influencing Emergency Department (ED) doctors’ decisions to order CT of the head or cervical spine.

In-depth semi-structured interviews were conducted with purposively selected ED doctors from two affiliated public hospitals. An interview tool with 10 questions, including three hypothetical scenarios, was developed and validated to guide discussions. Interviews were audio recorded, transcribed verbatim, and compared with field notes. Transcribed data were imported into NVivo Release 1.3 to facilitate coding and thematic analysis.

In total 21 doctors participated in semi-structured interviews between February and December 2020; mean interview duration was 35min. selleck chemicals Data saturation clinical decision support tools and an overall strategy to improve awareness of low-value care is needed. Strategies to reduce low-yield CT ordering will need to be sustainable, sophisticated and supportive to achieve lasting change.

The oncogenic role of doublecortin-like kinase 1 (DCLK1) as a putative cancer stem cell (CSC) marker has been clarified in colorectal cancer (CRC). Isoform-specific functions of DCLK1 have shed new light on different functions of DCLK1 short (DCLK1-S) and DCLK1 long (DCLK1-L) isoforms in tumor initiation, growth, and metastasis. Therefore, the current systematic review and meta-analysis aimed to review the available in vitro, in vivo, and clinical evidence on the oncogenic roles and clinical significance of DCLK1 isoforms in colorectal cancer.

The literature databases of PubMed, Scopus, ISI Web of Science, and Embase were searched to identify eligible articles. The description characteristics of in vitro and pre-clinical studies were extracted from identified reports. In addition, hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were recorded to determine the relationships between DCLK1-L and DCLK1-S expression and prognostic outcomes in patients with CRC.

Both in vitro and i DFS/RFS/PFS (HR = 1.913, 95% CI 1.230-2.973, p = 0.004).

The current findings strongly supported that the DCLK1-S isoform may play a crucial role in the invasion, aggressive tumor behavior, and worsened survival outcomes of CRC patients. However, further critical investigations related to the potential preclinical and clinical utilities of DCLK1-S as a specific CRC-CSC marker are warranted.

The current findings strongly supported that the DCLK1-S isoform may play a crucial role in the invasion, aggressive tumor behavior, and worsened survival outcomes of CRC patients. However, further critical investigations related to the potential preclinical and clinical utilities of DCLK1-S as a specific CRC-CSC marker are warranted.

Behavioral science researchers are increasingly collecting detailed location data such as second-by-second GPS tracking on participants due to increased ease and affordability. While intraindividual variability has been discussed in the travel literature for decades, traditional methods designed for studying individual differences in central tendencies limit the extent to which novel questions about variability in lived experiences can be answered. Thus, new methods of quantifying behavior that focus on intraindividual variability are needed to address the context in which the behavior occurs and the location tracking data from which behavior is derived.

We propose deviations from typical paths as a data processing technique to separate individual-level typical travel behavior from a location tracking data set in order to highlight atypical travel behavior as an outcome measure.

A simulated data example shows how the method works to produce deviation measures from a location dataset. Analysis of these deviations offers additional insights compared to traditional measures of maximum daily distance from home.

This process can be integrated into larger research questions to explore predictors of atypical behavior and potential mechanisms of behavior change.

This process can be integrated into larger research questions to explore predictors of atypical behavior and potential mechanisms of behavior change.

Despite meeting operative indications for primary hyperparathyroidism (PHPT), many patients never undergo parathyroidectomy. We hypothesized that patients with limited English proficiency (LEP) would be less likely to undergo parathyroidectomy than English-proficient (EP) patients.

We retrospectively analyzed patients with PHPT from an institution-wide registry who met operative criteria between 2010 and 2018. The cohort was stratified by English proficiency. Univariate associations between sociodemographic and clinical factors with parathyroidectomy were assessed. A multivariable logistic regression model was created to assess independent predictors of parathyroidectomy.

Among a cohort of 1,104 patients, 262 (24%) underwent parathyroidectomy. LEP patients (n=135, 12%) were significantly younger (mean age 62 vs. 69, p<0.001), more likely non-white race and ethnicity (p<0.001), and less likely to have private insurance (p<0.001). After adjusting for covariates, non-English and non-Spanish preferred language was an independent negative predictor of undergoing parathyroidectomy (OR 0.46, 95% CI 0.21-0.95, p=0.037).

Limited English proficiency may be an independent barrier to appropriate surgical management of PHPT. Systems-level and disease-specific interventions are needed to address this disparity faced by patients with LEP.

Limited English proficiency may be an independent barrier to appropriate surgical management of PHPT. Systems-level and disease-specific interventions are needed to address this disparity faced by patients with LEP.

Pain in cattle is a major welfare problem, as cattle mask their pain. Subjective and objective parameters to assess pain in cattle have been described. Among the objective parameters to evaluate pain in cattle is substance P (SP). SP is a neurotransmitter, which is involved in the processing of noxious information to the brain; it seems to be a more objective indicator for nociception than cortisol, which has long been used as a biomarker for pain and stress in cattle. The objective of this systematic review was to assess the existing literature about SP during painful procedures, conditions, and diseases in cattle in form of a systematic review.

Following the PRISMA statement, 36 out of 236 studies were included in this systematic review. Study design, grouping, age and weight of animals, processing of blood samples for the assessment of SP, and results were heterogenous. The largest number of studies originated from the United States of America and Canada and were published in 2018. A higher number of s missing and is needed to assess factors others than nociception which might influence the SP concentrations in the blood plasma.Lung cancer is the second most common cancer and the leading cause of cancer-related death worldwide. Molecular imaging using [18F]fluorodeoxyglucose Positron Emission Tomography and/or Computed Tomography ([18F]FDG-PET/CT) plays an essential role in the diagnosis, evaluation of response to treatment, and prediction of outcomes. The images are evaluated using qualitative and conventional quantitative indices. However, there is far more information embedded in the images, which can be extracted by sophisticated algorithms. Recently, the concept of uncovering and analyzing the invisible data extracted from medical images, called radiomics, is gaining more attention. Currently, [18F]FDG-PET/CT radiomics is growingly evaluated in lung cancer to discover if it enhances the diagnostic performance or implication of [18F]FDG-PET/CT in the management of lung cancer. In this review, we provide a short overview of the technical aspects, as they are discussed in different articles of this special issue. We mainly focus on the diagnostic performance of the [18F]FDG-PET/CT-based radiomics and the role of artificial intelligence in non-small cell lung cancer, impacting the early detection, staging, prediction of tumor subtypes, biomarkers, and patient’s outcomes.

Endometrial fibrosis caused by intrauterine adhesion (IUA) can lead to hypomenorrhea, amenorrhea, and even infertility and abortion. The postoperative recurrence rate of severe IUA remains high, giving rise to low pregnancy rates. An extracellular matrix (ECM) scaffold, a new biological material that can promote cell proliferation and differentiation at lesions, has been widely used in general surgery and neurosurgery. The present study applied ECM scaffolds in obstetrics and gynecology for the first time to improve endometrial fibrosis, repair severe IUA, and improve pregnancy outcomes for infertile patients.

This paper presents a prospective randomized single-blind controlled superiority study of infertile women aged ≤40 years with IUA. According to the scoring criteria for IUA established by the American Fertility Society, patients with moderate or severe IUA were randomized into two groups at a ratio of 11; patients in the experimental group were treated with an ECM scaffold (small intestinal submucosile patients with moderate/severe IUA.

Chinese Clinical Trial Register ChiCTR2100052027 . Registered onOctober 14, 2021.

Chinese Clinical Trial Register ChiCTR2100052027 . Registered on October 14, 2021.

Untreated dental caries negatively impacts a child’s quality of life including overall health and wellbeing, growth and development, social interaction ability, and school attendance. School-based toothbrushing programs have been recognised as an effective intervention to reduce the burden of dental caries. However, limited information is available to understand the real-world enablers and challenges in the implementation and sustainability of toothbrushing programs. This review aims to understand the barriers and enablers in the implementation and sustainability of toothbrushing programs in early childhood settings and primary schools.

Five electronic databases [i.e., CINAHL (EBSCO), Medline (EBSCO), EMBASE (Ovid), Web of Science, and PsycINFO] and backward citation chasing were performed. The last updated databases searches were conducted in May 2022. Studies reporting on barriers and enablers in the implementation and sustainability of toothbrushing programs in early childhood settings or primary schoohood settings and primary schools which need to be considered for developing oral health promotion initiatives.

The results of this systematic review identify key enablers and barriers for toothbrushing programs in early childhood settings and primary schools which need to be considered for developing oral health promotion initiatives.

The pandemic of coronavirus disease 2019 (COVID-19) has changed human behavior in areas such as contact patterns and mask-wearing frequency. Exploring human-human contact patterns and mask-wearing habits in high-risk groups is an essential step in fully understanding the transmission of respiratory infection-based diseases. This study had aims to quantify local human-human (H-H) contacts in high-risk groups in representative provinces of China and to explore the occupation-specific assortativity and heterogeneity of social contacts.

Delivery workers, medical workers, preschoolers, and students from Qinghai, Shanghai, and Zhejiang were recruited to complete an online questionnaire that queried general information, logged contacts, and assessed the willingness to wear a mask in different settings. The “group contact” was defined as contact with a group at least 20 individuals. The numbers of contacts across different characteristics were assessed and age-specific contact matrices were established. A generalized additive mixed model was used to analyze the associations between the number of individual contacts and several characteristics.