Adoption Of Guidelines Research Articles

Validation and Feasibility of the Postnatal Growth and Retinopathy of Prematurity Retinal Screening Criteria at a Level IV Tertiary Care Neonatal Intensive Care Unit.

Retinopathy of prematurity (ROP) is detected in preterm infants by standardized screening programs, but in general, they have poor sensitivity. The Postnatal Growth and Retinopathy of Prematurity (G-ROP) algorithm uses weight gain to predict ROP superior reported sensitivity. Our objectives are to (1) independently validate the sensitivity of G-ROP criteria for the detection of ROP in infants born at >28 weeks' gestation in a tertiary care unit in the United States and (2) to calculate the cost savings associated with a potential reduction in examinations. This is a retrospective analysis of retinal screening examination data, with post-hoc application of G-ROP criteria to determine whether G-ROP criteria had acceptable sensitivity and specificity in diagnosing Type 1 and Type 2 ROP. All infants born at >28 weeks who were screened by current American Academy of Pediatric Ophthalmologists/American Academy of Pediatrics guidelines at Oklahoma Children's Hospital at the University of Oklahoma Health Sciences Center, between 2014 and 2019, were included. Subset analysis of infants screened by second tier criteria was also performed. Potential cost savings were estimated by analyzing frequency of billing codes. And by calculating the number of infants who could have potentially been spared examination. The G-ROP criteria had 100% sensitivity in detecting type 1 and 87.6% sensitivity in detecting type 2 ROP, which would have reduced infants screened by 50%. All infants in the second tier who would require treatment were detected. A cost saving of 49% was projected. The G-ROP criteria are easy to apply in real-world setting, thus establishing feasibility. The algorithm identified all cases of type 1 ROP; however, some cases of type 2 ROP were not detected. The annual savings in hospital examination cost by using these criteria would be 50%. Therefore, G-ROP criteria can safely be used to screen for ROP and may reduce the number of unnecessary examinations. · The G-ROP screening criteria are safe and predict 100% of treatment warranted ROP.. · Adoption of G-ROP criteria is feasible for level IV NICUs.. · Adoption of G-ROP screening guidelines will result in significant cost savings..

Modeling the Adoption of 5760 Clinical Studies Into Practice Across 5 Surgical Specialties

IntroductionNo studies exist that explore the factors that influence the process of synthesizing new knowledge into perioperative standards of care and the operating room. We sought to model the adoption of clinical research into surgical practice and identify modifiable factors influencing the latency of this translation. MethodsWe created a data set comprised of all UpToDate articles between 2011 and 2020, sampled at 3-mo intervals, to explore how research is incorporated at the point-of-care (POC)—studying 5760 new references from 204 journals across five surgical specialties, compared to all uncited articles published during the same interval. UpToDate authors serve as specialty curators of the vast surgical literature, with an audience of more than a million clinicians in over 180 countries across 3200 institutions. Unlike society guidelines, UpToDate also provides the necessary granularity to quantify the time in bringing research to the bedside. Our main outcomes are citation rates and time-to-citation, split by specialty, journal, article type, and topics. We also model the influence of impact factor, geography, and funding and, finally, propose new impact indices to help with prioritizing surgical literature. ResultsWe highlight variation in adoption of clinical research by specialty. We show, despite representing a lower quality of evidence, surgical case reports are one of the most cited article types. Furthermore, most clinical trials (94%-100%) in surgical journals are never incorporated into POC reference lists. While few, pragmatic trials were the most likely to be cited of any article type in any surgical specialty (40%). Journal impact factor did not correlate with time-to-citation or proportion of articles cited in three of five surgical specialties, suggesting differences in how specialties synthesize/value research from specialty journals. Our two metrics, the Clinical Relevancy and Immediacy Indices, were defined to capture this impact/relevance to surgical practice. Of the five surgical subspecialties, gynecology references were >5-fold more likely to get cited, had a larger fraction of higher quality evidence incorporated, and demonstrated more success with POC adoption of practice guidelines. We also quantified the cost of translating research to surgical practice per specialty and generated maps that highlight institutions successful in translating research to the POC. The higher expenditure of National Institutes of Health funding in gynecology may reflect the cost of higher quality research per citation. ConclusionsUnderstanding translational latency is the first step to exposing blocks that slow the adoption of research into everyday surgical practice and to understanding why increasing research funding has not yielded comparative gains in surgical outcomes. Our approach reveals new methods to monitoring the efficiency of research investments and evaluating the efficacy of policies influencing the translation of research to surgical practice.

Survey content validation evaluating the dissemination and implementation of deprescribing guidelines.

Policies, protocols and processes within organisations can facilitate or hinder guideline adoption. There is limited knowledge on the strategies used by organisations to disseminate and implement evidence-based deprescribing guidelines or their impact. We aimed to develop an online survey targeting key organisations involved in deprescribing guideline endorsement, dissemination, modification or translation internationally. Survey questions were drafted, mirroring the six components of the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework. Content validation was undertaken and established by a panel of clinicians, researchers and implementation experts. A 52-item survey underwent two rounds of content validation. The minimum threshold (I-CVI > 0.78) for relevance and importance was met for 39 items (75%) in the first round and 44 of 48 items (92%) in the second round. The expert panel concluded that the adoption, implementation and effectiveness survey sections were largely relevant and important to this topic, whereas the reach and maintenance sections were harder to understand and may be less pertinent to the research question. A 44-item survey investigating dissemination and implementation strategies for deprescribing guidelines has been developed and its content validated. Widespread survey distribution may identify effective strategies and inform dissemination and implementation planning for newly developed guidelines.

Ways to get a more balanced gender representation in addiction journals' management and workforce.

Although the scientific community, particularly academic publishing, claims to be gender-neutral and based on meritocracy, it mirrors other parts of modern society, wherein residual gender imbalances and implicit and explicit gender biases are reproduced. In this report, we address gender imbalances (in particular, the overrepresentation of men) in the editorial workforce of academic journals as barriers to women's promotion and career progression in addiction science. We also consider potential gender-related elements and biases in the peer-review and editorial decision-making processes, which may result in women's lower publication rates, thereby creating another gender-related barrier to women's promotion, career progression and academic recognition. Establishing a more balanced gender representation in addiction publishing will require the adoption of the SAGER guidelines and the development of Gender Equality Plans for addiction specialty journals. Finally, although our focus concerns gender, the organisational mechanisms identified here also affect other types of heterogeneity and intersectional thinking.

The impact of an e-newsletter or animated video to disseminate outdoor free-play information in relation to COVID-19 guidelines in New South Wales early childhood education and care services: a randomised controlled trial

BackgroundState-based Guidelines were issued for Early Childhood Education and Care (ECEC) services (caring for children 0–6 years) recommending greater time outdoors and inclusion of indoor-outdoor programs to facilitate social distancing to reduce spread of COVID-19. The aim of this 3-arm randomised controlled trial (RCT) was to examine the impact of different dissemination strategies on increasing ECEC service intentions to adopt recommendations from the Guidelines.MethodsThis was a post-intervention only RCT. A sample of eligible ECEC services in New South Wales (n = 1026) were randomly allocated to one of three groups; (i) e-newsletter resource; (ii) animated video resource; or (iii) control (standard email). The intervention was designed to address key determinants of guideline adoption including awareness and knowledge. Following delivery of the intervention in September 2021, services were invited to participate in an online or telephone survey from October-December 2021. The primary trial outcome was the proportion of services intending to adopt the Guidelines, defined as intention to; (i) offer an indoor-outdoor program for the full day; or (ii) offer more outdoor play time. Secondary outcomes included awareness, reach, knowledge and implementation of the Guidelines. Barriers to Guideline implementation, cost of the dissemination strategies and analytic data to measure fidelity of intervention delivery were also captured.ResultsOf the 154 services that provided post-intervention data, 58 received the e-newsletter (37.7%), 50 received the animated video (32.5%), and 46 received the control (29.9%). Services who received the animated video had nearly five times the odds (OR: 4.91 [1.03, 23.34] p = 0.046) than those in the control group, to report having intentions to adopt the Guidelines. There were no statistically significant differences in awareness or knowledge of the Guidelines between either intervention or control services. Development costs were greatest for the animated video. The extent to which the dissemination strategy was viewed in full, were similar for both the e-newsletter and animated video.ConclusionThis study found potential for the inclusion of interactive strategies to disseminate policy and guideline information within the ECEC setting, in the context of the need for rapid communication. Further research should explore the added benefits of embedding such strategies within a multi-strategy intervention.Trial registrationRetrospectively registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) on the 23/02/2023 (ACTRN 12,623,000,198,628).

Urban building energy modelling-based framework to analyze the effectiveness of the community-wide implementation of national energy conservation codes

PurposeThe building sector contributes one-third of the energy-related carbon dioxide globally. Therefore, framing appropriate energy-related policies for the next decades becomes essential in this scenario to realize the global net-zero goals. The purpose of the proposed study is to evaluate the impact of the widespread adoption of such guidelines in a building community in the context of mixed-mode buildings.Design/methodology/approachThis study decentralizes the theme of improving the energy efficiency of the national building stock in parcels by proposing a community-based hybrid bottom-up modelling approach using urban building energy modelling (UBEM) techniques to analyze the effectiveness of the community-wide implementation of energy conservation guidelines.FindingsIn this study, the UBEM is developed and validated for the 14-building residential community in Mumbai, India, adopting the framework. Employing Energy Conservation Building Code (ECBC) compliance on the UBEM shows an energy use reduction potential of up to 15%. The results also reveal that ECBC compliance is more advantageous considering the effects of climate change.Originality/valueIn developing countries where the availability of existing building stock information is minimal, the proposed study formulates a holistic framework for developing a detailed UBEM for the residential building stock from scratch. A unique method of assessing the actual cooling load of the developed UBEM is presented. A thorough sensitivity analysis approach to investigate the effect of cooling space fraction on the energy consumption of the building stock is presented, which would assist in choosing the appropriate retrofit strategies. The proposed study's outcomes can significantly transform the formulation and validation of appropriate energy policies.

A Retrospective Study on the Adoption of Lipid Management Guidelines in Post-Myocardial Infarction Patients in a Tertiary Care Centre.

Lipid management after acute myocardial infarction (AMI) is one of the important aspects of secondary prevention in the high cardiovascular (CV) risk group, and targeted reduction of low-density lipoprotein cholesterol (LDL-C) remains the primary target for lipid therapy after myocardial infarction (MI). To conduct a retrospective study of the adequacy of lipid management in post-MI patients admitted to a tertiary care centre as compared to the 2019 European Society of Cardiology (ESC) guidelines for the management of dyslipidaemia. The study was a retrospective review of medical records of patients admitted with MI under the Ubora Heart Service, Nairobi Hospital, from January 2020 to June 2022. The study population included 79 patients, with a mean age of 59.3 (SD ±12), predominantly male (61 patients, 77.2%), and of African descent (60 patients, 75.9%). The majority of the study population presented with an ST-segment elevation myocardial infarction (STEMI) (62%), and the six most prevalent cardiovascular risk factors recorded amongst the patients were: systemic arterial hypertension in 50 (63.3%) patients; dyslipidaemia in 34 (43.0%); type II diabetes mellitus (T2DM) in 25 (31.6); history of smoking in 12 (15.2%); obesity or being overweight in 12 (15.1%); and family history of premature coronary artery disease or sudden cardiac death in four (5.1%) patients. Moreover, 88.6% of the patients had their lipid profile assessment done within 48 hours of admission, with a mean LDL-C level of 3.18 mmol/L (SD ±.18). All the patients recruited in the study were started on high-intensity statins with either 40 mg or 80 mg of atorvastatin or 20 mg or 40 mg of rosuvastatin. Thirty-nine (44%) patients recruited had repeat lipid profiles on follow-up, with a median lipid analysis time of five months (interquartile range (IQR): 2.0-10.0). Of those, only six (17.1%) achieved the LDL-C goal of <1.4 mmo/L while only 16 (45.7%) achieved a greater than 50% reduction from their baseline LDL-C level, with three (8.6%) patients having an increased LDL-C level from baseline. Overall, 14.7% of the patients studied achieved the guideline-recommended LDL-C goal of an LDL-C target of <1.4 mmo/L and a ≥ 50% reduction from baseline LDL-C. After five months of follow-up, 75 (94.9%) patients were on statin monotherapy, with 4 (5.1%) on high-intensity statin and ezetimibe combination therapy. This retrospective study highlights the need for early sensitisation and the adoption of secondary prevention strategies in acute coronary syndrome (ACS), as recommended by the 2019 ESC guidelines.

Prevention, diagnosis and treatment of cardiac implantable electronic device infections. Position paper of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC)

The number of cardiac implantable electronic device (CIED) implantations has increased over recent years as a result of population growth, increasing life expectancy, adoption of guidelines, and better access to healthcare. Device-related infection is, however, one of the most serious complications of CIED therapy associated with significant morbidity, mortality, and financial healthcare burden. Although many preventive strategies such as administration of intravenous antibiotic therapy before implantation are well recognized, uncertainties still exist about other regimens. Uncertainties have remained about the role of various preventive, diagnostic, and treatment measures such as skin antiseptics, pocket antibiotic solutions, anti-bacterial envelopes, prolonged antibiotics post-implantation, and others. The key aspect to successful treatment of definite CIED infections is complete removal of all parts of the system and transvenous hardware, including the device and all leads. Thus, transvenous lead extraction has been increasing. Expert consensus statements on how to prevent, diagnose, and treat CIED infections and on lead extraction have been published by the European Heart Rhythm Association in 2020 and 2018, respectively. The aim of this AIAC position paper is to describe the current knowledge on the risks for device-related infections and to assist healthcare professionals in their clinical decision making regarding its prevention, diagnosis, and management by providing the latest update of the most effective strategies.

2022 White Paper on Recent Issues in Bioanalysis: FDA Draft Guidance on Immunogenicity Information in Prescription Drug Labeling, LNP & Viral Vectors Therapeutics/Vaccines Immunogenicity, Prolongation Effect, ADA Affinity, Risk-based Approaches, NGS, qPCR, ddPCR Assays (Part 3 - Recommendations on Gene Therapy, Cell Therapy, Vaccines Immunogenicity & Technologies; Immunogenicity & Risk Assessment of Biotherapeutics and Novel Modalities; NAb Assays Integrated Approach).

The 2022 16th Workshop on Recent Issues in Bioanalysis (WRIB) took place in Atlanta, GA, USA on September 26-30, 2022. Over 1000 professionals representing pharma/biotech companies, CROs, and multiple regulatory agencies convened to actively discuss the most current topics of interest in bioanalysis. The 16th WRIB included 3 Main Workshops and 7 Specialized Workshops that together spanned 1week in order to allow exhaustive and thorough coverage of all major issues in bioanalysis, biomarkers, immunogenicity, gene therapy, cell therapy and vaccines. Moreover, in-depth workshops on ICH M10 BMV final guideline (focused on this guideline training, interpretation, adoption and transition); mass spectrometry innovation (focused on novel technologies, novel modalities, and novel challenges); and flow cytometry bioanalysis (rising of the 3rd most common/important technology in bioanalytical labs) were the special features of the 16th edition. As in previous years, WRIB continued to gather a wide diversity of international, industry opinion leaders and regulatory authority experts working on both small and large molecules as well as gene, cell therapies and vaccines to facilitate sharing and discussions focused on improving quality, increasing regulatory compliance, and achieving scientific excellence on bioanalytical issues. This 2022 White Paper encompasses recommendations emerging from the extensive discussions held during the workshop and is aimed to provide the bioanalytical community with key information and practical solutions on topics and issues addressed, in an effort to enable advances in scientific excellence, improved quality and better regulatory compliance. Due to its length, the 2022 edition of this comprehensive White Paper has been divided into three parts for editorial reasons. This publication (Part 3) covers the recommendations on Gene Therapy, Cell therapy, Vaccines and Biotherapeutics Immunogenicity. Part 1 (Mass Spectrometry and ICH M10) and Part 2 (LBA, Biomarkers/CDx and Cytometry) are published in volume 15 of Bioanalysis, issues 16 and 15 (2023), respectively.

Maize planting date and maturity in the US central Great Plains: Exploring windows for maximizing yields

Region-specific guidelines for maize in the US Great Plains are needed to account for variability in farmer practices and inherent soil and climate differences. Therefore, it becomes critical to define environment tailored management strategies for maize crop to improve and sustain yields over time. The aims of this study were to: i) define homogenous maize yield environments classified as related to the maximum yield and its stability over time in the US central Great Plains region; ii) explore the combinations of planting date and hybrid maturity that lead to optimal yield for each of the previously defined homogenous maize yield environments; and iii) identify environments presenting different windows for maximizing yields (combinations of planting date by hybrid maturity). Hybrid maturity (growth cycle) by planting date combinations were explored at 70 sites within central and eastern Kansas and northern Oklahoma (herein defined as the US central Great Plains region) using 30 years of historical weather data. In addition to the analysis of an extensive maize field dataset, a crop growth model, Agricultural Production Systems Simulator (APSIM), was utilized to evaluate the crop yield and phenology of all hybrid maturity by planting date combinations to define environment tailored management strategies. The simulated yields were spatially clustered based on attainable yield and stability over time to delimit more homogeneous productivity environments. Overall, greater yields were attained with long-maturing hybrids (comparative relative maturity, CRM, 101 and 115). Delaying the planting date from April to mid-May decreased yield in eastern environments. Moreover, late planting maintained yields and increased stability in central environments. For central Kansas and Oklahoma, anticipation of physiological maturity date (3–16 days) with reduced yield penalties (<5%) were possible by using short-season hybrid maturities (CRM 85). Future scenarios for intensification could be explored in those environments presenting more windows for maximizing yields, either with early planting and harvest dates or via late planting providing time for a short crop before maize. Adoption of more region-specific guidelines for maize management could help to optimize yield and its stability over time and seek further opportunities to diversify risk and intensify our current maize-based farming systems in the US central Great Plains.

Comparing the resource implications of old and new colorectal adenoma surveillance guidelines in Australia.

The latest update to the Australian adenoma surveillance guideline in 2018 introduced a novel risk stratification system with updated surveillance recommendations. The resource implications of adopting this new system are unclear. To quanitfy the resource demands of adopting new over old adenoma surveillance guidelines. We studied data from 2443 patients undergoing colonoscopies, in which a clinically significant lesion was identified in their latest, or previous procedure(s) across five Australian hospitals. We excluded procedures with inflammatory bowel disease, new or prior history of colorectal cancer or resection, inadequate bowel preparation and incomplete procedures. Old and new Australian surveillance intervals were calculated according to the number, size and histological characteristics of lesions identified. We used these data to compare the rate of procedures according to each guideline. Based on the procedures for 766 patients, the new surveillance guidelines significantly increased the number of procedures allocated an interval of 1 year (relative risk (RR): 1.57, P = 0.009) and 10 years (RR: 3.83, P < 0.00001) and reduced those allocated to half a year (RR: 0.08, P = 0.00219), 3 years (RR: 0.51, P < 0.00001) and 5 years (RR: 0.59, P < 0.00001). Overall, this reduced the relative number of surveillance procedures by 21% over 10 years (25.92 vs 32.78 procedures/100 patient-years), which increased to 22% after excluding patients 75 or older at the time of surveillance (19.9 vs 25.65 procedures/100 patient-years). The adoption of the latest Australian adenoma surveillance guidelines can reduce demand for surveillance colonoscopy by more than a fifth (21-22%) over 10 years.

Anaemia: An Issue Before and After Cardiac Surgery

Evidence suggests that there is a significant gap between the release and adoption of patient blood management guidelines. This study aimed to examine the prevalence of preoperative anaemia and anaemia on hospital discharge in patients undergoing cardiac surgery, including the incidence of transfusion of blood and blood products.

Just ASK: A quality improvement project to enhance smoking assessment and treatment.

6571 Background: Persistent smoking after cancer diagnosis causes adverse clinical outcomes. ASCO and other organizations view smoking assessment and treatment as indicators of high-quality cancer care. Yet, adoption of clinical practice guidelines like the 3As (Ask, Advise and Assist) for smoking assessment and treatment has been slow and inconsistent in cancer care settings. Methods: Led by the American College of Surgeons Cancer Programs’ Commission on Cancer (CoC) and National Accreditation Program for Breast Centers (NAPBC), the “Just ASK” national quality improvement project focuses on enhancing smoking assessment and treatment in cancer care settings. All CoC/NAPBC programs (n~2000) were invited to participate, which consisted of educational webinars, online resources, and 3 online surveys (baseline, 6- and 12-month) collecting information on smoking assessment and treatment practices, plus other variables (e.g., organizational priority, implementation barriers). Program participation was incentivized by fulfillment of accreditation standards. Results: In total, 776 programs (731 CoC, 45 NAPBC), participated. At baseline, most programs strongly endorsed the importance of addressing smoking within cancer care and the majority of programs reported routinely assessing smoking (90%) and advising all patients reporting current smoking to quit (71%). However, routine delivery of evidence-based smoking cessation assistance (e.g., quitline referral, cessation medications, counseling services) was low (all &lt; 30%). Program retention was excellent (91%). As shown in the table, the 12-month follow-up revealed marked improvements in evidence-based Ask, Advise and Assist, practices. Conclusions: At enrollment, the importance of addressing smoking was evident and high rates of smoking assessment were reported. At 12-month follow-up, marked improvement was reported in all quality indicators of the 3As. These findings guided the sharing of strategies for improving patient assessment, clinical workflow and documentation. Suboptimal delivery of smoking cessation assistance persisted despite overall improvements, which highlight persistent challenges and opportunities for implementing smoking assessment and treatment in cancer care settings. [Table: see text]

A cross-sectional survey examining clinician characteristics, practices, and attitudes associated with adoption of the 2019 American Society for Colposcopy and Cervical Pathology risk-based management consensus guidelines.

The 2019 American Society for Colposcopy and Cervical Pathology (ASCCP) risk-based management consensus guidelines are the most recent national guidelines for the management of abnormal cervical cancer screening tests. These guidelines benefit patients by concentrating testing and treatment in those at highest cervical cancer risk. Adoption of guidelines often occurs slowly, with few studies examining the factors associated with guideline-adherent management of abnormal results. To elucidate the factors associated with the use of the 2019 ASCCP guidelines among clinicians who perform cervical cancer screening, physicians and advanced practice professionals who perform cervical cancer screening were cross-sectionally surveyed. Clinicians responded to screening vignettes with differing recommendations for management between the 2019 and prior management guidelines. Screening vignette 1 involved reduction of invasive testing on a low-risk patient; screening vignette 2 involved increased surveillance testing on a high-risk patient. Binomial logistic regression models determined the factors associated with the use of the 2019 guidelines. A total of 1251 clinicians participated from across the United States. For screening vignettes 1 and 2, guideline-adherent responses were given by 28% and 36% of participants, respectively. Management recommendations differed by specialty and were incorrect in different situations: there was inappropriate invasive testing by obstetrics and gynecology physicians (vignette 1) and inappropriate discontinuation of screening by family and internal medicine physicians (vignette 2). Regardless of their chosen response, over half erroneously believed they were guideline adherent. Many clinicians who believe they are following appropriate guidelines may not realize their management strategy is inconsistent with the 2019 guidelines. Education initiatives tailored to clinician specialty could address the understanding of current guidelines, encourage the use of updated guidelines, maximize patient benefits, and minimize harms. The 2019 American Society for Colposcopy and Cervical Pathology risk-based management consensus guidelines are the most recent national guidelines for abnormal cervical cancer screening test management. We surveyed over 1200 obstetrics and gynecology (OB/GYN), family medicine, and internal medicine physicians and advanced practice providers about their screening and abnormal results follow-up practices in relation to guidelines. Few clinicians are following the 2019 guidelines. Management recommendations differed by clinician specialty and were incorrect in different situations: there was inappropriate invasive testing by OB/GYN physicians and inappropriate screening discontinuation by family and internal medicine physicians. Education tailored by clinician specialty could address the understanding of current guidelines, encourage the use of updated guidelines, maximize patient benefits, and minimize harms.

What guidelines?: Attitudes and behaviors for prescribing prophylactic hepatic encephalopathy medications.

What guidelines?: Attitudes and behaviors for prescribing prophylactic hepatic encephalopathy medications.

Amplicon Sequencing Minimal Information (AsqMI): Quality and Reporting Guidelines for Actionable Calls in Biodefense Applications.

Accurate, high-confidence data is critical for assessing potential biothreat incidents. In a biothreat event, false negative and false positives results have serious consequences. Worst case scenarios can result in unnecessary shutdowns or fatalities at an exorbitant monetary and psychological cost, respectively. Quantitative polymerase chain reaction assays for agents of interest have been successfully used for routine biosurveillance. Recently, there has been increased impetus for adoption of amplicon sequencing (AS) for biosurveillance because it enables discrimination of true positives from near-neighbor false positives, as well as broad, simultaneous detection of many targets in many pathogens in a high-throughput scheme. However, the high sensitivity of AS can lead to false-positives. Appropriate controls and workflow reporting can help address these challenges. Data reporting standards are critical to data trustworthiness. The standards presented herein aim to provide a framework for method quality assessment in biodetection. We present a set of standards, Amplicon Sequencing Minimal Information (AsqMI), developed under the auspices of the AOAC INTERNATIONAL Stakeholder Program on Agent Detection Assays for making actionable calls in biosurveillance applications. In addition to the first minimum information guidelines for AS, we provide a controls checklist and scoring scheme to assure AS run quality and assess potential sample contamination. Adoption of the AsqMI guidelines will improve data quality, help track workflow performance, and ultimately provide decision makers confidence to trust the results of this new and powerful technology. AS workflows can provide robust, confident calls for biodetection; however, due diligence in reporting and controls are needed. The AsqMI guideline is the first AS minimum reporting guidance document that also provides the means for end users to evaluate their workflows to improve confidence. Standardized reporting guidance for actionable calls is critical to ensuring trustworthy data.

The Spatial Evolution and Characteristics of Korean Ethnic Dwellings in the Tumen River Basin

Korean ethnic dwellings have changed rapidly with the urban development of China. However, approaches to this kind of rural construction included insufficient architectural space in their design to meet the needs of contemporary life. We therefore need to better understand the spatial evolution of Korean ethnic dwellings and how to best capture their current spatial characteristics. Taking an Architectural Planning perspective, we looked at 38 typical Korean ethnic dwellings in the Tumen River Basin, the ways in which their spatial character has changed, and the behavior of their residents, before summarizing their overall spatial characteristics. The research revealed that, through the influence of other cultures, elements of the plan form of Korean ethnic dwellings have been enriched and have grown in complexity. This has been accompanied by changes in residential behavior. We identified four types of changes of spatial characteristics: simplification and opening up; local changes of use; adoption of policy guidelines; the influence of other ethnic groups. Results of this research might serve as a reference for the future construction of Korean ethnic dwellings and inform research on other ethnic residences, thereby enriching the development of ethnic culture in China.

MP77-08 PROSTATE CANCER PRESENTATION IN A COMMUNITY SETTING A DECADE SINCE THE USPSTF GRADE D RECOMMENDATION

You have accessJournal of UrologyCME1 Apr 2023MP77-08 PROSTATE CANCER PRESENTATION IN A COMMUNITY SETTING A DECADE SINCE THE USPSTF GRADE D RECOMMENDATION Franklin Gaylis, Edward Cohen, Paul Dato, Rose Prime, Julie Cramer, Katayune Golshan, Sonia Romo, Sepi Mahooti, Michael Leapman, Robert Topp, and William Catalona Franklin GaylisFranklin Gaylis More articles by this author , Edward CohenEdward Cohen More articles by this author , Paul DatoPaul Dato More articles by this author , Rose PrimeRose Prime More articles by this author , Julie CramerJulie Cramer More articles by this author , Katayune GolshanKatayune Golshan More articles by this author , Sonia RomoSonia Romo More articles by this author , Sepi MahootiSepi Mahooti More articles by this author , Michael LeapmanMichael Leapman More articles by this author , Robert ToppRobert Topp More articles by this author , and William CatalonaWilliam Catalona More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003351.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The United States Preventative Services Task Force (USPSTF) issued a grade “D” recommendation against PSA-based prostate cancer (PCa) screening in 2012. We present an analysis of a prospectively collected data repository including PCa tumor burden, Gleason score group, PSA and prostate biopsy positivity rates in a community setting a decade since the Task Force recommendation METHODS: We identified 7,914 patients undergoing prostate biopsy between April 2011 and December 2021 from the Genesis Healthcare Partner’s (large urology group practice) electronic medical record (EMR). For 2011, we annualized the number of biopsies performed based on an imputed estimate from April through December of 2011. We compiled the number of prostate biopsies and proportions of biopsies demonstrating cancer, Gleason score (6, 7, 8-10), and the maximum positive biopsy core percentage involvement with cancer. Statistical analysis included Chi Square and a one-way ANOVA. RESULTS: The annual biopsy rate was significantly higher in 2011 (997 cases [748 actual cases plus 249 estimated cases] than for all other years. Chi Square analysis indicated a significant consistent increase (p<0.001) in the percentage of positive biopsies between 2011 (44.25%) and 2021 (65.91%). The proportion of low grade disease significantly decreased (p<0.001) between 2011 and 2021 from 49.12% to 33.33%, while the proportion high grade disease significantly increased (p<0.001) from 16.47% to 27.59%. The proportion of intermediate grade disease significantly increased (p<0.001) from 34.41% in 2011 to 39.08% in 2021. The mean maximum positive biopsy core percentage was lower in 2011 (48.00+.33%) versus 2021 (55.00+.29%) (p<0.001). A non-parametric independent samples Kruskal-Wallis test with Bonferroni post hoc comparisons indicated that the median PSA levels were similar during 2011-2012 (6.7 – 6.9 ng/ml) and were significantly lower (p<.05) than the median PSA values measured during 2020-2021 (8.5 – 9 ng/ml). Study limitations include uncertainty about the extent of adoption of USPSTF guidelines in the practices, possible inaccurate attribution of causality (versus imaging and biomarker effects). Its strengths include prospective acquisition of granular data and findings that align with studies showing increases in metastatic disease and PCa-specific mortality during this interval. CONCLUSIONS: We identified a temporal association between the USPSTF 2012 recommendation against screening and increasing volume and proportion of high-grade prostate cancer. This trend was not reversed following the 2018 ‘Grade C’ revision to the USPSTF guideline. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1104 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Franklin Gaylis More articles by this author Edward Cohen More articles by this author Paul Dato More articles by this author Rose Prime More articles by this author Julie Cramer More articles by this author Katayune Golshan More articles by this author Sonia Romo More articles by this author Sepi Mahooti More articles by this author Michael Leapman More articles by this author Robert Topp More articles by this author William Catalona More articles by this author Expand All Advertisement PDF downloadLoading ...

Application of the socio-ecological model in the efforts to end COVID-19 in Sub-Saharan Africa: The challenges and success stories.

The Novel Coronavirus (COVID-19) was detected in December 2019 in the Hubei Province of China. Also known as 2019-nCoV, the outbreak was declared a pandemic by the World Health Organization (WHO) in March 2020. The WHO thus proposed country and technical guidelines in responding to the COVID-19 pandemic. This paper reviewed the preparedness of sub-Saharan African (SSA) countries in ending the pandemic through the adoption of the WHO guidelines. The Socio-Ecological Model was adopted as a conceptual framework in conducting our analysis. We realized that while striving to implement the WHO guidelines, a plethora of microsystem, mesosystem, exosystem, macrosystem, and chronosystem factors make it difficult for SSA countries to achieve the desired results aimed at halting the spread of the virus. SSA countries may, therefore, not be able to end the COVID-19 pandemic soon. We recommend various interventions including short- and long-term loan facilities from donor agencies, decentralization of COVID-19 testing to sub-national levels, and increased community engagement to improve risk communication and adherence to public health measures to end the spread of COVID-19 in SSA.

Spring Cleaning: Time to Tidy Up Coding and Billing Processes

This article provides tips for reviewing and “cleaning up” coding and billing practices. This includes the following topics: Appropriate adoption of new codes and guidelines Reviewing accounts receivable processes and outcomes Updating any outdated resources and exploring new options