Medicine Experts Research Articles

Enhancing Nutritional Care in Cancer: Development and Face Validation of the Chemotherapy Dietary Adherence Scale

Background: Dietary adherence during chemotherapy is crucial for managing side effects and maintaining nutritional status. However, there is a lack of validated tools to measure dietary adherence in this context. The aim of this study was to develop and validate the Chemotherapy Dietary Adherence Scale (CDAS) for assessing dietary adherence among cancer patients undergoing chemotherapy. Methods: A cross-sectional study was conducted over 2 months. The CDAS was developed through a literature review and expert consultation. Face and content validation were performed with 25 experts in oncology, dietetics, and community medicine. The Content Validity Index (CVI) was calculated at both the item (I-CVI) and scale (S-CVI) levels. Results: The expert panel comprised diverse professionals (40% public health experts, 20% medical oncologists, and 20% dietitians). Face validation showed 85% agreement on grammar, clarity, and content. The I-CVI was 0.81, and the S-CVI was 0.83, indicating strong content validity. Conclusion: The CDAS demonstrated robust content validity and relevance for assessing dietary adherence in cancer chemotherapy patients. Further research is needed to evaluate its psychometric properties and clinical utility.

Empowering of Oncology Patients and Informal Caregivers: Analysis of an Interdisciplinary Seminar Model for Breast Cancer and Gyneco-Oncological Patients

Introduction: The interdisciplinary empowerment seminar aims to familiarize patients and informal caregivers (ICs) with supportive measures, focusing on understanding disease, therapy, and side effect management. Methods: The seminar, conducted in two courses over 1-month intervals prior to chemotherapy, included lectures, supportive materials, Q and A sessions, and individual discussions with experts in nutrition, exercise, psycho-oncology, and complementary medicine. Evaluation is based on a self-developed questionnaire and questionnaires on QoL (EORTC-QLQ-C30, BR23, CX24, OV28), anxiety and depression (HADS-D) at week 0, 5, 9, and 12. A control group with standard of care was evaluated at baseline and after 12 weeks. Results: Between October 2020 and May 2021, 19 patients and 9 ICs participated in the seminar. The control group included 20 patients. 96.4% of participants were highly satisfied with the seminar and would recommend it. QoL deterioration was more pronounced in the control group (control: week 0 = 67.6; week 12 = 61.7; intervention: week 0 = 60.8; week 12 = 60.7). This trend could not be proven by analysis of interaction (mixed ANOVA: p = 0.114). Increased confidence of participants’ knowledge about side effects was shown, and ICs reported higher confidence in knowledge and coping with the disease. Conclusions: The seminar received positive feedback and indicated increased knowledge and a trend toward better QoL preservation. Larger studies are needed for confirmation. The seminar effectively addressed unique needs, bolstering confidence and knowledge. Interdisciplinary patient and caregiver empowerment seminars can improve disease-related knowledge and positively affect QoL at the start of chemotherapy. Informational needs can be satisfied. Offering educational seminars and fostering individualized support networks can increase quality of care.

Piezoelectric Biomedical Material, Poly-L-Lactic Acid (PLLA), in the Treatment of Spinal Epidural Compression: Diagnosis, Monitoring, and Postoperative Support

This study aims to design an intelligent biomedical piezoelectric material for monitoring the pressure in the spinal epidural space caused by postoperative hematoma compression (spinal epidural hematoma). Hematoma compression in the spinal epidural space is a clinically challenging condition that is difficult to diagnose, and failure to address it within forty-eight hours may lead to severe consequences. Given its urgency, prompt and accurate diagnosis and intervention are crucial. Due to its elusive diagnostic nature, patients often miss the opportune time for treatment. Therefore, this study utilizes poly L-lactic acid (PLLA), an FDA-approved highly biocompatible biomaterial. After undergoing high-pressure polarization, PLLA exhibits excellent piezoelectric properties, making it an ideal material for monitoring intracavitary pressure. Additionally, since postoperative hematoma formation is a primary cause of spinal epidural membrane compression, this study integrates urokinase, a potent thrombolytic protein, with PLLA electrospun fibers, enabling preliminary treatment upon pressure detection.This intelligent organic biomedical material not only enables real-time monitoring of postoperative spinal epidural space pressure but also passively utilizes ultrasound to release urokinase from PLLA fibers for initial treatment when pressure is detected. Furthermore, the application of electrospun PLLA biomedical material makes the material more easily moldable and simplifies the manufacturing process, expanding its potential applications. In summary, this technology combines expertise in organic materials science, electrochemistry, and clinical medicine, offering an innovative approach to addressing the crisis posed by hematoma compression in the spinal epidural space. In future clinical applications, this technology holds the promise of providing earlier and more effective treatment for patients, potentially becoming a significant breakthrough in the fields of medical electronics and biomedical engineering. Keywords: Piezoelectric Biomaterial, Pressure Monitoring Sensor, Drug Control Release, Postoperative Support, Diagnostic Innovation

Direct to psychology for sleep disorders: Innovating models of care in the hospital and health service.

A 'Direct to Psychology Insomnia' pathway was developed for implementation within a multidisciplinary sleep disorders service in a tertiary hospital in Brisbane, Australia. The project was informed by implementation science principles and methodology to re-design the model of care (MoC). A consensus group workshop using the Nominal Group Technique (NGT) with 12 multidisciplinary staff was undertaken to develop the new MoC. The workshop explored inclusion and exclusion criteria for a Direct to Psychology pathway including patient flow and enablers. The team endorsed a MoC that was acceptable to stakeholders and addressed service-level imperatives. The findings highlighted that patient inclusion or exclusion should be overseen by the Sleep Physician team and an Advanced Psychologist with behavioural sleep medicine expertise. Continuum of care for patients referred via primary care providers was considered. Barriers and risks to the MoC changes were identified which informed the refinement of the MoC.

International Benchmark for Total Metabolic Tumor Volume Measurement in Baseline 18F-FDG PET/CT of Lymphoma Patients: A Milestone Toward Clinical Implementation.

Total metabolic tumor volume (TMTV) is prognostic in lymphoma. However, cutoff values for risk stratification vary markedly, according to the tumor delineation method used. We aimed to create a standardized TMTV benchmark datasetallowing TMTV to be tested and applied as a reproducible biomarker. Methods: Sixty baseline 18F-FDG PET/CT scans were identified with a range of disease distributions (20 follicular, 20 Hodgkin, and 20 diffuse large B-cell lymphoma). TMTV was measured by 12 nuclear medicine experts, each analyzing 20 cases split across subtypes, with each case processed by 3-4 readers. LIFEx or ACCURATE software was chosen according to reader preference. Analysis was performed stepwise: TMTV1 with automated preselection of lesions using an SUV of at least 4 and a volume of at least 3 cm3 with single-click removal of physiologic uptake; TMTV2 with additional removal of reactive bone marrow and spleen with single clicks; TMTV3 with manual editing to remove other physiologic uptake, if required; and TMTV4 with optional addition of lesions using mouse clicks with an SUV of at least 4 (no volume threshold). Results: The final TMTV (TMTV4) ranged from 8 to 2,288 cm3, showing excellent agreement among all readers in 87% of cases (52/60) with a difference of less than 10% or less than 10 cm3 In 70% of the cases, TMTV4 equaled TMTV1, requiring no additional reader interaction. Differences in the TMTV4 were exclusively related to reader interpretation of lesion inclusion or physiologic high-uptake region removal, not to the choice of software. For 5 cases, large TMTV differences (>25%) were due to disagreement about inclusion of diffuse splenic uptake. Conclusion: The proposed segmentation method enabled highly reproducible TMTV measurements, with minimal reader interaction in 70% of the patients. The inclusion or exclusion of diffuse splenic uptake requires definition of specific criteria according to lymphoma subtype. The publicly available proposed benchmark allows comparison of study results and could serve as a reference to test improvements using other segmentation approaches.

Impact of text-only versus large text-and-picture alcohol warning formats: A functional magnetic resonance imaging study in French young male drinkers.

Although the World Health Organization recommends visible and clear warning labels about the risks of alcohol consumption on containers and advertising, many of the currently used labels are too small to be visible. This study investigated the brain activity (using fMRI) and alcohol consumption intentions of French young men exposed to two warning formats displayed on alcoholic beverage advertisements: a small Text-only Alcohol Warning (TAW) currently used in many countries, and a larger text-and-picture alcohol warning (PAW). Seventy-four eligible 18-25-year-old male drinkers completed a face-to-face individual visit with a physician expert in addiction medicine. This was followed by the fMRI session during which they viewed 288 stimuli [96 alcohol advertisements with TAWs, the same 96 advertisements with PAWs, and 96 water advertisements (controls)] for 3 s each. If the advertisement made participants want ("yes")/do not want ("no") to consume the product, they pressed the corresponding button (self-report responses). The number of "yes" responses was compared between advertisement types with a paired sample t-test. Whole-brain and region-of-interest (ROI) analyses of the fMRI data were performed. Whole-brain BOLD fMRI highlighted contrasting effects of PAWs and TAWs. Compared with TAWs, PAWs elicited more activation in the precuneus, angular gyrus, occipital, frontal and temporal areas, and less activation in the nucleus accumbens, ventral tegmental areas, and putamen areas (regions of the reward circuit). The ROI analysis confirmed less activation in the reward circuit (left and right ventral tegmental areas, left and right nucleus accumbens) when viewing PAWs than TAWs. Analysis of the self-report responses indicated that the desire to consume the advertised alcohol product was lower when PAWs were viewed (compared with TAWs) (T = 8.18, p < 10-11). This is the first fMRI study to assess the effect of different alcohol warning formats. Our findings show that compared with TAWs, stronger PAWs in advertisements elicited less activity in key regions of the reward system. This suggests that the effects may influence the desire to consume alcohol products (self-report response analysis). These results could help policymakers who are interested in developing more effective labeling measures that target young people.

Zhiqiao Gancao decoction regulated JAK2/STAT3/ macrophage M1 polarization to ameliorate intervertebral disc degeneration

BackgroundZhiqiao Gancao decoction (ZQGCD) was created by Professor Gong Zhengfeng, a renowned Chinese medicine expert. Clinical studies have shown its efficacy in alleviating pain and enhancing lumbar function in intervertebral disc degeneration (IDD) patients. However, the precise mechanism of ZQGCD in treating IDD remains unclear. MethodsThe active components of ZQGCD were identified using Liquid chromatography-tandem mass spectrometry (LC-MS/MS). A rat model of intervertebral disc degeneration was established, and rats in each group received ZQGCD for three weeks. Assessment parameters included hyperalgesia status, observation of intervertebral disc tissue degeneration and macrophage infiltration, and analysis of JAK2/STAT3 pathway protein expression in the intervertebral disc. Primary macrophage M1 polarization was induced using LPS, with cells treated using the JAK2 inhibitor (AZD1480) and ZQGCD to evaluate macrophage polarization, cellular supernatant inflammatory factors, and JAK2/STAT3 pathway expression. Macrophage supernatant served as a conditioned medium to observe its effects on the proliferation of nucleus pulposus cells (NPCs) and the expression of collagen II and MMP3 proteins. ResultsA total of 81 active components were identified in ZQGCD. Following ZQGCD treatment, infiltrating macrophages in intervertebral disc tissues of model rats decreased, the content of M1 macrophages decreased, while the content of M2 macrophages increased, the expression of proinflammatory factors and pain-inducing factors in serum decreased, and the expression of substance P in intervertebral disc tissue decreased. Consequently, the intervertebral disc degeneration and hyperalgesia of rats were improved. In vitro studies revealed that LPS induced M1 macrophage polarization. By inhibiting the JAK2/STAT3 pathway, both JAK2 inhibitors and ZQGCD effectively suppressed M1 polarization, resulting in decreased levels of IL-1β, IL-6, TNF-α, and various other inflammatory factors. Consequently, this inhibition led to a delay in the degeneration of NPCs. ConclusionThere is macrophage infiltration in the intervertebral disc tissue of IDD rats, and JAK2/STAT3 pathway is activated, macrophages are polarized to M1 type, resulting in inflammatory microenvironment, leading to intervertebral disc degeneration and hyperalgesia. ZQGCD exhibited a delaying effect on IDD and improved hyperalgesia by inhibiting the JAK2/STAT3/macrophage M1 polarization pathway.

Assessing the state of obesity care: Quality, access, guidelines, and standards.

An international panel of obesity medicine experts from multiple professional organizations examined patterns of obesity care and current obesity treatment guidelines to identify areas requiring updating in response to emerging science and clinical evidence. The panel focused on multiple medical health and societal issues influencing effective treatment of obesity and identified several unmet needs in the definition, assessment, and care of obesity. The panel was held in Leesburg, Virginia in September 2019. The panelists recommended addressing these unmet needs in obesity medicine through research, education, evaluation of delivery and payment of care, and updating clinical practice guidelines (CPG) to better reflect obesity's pathophysiological basis and heterogeneity, as well as the disease's health, sociocultural, and economic complications; effects on quality of life; need for standards for quantitative comparison of treatment benefits, risks, and costs; and the need to more effectively integrate obesity treatment guidelines into routine clinical practice and to facilitate more direct clinician participation to improve public understanding of obesity as a disease with a pathophysiological basis. The panel also recommended that professional organizations working to improve the care of people with obesity collaborate via a working group to develop an updated, patient-focused, comprehensive CPG establishing standards of care, addressing identified needs, and providing for routine, periodic review and updating. Unmet needs in the definition, assessment and treatment of obesity were identified and a blueprint to address these needs developed via a clinical practice guideline that can be utilized worldwide to respond to the increasing prevalence of obesity.

The Critical Role of Community Pharmacists in Blood Pressure Monitoring.

Arterial hypertension is the most important modifiable risk factor for cardiovascular morbidity and mortality. In some countries, pharmacists' patient-centered approach has become a common practice, and their role in supporting the management of cardiovascular disease has been successfully developed for years. In particular, recent findings have confirmed benefits of pharmacist-provided hypertension care. Current guidelines emphasize the need for regular BP measurements in subjects age 40 years and older, who are at increased risk of hypertension. A panel of experts in cardiology, hypertensiology, family medicine, and pharmacy presented a narrative review of implementing community pharmacy blood pressure (CPBP) measurements into Polish pharmacy practice to assist pharmacists in CPBP readings. The paper focuses on basic aspects of management of untreated patients with elevated blood pressure levels, as well as management of individuals diagnosed with hypertension, who should follow their primary care physicians' recommendations for anti-hypertensive therapy. The article also includes a few important aspects related to CPBP measurement, such as equipment and techniques. Development of ready-made schemes of procedures for patients with different results of blood pressure measurement could ensure a uniform standard of services provided by pharmacists. This gives an opportunity to provide such patients with medical care and initiate treatment, and facilitates effective maintenance of BP in hypertensive subjects. This article reviews the role of pharmacists in Poland in screening for hypertension by taking blood pressure measurements.

Silent while living, speaks when dead- A case report of manual strangulation

Victim of throttling in majority of the cases die instantaneously as the perpetrator continues to apply pressure till death ensues. In certain cases, victim may survive for some time if pressure is withdrawn due to any reason. In such cases, after the incident, he/she may not be conscious or able to speak for giving history; but the injuries produced by application of pressure by palms and fingers, if looked for them carefully, may speak by themselves about the incident. Presenting here, a case of 52 years old female, where the “made-up” history by the relatives misdirected the thinking process of the clinicians as the patient could not speak at all at the time of admission to the hospital until death. Autopsy conducted on 5 day of hospitalization revealed typical signs of the homicidal act the victim was subjected to, which could have been identified in the “fresh” stage at the time of admission and could have helped in some more detailed medico legal investigations if it could have been referred to Forensic Medicine experts of the institute. This case report stresses on the need of multi-disciplinary approach at the time of treatment of any patient with suspicious history, to have some different angle of view with regards to medico legal concerns and hence, it is discussed here.

Forensic Medical Examiners’ Role in Resolving Malpractice Claims:Legal and Ethical Obligations

In the last few years, the trends of malpractice claims have escalated worldwide. In many judicial systems, forensic medical examiners manage malpractice lawsuits because of their experience in medical, legal, and ethical aspects of healthcare. They analyze medical records to objectively investigate consent-related issues and verify any neglect or deviations from standard medical care. Then, the extent of harm is evaluated in the surviving cases by determining the degree of resulting infirmity. Judicial penalty and compensation depend on the infirmity’s percentage. In cases involving patient death, comprehensive post-mortem examinations are performed to explore potential medical errors, death causes, and causal relations between error and the occurrence of death. It is essential to consider that evaluating technical errors necessitates the expert opinions of consultants from the same specialties as the accused physicians. The legal obligation for all forensic medicine experts is to provide objective, unbiased, evidence-based medicolegal reports. The ethical commitments include preserving the confidentiality of data of both patients and accused healthcare providers. Also, forensic medical examiners could actively participate in healthcare education to protect medical staff against future malpractice accusations.

Oral Oncology: Two elective courses for advanced undergraduates - An Argentine teaching experience

The COVID-19 pandemic prompted significant adaptations in educational practices at Universidad Nacional de Córdoba, including the integration of e-learning and virtual education modalities. In response to an observed increase in advanced-stage oral cancer cases post-2020, we developed new educational strategies aimed at OC prevention and awareness. This study presents our experience with an innovative undergraduate program focusing on Oral Oncology and Oral Potentially Malignant Disorders. Two elective courses were integrated into the curriculum, featuring contributions from Oral Medicine and Pathology experts across several Latin American countries via virtual platforms. Each course provided comprehensive training, including clinical practice and telemedicine protocols for early lesion identification. A total of 107 students successfully completed the courses, highlighting the program's effectiveness in enhancing student engagement and competence in OC prevention. Recommendations from this initiative include reinforcing undergraduate curricula with OC-focused education and promoting international collaboration in higher education for comprehensive training. Future research should assess the long-term impact of such programs on early OC diagnosis and patient referral practices.

18F-FDG PET/CT Radiomics-Based Multimodality Fusion Model for Preoperative Individualized Noninvasive Prediction of Peritoneal Metastasis in Advanced Gastric Cancer.

This study was designed to develop and validate a machine learning-based, multimodality fusion (MMF) model using 18F-fluorodeoxyglucose (FDG) PET/CT radiomics and kernelled support tensor machine (KSTM), integrated with clinical factors and nuclear medicine experts' diagnoses to individually predict peritoneal metastasis (PM) in advanced gastric cancer (AGC). A total of 167 patients receiving preoperative PET/CT and subsequent surgery were included between November 2006 and September 2020 and were divided into a training and testing cohort. The PM status was confirmed via laparoscopic exploration and postoperative pathology. The PET/CT signatures were constructed by classic radiomic, handcrafted-feature-based model and KSTM self-learning-based model. The clinical nomogram was constructed by independent risk factors for PM. Lastly, the PET/CT signatures, clinical nomogram, and experts' diagnoses were fused using evidential reasoning to establish the MMF model. The MMF model showed excellent performance in both cohorts (area under the curve [AUC] 94.16% and 90.84% in training and testing), and demonstrated better prediction accuracy than clinical nomogram or experts' diagnoses (net reclassification improvement p < 0.05). The MMF model also had satisfactory generalization ability, even in mucinous adenocarcinoma and signet ring cell carcinoma which have poor uptake of 18F-FDG (AUC 97.98% and 89.71% in training and testing). The 18F-FDG PET/CT radiomics-based MMF model may have significant clinical implications in predicting PM in AGC, revealing that it is necessary to combine the information from different modalities for comprehensive prediction of PM.

Real-world approaches to outpatient treatment of status migrainosus: A survey study.

Identify how the American Headache Society (AHS) membership manages status migrainosus (SM) among outpatients. SM is defined as a debilitating migraine attack lasting more than 72 h. There is no standard of care for SM, including whether a 72-h duration is required before the attack can be treated as SM. The Refractory Headache Special Interest Group from AHS developed a four-question survey distributed to AHS members enquiring (1) whether they treat severe refractory migraine attacks the same as SM regardless of duration, (2) what their first step in SM management is, (3) what the top three medications they use for SM are, and (4) whether they are United Council for Neurologic Subspecialties (UCNS) certified. The survey was conducted in January 2022. Descriptive statistical analyses were performed. Responses were received from 196 of 1859 (10.5%) AHS members; 64.3% were UCNS certified in headache management. Respondents treated 69.4% (136/196) of patients with a severe refractory migraine attack as SM before the 72-h period had elapsed. Most (76.0%, 149/196) chose "treat remotely using outpatient medications at home" as the first step, 11.2% (22/196) preferred procedures, 6.1% (12/196) favored an infusion center, 6.1% (12/196) sent patients to the emergency department (ED) or urgent care, and 0.5% (1/196) preferred direct hospital admission. The top five preferred medications were as follows: (1) corticosteroids (71.4%, 140/196), (2) nonsteroidal anti-inflammatory drugs (NSAIDs) (50.1%, 99/196), (3) neuroleptics (46.9%, 92/196), (4) triptans (30.6%, 60/196), and (5) dihydroergotamine (DHE) (21.4%, 42/196). Healthcare professionals with expertise in headache medicine typically treated severe migraine attacks early and did not wait 72 h to fulfill the diagnostic criteria for SM. Outpatient management with one or more medications for home use was preferred by most respondents; few opted for ED referrals. Finally, corticosteroids, NSAIDs, neuroleptics, triptans, and DHE were the top five preferred treatments for home SM management.

School maturity and the quest for normalcy: how parental complaints shaped expertise and state policies in socialist Hungary and East Germany, 1960s-1980s

ABSTRACT After World War II, socialist states developed a new schooling system aimed at building an egalitarian society. While there is a solid body of research discussing the relationship between the intent and effect of the egalitarian design of socialist school systems, the importance of school maturity assessments for the socialist project has received only minor attention. This article discusses how the introduction of school maturity assessments developed by experts in medicine, psychology, and pedagogy in 1960s Hungary and East Germany contributed to the visibility of children who were deemed immature. It shows that both socialist states developed institutional solutions beyond the standard school system for tackling the problem of school immaturity in children; these solutions, in turn, evoked different reactions from parents. As the article discusses, parents used various avenues to oppose the official expert assessments with which they disagreed. In both countries, parents increasingly voiced their opinions in complaint letters addressed to the state in a quest to overcome what they perceived as a severe threat to their children’s ‘normal’ development. By tracing parental bottom-up initiatives, the article investigates how parental agency ultimately shaped state policies and expertise despite the asymmetrical power relations that were present in these authoritarian societies. To show the interplay of parental agency, experts, and the state, we employ a combination of two methodological approaches, the sociology of expertise and the concept of Eigensinn, for understanding the spaces of negotiation and the role expertise plays in it. This article thereby sheds light on parental agency and its impact on expertise and state policies concerning school maturity in two socialist states that offered very different institutional answers to the problem; bureaucratic approaches towards complaint letters also varied significantly.

Applying quantitative and systems pharmacology to drug development and beyond: An introduction to clinical pharmacologists.

Quantitative and systems pharmacology (QSP) is an innovative and integrative approach combining physiology and pharmacology to accelerate medical research. This review focuses on QSP's pivotal role in drug development and its broader applications, introducing clinical pharmacologists/researchers to QSP's quantitative approach and the potential to enhance their practice and decision-making. The history of QSP adoption reveals its impact in diverse areas, including glucose regulation, oncology, autoimmune disease, and HIV treatment. By considering receptor-ligand interactions of various cell types, metabolic pathways, signaling networks, and disease biomarkers simultaneously, QSP provides a holistic understanding of interactions between the human body, diseases, and drugs. Integrating knowledge across multiple time and space scales enhances versatility, enabling insights into personalized responses and general trends. QSP consolidates vast data into robust mathematical models, predicting clinical trial outcomes and optimizing dosing based on preclinical data. QSP operates under a "learn and confirm paradigm," integrating experimental findings to generate testable hypotheses and refine them through precise experimental designs. An interdisciplinary collaboration involving expertise in pharmacology, biochemistry, genetics, mathematics, and medicine is vital. QSP's utility in drug development is demonstrated through integration in various stages, predicting drug responses, optimizing dosing, and evaluating combination therapies. Challenges exist in model complexity, communication, and peer review. Standardized workflows and evaluation methods ensure reliability and transparency.

Study of feline immunodeficiency virus prevalence and expert opinions on standards of care.

The purpose of this study was to identify knowledge gaps in the global prevalence of feline immunodeficiency virus (FIV) and to obtain professional opinions and experiences regarding FIV in selected countries. We conducted a literature review of abstracts that reported the prevalence of FIV and interviewed experts in feline medicine and retroviruses from different countries to determine regional perspectives. A total of 90 articles reporting FIV prevalence as a primary unbiased population-level analysis between 1980 and 2017 were indexed. FIV prevalence, demographics, year and location were analyzed. Statistics were evaluated and compared. In total, 10 experts were interviewed. Results were analyzed for congruence with the findings of the literature review. FIV prevalence was typically in the range of 5-8%, with a global prevalence of 4.7%, and remained largely constant over the reporting period (1980-2017). Over 90% of articles reported greater prevalence in older male cats. More studies were conducted in North America and Europe and reported the lowest prevalence. Expert-estimated prevalence approximated literature review prevalence. Attitudes and recommendations for management were consistent among experts. The limitations of the present review include varying inclusion criteria of cats tested in different studies, variation in testing modalities and the inability to conduct summary statistics across dissimilar cohorts. The global prevalence of FIV has not changed since its discovery 40 years ago. Prevalence is higher in older male cats and is lower in North America and Europe than other continents. Experts agree that FIV is not typically a disease of high concern and is often associated with infections of the oral cavity. Vaccination is not typically recommended and has been discontinued in North America. The evaluation of risk factors for FIV progression is useful in managing infections. Recommendations for future research include analyses to determine copathogen and environmental factors that impact progression, assessment of life span impacts and investigations of treatment efficacy and side effects.

2024 AAFP intercat tension guidelines: recognition, prevention and management.

Social tension or conflict between household cats is common but, because it often manifests as subtle behavioral changes, it can go unnoticed; it is precisely because most signs are subtle and unrecognized that the term 'tension' is used. Where associated tension-related chronic fear-anxiety leads to more overt behavioral concerns and stress-associated disease, cats may face relinquishment by caregivers or even euthanasia if the tension is not relieved. The '2024 AAFP intercat tension guidelines: recognition, prevention and management' have been authored by a Task Force of board-certified veterinary and applied behaviorists and clinical experts in feline medicine and behavior convened by the American Association of Feline Practitioners. The aim is to support veterinary professionals in understanding social behavior between cats and, more specifically, in recognizing intercat tension, preventing or minimizing its occurrence and managing the stressors. In developing the Guidelines, the Task Force has modified the five pillars of a healthy feline environment to provide a framework to assist the prevention or management of intercat tension in households with two or more cats. Because feline social behavior is often misunderstood, the Guidelines debunk 10 common myths that have the potential to negatively impact the wellbeing of companion cats. Extensively illustrated with visual examples of intercat tension and an Appendix detailing a number of case studies, the Guidelines also include a comprehensive table of psychotherapeutic medications, and a detailed algorithm that outlines a systematic approach to preventing, recognizing and resolving intercat tension. A step-by-step approach to introducing a new cat into a household with one or more resident cats is included to further support veterinarians, and a range of management tools to promote client education accompany the Guidelines.

Reporting guidelines for precision medicine research of clinical relevance: the BePRECISE checklist.

Precision medicine should aspire to reduce error and improve accuracy in medical and health recommendations by comparison with contemporary practice, while maintaining safety and cost-effectiveness. The etiology, clinical manifestation and prognosis of diseases such as obesity, diabetes, cardiovascular disease, kidney disease and fatty liver disease are heterogeneous. Without standardized reporting, this heterogeneity, combined with the diversity of research tools used in precision medicine studies, makes comparisons across studies and implementation of the findings challenging. Specific recommendations for reporting precision medicine research do not currently exist. The BePRECISE (Better Precision-data Reporting of Evidence from Clinical Intervention Studies & Epidemiology) consortium, comprising 23 experts in precision medicine, cardiometabolic diseases, statistics, editorial and lived experience, conducted a scoping review and participated in a modified Delphi and nominal group technique process to develop guidelines for reporting precision medicine research. The BePRECISE checklist comprises 23 items organized into 5 sections that align with typical sections of a scientific publication. A specific section about health equity serves to encourage precision medicine research to be inclusive of individuals and communities that are traditionally under-represented in clinical research and/or underserved by health systems. Adoption of BePRECISE by investigators, reviewers and editors will facilitate and accelerate equitable clinical implementation of precision medicine.

SOME BIOLOGICAL AND ECOLOGICAL FEATURES OF HYPODERMA LATREILLE, 1818 IN TAVUSH REGION OF ARMENIA

Background. Cattle hypodermosis is a chronic parasitic disease (entomosis) that occurs as a result of parasitizing the larvae of warble flies in the body of animals. Disease is common in more than 55 countries of the world, causing great economic damage. It is considered as a parasitic disease with a certain zoonotic potential. Purpose. To conduct research on biological and ecological features of the warble flies that determines certain epidemiological traits of the caused pathology in Tavush Region of Armenia. Materials and methods. The observations were carried out in Tavush Region, and the experiments were carried out at the Research Center for Veterinary Medicine and Veterinary Sanitary Expertise at the Armenian National Agrarian University. The warble flies marked with stain, were released at a distance of 0.5 to 1.5 km from livestock farms with subsequent search and trapping of insects, located on pastures and on the skin of animals. Generally, 275 warble flies were released. Warble fly activity was evaluated visually counting the comparative number of flying insects at the fixed point per minute at different times of the day, as well as animal anxiety state caused by warble flies was identified. Statistical processing of experimental data was performed by means of “Vassart.net” online calculator. Results. Female warble flies Hypoderma bovis flew up to 12.1 km, while female warble flies H. lineatum did it up to 8.6 km. Females of H. bovis and H. lineatum demonstrated various spatial and circadian flying activity that depends on season, and altitude above the sea level. Spring generation of warble flies is more resistant to low air temperatures compared to the summer generation. Mild and humid summers, as well as an increase in the number of animals, contribute to an increase in the population of warble flies, while high temperature and high soil moisture contribute to the mass death of warble fly pupae developing in the ground. Conclusion. The research data cited in the article, detect the presence of a wide range of biocenotic factors that determine the epidemiology of cattle hypodermosis in the Tavush region of the Republic of Armenia. Cattle hypodermosis control plan was designed based on the results of the research, as well as natural and climatic conditions of Tavush region. Pasture prevention activities and periodic treatment of the cattle with insecticides were emphasized.