Important Updates Research Articles

NCCN Guidelines® Insights: Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, Version 2.2024.

The NCCN Guidelines for Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic focus primarily on assessment of pathogenic/likely pathogenic (P/LP) variants associated with increased risk of breast, ovarian, pancreatic, and prostate cancer, including BRCA1, BRCA2, CDH1, PALB2, PTEN, and TP53, and recommended approaches to genetic counseling/testing and care strategies in individuals with these P/LP variants. These NCCN Guidelines Insights summarize important updates regarding: (1) a new section for transgender, nonbinary and gender diverse people who have a hereditary predisposition to cancer focused on risk reduction strategies for ovarian cancer, uterine cancer, prostate cancer, and breast cancer; and (2) testing criteria and management associated with TP53 P/LP variants and Li-Fraumeni syndrome.

“Nimble Sociality and Belonging”: an Ethnography of Migrants’ Responses to Bans on Associational Life During the COVID-19 Pandemic

Within the past few years, pandemics like HIV/AIDS, influenza, and SARS-CoV-2 have become common worldwide. The COVID-19 pandemic, which broke out recently, profoundly impacted the world. As part of containing this pandemic, lockdowns which put a moratorium on human mobility and associational life became a dominant measure. Yet these mobilities and associational life are the lifeblood of migrants and diaspora belonging. This paper examines the impacts of bans on associational life on migrants and, further, what migrants did to continue living in the absence of these associations during the COVID-19 pandemic. The paper is based on a case study of Lydiate informal settlement in Zimbabwe, where Malawian migrants have established an ethnic enclave to shield themselves from the precarity and injustices of foreign lands. Through convivial and digital ethnographic fieldwork, the paper revealed that bans on associational life disrupted community engagements and binding religious associational life, increased targeted violence and “othering,” and perpetuated stigma and discrimination and loss of ties with family and fictive kin. However, migrants restructured their associational life by adopting agile and new forms of belonging to get by, including relocating religious shrines to more secretive places or conducting religious ceremonies in the dark, drinking beer within the perimeter of the settlement, using of WhatsApp and instant messaging and WhatsApp groups for important community updates, and collective resistance. I termed these strategies “nimble forms of sociality and belonging,” meaning there are lithe mechanisms that migrants employ to further their sociality even when they are restricted.

Dependency Update Strategies and Package Characteristics

Managing project dependencies is a key maintenance issue in software development. Developers need to choose an update strategy that allows them to receive important updates and fixes while protecting them from breaking changes. Semantic Versioning was proposed to address this dilemma, but many have opted for more restrictive or permissive alternatives. This empirical study explores the association between package characteristics and the dependency update strategy selected by its dependents to understand how developers select and change their update strategies. We study over 112,000 Node Package Manager (npm) packages and use 19 characteristics to build a prediction model that identifies the common dependency update strategy for each package. Our model achieves a minimum improvement of 72% over the baselines and is much better aligned with community decisions than the npm default strategy. We investigate how different package characteristics can influence the predicted update strategy and find that dependent count, age, and release status to be the highest influencing features. We complement the work with qualitative analyses of 160 packages to investigate the evolution of update strategies. While the common update strategy remains consistent for many packages, certain events such as the release of the 1.0.0 version or breaking changes influence the selected update strategy over time.

Diagnosis, management, and follow-up of the incidentally discovered adrenal mass: CUA Guideline Endorsed by the AUA.

Incidental adrenal masses are common and require a multidisciplinary approach to evaluation and management that includes family physicians, urologists, endocrinologists, and radiologists. The purpose of this guideline is to provide an updated approach to the diagnosis, management, and follow-up of adrenal incidentalomas, with a special focus on the areas of discrepancy/controversy existing among the published guidelines from other associations. This guideline was developed by the Canadian Urological Association (CUA) through a working group comprised of urologists, endocrinologists, and radiologists and subsequently endorsed by the American Urological Association (AUA). A systematic review utilizing the GRADE approach served as the basis for evidence-based recommendations with consensus statements provided in the absence of evidence. For each guideline statement, the strength of recommendation was reported as weak or strong, and the quality of evidence was evaluated as low, medium or high. The CUA working group provided evidence- and consensus-based recommendations based on an updated systematic review and subject matter expertise. Important updates on evidence-based radiological evaluation and hormonal testing are included in the recommendations. This guideline clarifies which patients may benefit from surgery and highlights where short term surveillance is appropriate. Incidentally detected adrenal masses require a comprehensive assessment of hormonal function and oncologic risk. This guideline provides a contemporary approach to the appropriate clinical, radiographic, and endocrine assessments required for the evaluation, management, and follow-up of patients with such lesions.

Development of a consortium to examine organ donation legislative and system reforms: A report from the LEADDR consortium.

In April 2019, the province of Nova Scotia became the first jurisdiction in North America to pass legislation that incorporated deemed consent for deceased organ donation. The reform included many other important updates, including the hierarchy for consent, enabled donor and recipient contact, and mandatory referral of potential deceased donors. Additionally, system reforms were implemented to improve the deceased donation system in Nova Scotia. A collection of national colleagues identified the magnitude of the opportunity to develop a comprehensive strategy to measure and evaluate the impact of the legislative and system reforms. This article describes the successful development of a consortium from both national and provincial jurisdictions that included experts from a variety of backgrounds and clinical and administrative disciplines. In describing the creation of this group, we hope to offer our case example as a model for the evaluation of other health system reforms from a multidisciplinary perspective.

Implementing Website-Based School Information Systems in Public Elementary Schools Using Waterfall Model

This research focuses on implementing a web-based school information system at SDN 14 Pontianak City, a renowned public elementary school with a rich historical background. The study aims to address challenges related to ineffective internal information delivery within the school. Currently, reliance on group chats for school-related activities poses obstacles in efficiently disseminating crucial information, including new student registration, extracurricular activities, competition achievements, vision and mission statements, and important updates. To overcome these challenges, a website-based school information system is proposed. It aims to seamlessly deliver essential school-related information to a wider audience, including parents and prospective parents. The system ensures easy access to information that was previously confined to the school's internal environment. The research employs the structured development process of the waterfall model, utilizing context diagrams, data flow diagrams (DFD), and entity relation diagrams (ERD) for a well-defined system design. Rigorous testing using the black box approach ensures website functionality and reliability. Implementation of this web-based school information system is expected to substantially improve information dissemination, benefiting the entire school community by providing convenient access to vital information for parents and prospective parents. This improvement will foster enhanced communication and engagement within the school ecosystem.

Updating the Targeted Therapy Paradigm for Patients With Metastatic NSCLC.

The treatment paradigm for metastatic non-small cell lung cancer has changed significantly since the advent of targeted therapy. During JADPRO Live 2022, presenters focused on important updates to clinical practice guidelines, data from recent clinical trials of biomarkers and their respective targeted therapies, and best practices for monitoring and managing side effects associated with targeted therapies for metastatic non-small cell lung cancer.

FedTCR: communication-efficient federated learning via taming computing resources

Federated learning (FL) enables clients learning a shared global model from multiple distributed devices while keeping training data locally. Due to the synchronous update mode between server and devices, the straggler problem has become a significant bottleneck for efficient FL. Existing approaches attempt to tackle this issue by using asynchronous-based model aggregation. However, these researches are only from the perspective of changing global model updating manner to mitigate straggler effect. They do not investigate the intrinsic reasons for the generation of the straggler effect, which could not fundamentally solve this problem. Furthermore, asynchronous-based approaches usually ignore those slow-responding but important local updates while frequently aggregating fast-responding ones during the whole training process, which may come with degradation in model accuracy. Thus, we propose FedTCR, a novel Federated learning approach via Taming Computing Resources. FedTCR includes a coarse-grained logical computing cluster construction algorithm (LCC) and a fine-grained intra-cluster collaborative training mechanism (ICT) as part of the FL process. The computing resource heterogeneity among devices and the communication frequency between devices and the server are indirectly tamed during this process, which substantially resolves the straggler problem and significantly improves the communication efficiency for FL. Experimental results show that FedTCR achieves much faster training performance, reducing the communication cost by up to 8.59,times while improving 13.85% model accuracy, compared to state-of-the-art FL methods.

Нова класификация на частите на речта в съвременния български език. Таксономични термини и принципи

In building my classification model, I have made several important theoretical up-dates and justifications. I take the term “word class” to be more accurate than “part of speech”, since the subject of discussion is the typological segmentation of lexemes. In this sense, the characteristics expressed by a word independently, without the need for context, acquire special significance in a taxonomy. Most prominently, these features are a word’s morphologically (inflectionally) conditioned grammatical meanings that make up the relevant morphological categories. This is the reason why in classifying variable lexemes in Bulgarian, I attribute a primary role to the morphological factor. I put forward the idea that a word class should include words with the same formative potential, expressing respectively the same grammemes and morphological categories. As a further condition for distinguishing an autonomous class, I propose a requirement that at least one semantically specific morphological category should be expressed. When establishing the taxonomic work base, I do not ignore the logical-semantic and the syntactic operational criteria. According to the former, words are defined as denotative or non-denotative, designators, attributes, attributes of attributes, substituting words, etc. According to the latter, lexemes belonging to one and the same part of speech must have identical syntactic functions. This factor takes on a leading role in the classification of invariable words.

Asthma & COPD Treatment Guideline Updates

This article provides a summary of the newly updated asthma and COPD treatment guidelines. The Global Initiative for Asthma (GINA) treatment guidelines were updated in 2022. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment guidelines were updated in 2023. Both the GINA and GOLD treatment guidelines are published by Science Committees composed of physicians from various countries; the Science Committees meet twice yearly to review published literature and update the guideline recommendations if necessary. The purpose of this article is to highlight some of the important updates to the GINA and GOLD treatment guidelines.

New perspectives on the early cities and states in Mesoamerica

The two edited volumes reviewed here provide up-to-date overviews of their respective topics in Mesoamerican archaeology: the development of the early cities in the region (Early Mesoamerican cities) and the ways in which one such city grew to influence or control a large portion of the region (Teotihuacan and Early Classic Mesoamerica). Both volumes were developed from SAA (Society for American Archaeology) conference sessions and—for better or worse—this remains evident in their internal variability in the definition of key terms and the lines of evidence presented in different chapters. Both focus on identifying and discussing the processes behind observed phenomena, rather than binary determinations of whether a given case was or was not a city, state or empire. Most of the chapters in both volumes also include significant quantities of data generated over the past 10–15 years, which provide important updates to traditional narratives. In the case of Cities, the influx of new data is largely driven by the explosive potential of LiDAR to identify landscape-level settlement patterns in lowland portions of Mesoamerica, and the resulting chapters are biased toward lowland cases. In Teotihuacan, much of the new information comes from a majority-Mexican list of authors, who work at sites in a broad range of locations across the country. Both volumes deftly avoid rehashing what have historically been the most visible debates on each of their topics: the Olmec mother/sister culture debate and the nature of Teotihuacan/Maya interaction, respectively.

Abstract TP28: Support For The Stroke Program Coordinator

Introduction: The role of stroke program coordinator (SPC) has historically been underestimated and not well supported. SPCs generally have overall responsibility and accountability for the program yet are rarely afforded the appropriate training and support. A network that is focused on improving stroke prevention and care in three midwestern states recognized the turn-over in this integral role and prioritized efforts to provide better support by offering a variety of services, resources, and education. Methods: Network staff provide new SPCs an initial personal orientation to the network and to their role. There is also a full-day training session that is offered twice a year to learn more in-depth information about stroke and program management. The network hosts a SPC teleconference quarterly to provide information about important programmatic and clinical updates, upcoming events, and to encourage sharing of best practices. One resource offered to affiliate hospitals of the network, the Stroke Program Management Guidebook was created with over 200 deliverables that are designed to help efficiently and effectively build/maintain a program, and to help with certification goals. New affiliate hospitals receive a comprehensive “Initial Program Curriculum”, including a review of these deliverables, strategic planning, advisory services, education about program development/management, community education, continuous quality improvement, and multi-disciplinary clinical care. Conclusion: An evaluation of how these support services affect the hospital and their stroke program coordinator has not been formally completed. However, in 2014 the network had 24 hospitals, 25% of those had achieved some level of stroke certification. Today there are 37 hospitals and 51% of these hospitals have achieved some level of stroke certification. Of those hospitals, 10 have reached acute stroke ready certification, seven primary stroke certification and two have obtained comprehensive stroke certification. From 2014 to today this network has trained 166 stroke program coordinators within affiliate hospitals. Further research is needed to determine the true impact of the additional SPC support provided by the network.

NCCN Guidelines® Insights: Hematopoietic Cell Transplantation, Version 3.2022.

The NCCN Guidelines for Hematopoietic Cell Transplantation (HCT) provide an evidence- and consensus-based approach for the use of autologous and allogeneic HCT in the management of malignant diseases in adult patients. HCT is a potentially curative treatment option for patients with certain types of malignancies; however, recurrent malignancy and transplant-related complications often limit the long-term survival of HCT recipients. The purpose of these guidelines is to provide guidance regarding aspects of HCT, including pretransplant recipient evaluation, hematopoietic cell mobilization, and treatment of graft-versus-host disease-a major complication of allogeneic HCT-to enable the patient and clinician to assess management options in the context of an individual patient's condition. These NCCN Guidelines Insights provide a summary of the important recent updates to the NCCN Guidelines for HCT, including the incorporation of a newly developed section on the Principles of Conditioning for HCT.

Highlights from the Tenth International Workshop on HIV Persistence during Therapy, December 13-16, 2022, Miami, Florida-USA

The International Workshop on HIV Persistence during Therapy provides a forum in which HIV/AIDS researchers gather to share the latest research findings related to viral reservoirs and cure. The Tenth Workshop, which was attended by over 400 delegates, extended over 4 days and comprised eight sessions covering topics from the basic science of viral persistence to therapeutic approaches to HIV cure. Furthermore, satellite sessions on the first day of the Conference featuring cure research endeavours being pursued by the Bill and Melinda Gates Foundation as well as those being coordinated under the National Institutes of Health Martin Delaney Collaboratory program, provided important updates on research advances being made in these initiatives. As with previous conferences, the International Workshop on HIV Persistence during Therapy is primarily abstract-driven with only one invited talk for each of the sessions. This format, therefore, increases the number of presentations from early-stage investigators. Furthermore, presentations by Community representatives illustrated approaches to creating cure research literacy with effective messaging for the Community. The following article offers a synopsis of the meeting sessions. Due to space constraints, some presentations may have only been briefly discussed. Nevertheless, the Workshop abstracts can be found online (https://www/sciencedirect.com/journal/journal-of-virus-eradication/vol/8/suppl/S).

Introduction to IEEE 841-2020 for Severe Duty Squirrel Cage Induction Motors—Up to and Including 370 kW (500 hp): Improving Motor Reliability, Maintainability, and Energy Efficiency

IEEE 841-2020 IEEE standard for petroleum and Chemical Industry—Premium Efficiency Severe Duty, Totally Enclosed (TEFC) Squirrel-Cage Induction Motors—Up to and Including 370 kW 500 hp to be issued in 2020 has been updated and improved from the 2009 version. The standard covers three-phase premium-efficiency severe-duty TEFC squirrel-cage induction motors with antifriction bearings in sizes up to and including 370 kW (500 hp). Important changes and updates have been made to the standard, including the addition of some applications for ASD motors in classified locations. Improvements to the standard are reviewed in detail. Requirements are identified that improve motor reliability and increase motor life.

What's new in the WHO 2022 classification of kidney tumours?

The World Health Organization (WHO) 2022 classification of urinary and male genital tumours (5th edition) has significantly improved our understanding of the morphologic, immunohistochemical, and molecular characteristics of renal tumours. The aim of this review is to outline the most important changes and diagnostic updates in the WHO 2022 classification of kidney tumours. A major change in this edition is the grouping of renal tumours into broader categories that include "clear cell renal tumours", "papillary renal tumours", "oncocytic and chromophobe renal tumours", "collecting duct tumours" as well as adding two categories of "other renal tumours" and "molecularly defined renal carcinomas". Novel entities included in the WHO 2022 classification are eosinophilic solid and cystic renal cell carcinoma (ESC RCC), anaplastic lymphoma kinase (ALK)-rearranged RCC and ELOC (formerly TCEB1)-mutated RCC. The category of "other renal tumours" includes a group of diverse, unrelated renal tumours that do not fit into other categories. The group of "molecularly defined renal carcinomas" reflects recent discoveries in the renal tumour genomics. These molecularly-defined renal entities demonstrate a set of morphologic features reflecting genotype-phenotype relationships. Final diagnosis of such entities rests on phenotypic and immunohistochemical (IHC) correlation, usually associated with IHC surrogate makers that reflect specific genetic abnormalities.

Future of the Academy 2023-2025

Future of the Academy 2023-2025

From Editor-in-Chief: Exceptional news and updating goals, current issue, AHA 2022 congress, important practice updates and keeping your patients safe from severe COVID and tripledemic

From Editor-in-Chief: Exceptional news and updating goals, current issue, AHA 2022 congress, important practice updates and keeping your patients safe from severe COVID and tripledemic

Commentary on the new 2022 European Society of Human Reproduction and Embryology (ESHRE) endometriosis guidelines.

Endometriosis is a prevalent benign illness defined by the presence of endometrial glands and stroma outside of the uterine cavity, primarily on the ovary, pelvic peritoneum, and rectovaginal septum, resulting in a variety of symptoms, including dysmenorrhea and infertility. Traditionally, prolonged medical therapy has been needed in most cases since a conservative approach to surgery has usually been taken, especially in young women. In 2022, new European Society of Human Reproduction and Embryology (ESHRE) guidelines were published that present different directions for diagnosis and treatment from the past. Furthermore, the guidelines for the diagnosis and management of endometriosis are more precise and applicable than in previous editions. Thus, referring to the representative changes in the new guidelines and important updates will be beneficial for the diagnosis and management of endometriosis. This paper provides a brief overview of these developments.

A comprehensive update to the Mycobacterium tuberculosis H37Rv reference genome

H37Rv is the most widely used Mycobacterium tuberculosis strain, and its genome is globally used as the M. tuberculosis reference sequence. Here, we present Bact-Builder, a pipeline that uses consensus building to generate complete and accurate bacterial genome sequences and apply it to three independently cultured and sequenced H37Rv aliquots of a single laboratory stock. Two of the 4,417,942 base-pair long H37Rv assemblies are 100% identical, with the third differing by a single nucleotide. Compared to the existing H37Rv reference, the new sequence contains ~6.4 kb additional base pairs, encoding ten new regions that include insertions in PE/PPE genes and new paralogs of esxN and esxJ, which are differentially expressed compared to the reference genes. New sequencing and de novo assemblies with Bact-Builder confirm that all 10 regions, plus small additional polymorphisms, are also present in the commonly used H37Rv strains NR123, TMC102, and H37Rv1998. Thus, Bact-Builder shows promise as an improved method to perform accurate and reproducible de novo assemblies of bacterial genomes, and our work provides important updates to the primary M. tuberculosis reference genome.