BACKGROUND: Australia rapidly developed COVID-19 quarantine programs to reduce the adverse outcomes of a novel pathogen imported by visitors and returned travellers. Different quarantine pathways were utilised over the pandemic, yet no definitive cohort map exists to guide future preparedness. We created a whole-of-system cohort journey map of Australian quarantine cohorts to inform future pandemic preparedness activities.
METHODS: Australian parliamentary websites and Google were searched for publicly available grey literature from 2019 to 2023. Data about quarantine cohorts, pandemic plans and documents, journey activities, viral escape events, and quarantine recommendations were extracted and plotted to produce a whole-of-system cohort journey map.
RESULTS: The system mapping process identified 22 distinct quarantine cohort journeys during COVID-19, yet few of the cohorts were mentioned in pandemic and emergency plans. Viral escape events were documented 27 times, and COVID-19 reviews and inquiries produced 282 quarantine-specific recommendations. Cohorts included international and domestic travellers who experienced home, hotel, and facility quarantine iterations. Other cohorts, such as humanitarian evacuations, diplomats, airline crews, community close contacts, and people experiencing homelessness, had distinctive quarantine journeys.
CONCLUSIONS: This whole-of-system quarantine cohort map furthers the case for governments and policymakers to update pandemic plans to include the 22 identified cohorts and test plans through pandemic exercises. Recommendations from inquiries should be acquitted to reduce the risk of viral escape and to strengthen national preparedness if quarantine systems are required in future pandemic responses.

Double-blind, placebo-controlled, randomized controlled trials are the gold standard for clinical trials in nutrition science. For trials of whole diets, dietary counseling are advantageous as they offer clinical translatability although can vary in the fidelity of the intended intervention from participant to participant and across studies. Feeding trials, in which most or all food is provided, offer high precision and can provide proof-of-concept evidence that a dietary intervention is efficacious and can also better evaluate the effect of known quantities of foods and nutrients on physiology. However, they come with additional methodological complexities. Feeding trials also call for a variety of unique methodological considerations, not least of which relate to the design and delivery of diets to participants. This review aims to provide a comprehensive summary of recommendations for design and conduct of feeding trials, encompassing domiciled and non-domiciled feeding trials. Several pertinent aspects of trial design and methodology are discussed, including defining the study population to maximize retention, safety and generalisability of findings, recommendations for design of control interventions and optimising blinding, and specific considerations for clinical populations. A detailed stepwise process for menu design, development, validation and delivery are also presented. These recommendations aim to facilitate methodologic consistency and execution of high quality feeding trials, ultimately facilitating improved understanding of the role of diet in treating disease and the underpinning mechanisms.

Lung cancer (LC) is a leading cause of cancer-related mortality worldwide. Lung Cancer Screening (LCS) programs that use low-dose computed tomography (LDCT) have been shown to reduce LC mortality by up to 25 % and are considered cost-effective. The European Health Union has encouraged its Member States to explore the feasibility of LCS implementation in their respective countries. The task force conducted a comprehensive literature review and engaged in extensive discussions to provide recommendations. These recommendations encompass the essential components required to initiate pilot LCS programs following the guidelines established by the World Health Organization. They were tailored to align with the specific context of the Portuguese healthcare system. The document addresses critical aspects, including the eligible population, methods for issuing invitations, radiological prerequisites, procedures for reporting results, referral processes, diagnostic strategies, program implementation, and ongoing monitoring. Furthermore, the task force emphasized that pairing LCS with evidence-based smoking cessation should be the standard of care for a high-quality screening program. This document also identifies areas for further research. These recommendations aim to guarantee that the implementation of a Portuguese LCS program ensures high-quality standards, consistency, and uniformity across centres.

Puerto Rico (PR) is a United States (US) territory with a history of colonial violence, poverty, and government corruption. Due to these sociopolitical factors and natural disasters (e.g., hurricanes and earthquakes), there has been a sharp increase in PR residents migrating to the mainland US. Local media and professional health organizations focus on the impact of medical migration on the PR health system (e.g., health personnel shortages and long waiting periods for critical care). According to the PR College of Physicians and Surgeons, 365-500 physicians have left annually since 2014, which represents a crisis of access to health services. However, few studies have focused on ways to mitigate medical migration from PR to the US mainland. This article describes the recommendations provided by migrating and non-migrating Puerto Rican Physicians (PRPs) to mitigate medical migration from PR to the US mainland. We focus on qualitative data from a mixed-methods NIH-funded study (1R01MD014188) to explore factors that motivate or mitigate migration among migrating (n = 26) and non-migrating (n = 24) PRPs. Interviews were analyzed following thematic analysis guidelines. Results show the following themes: 1) strategies to retain early-career medical residents living in PR; 2) recommendations for local government on future health policy; and 3) work environment initiatives for health institutions to mitigate physician migration. Findings suggest multilevel efforts are required to mitigate medical migration in PR.

BACKGROUND: GRADE-ADOLOPMENT is widely applied to efficiently use existing credible guidelines and contextualize them to a target setting.
OBJECTIVE: To highlight the experiences of a Latin American Guideline Development Group applying GRADE-ADOLOPMENT to adapt the American Society of Hematology\'s clinical practice guideline on managing venous thromboembolisms in Latin America.
METHODS: We employed a mixed-methods post-evaluation using self-administered surveys and semi-structured interviews. We assessed the Latin American guideline development group\'s (GDG) (1) general satisfaction and confidence using the approach (2) their ratings on the usefulness, appropriateness, and importance of GRADE-ADOLOPMENT and its tools to inform their judgements and (3) any additional facilitators and barriers to refine the process.
RESULTS: Eleven of the 14 GDG members including nine panelists and two methodologists, provided survey responses and eight participated in the interview. Respondents felt \"mostly\" or \"completely\" satisfied with the adapted guideline. Eight panelists surveyed agree GRADE-ADOLOPMENT is useful in countries with limited resources. Although panelists expressed initial apprehensions in their understanding of the process, they demonstrated enhanced confidence in their capacity to apply GRADE after completing workshop training and by acquiring experience. Panelists re-iterated the importance of considering evidence-to-decision criteria (i.e., resources, feasibility, and cost-effectiveness) when adapting recommendations. The GDG encountered challenges with collecting local and regional data, prioritizing recommendations while considering intra-regional diversity, and the lengthy publication period, although the latter stemmed from procedures not related to GRADE-ADOLOPMENT.
CONCLUSIONS: GRADE-ADOLOPMENT is an important tool to facilitate the adaptation and uptake of clinical practice guidelines in novel settings. The GDG felt satisfied with their overall experience using the GRADE-ADOLOPMENT approach. However, their experience could have been optimized if they had access to robust regional evidence, more recommendations to adapt from, and worked with more efficient guideline production timelines.

BACKGROUND: The updates to the European recommendations and the German guidelines for the treatment of systemic sclerosis are expected shortly, which are very good evidence-based guidelines for all those treating the disease; however, there are still disease manifestations with insufficient studies and current study results that were published after the review of the literature for the guidelines and might be of interest to the reader.
OBJECTIVE: The aim of this work is to provide an overview of the publications in the last year that are interesting from the authors\' point of view. The aim is to provide practically relevant information on the current state of knowledge that can supplement the guidelines.
RESULTS: The pathogenesis of systemic sclerosis (SSc) is becoming better understood in its interplay between environmental factors and the development of autoantibodies. There have also been overviews of the manifestation and prognosis of cardiac involvement in the last year. The American Thoracic Society issued the first guidelines for the treatment of interstitial lung disease in SSc. There are an increasing number of studies that suggest that disease-modulating combination therapies, such as rituximab and mycophenolate mofetil (MMF) are beneficial. Work addressing the involvement of joints suggests that inflammatory changes are common. Current options for the treatment of gastrointestinal involvement are presented.
CONCLUSIONS: The diagnosis and treatment of systemic sclerosis is making progress and many symptoms and complications are treatable. Nevertheless, much remains to be done to improve the quality of life of the patients.
UNASSIGNED: HINTERGRUND: In Kürze werden die Aktualisierungen der europäischen Empfehlungen wie auch die deutschen Leitlinien zur Behandlung der systemischen Sklerose (SSc) erwartet. Diese Arbeiten stellen eine evidenzbasierte sehr gute Richtschnur für alle Behandelnden dar. Es bestehen jedoch Krankheitsmanifestationen mit unzureichender Studienlage und aktuelle Studienergebnisse, die nach Erstellung der Literatur zu den Leitlinien veröffentlicht wurden und für den Leser interessant sein könnten.
UNASSIGNED: Ziel dieser Arbeit soll es sein, einen Überblick über die Publikationen des letzten Jahres zu geben, die aus Sicht der Autoren interessant sind. Es sollen praxisrelevante Informationen zum aktuellen Wissensstand gegeben werden, die die neuen Leitlinien ergänzen können.
UNASSIGNED: Die Pathogenese der systemischen Sklerose wird in ihrem Wechselspiel zwischen Umweltfaktoren und der Entwicklung von Autoantikörpern besser verstanden. Auch bezüglich der kardialen Beteiligung gab es im letzten Jahr Übersichten über deren Manifestationen und Prognose. Die amerikanische Thorax-Gesellschaft gab erste Leitlinien zur Behandlung der interstitiellen Lungenerkrankung bei SSc heraus. Es gibt zunehmend Studien, die krankheitsmodulierende Kombinationstherapien, wie z. B. Rituximab und Mycophenolat-Mofetil (MMF), vorteilhaft erscheinen lassen. Arbeiten zur Gelenkbeteiligung legen nahe, dass entzündliche Veränderungen häufig sind. Die aktuellen Optionen zur Behandlung der gastrointestinalen Beteiligung werden aufgezeigt.
UNASSIGNED: Die Diagnostik und Therapie der systemischen Sklerose zeigt Fortschritte. Viele Symptome sind behandelbar. Es bleibt dennoch viel zu tun, die Lebensqualität unserer Patienten zu verbessern.

Successful multichannel intraluminal impedance and pH monitoring (MII-pHM) studies rely on constant attendants (CAs) or family members (and sometimes the patients themselves) to assist in the execution and facilitation of the MII-pHM study. While \"pushing buttons\" [corresponding to specific symptoms, body position (upright versus recumbent), and meal start and stop times] on the MII-pHM system recording box is indeed a big part of MII-pHM study execution and facilitation, there are other concerns and duties that are equally as important. This paper outlines some of the important duties of the study facilitator (or patient) during a MII-pHM study. When provided with the proper training, study facilitators invigilating the MII-pHM study will be better able to contribute to the data collection process and ultimately to produce data that when analyzed will lead to better interpretations, clinical recommendations, and good clinical outcomes. When executed properly, MII-pHM studies have the potential to assess diurnal exposure of the esophageal mucosa to gastric/duodenal contents, provide insight regarding the proximal extent of gastroesophageal reflux (GER), provide a measurement of the mean esophageal pH, and assess mucosal integrity and temporal relationship between GER and the symptoms of interest. While several groups have offered recommendations for proper execution of the MII-pHM study, to our knowledge, there have not been publications wherein recommendations were compiled to form a single source document.

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UNASSIGNED: Urinary incontinence (UI) consists of involuntary leakage of urine during the storage phase of urination.
UNASSIGNED: An anonymous survey was given to Spanish and Italian veterinarians about canine UI treated cases, diagnosis, treatment, follow-up, and professional interest.
UNASSIGNED: Most veterinarians treated ≤3 cases/quarter, resulting in the percentage of incontinence males being lower than that of females (1-4% vs 0-24%). The percentage of spayed incontinent females was lower in Spain (0-24%) than in Italy (75-100%). Most diagnoses were based on a diagnostic algorithm (Spain: 88.7%; Italy: 65.3%); patient report and history, blood work, urinalysis and abdominal ultrasound. Urethral/bladder pressure measurement was unusual (Spain: 0.2%; Italy: 2.4%). In Spain, radiology with contrast medium and CT urography (26.3% and 34.4%, respectively) were more frequent than in Italy (11.6% and 22.7%, respectively). When suspecting urethral sphincter mechanism incompetence pharmacological trial (Spain: 93.2%; Italy: 78.9%). The first-choice medical treatment was Phenylpropanolamine, followed by Ephedrine and Deslorelin. When pharmacotherapy failed, the most frequent option was drug change, followed by increased drug dosage/frequency of administration, surgical therapy and colposuspension. A review was completed after the first week of treatment followed by periodic reviews. Most of the respondents participated in continuing education only if UI occurred in their everyday practice (Spain: 63.0%; Italy: 55.4%) and about 30% responders did it regardless of the number of UI cases treated (Spain: 30.5%; Italy: 37.4%).
UNASSIGNED: Some recommendations in clinical practice were made. UI can be underestimated by owners; therefore, a complete history should be obtained by veterinarians. Veterinarians should carefully evaluate if spaying is advisable considering it could increase UI risk. A step-by-step approach is recommended and a specific diagnostic-therapeutic algorithm for UI in dogs is provided. Conservative approaches (regular exercise, weight loss in overweight dogs and observing an \"incontinence diary\" to identify abnormal patterns of urination) are advisable.

Non-invasive ultrasound neuromodulation has experienced exponential growth in the neuroscientific literature, recently also including clinical studies and applications. However, clinical recommendations for the secure and effective application of ultrasound neuromodulation in pathological brains are currently lacking. Here, clinical experts with neuroscientific expertise in clinical brain stimulation and ultrasound neuromodulation present initial clinical recommendations for ultrasound neuromodulation with relevance for all ultrasound neuromodulation techniques. The recommendations start with methodological safety issues focusing on technical issues to avoid harm to the brain. This is followed by clinical safety issues focusing on important factors concerning pathological situations.