Mayo Clinic Health System

This study examined long-run HIV dynamics in the Philippines and ASEAN using official annual HIV indicator series from 1990 to 2024. Employing a quantitative longitudinal comparative design, the study drew on secondary data from World Bank HIV indicators sourced from UNAIDS estimates. The Philippines served as the anchor case, while ASEAN countries functioned as comparator units where sufficient annual observations were available. The analysis covered six core indicators: people living with HIV (PLHIV), new HIV infections, new HIV infection rate, HIV prevalence among adults aged 15–49 years, AIDS-related deaths, and antiretroviral therapy (ART) coverage. Because ART coverage had a shorter usable series, it was analyzed separately as a later-period treatment indicator. The official metadata identify the prevalence and incidence series as annual UNAIDS-based measures, with the prevalence series visibly spanning 1990–2024, while ART coverage is defined as the percentage of people living with HIV receiving antiretroviral therapy. Results showed a pronounced long-run escalation of the Philippine HIV profile. From 1990 to 2024, PLHIV increased from 200 to 220,000, new HIV infections from 100 to 30,000, new HIV infection rate from 0.01 to 0.48 per 1,000 uninfected population, HIV prevalence from 0.1% to 0.3%, and AIDS-related deaths from 100 to 2,300. ART coverage rose from 0% in 2000 to 40% in 2024. Phase-based analysis indicated that the strongest acceleration occurred during 2000–2010, when annualized growth reached 31.8% for PLHIV, 24.8% for new infections, 25.9% for incidence, and 17.5% for AIDS-related deaths. In the latest-year ASEAN comparison, the Philippines ranked first in both new HIV infections and new HIV infection rate, but only fifth in PLHIV, joint seventh in prevalence, and last in ART coverage among comparison countries. These findings indicate that the Philippine HIV situation is best interpreted not as the region’s highest-prevalence case, but as a transmission-intensive and treatment-weak case within ASEAN. The study concludes that incidence-centered monitoring, treatment expansion, and longitudinal health analytics are essential for understanding and responding to the country’s HIV trajectory.

Carbohydrate availability and caffeine ingestion have been shown to elicit improvements in performance independently of one another. The purpose of the study was to examine the effect of a carbohydrate + caffeine beverage on performance and perceived effort in soccer players. Forty-three collegiate women’s soccer athletes were recruited to participate during a single day of simulated match play, in which each team played once. Athletes consumed either a carbohydrate + caffeine (Experimental) beverage or a control (Control) beverage (flavored water) during half-time in a double-blind, placebo-controlled, randomized control trial design. Prior to and after each game, Ratings of Perceived Exertion (RPE) and blood glucose levels were assessed. Heart rate, training impulse (TRIMP), total distance covered, high-speed distance, and velocity were recorded. Blood glucose levels after the match simulation were positively associated with total distance (r = 0.434; p = 0.01), distance per minute (r = 0.439; p < 0.01), average velocity (r = 0.438; p = 0.01), and TRIMP (r = 0.404; p = 0.018) during the second half. There was a significant main effect for half regarding blood glucose (p < 0.001), total distance (p < 0.001), high-speed distance (p < 0.001), and TRIMP (p = 0.046). There was a significant half × condition effect for blood glucose (p = 0.05). Pairwise comparisons indicated the Experimental beverage condition resulted in a +27 mg/dL (95% CI: −3.6, 58.8) difference compared to the Control beverage following the 2nd Half. In the current study, consumption of the carbohydrate + caffeine beverage during half-time resulted in higher blood glucose levels post-game compared to placebo; however, the experimental beverage did not influence the total distance covered, average velocities, average heart rate, or TRIMP values during the second half of simulated match play.

Procedural competence is essential to clinical practice, yet assessment of technical skills such as suturing remains highly variable and often relies on subjective evaluations. While tools with limited validity evidence exist in surgical specialties, their use in family medicine is limited. This study evaluated the interrater reliability of a suture assessment tool developed by Sundhagen et al when used by family medicine faculty to evaluate the simple interrupted suturing skills of family medicine residents. In this cross-sectional reliability study, 15 core faculty members from four family medicine residency programs were recruited to evaluate the simple interrupted suturing skills of 20 family medicine residents using a modified suture assessment tool developed by Sundhagen et al. Intraclass correlation coefficients were used to evaluate interrater reliability. Light's κ was calculated for each question. A total of 15 evaluators assessed 20 videos of resident suturing performance. The Light's κ estimates ranged from 0.11 to 0.50, indicating slight to moderate agreement. None of the items reached the threshold for substantial agreement (κ≥0.61). The modified Sundhagen suture assessment tool demonstrated fair to moderate reliability when used to evaluate family medicine residents. While the level of agreement limits the tool's effectiveness for standardized summative assessment, the tool may still offer value as a structured framework for formative feedback. Future studies may improve reliability through refined rater training, behaviorally anchored scoring criteria, and the use of visual exemplars.

Fields, JB, Jones, MT, Kitts, SE, King, EL, and Jagim, AR. Relationships between disordered eating, body dissatisfaction, and low energy availability in women collegiate athletes. J Strength Cond Res 40(2): e164-e171, 2026-Women collegiate student-athletes face unique challenges regarding nutrition, body image, and athletic performance, increasing their risk for low energy availability (LEA), disordered eating (DE), and body dissatisfaction (BID). However, limited data exist exploring LEA, DE, and BID across a variety of women's sports. Therefore, the purpose of this study was to evaluate the prevalence of and relationships among LEA risk, DE behaviors, and BID in women collegiate athletes from multiple sports. Division I, II, and III women student-athletes ( n = 115) participated in this cross-sectional, descriptive study. Athletes completed the low energy availability for females questionnaire (LEAF-Q), eating attitudes test (EAT-26), muscularity-oriented eating test (MOET), and body dissatisfaction items from the eating disorder examination questionnaire (EDE-Q) to assess LEA risk, DE behaviors, and BID, respectively. Sixty-four percentages of athletes were at risk for LEA, with the highest prevalence in volleyball (100%), wrestling (68%), lacrosse (67%), and cross country (57%). However, only 8% of athletes were classified at risk for eating disorders. Notably, 81 and 84% of athletes reported body weight and shape dissatisfaction, respectively, which was strongly associated with disordered eating behaviors (EAT-26: r = 0.707; MOET: r = 0.723, p < 0.001). These results show a high prevalence of LEA risk and BID across athletes, with DE behaviors strongly linked to body image concerns. Despite a high LEA risk among athletes, clinical eating disorder risk remained low, suggesting that undereating may often be unintentional. Targeted interventions focused on nutritional education, body image, and psychological support are critical for improving health and performance outcomes among collegiate women student-athletes.

Idiopathic subglottic stenosis (iSGS) occasionally affects women of childbearing age. Surgical intervention is the primary treatment, yet limited research exists on factors influencing disease severity. This study explores the impact of hormonal contraception on iSGS recurrence rates and surgery-free intervals. This retrospective study was conducted at a tertiary academic care center. Patients using hormonal birth control (e.g., estrogen-progesterone pills, progesterone implants) during their first procedure were classified in "Birth Control (BC)" group, while those not using contraceptives were placed in "No Birth Control (NBC)" group. Poisson regression evaluated recurrence rates, and Mann-Whitney tests assessed surgery-free intervals. Kaplan-Meier analysis estimated time to first recurrence, adjusting for age and follow-up duration. Twenty-six patients were in the NBC group and 12 in the BC group (average ages 37 and 34, respectively). Patients in the NBC group were 2.6 times more likely to experience recurrence compared to those in the BC group (p = 0.001). The expected number of recurrences for the BC group was 0.4 times that of the NBC group (95% CI: 0.2-0.7; p = 0.001). Furthermore, patients taking birth control were significantly less likely to have a first recurrence (HR: 0.4; 95% CI: 0.2-0.9; p = 0.025) and had longer times to first recurrence (Figure1; p = 0.031). Birth control appears to protect against iSGS severity, potentially through hormonal mechanisms. Hormonal contraception may serve as a non-surgical alternative for managing iSGS. Future prospective studies may evaluate outcomes in newly diagnosed iSGS patients started on birth control compared to those not using hormonal contraceptives.

Colorectal cancer remains a leading cause of cancer associated death in the United States and colonoscopy the primary screening strategy for prevention. Rates of adenomatous and serrated neoplasia detection are inversely associated with postcolonoscopy colorectal cancer. This crucial quality metric depends on accurate ascertainment of colorectal neoplasia findings from both endoscopy and histopathology records. We aimed to assess the feasibility of a random forest machine learning model to rapidly and accurately categorize colorectal neoplasia from electronic health record data. A retrospective cohort study compared neoplasia detection rates among individuals undergoing colonoscopy at a large academic institution to develop a rule-based algorithm to categorize colorectal neoplasia from endoscopy reports and pathology systematized nomenclature of medicine - clinical terms. This cohort provided a large training set to develop a natural language processing system using a random forest approach to automatically classify unstructured pathology findings into adenoma, serrated, or advanced neoplasms. This system was manually validated through an independent holdout set. The training set comprised 35,953 unstructured pathology reports with matched systematized nomenclature of medicine - clinical terms from 95,188 unstructured colonoscopy reports. The final model was assessed on an independent holdout set of 337 manually annotated procedures obtaining an area under the receiver operating characteristic curve of 0.997 (confidence interval [CI] 0.994-1), 0.99 (CI 0.98-1), and 0.99 (CI 0.98-0.99) for prediction of adenoma, serrated, and advanced lesions, respectively. The random forest-based hybrid natural language processing system for classification of colonoscopy results was both accurate and explainable. NLP combined with effective machine learning algorithms can provide a scalable strategy for colonoscopy quality monitoring.

BACKGROUND AND OBJECTIVES:Surgeon-team familiarity is a critical factor that affects surgical outcomes. The relationships between familiarity and surgical outcomes are varied, and an operational definition of this measure remains underdeveloped. This study creates an effective time-based measure of surgeon-team familiarity and assesses its association with clinical and operational outcomes for neurosurgery.METHODS:Retrospective analysis of 9049 neurosurgery cases performed at 2 campuses of a tertiary academic medical center over a 3-year timeframe was conducted. This study measures normalized case duration as a proxy for operational performance and 30-day postoperative complications for clinical outcomes. Multivariate linear regression and logistic regression were used to analyze relationships between surgeon-team familiarity and surgical outcomes, with risk factors as control variables for case mix.RESULTS:For normalized case duration, the coefficient of surgeon-team familiarity is negative (β = −0.015, P = .03), but the squared term exhibits a positive relationship (β = 0.049, P = .003). The overall regression is statistically significant (R2 = 0.046, adjusted R2 = 0.045, P < .001). The logistic regression shows that surgeon-team familiarity scores are negatively correlated (odds ratio = 0.356, 95% CI [0.126, 0.987]) with the risks of postoperative complications. It is statistically significant and explains between 2.4% (Cox & Snell R Square) and 6.0% (Nagelkerke R Square) of the variance for postoperative complications.CONCLUSION:This study found that surgeon-team familiarity is positively associated with neurosurgery outcomes. Teams familiar with the surgeons will likely improve operational performance and reduce the risk of postoperative complications, whereas too much familiarity may lengthen the case duration. Surgical practice leaders can use electronic health record data to define appropriate familiarity scores and incorporate key metrics when developing surgical team assignments for optimal operating room performance.